La. Admin. Code tit. 48 § V-4103

Current through Register Vol. 50, No. 9, September 20, 2024
Section V-4103 - Definitions
A. The following words and terms are defined for the purposes of this Subpart and for all contracts, guidelines, instructions, forms and other documents related hereto.

Abbreviated Administrative Review-a procedure by which a vendor may appeal specified adverse actions by LA WIC to an independent reviewer.

Above-50-Percent (A-50) Vendors-vendors that derive more than 50 percent of their annual food sales revenue from WIC approved food items, and new vendor applicants expected to meet this criterion under guidelines approved by the Food and Nutrition Service (FNS) of USDA.

Abuse-diversion of resources away from necessary LA WIC services benefits

Adjustment-price adjustment.

Administrative Review-Repealed.

Applicants-pregnant women, breastfeeding women, postpartum women, infants, and children who are applying to receive WIC benefits, and the breastfed infants of applicant breastfeeding women. Applicants include individuals who are currently participating in the program but are re-applying because their certification period is about to expire.

Authorized Supplemental Foods/WIC-Approved Foods-Repealed.

Authorized WIC Vendor-a store owned by a sole proprietorship, partnership, cooperative association, corporation, limited liability company, or other business entity that is authorized by LA WIC to provide WIC-approved food items to WIC participants under a retail food delivery system. Each store must have a single, fixed location and must be authorized separately from other stores owned by the business entity.

breastfeeding-the practice of feeding a mother's breastmilk to her infant(s) on an average frequency of at least once a day.

breastfeeding Women-women up to 1 year postpartum who are breastfeeding their infants.

Cash-Value Voucher (CVV)-a fixed-dollar amount check, voucher, electronic benefit transfer (EBT) card or other document which is used by a participant to obtain authorized fruits and vegetables.

Cash Value Benefit-Cash value voucher.

Cash Value Voucher -a fixed-dollar amount used by a participant to obtain authorized fruits and vegetables

Categorical Eligibility-persons who meet the definitions of pregnant women, breastfeeding women, postpartum women, infants or children.

Certification-the implementation of criteria and procedures to assess and document each applicant's eligibility for the program.

Change of Location-Repealed.

Change of Ownership-Repealed.

Change of Ownership-a change that results when all of the assets of the store are sold or transferred to a new owner or business entity. This includes adding a new partner(s).

Children-persons who have had their first birthday but have not yet attained their fifth birthday.

Civil Money Penalty (CMP)-a monetary penalty imposed in lieu of disqualification as a sanction applied due to inadequate participant access.

Clinic-a facility where applicants are certified.

CMP-civil money penalty.

Competent Professional Authority-an individual on the staff of the local agency authorized to determine nutritional risk and prescribe supplemental foods. The following persons are the only persons the state agency may authorize to serve as a competent professional authority: physicians, nutritionists (bachelor's or master's degree in nutritional sciences, community nutrition, clinical nutrition, dietetics, public health nutrition or home economics with emphasis in nutrition), dieticians, registered nurses, physician's assistants (certified by the National Committee on Certification of Physician's Assistants or certified by the state medical certifying authority), or state or local medically trained health officials. This definition also applies to an individual who is not on the staff of the local agency but who is qualified to provide data upon which nutritional risk determinations are made by a competent professional authority on the staff of the local agency.

Competitive Price Criteria (CPC)-the prices a vendor or vendor applicant charges for a selection of WIC approved food items as compared to the prices charged by other vendors within the same vendor peer group.

Compliance Buy-a covert, on-site investigation in which a representative of the program poses as a WIC participant, parent, or caretaker of an infant or child participant, or proxy, conducts one or more WIC transactions, and does not reveal during the visit that he or she is a program representative.

Compliance Investigation-compliance buys and/or inventory audits.

Confidential Participant Information-confidential applicant and WIC participant information is any information about an applicant or WIC participant whether it is obtained from the applicant or WIC participant, another source, or generated as a result of WIC application, certification, or participation, that individually identifies an applicant or WIC participant and/or family member(s). Applicant or WIC participant information is confidential, regardless of the original source.

Confidentiality-Repealed.

Confidentiality Vendor Information-any information about a vendor (whether it is obtained from the vendor or any other source) that individually identifies the vendor except for vendor's name, address, telephone number, web site/email address, store type, and authorization status.

Corrective Action Plan (CAP)-a plan submitted by a vendor to take remedial action(s) to correct a violation(s) of LA WIC vendor rules and regulations.

Courtesies-LA WIC requires vendors to offer WIC participants the same services that are offered to other customers, such as, but not limited to, helping the customer to obtain an item from a shelf or from behind a counter, bagging food for the customer, and assisting with loading the food into a vehicle.

CSFP-the Commodity Supplemental Food Program administered by the U.S. Department of Agriculture, authorized by section 4 of the Agriculture and Consumer Protection Act of 1973 [7 U.S.C. 1431(a)], as amended, and governed by 7 CFR Part 247.

Days-calendar days.

Deficiency-inventory audit deficiency.

Disqualification-the act of ending the program participation of a WIC participant, vendor or authorized state or local agency.

Documentation-the presentation of written documents which substantiate statements made by an applicant, WIC participant, person applying on behalf of an applicant, vendor, and/or vendor applicant.

Drug-

a. beverage containing alcohol;
b. controlled substance (having the meaning given it in section 102 of the Controlled Substances Act of 1970 (21 U.S.C. 802(6)), as amended; or
c. controlled substance analogue (having the meaning given it in section 102 of the Controlled Substances Act of 1970 [21 U.S.C. 802(32)], as amended.

Dual Participation-simultaneous participation in LA WIC in more than one WIC clinic.

Electronic Benefit Transfer (EBT)-a method that permits electronic access to WIC benefits using a card or other access device approved by the Secretary of USDA.

Electronic Benefit Transfer (EBT) Capable- demonstration by a vendor or vendor applicant that its cash register system or payment device can accurately and securely obtain WIC food balances associated with an EBT card, maintain the necessary files such as the authorized product list, hot card file and claim file and successfully complete WIC EBT purchases.

Electronic Signature-an electronic sound, symbol, or process, attached to or associated with an application or other record and executed and or adopted by a person with the intent to sign the record.

Equitable Treatment-vendors will offer WIC participants the same courtesies that are offered to other (non-WIC) customers.

Family-a group of related or nonrelated individuals who are living together as one economic unit, except that residents of a homeless facility or an institution shall not all be considered as members of a single family.

FNS-the Food and Nutrition Service of the U.S. Department of Agriculture.

Food Costs-the costs of supplemental foods, determined in accordance with 7 CFR § 246.14(b).

Food Delivery System-the method used by state and local agencies to provide WIC-approved foods items to WIC participants.

Food Instrument (FI)-Repeal.

Food Package-WIC-eligible food items designed to meet the special nutritional needs of the WIC participant and issued in designated quantities and types.

Food Sales-sales of all SNAP eligible foods intended for home preparation and consumption, including meat, fish, and poultry; bread and cereal products; dairy products; and fruits and vegetables. Food items such as condiments and spices, coffee, tea, cocoa, and carbonated and noncarbonated drinks may be included in food sales when offered for sale along with foods in the categories identified above. Food sales do not include sales of any items that cannot be purchased with SNAP benefits, such as hot foods or food that will be eaten in the store.

Fraud-regarding any and all LA WIC matters, a misrepresentation or a suppression of the truth made with the intention either to obtain an unjust advantage for a party or to cause a loss or inconvenience to the other

Full Administrative Review-a procedure by which a vendor may appeal specified adverse actions by LA WIC to the Division of Administrative Law of the Louisiana Department of the State Civil Service.

Full Line Grocery Store-Repealed.

Health Services-ongoing, routine pediatric and obstetric care (such as infant and child care and prenatal and postpartum examinations) or referral for treatment.

Homeless Facility-the following types of facilities which provide meal service:

a. a supervised publicly or privately operated shelter (including a welfare hotel or congregate shelter) designed to provide temporary living accommodations;
b. a facility that provides a temporary residence for individuals intended to be institutionalized; or
c. a public or private place not designed for, or normally used as, a regular sleeping accommodation for human beings.

Homeless Individual-a woman, infant or child:

a. who lacks a fixed and regular nighttime residence; or
b. whose primary nighttime residence is:
i. a supervised publicly or privately operated shelter (including a welfare hotel, a congregate shelter, or a shelter for victims of domestic violence) designated to provide temporary living accommodation;
ii. an institution that provides a temporary residence for individuals intended to be institutionalized;
iii. a temporary accommodation of not more than 365 days in the residence of another individual; or
iv. a public or private place not designed for, or ordinarily used as, a regular sleeping accommodation for human beings.

Incentive Items/Incentives-an item or service provided by a vendor to attract customers or encourage customer loyalty.

Infant Formula-a food that meets the definition of an infant formula in section 201(z) of the Federal Food, Drug, and Cosmetic Act of 1938 (21 U.S.C. 321(z)), and that meets the requirements for an infant formula under section 412 of the federal Food, Drug, and Cosmetic Act of 1938 (21 U.S.C. 350a), as amended, and the regulations at 21 CFR parts 106 and 107 published on April 1, 2021.

Institution-any residential accommodation which provides meal service, except private residences and homeless facilities.

Infants-persons under 1 year of age.

Inventory Audit-the examination of food invoices or other proofs of purchase to determine whether a vendor has purchased sufficient quantities of supplemental food(s) to provide WIC participants with the quantity of supplemental food(s) redeemed during a given period of time.

Inventory Audit Deficiency-the monetary value of a vendor's claimed reimbursement for the sale of supplemental food(s) that exceeds the store's documented inventory of supplemental food(s) for a specific period of time.

Judicial Review-the procedure by which a vendor may appeal a decision rendered at an administrative review, or a WIC participant may appeal a decision rendered at a fair hearing.

LA WIC-the Louisiana WIC Program.

Local Agency-a public or private, nonprofit or human service agency which provides health services, either directly or through contract, in accordance with 7 CFR § 246.5.

Maximum Allowable Reimbursement Level (MARL)- the highest reimbursement amount for WIC approved food items for each peer group.

Migrant Farmworker-an individual whose principal employment is in agriculture on a seasonal basis, who has been so employed within the last 24 months, and who establishes, for the purposes of such employment, a temporary abode.

Monitoring-routine monitoring.

Monitoring Review-routine monitoring.

Non-A50 Vendors-Repealed.

Nonprofit Agency-a private agency which is exempt from federal income tax under the Internal Revenue Code of 1954, (title 26 of the U.S.C), as amended.

Nutrition Education-individual and group sessions and the provision of materials that are designed to improve health status and achieve positive change in dietary and physical activity habits, and that emphasize the relationship between nutrition, physical activity, and health, all in keeping with the personal and cultural preferences of the individual.

Nutritional Risk-

a. detrimental abnormal nutritional conditions detectable by biochemical or anthropometric measurements;
b. other documented nutritionally related medical conditions;
c. dietary deficiencies that impair or endanger health;
d. conditions that directly affect the nutritional health of a person, including alcoholism or drug abuse; or
e. conditions that predispose persons to inadequate nutritional patterns or nutritionally related medical conditions, including, but not limited to, homelessness and migrancy

Other Harmful Substances-other substances such as tobacco, prescription drugs and over-the-counter medications that can be harmful to the health of the WIC population, especially the pregnant woman and her fetus.

Participant Access-the ability of a WIC participant to adequately access WIC approved food items from vendors for which LA WIC has established participant access criteria in accordance with federal regulations at 7 CFR part 246.

Participant Violation-any intentional action of a WIC participant, caregiver or a proxy that violates federal or state statutes, regulations, policies or procedures governing the program.

Participants-pregnant women, breastfeeding women, postpartum women, infants and children who are receiving WIC approved food items or cash-value vouchers under the program, and the breastfed infants of WIC participant breastfeeding women.

Participation-the sum of the number of:

a. persons who received WIC approved food items or cash-value vouchers during the reporting period;
b. infants who did not receive WIC approved food items or cash-value vouchers but whose breastfeeding mother received WIC approved food items or cash-value vouchers during the report period; and
c. breastfeeding women who did not receive WIC approved food items or cash-value vouchers but whose infant received WIC approved food items or cash-value vouchers during the report period.

Peer Group-a group of vendors that is based on common characteristics or criteria that affect food prices. Vendors are grouped for management and cost containment purposes.

Postpartum Women-usually, women up to six months after termination of pregnancy.

Pregnant Women-women determined to have one or more embryos or fetuses in utero.

Price Adjustment-changes made to the reimbursement amount by LA WIC, in accordance with the vendor agreement, to ensure that the payment to the vendor complies with LA WIC's price limitations.

Program-the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) authorized by section 17 of the Child Nutrition Act of 1966, as amended (unless the context in which this word is used in this Subpart clearly indicates otherwise).

Proxy-any person designated by a WIC participant, or by a parent or caretaker of an infant or child participant, to obtain and transact WIC benefits and/or to obtain WIC approved food items on behalf of a WIC participant. The proxy shall be designated consistent with LA WIC's procedures established pursuant to 7 CFR § 246.12(r)(1). Parents or caretakers applying on behalf of a child or infant WIC participants are not proxies.

Regular Vendors (Non-A-50)-vendors that do not meet the vendor selection criterion for above-50-percent (A-50) vendors.

Reimbursement-the payment from LA WIC to a vendor for WIC transactions in accordance with the vendor agreement.

Routine Monitoring-an overt, on-site monitoring visit during which program representatives identify themselves to vendor personnel.

Sanctions-adverse actions including, but not limited to, termination of the vendor agreement, and/or disqualification or civil money penalties (CMPs), taken by LA WIC against a vendor after a vendor fails to comply with vendor rules and regulations. The sanction schedule appears in the vendor guide and policy manual.

Secretary-the Secretary of Agriculture.

Sign or Signature-a handwritten signature on paper or an electronic signature. If LA WIC chooses to use electronic signatures, LA WIC shall ensure the reliability and integrity of the technology used and the security and confidentiality of electronic signatures collected in accordance with sound management practices, and applicable federal law and policy, and the confidentiality provisions at 7 CFR § 246.26.

State-the state of Louisiana.

State Agency-the state of Louisiana, Louisiana Department of Health, Office of Public Health, Center for Community and Preventive Health, Bureau of Nutrition Services.

State Plan-a plan of program operation and administration that describes the manner in which LA WIC intends to implement and operate all aspects of program administration within its jurisdiction in accordance with 7 CFR § 246.4.

Supplemental Foods-those foods containing nutrients determined by nutritional research to be lacking in the diets of pregnant, breastfeeding and postpartum women, infants, and children, and foods that promote the health of the population served by LA WIC as indicated by relevant nutrition science, public health concerns, and cultural eating patterns, as prescribed by the Secretary in 7 CFR § 246.10.

Supplemental Nutrition Assistance Program (SNAP)- the program authorized by the Food and Nutrition Act of 2008 (7 U.S.C. 2011 et seq.), in which eligible households receive benefits that can be used to purchase food items from authorized retail stores and farmers' markets.

Termination-the ending of a vendor agreement by the state agency for administrative reasons.

Unauthorized Food Item-allowing the purchase of any food item that is not a WIC approved food item, the purchase of any WIC approved food item that is not prescribed for a particular WIC participant, or the purchase of any WIC approved food item in excess of available WIC benefits.

USDA-the United States Department of Agriculture.

Vendor-authorized WIC vendor.

Vendor Agreement-a contract between an authorized WIC vendor and LA WIC.

Vendor Authorization-the process by which LA WIC assesses, selects, and enters into agreements with stores that apply or subsequently reapply to be an authorized WIC vendors.

Vendor ID-vendor identification number.

Vendor Identification Number-a distinctive number assigned to each authorized WIC vendor that is confidential.

Vendor Limiting Criteria-criteria established by LA WIC to determine the maximum number and distribution of vendors it authorizes pursuant to 7 CFR § 246.12(g)(2).

Vendor Number-Repealed.

Vendor Overcharge -intentionally or unintentionally charging LA WIC more for a WIC-approved food item than is permitted under the vendor agreement, such as a vendor charging more for a WIC approved food item in the WIC transaction than the shelf price of the item. WIC transactions submitted by the vendor for redemption that are adjusted by LA WIC to meet cost containment measures are not considered vendor overcharges.

Vendor Portal -Repealed.

Vendor Rules and Regulations-provisions that control vendor participation within LA WIC including, but not limited to, affirmations made in the vendor application and the vendor agreement, and federal and state rules, regulations, guidance and policy governing LA WIC as well as the vendor guide, memorandums and policy manual.

Vendor Selection Criteria-the criteria established by LA WIC to select individual vendors for WIC authorization consistent with the requirements in 7 CFR § 246.12(g)(3) and (g)(4) and found in the vendor rules and regulations.

Vendor Termination-the dissolution of a vendor agreement.

Vendor Violation-any intentional or unintentional action of a vendor's current owners, officers, managers, agents, or employees (with or without the knowledge of management) that violates the vendor agreement or federal or state statutes, regulations, policies, or procedures governing LA WIC.

WIC-the Special Supplemental Nutrition Program for Women, Infants and Children authorized by section 17 of the Child Nutrition Act of 1966, 42 U.S.C. 1786.

WIC Approved Food Items-those supplemental foods authorized by LA WIC for issuance to WIC participants.

WIC Benefit-a supplemental food benefit issued to WIC participants in the form of a cash value voucher (CVV) or EBT card.

WIC Federal Regulations- the regulations contained within part 246 of title 7 of the Code of Federal Regulations ( 7 CFR 246) published on January 1, 2021 and titled the Special Supplemental Nutrition Program for Women, Infants and Children.

WIC Program-Repealed.

WIC Transaction-an electronic benefit transfer (EBT) of a WIC benefit.

WIC Transaction for Food Not Received-occurs when LA WIC reimburses a vendor for a WIC approved food item(s) not received by the WIC participant.

La. Admin. Code tit. 48, § V-4103

Promulgated by the Department of Health and Human Resources, Office of Preventive and Public Health Services, LR 13:246 (April 1987), amended by the Department of Health and Hospitals, Office of Public Health, LR12:869 (December 1988), Amended by the Department of Health, Office of Public Health, LR 43331 (2/1/2017), Amended LR 491399 (8/1/2023).
AUTHORITY NOTE: Promulgated in accordance with R.S. 46:972.