WIC Program Monitoring

Program monitoring is a routine, quality assurance function the WIC program uses to ensure high-quality, consistent services are provided to the communities we serve across Washington state and participating Tribal Nations.

The monitoring process is performed for every local agency at least once every two years. The monitor must include at least 20% of the clinic sites or one clinic site for each agency, whichever is greater. They are conducted remotely or onsite as determined by the state monitor staff.

Goals of the monitor:

  • Identify areas of strengths and improvement for local agencies, working collaboratively to address areas of opportunity.
  • Identify areas of common confusion across local agencies to improve state policy and processes.
  • Ensure consistently good service to all WIC-eligible Washington residents.
  • Quality control for adherence to WA state WIC policy as outlined in the policy manual and mandated by the federal Food Nutrition Service (FNS).

Want to stay up to date with the latest information on Washington State WIC Program Monitoring?

Sign up for WIC Program Monitoring listserve

Current Program Monitors in Washington

DOH State WIC Common Trends Report

What is the WIC Monitoring Process?

Frequently Asked Questions About the Monitor Process

Resources for Local Agencies

Current Program Monitors in Washington

  • Community Health of Central Washington
  • Chelan-Douglas Health District
  • Clallum County Health & Human Services
  • Confederated Tribe of Colville Reservation
  • Columbia Valley Community Health
  • Family Health Centers
  • Grays Harbor County Public Health & Social Services Department
  • Jefferson County Public Health
  • Kitsap Community Resources
  • Klickitat County Public Health Department
  • Lewis County Public Health & Social Services Department
  • Lincoln County Health Department
  • Lower Elwha Klallam Tribe
  • Multi-Care Health System
  • NE Tri-County Health District
  • Pacific County Public Health & Human Services Department
  • Pregnancy Aid of Snohomish County
  • Puyallup Tribe Health Authority
  • Quinault Indian Nation
  • Quiluete Tribe
  • Sea-Mar Community Health Center
  • Seattle Indian Health Board
  • Skamania County Community Health Department
  • South Puget Intertribal Planning Agency
  • Spokane Regional Health District
  • Spokane Tribe of Indians
  • Tulalip Tribe Health Clinic
  • Skagit CO PHD #304 United General Hospital
  • Wahkiakum County Health & Human Services
  • West Central Community Development Association

Previous FFY 2023 Monitor Common Trends Summary

The WIC program monitor team completed program monitors for half of local agency each year.

The following is a list of the common trends that agencies had on their monitor reports in FFY 2023.

  • Missing Local Agency, Policies, Agreements, Approvals and other Required Documents
    • Including lack of good tracking and storage system for these documents
  • Missing assessment for and documentation of needed referrals
    • Including not referring to WIC RDN per policy
  • Staffing and Management Issues that impact WIC services and Access
    • High staff turnover
  • Missing Incomplete/Inconsistent Documentation
    • Missing dietary and health assessment documentation
    • Missing Care Plan Notes per policy, including Farmer’s Market Nutrition Program and Breastfeeding Reviews
    • Documenting in family care plan when should be in individual care plan.
  • Incomplete Dietary & Health assessment
    • Skipping substance use, food insecurity, and safety questions
    • Not fully exploring Health conditions, Anthropometric measures, or Hemoglobin & Lead status.
    • Not asking probing questions as needed to fully assess risk
  • Missing & Improperly Assigned Risks
    • Related to incomplete dietary & health assessments or not asking clarifying questions.
    • Related to misunderstanding of the risk.

April 2024 Q&A: Program Monitoring for Local Agencies (youtube.com)

March 2024 Q&A: Program Monitoring Q&A for Local Agencies - (youtube.com)

January 2024 Q&A: Program Monitoring (youtube.com)

December 2023 Q&A: Program Monitoring (youtube.com)

October 2023 Q&A: Common Trends (youtube.com)

If you have any questions about the information on this page or the WIC monitor process, please submit a question for the State WIC Program Monitoring Unit or email us at WICProgramMonitoring@doh.wa.gov.


What is the WIC Monitoring Process?

The monitor is not meant to be a punishment or punitive in any way. It is meant to be informative for both the state and the local agency.

The monitor provides quality assurance for adherence to Washington State WIC Policy and federal Food and Nutrition Service (FNS) Policy. Monitoring is a requirement of FNS – and each clinic must be monitored at least every two years. FNS can request that the state monitor more often as needed.

The monitor is meant to:

  • Identify areas of strength and improvement for local agencies
  • Identify areas of common confusion, which can help state improve our policies and processes.
  • Ultimately, our main goal is to ensure consistently good service to all WIC eligible Washington residents. We want clients and potential clients to expect the same level of quality WIC service statewide.

Please note: In 2024, we are adding an onsite component to monitoring to better assess clinic environment and customer services while aligning with new requirements to offer both in person and remote services.

The monitor team runs on the Federal Fiscal Year (FFY) schedule.

Q1: October-December

  • State Program Monitors wrap up Common Trends from the previous FFY and prepare for the current monitoring process to begin.
  • The state WIC office updates website and training materials, tools based on feedback and policy changes, and presents Common Trends to other state WIC office units to improve processes.
  • We welcome feedback from local agencies on how to improve the tools, resources, and monitoring process to reduce burden on staff. To submit feedback, email WICProgramMonitoring@doh.wa.gov.

Q2: January-March

  • By mid-January, State Program Monitors will notify local agencies of a monitor for the fiscal year.
  • Agencies have until March 1 to submit their documents on the checklist. The state monitor staff will send reminder emails to all or non-responsive local agencies as needed. Late submissions are taken into consideration as an area for improvement in the monitor.

Q3: April-June

  • In the first two weeks of April, agencies receive an email with next steps and observation instructions.
  • By June 1, the state must perform remote or in person observations of Certification appointment(s) completed by a Certifier and High-Risk appointment(s) completed by a Registered Dietitian Nutritionist.
  • The State Program Monitors are coordinating observations, reviewing submitted documents, performing chart reviews of participant files, and working with other state staff to capture needed information.
  • The State Program Monitor uses the Monitor Evaluation Tool to review the local agency’s overall compliance to state policy with the data gathered throughout the monitor process.

Q4: July-September

  • The State Program Monitor schedules a debrief with local agencies between July 1 through August 1 to discuss strengths, weaknesses, opportunities, and threats (SWOT) for the local agency.
  • Within five business days after the debrief, the Monitor Report is approved by the State Program Monitor Supervisor and sent to local agencies with their local program consultant (LPC) and breastfeeding peer counseling consultant (BFPCC) copied on the email.
    • The local agency has 20 business days from receiving the monitor report to submit their plan for improvement in the identified areas of weakness.
    • The State Monitor Staff will approve the plan or send it back to the local agency with comments for editing.
    • All plans must be final by September 30 as required by federal law. This is high priority for local agencies.
    • If local agencies are non-responsive to any step of the monitor process, state monitor staff may engage state WIC leadership and local agency leadership to discuss the issue.

Frequently Asked Questions About the Monitor Process

We encourage local agencies to reach out to the state office for clarity and guidance on the monitoring process. We offer a virtual opportunity to email or ask questions and connect with other local agencies on the fourth Thursday of each month, between 1-2 p.m. For a list of frequently asked questions or to submit questions about the monitoring process, see the Local WIC Clinic Monitoring FAQ meeting webpage.

Resources for Local Agencies

Resources for your monitoring and observation process

If you have any questions about the information on this page or the WIC monitor process more generally, please contact: WICProgramMonitoring@doh.wa.gov.