OMB Control No: 0584-XXXX
Expiration Date: XX/XX/20XX
Appendix X2a: WIC MIS Data Pull Instructions
WIC MIS Data Pull Instructions
II. Components of the WIC MIS Data Pull Form 2
III. Requested Data by Section and Tab 3
Section 1: (1a) Enrollment CY 2019 – (4b) Re-Certification 3
Tabs (1a) Enrollment CY 2019 & (1b) Enrollment CY 2020 3
Tabs (2a) New Certification CY 2019 & (2b) New Certification CY 2020 4
Tabs (3a) Re-Certification CY 2019 & (3b) Re-Certification CY 2020 4
Section 2: (4a) Redemption CY 2019 & (4b) Redemption CY 2020 4
Tabs (4a) Redemption CY 2019 & (4b) Redemption CY 2020 4
Section 3: (5) Nutrition Education Rate & (6) No-Show Rate 5
Tab (5) Nutrition Education Rate 5
Background:
The Families First Coronavirus Response Act (P.L. 116-127, FFCRA), as amended by the Continuing Appropriations Act, 2021 and Other Extensions Act (P.L. 116-159), provides the U.S. Department of Agriculture (USDA) the statutory and regulatory waiver authorities necessary in a public health emergency such as COVID-19 to allow for social distancing in the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC).
The FFCRA requires that WIC SAs receiving Federal waivers fulfill certain reporting requirements—these requirements are described in detail in sections 2203(b) and 2203(b) of the FFCRA and also in the provided guide “How to Fulfill the FFCRA WIC Waiver Reporting Requirements: Instructions and Tools.”
To help SAs and local agencies (LAs) meet these reporting requirements with minimal burden, FNS has developed a series of reporting tools: (1) WIC State Agency Waiver FFCRA Reporting Data Online Form (SA Waiver Reporting Form), (2) WIC Local Agency Waiver FFCRA Reporting Data Online Form (LA Waiver Reporting Form), and (3) the attached WIC MIS Data Pull Form. These tools ensure that SA and LA reports are collected in a standard format that can be analyzed. Instructions for completing the SA and LA Waiver Reporting Forms have been emailed to SAs. Instructions for completing the WIC MIS Data Pull Form are outlined below.
Purpose:
The WIC MIS Data Pull Form will collect administrative data from two time periods, Calendar Year (CY) 2019 and CY 2020. To complete this, SAs can either:
Populate each of the form’s tabs with the requested administrative data, and submit the completed form to FNS; or
Compile existing Management Information System (MIS) reports containing the data requested on the WIC MIS Data Pull Form, and submit those reports to FNS.
We recognize that SA data and MIS reports may vary. If your SA is unable to obtain any specific data requested in the WIC MIS Data Pull Form, please notify [CONTRACTOR CONTACT] within 5 business days after receipt of the form to discuss alternative data collection options.
The WIC MIS Data Pull Form is divided into three sections and 10 different tabs as described below. Sections 1 and 2 ask for monthly data from CY 2019 and CY 2020 (January 2019 through December 2020), and Section 3 asks for data from one selected reference month for each year: June 2019 and June 2020.
Section 1 Tabs (Monthly Data):
(1a) Enrollment, CY 2019
(1b) Enrollment, CY 2020
(2a) New Certifications, CY 2019
(2b) New Certifications, CY 2020
(3a) Re-Certifications, CY 2019
(3b) Re-Certifications, CY 2020
Section 2 Tabs (Monthly Data):
(4a) Redemption, CY 2019
(4b) Redemption, CY 2020
Section 3 Tabs (Specified Months Only):
(5) Nutrition Education Rate, June 2019 and June 2020
(6) No-Show Rate, June 2019 and June 2020
A Comment box is located in the first row of each tab. Please use this Comment box for the following:
If your SA prefers to submit an MIS report(s) in lieu of completing the tab, please document the name of the report and on what page/section the data are located in the Comment box on the respective tab.
If your SA cannot provide any of the data requested in a particular tab, please provide an explanation in the Comment box on the respective tab and notify [CONTRACTOR CONTACT] within 5 business days after the receipt of the form to discuss alternative data collection options.
Data entry instructions are similar for “(1a) Enrollment CY 2019” tab through “(4b) Re-Certification CY 2020” tab. The specific category for the data requested for each tab is described after the table below. If data for any sub-category indicated in Column A (e.g., 1a. Pregnant) is not available, please indicate the unavailability by putting “N/A” in Column B next to the sub-category.
If your SA prefers to submit an MIS report(s) in lieu of completing the tab, please document the name of the report and on what page/section the data are located in the Comment box on the respective tab.
If your SA is unable to obtain any specific data requested in these tabs, please provide an explanation in the Comment box on the respective tab and notify [CONTRACTOR CONTACT] within 5 business days after the receipt of the form to discuss alternative data collection options.
“(1a) Enrollment CY 2019” tab and “(1b) Enrollment CY 2020” tab ask for WIC enrollment numbers (not WIC participation) per each month indicated in Row 3 of the tab.
The values listed in the “Enrollment” tabs should represent the total number of persons listed on WIC master lists or in WIC operating files who are certified to receive WIC benefits as of each month listed in Row 3. This definition of “Enrollment” is the same as the total counts of persons included in the database submitted for the WIC Participant and Program Characteristics (WIC PC) report every two years.
Persons to include when calculating enrollment (same definition as WIC PC):
All participants, some of whom will have been certified up to 1 year ago
Partially breastfeeding women, even if they receive no food package
Fully breastfed infants, even if they receive no food package
However, only the total numbers of “Enrollment” are requested, unlike WIC PC which collects data per each individual participant.
Enter enrollment numbers for CY 2019 in “(1a) Enrollment CY 2019” tab and enrollment numbers for CY 2020 in “(1b) Enrollment CY 2020” tab.
Please do not enter FNS-798 participation numbers (total numbers of persons who received at least one WIC food instrument or food during the corresponding month indicated in Row 3) on these tabs. FNS already has access to FNS-798 participation numbers and does not need to collect them here.
“(2a) New Certification CY 2019” tab and “(2b) New Certification CY 2020” tab ask for new WIC certification numbers per each month indicated in Row 3 of the tab.
The number of New Certifications should not include numbers in “(4a) Re-Certification CY 2019” tab and “(4b) Re-Certification CY 2020” tab.
Please exclude any Re-Certification numbers, which means the numbers of certifications for participants returning to WIC.
Enter New Certification numbers for calendar year 2019 in “(2a) New Certification CY 2019” tab and New Certification numbers for calendar year 2020 in “(2b) New Certification CY 2020” tab.
“(3a) Re-Certification CY 2019” tab and “(3b) Re-Certification CY 2020” tab ask for WIC Re‑Certification numbers per each month indicated in Row 3 of the tab, which means the number of certification for participants returning to WIC.
The number of Re-Certifications should not be included in the numbers in “(2a) New Certification CY 2019” tab and “(2b) New Certification CY 2020” tab.
Enter Re-Certification numbers for calendar year 2019 in “(3a) Re-Certification CY 2019” tab and Re-Certification numbers for calendar year 2020 in “(3b) New Certification CY 2020” tab.
If your SA prefers to submit an MIS report(s) in lieu of completing the tab, please document the name of the report and on what page/section the data are located in the Comment box on the respective tab.
If your SA is unable to obtain any specific data requested in these tabs, please provide an explanation in the Comment box on the respective tab and notify [CONTRACTOR CONTACT] within 5 business days after the receipt of the form to discuss alternative data collection options.
“(4a) Redemption CY 2019” tab and “(4b) Redemption CY 2020” tab ask for the total quantity or dollar value issued and redeemed for each food item in the WIC food package, per month indicated in Row 3.
Position |
Data Description |
Column A |
Enter the category code that your SA uses for the food item (if applicable). |
Column B |
Enter the subcategory code that your SA uses for the food item (if applicable). |
Column C |
Enter the unit of measure used in your redemption and issuance data (e.g., dollars, gallons, ounces, packages, etc.). |
Column D |
Enter food item description (e.g., “Milk” or “Whole Milk”). |
For Columns D – AM, there are three columns under each month indicated in Row 3.
Column Title |
Data Description |
“Redeemed” |
Enter the total amount redeemed of the food item indicated in Columns A – C for each month. |
“Issued” |
Enter the total amount issued of the food item indicated in Columns A – C for each month. |
“Redemption Rate” |
Do not enter anything. Cells under this column have formulas embedded to calculate Redemption rates. |
For Columns D – AM, there are three columns under each month indicated in Row 3. Please enter EBT Redemption and EBT Issuance amounts for calendar year 2019 in “(4a) Redemption CY 2019” tab and EBT Redemption and EBT Issuance amounts for calendar year 2020 in “(4b) Redemption CY 2020” tab.
Unlike the other two sections above, Section 3 is targeted for the reference months of June 2019 and June 2020 only.
If your SA prefers to submit an MIS report(s) in lieu of completing the tab, please document the name of the report and on what page/section the data are located in the Comment box on the respective tab.
If your SA is unable to obtain any specific data requested in these tabs, please provide an explanation in the Comment box on the respective tab and notify [CONTRACTOR CONTACT] within 5 business days after the receipt of the form to discuss alternative data collection options.
To calculate the Nutrition Education rates for June 2019 and June 2020, “(5) Nutrition Education Rate” tab asks for:
the number of completed WIC Nutrition Education Appointments; and
the number of scheduled WIC Nutrition Education Appointments.
The number of scheduled WIC Nutrition Education Appointments should include every appointment including the appointments which were re-scheduled.
Position |
Column B |
Column C |
Rows 6-13: Enter the numbers from June 2020 |
Enter the number of completed WIC Nutrition Education Appointments by corresponding sub-categories indicated in Column A |
Enter the number of scheduled WIC Nutrition Education Appointments by corresponding sub-categories indicated in Column A
|
Rows 19-26: Enter the numbers from June 2019 |
Enter the number of completed WIC Nutrition Education Appointments by corresponding sub-categories indicated in Column A |
Enter the number of scheduled WIC Nutrition Education Appointments by corresponding sub-categories indicated in Column A
|
Please enter “N/A” if any specific number is not available.
Do not enter anything in Column D. Column D will automatically populate the Nutrition Education Rate using the following formula:
However, even if your SA cannot provide every number requested, please try to answer the question 3 in Row 29.
Question 3 asks whether the Nutrition Education Rate in June 2020 was higher, lower, or about the same as one year earlier in June 2019.
To calculate the No-Show rates for June 2019 and June 2020, “(6) No-Show Rate” tab asks for:
the number of completed WIC certification appointments; and
the number of scheduled WIC certification appointments.
The number of scheduled certification appointments should include every scheduled certification appointments, including the appointments which were re-scheduled.
Position |
Column B |
Column C |
Rows 6-13: Enter the numbers from June 2020 |
Enter the number of completed WIC Certification Appointments by corresponding sub-categories indicated in Column A |
Enter the number of scheduled WIC Certification Appointments by corresponding sub-categories indicated in Column A
|
Rows 19-26: Enter the numbers from June 2019 |
Enter the number of completed WIC Certification Appointments by corresponding sub-categories indicated in Column A |
Enter the number of scheduled WIC Certification Appointments by corresponding sub-categories indicated in Column A
|
Do not enter anything in Column D. Column D will automatically populate the No-Show Rate using the below formula.
However, even if your SAs cannot provide every number requested, please try to answer the question 3 in Row 29.
Question 3 asks whether the No-Show Rate in June 2020 was higher, lower, or about the same as one year earlier in June 2019.
The WIC MIS Data Pull Form will assist SAs in fulfilling their FFCRA waiver-related reporting requirements and provide valuable insights on the impact of COVID-19 and the FFCRA waivers on WIC. If your SA is unable to obtain any specific data requested in the form, please provide an explanation in the Comment box on the respective tab and notify [CONTRACTOR CONTACT] within 5 business days after the receipt of the form to discuss alternative data collection options. If you have any questions about the form or the information required to complete it, please contact [CONTRACTOR CONTACT]. The FNS points of contact for this collection are Alex Bush (Alexander.Bush@usda.gov) and Hunjin Lee (Hunjin.Lee@usda.gov).
We appreciate your time and work to complete the WIC MIS Data Pull Form and for your dedication to serving the participants of the WIC Program.
This information is being collected to assist the Food and Nutrition Service in response to requirements in the Families First Coronavirus Response Act. This is a voluntary collection and FNS will use the information to respond to Congressional requirements identified in the Act. This collection does not request any personally identifiable information under the Privacy Act of 1974. According to the Paperwork Reduction Act of 1995, an agency may not conduct or sponsor, and a person is not required to respond to, a collection of information unless it displays a valid OMB control number. The valid OMB control number for this information collection is 0584-xxxx. The time required to complete this information collection is estimated to average 1.5 hours per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden, to: U.S. Department of Agriculture, Food and Nutrition Service, Office of Policy Support, 1320 Braddock Place, 5th Floor, Alexandria, VA 22314 ATTN: PRA (0584-xxxx). Do not return the completed form to this address.
File Type | application/vnd.openxmlformats-officedocument.wordprocessingml.document |
Author | Lee, Hunjin - FNS |
File Modified | 0000-00-00 |
File Created | 2022-01-31 |