“It Was Actually Pretty Easy”: COVID‐19 Compliance Cost Reductions in the WIC Program

Abstract

In recent years, scholars have examined the barriers to accessing public assistance benefits. Research identifies learning, compliance, and psychological costs as deterring program use. Compliance costs reflect the burdens of following program rules, which may entail providing documentation, responding to discretionary demands of bureaucrats, or attending appointments to maintain benefits. Studies identify one element of compliance costs—quarterly appointments—as a barrier to continued WIC participation. This article draws on 44 in‐depth qualitative interviews with participants in the Special Supplemental Nutrition Assistance Program for Women, Infants, and Children (WIC). We examine how WIC participants perceive the reduction of compliance costs following the implementation of remote appointments in response to the COVID‐19 pandemic. WIC participants report satisfaction with remote appointments and a reduction in the compliance costs of accessing and maintaining benefits. We conclude by recommending longer term changes to policy and practices to increase access and continuity in WIC receipt.

Federal Food Assistance Program Participation during the COVID-19 Pandemic: Participant Perspectives and Reasons for Discontinuing

“…Such flexibilities that reduce virus exposure for SNAP- and WIC-eligible individuals are particularly important given the disparities in COVID-19 infection rates driven by unequal heightened infection risks occurring among non-White and low-income households [ 12 , 13 , 14 , 15 ] who are also disproportionately impacted by food insecurity [ 16 , 17 ]. The literature shows that WIC participants are interested in telehealth options to address documented participant burdens, including travel to WIC clinic locations [ 18 ], clinic wait times [ 19 ], and finding time for appointments during clinic hours [ 20 , 21 , 22 ]. As further evidence of the importance of physical presence flexibilities for WIC participants, all states that did not have WIC electronic benefits transfer systems [ 23 ] in place prior to the onset of the pandemic and experienced resultant delays in transitioning to remote benefit issuance experienced declines in WIC participation early in the COVID-19 pandemic.…”

‘I don’t know nothing about that’: How “learning costs” undermine COVID-related efforts to make SNAP and WIC more accessible

“…Further, evidence suggests that these costs burden the most vulnerable and marginalized (Barnes & Henly, 2018; Chudnovsky & Peeters, 2021; Nisar, 2018) who lack the cognitive and human capital to successfully navigate these costs (Christensen et al, 2020; Döring, 2021; Herd, 2015). Given the crucial role of administrative burdens in shaping access to public benefits, examining administrative burdens, and the policy changes designed to reduce these burdens, have risen in importance during the COVID-19 pandemic (Baekgaard et al, 2021; Barnes & Petry, 2021).…”

Pandemic-Era WIC Participation in Wilmington, Delaware: Participants’ Experiences and Challenges

“…Although most participants in our sample had positive perceptions of the remote appointments, a few participants recalled that they faced difficulties communicating with WIC staff over the phone and missed certain aspects of in-person appointments (i.e., forming relationships with doctors). Mixed perceptions of remote appointments have also been identified in prior studies [ 12 , 33 ]. Thus, research suggests that moving forward, implementation of hybrid WIC service and appointment options may be warranted [ 23 , 38 ].…”

“…Specifically, participants perceived the remote appointments to be more efficient, and safer, than in-person appointments. Research conducted prior to the pandemic indicated that certain aspects of in-person appointments (e.g., long wait times, leaving the house with children) were burdensome for participants and made appointment attendance challenging [ 12 , 17 ]. More recent research, which was conducted after pandemic-related WIC program modifications were enacted, found that many participants were satisfied with remote options and prefer them over traditional in-person appointments [ 12 , 13 , 23 ].…”

“…A large body of previous research demonstrates that WIC participants often face difficulties with in-store benefit redemption [ 10 , 11 , 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 ]. Several factors have been shown to contribute to these redemption challenges including a lack of accurate, consistent shelf labeling [ 10 , 11 , 17 , 18 , 19 , 20 , 21 ], low stock of WIC-approved foods [ 11 , 15 , 16 , 20 , 22 , 23 ], issues at the checkout (i.e., perceived stigma and long waiting times) [ 10 , 11 , 17 , 24 ], confusion about WIC-eligible items (i.e., brands and sizes) [ 17 , 24 ], and inconsistencies between the register and the information participants receive from the program/WIC apps, particularly following program and policy changes [ 20 , 22 , 24 ].…”