A first step toward improving health in California is making sure mothers and their children have enough to eat. The Special Supplemental Nutrition Program for Women, Infants, and Children program, commonly referred to as WIC, is designed to meet that aim.
The program is associated with reduced infant deaths, fewer premature births and lower health care costs, among other health benefits. While six million women, infants, and children across America participate in WIC, there is still opportunity to amplify its reach and impact. Nationally, just over 50 percent of people eligible for WIC are enrolled.
WIC is needed and effective. However, there are multiple barriers to accessing services. One significant reason WIC is underutilized is the administrative burden the program imposes on referring agencies and families when it comes to enrollment and recertification. Even today, most referrals are managed by fax and paper. By modernizing how health data is shared with local WIC agencies, we can increase program enrollment, enhance care coordination with health care providers and improve the health of high-risk, underserved populations.
In California, WIC enrollment is among the highest in the nation with over 66 percent of those eligible enrolled. This creates opportunities for the state to inform best practices nationwide. State-led and local WIC data sharing initiatives are demonstrating how streamlined data sharing and collaboration can contribute to identifying and enrolling eligible families into the WIC program. Here’s how:
Easier referrals
Privacy and consent rules limit the data that WIC can share with other agencies about enrollees. But innovative “one-way” data sharing approaches are proving to be immensely successful. For example, one WIC agency in Santa Cruz collaborated with a care coordination referral platform and the local health information organization to implement electronic referrals. Through this partnership, electronic referrals are now routed directly from providers to WIC agency staff in real-time. WIC staff can also readily access clinical information, resulting in timely enrollment and recertification.
Another approach in San Francisco links the local WIC agency with EPIC, an electronic health records software. Health care providers can now refer patients to WIC electronically, and San Francisco’s WIC agency can contact families with pre-filled applications using read-only information in EPIC.
Linking WIC and Medi-Cal data
To identify eligibility gaps, California’s WIC division teamed up with Medi-Cal, the state’s Medicaid program, on a data linkage project. Their efforts resulted in the discovery of 500,000 WIC-eligible children who were enrolled in Medi-Cal, but not in WIC. This data-driven revelation allowed the state agency to share aggregated information with local WIC agencies to conduct tailored, more effective outreach to drive enrollment.
Beginning in 2024, California is also requiring Medi-Cal managed care plans to identify WIC-eligible members and support enrollment, further driving access through data integration.
Improving how data is shared with WIC strengthens the program’s connections with the health care delivery system. This creates opportunities for WIC enrollees to receive better care coordination and access to services.
Federal policy changes
Policy changes at the federal level also help local WIC agencies engage in data initiatives to remove barriers and better serve their clients. For example, the U.S. Department of Agriculture has issued guidance to state WIC agencies aimed at making data sharing with other state programs and health care providers easier to support WIC enrollment. Using funding and authority in the American Rescue Plan Act of 2021, the department has also allocated funds to modernize WIC through technology and data sharing initiatives and extended the option of providing services remotely.
Improving access for high-risk populations
WIC is a proven benefit that could help twice as many Americans as it does currently. States and health systems should make increasing enrollment in their WIC programs a top priority. To enact change in California, WIC agencies can participate in and build upon the pioneering statewide data exchange effort launched in 2022 known as the Data Exchange Framework, and the Medi-Cal overhaul initiative CalAIM. Programs in other states can look to data sharing initiatives underway across health and human services agencies to advance data linkages.
While each state and region has its own initiatives, policies, and innovations, what’s true everywhere is that data sharing, especially when layered into care coordination processes, is a promising practice for higher WIC enrollment and utilization. The resulting ability to center patients and meaningfully improve access to care for high-risk, underserved populations is a goal that we should all be striving to achieve.
Karen Farley is executive director of the California WIC Association.
Timi Leslie is executive director of Connecting for Better Health and president of the health care consultancy BluePath Health.
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