WIC Infant Formula Medical Documentation Waiver

This letter is in response to correspondence from WIC state agencies requesting program flexibility with regard to medical documentation requirements in the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC), as a result of the impact of the ongoing Coronavirus Disease 2019 (COVID-19) pandemic and the 2022 Abbott recall of certain powder infant formula on the nationwide supply chain leading to both periodic location- and product-based WIC infant formula shortages.

Applicable WIC state agencies individually requested waivers of WIC regulations at 7 CFR 246.10(d)(1)(i) which require medical documentation for issuance of noncontract brand infant formula. These state agencies cited significant impacts on the ability of participants to obtain contract brand infant formula due to low stock during the 2022 Abbott recall of certain powder infant formula which compounds supply chain disruptions resulting from COVID-19 supply chain disruptions. USDA’s Food and Nutrition Service (FNS) understands that requiring such documentation is not feasible as state agencies quickly respond to the COVID-19 related nationwide supply chain issues that have been exacerbated by this recall. A waiver to provide administrative flexibility to allow for the issuance of noncontract brand infant formula without medical documentation for infants in Food Packages I and II removes a requirement that under current circumstances could prevent the provision of essential Program benefits to participants.

Pursuant to the authority granted under the Robert T. Stafford Disaster Relief and Emergency Assistance Act (42 USC 5121-5207), FNS approves this waiver request for WIC state agencies listed in the attachment through the earlier of either Sept. 30, 2022 or the expiration date of the major disaster declaration in the affected area.

This waiver is only applicable to regulations at:

• 7 CFR 246.10(d)(1)(i) which requires medical documentation for the issuance of noncontract brand infant formula.

Approval is granted to waiver this requirement for WIC participants receiving Food Packages I and II. As applicable, the WIC Competent Professional Authority (CPA) should still perform a nutrition assessment to ensure the correct formula and amounts are issued to the participant and documented.

Approval is not granted to waive the following supplemental foods and regulatory requirements:

• 7 CFR 246.10(d)(1)(ii-vi), which defines other instances where medical documentation is required;
• 7 CFR 246.10(d)(4), which defines the technical requirements of medical documentation;
• 7 CFR 246.10(d)(5), which prohibits WIC staff from assuming medical oversight and instruction for participants receiving supplemental foods that require medical documentation; and
• 7 CFR 246.10(e)(3)(i), which defines the qualifying conditions to be eligible to receive food package III

This waiver only applies to the state agencies’ response to the 2022 Abbott recall of certain powder infant formula. Unless a state agency has additional active FNS waivers, all other federal WIC requirements must be met. WIC state agencies should work with their legal counsel, procurement offices, and infant formula rebate contractors, as appropriate.

USDA FNS appreciates WIC state agencies’ commitment to quickly responding to the COVID-19 related nationwide supply chain issues that have been exacerbated by this recall.

DIANE KRIVISKI
Associate Administrator
Supplemental Nutrition and Safety Programs

List of WIC state agencies that have been granted this waiver

Granted May 23, 2022

• Eastern Band of Cherokee Indians WIC
• Mississippi Band of Choctaw Indians WIC

Granted May 20, 2022

• Alabama WIC
• Georgia WIC
• Mississippi WIC
• North Carolina WIC

Granted May 18, 2022

• Florida WIC
• Indiana WIC
• New Jersey WIC
• Ohio WIC

Granted May 17, 2022

• Michigan WIC
• South Carolina WIC

Granted May 13, 2022

• New York WIC

Granted March 23, 2022

• Muscogee Creek Nation WIC

Granted Feb. 28, 2022

• Arkansas WIC

Granted Feb. 25, 2022

• Citizen Potawatomi Nation WIC
• Colorado WIC
• Inter-Tribal Council of Oklahoma WIC
• Wichita, Caddo, and Delaware Tribes WIC

Granted Feb. 24, 2022

• Eight Northern Indian Pueblos Council WIC

Granted Feb. 23, 2022

• California WIC
• Chickasaw Nation WIC
• Otoe Missouria WIC

Granted Feb. 22, 2022

• Arizona WIC
• New Mexico WIC
• Oklahoma WIC
• Omaha Nation WIC
• Rosebud Sioux Tribe WIC

Granted Feb. 21, 2022

• Cherokee Nation of Oklahoma WIC
• Choctaw Nation of Oklahoma WIC
• Five Sandoval Indian Pueblos, Inc. WIC
• Louisiana WIC
• Maine WIC
• Navajo Nation WIC
• Osage Nation WIC
• Pueblo of Isleta WIC
• Texas WIC
• Utah WIC
• Washington WIC
• Pueblo of Zuni WIC

Granted Feb. 20, 2022

• Alaska WIC
• American Samoa WIC
• Commonwealth of the Northern Mariana Islands WIC
• Connecticut WIC
• Delaware WIC
• District of Columbia WIC
• Guam WIC
• Hawaii WIC
• Idaho WIC
• Iowa WIC
• Inter-Tribal Council of Arizona WIC
• Inter-Tribal Council of Nevada WIC
• Kansas WIC
• Kentucky WIC
• Maryland WIC
• Massachusetts WIC
• Minnesota WIC
• Missouri WIC
• Montana WIC
• Nebraska WIC
• Nevada WIC
• New Hampshire WIC
• North Dakota WIC
• Oregon WIC
• Pennsylvania WIC
• Rhode Island WIC
• South Dakota WIC
• Standing Rock Sioux Tribe WIC
• Tennessee WIC
• U.S. Virgin Islands WIC
• Vermont WIC
• Virginia WIC
• West Virginia WIC
• Wisconsin WIC
• Wyoming WIC