The following words and terms, when used in this part, have
the following meanings, unless the context clearly indicates otherwise:
Above-50-percent-store-A store that derives
more than 50% of its annual food sales revenue from WIC checks, and a new store
applicant expected to meet this criterion under guidelines approved by
USDA-FNS.
Allowable foods-Foods and infant formula on
the WIC food list. These products meet nutritional standards established by the
USDA-FNS and are authorized by the Department for purchase with WIC
checks.
Applicant-An individual applying to become
a participant.
Authorization-The grant of authority to a
store to serve as a WIC authorized store.
Authorized representative-
(i) For an applicant or participant, a parent
or guardian of an applicant or participant who is an infant or child, a proxy
or endorser, or an individual designated to represent the applicant or
participant in administrative proceedings involving the WIC Program.
(ii) For a store, an individual designated by
the store to represent it in administrative proceedings involving the WIC
Program.
(iii) For a compliance buy
or WIC transaction review, the person conducting the compliance buy or WIC
transaction review.
Breastfeeding woman-A woman, during 1 year
postpartum, who is breastfeeding her infant.
Certification-The Department's acceptance
of an applicant to participate in the WIC Program as a participant.
Child-A person 1 year of age or older but
under 5 years of age.
Claim-A demand for reimbursement of an
overcharge or other improper charge to the WIC Program as a result of a store
violation.
Clinic-A facility where applicants apply
for and participants receive WIC Program services other than food
benefits.
Competitive price-The price established by
the Department, at or below which a store shall maintain the required minimum
inventory.
Compliance buy-A covert purchase at a WIC
authorized store, with a WIC check, conducted to enable the Department to
evaluate adherence by a WIC authorized store with this part governing the
store's participation in the WIC Program.
Compliance investigation-A series of at
least two compliance buys conducted at the same WIC authorized store.
Competent professional authority-
(i) An individual on the staff of the local
agency authorized to determine nutritional risk and prescribe supplemental
foods. The following persons are the only persons the Department will authorize
to serve as a competent professional authority: physicians, nutritionists
(Bachelor's or Master's Degree in Nutritional Sciences, Community Nutrition,
Clinical Nutrition, Dietetics, Public Health Nutrition or Home Economics with
emphasis on nutrition), dieticians, registered nurses, physician's assistants
(certified by the National Committee on Certification of Physician's Assistants
or certified by the State medical certifying authority), or State or local
medically trained health officials.
(ii) The term also applies to an individual
who is not on staff at the local agency but who is qualified to provide data
upon which nutritional risk determinations are made by a competent professional
authority on staff of the local agency.
Contract brand-The specific manufacturer
brand of an allowable food that the Department is contractually bound to
prescribe for participants.
Department-The Department of Health of the
Commonwealth.
Disqualification-
(i) For the purposes of this chapter and
1103, 1105, 1107, 1109 and 1113, the term means the action by the Department to
end participation of a WIC authorized store in the WIC Program for reasons of
fraud, abuse or other violations of this part governing the store's
participation in the WIC Program.
(ii) For purposes of Chapter 1111 (relating
to applicant and participant appeals), the term means action by the Department
or local agency to end participation of a participant who no longer meets the
qualifications necessary to participate in the WIC Program or for reasons of
fraud, abuse or violation of standards governing the participant's enrollment
in the WIC Program.
Division of WIC-Division of WIC in the
Department.
Endorser-The parent or guardian of an
infant or child participant who is authorized to use and sign the WIC checks of
the infant or child for purchase of allowable foods.
Filing date-The date on which the local
agency or the Department receives an appeal.
Food items-Items sold for human consumption
that are eligible for purchase under the Food Stamp Program.
Food prescription-A designation by a
competent professional authority of allowable foods in specified quantities to
meet a participant's nutritional needs based upon a determination of
nutritional risk.
Food sales-
(i) Sales of all Food Stamp Program eligible
foods intended for home preparation and consumption, including meat, fish, and
poultry; bread and cereal products; dairy products; fruits and
vegetables.
(ii) Food items such as
condiments and spices, coffee, tea, cocoa and carbonated and noncarbonated
drinks may be included in food sales when offered for sale along with foods in
the categories identified in this definition.
(iii) The term does not include the sale of
any item that cannot be purchased with food stamp benefits, such as hot foods
or food that will be eaten in the store.
Food Stamp Program-The government benefits
program operated under the authority of the Food Stamp Act of 1964 (7 U.S.C.
Chapter 51) and 55 Pa. Code Part II, Subpart L (relating to Food Stamp
Program), and administered by the USDA-FNS and the Department of Public
Welfare.
Full line grocery store-A store
that:
(1) Offers for sale, in addition
to WIC authorized foods,
food items from each of the following four food
categories on a continuous basis:
(i) Meat,
poultry or fish.
(ii) Bread or
cereal.
(iii) Vegetables or
fruits.
(iv) Dairy.
(2) Has available for sale at all
times of operation and displays in a public area of the store, a minimum of
three different varieties of food items in each of the four above listed food
categories.
Health services-Routine pediatric and
obstetric care (such as infant and child care and prenatal and postpartum
examinations) or referral for treatment.
High risk store-A store identified as a
possible perpetrator of fraud or abuse through analysis of redemption patterns
of WIC checks or WIC sales, or by complaints of participants or WIC Program
staff.
Infant-A person under 1 year of age.
Inventory audit-A comparison of a WIC
authorized store's inventory levels of a particular allowable food over a
specific period of time, to purchases of the allowable food with WIC checks
during the same period of time, to determine if the store had a quantity of the
allowable food available for sale during that time sufficient to support its
claim for reimbursement for the sale of the allowable food.
Local agency-A public or private nonprofit
health or human service agency with which the Department contracts to provide
WIC Program services for a specific geographic area.
Maximum allowable price-The maximum price
the Department will pay for an allowable food.
Nutritional risk-A determination that one
of the following exists:
(i)
Detrimental or abnormal nutritional conditions detectable by biochemical or
anthropometric measurements.
(ii)
Other documented nutritionally related medical conditions.
(iii) Dietary deficiencies that impair or
endanger health.
(iv) Conditions
that predispose persons to inadequate nutritional patterns or nutritionally
related medical conditions.
Onsite review-A visit to a store by
Federal, Department or local agency personnel to determine if the store meets
the selection criteria necessary to be a WIC authorized store, or a visit to a
WIC authorized store to determine whether the store is complying with this part
governing the store's participation in the WIC Program. An onsite review may be
announced or unannounced.
Overcharge-A charge by a WIC authorized
store to the WIC Program through redemption of a WIC check for an allowable
food in excess of the store's shelf price for that food or in excess of the
price charged a non-WIC participant for that food.
Overpayment-Payment to a WIC authorized
store of a WIC check redeemed by the store in an amount in excess of the amount
to which the store was entitled based upon the maximum allowable price
applicable to the store's peer group for each allowable food authorized for
purchase on the WIC check.
Participant-A pregnant woman,
breast-feeding woman, postpartum woman, infant or child enrolled in the WIC
Program.
Participant certification period-The period
of time during which an individual is authorized to participate in the WIC
Program.
Peer group-The classification of an
authorized store under the store peer group system, as determined by the
criteria selected by the Department, including size of a store sales floor,
number of cash registers in the store, number of stores owned, and county where
the store is located.
Periodic review-Contemporaneous announced
onsite reviews of stores in a trade area conducted not less than once every 3
years to select stores for reauthorization.
Postpartum woman-A woman, during 6 months
after termination of pregnancy.
Pregnant woman-A woman determined to have
one or more embryos or fetuses in utero.
Premises-The sales floor and storage areas
within the building housing the WIC authorized store.
Price adjustment-The retroactive reduction
in the amount paid for a redeemed check as a result of a determination of
overpayment.
Probationary authorization-The Department's
probationary authorization of a WIC authorized store when inadequate
participant access would occur if the store were not authorized or reauthorized
or when the store is reviewed prior to opening to the public and has not yet
stocked its dairy section or its frozen juice section.
Proxy-A person authorized by the local
agency and the participant, or by the participant's parent or guardian if the
participant is an infant or child, to pick up or use WIC checks to make
purchases for that participant.
Reauthorization-The Department's renewal of
authorization.
Redemption-Submission of a WIC check by a
WIC authorized store to its bank for the purpose of securing a money payment
for the amount appearing in the "Pay Exactly" box on the WIC check.
Routine review-An unannounced onsite review
of a WIC authorized store to evaluate adherence by the store with the
requirements in this part governing the store's participation in the WIC
Program.
Sales floor-The display shelving, the floor
in the area normally used for retail trade and the area behind the customer
service desk, excluding other areas not accessible to the general
public.
Sanction-
(i) A penalty imposed by the Department upon
a WIC authorized store for violation of this part governing the store's
participation in the WIC Program.
(ii) The term does not include a decision to
deny authorization or reauthorization following an announced onsite review.
Secretary-The Secretary of the
Department.
Selection criteria-Criteria in §
1103.4 (relating to selection
criteria for authorization and reauthorization) which the Department has
established which a store seeking to be authorized or reauthorized is required
to satisfy.
Stale-dated-After the date imprinted on the
product as the recommended last date for sale or use.
Standard formula-Infant formula products
that do the following:
(i) Meet the
Federal WIC regulatory definition of an iron-fortified formula (7 CFR
246.10(c)(1)(I) (relating to
supplemental foods)).
(ii) Comply
with the
Infant Formula
Act of 1980, the
act of September 26, 1980 (Pub. L. No.
96-359, 94 Stat.
1190), which amended the Food and Drug
Act.
(iii) Meet the requirements of an "infant
formula" as opposed to an "exempt infant formula" or "medical food" as
determined by the Food and Drug Administration (FDA), United States Department
of Health and Human Services.
Store peer group system-A classification of
authorized stores into groups based on common characteristics or criteria
including size of a store sales floor, number of cash registers in the store,
number of stores owned, and a measure of geography, such as metropolitan or
other statistical areas that form distinct labor and product markets that
affect food prices, for the purposes of applying appropriate competitive
pricing criteria to stores at authorization and reauthorization and limiting
payment for foods to competitive levels.
Store violation-Intentional or
unintentional action by the owners, officers, managers, agents or employees of
a WIC authorized store that violates the requirements in this part governing
the store's participation in the WIC Program and that may result in a
claim.
Temporary authorization-The Department's
temporary and conditional authorization of a WIC authorized store that fails to
meet specified selection criteria during the initial onsite review for purpose
of reauthorization.
Trade area-A designated geographic area
within the geographical area assigned to a local agency, which is organized to
serve the participant populations in that designated area.
USDA-FNS-The United States Department of
Agriculture, Food and Nutrition Service.
WIC authorized store-A retail food store
which is authorized or reauthorized in accordance with §
1103.1 (relating to authorization
and reauthorization process and requirements) to provide allowable foods to
participants by accepting WIC checks.
WIC check-A negotiable instrument issued to
participants to purchase allowable foods at WIC authorized stores.
WIC food list-A list published by the
Department in the
Pennsylvania Bulletin of foods and infant
formula which may be purchased with WIC checks.
WIC identification card-A document issued
by the Department to a participant, which is used for identification purposes
and verification of eligibility to purchase allowable foods with WIC checks at
a WIC authorized store.
WIC Program-The Special Supplemental
Nutrition Program for Women, Infants and Children.
WIC Program benefits-Supplemental foods,
nutrition education and referral to health services.
WIC transaction-The presentation of a WIC
check by a participant or authorized representative to a WIC authorized store
resulting in the purchase of one or more of the allowable foods designated on
the check.
WIC transaction review-The presentation of
a WIC check by a Federal, Department or local agency representative to purchase
foods at a WIC authorized store, which does not result in the actual tender of
the WIC check or the purchase of the foods, to evaluate adherence by a WIC
authorized store with the requirements in this part governing the store's
participation in the WIC Program.
