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.  Monitoring is meant to be informative for both the local agency and state office, not punitive in any way.

The monitoring process is required by Washington State WIC Policy and federal Food and Nutrition Service (FNS) Policy.  Monitoring must be performed for each local agency at least every two years and must include 20% of the clinic sites or one clinic site per agency, whichever is greater. FNS may request the state monitor more often as needed. Some monitoring activities must occur onsite and in person while others may be conducted remotely, as determined by state monitor staff.

Goals of the monitor:

• Identify areas of local agency strength and opportunities for improvement
• Work collaboratively to address gaps in consistently good service to all WIC-eligible Washington residents.
• Identify areas of common confusion across local agencies to improve state policy and processes.
• Quality control for adherence to Washington State WIC policy and as mandated by the federal Food Nutrition Service.

Current Program Monitors in Washington

What is the WIC Monitoring Process?

DOH State WIC Common Trends Report

Resources for Local Agencies

2025 Program Monitors in Washington

Previous FFY 2023 Monitor Common Trends Summary

FFY 2024 Common Trends:

General Observations

• WICHealth.org not used due to poor follow-up processes.
• Use of unapproved abbreviations in care plan documentation.
• LA's not utilizing video opportunity/platforms for participants to provide proofs.
• Some agencies without a WIC Coordinator.
• Some agencies without an RDN to complete HR appts.
• Not completing all self-evaluation tasks.

Documentation Issues

• Missing documentation of dietary and health assessment questions.
• Missing nutrition care plans (for cert, sub-cert, or NE contacts), HRCP, FMNP, and BFR review documentation.
  • Putting notes in family care plans when should be in the individual care plan.
• Wide range of unapproved abbreviations used in documentation.
• Missing goals and follow up discussion documentation.

Missing Referral Assessment & Documentation

• Inconsistent or incomplete referral documentation to all mandated referrals at every certification and subsequent certification.
• Staff not assessing for and referring to Help Me Grow WA Network/local referrals, Medicaid, Immunizations, and substances abuse counseling & treatment.
• Inconsistent assessment and documentation of immunization status for infants and children 24 months of age or less.

Appointment Issues

• Not asking all or some of the following requirements during appointments: 
  • Voter registration
  • Additional caregiver or proxy
  • Verbal R&R statement
  • Exploration of shopping experience or assessing WIC foods/changes to food package
  • Follow-up on previous goals or previous nutrition education

Anthropometrics & Hemoglobin

• Many local agencies are not obtaining weights, heights, or hemoglobin levels per policy.
• Per policy, required to follow-up with participant or doctor within 60-90 days, but this is not occurring.
• The plan for follow up and attempts to gain this information should be documented.
• Some clinics missing equipment necessary to complete Hgb checks and/or staff trained to complete so they're incorrectly marking "unable to obtain level" in Cascades.

Physical Environment & Onsite Visit Evaluation

• Equipment maintenance logs missing.
• Calibration of scales not being completed consistently per policy.
• Signage outside building identifying WIC location is missing, unclear or outdated.
• Clinic information not updated with state WIC (hours, address, etc.). WIC Staff and Clinic Change Form

Missing Local Agency Policies, Agreements, Approvals, and Other Required Documents

• Many late, outdated, or missing altogether (greater than 2 years old, some referring to WIC checks still).
• Inconsistent naming and file type makes it hard for monitoring staff to confirm everything is present.
• Lack of good tracking & storage system for required documents.
• Missing training logs for all staff.

Staff and Local Agency Management Issues Impacting WIC Services & Access

• Anxiety and fear during biennial monitor due to high administrative burden & perceived risk to funding.
• High staff turnover.
  • Inexperienced coordinators struggle to complete admin tasks
  • Trouble with RDN hiring and retention
• Skipping required self-evaluation.
  • Hard with staff of one
  • Still required per CFR

FMNP Issues

• No documentation at all of issuing FMNP benefits or documentation is placed in family care plan versus individual care plan.
• Missing fruit and vegetable FMNP nutrition education and documentation.
• FMNP policy not detailed per WA WIC policy.
• Not contacting state by the August date to reallocate unspent FMNP funds.

BFPC Program

• Missing family alerts.
• Missing frequency of contacts requirements.
• Missing documentation in care plan.

What is the WIC Monitoring Process?

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.

Resources for Local Agencies

Resources for your monitoring and observation process

• Join the monthly WIC Update Webinar for local agency staff
• WIC Program Monitoring Information for WIC Local Agencies on SharePoint
• WA WIC Program Monitor Trainings:
  • WA WIC Monitor Introduction and Policy (YouTube)
  • WA WIC Monitor Process (YouTube)
  • WA WIC Evaluation Tool and Monitor Report (YouTube)
  • WA WIC Validation (YouTube)
• WIC Code of Federal Regulations
• WIC Policy Volume 2 Chapter 6 Monitoring and Audits
• WIC Local Agency Self Evaluation Toolkit (Excel)
• WIC Local Agency SharePoint site

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