Dual Participation, Participant Rights and Responsibilities, Fair Hearing Procedures, and Sanction System


  1. 1. Dual Participation (WIC only or WIC/CSFP)
  2. 2. Participant Rights and Responsibilities
  3. 3. Fair Hearing and Sanction System

1. Dual Participation (WIC only or WIC/CSFP)

  1. The State agency has written procedures to prevent and detect dual participation within each local agency and between local agencies
    • Yes (Please attach any descriptions of policy in Appendix or cite appropriate section(s) of the Procedure Manual)  - Checked
    • No
  2. The State agency has a written agreement with the Commodity Supplemental Food Program that includes specific procedures for the detection and prevention of dual participation (attach a copy of the agreement or provide a citation of where a copy is located)
    • Yes - Checked
    • No
    • Not applicable
  3. The State agency has a written agreement with the Indian State agency(ies) or other geographic State agencies in close proximity for the detection and prevention of dual participation (attach a copy of each applicable agreement or provide a citation of where a copy is located)
    • Yes
    • No  - Checked
    • Not applicable
  4. The State agency has established procedures to handle participants found in violation due to dual participation
    • Yes (Please attach any descriptions of policy in Appendix or cite Procedure Manual)  - Checked
    • No

ADDITIONAL DETAIL: Certification and Eligibility Appendix and/or Procedure Manual (citation): WIC PPM Part 3 Certification Standards, Part 18

2. Participant Rights and Responsibilities

  1. The State agency has uniform notification procedures that are used by all local agencies statewide
    • Yes  - Checked
    • No
  2. The State agency requires all local agencies to inform applicant/participant of his/her rights and responsibilities in written form
    • Yes  - Checked
    • No
  3. The State agency has implemented a policy of disqualifying participants for not picking up food instruments:
    • Yes  - Checked
    • No
    • Not applicable
    • If yes, the policy is communicated to participants in the participant rights and responsibilities materials
      • Yes  - Checked
      • No
      • Not applicable
  4. The State agency has developed special notification policies and procedures for the following:
    • applicant/participant who cannot read  - Checked
    • applicant/participant who speaks in a language other than English  - Checked
    • homeless
    • migrants
    • persons with disabilities
    • other (specify):
  5. The State agency requires all local agencies to provide notification of participant rights and responsibilities in the following situations:
    • eligibility at each certification  - Checked
    • ineligibility at initial certification  - Checked
    • mid-certification disqualification  - Checked
    • expiration of a certification period  - Checked
    • waiting list status  - Checked
    • other (specify):

ADDITIONAL DETAIL: Certification and Eligibility Appendix and/or Procedure Manual citation): WIC PPM, Part 3, Section 17

3. Fair Hearing and Sanction System

  1. The State has a law or regulation governing participant appeals
    • Yes - Checked
    • No
  2. The State agency has established statewide fair hearing procedures
    • Yes; attach fair hearing procedures for participants or specify the location in the Procedure Manual and reference below.  - Checked
    • No
  3. State or local agency actions against participants include (check all that apply):
    • reclaiming the value of improperly received benefits  - Checked
    • disqualification from the program for up to one year  - Checked
    • suspension from the program mid-certification
    • other (specify):
  4. Appeal hearings are held at:
    • WIC State agency parent agency
    • other State agency or hearing board (specify):
    • local WIC agency  - Checked
    • other (specify):
  5. Statewide fair hearing procedures include (check all that apply):
    • request for hearing - Checked
    • local agency responsibilities  - Checked
    • denial or dismissal of request - Checked
    • continuation of benefits  - Checked
    • rules of procedure - Checked
    • responsibilities of hearing official  - Checked
    • fair hearing decision - Checked
    • judicial review - Checked
    • other (specify):
  6. State agency procedures require written notification for (check all that apply):
    • appeal rights
    • request for hearing  - Checked
    • denial or dismissal of request
    • notice of hearing  - Checked
    • termination within certification period - Checked
    • fair hearing decision  - Checked
    • judicial review
    • other (specify):
  7. The State agency has established timeframes to govern each step of the hearing process
    • Yes - Checked
    • No
  8. The State agency requires all local agencies to document any notification/correspondence in the participant's file
    • Yes - Checked
    • No
  9. The State agency has a written sanction policy for participants
    • Yes (If yes, provide appropriate citation below)  - Checked
    • No
  10. The State agency has established procedures which determine the type and levels of sanctions to be applied against participants
    • Yes - Checked
    • No

ADDITIONAL DETAIL: Certification and Eligibility Appendix and/or Procedure Manual (citation): WIC PPM , Part 3, Section 18