Better
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M
A
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AND
W
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,
INFANTS
&
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VENDOR
AUTHORIZATION
APPLICATION
1-800-242-4WIC (4942)
www.mdwic.org
Maryland WIC
P
r
ogram
Maryland Department
of
Health and Mental
H
ygiene
Martin O’Malley,
G
o
v
e
r
nor
Anthony
G.
Brown, Lt.
G
o
v
e
r
nor
J
o
s
hu
a
M.
Sharfstein,
M.D.,
Secretary, DHMH
MARYLAND WIC PROGRAM
VENDOR APPLICATION PACKAGE
CONTENTS PAGE
Introduction ------------------------------------------------------------------------------- 2
Applicant’s Minimum Qualifications ------------------------------------------------ 4
How Applications are Processed --------------------------------------------------- 6
Minimum Stock Requirements ------------------------------------------------------ 9
Application Instructions ------------------------------------------------------------ ----13
Attachments: Application Pages (Last 3 pages of this package)
Maryland WIC Authorized Foods List
WIC Vendor Agreement (2) (Complete and return both!)
PLEASE CAREFULLY READ THIS ENTIRE PACKAGE BEFORE COMPLETING
AND SUBMITTING THE VENDOR APPLICATION
APPLICANTS ARE REQUIRED TO MEET THE STOCKING REQUIRESMENTS
AT THE TIME OF APPLICATION SUBMISSION.
Revised: October 2013
2
INTRODUCTION
WHAT IS WIC?
The Special Supplemental Nutrition Program for Women, Infants and Children, or
WIC is a nutritional program for pregnant women, breastfeeding mothers,
postpartum mothers, babies, and children under five years old. WIC participants
must have family income that are less than 185% of the poverty level and have
health problems that can be improved through good nutrition.
The foods WIC provides include:
Baby foods – fruits and vegetables for all infants and meat for exclusively
breastfed infants
Beans
Canned tuna, salmon, and sardines for some women
Cereal
Cheese
Eggs
100% fruit juice
Fruits and vegetables (fresh, frozen, canned)
Iron fortified infant formula
Infant cereal
Milk
Peanut Butter
Soy Milk
Tofu
Whole wheat bread (or brown rice or whole wheat or soft corn tortillas)
WIC also refers participants to health and social service programs and
provides information on good eating habits to help people be healthy and eat well.
Infants whose mothers participate in WIC weigh more when they are born
and have fewer health problems than infants whose mothers did not participate.
Children who participate in WIC are less likely to have anemia (blood problems)
than children who do not participate.
The United States Department of Agriculture (USDA) funds WIC, which is
run by the Maryland Department of Health and Mental Hygiene, Family Health
Administration. WIC is administered at the local level by local WIC agencies such
as Health Departments and Community Health Centers that operate throughout
Maryland.
WIC is different from the Food Stamp Program because participants can only
buy the types and quantities of foods shown on their checks. They can only buy
nutritious foods prescribed by the WIC Program. WIC participants can only use
their checks at stores that have a signed agreement with the State WIC Agency.
The stores and people who sell WIC foods are very important because they:
Revised: October 2013
3
Help people become healthier;
Are located statewide to give WIC Participants shopping options at a
variety of locations; and
Make sure that WIC customers buy only those foods prescribed on their
WIC checks.
WIC AUTHORIZES THE FOLLOWING TYPES OF VENDORS:
Food Store - A grocery store licensed under Code of Maryland
Regulations (COMAR) 10.15.03 that has no pharmacy on its premises.
Pharmacy - A drug store licensed by the State Board of Pharmacy that
does not have a food store under the same ownership on its premises.
Food Store/Pharmacy Combination - A food store and a pharmacy under
the same ownership on the same premises.
Commissary - A grocery store located on a military installation and/or
owned by the Department of Defense.
The WIC Program also authorizes farmers participating in the Farmers’
Market Nutrition Program to accept WIC fruit and vegetable checks at authorized
Farmers’ Markets.
With the exception of military commissaries, the Maryland WIC Program will
not authorize stores that are expected to receive 50% or more of their eligible
food sales revenue from WIC. Additionally, if after authorization a WIC
vendor is determined to derive 50% or more of its eligible food sales revenue
from WIC, authorization shall be terminated. Eligible foods sales do not
include items that are not eligible for purchase under the Food Stamp
Program (FSP).
HOW IS YOUR STORE PAID?
After a store has accepted a WIC check as payment for WIC foods, the
check may be deposited in the bank for payment. All WIC checks deposited in the
bank must have a WIC vendor stamp on the front in the designated area, and an
endorsement by the vendor on the back in order to be paid. Checks improperly
processed may be rejected by the bank and returned unpaid to the vendor.
Your agreement with the Maryland WIC Program lets you accept checks only
from Maryland. If you take them from another state or Washington, D.C. Virginia,
Delaware, Pennsylvania, you must be authorized by those jurisdictions to accept
their WIC checks. The Maryland WIC Program cannot pay you for any checks
other than Maryland WIC checks.
Revised: October 2013
4
APPLICANT’S MINIMUM QUALIFICATIONS AND OTHER REQUIREMENTS
To be considered for authorization as a WIC vendor, owners of retail food
stores, combination food store/pharmacies, or pharmacies must meet the following
criteria:
A completed application must be received by the State Agency from a retail
food store, combination retail food store/pharmacy, or pharmacy operating at
a fixed location within the State of Maryland and must be accessible to the
disabled. The vendor must hold a food service facility license issued by a
local health department or department of environment. In order to qualify as
a combination retail food store/pharmacy or pharmacy, the applicant must
maintain a current registration or license issued by the State of Maryland
Board of Pharmacy, or is licensed to distribute pharmaceuticals.
If the store is not a pharmacy, it must meet the minimum stock requirements
as specified in the “Required Minimum Stock” section of this Application
Package. Minimum stock must be on the store premises as of the date
and time of submission of the Vendor Application and the State Agency
on-site review.
The store must be operational at the time of the on-site review by the State
Agency.
The store must have authorization from the Food Stamp Program and may
not be currently disqualified or suspended from the WIC Program or the
Food Stamp Program.
The applicant must maintain the store in a sanitary condition, with no
evidence of excess un-removed rubbish, vermin, or general lack of
cleanliness.
If a combination food store/pharmacy or pharmacy, the applicant must be
able to provide, within 48 hours of a request from a participant or the
Program (excluding weekends and holidays), any WIC authorized infant
formula.
Except for a pharmacy or military commissary, a vendor applicant shall have
actual highest current shelf prices that are less than or equal to 125% of the
Peer Group average in the vendor applicant’s region during the month of
application, as determined by the State agency.
The applicant must owe no outstanding payment(s) to the State Agency that
are more than 90 days overdue.
Applicants not meeting the above qualification criterion will be declared
unqualified, and the application will not be processed. Meeting the criterion
Revised: October 2013
5
above does not constitute authorization to redeem Maryland WIC checks with
the following exception:
An applicant currently participating as an authorized vendor for which a
protest/appeal of State Agency disqualification or suspension is pending a
decision at the time an application is received may continue accepting WIC
checks until a decision regarding the appeal has been rendered.
If the result of the protest/appeal upholds the State Agency’s action, the
Vendor Agreement will be terminated. If the result of the protest/appeal
overturns the State Agency’s action, the Vendor Agreement shall remain in
effect.
Revised: October 2013
6
HOW APPLICATIONS ARE PROCESSED
The State Agency, under current regulations, has 60 days to process an acceptable
application for WIC authorization. At any time during that period, an unannounced
on-site review will be conducted. The on-site review consists of checking to verify
minimum stock, collecting prices, and verifying information contained on the
application.
After an on-site review is conducted, the prices collected by State Agency
staff are analyzed and compared to prices for other stores similar in size and
geographic location. These groupings are called “Peer Groups”. Currently,
there are three size categories and 19 Peer Groups. They are as follows:
Region 1 consists of Allegany and Garrett Counties.
Peer Group 1, Region 1, Large Stores, 8 or more check out lanes;
Peer Group 2, Region 1, Medium Stores, 4 to 7 check out lanes;
Peer Group 3, Region 1, Small Stores, 1 to 3 check out lanes;
Region 2 consists of Frederick and Washington Counties.
Peer Group 4, Region 2, Large Stores, 8 or more check out lanes;
Peer Group 5, Region 2, Medium Stores, 4 to 7 check out lanes;
Peer Group 6, Region 2, Small Stores, 1 to 3 check out lanes;
Region 3 consists of Anne Arundel, Baltimore, Carroll, Harford, and Howard
counties.
Peer Group 7, Region 3, Large Stores, 8 or more check out lanes;
Peer Group 8, Region 3, Medium Stores, 4 to 7 check out lanes;
Peer Group 9, Region 3, Small Stores, 1 to 3 check out lanes;
Region 4 consists of Baltimore City.
Peer Group 10, Region 4, Large Stores, 8 or more check out lanes;
Peer Group 11, Region 4, Medium Stores, 4 to 7 check out lanes;
Peer Group 12, Region 4, Small Stores, 1 to 3 check out lanes;
Revised: October 2013
7
Region 5 consists of Montgomery and Prince George’s Counties.
Peer Group 13, Region 5, Large Stores, 8 or more check out lanes;
Peer Group 14, Region 5, Medium Stores, 4 to 7 check out lanes;
Peer Group 15, Region 5, Small Stores, 1 to 3 check out lanes;
Region 6 consists of Calvert, Caroline, Cecil, Charles, Dorchester, Kent,
Queen Anne's, Saint Mary's, Somerset, Talbot, Wicomico, and Worcester
counties.
Peer Group 16, Region 6, Large Stores, 8 or more check out lanes;
Peer Group 17, Region 6, Medium Stores, 4 to 7 check out lanes;
Peer Group 18, Region 6, Small Stores, 1 to 3 check out lanes.
Peer Group (19)* Potential above 50% vendors.
*Peer Group (19) is designated for vendors that appear to derive more than 50% of
the vendor’s eligible food sales from the redemption of WIC food instruments.
Vendors placed in this Peer Group will only be paid the statewide average of all
non-above 50% vendors until the vendor has demonstrated that it is not an above
50% vendor. If the vendor is unable to demonstrate that it is not an above 50%
vendor, the vendor’s authorization shall be terminated.
Your store’s prices are only compared to other store’s prices in your Peer Group.
This ensures that your stores prices are fairly evaluated. If it is determined that
your store’s prices exceed 125% of the Peer Group average, you will be
denied authorization, and advised of the denial in writing.
If your store’s prices are determined to be acceptable, and all other authorization
criteria have been met, you will be notified in writing that your application has been
approved. You will also be advised of the next available New Vendor Training
class. New Vendor Training is mandatory and provides important instructions for
processing WIC transactions.
Upon completion of training, you will receive your vendor identification stamps. All
approved applicants receive 2 self-inking stamps used to affix the Vendor
Identification Number on WIC checks in the designated area. If your vendor
stamps are lost, become damaged, or wear out, you are responsible for
replacement.
If for any reason your store’s application is denied, you will receive written
notification of the reason for denial and advised of your right to appeal. If a store is
denied authorization three times in a year, the applicant vendor cannot
Revised: October 2013
8
reapply for WIC authorization until 1 year after the last denial date or after the
date of appeal’s result is made.
MILITARY COMMISSARIES
The U.S. Department of Agriculture and the U.S. Department of Defense have
entered into a Memorandum of Understanding to clarify the basic responsibilities of
the State WIC agencies or their designated local agencies and military
commissaries authorized to be WIC vendors.
Military Commissaries, as federal entities, are exempt from some State
requirements; however, the State WIC Agency may still authorize them as WIC
vendors pursuant to CFR §246.12(f)(1) of the federal regulations for the WIC
Program, which permits modification of the Vendor Agreement. A commissary will
be required to submit application information to the Program by the deadline if one
is given.
Revised: October 2013
9
Required Minimum Stock as of October 1, 2013
“WIC Pharmacy Only” stores are not required to carry the minimum stock and may only
redeem WIC checks that provide infant formula unless the pharmacy is authorized as a
“Food Store/Pharmacy” and carries the required minimum stock. All pharmacies and food
store/pharmacies must be able to provide, within 48 hours of request (excluding
weekends and holidays), any infant formula prescribed on a WIC check.
Food
Item
Specifications
Size
Quantity
Milk
Whole
Gallons
4
Low fat (1%) or fat free (nonfat)
Gallons
10
Cheese
Domestic - block or sliced – 4 varieties: (American,
Cheddar, Monterey Jack, Mozzarella, or Swiss)
16 ounces
6
Eggs
White, medium or large
Dozen
6
Beans
Dried – 2 varieties: (Beans like: kidney, navy,
garbanzo, or lima)
Split peas, black-eyed peas, or lentils.
1 pound
3
Canned – packed in water – 3 varieties: (Beans like:
kidney, navy, garbanzo, or lima.)
14 – 16 ounces
12
Peanut
Butter
Plain, smooth, crunchy, or extra crunchy, or creamy.
16 – 18 ounces
6
Canned
Fish
Packed in water – 2 varieties: (Chunk Light Tuna,
Pink Salmon, or Sardines)
Tuna(5-6 oz)
Salmon(5,6,or
7.5 oz)
Sardines(3.75
oz)
30 ounces
Vendors must stock at least 2 varieties from cereal groups A and B and 1 variety from group C.
Cereal
A. Corn, wheat, oats, or rice:
Kellogg’s Rice Krispies, Kellogg’s Special K, and
Kellogg’s Corn Flakes
Malt-O-Meal Oat Blenders Honey,
Malt-O-Meal Oat Blenders Honey & Almonds,
Malt-O-Meal Hot Wheat Cereal
18 ounces or
larger
6 boxes
B. Whole grain, wheat or oats:
General Mills Cheerios (Plain)
General Mills Kix
Kellogg’s All Bran Complete Wheat Flakes
Kellogg’s Frosted Mini Wheats (Big Bites & Original)
Kellogg’s Scooby-Doo
Post Grape Nuts
Post Grape Nuts Flakes
Post Lightly Frosted Shredded Wheat
Post Honey Bunches of Oats (Vanilla Bunches,
Honey Roasted, Almond, Cinnamon Bunches)
Post Honey Nut Shredded Wheat
Quaker Oatmeal Squares with Brown Sugar
Quaker Cinnamon Oatmeal Squares
Quaker Life
18 ounces or
larger
6 boxes
C. Hot cereal – 1 variety:
B& G Foods Cream of Wheat 1 minute and 2 ½
minute
Quaker Instant Oatmeal (Original)
Quaker Instant Grits (Original)
11.8 ounces or
larger
1 box
Revised: October 2013
10
Vendors must stock at least 2 varieties of whole grain products from the list below.
Whole
Grain
Products
15-16 ounces
4 pounds
(total)
16 ounces
16 ounces
Fruits &
Vegetables
$32 total value
Vendors must stock at least 2 varieties from 100% juice groups A and B.
100%
Juice
64 ounces
6
(total)
11.5 – 12 ounces
9
(total)
Infant
Formula
12.4 ounces
24
13 ounces
16
12.9 ounces
6
13 ounces
18
Infant
Cereal
8 or 16 ounces
6
(total)
Baby Food
3.5 – 4 ounces
32
(total)
Baby Meat
2.5 ounces
31
(total)
Revised: October 2013
11
INFANT FORMULA SUPPLIER DIRECTORY
Below are infant formula sources for Maryland WIC authorized vendors. As a
Maryland WIC authorized vendor, infant formula may only be obtained from the
sources provided in this directory. If you do not see your current source listed
please contact this office at 410-767-5258 or 1-800-242-4942 (toll free) for
guidance. Note: You may have a different address for the same sources, which
is acceptable. You may change your source at any time provided your new source
is listed. This directory will be updated annually and is also available online at
www.mdwic.org
Manufacturers
Mead Johnson
282 Galahad Drive
Rochester, NY 14623-5508
585-334-9377
Nestle USA
800 North Brand Blvd
Glendale, CA 91203
617-770-2638
Abbott Laboratories
3300 Stelzer Road
Columbus OH 43219
PBM Nutritionals
147 Industrial Park Road
Georgia, VT 05468-2109
800-959-2066 x131
Nutricia North America
9900 Belward Campus Drive Ste 100
Rockville MD 20850
Solus Products, LLC
8910 Purdue Road, Suite 230
Indianapolis, IN 46268
Distributors
Cardinal Health
1120 Commerce Blvd
Swedesboro, NJ 08085
301-341-4308
Jetro
3405 Annapolis Road
Baltimore, MD 21227
410-354-1500
Moran Foods, Inc.
9822 Prosperity Lane
Williamsport, MD 21795
800-828-1530
Supervalu, Inc
8258 Richfood Road
Mechanicsville, VA 23116
800-444-7424
Supervalu, Inc.
3900 Industrial Road
Harrisburg, PA 17110
717-232-6821
Food Lion Distribution Center #7
Lot 16 Commerce Ave
Greencastle, PA 17225
717-597-1100
Lancaster Distribution Center
500 S Muddy Creek Road
Denver, PA 17517
717-335-4000
Revised: October 2013
12
Wholesalers
Associated Wholesalers, Inc
Route 422
Robesonia, PA 19551-0067
800-927-7771
AWI
600 Arsenal Road
York, PA 17402
717-854-1505
B-Green Cash & Carry
1300 S Monroe St
Baltimore, MD 21230
410-539-6134
B-Green Cash & Carry
2401 Belair Road
Baltimore, MD 21213
410-563-0323
Bill’s Wholesale Grocery, Inc.
211 Meadows Ridge Drive
Mt. Norris, PA 15349
800-288-2565
Bozzuto’s, Inc.
275 Schoolhouse Road
Chesire, CT 06410
800-243-9761
C & S Wholesale Grocers
100 Quality Circle, Suite 107
Harrisburg, PA 17112
717-657-7720
Cho Wholesaler, Inc.
1818 Pennsylvania Ave
Baltimore, MD 21217
571-288-9844
Economy Wholesale Co.
P O Box 346
Lavale, MD 21502
301-724-0202
George J. Falter
P O Box 24176
Baltimore, MD 21227
800-322-3491
Maryland Cash & Carry
1808 N Patterson Park Ave
Baltimore, MD 21213
410-558-2047
Nash Finch Company
1100 Prosperity Ave
Lima, OH 45802
800-472-1847
Revised: October 2013
13
VENDOR APPLICATION INSTRUCTIONS
Please carefully read and follow the instructions provided for completing your
application for WIC authorization.
Clearly print or type your answers.
Fill in all blanks. If a particular question does not apply to your store, write
“N/A” for Not Applicable.
List the names of all of the owners of the store. If the store is incorporated,
write the name of the corporation and list the names of the President, Vice
President, Treasurer, and the address of the corporation.
Utilize your store’s last federal or state tax form to provide gross annual
sales. If the store is new, provide an estimate. This information will be kept
confidential.
Sign and date each application. Vendor applications must be signed and
dated to be considered valid.
Sign, date, and return each Vendor Agreement (included in this package).
One will be returned to you at the time of authorization.
Failure to provide accurate information may result in unnecessary delays in
processing your application. Incomplete applications will be returned. If it is
determined that false information was provided, the application will be
denied.
Receipt of Applications
Applications may be hand delivered or mailed. Mail or deliver the applications to:
Maryland Department of Health and Mental Hygiene
Maryland WIC Program
201 W. Preston Street, Room 103
Baltimore, MD 21201
Your application will be approved or denied within 60 days of receipt by this
office. If you have questions or difficulty completing this application, please contact
Mr. Siwon Lee at 410-767-5433, Ms. Tiasha Taylor at 410-767-3519,
Mr. Bryan Rossi at 410-767-5251, or call toll free at 1-800-242-4942 for assistance.
FAXED APPLICATIONS CANNOT BE ACCEPTED
Things to remember before you apply
1. Keep minimum stock in your store when you send the application to the office.
-The most common reason for denial is failing to meet the minimum stock requirements. Please
review pages 9 to 10 of this package and WIC Authorized Food List ensure you are in compliance
before you submit your application.
2. Authorization onsite reviews are not announced.
-An authorization onsite inspection may occur at any time after the receipt of an application.
3. You must hold a copy or original food service facility license issued by a local health
department in your store for verification.
- You will be required to show the document in on-site review.
4. The regulatory processing time for processing applications is 60 days from the date the
application is received by the State WIC office.
-Properly completed applications are typically processed in less than 60 days. However, applications
are processed in the order they are received. Processing times vary depending upon the volume of
applications pending processing and staff availability.
5. If a store is denied authorization three times in a year, the applicant may not reapply for WIC
authorization until 1 calendar year after the last denial date.
-You may reapply any time after a calendar year has passed.
6. If it is determined that your store’s prices exceed 125% of the Peer Group average, you will be
denied authorization, and advised of the denial in writing. If you are applying for
reauthorization, you will be given the opportunity to adjust your prices.
- Please keep the prices of your store’s WIC food items competitive.
7. The store must have authorization from the Food Stamp Program and may not be currently
disqualified or suspended from the Food Stamp Program.
-If your store is currently under suspension from the WIC Program, you may reapply for WIC
authorization after the end of the suspension period.
8. If you have any questions, please contact the WIC office.
Check list
3 page Application form
All boxes filled in.
Pages 3 signed.
2 Original Signed Vendor Agreements
Page 1 line 1, 2 not 3
Page 5, 9,10, 11, 12
Application
Accepted
On-site review
New Vendor
Training
AUTHORIZED