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Only 4 in 10 Idahoans who qualify enroll for WIC. State officials working to change that

By Kyle Pfannenstiel Idaho Capital Sun

Hailey Martinez, 28, a mother of four children, says everything she does is for her kids.

But she wasn’t sure she would have more than one child initially, since she struggled with breastfeeding her first daughter.

Accessing benefits for formula on the Women, Infants and Children (WIC) nutrition program has helped her grow and support her family, she said, even when she doesn’t qualify for food stamps or Medicaid directly herself.

“Everything (WIC offers) really does help me. I’m really blessed to get at least that,” Martinez said.

Enrollment in WIC is low across the nation, and even lower in Idaho, where only 41% of people eligible are on the program, according to national estimates.

But officials administering WIC services in Idaho say they are working to combat low WIC enrollment by spreading the word online and at events and by trying to understand more about why eligible Idahoans aren’t on the program.

There are many reasons people don’t enroll in WIC, experts say. Some people might not have the time or access to transportation to attend appointments. Some might not want to access public assistance on the program, which provides nutritional assistance to people on WIC.

But some people might not know that they can earn more and still qualify for the program, compared to other public assistance programs.

“One of the biggest barriers is just knowing about the program. There are many people that don’t realize they qualify because they just assume that the income guidelines are low. But the income guidelines are much higher than people realize,” said Leah Sallas, Idaho WIC program director.

Another barrier that Idaho officials think plays a role is that Idahoans are independent, Sallas said. She said she believes that’s a reason that enrollment in WIC in Idaho – and neighboring states in the West – is lower than the national average, which indicates about half of eligible people are enrolled in WIC nationwide.

What exactly is WIC?

WIC is a supplemental nutrition program for women, infants and children. WIC provides free foods, such as fresh fruits, milk, eggs, cheese, cereal, juice, beans and peanut butter, to approved families, in addition to screenings for health, nutrition counseling, breastfeeding information and support, help from registered dietitians and referrals to other services, such as food banks and rental assistance programs.

“You name it, we will help try to find a resource,” said Emily Waddoups, WIC program manager at Central District Health. “… We’re trying to improve people’s lives. WIC is out to improve nutrition and health outcomes, but also make it so that they can make those healthy outcomes. So if that means they can’t focus on nutrition right now because they need help with housing, we will try and help with the housing so they can focus on nutrition. But we’re trying to improve lives and nutrition for the long term.”

People who administer WIC services in Idaho know families well, Sallas said. If children are not meeting developmental goals on time, she said WIC officials can connect families with resources like medical providers to help.

People who meet the income eligibility guidelines can find a WIC income clinic near them on to see if they qualify.

Do you qualify for the nutrition program?

To qualify, people must be pregnant, recently pregnant, breastfeeding or have a child under age 5. Idaho’s WIC program is only open to Idaho residents who have low to moderate income and “have a need that can be helped by WIC foods.”

The average Idahoan accessing WIC receives about $64 in food per month, the state health department estimates.

People can earn more and qualify for WIC than other public programs, officials note.

A family of four, for instance, could qualify for WIC if they earn up to $55,500 each year, according to Idaho’s income guidelines for WIC. A household of two can earn up to $36,482 each year, or $702 each week, and still qualify. WIC counts pregnant women as two people.

When Martinez had her first child at 16 years old, she had no idea about the program. She found the program herself by looking online.

She had been trying for months to breastfeed her first child, but her daughter wasn’t getting enough nutrition from breastfeeding alone. She needed help affording formula – which WIC offered.

She initially felt pressure to breastfeed in the program, but eventually found support at Central District Health, where she still receives services for her younger three children.

“The fact that WIC does offer formula is the best thing WIC can offer to a mother who wants to have children. It honestly has changed my life,” Martinez said.

WIC has also helped Martinez, who isn’t able to access other public assistance programs. Her kids are on Medicaid, but she doesn’t qualify. She also doesn’t qualify for SNAP, formerly known as food stamps.

WIC enrollment is growing, but still more Idahoans could benefit from the program. In the past year, enrollment in Idaho WIC has grown 5%, said Sallas, who heads Idaho’s WIC program.

The economy is a big driver of WIC enrollment, she said. High food prices drive people to enroll in WIC, she said.

What Idaho officials are doing to boost enrollment in the program

Researchers at Boise State University are starting to study why people don’t enroll in WIC services at Central District Health through $60,000 in pending federal grant funds.

Ellen Schafer, assistant professor at BSU’s School of Public and Population Health, says this research could help Central District Health identify how the health district can serve more people through WIC. Schafer said the work is important to fine-tune communication to different people eligible but not enrolled in WIC services, such as people who decline because they feel other people need it more than them or people unable to make appointments.

“Understanding some of these differentiating characteristics will hopefully help with communication around referrals, recruitment and retention – and ultimately increase enrollment and retention,” Schafer said.

Boise State researchers hope to better understand barriers to people being on the program through interviews or focus groups and surveys to people who are eligible but do not participate in WIC. Researchers hope to start the research this fall, and wrap up the work in one year, Schafer said.

Since the pandemic, the state has also opted into federal waivers to allow people to attend WIC appointments online, Sallas said, which she said makes it easier for busy families to do appointments at home instead of in a clinic. She said Idaho also opted into another waiver to expand the benefits for fruits and vegetables from $10-11 per participant per month to $25 to $49 per month.

Idaho’s WIC program has also been working with Medicaid and SNAP to identify other people eligible for WIC who aren’t enrolled, Sallas said.

Central District Health this summer started spending funds through a $531,612 grant from the U.S. Department of Agriculture meant to find innovative strategies for outreach for WIC. That grant has helped them hire a WIC outreach coordinator, start hosting mobile WIC clinics outside of their typical locations and build partnerships and host events in rural counties.

She said Central District Health – which serves Ada, Boise, Elmore and Valley counties – is particularly focused through the grant on working with migrant workers, the area’s refugee population and rural counties to understand more about WIC resources.

“The goal of WIC is to help people make life long lasting healthy habits,” Waddoups said. “We’re here to help people. We’re not here to judge.”