Special Supplemental Nutrition Program for Women, Infants, and Children (WIC): Implementation of the Access to Baby Formula Act of 2022 and Related Provisions, 86545-86563 [2023-26641]
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86545
Rules and Regulations
Federal Register
Vol. 88, No. 239
Thursday, December 14, 2023
This section of the FEDERAL REGISTER
contains regulatory documents having general
applicability and legal effect, most of which
are keyed to and codified in the Code of
Federal Regulations, which is published under
50 titles pursuant to 44 U.S.C. 1510.
The Code of Federal Regulations is sold by
the Superintendent of Documents.
DEPARTMENT OF AGRICULTURE
Food and Nutrition Service
7 CFR Part 246
[FNS–2023–0027]
RIN 0584–AE94
Special Supplemental Nutrition
Program for Women, Infants, and
Children (WIC): Implementation of the
Access to Baby Formula Act of 2022
and Related Provisions
Food and Nutrition Service
(FNS), U.S Department of Agriculture
(USDA).
ACTION: Final rule with request for
comment.
AGENCY:
This rulemaking serves to
amend the Special Supplemental
Nutrition Program for Women, Infants,
and Children (WIC) Program regulations
by incorporating provisions of the
Access to Baby Formula Act of 2022 and
making related amendments. ABFA
establishes waiver authority for the
Secretary of Agriculture to address
certain emergencies, disasters, and
supply chain disruptions impacting
WIC, and adds requirements to State
agency infant formula cost containment
contracts to protect against disruptions
to the Program in the event of a recall.
The provisions focus on improving State
agencies’ ability to ensure continuity of
Program operations during emergency
periods (i.e., emergencies, disasters, and
public health emergencies) and supply
chain disruptions, while ensuring
access to Program benefits among lowincome pregnant and postpartum
participants, infants, and children up to
5 years of age who are at nutritional
risk.
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SUMMARY:
This rule is effective February
12, 2024. Written comments must be
received on or before February 12, 2024
to be assured of consideration. Online
comments submitted through the
Federal eRulemaking Portal on this rule
DATES:
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must be received on or before February
12, 2024.
ADDRESSES: The Food and Nutrition
Service, USDA, invites interested
persons to submit written comments on
this final rule. USDA seeks comment on
all aspects of this rule. Comments may
be submitted in writing by one of the
following methods:
• Federal eRulemaking Portal: Go to
https://www.regulations.gov. Follow the
online instructions for submitting
comments.
• Regular U.S. Mail: WIC
Administration, Benefits, and
Certification Branch, Policy Division,
Food and Nutrition Service, P.O. Box
2885, Fairfax, Virginia 22031–0885.
• Overnight, Courier, or Hand
Delivery: Allison Post, WIC
Administration, Benefits, and
Certification Branch, Policy Division,
Food and Nutrition Service, 1320
Braddock Place, 3rd Floor, Alexandria,
Virginia 22314.
• All written comments submitted in
response to this final rule will be
included in the record and will be made
available to the public. Please be
advised that the substance of the
comments and the identity of the
individuals or entities submitting the
comments will be subject to public
disclosure. FNS will make the written
comments publicly available on the
internet via https://www.regulations.gov.
FOR FURTHER INFORMATION CONTACT:
Allison Post, Chief, WIC
Administration, Benefits, and
Certification Branch, Policy Division,
Supplemental Nutrition and Safety
Programs, Food and Nutrition Service,
USDA, 1320 Braddock Place,
Alexandria, Virginia, (703) 457–7708 or
Allison.Post@usda.gov.
SUPPLEMENTARY INFORMATION:
I. Overview
On May 21, 2022, the President
signed the Access to Baby Formula Act
of 2022 (ABFA, Pub. L. 117–129) into
law. ABFA amends Section 17 of the
Child Nutrition Act of 1966 (CNA, 42
U.S.C. 1786) to (1) establish permanent
waiver authority to the Secretary of
Agriculture to address certain
emergencies, disasters, and supply
chain disruptions impacting WIC; and
(2) require WIC State agency infant
formula cost containment contracts to
include specific remedies to protect
against disruptions to the Program in
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the event of an infant formula recall.
This rule amends 7 CFR part 246 to
codify the provisions of ABFA and
implement related changes which will
strengthen WIC’s ability to address
emergency periods and supply chain
disruptions, particularly those
impacting infant formula. For the
purpose of this rule:
• emergency periods are defined as a
public health emergency declared by the
Secretary of Health and Human Services
and any renewal of such a public health
emergency; a presidentially declared
major disaster; or a presidentially
declared emergency, in alignment with
the definition set forth in ABFA.1 2
• supply chain disruption is defined
as a shortage of WIC supplemental
foods, including infant formula, that
limits WIC participants’ ability to
reasonably purchase WIC supplemental
foods benefits within a State agency’s
jurisdiction, as determined, and
declared by the Secretary, in alignment
with the definition set forth in ABFA.3
Specifically, this rulemaking will:
(1) Codify permanent, expanded
waiver authority of the Secretary to help
ensure continuity of WIC services
during emergency periods and supply
chain disruptions impacting WIC.
(2) Codify requirements for WIC State
agencies to include language in their
WIC infant formula cost containment
contracts that describes remedies in the
event of an infant formula recall,
including how an infant formula
manufacturer would protect against
disruption to supplemental food access
by WIC participants.
(3) Add a new provision that WIC
State agencies must include as a part of
the State Plan a ‘‘plan of alternate
operating procedures’’ in the event of an
emergency period, supplemental food
recall, or other supply chain disruption.
In the development of this rule, the
Department prioritized equity, access,
and nutrition security for WIC
1 Public Health Service Act, 42 U.S.C. 247d § 319
(2003). https://www.govinfo.gov/content/pkg/
USCODE-2019-title42/pdf/USCODE-2019-title42chap6A-subchapII-partB-sec247d.pdf.
2 Robert T. Stafford Disaster Relief and Emergency
Assistance Act, 42 U.S.C. 5121 et seq. § 102 (1988).
https://www.fema.gov/sites/default/files/
documents/fema_stafford_act_2021_vol1.pdf.
3 FEMA, ‘‘Disaster Declaration Process,’’ May
2011. Available online at: https://www.fema.gov/
pdf/media/factsheets/dad_disaster_declaration.pdf.
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applicants and participants.4 The
Department also recognizes that the rule
may impact WIC State agencies,
including Indian Tribal Organizations
(ITOs), local agencies, clinics, and WICauthorized vendors. Additionally, the
Department recognizes that the rule may
impact infant formula manufacturers.
While WIC is not designed to be a
disaster assistance program, this rule
aims to improve the continuity of
services and Program benefits and
access to supplemental foods for
participants during these unforeseen
circumstances. Relatedly, customer
service, participation, and retention, as
well as program integrity, have also
been considered in this rulemaking. To
support WIC State agencies in equitable
implementation of this rulemaking, FNS
plans to provide WIC State agencies
with technical assistance, which may
include guidance documents,
memoranda, webinars, and/or
presentations at conferences. In
addition, FNS will explore ways to
support WIC State agencies in providing
alternative languages and formats and
effective communication of program
changes, including with auxiliary aids
and services to participants and
vendors.
Given the need for swift
implementation of ABFA following
recent disruptions to the supply chain
and wide-ranging effects of the infant
formula recall, this is a final rule with
request for comments pursuant to the
Administrative Procedure Act’s
exemption on matters relating to agency
management or personnel or to public
property, loans, grants, benefits, or
contracts.5 It is imperative the
provisions are implemented as soon as
is feasible so that FNS and WIC State
agencies have mechanisms in place to
ensure continuity of operations and
access to Program benefits for WIC
participants. The Department has
requested comments on specific topics
in this rule that can inform future
rulemaking, policy, and/or guidance
related to infant formula and will
consider comments on all aspects of the
rule when developing guidance and
policy. Given the prescriptive nature of
ABFA and the need for swift
implementation ultimately in the
interest of WIC participants, the
4 U.S. Department of Agriculture, Food and
Nutrition Service, ‘‘Food and Nutrition Security.’’
Available online at: https://www.usda.gov/
nutrition-security#:∼:text=Nutrition%20
security%20means%20consistent%20access,
Tribal%20communities%20and%20Insular
%20areas.
5 Administrative Procedure Act, 5 U.S.C. 553
(1966). https://uscode.house.gov/view.xhtml?
req=granuleid:U.S.C.-prelim-title5section553&num=0&edition=prelim.
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Department believes this approach best
serves the public interest. The
Department has collected, and will
consider, input from stakeholders to
ensure the implementation of this rule
supports the WIC population and
achieves the intended results. For
example, FNS Regional Operations and
Support has collected feedback on FNS’
response to the infant formula recall and
the Coronavirus Disease 2019 (COVID–
19) public health emergency from FNS
Regional Offices and WIC State
agencies. FNS has considered this
feedback in development of this rule
and will continue to do so when
developing guidance and policy to
support the successful implementation
of the rule. The Department recognizes
the value of stakeholder feedback and
will continue to seek and collect
feedback to inform future technical
assistance.
II. Background
A. Overview of WIC
WIC is currently administered by 89
WIC State agencies, including the 50
geographic states, the District of
Columbia, 33 Indian Tribal
Organizations (ITOs), and five U.S.
Territories (the Commonwealth of the
Northern Mariana Islands, American
Samoa, Guam, Puerto Rico, and the U.S.
Virgin Islands). By providing
supplemental foods, nutrition
education, including breastfeeding
promotion and support, and referrals to
health and other social services, WIC
addresses the nutritional needs and
safeguards the health of low-income
pregnant and postpartum participants,
infants, and children up to 5 years of
age who are at nutritional risk.
According to their participant
category and nutritional needs, WIC
participants receive supplemental foods
on a monthly basis from one of seven
evidence-based food packages. The
amounts and categories of foods
provided are intended to supplement
participants’ diets and provide specific
nutrients known to be lacking in the
diets of WIC’s target population.
WIC participants typically access
supplemental foods, including infant
formula, through a retail food delivery
system. In such systems, a WIC shopper
goes to a WIC-authorized vendor (i.e., a
retail store authorized by the State
agency), selects foods available in their
benefit balance, and uses a food
instrument, typically an Electronic
Benefits Transfer (EBT) card, to
purchase the items. Outside of a retail
food delivery system, some WIC
participants access their supplemental
foods through a home food delivery or
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direct distribution system operated by
the WIC State agency. Additionally,
WIC participants with certain medical
conditions who require exempt
formulas or WIC-eligible nutritionals
may receive these as part of, or in
addition to, their WIC food package
with appropriate documentation. These
exempt formulas and WIC-eligible
nutritionals are procured outside of the
traditional WIC State agency costcontainment contracting process for
standard milk and soy-based infant
formula and may be purchased at the
store like their other WIC items, or
through other systems set up by the WIC
State agency, depending on availability
and need for the product(s).
B. WIC Program Waiver Authority
Historically, WIC has had limited
authority to waive Program
requirements. However, since the onset
of the COVID–19 public health
emergency, WIC has experienced a
series of disruptions to Program
operations necessitating the ability for
USDA’s Food and Nutrition Service
(FNS) to have permanent waiver
authority.
On February 17, 2022, a major infant
formula manufacturer voluntarily
recalled certain powder infant formula,
including exempt infant formula. While
recalls may be conducted because a
mandatory order has been issued by the
U.S. Food and Drug Administration
(FDA) under statutory authority, they
can also be conducted voluntarily by a
manufacturer, as in this case. This recall
exacerbated existing supply chain issues
resulting from the ongoing COVID–19
public health emergency. During its
early response to the shortage, FNS used
waiver authority granted under Section
301 of the Robert T. Stafford Disaster
Relief and Emergency Assistance Act,
(‘‘Stafford Act,’’ 42 U.S.C. 5121), to
approve several waiver types for WIC
State agencies to help WIC participants
obtain infant formula. This was possible
because of existing COVID–19 major
disaster declarations covering the
geographic areas of all WIC State
agencies, including States, ITOs, and
Territories.6 7
Section 301 of the Stafford Act
provides any Federal agency charged
with the administration of a federal
6 FEMA, ‘‘COVID–19 Disaster Declarations,’’
August 20, 2021. Available online at: https://
www.fema.gov/covid-19.
7 FEMA, ‘‘FEMA Assistance for Tribal
Governments,’’ March 17, 2021. Available online at:
https://www.fema.gov/fact-sheet/fema-assistancetribal-governments#:∼:text=
Tribes%20that%20are%20Recipients
%20will%20have%20a%20direct,in%20
the%20Tribal%20Declarations%20
Pilot%20Guidance.%20More%20items.
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assistance program with the authority to
modify or waive administrative
conditions for assistance that would
otherwise prevent the giving of
assistance if the inability to meet such
conditions is a result of the major
disaster. Activation of Section 301 of the
Stafford Act requires a State Governor’s
request and the President’s approval.
When approved, these are referred to as
Major Disaster Declarations. Section 301
of the Stafford Act cannot be activated
by emergency declarations, public
health emergencies, or supply chain
disruptions. Prior to March 2020,
Section 301 of the Stafford Act was the
only waiver authority available to grant
administrative flexibilities in WIC.
On March 13, 2020, the ongoing
COVID–19 crisis was declared a public
health emergency of sufficient severity
and magnitude to warrant declaration of
a nationwide public health emergency
through the Secretary of Health and
Human Services. Over the next several
weeks, in response to the COVID–19
public health emergency, major disaster
declarations were put into place
covering all WIC State agencies,
including States, Indian Tribal
Organizations, and U.S. Territories,
pursuant to Section 501(b) of the
Stafford Act. While the major disaster
declarations would eventually enable
WIC State agencies to request regulatory
waivers under the Stafford Act’s
authority, immediate and additional
flexibilities were necessary to support
WIC State agencies.
Therefore, on March 18, 2020, the
Families First Coronavirus Response
Act (FFCRA, Pub. L. 116–127) was
signed into law to assist with the
COVID–19 public health emergency.
USDA received temporary authority to
provide WIC State agencies with
flexibilities necessary to continue
operations and safely provide Program
benefits to participants. Specifically,
Section 2203 of FFCRA provided USDA
with the statutory waiver authority
necessary to waive the physical
presence requirement for all applicants
and participants seeking certification or
recertification in WIC; and defer
anthropometric (i.e., height/length and
weight) and bloodwork requirements
which are used to determine nutritional
risk. As a result, FNS waived the
statutory requirement for in-person WIC
clinic visits, thereby encouraging social
distancing, during the COVID–19 public
health emergency. Under Section 2204
of FFCRA, WIC State agencies could
also request USDA to waive or modify
WIC regulations. Such requests could
only be granted if the WIC State agency
(1) could not meet regular Program
requirements due to COVID–19, and (2)
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such waiver or modification was
necessary to provide assistance to WIC
participants. As prescribed in FFCRA,
the Department had the authority to
provide waivers through September 30,
2020, which was then extended through
September 30, 2021, through the
Continuing Appropriations Act, 2021
and Other Extensions Act (Pub. L. 116–
159). Certain WIC waivers granted prior
to September 30, 2021, were then
extended through FNS’ policy guidance
until 90 days after the end of the
nationally declared public health
emergency under Section 319 of the
Public Health Service Act,8 which
ended on May 11, 2023, per
announcement from the U.S.
Department of Health and Human
Services (HHS). FFCRA provided USDA
with the necessary authority to provide
WIC State agencies with the flexibility
to pivot operations and continue serving
Program participants during a public
health emergency. However, USDA’s
authority was temporary and designed
to specifically address COVID–19.
While the existing COVID–19 major
disaster declarations and resulting
Stafford Act authority provided a
vehicle through which FNS could grant
WIC State agencies waivers, under
normal circumstances, such waiver
authority would not typically be
available for the Department to respond
to an infant formula recall, nor could
the Department issue nationwide
waivers. As a result, in direct response
to the infant formula recall, Congress
recognized the need to provide USDA
with permanent authority to waive or
modify certain statutory and regulatory
requirements when certain conditions
are present.
ABFA amended Section 17 of the
CNA (42 U.S.C. 1786) to (1) establish
waiver authority for the Secretary of
Agriculture to address certain
emergencies, disasters, and supply
chain disruptions impacting WIC; and
(2) require WIC State agency infant
formula cost containment contracts to
include specific remedies to protect
against disruptions to the Program in
the event of a recall. Unlike the Stafford
Act, ABFA provides USDA with the
authority to issue waivers for one or
more State agencies, including
nationwide, and does not require that
each State agency individually request
specific waivers. As a result of ABFA,
FNS issued an implementing policy
8 U.S. Department of Agriculture, Food and
Nutrition Service, ‘‘WIC Policy Memorandum
#2021–10: Updated Expiration Schedule for
Existing FNS-Approved WIC COVID–19 Waivers,’’
September 20, 2021. Available online at: https://
www.fns.usda.gov/wic/policy-memorandum-202110.
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memorandum describing the infant
formula cost containment contract
requirements and waiver authority.9 In
order to provide WIC State agencies
with additional notice in anticipation of
the expiration of the major disaster
declarations in affected areas which
formally ended May 11, 2023, FNS
transferred waivers originally approved
under the Stafford Act and the existing
COVID–19 major disaster declaration for
the affected area to approval under the
waiver authority granted by ABFA and
the existing COVID–19 major disaster
declaration for the affected area.
Accordingly, to aid WIC participants in
purchasing infant formula using WIC
benefits, FNS extended waivers set to
expire under the ABFA authority and
established a new expiration date for
most waivers granted in response to the
infant formula recall through the earlier
of either January 31, 2023, or 60 days
after the expiration of the COVID–19
major disaster declaration in the
affected area.10 This revised expiration
schedule applied to most waiver types,
including those related to medical
documentation, maximum monthly
allowances of infant formula, imported
formula authorization and issuance, and
vendor substitutions.11 This expiration
date was again extended on December
19, 2022, in a letter sent to WIC State
agencies and formally implemented
through FNS Policy Memorandum
#2023–3: Unwinding Formula
Flexibilities in WIC on February 2, 2023.
FNS communicated that revised
expiration dates for the formula waivers
included rolling extensions for various
waivers through June 30, 2023, based on
the continued need for flexibility by the
WIC State agencies.12
9 U.S. Department of Agriculture, Food and
Nutrition Service, ‘‘WIC Policy Memorandum
#2022–6: Implementation of the Access to Baby
Formula Act of 2022 Public Law 117–129,’’ June 6,
2022. Available online at: https://
www.fns.usda.gov/wic/implementation-accessbaby-formula-act-2022.
10 U.S. Department of Agriculture, Food and
Nutrition Service, ‘‘WIC Policy Memorandum
#2023–1: Abbott Infant Formula Recall Waiver
Expiration Schedules,’’ November 8, 2022.
Available online at: https://www.fns.usda.gov/
resource/abbott-infant-formula-recall-waiverexpiration-memo#.
11 U.S. Department of Agriculture, Food and
Nutrition Service, ‘‘WIC Policy Memorandum
#2022–6: Implementation of the Access to Baby
Formula Act of 2022 Public Law 117–129,’’ June 6,
2022. Available online at: https://
www.fns.usda.gov/wic/implementation-accessbaby-formula-act-2022.
12 U.S. Department of Agriculture, Food and
Nutrition Service, ‘‘WIC Policy Memorandum
#2023–3: Unwinding Infant Formula Flexibilities in
WIC,’’ February 1, 2023. Available online at: https://
www.fns.usda.gov/wic/policy-memorandum-20233-unwinding-infant-formula-flexibilities.
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C. WIC Disaster Planning
WIC State agencies are required to
submit an annual plan for Program
operations. Program regulations at 7
CFR 246.4 define State Plan
requirements, but plans to address
potential emergencies, disasters, or
significant disruptions in operations are
not currently one of the required
elements. Nearly all State agencies
already voluntarily maintain a disaster
plan; however, these plans are typically
part of a broader health department or
other State agency disaster plan and do
not address WIC-specific Program
operations during emergencies nor do
they typically address other operational
disruptions beyond natural disasters.
FNS provides information to help
WIC State agencies plan for meeting the
needs of WIC participants and
applicants prior to and during a disaster
response; plan for continued WIC
benefits during public health
emergencies; and plan for other
situations that disrupt regular WIC
operations through the guidance
document, Guide to Coordinating
Special Supplemental Nutrition
Program for Women, Infants, and
Children (WIC) Services When Regular
Operations Are Disrupted.13 This
guidance highlights operational
flexibilities in WIC regulations that WIC
State agencies may implement quickly.
The COVID–19 public health emergency
and the infant formula recall
highlighted the need for all State
agencies to have formal contingency
plans in place to ensure the continuity
of WIC operations during emergency
periods (i.e., emergencies, disasters, and
public health emergencies) and supply
chain disruptions, while ensuring
access to Program benefits among lowincome pregnant and postpartum
participants.
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D. Infant Formula Cost Containment
Historical Background
In the 1980s WIC State agencies
became increasingly interested in cost
containment initiatives due to rising
food costs and their potential to limit
Program participation due to
insufficient funding. Infant formula
represented a significant portion of WIC
food costs so there was specific interest
in infant formula cost containment
contracts. Early initiatives by some State
agencies were so successful that in
1989, the Agriculture Appropriations
13 U.S. Department of Agriculture, Food and
Nutrition Service, ‘‘Guide to Coordinating Special
Supplemental Nutrition Program for Women,
Infants, and Children (WIC) Services When Regular
Operations Are Disrupted,’’ January 18, 2022.
Available online at: https://www.fns.usda.gov/wic/
guide-coordinating-wic-service-during-disasters.
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Act of 1989 (Pub. L. 100–460) directed
all WIC State agencies to explore the
feasibility of cost-containment measures
and implement such a measure if found
to be viable. Although the provisions of
the Agriculture Appropriations Act of
1989 expired on September 30, 1989,
the Child Nutrition and WIC
Reauthorization Act of 1989 (Pub. L.
101–147) extended these provisions and
required the Secretary to prescribe
regulations to carry out these
provisions. The Child Nutrition and
WIC Reauthorization Act of 1989 also
outlined exceptions to these provisions,
notably for ITOs that operate their own
WIC Program and serve less than 1,000
participants.
The WIC Infant Formula Procurement
Act of 1992 (Pub. L. 102–512) amended
the CNA to enhance competition among
infant formula manufacturers and
reduce the per unit costs of infant
formula purchased by WIC. In 1996,
FNS issued WIC Policy Memorandum
#96–6: WIC Infant Formula Rebate
Reviews, which provides guidance to
avoid rebate billing discrepancies and
can serve as a WIC State agency
reference during the procurement and
contracting process.14 Congress also
amended the CNA through the Child
Nutrition and WIC Reauthorization Act
of 2004 (Pub. L. 108–265) to include
additional technical definitions that
further clarified how cost containment
systems must be structured. FNS
established regulations to implement
each of these laws and released WIC
Policy Memorandum #2004–4:
Implementation of the Infant Formula
Cost Containment Provisions of P.L.
108–265 to address Public Law 108–
265.15
During the onset of the nationwide
infant formula shortage and prior to the
passage of ABFA, there were no federal
requirements for infant formula rebate
contracts to include remedies in the
event of a recall. FNS used its limited
waiver authority under the Stafford Act
to issue waivers to allow WIC State
agencies to exceed the maximum
monthly allowance for infant formula
14 U.S. Department of Agriculture, Food and
Nutrition Service, ‘‘WIC Policy Memorandum #96–
6: WIC Infant Formula Rebate Reviews,’’ March 12,
1996. Available online at: https://www.fns.
usda.gov/wic/infant-formula-rebate-reviews.
15 U.S. Department of Agriculture, Food and
Nutrition Service, ‘‘WIC Policy Memorandum
#2004–4: Implementation of the Infant Formula
Cost Containment Provisions of P.L.aw 108–265,’’
July 30, 2004. Available online at: https://www.fns.
usda.gov/wic/implementation-infant-formula-costcontainment-provisions-pl-108-265#:∼:
text=This%20memorandum%20provides%20
guidance%20on%20the%20implementation%20of,
2004%2C%20%28Reauthorization%20
Act%29%20enacted%20on%20June%2030
%2C%202004.
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and exempt infant formula and issue
non-contract brand formula without
medical documentation (except in Food
Package III). Each WIC State agency had
to come to an agreement with the
manufacturer holding their rebate
contract on Program flexibilities
allowed under these waivers to protect
against disruption to Program
participants. Additionally, the infant
formula manufacturer whose product
was the subject of the voluntary recall
voluntarily paid rebates on competitive,
non-contract brand infant formula in
WIC State agencies where they held the
contract.
E. Infant Formula Cost Containment
Contracts
The Child Nutrition Act of 1966,
(CNA, 42 U.S.C. 1786(h)(8)(A)(i)(I)) and
WIC Program regulations at 7 CFR
246.16a require most WIC State agencies
to continuously operate a cost
containment system for infant formula.
WIC State agencies have historically met
this requirement through a competitive
bidding process that requires sealed
bids, for single-supplier rebate
contracts. WIC State agencies solicit
sealed bids and award a contract to the
manufacturer offering the lowest price.
Contracted manufacturers provide a
rebate on each can of their infant
formula purchased by Program
participants through authorized WIC
vendors. The WIC State agency invoices
the manufacturer for payment directly
to the WIC State agency, which does not
impact the payments to retail stores who
accept WIC transactions. The resulting
rebate payments from manufacturers are
used to offset WIC food costs, allowing
WIC State agencies to serve more WIC
participants. Each WIC State agency or
alliance of State agencies that solicits for
a rebate contract manages their own
procurement and contracting process
through execution and implementation.
WIC State agencies may implement an
alternative cost containment system;
however, the system must provide a
savings equal to or greater than a singlesupplier competitive system through the
process described in WIC regulations at
7 CFR 246.16a(d). To date, WIC State
agencies have not implemented any
alternative cost containment systems.
Once a contract is executed and
implemented, the contract brand milk
and soy-based formulas are added to the
WIC State agency’s Approved Product
List (APL) and are made available for
issuance and redemption throughout the
State agency’s WIC Program. A
competent professional authority (CPA)
in the WIC clinic setting is responsible
for completing a nutrition assessment
for WIC participants, and then
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prescribing and individually tailoring
an appropriate food package. The
primary contract brand milk- or soybased infant formula is considered ‘‘first
choice’’ and will be issued as the default
in the food packages for infants who
receive formula from WIC. Based on
information from the participant,
including cultural or dietary
preferences, and/or nutrition assessment
findings, an alternate formula, such as a
soy-based option or another milk-based
option, within the rebate contract (i.e.,
contract brand infant formula) may be
deemed appropriate for issuance.
Medical documentation is generally not
required for milk- and soy-based
contract brand infant formulas offered
under the rebate contract.
Infant formula rebate funds offset a
significant amount of food costs. In
fiscal year 2022, infant formula rebate
amounts totaled approximately $1.5
billion, the cost of providing benefits to
an average of 1.32 million participants
each month, or 21 percent of WIC
participants monthly, as indicated by
the WIC Financial Management and
Participation Report (FNS–798).
III. Discussion of Regulatory
Amendments
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A. Add Waiver Authority Granted by the
Access to Baby Formula Act
1. Add New Definitions (§ 246.2)
This rule adds definitions of
Emergency period, Qualified
administrative requirement, Recall, and
Supply chain disruption consistent with
ABFA statutory language.
a. This rule defines an Emergency
period as a period during which there
exists: (1) a presidentially declared
major disaster as defined under Section
102 of the Robert T. Stafford Disaster
Relief and Emergency Assistance Act
(42 U.S.C. 5121 et seq.), (2) a
presidentially declared emergency as
defined under Section 102 of the Robert
T. Stafford Disaster Relief and
Emergency Assistance Act (42 U.S.C.
5121 et seq.), (3) a public health
emergency declared by the Secretary of
Health and Human Services under
Section 319 of the Public Health Service
Act (42 U.S.C. 247d), or (4) a renewal of
such a public health emergency
pursuant to Section 319. This aligns
with the definition provided by AFBA
and does not include State-declared
emergencies, disasters, or public health
emergencies.
b. This rule defines Qualified
administrative requirement as (1) a
statutory requirement under Section 17
of the CNA (42 U.S.C. 1786), or (2) a
regulatory requirement issued pursuant
to this section. This aligns with the
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definition provided by ABFA and
encompasses the scope of Program
requirements that may be waived or
modified by the Secretary.
c. This rule defines Recall as it is
defined in the U.S. Food and Drug
Administration (FDA) regulations in 21
CFR 7.3(g) or any successor regulation.
FDA defines recall as a firm’s removal
or correction of a marketed product that
the FDA considers to be in violation of
the laws it administers and against
which the agency would initiate legal
action (e.g., seizure). Recall does not
include a market withdrawal, which is
defined at 21 CFR 7.3(j) as a firm’s
removal or correction of a distributed
product which involves a minor
violation that would not be subject to
legal action by the FDA or which
involves no violation (e.g., normal stock
rotation practices, routine equipment
adjustments and repairs, etc.) or a stock
recovery, which is defined at 21 CFR
7.3(k) as a firm’s removal or correction
of a product that has not been marketed
or that has not left the direct control of
the firm (i.e., the product is located on
premises owned by, or under the control
of, the firm and no portion of the lot has
been released for sale or use). The
Department is committed to continued
alignment with FDA’s definition of
recall. Recalls may be conducted
voluntarily by a manufacturer or may be
required by FDA.
d. This rule defines Supply chain
disruption as a shortage of WIC
supplemental foods that limits WIC
participants’ ability to reasonably
purchase supplemental foods using WIC
benefits within a State agency’s
jurisdiction, as determined, and
declared by the Secretary for the
purposes of WIC. This definition reflects
ABFA statutory language and clarifies
that supply chain disruption
declarations as defined in this
rulemaking are specifically for the
purposes of WIC and do not impact or
extend authority to other programs or
entities. Supply chain disruptions can
occur within any portion of a State
agency’s jurisdiction, throughout the
State agency’s jurisdiction, or within
several State agencies’ jurisdictions,
including nationwide. In accordance
with ABFA, supply chain disruptions
include those caused by recalls of WIC
supplemental foods. Other causes of
supply chain disruptions under ABFA
may include but are not limited to, labor
shortages, temporary business
disruptions, delays in the availability of
products across a wide range of
industries, production issues, a
mismatch between supply and demand
or other shortages impacting WIC
supplemental foods. The Department
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recognizes that unforeseen
circumstances beyond those described
may also cause a shortage of WIC
supplemental foods that limits
participants’ ability to purchase such
foods using WIC benefits. However, not
every potential cause described here, or
potential unforeseen circumstance may
impede the transaction and redemption
of WIC benefits for supplemental foods.
Therefore, the definition of supply
chain disruption is not limited to any
specific causes so that the Department
maintains the flexibility to determine if
a supply chain disruption has occurred
and is able to respond to any future
disruptions.
2. Specify Criteria for Establishing
Waivers and Timeframes for Use
(§ 246.29)
This rule creates a new provision at
§ 246.29 that specifies the criteria under
which a waiver or modification may be
established, information WIC State
agencies must provide to FNS when
requesting a waiver, and the timeframes
during which waivers will remain
available for use by WIC State agencies.
a. Requirements for Establishing a
Waiver
This rule provides a non-exhaustive
list of conditions that must be met for
the Secretary to waive a qualified
administrative requirement for one or
multiple WIC State agencies during an
emergency period or supply chain
disruption. In accordance with ABFA
statutory provisions, a waiver may be
established when the following criteria
are met (1) the qualified administrative
requirement cannot be implemented
during any part of the emergency period
or supply chain disruption, (2) the
waiver is necessary to serve
participants, and (3) the waiver does not
substantially weaken the nutritional
quality of supplemental foods. If the
criteria are met, the Secretary may issue
either nationwide waivers available for
WIC State agencies to opt into, or State
agency-specific waivers.
The Department is including
additional specifications in this
rulemaking that the waiver or
modification must:
(1) Not materially impair any
statutory or regulatory right of
participants or potential participants as
set forth at 7 CFR 246.8 and 7 CFR parts
15, 15a and 15b which includes all
protected classes for federally assisted
programs in USDA;
(2) Not present an unreasonable
barrier to participation;
(3) Not create new or additional
eligibility requirements for
participation;
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(4) Comply with 7 CFR 246.13(b) to
ensure State agencies maintain effective
control over and accountability for all
Program grants and funds;
(5) Offer substitution options with
similar nutritional quality, that most
closely provide the maximum monthly
allowance of supplemental foods, and
that do not create new supplemental
food categories as set forth in 7 CFR
246.10(e)(12) Table 4; and
(6) Meet additional requirements for
the request and approval as determined
necessary by FNS.
Including these requirements is
intended to provide WIC State agencies
seeking waivers with basic parameters
and to protect participants and
applicants. While this rule will allow
for more flexibilities in Program
operations, the Department is
committed to continued equity, access,
and nutrition security for WIC
applicants and participants and
preventing unforeseen barriers to
participation. Further, the Department is
committed to clear and timely
communication with State and local
agency staff, WIC participants, and the
public when an emergency period or
supply chain disruption has been
declared.
confirm the WIC State agency’s request
meets the conditions required to waive
or modify a qualified administrative
requirement during an emergency
period or supply chain disruption.
However, contingent on the specific
situation, FNS maintains the right to
require additional information from a
WIC State agency to support its waiver
request. For example, a WIC State
agency seeking a waiver or waiver
extension may be required to provide
justification, including, but not limited
to, data to support the request, how the
waiver will be implemented, estimated
impact on WIC food funds for the time
period being requested, or an
explanation of how the WIC State
agency will track or monitor the
continued necessity for the waiver. The
Department recognizes that each
emergency period and supply chain
disruption is unique and therefore State
agencies may be asked to provide
different types of information relevant
to the specific scenario. Additional
information regarding the waiver
submission and review process will be
provided through subsequent policy
guidance.
b. Information Required From WIC State
Agencies Requesting a Waiver
ABFA laid out certain requirements
that must be met for a waiver to be
granted by FNS to a WIC State agency.
A WIC State agency may request that a
qualified administrative requirement be
waived or modified through submission
of a waiver request if the Secretary has
not already issued an applicable
nationwide waiver available for a WIC
State agency to opt into. This rule
establishes the minimum information a
WIC State agency must provide to FNS
when requesting a waiver to ensure that
these criteria are met. Specifically,
when submitting a request to FNS, WIC
State agencies must provide:
(i) The qualified administrative
requirement the State agency is
requesting to waive or modify
(including the statutory or regulatory
citation) and an explanation for why it
cannot be met;
(ii) Justification for why the waiver is
necessary to continue WIC services;
(iii) An explanation that the waiver
meets the conditions set forth in new
section 7 CFR 246.29(a);
(iv) The emergency period or supply
chain disruption under which the
request is being made; and
(v) The period for which the
flexibility is being requested.
The Department has deemed this the
minimum information necessary to
This rule codifies the timeframes
during which waivers can be available
for use by WIC State agencies, as
provided by ABFA. Waivers may be
established at any time during an
emergency period or supply chain
disruption.
A waiver established during an
emergency period may be available for
the duration of the emergency period
and up to 60 days after the end of the
emergency period. A waiver established
during a declared supply chain
disruption may be available for:
(i) a period of up to 45 days from a
date determined by the Secretary and
renewed with at least 15 days’ notice
provided by the Secretary, and
(ii) no more than 60 days after the
supply chain disruption declaration
ceases to exist.
In accordance with ABFA, if the
Secretary determines that a supply
chain disruption exists and issues a
waiver, the Secretary will notify each
State agency affected by the disruption.
Likewise, the Secretary will notify each
State agency affected by the disruption
and granted a waiver as a result of the
disruption at least 15 days prior to the
end of the 45-day period if the supply
chain disruption declaration has been
renewed. FNS will communicate any
supply chain disruption renewals as
they occur and provide technical
assistance on the process as needed.
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c. Duration of Waiver Availability
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B. Update Requirements for State
Agency Infant Formula Cost
Containment Contracts
1. Establish Minimum Required
Remedies for Infant Formula Cost
Containment Contracts (§ 246.16a)
This rule establishes that a State
agency must include remedies in the
event of a recall in their infant formula
cost containment contract to protect
against disruption in infant formula
supply to participants. In accordance
with applicable Program requirements
and the infant formula cost containment
contract, the State agency will
determine when remedies take effect
and remain in effect. At minimum, the
State agency’s infant formula cost
containment contract must:
(1) Allow infant formula to be issued
in all unit sizes that may exceed the
maximum monthly allowance. The State
agency and contracted infant formula
manufacturer must prioritize unit sizes
that most closely provide the maximum
monthly allowance;
(2) Allow the issuance of non-contract
brand formula without medical
documentation (except in Food Package
III);
(3) When any contract brand infant
formula of the contracted manufacturer
is the subject of a recall, require the
contracted manufacturer to:
(i) Provide the State agency with an
action plan, within a timeframe
established within the contract, which
includes supply data, to meet infant
formula demand and limit disruption to
Program participants in the affected
jurisdiction(s) and
(ii) Pay rebates on competitive, noncontract brand infant formula that meets
the definition of infant formula at 7 CFR
246.2.
WIC State agencies may work with
their legal counsel and procurement
offices to include additional remedies
beyond these regulatory minimum
remedies in their infant formula
contracts. WIC State agencies may also
negotiate flexibilities that are within
regulatory requirements and do not
require Program waivers with their
contracted infant formula
manufacturers.
As previously described, in response
to the sustained nationwide infant
formula shortage—resulting from the
February 17, 2022, voluntary recall of a
major source of powder infant formula,
including exempt infant formula—
which exacerbated existing COVID–19
shortages, FNS used its limited waiver
authority under the Stafford Act to issue
waivers. This was possible because of
existing COVID–19 major disaster
declarations covering the geographic
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areas of all WIC State agencies,
including States, ITOs, and Territories.
These waivers allowed WIC State
agencies to benefit from three specific
remedies to: (1) exceed the maximum
monthly allowance for infant formula to
allow for the purchase of larger unit
sizes; (2) issue non-contract brand
formula without medical documentation
(except in Food Package III); and (3)
receive rebates for non-contract brand
infant formula, when their contracted
manufacturer’s product was the subject
of the recall. As a result, State agencies
were able to allow for the purchase of
available formula when the contract
brand or size was unavailable during
shortages. Because these three specific
remedies assisted State agencies with
meeting participants’ needs during the
sustained nationwide infant formula
shortage, such remedies were included
as suggestions in WIC Policy
Memorandum #2022–6: Implementation
of the Access to Baby Formula Act of
2022–PL 117–129 and are now being
codified in this rulemaking.16 Exceeding
the maximum monthly allowance for
infant formula to allow for the purchase
of larger unit sizes and issuing noncontract brand formula without medical
documentation (except in Food Package
III) will continue to require an approved
waiver before a State agency can
operationalize these remedies, and must
be operationalized within the active
waivers’ timeframe in order to remain in
compliance with Program requirements.
During the sustained nationwide
infant formula shortage, State agencies
worked with their infant formula
contracted manufacturer to collect
supply data in order to respond to
participant needs. This data proved
valuable to State agencies’ ability to
respond to the shortages. Thus, the
provision of an action plan, which
includes supply data, to meet infant
formula demand and limit disruption to
Program participants in the affected
jurisdiction(s) when any contract brand
infant formula of the contracted
manufacturer is the subject of a recall
has been included as a minimum
remedy in this rule. The State agency
and contracted manufacturer must
establish a timeframe by which the
manufacturer must provide the State
agency with an action plan following
the recall of any contract brand infant
formula of the contracted manufacturer.
The Department recommends that these
16 U.S. Department of Agriculture, Food and
Nutrition Service, ‘‘WIC Policy Memorandum
#2022–6: Implementation of the Access to Baby
Formula Act of 2022 Pub. L. 117–129,’’ June 6,
2022. Available online at: https://www.fns.
usda.gov/wic/implementation-access-baby-formulaact-2022.
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86551
action plans be provided to State
agencies within 48 hours following the
recall of any contract brand infant
formula of the contracted manufacturer.
In establishing the remedies, the
Department considered requiring
manufacturers to maintain a stockpile of
infant formula for use in the event of a
recall. The Department considered
potential logistics involved, such as:
types and quantity of formula to
stockpile, potential locations, the level
of stockpile maintenance necessary to
rotate stock, and development of a
distribution plan related to stockpiling.
Ultimately, the Department determined
that the cost and administrative burden
necessary to require manufacturers to
maintain a stockpile in excess of
manufacturers’ usual inventory would
likely be too extensive for practical
implementation and would counteract
any potential benefits for the Program.
Currently, the Program provides
infant formula in all three physical
forms available in the retail
marketplace, which are powder, liquid
concentrate, and ready-to-feed.17 While
7 CFR 246.10(e)(1)(iv) offers State
agencies the flexibility to issue powder
or concentrated liquid, 7 CFR
246.16a(c)(4) requires infant formula
manufacturers to bid on all three
physical forms. Currently powder is the
predominant form in the marketplace
and some manufacturers do not produce
liquid concentrate. Requiring liquid
concentrate in WIC could impact some
manufacturers’ ability to competitively
bid and meet contractual requirements.
Therefore, the Department is seeking
public comment on the operational and
financial impacts to the Program of
modifying the requirement for infant
formula manufacturers to bid on liquid
concentrate. Through this rulemaking,
the Department is not making any
changes to the current bidding
requirements at 7 CFR 246.16a(c)(4) or
the physical forms of infant formula that
may be issued in accordance with 7 CFR
246.10(e)(1)(iv).
preamble, Requirements for and
Evaluation of WIC Program Bid
Solicitations for Infant Formula Rebate
Contracts (65 FR 51213–51229), and
WIC Policy Memorandum #99–3:
Evaluation Criteria for Infant Formula
Rebate Contracts.18 19
The inclusion of the terms responsive
and responsible were initially intended
to help ensure WIC State agencies select
formula manufacturers that fully
respond to the invitation to bid and
meet eligibility requirements in statute
and regulation. However, since these
terms were not defined, they resulted in
ambiguity in their application. This rule
removes the responsibility requirement
and defines the responsiveness
requirement. Under the modified
provision, a bidder must submit a bid
that conforms to the solicitation and
meets requirements at § 246.16a to be
considered responsive. The rule adds
language to clarify this meaning, which
will provide consistent application of
the term and ensure that all responsive
bids will receive consideration.
2. Clarify Terminology in Infant
Formula Cost Containment Contracts
(§ 246.16a(c)(5))
This rule clarifies terminology at 7
CFR 246.16a(c)(5). Specifically, the
current terms ‘‘responsive and
responsible’’ used in the regulations to
describe bidders are consolidated under
this rulemaking to ‘‘responsive.’’
Responsive is further defined for
clarification, consistent with the intent
stated in a previous rulemaking
18 U.S. Department of Agriculture, Food and
Nutrition Service, ‘‘Special Supplemental Nutrition
Program for Women, Infants and Children (WIC):
Requirements for and Evaluation of WIC Program
Bid Solicitations for Infant Formula Rebate
Contracts,’’ 65 FR 51213–51229. (August 23, 2000).
Available online at: https://
www.federalregister.gov/documents/2000/08/23/0021423/special-supplemental-nutrition-program-forwomen-infants-and-children-wic-requirements-forand#:∼:text=A%20key%20component%20to%20
the%20success%20of%20infant,than%20savings
%20generated%20by%20a%20competitive
%20bidding%20system.
19 U.S. Department of Agriculture, Food and
Nutrition Service, ‘‘WIC Policy Memorandum #99–
3: Evaluation Criteria for Infant Formula Rebate
Contracts,’’ October 14, 1998. Available online at:
https://www.fns.usda.gov/wic/evaluation-criteriainfant-formula-rebate-contracts.
17 Ready-to-feed formulas may be authorized only
under certain circumstances, as specified at 7 CFR
246.10(e)(1)(iv).
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C. Add Requirement for State Agency
Plans of Alternate Operating Procedures
(§ 246.4(a))
This rule adds a new provision
requiring WIC State agencies to include
a plan of alternate operating procedures,
commonly referred to as a disaster plan,
as part of their State Plan. This
provision will ensure WIC State
agencies have plans in place to support
continuity of operations in the event of
a disruption of WIC services, including
but not limited to emergency periods,
supplemental food recalls, and other
supply chain disruptions.
State Plans are submitted annually by
WIC State agencies as a prerequisite to
receiving funds. State Plans must be
updated as needed to reflect substantive
changes to the State agencies’ Program
design and operation. Therefore, as a
part of the State Plan, alternate
operating procedures must also be
updated as needed to reflect any
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substantive changes resulting from
lessons learned as WIC State agencies
respond to emergency periods and
supply chain disruptions. Such updates
will allow WIC State agencies to prepare
and respond to these events more
effectively in the future. Additionally,
FNS encourages WIC State agencies to
review their State Plans and ensure they
continue to meet the needs of Program
stakeholders. State Plans are a vehicle
through which WIC State agencies can
outline short- and long-term goals
necessary to improve Program design
and operation. For example, State
agencies may include descriptions of
goals and action plans to facilitate
continued improvement in the delivery
of Program benefits and service during
Program disruptions as a part of their
alternate operating procedures.
Both the COVID–19 public health
emergency and the 2022 infant formula
recall and sustained infant formula
shortage required nearly all WIC State
agencies to quickly develop and
implement alternative plans for running
their programs. While some WIC State
agencies, such as those with experience
in dealing with natural disasters, may
have established alternative operations
plans, these plans are typically part of
a broader health department or other
State agency disaster plan and do not
address WIC-specific Program
operations during disruptions nor do
they typically address other operational
disruptions beyond natural disasters.
This resulted in ex post facto
development of policies and procedures
and ultimately varying levels of Program
disruption during the COVID–19 public
health emergency and the 2022 infant
formula recall and sustained infant
formula shortage. These two events
highlight the need for all WIC State
agencies to be prepared to continue
operations when faced with a number of
potential disruptions. The FNS-required
alternate operating procedures set
baseline minimum elements that must
be included by all WIC State agencies,
and in turn provide greater transparency
to FNS on actions each State agency will
take in the event of a disruption. The
Department believes that proactive State
agency development of robust alternate
operating procedures will minimize the
negative impact of such disruptions to
WIC operations and services, position
State agencies to be better prepared to
adjust to unexpected situations, and
ensure the availability of authorized
supplemental foods, including infant
formula.
The Department recognizes that a
variety of situations, including a
supplemental food recall, may prompt
the Secretary to declare a supply chain
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disruption. However, WIC State
agencies must be prepared to respond to
supplemental food recalls whether or
not an official supply chain disruption
declaration has been made. As such,
WIC State agencies’ alternate operating
procedures must specifically and
directly address supplemental food
recalls, with an emphasis on infant
formula recalls, including specialty
products, as part of the section
addressing supply chain disruptions as
a whole. The Department is committed
to supporting WIC State agencies in
prioritizing resources and developing a
separate plan for the distribution of
specialty formula.
The Department understands the
same event may impact WIC State
agencies differently dependent upon
their geographic location, participant
populations, and other factors. As such,
the Department encourages each WIC
State agency to consider potential
events unique to their location and
identify how the State agency will meet
the needs of their participant
populations when developing alternate
operating procedures. To assist with
anticipation of potential events, the
Department expects WIC State agencies
to establish relationships with relief
agencies responsible for disaster and
public health emergency planning
applicable to the State agency’s
jurisdiction and participants and
leverage these relationships as needed.
Ultimately, the intent of such
relationships is for the WIC State agency
to make data-informed decisions in
order to better meet the needs of their
jurisdiction’s populations. Nevertheless,
WIC State agencies must also consider
the unique and sudden nature of events
that disrupt regular WIC operations
when developing alternate operating
procedures.
Alternate operating procedures must
describe the process by which the WIC
State agency will minimize the negative
impact to WIC operations and services
and ensure the availability of authorized
supplemental foods, especially infant
formula, to the extent feasible. At a
minimum, alternate operating
procedures must include:
(i) A plan to address operation of
specific Program areas including:
a. Access to Program records;
b. Alternate certification and benefit
issuance;
c. Verification of Certification (VOC)
issuance;
d. Food package adjustments;
e. Vendor requirements;
f. Benefit redemption; and
g. Food delivery systems.
(ii) A plan to ensure continuity of
WIC services and address the needs of
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participants with documented
qualifying conditions receiving Food
Package III, rural areas, tribal
populations, and other priority
populations in the affected area, as
applicable;
(iii) A designated emergency contact
within the State agency for emergency
periods, supply chain disruptions, and
supplemental food recalls;
(iv) A designated emergency contact
within the State agency to address the
needs of participants with documented
qualifying conditions receiving Food
Package III;
(v) A plan to establish a relationship
with relief agencies responsible for
disaster and public health emergency
planning applicable to the State
agency’s jurisdiction and participants to
support data-informed approaches when
responding to emergency periods,
supplemental food recalls, and other
supply chain disruptions;
(vi) A plan to limit the disruption of
infant formula benefits in the event of
an emergency period, supplemental
food recall, and other supply chain
disruption;
(vii) A communications plan to keep
FNS, State and local agency staff,
authorized WIC vendors, WIC
participants, and the public informed
during an emergency period,
supplemental food recall, or other
supply chain disruption.
(viii) A plan to report to FNS on
alternate operating procedures
implemented during an emergency
period, supplemental food recall, and
other supply chain disruptions, which
includes Program data and information
on the impact of benefit use and
delivery.
(ix) A plan to adjust State agency
specific minimum requirements for the
variety and quantity of supplemental
foods that a vendor applicant must stock
to be authorized.
Minimum requirements outlined in
this provision reflect current guidance
found in the Guide to Coordinating WIC
Service During Disasters.20 In
developing and implementing the
alternate procedures, State agencies
must take into account existing
requirements for technology projects in
accordance with FNS Handbook 901.21
For example, if a State agency decides
20 U.S. Department of Agriculture, Food and
Nutrition Service, ‘‘Guide to Coordinating WIC
Service During Disasters,’’ January 18, 2022.
Available online at: https://www.fns.usda.gov/wic/
guide-coordinating-wic-service-during-disasters.
21 U.S. Department of Agriculture, Food and
Nutrition Service, ‘‘FNS Handbook 901,’’ January 8,
2020. Available online at: https://
www.fns.usda.gov/sso/fns-handbook-901-v2advance-planning-documents.
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to take steps to integrate changes to their
management information system (MIS)
to facilitate better service to participants
during Program disruptions, State
agencies should consult FNS Handbook
901 to secure approval and the
requested funding, if applicable.
Subsequent to this rulemaking, FNS will
issue updated guidance to WIC State
agencies outlining required components
of the plan and continue to ensure the
existing guidance found in the Guide to
Coordinating WIC Service During
Disasters is up to date and available for
reference.22 This Guide will also
provide additional detail regarding
provisions for WIC State agency
consideration in development of their
disaster plans. For example, additional
alternate operating procedures may
include:
• designating alternate means and
locations for certification and benefit
issuance for circumstances in which the
conventional means and locations are
not possible or optimal;
• establishing a plan to support
individuals seeking WIC services
receiving a full nutrition assessment and
appropriate referrals;
• establishing a plan with health care
centers or other providers of exempt
infant formula and WIC-eligible
nutritionals for the distribution of these
products to participants with
documented qualifying conditions
receiving Food Package III
• developing a WIC formula (infant
formula, exempt infant formula, or WICeligible nutritional) distribution plan;
and,
• if a WIC State agency already has a
direct distribution or home delivery
system in place, updating policy to
specifically include provisions
reasonable to institute during recalls
and/or supplemental food shortages.
Ultimately, this provision is intended
to minimize adverse impacts to WIC
operations and the continuation of WIC
benefits during an emergency period,
supplemental food recall, and other
supply chain disruptions impacting
WIC’s normal operations. Further,
participants living in rural areas, on
Tribal lands, following cultural or
religious food practices, and/or having
qualifying conditions and receiving
Food Package III are potentially most
impacted during an emergency period,
supplemental food recall, and other
supply chain disruptions. The
Department expects this rule to ensure
more consistent and safe access to the
22 U.S. Department of Agriculture, Food and
Nutrition Service, ‘‘Guide to Coordinating WIC
Service During Disasters,’’ January 18, 2022.
Available online at: https://www.fns.usda.gov/wic/
guide-coordinating-wic-service-during-disasters.
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foods these most vulnerable participants
need by anticipating and preparing how
to meet those needs before any potential
Program disruptions. This rule will
allow for more flexibilities in Program
operations and will require WIC State
agencies to develop plans to address the
needs of unique and vulnerable
populations overall.
Finally, the Department recognizes
WIC is not designed to be a disaster
assistance program and is not
considered a first response option for
disaster survivors. As such, the
Department continues to encourage WIC
State agencies to work with State and
local emergency services offices, as well
as the Federal Emergency Management
Agency (FEMA), to the maximum extent
practicable, to provide participants with
a coordinated disaster response during
an emergency period.
IV. Implementation
Because the majority of the revisions
described in this rulemaking are
introducing opportunities for increased
flexibility for WIC State agencies, this
final rule will take effect 60 days after
publication, except for § 246.4(a), which
is the provision requiring WIC State
agencies to include, as a part of the State
Plan, a plan of alternate operating
procedures, commonly referred to as a
disaster plan, in accordance with FNS
guidance.
For § 246.4(a), these changes are
required to be implemented with State
agency FY 2025 State Plan submissions,
due to FNS no later than August 15,
2024. This timeline recognizes WIC
State agencies will need the time to
develop and refine their alternate
operating procedures to meet the
requirements of this provision.
Per WIC Policy Memorandum #2022–
6: Implementation of the Access to Baby
Formula Act of 2022—PL 117–129, all
contracts entered into or renewed on or
after May 21, 2022, the date of
enactment of ABFA, are expressly
required by law to include language in
their WIC infant formula rebate
contracts that describes remedies in the
event of an infant formula recall,
including how an infant formula
manufacturer would protect against
disruption to Program participants in
the State (i.e., ensure that WIC
participants can purchase formula using
WIC benefits). Section 246.16a as
amended codifies these requirements
and the provisions as described herein
must be strictly applied to all infant
formula contracts entered into or
renewed once the final rule takes effect.
FNS considers a new contract to be
entered into upon award after a
competitively bid process.
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86553
The Department seeks comments from
WIC State agencies on the type and
scope of administrative burden that may
be associated with implementing the
provisions in this rule in this manner.
Procedural Matters
Executive Order 12866, 13563 and
14094
We have examined the impacts of this
rule as required by Executive Order
12866 on Regulatory Planning and
Review (September 30, 1993), Executive
Order 13563 on Improving Regulation
and Regulatory Review (January 18,
2011), Executive Order 14094 entitled
‘‘Modernizing Regulatory Review’’
(April 6, 2023), the Regulatory
Flexibility Act (RFA) (September 19,
1980, Pub. L. 96–354), section 1102(b) of
the Social Security Act, section 202 of
the Unfunded Mandates Reform Act of
1995 (March 22, 1995; Pub. L. 104–4),
Executive Order 13132 on Federalism
(August 4, 1999), and the Congressional
Review Act (5 U.S.C. 804(2)).
Executive Orders 12866, 13563 and
13563 direct agencies to assess all costs
and benefits of available regulatory
alternatives and, if regulation is
necessary, to select regulatory
approaches that maximize net benefits
(including potential economic,
environmental, public health and safety
effects, distributive impacts, and
equity). The Executive Order 14094
entitled ‘‘Modernizing Regulatory
Review’’ (hereinafter, the Modernizing
E.O.) amends section 3(f)(1) of Executive
Order 12866 (Regulatory Planning and
Review). The amended section 3(f) of
Executive Order 12866 defines a
‘‘significant regulatory action’’ as an
action that is likely to result in a rule:
(1) having an annual effect on the
economy of $200 million or more in any
1 year (adjusted every 3 years by the
Administrator of OIRA for changes in
gross domestic product), or adversely
affect in a material way the economy, a
sector of the economy, productivity,
competition, jobs, the environment,
public health or safety, or State, local,
territorial, or tribal governments or
communities; (2) creating a serious
inconsistency or otherwise interfering
with an action taken or planned by
another agency; (3) materially altering
the budgetary impacts of entitlement
grants, user fees, or loan programs or the
rights and obligations of recipients
thereof; or (4) raise legal or policy issues
for which centralized review would
meaningfully further the President’s
priorities or the principles set forth in
the Executive Order, as specifically
authorized in a timely manner by the
Administrator of OIRA in each case.
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A regulatory impact analysis (RIA)
must be prepared for major rules with
significant regulatory action/s and/or
with significant effects as per section
3(f)(1) ($200 million or more in any 1
year). Based on our estimates, OMB’s
Office of Information and Regulatory
Affairs has determined that this
rulemaking is ‘‘significant’’ and not
‘‘major’’ under Subtitle E of the Small
Business Regulatory Enforcement
Fairness Act of 1996 (also known as the
Congressional Review Act).’’ Therefore,
OMB has reviewed this final regulation,
and the Department has provided the
following assessment of their impact.
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Regulatory Impact Analysis
As required for all rules designated as
Significant by the Office of Management
and Budget, an economic summary was
developed for this final rule. The
following summarizes the conclusions
of the regulatory impact analysis:
Need for Action: As described in the
preamble, this rulemaking serves to
amend the Special Supplemental
Nutrition Program for Women, Infants,
and Children (WIC) Program regulations
by incorporating provisions of the
Access to Baby Formula Act of 2022
(ABFA) and making related
amendments. ABFA establishes waiver
authority for the Secretary of
Agriculture to address certain
emergencies, disasters, and supply
chain disruptions impacting the WIC
Program, and adds requirements to State
agency infant formula cost containment
contracts to protect against disruptions
to the Program in the event of a recall.
The amendments made via this rule are
expected to improve State agencies’
ability to ensure continuity of Program
operations during emergencies,
disasters, and supply chain disruptions,
while ensuring access to Program
benefits among low-income infants,
children, and pregnant, postpartum, and
breastfeeding individuals.
Affected Parties: WIC participants and
those involved in the provision of infant
formula to WIC participants, including
the USDA Food and Nutrition Service
(FNS), State and local agencies,
including Indian Tribal Organizations
(ITOs), clinics, infant formula
manufacturers, and retail vendors.
I. Statement of Need
On May 21, 2022, the Access to Baby
Formula Act of 2022 (Pub. L. 117–129)
was signed into law. ABFA amends
Section 17 of the Child Nutrition Act of
1966 (CNA, 42 U.S.C. 1786) to (1)
establish waiver authority to the
Secretary of Agriculture to address
certain emergencies, disasters, and
supply chain disruptions impacting the
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WIC Program; and (2) require State
agency infant formula cost containment
contracts to include specific remedies to
protect against disruptions to the
Program in the event of a recall. This
rule amends 7 CFR part 246 to codify
the provisions of ABFA, which
strengthens WIC’s ability to address
emergencies, disasters, and supply
chain disruptions, particularly those
impacting infant formula.
II. Background
Established in 1974, the mission of
the Special Supplemental Nutrition
Program for Women, Infants, and
Children (WIC) is to safeguard the
health of low-income pregnant,
postpartum, and breastfeeding
individuals, infants, and children ages 1
through 4 years who are at nutritional
risk by providing nutritious foods to
supplement diets, nutrition education
(to include breastfeeding promotion and
support), and referrals to health and
other social services. Participation in
WIC is associated with improved
pregnancy outcomes and lower infant
mortality. WIC participation is also
associated with improved diet quality.23
In Federal fiscal year (FY) 2022, WIC
served an average of 6.24 million
infants, children, and pregnant,
breastfeeding, and postpartum
individuals per month.24
On March 13, 2020, the President
declared the ongoing COVID–19 a
public health emergency of sufficient
severity and magnitude to warrant
declaration of a nationwide emergency.
The President later approved major
disaster declarations for State agencies,
including Indian Tribal Organizations
and U.S. Territories pursuant to section
501(b) of the Stafford Act.
On March 18, 2020, the Families First
Coronavirus Response Act (FFCRA, Pub.
L. 116–127) was signed into law to
assist with the COVID–19 public health
emergency, which provided additional
funding for WIC and offered additional
flexibilities by providing USDA with
authority to grant certain programmatic
waivers to State agencies to enable WIC
to continue serving WIC participants in
23 Caulfield, L., Bennett, W., Gross, S., Hurley, K.,
Ogunwole, S., Venkataramani, M., Lerman, J.,
Zhang, A., Sharma, R., Bass, E. (2022). Maternal and
Child Outcomes Associated with the Special
Supplemental Nutrition Program for Women,
Infants, and Children (WIC). Comparative
Effectiveness Review No. 253. Prepared by the
Johns Hopkins University Evidence-based Practice
Center under Contract No. 75Q80120D00003.)
AHRQ Publication No. 22–EHC019. Rockville, MD:
Agency for Healthcare Research and Quality. DOI:
https://doi.org/10.23970/AHRQEPCCER253.
24 U.S. Department of Agriculture Food and
Nutrition Service. WIC Data Tables, 2021. Available
online at: https://www.fns.usda.gov/pd/wicprogram.
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the midst of a public health crisis (e.g.,
the physical presence requirement was
waived to encourage social distancing
and reduce in-person visits to WIC
clinics).
On February 17, 2022, a major infant
formula manufacturer voluntarily
recalled certain powder infant formula,
including exempt infant formula. This
recall exacerbated existing supply chain
issues resulting from the ongoing
COVID–19 public health emergency. In
response to this recall, USDA used its
limited waiver authority granted under
Section 301 of the Robert T. Stafford
Disaster Relief and Emergency
Assistance Act, ‘‘Stafford Act’’ (42
U.S.C. 5121) to help WIC participants
obtain infant formula. This was possible
because of existing COVID–19 major
disaster declarations in all WIC State
agencies, including States, Indian Tribal
Organizations, and U.S. Territories.
While the existing COVID–19 major
disaster declaration and resulting
Stafford Act authority provided a
vehicle through which USDA could
grant WIC State agencies waivers, under
normal circumstances such waiver
authority would not typically be
available for the Department to respond
to an infant formula recall, nor could
the Department issue nationwide
waivers. As a result, Congress
recognized the need to provide longterm waiver flexibilities, and the
President signed ABFA into law on May
21, 2022, in direct response to the infant
formula recall. ABFA amended Section
17 of the Child Nutrition Act of 1966 (42
U.S.C. 1786) to (1) establish waiver
authority to the Secretary of Agriculture
to address certain emergencies,
disasters, and supply chain disruptions
impacting the WIC Program; and (2)
require WIC State agency infant formula
cost containment contracts to include
specific remedies to protect against
disruptions to the Program in the event
of a recall.
This rule amends 7 CFR part 246 to
codify the provisions of ABFA.
III. List of Rule Provisions and Impacts
Most of the provisions in this rule are
required by ABFA; the provisions added
by the Secretary that go beyond ABFA’s
requirements are noted below and
include consolidating language in the
regulations to describe bidders to
‘‘responsive’’ and requiring State
agencies to create plans of alternate
operating procedures. A list of the rule’s
provisions and a discussion of their
likely impacts to the WIC Program, on
Program cost, and on affected parties
follows.
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A. Add Waiver Authority Granted by
the Access to Baby Formula Act
1. Add New Definitions
i. Program Impact: This rule adds
definitions of Emergency period,
Qualified administrative requirement,
Recall, and Supply chain disruption in
order to incorporate ABFA statutory
language.
ii. Cost Impact: USDA estimates no
change in cost associated with this
provision. This change merely adds
definitions required for operational
clarity under ABFA.
iii. Impact on Affected Parties: USDA
estimates no impact on affected parties.
Impacts on affected parties that arise
due to other provisions of this rule are
discussed below.
2. Specify Criteria for Establishing
Waivers or Modification and
Timeframes for Use
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i. Program Impact: This rule creates a
new provision at § 246.29 that specifies
(1) criteria under which a waiver or
modification may be established, (2)
information State agencies must provide
to FNS when requesting a waiver, and
(3) the timeframes during which waivers
will remain available for use by State
agencies. One recent example of a
category of waivers is physical presence
waivers.25 The Families First
Coronavirus Response Act gave USDA
authority to grant waivers to State
agencies of the requirement that all
individuals seeking to enroll or re-enroll
in WIC do so in person (i.e., physical
presence). This waiver also allowed
State agencies to defer certain
anthropometric (i.e., height/length and
weight) and bloodwork requirements
used to determine nutritional risk. The
physical presence waiver allowed
USDA to encourage social distancing
and decrease the spread of COVID–19
while ensuring continuity of operations
for State and local WIC agencies and for
WIC participants.
A second recent example of a category
of waivers are the food package
substitution waivers.26 These waivers
allowed State agencies to permit
approved substitutes for the types and
amounts of certain WIC-prescribed
25 Almost all State agencies (88 of 89 State
agencies) used a physical presence waiver
sometime during the COVID–19 pandemic. For
more information on physical presence waivers by
State agency, see https://www.fns.usda.gov/
disaster/pandemic/covid-19/wic-physical-presencewaiver.
26 A large majority of State agencies (70 of 89)
issued food package substitution waivers for one or
more food types. For more information on food
package substation waivers by State agency, see
https://www.fns.usda.gov/wic/food-packagesubstitution-waiver.
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foods if their availability is limited. For
example, as appropriate based on local
food marketplace circumstances, State
agencies were approved, upon request,
to allow participants to substitute milk
of any available fat content if prescribed
varieties are not available; substitute
authorized whole grains in package
sizes up to 24 oz. when 16 oz. packages
are not available; and/or substitute 18count cartons of eggs when 12-count
cartons are unavailable. These waivers
enabled WIC participants to continue to
receive appropriate supplemental foods
during shortages of the specific products
and/or package sizes that were
previously authorized by the State
agencies.
ii. Cost Impact: USDA was unable to
reliably estimate the change in cost
associated with this provision, beyond
the very slight change in burden hours
(38 hours across all State agencies
annually) associated with this
provision. Although USDA estimates a
negligible increase in burden hours due
to this provision, USDA also notes that
formalizing the criteria for establishing
waivers and timeframes for waiver use
makes the waiver process more
predictable for both State agencies and
the Federal government and greatly
decreases the likelihood of repeated
waiver revisions and submissions in
order to meet waiver requirements.
USDA is unable to reliably quantify the
costs of future waivers since the types
and scope/scale of future waivers will
be in response to unknown events.
USDA notes that some waivers have the
possibility to increase or decrease the
cost of the Program, though USDA
generally expects these possible cost
impacts to be small. For example, it is
possible that the physical presence
waiver either increased or decreased
administrative costs for some local WIC
clinics, depending on whether the local
clinics increased or decreased staffing or
office space in response to moving to
phone or online certification/
recertification of participants. Ninetynine percent of State agencies reported
that the physical presence waivers were
‘‘very’’ or ‘‘extremely important’’ to
ensuring quality services during the
COVID–19 pandemic, and some State
agencies reported that the physical
presence waivers allowed them to serve
more participants with fewer staff or in
less time, which points to potential cost
savings generated by the physical
presence waivers.27 Similarly, food
package substitution waivers may
27 Unpublished data collected by USDA as a part
of State agency reporting on FFCRA waiver use.
These data will be released in an upcoming USDA
report.
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86555
increase or decrease food costs slightly,
depending on whether the food package
substitutions are for items slightly more
or less expensive than those typically
included in the food package.
Approximately 90 percent of State
agencies reported that the food
substitution waivers were ‘‘very
important’’ or ‘‘extremely important’’ to
ensuring quality services during the
COVID–19 pandemic, pointing to the
waivers’ contribution to ensuring
continued operations during the
pandemic.28 Neither the physical
presence waiver nor the food package
substitution waivers issued during the
COVID–19 pandemic were found to
result in significant increases or
decreases in WIC spending at the
Federal level.29 In FY2019, FY2020, and
FY2021, Federal spending on WIC was
$5.3, $5.0, and $5.0 billion, respectively,
while participation during the same
Fiscal Years was 6.4, 6.2, and 6.2
million individuals. Therefore, the
effect of waivers in the aggregate during
the COVID–19 emergency does not
appear to have had a significant effect
on Federal WIC costs, though it is
possible that individual waivers may
have increased or decreased Federal
WIC costs.
The use of waivers in the past has
generally focused on ensuring
continued operation of the WIC Program
as normally as possible under temporary
and extraordinary circumstances.
Waiver authority as authorized by
ABFA must continue to be used
primarily for this purpose; therefore,
USDA does not predict that the future
use of waivers will lead to either
substantial costs or savings.
iii. Impact on Affected Parties: USDA
estimates an increase in burden on State
agencies as a result of this provision, but
this provision will also clarify and
standardize the steps that a State agency
must undertake in order to submit a
waiver request, which could save some
State agencies effort in the long run by
preventing State agencies from having to
resubmit waiver requests multiple times
because their initial requests do not
meet the waiver requirements or do not
provide enough information for FNS to
understand why the waiver is necessary
in order to continue Program operations.
USDA also notes that waiver authority
has generally been granted to FNS
programs when it was needed in the
past, and this provision does not make
28 Ibid.
29 WIC program data for the periods before and
during the COVID–19 pandemic (available online at
https://www.fns.usda.gov/pd/wic-program) do not
show any substantial increase or decrease in WIC
spending, in spite of the hundreds of waivers in
place during the COVID–19 pandemic.
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the process for requesting a waiver more
burdensome than it already was when
FNS implemented waivers during the
COVID–19 public health emergency.
More generally, waiver authority allows
USDA and State and local WIC agencies
to continue to operate the WIC Program
as intended during extraordinary times,
without compromising the quality of
WIC services or supplemental nutrition
and without increasing the burden on
WIC participants. Clear requirements
and a simplified waiver process will
allow State agencies and USDA to put
waivers in place more quickly, enabling
State agencies and USDA to rapidly
respond to emergency situations and
meet waiver applicant and participant
needs.
B. Update Requirements for State
Agency Infant Formula Cost
Containment Contracts
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1. Establish Minimum Required
Remedies for Infant Formula Cost
Containment Contracts
i. Program Impact: While ABFA
generally requires that infant formula
cost containment contracts include
remedies to protect against disruption to
Program participants in the event of an
infant formula recall, this rulemaking
codifies into regulations specific
minimum remedies that assisted State
agencies with meeting participants’
needs during a major infant formula
recall. The minimum remedies must
include (1) that infant formula issuance
may exceed the maximum monthly
allowance to allow for the purchase of
all unit sizes; (2) non-contract brand
formula can be issued without medical
documentation (except in Food Package
III); and (3) when the contracted brand
infant formula is the subject of the
recall, require the contracted infant
formula manufacturer to provide the
State agency with an action plan, which
includes supply data, to meet infant
formula demand and limit disruption to
Program participants in the affected
jurisdiction(s) within 10 calendar days
of the recall, and pay rebates on
competitive, non-contract brand infant
formula that meets the definition of
infant formula at 7 CFR 246.2. WIC State
agencies may work with their legal
counsel and procurement offices to
include additional remedies beyond
these regulatory minimum remedies in
their infant formula contracts. WIC State
agencies may also negotiate flexibilities
that are within regulatory requirements
and do not require Program waivers
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with their contracted infant formula
manufacturers.
ii. Cost Impact: USDA was unable to
reliably estimate the change in costs
associated with this provision, beyond
the small change in burden hours (148
hours across all State agencies annually)
associated with this provision. Although
USDA acknowledges that there will be
cost impacts associated with this
provision in the event of future recalls,
at this time, USDA is unable to reliably
quantify the costs of future remedies,
since the types and scope/scale of future
remedies will be in response to
unknown events, and therefore, USDA
does not include a formal estimate of
the 5-year cost of this provision. Instead,
the following section provides a historic
look at the frequency, scale, and cost of
previous infant formula recalls for
illustrative purposes as well as an
estimate of the cost impact that could
result from even modest changes to
infant formula contract rebate rates.
The first two parts of the provision
grant administrative flexibilities to
ensure continued formula supply to
WIC participants (1) by enabling State
agencies to issue all unit sizes and, in
some cases, exceed the maximum
monthly allowance for formula during
issuance if some package sizes are not
available in the local marketplace (2) by
enabling State agencies to issue noncontract brand formula without medical
documentation (except in Food Package
III) in the event that the contract brand
formula is unavailable.
The third part of the provision—that
the contracted infant formula
manufacturer will pay rebates on
competitive non-contract brand infant
formula when the contracted infant
formula manufacturer’s product is the
subject of the recall—has the potential
to impose costs on infant formula
manufacturers. As described above,
during the most recent major infant
formula recall, the infant formula
manufacturer whose product was the
subject of the voluntary recall
temporarily continued paying rebates on
competitive non-contract brand infant
formula in the WIC State agencies where
they held the contract. Adding this
remedy to future infant formula cost
containment contracts requires all infant
formula manufacturers to pay these
rebates in the future when their product
is the subject of a recall, which in turn
could pose an added cost to the
manufacturer subject to the recall while
their product is off the market.
In the event that a supply chain
disruption necessitates issuing a waiver
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Sfmt 4700
to a State agency allowing the issuance
of non-contract infant formula without
medical documentation, but where the
contracted infant formula manufacturer
in that State agency is not the subject of
a recall and thus not obligated to pay
rebates on non-contract products as
described above, then USDA expects to
see a decrease in rebate income relative
to the amount of non-contract brand
formula issued in that State agency. Any
decrease in rebate income relative to the
amount of non-contract brand formula
issued would increase WIC food
expenditures on infant formula for
USDA, as was the case in State agencies
without contracts with a specific major
infant formula manufacturer during the
2022 major infant formula recall. While
the Department is not able to estimate
the scale of future recalls, a look back
at typical infant formula rebate
amounts, prior to the 2022 voluntary
recall by a major infant formula
manufacturer of certain powder infant
formula, including exempt infant
formula, provides a helpful estimate of
possible costs. USDA received
approximately $1.6 billion in WIC
infant formula rebates in FY 2021, while
the monthly average number of fully
formula-fed infant participants was
approximately 962,000, and the
monthly average number of partially
breastfed infant participants was
approximately 329,000, resulting in an
average monthly rebate of $103.38 per
infant receiving a WIC food package
with infant formula. As an example of
scale, it would therefore cost USDA
around $10.3 million to cover the lost
rebate amounts for 100,000 average
infants receiving formula per month,
based on FY 2021 costs.30
Our analysis suggests that most infant
formula recall events in the past 20
years have been recalls of small
amounts of products—usually single
batches or lot numbers, and almost all
covering fewer than around 100,000
cans of infant formula per recall—and
would not require the kind of large-scale
intervention that the major infant
formula recall in 2022 required. One
available list of infant formula recalls
from 1982–2005 showed no large
nationwide recalls (except for one in
2001 that was a result of mislabeling,
not product contamination).31 Similarly,
a search of FDA’s Enforcement Database
30 Analysis of FNS administrative data, available
at https://www.fns.usda.gov/pd/wic-program.
31 See https://flca.info/HTMLobj-154/Recalls.pdf.
Accessed December 7, 2022.
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showed only small recalls of infant
formula (fewer than 100,000 cans per
recall that likely did not disrupt the
supply chain) from June 2012 through
2022, until the large major infant
formula recall.32
Finally, USDA notes that these
provisions may impact rebate amounts
offered on infant formula contracts
moving forward. If this rule changes the
incentive for infant formula
manufacturers to increase or decrease
rebate bids on infant formula contracts
through the competitive bidding
process, it could increase or decrease
the rebate amounts offered by infant
formula manufacturers to State
Agencies. This would consequently
decrease or increase Federal WIC food
costs. However, when examining the
limited number of infant formula
contracts awarded either (1) since the
start of the major infant formula recall,
or (2) since the passage of ABFA, which
included contracts that require the three
remedies outlined in this rule, USDA
was not able to discern a pattern of
either increased or decreased formula
rebate bids; some offered rebate
amounts increased slightly and others
decreased slightly, similar to how
formula contracts have changed over
time in the past. Therefore, USDA is not
able to estimate that these provisions
will have an impact on the rebates
offered in future infant formula
contracts. However, to provide a sense
of scale, USDA notes that WIC received
$1.6 billion in rebates from infant
formula and food manufacturers in
FY2021; a nationwide 5 percent
increase or decrease in average infant
formula rebate amounts offered to State
agencies would decrease or increase
Federal WIC food spending by $80
million per year.
iii. Impact on Affected Parties: The
extent to which other impacts of these
provisions will be realized largely
depends on how often and at what scale
they are needed in responding to future
recalls. In the event that an infant
formula manufacturer is never subject to
a recall, then the impact of these
remedies on infant formula
manufacturers will be minimal.In the
event of a recall, these provisions grant
substantial benefits to WIC State and
local agencies, WIC vendors, and WIC
participants. The minimum remedies
described above benefit WIC State
32 Search available at https://www.fda.gov/safety/
recalls-market-withdrawals-safety-alerts/
enforcement-reports. Accessed December 7, 2022.
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agencies by providing a substantially
streamlined administrative process to
approve and issue new infant formula
benefits in the event of a recall. WIC
vendors benefit from the certainty that
WIC participants will continue to be
issued and be able to purchase infant
formula. Finally, these remedies are
intended to protect WIC participants
from disruptions in access to infant
formula during product recalls. For
infant formula manufacturers, if their
product is subject to a recall these
provisions will require them to pay
rebates on non-contract infant formula
in their contracted State agencies.
However, these provisions also provide
certainty as to how all stakeholders in
the WIC infant formula supply chain—
the Federal Government, State and local
WIC agencies, WIC vendors, WIC
clinics, and infant formula
manufacturers—will respond and what
responsibilities they bear in the event of
a formula recall.
2. Clarify Terminology in Infant
Formula Cost Containment Contracts
i. Program Impact: This rule will
clarify terminology at 7 CFR
246.16a(c)(5). Specifically, the current
terms ‘‘responsive and responsible’’
used in the regulations to describe
bidders are consolidated to
‘‘responsive.’’ Responsive is further
defined for clarification; to be
responsive, a bidder must submit a bid
that conforms to the solicitation and
must meet requirements at 246.16a. The
rule adds language to clarify this
meaning, which will enhance consistent
application of the term and ensure that
all responsive bids will receive
consideration. This provision is not
required by ABFA.
ii. Cost Impact: USDA is not able to
estimate a change in cost associated
with this provision. Improved clarity
may slightly lower administrative costs
to State agencies or infant formula
manufacturers.
iii. Impact on Affected Parties: This
change improves the clarity of the
bidding process for infant formula
contracts between State agencies and
infant formula manufacturers.
C. Add Requirement for State Agency
Plans of Alternate Operating Procedures
i. Program Impact: This rule will add
a new provision that State agencies
must include as a part of the State Plan
a plan of alternate operating procedures,
commonly referred to as disaster plans,
in the event of a disruption of WIC
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services. Requiring States to have these
plans in place prior to a disaster will
help mitigate potential impacts as States
would have uniform baseline measures
in place to address potential barriers to
Program operations and allow State
agencies to respond more quickly
during these unforeseen events. This
provision is not required by ABFA.
ii. Cost Impact: USDA was unable to
estimate the change in cost associated
with this provision, beyond the change
in burden hours (1,869 hours across all
State agencies annually) associated with
this provision. Some State agencies may
already include components of a plan of
alternate operating procedures in their
State Plan; for these State agencies, this
provision poses a minimal additional
burden to update their procedures in
accordance with regulations. Although
there may be a small increase in burden
as State agencies write alternative
operating procedures to include in
future State Plans, USDA anticipates
that having these plans in place may
decrease burden on State agencies and
improve State agencies’ responsiveness
during a disaster, although USDA is not
able to quantify these potential benefits.
iii. Impact on Affected Parties: USDA
anticipates a small increase in burden
on some State agencies. However, USDA
expects that having these plans in place
will leave State agencies more prepared
in the event of a disaster and will help
mitigate the disruptions WIC
participants might face in the event of
a disaster.
IV. Summary of Impacts
A. Cost Impact
The costs of the rule that were able to
be estimated are the result of an increase
in reporting and recordkeeping burden
associated with the provisions of the
rule (an increase of 2,055 reporting and
recordkeeping hours annually across all
State agencies), most of which are due
to the provision requiring alternative
operating procedures in State Plans.
USDA estimates these costs to be $0.6
million to the State agencies over the
five years from FY 2024 to FY 2028.33
33 Costs associated with State agency burden
hours are calculated using the hourly total
compensation for all State and Local workers from
the Bureau of Labor and Statistics (BLS) for FY 2021
and inflated according to the CPI–W increase in
OMB’s economic assumptions for the FY2023
President’s Budget for years FY2024–FY2028
(https://data.bls.gov/timeseries/CMU301000
0000000D).
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TABLE 1—ESTIMATED STATE AGENCY COSTS DUE TO CHANGE IN ADMINISTRATIVE 34 BURDEN, FY 2024–2028
Fiscal year
(millions)
Increase in State Agency Reporting and Recordkeeping Burden
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B. Benefit Impact
As discussed in detail above, the
provisions of this rule strengthen USDA
and WIC State agencies’ ability to
address emergencies, disasters and
supply chain disruptions, particularly
those impacting infant formula by (1)
codifying permanent, expanded waiver
authority of the Secretary to help ensure
continuity of WIC services during
certain emergencies, disasters, and
supply chain disruptions impacting the
WIC Program; (2) codifying
requirements for State agencies to
include language in their WIC infant
formula cost containment contracts that
describes remedies in the event of an
infant formula recall, including how an
infant formula manufacturer would
protect against disruption to benefit
access by WIC participants, and (3)
requiring that State agencies include as
a part of their State Plans a ‘‘plan of
alternate operating procedures’’ in the
event of an emergency period, supply
chain disruption, or supplemental food
recall.
Although USDA is not able to
quantify the benefits generated by this
rule, USDA expects for the provisions of
this rule to improve the Federal
Government’s and State agencies’
readiness to respond to emergencies,
disasters, or supply chain disruptions.
Improved readiness should decrease
uncertainty to State and local WIC
agencies, WIC clinics, infant formula
manufacturers, WIC-authorized vendors,
and WIC participants and should
improve the continued provision of WIC
services and benefits to WIC
participants in the event of a
emergencies, disasters, or supply chain
disruption.
C. Participation and Distributional
Impacts
As noted in the above analysis, the
Department does not project a
participation impact attributable to this
rule; the changes made by this rule are
largely administrative in nature and
strive to ensure continued, smooth
operation of WIC during extraordinary
events. The changes are unlikely to be
visible to WIC-eligible individuals and
34 Amounts may not sum to the total shown due
to rounding.
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2024
2025
2026
2027
2028
Total
$ 0.1
$ 0.1
$ 0.1
$ 0.1
$ 0.1
$ 0.6
WIC participants in a way that affects
their decision to participate or continue
to participate in the WIC Program.
Previous analyses have studied the
effects that WIC has on individuals who
do not participate in WIC.35 The
Department is unable to reliably
estimate an effect of this rule on nonWIC participants, as the provisions of
this rule that are non-administrative and
not costed (i.e., the non-administrative
consequences of the waiver provisions
and the infant formula contract
provisions) do not come into force
except in response to future,
unpredictable events. Furthermore, the
limited datapoints the Department does
have do not indicate that this rule is
likely to affect infant formula rebates in
a meaningful way and, therefore, is
unlikely to affect the wider infant
formula market. To the extent that the
provisions of this rule helps ensure
continued infant formula supply in the
event of a supply chain disruption, this
rule could have positive spillover effects
on non-WIC participants, as the infant
formula available for purchase to WIC
participants will also be available for
purchase by non-WIC participants.
Regulatory Flexibility Act
The Regulatory Flexibility Act (5
U.S.C. 601–612) requires agencies to
analyze the impact of rulemaking on
small entities and consider alternatives
that would minimize any significant
impacts on a substantial number of
small entities. Pursuant to that review,
it has been certified this rule would not
have a significant impact on a
substantial number of small entities.
This final rule would not have a
significant economic impact on a
substantial number of small entities.
This final rule would not have an
adverse impact of small entities in the
WIC; the impact is not significant as it
allows for greater options and
flexibilities to support the continuation
of WIC services during emergency
periods and supply chain disruptions.
State agencies are already required to
35 See, for example, Oliveira, V. and Fraza
˜ o, E.
(2015), ‘‘Painting a More Complete Picture of WIC:
How WIC Impacts Nonparticipants,’’ available
online at https://www.ers.usda.gov/amber-waves/
2015/april/painting-a-more-complete-picture-ofwic-how-wic-impacts-nonparticipants/.
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continuously operate a cost containment
system for infant formula, with some
exceptions. Notably, ITOs with 1,000 or
fewer participants are exempt from this
provision. Further, the Department has
encouraged WIC State agencies to
develop disaster plans in the event of
disruptions to Program operations. Of
the 89 WIC State agencies, 82 State
agencies have disaster plans in place.
Factual Basis
The provisions of this final rule apply
to small local agencies operating the
Special Supplemental Nutrition
Program for Women, Infants and
Children, and to State agency staff who
must monitor local agencies in remote
locations. These entities meet the
definitions of ‘‘small governmental
jurisdiction’’ and ‘‘small entity’’ in the
Regulatory Flexibility Act. These
entities will not be negatively impacted
by the changes and options in this rule.
Congressional Review Act
Pursuant to the Congressional Review
Act (5 U.S.C. 801 et seq.), the Office of
Information and Regulatory Affairs
designated this rule as not a ’major rule’
as defined by 5 U.S.C. 804(2).
Unfunded Mandates Reform Act
Title II of the Unfunded Mandates
Reform Act of 1995 (UMRA), Public
Law 104–4, establishes requirements for
Federal agencies to assess the effects of
their regulatory actions on State, local
and tribal governments, and the private
sector. Under section 202 of the UMRA,
the Department generally must prepare
a written statement, including a cost
benefit analysis, for proposed and final
rules with ‘‘Federal mandates’’ that may
result in expenditures by State, local or
tribal governments, in the aggregate, or
the private sector, of $177 million or
more in 2023 (when adjusted for
inflation; GDP deflator source: Table
1.1.9 at https://www.bea.gov/iTable) in
any one year. When such a statement is
needed for a rule, Section 205 of the
UMRA generally requires the
Department to identify and consider a
reasonable number of regulatory
alternatives and adopt the most cost
effective or least burdensome alternative
that achieves the objectives of the rule.
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This final rule does not contain
Federal mandates (under the regulatory
provisions of Title II of the UMRA) for
State, local and tribal governments, or
the private sector of $146146177146146
million or more in any one year. Thus,
the rule is not subject to the
requirements of Sections 202 and 205 of
the UMRA.
Executive Order 12372
The Special Supplemental Nutrition
Program for Women, Infants, and
children (WIC) is listed in the Catalog of
Federal Domestic Assistance under
Number 10.557 and is subject to
Executive Order 12372, which requires
intergovernmental consultation with
State and local officials. (See 2 CFR
chapter IV.)
Federalism Summary Impact Statement
Executive Order 13132 requires
Federal agencies to consider the impact
of their regulatory actions on State and
local governments. Where such actions
have federalism implications, agencies
are directed to provide a statement for
inclusion in the preamble to the
regulations describing the agency’s
considerations in terms of the three
categories called for under Section
(6)(b)(2)(B) of Executive Order 13132.
The Department has considered the
impact of this rule on State and local
governments and has determined that
this rule does not have federalism
implications. Therefore, under Section
6(b) of the Executive Order, a federalism
summary is not required.
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Executive Order 12988, Civil Justice
Reform
This final rule has been reviewed
under Executive Order 12988, Civil
Justice Reform. This rule is intended to
have preemptive effect with respect to
any State or local laws, regulations, or
policies which conflict with its
provisions or which would otherwise
impede its full and timely
implementation. This rule is not
intended to have retroactive effect
unless so specified in the Effective Dates
section of the final rule. Prior to any
judicial challenge to the provisions of
the final rule, all applicable
administrative procedures must be
exhausted.
Civil Rights Impact Analysis
FNS has reviewed the final rule, in
accordance with the Department
Regulation 4300–004 ‘‘Civil Rights
Impact Analysis,’’ to identify and
address any major civil rights impacts
the proposed rule might have on
participants on the basis of race, sex,
national origin, disability, and age. The
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requirements outlined in the final rule
aim to remove barriers to WIC food
access. The changes would impact WIC
State agencies, including ITOs, WIC
local agencies and clinics, participants
and WIC vendors in ways that are
expected to increase equity and access
for WIC participants during times of
disaster.
To mitigate potential impacts on
Program access for LEP populations and
persons with disabilities, FNS will
provide WIC State agencies with
technical assistance aimed at ensuring
that communications about program
changes are available in appropriate
languages and in alternative formats for
persons with disabilities. After
reviewing the potential impacts, FNS
does not believe the rule would result
in civil rights impacts on protected
groups of WIC participants and
applicants. However, the FNS CRD will
propose further outreach and mitigation
strategies to alleviate any unforeseen
impacts, if deemed necessary.
Executive Order 13175
Executive Order 13175 requires
Federal agencies to consult and
coordinate with Tribes on a
government-to-government basis on
policies that have Tribal implications,
including regulations, legislative
comments or proposed legislation, and
other policy statements or actions that
have substantial direct effects on one or
more Indian Tribes, on the relationship
between the Federal Government and
Indian Tribes, or on the distribution of
power and responsibilities between the
Federal Government and Indian Tribes.
Tribal consultation regarding this rule
was conducted on November 8, 2022.
FNS provided an opportunity for
consultation on the rule and Tribal
leaders were generally supportive. If a
Tribe requests consultation on this
rulemaking in the future, FNS will work
with USDA’s Office of Tribal Relations
to ensure meaningful consultation is
provided.
Paperwork Reduction Act
The Paperwork Reduction Act of 1995
(44 U.S.C. Chap. 35; 5 CFR part 1320)
requires the Office of Management and
Budget (OMB) approve all collections of
information by a Federal agency before
they can be implemented. Respondents
are not required to respond to any
collection of information unless it
displays a current valid OMB control
number.
This final rule impacts existing
information collection requirements that
are contained in OMB Control Number
0584–0043 Special Supplemental
Nutrition Program for Women, Infants,
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86559
and Children (WIC) Program
Regulations—Reporting and
Recordkeeping (expiration date
December 31, 2023) which are subject to
review and approval by OMB in
accordance with the Paperwork
Reduction Act of 1995. Additionally,
the waiver elements of this rule are
already in effect but codified in this rule
and have been previously approved by
OMB under OMB #0584–0687. Any
further public comment on the waiver
information collection solicited in
response to this rule will be used to
inform the next revision of the
information collection. Therefore, FNS
is submitting for public comment in this
rule the changes in the information
collection burdens in OMB Control
Numbers 0584–0043 that would result
from adoption of this rule. The
information collection and
recordkeeping requirements included in
this final rule have been submitted by
the Agency to OMB for approval which
is currently pending. FNS will not
collect any information associated with
this rule until the information
collections are approved by OMB.
Comments on the information
collection for this final rule must be
received by February 12, 2024.
Comments may be sent to: Allison
Post, Food and Nutrition Service, U.S.
Department of Agriculture, 1320
Braddock Place, 3rd Floor, Alexandria,
VA 22314. Comments will also be
accepted through the Federal
eRulemaking Portal. Go to https://
www.regulations.gov and follow the
online instructions for submitting
comments electronically.
Comments are invited on: (a) whether
the collection of information is
necessary for the proper performance of
the functions of the Department,
including whether the information shall
have practical utility; (b) the accuracy of
the Department’s estimate of the burden
of the proposed collection of
information, including the validity of
the methodology and assumptions used;
(c) ways to enhance the quality, utility,
and clarity of the information to be
collected; and (d) ways to minimize the
burden of the collection of information
on those who are to respond, including
use of appropriate automated,
electronic, mechanical, or other
technological collection techniques or
other forms of information technology.
All responses to this notice will be
summarized and included in the request
for OMB approval. All comments will
also become a matter of public record.
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a. Revisions to OMB Control Number
0584–0043
Title: Special Supplemental Nutrition
Program for Women, Infants, and
Children (WIC) Program Regulations—
Reporting and Recordkeeping Burden.
OMB Number: 0584–0043.
Expiration Date: 12/31/2023.
Type of Request: Revision of a
currently approved collection.
Abstract: This is a revision of existing
information collection requirements in
the information collection under OMB
Control Number 0584–0043 that are
affected by this rulemaking. Under this
rule, the Department amends 7 CFR part
246 to codify the provisions of ABFA
and implement related changes which
will strengthen WIC’s ability to address
emergency periods and supply chain
disruptions, particularly those
impacting infant formula. This final rule
impacts the burden associated with
reporting and recordkeeping
requirements for State agencies. This
final rule may also result in additional
financial costs to State agencies.
(i) Burden Revisions Related to State
Plan Requirements
This rule requires WIC State agencies
to include, as a part of the State Plan,
a plan of alternate operating procedures,
commonly referred to as a disaster plan
in accordance with FNS guidance.
Although current WIC regulations do
not require WIC State agencies to
develop and implement disaster plans,
the Department has always encouraged
WIC State agencies to develop them.
While many WIC State agencies have a
disaster plan, they are typically part of
a broader health department or other
State agency disaster plan and do not
address WIC-specific Program
operations during emergency periods
and supply chain disruptions.
FNS estimates that 82 WIC State
agencies have a disaster plan, and that
it will take these State agencies an
additional 16 hours to update their
existing disaster plans to conform with
the added specific requirements for
these plans included in this rulemaking.
Of the remaining 7 WIC State agencies
who do not have existing disaster plans,
FNS estimates that it will take these
State agencies 80 hours to develop
disaster plans in accordance with this
rulemaking. Therefore, FNS estimates
that this rule would result in an increase
of 21 burden hours to each State
agency’s reporting burden ((82 State
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agencies × 16 hours) + (7 State agencies
× 80 hours)/89 State agencies = 21
burden hours). This would increase the
burden hours to submit an annual State
Plan from 134.62 to 155.62 which
would increase the associated reporting
burden by 1,869 burden hours.
(ii) Burden Revision Related to Infant
Formula Cost Containment Contracts
Remedies
This rule requires State agencies to
include minimum required remedies in
infant formula cost containment
contracts to ensure that, in the event of
an infant formula recall, any State
agency for whom the Secretary has
issued a waiver(s) under the conditions
described in § 246.29 will be able to
enact remedies to protect against
disruption to Program participants. All
State agencies must continuously
operate a cost containment system for
infant formula, with some exceptions.
Notably, ITOs with 1,000 or fewer
participants are exempt from this
provision. As such, 79 State agencies
out of 89 WIC State agencies have infant
formula cost containment contracts.
Contracts that State agencies entered
into after ABFA was enacted on May 21,
2022 may already include some of the
requirements specified in this rule, as
WIC Policy Memorandum #2022–6
suggested remedies that are being
codified in this rule. However,
regardless of whether State agencies
have included some of the remedies into
their contracts, this rule includes greater
specificity on the requirements outlined
in WIC Policy Memorandum #2022–6
and an additional requirement.
Therefore, incorporating the rule’s
minimum required remedies in infant
formula cost containment contracts
would require an estimated one-time
two-hour burden per State agency.
Therefore, FNS estimates that this rule
would result in a one-time increase in
148 burden hours to State agencies’
reporting burden (79 State agencies × 2
burden hours = 148 burden hours).
Additionally, this rule requires infant
formula manufacturers to provide State
agencies with an action plan to meet
formula demand and limit disruption to
Program participants in the affected
jurisdiction(s) in the event of an infant
formula recall. This plan must include
current supply data to assist the State
agency in their recall response. Based
on the rarity of large-scale infant
formula recalls, FNS estimates that one
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Fmt 4700
Sfmt 4700
State agency and one infant formula
manufacturer will be impacted by an
infant formula recall each year, and that
it will take the infant formula
manufacturer 4 hours to provide the
State agency with an action plan with
current supply data. Therefore, FNS
estimates that this rule would result in
an additional 4 burden hours to
businesses’ reporting burden (1 infant
formula manufacturer × 4 burden hours
= 4 burden hours).
(iii) Burden Revisions Related to
Emergency Period and Supply Chain
Disruption Recordkeeping
This rule requires State agencies
establish a plan to report to FNS on
alternate operating procedures
implemented during an emergency
period, supplemental food recall, and
other supply chain disruptions, which
includes Program data and information
on the impact of benefit use and
delivery. Additionally, this rule requires
infant formula manufacturers to provide
State agencies with an action plan to
meet formula demand and limit
disruption to program participants in
the affected jurisdiction(s) in the event
of an infant formula recall. This plan
must include current supply data to
assist the State agency in their recall
response. FNS estimates that 15 State
agencies will implement alternate
operating procedures in the event of an
emergency period or supply chain
disruption, including an infant formula
recall, each year. FNS estimates that it
will take State agencies 2 hours to
record data related to alternate operating
procedures implemented during an
emergency period or supply chain
disruption, and supply data from infant
formula manufacturers in the event of
an infant formula recall. Therefore, FNS
estimates that this rule would result in
an additional 30 burden hours to State
agencies’ recordkeeping burden (15
State agencies × 2 burden hours = 30
burden hours).
Respondents: State agencies,
including Indian Tribal Organizations
and U.S. Territories (note that burden
estimates for local agencies are not
affected by this rule).
Estimated Number of Respondents:
90.
Estimated Number of Responses per
Respondent: 1.99.
Estimated Total Annual Burden on
Respondents: 14,032.
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APPENDIX I—WIC BURDEN TABLE
Regulatory section
Estimated
number of
respondents
Information collected
Annual
responses
per
respondent
Total
annual
responses
Number of
burden
hours
per request
Estimated
total
burden
hours
Previous
submission
total hours
per person
Difference
due to
program
changes
REPORTING BURDEN ESTIMATES
Affected Public: State and
Local Agencies (including Indian Tribal Organizations and U.S. Territories)
246.4 .......................................
246.16a(j) ................................
Subtotal Reporting: State
and Local Agencies.
State Plan ................................
Infant formula cost containment contracts remedies.
89
74
1
1
89
74
155.62
2
13,850.18
148
11,981.18
0
1,869.00
* 148
..................................................
89
2
163
85.88
13,998
11,981
2,017.00
4
Affected Public: Business: Retail Vendors (WIC-Authorized Food Stores)
246.16a(j) ................................
Subtotal Reporting: Retail
Vendors *.
Grand Subtotal: Reporting.
Infant formula contractor action plan.
1
1
1
4
4
0
1 ..............................................
1.00
1
4.00
4
0
4
90 ............................................
1.82
164
85.38
14,002
11,981
2,021
RECORDKEEPING BURDEN ESTIMATES
Affected Public: State and Local Agencies (including Indian Tribal Organizations and U.S. Territories)
246.4(a)(30); 246.16a(j) ..........
Emergency Period and Supply
Chain Disruption Recordkeeping.
15
1
15
2
30
0
30
Subtotal: Recordkeeping ..
..................................................
15
1.00
15
2.00
30
0
30
..................................................
90
1.99
179
78.39
14,032
11,981
2,051
Grand Total: Reporting and Recordkeeping.
* There is a one-time information collection burden associated with this provision.
Summary of Requested Burden
Revisions:
TABLE 4—SUMMARY OF REQUESTED BURDEN REVISIONS TO #0584–0043
lotter on DSK11XQN23PROD with RULES1
Responses
Respondents
Time burden
Current Inventory: * Total Burden ...............................................................................................
Current Inventory: * Reporting .............................................................................................
Current Inventory: * Recordkeeping .....................................................................................
Total Burden Revision Requested ...............................................................................................
Burden Revision Requested: Reporting ...............................................................................
Burden Revision Requested: Recordkeeping ......................................................................
48,798,800
21,254,756
27,544,044
48,798,890
21,254,831
11,897
6,913,189
6,913,189
11,897
6,913,190
6,913,190
27,544,059
4,547,099
4,017,132
529,967
4,549,150
4,019,153
529,997
Difference in Total Burden from Rulemaking ................................................................
90
1
2,051
E-Government Act Compliance
List of Subjects in 7 CFR Part 246
The Department is committed to
complying with the E-Government Act,
to promote the use of the internet and
other information technologies to
provide increased opportunities for
citizen access to Government
information and services, and for other
purposes.
Administrative practice and
procedure, Civil rights, Food assistance
programs, Grant programs—health,
Grant programs—social programs,
Indians, Infants and children, Maternal
and child health, Nutrition, Penalties,
Reporting and recordkeeping
requirements, Women.
Accordingly, the Department amends
7 CFR part 246 as follows:
VerDate Sep<11>2014
16:17 Dec 13, 2023
Jkt 262001
PO 00000
Frm 00017
Fmt 4700
Sfmt 4700
PART 246—SPECIAL SUPPLEMENTAL
NUTRITION PROGRAM FOR WOMEN,
INFANTS AND CHILDREN
1. The authority citation for part 246
continues to read as follows:
■
Authority: 42 U.S.C. 1786.
2. Amend § 246.2 by adding the
definitions for ‘‘Emergency period,’’
‘‘Qualified administration requirement,’’
‘‘Recall’’ and, ‘‘Supply Chain
■
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Federal Register / Vol. 88, No. 239 / Thursday, December 14, 2023 / Rules and Regulations
Disruption’’ in alphabetical order to
read as follows:
§ 246.2
Definitions.
*
*
*
*
*
Emergency period means a period
during which there exists:
(1) A presidentially declared major
disaster as defined under section 102 of
the Robert T. Stafford Disaster Relief
and Emergency Assistance Act (42
U.S.C. 5121 et seq.).
(2) A presidentially declared
emergency as defined under section 102
of the Robert T. Stafford Disaster Relief
and Emergency Assistance Act (42
U.S.C. 5121 et seq.).
(3) A public health emergency
declared by the Secretary of HHS under
section 319 of the Public Health Service
Act (42 U.S.C. 247d).
(4) A renewal of such a public health
emergency pursuant to section 319.
*
*
*
*
*
Qualified administrative requirement
means a statutory requirement under
Section 17 of the Child Nutrition Act of
1966 (CNA; 42 U.S.C. 1786) or a
regulatory requirement issued pursuant
to this section.
*
*
*
*
*
Recall means recall as defined in 21
CFR 7.3(g) or any successor regulation.
Recalls may be conducted voluntarily
by a manufacturer or may be required by
FDA.
*
*
*
*
*
Supply chain disruption means a
shortage of WIC supplemental foods that
limits WIC participants’ ability
reasonably to purchase supplemental
foods using WIC benefits within a State
agency’s jurisdiction, as determined,
and declared by the Secretary for the
purposes of WIC.
*
*
*
*
*
■ 3. Amend § 246.4 by adding paragraph
(a)(30) to read as follows:
lotter on DSK11XQN23PROD with RULES1
§ 246.4
State plan.
(a) * * *
(30) Plans of alternate operating
procedures, commonly referred to as
disaster plans, to support the
continuation of WIC services during an
emergency period as defined at § 246.2,
supply chain disruption as defined at
§ 246.2, and supplemental food recall.
State agencies must consider the unique
and sudden nature of an emergency
period, supplemental food recall, and
other supply chain disruptions when
developing alternate operating
procedures. Alternate procedures must
describe the process by which the State
agency will minimize the negative
impact to WIC operations and services
and ensure the availability of authorized
VerDate Sep<11>2014
16:17 Dec 13, 2023
Jkt 262001
supplemental foods, especially infant
formula, to the extent feasible. At a
minimum, alternate operating
procedures must include(i) A plan to address operation of
specific Program areas including(A) Access to Program records;
(B) Alternate certification and benefit
issuance
(C) Verification of Certification (VOC)
issuance
(D) Food package adjustments;
(E) Vendor requirements;
(F) Benefit redemption; and
(G) Food delivery systems.
(ii) A plan to ensure continuity of
WIC services and address the needs of
participants with documented
qualifying conditions receiving Food
Package III, rural areas, Indian tribal
organizations, and other priority
populations in the affected area as
applicable;
(iii) A designated emergency contact
within the State agency for emergency
periods, supplemental food recalls, and
other supply chain disruptions;
(iv) A designated emergency contact
within the State agency to address the
needs of participants with documented
qualifying conditions receiving Food
Package III;
(v) A plan to establish relationships
with relief agencies responsible for
disaster and public health emergency
planning applicable to the State
agency’s jurisdiction and participants to
support data-informed approaches when
responding to emergency periods,
supplemental food recalls, and other
supply chain disruptions;
(vi) A plan to limit the disruption of
infant formula benefits in the event of
an emergency period, supplemental
food recall, and other supply chain
disruptions;
(vii) A communications plan to keep
FNS, State and local agency staff,
authorized WIC vendors, WIC
participants, and the public informed
during an emergency period
supplemental food recall, and other
supply chain disruptions;
(viii) A plan to report to FNS on
alternate operating procedures
implemented during an emergency
period, supplemental food recall, and
other supply chain disruptions which
includes Program data and information
on the impact of benefit use and
delivery; and
(ix) A plan to adjust State agency
specific minimum requirements for the
variety and quantity of supplemental
foods that a vendor applicant must stock
to be authorized.
*
*
*
*
*
■ 4. In § 246.16a:
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Fmt 4700
Sfmt 4700
a. Revise paragraph (c)(5); and
b. Add a new paragraph (n).
The revision and addition read as
follows:
■
■
§ 246.16a Infant formula and authorized
foods cost containment.
*
*
*
*
*
(c) * * *
(5) A State agency must award the
contract(s) to the responsive bidder(s)
offering the lowest total monthly net
price for infant formula or the highest
monthly rebate (subject to
paragraph(c)(4)(ii) of this section) for a
standardized number of units of infant
formula. To be responsive, a bidder
must submit a bid by the deadline set
by the State agency that conforms to the
solicitation and must meet requirements
at 246.16a and set forth in the bid
solicitation. The State agency must
calculate the lowest net price using the
lowest national wholesale cost per unit
for a full truckload of the infant formula
on the date of the bid opening.
*
*
*
*
*
(n) What minimum recall-related
provisions must be included in infant
formula cost containment contracts? A
State agency must include remedies in
the event of a recall in their infant
formula cost containment contract to
protect against disruption in infant
formula supply to participants. The
State agency will determine when
remedies take effect and remain in
effect, in accordance with applicable
Program requirements and the infant
formula cost containment contract. At
minimum, recall remedies in the State
agency’s infant formula cost
containment contract must:
(1) Allow infant formula to be issued
in all unit sizes that may exceed the
maximum monthly allowance. The State
agency and contracted infant formula
manufacturer must prioritize unit sizes
that most closely provide the maximum
monthly allowance;
(2) Allow the issuance of non-contract
brand infant formulas without medical
documentation, with the exception of
participants receiving Food Package III
as defined in section 246.10(e)(3) of this
Part; and
(3) When any contract brand infant
formula of the contracted manufacturer
is the subject of a recall, require the
contracted infant formula manufacturer
to:
(i) Provide the State agency with an
action plan, within a timeline
established within the contract, which
includes supply data, to meet infant
formula demand and limit disruption to
Program participants in the affected
jurisdiction(s); and
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(ii) Pay rebates on competitive, noncontract brand infant formula that meets
the definition of infant formula at 7 CFR
246.2.
■ 5. Add § 246.29 to read as follows:
lotter on DSK11XQN23PROD with RULES1
§ 246.29 Waivers of program
requirements.
(a) Required conditions. The Secretary
may waive or modify any qualified
administrative requirement for one or
more State agencies during an
emergency period or supply chain
disruption. Waivers or modifications
may be issued following a State agency
request or at the discretion of the
Secretary. To be considered, a waiver or
modification issued under this Section
must meet the following requirements:
(1) The qualified administrative
requirement cannot be implemented
during any part of the emergency period
or supply chain disruption.
(2) The waiver or modification is
necessary to serve participants and does
not substantially weaken the nutritional
quality of supplemental foods.
(3) The waiver or modification would
not result in material impairment of any
statutory or regulatory rights of
participants or potential participants as
set forth at 7 CFR 246.8 or 7 CFR parts
15, 15a and 15b.
(4) The waiver or modification would
not create a barrier to participation.
(5) The waiver or modification would
not create additional eligibility
requirements for participation.
(6) The waiver or modification would
comply with 7 CFR 246.13(b).
(7) The waiver or modification must
offer substitution options with similar
nutritional quality, that most closely
provide the maximum monthly
allowance of supplemental foods, and
that do not create new supplemental
food categories as set forth in 7 CFR
246.10(e)(12) Table 4.
(8) A State agency that requests a
waiver or modification meets additional
requirements for the request and
approval as determined necessary by
FNS.
(b) Timeframes for waiver request and
use. (1) Waiver starts. A waiver or
modification may be granted any time
during an emergency period or supply
chain disruption.
(2) Waiver duration.
(i) A waiver or modification
established during an emergency period
may be available for the emergency
period and up to 60 days after the end
of the emergency period.
(ii) A waiver or modification
established during a supply chain
disruption may be available for:
(A) a period of up to 45 days from the
date of waiver issuance and renewed
VerDate Sep<11>2014
16:17 Dec 13, 2023
Jkt 262001
with at least 15 days’ notice provided by
the Secretary; and
(B) no more than 60 days after the
supply chain disruption declaration
ceases to exist.
(c) State agency waiver requests. State
agencies shall submit requests for a
modification or waiver for USDA
approval. Requests shall include but not
necessarily be limited to:
(1) The qualified administrative
requirement the State agency is
requesting to modify or waive
(including the statutory or regulatory
citation) and an explanation for why it
cannot be met;
(2) Justification for why the waiver is
necessary to continue WIC services;
(3) An explanation that the waiver
meets the conditions set forth in 7 CFR
246.29(a);
(4) The emergency period or supply
chain disruption under which the
request is being made;
(5) The period for which the
flexibility is being requested.
Cynthia Long,
Administrator, Food and Nutrition Service.
[FR Doc. 2023–26641 Filed 12–13–23; 8:45 am]
BILLING CODE 3410–30–P
DEPARTMENT OF AGRICULTURE
Food and Nutrition Service
7 CFR Part 272
[FNS–2022–0005]
RIN 0584–AE86
Supplemental Nutrition Assistance
Program: Revision of Civil Rights Data
Collection Methods
Food and Nutrition Service
(FNS), Agriculture (USDA).
ACTION: Final rule.
AGENCY:
This rule finalizes provisions
of a proposed rule published on June 27,
2022. With this final rule, the Food and
Nutrition Service (FNS) is revising
Supplemental Nutrition Assistance
Program (SNAP) regulations that cover
collecting and reporting race and
ethnicity data by State agencies on
persons receiving benefits from SNAP.
This rule removes regulatory language
that provides an example that State
agencies might collect race and
ethnicity data by observation (also
referred to as ‘‘visual observation’’)
when participants do not voluntarily
provide the information on the
application form. In addition, based on
feedback from the commenters, this rule
prohibits using visual observation as a
data collection method for race and
SUMMARY:
PO 00000
Frm 00019
Fmt 4700
Sfmt 4700
86563
ethnicity. Through this rulemaking, FNS
intends to improve the quality of data
collected for purposes of Federal civil
rights law and policy including title VI
of the Civil Rights Act of 1964. USDA’s
Food and Nutrition Service is
committed to promoting equity and
inclusion through its Federal nutrition
assistance programs. This regulatory
change is consistent with this
Administration’s priorities and furthers
FNS’ commitment to building equitable
and inclusive systems for nutrition
access.
DATES: This rule is effective February
12, 2024.
FOR FURTHER INFORMATION CONTACT:
Maribelle Balbes, Chief, State
Administration Branch, Program
Accountability and Administration
Division, Supplemental Nutrition
Assistance Program, Food and Nutrition
Service, USDA, 1320 Braddock Place,
5th Floor, Alexandria, VA 22314, by
phone at (703) 605–4272 or via email at:
SM.FN.SNAPSAB@usda.gov.
SUPPLEMENTARY INFORMATION:
I. Background
Current Policy
Title VI of the Civil Rights Act of 1964
prohibits discrimination on the basis of
race, color, or national origin in
programs receiving Federal financial
assistance. Additionally, Department of
Justice (DOJ) regulations at title 28 of
the Code of Federal Regulations (CFR),
§ 42.406(a),1 require all Federal agencies
to provide guidelines for the collection
of race and ethnicity data from
applicants and beneficiaries of Federal
assistance programs sufficient to permit
effective enforcement of title VI.
Accordingly, SNAP regulations at 7 CFR
272.6(g) and (h) require State agencies to
collect race and ethnicity data on
participating households and report the
data to FNS to help ensure program
benefits are distributed without regard
to race, color, or national origin. FNS
uses this data to determine how
effectively FNS programs are reaching
potential eligible persons and
beneficiaries, identify areas where
additional outreach is needed, assist in
the selection of locations for compliance
reviews, and complete reports, as
required. State agencies report aggregate
race and ethnicity data to FNS annually
via the form FNS–101, ‘‘Participation in
Food Programs by Race’’ (Office of
Management and Budget (OMB) Control
Number 0584–0594, expiration 7/31/
2023). FNS uses this aggregate data to
conduct compliance reviews and
1 https://www.ecfr.gov/current/title-28/chapter-I/
part-42/subpart-F/section-42.406.
E:\FR\FM\14DER1.SGM
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Agencies
[Federal Register Volume 88, Number 239 (Thursday, December 14, 2023)]
[Rules and Regulations]
[Pages 86545-86563]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2023-26641]
========================================================================
Rules and Regulations
Federal Register
________________________________________________________________________
This section of the FEDERAL REGISTER contains regulatory documents
having general applicability and legal effect, most of which are keyed
to and codified in the Code of Federal Regulations, which is published
under 50 titles pursuant to 44 U.S.C. 1510.
The Code of Federal Regulations is sold by the Superintendent of Documents.
========================================================================
Federal Register / Vol. 88, No. 239 / Thursday, December 14, 2023 /
Rules and Regulations
[[Page 86545]]
DEPARTMENT OF AGRICULTURE
Food and Nutrition Service
7 CFR Part 246
[FNS-2023-0027]
RIN 0584-AE94
Special Supplemental Nutrition Program for Women, Infants, and
Children (WIC): Implementation of the Access to Baby Formula Act of
2022 and Related Provisions
AGENCY: Food and Nutrition Service (FNS), U.S Department of Agriculture
(USDA).
ACTION: Final rule with request for comment.
-----------------------------------------------------------------------
SUMMARY: This rulemaking serves to amend the Special Supplemental
Nutrition Program for Women, Infants, and Children (WIC) Program
regulations by incorporating provisions of the Access to Baby Formula
Act of 2022 and making related amendments. ABFA establishes waiver
authority for the Secretary of Agriculture to address certain
emergencies, disasters, and supply chain disruptions impacting WIC, and
adds requirements to State agency infant formula cost containment
contracts to protect against disruptions to the Program in the event of
a recall. The provisions focus on improving State agencies' ability to
ensure continuity of Program operations during emergency periods (i.e.,
emergencies, disasters, and public health emergencies) and supply chain
disruptions, while ensuring access to Program benefits among low-income
pregnant and postpartum participants, infants, and children up to 5
years of age who are at nutritional risk.
DATES: This rule is effective February 12, 2024. Written comments must
be received on or before February 12, 2024 to be assured of
consideration. Online comments submitted through the Federal
eRulemaking Portal on this rule must be received on or before February
12, 2024.
ADDRESSES: The Food and Nutrition Service, USDA, invites interested
persons to submit written comments on this final rule. USDA seeks
comment on all aspects of this rule. Comments may be submitted in
writing by one of the following methods:
Federal eRulemaking Portal: Go to https://www.regulations.gov. Follow the online instructions for submitting
comments.
Regular U.S. Mail: WIC Administration, Benefits, and
Certification Branch, Policy Division, Food and Nutrition Service, P.O.
Box 2885, Fairfax, Virginia 22031-0885.
Overnight, Courier, or Hand Delivery: Allison Post, WIC
Administration, Benefits, and Certification Branch, Policy Division,
Food and Nutrition Service, 1320 Braddock Place, 3rd Floor, Alexandria,
Virginia 22314.
All written comments submitted in response to this final
rule will be included in the record and will be made available to the
public. Please be advised that the substance of the comments and the
identity of the individuals or entities submitting the comments will be
subject to public disclosure. FNS will make the written comments
publicly available on the internet via https://www.regulations.gov.
FOR FURTHER INFORMATION CONTACT: Allison Post, Chief, WIC
Administration, Benefits, and Certification Branch, Policy Division,
Supplemental Nutrition and Safety Programs, Food and Nutrition Service,
USDA, 1320 Braddock Place, Alexandria, Virginia, (703) 457-7708 or
[email protected].
SUPPLEMENTARY INFORMATION:
I. Overview
On May 21, 2022, the President signed the Access to Baby Formula
Act of 2022 (ABFA, Pub. L. 117-129) into law. ABFA amends Section 17 of
the Child Nutrition Act of 1966 (CNA, 42 U.S.C. 1786) to (1) establish
permanent waiver authority to the Secretary of Agriculture to address
certain emergencies, disasters, and supply chain disruptions impacting
WIC; and (2) require WIC State agency infant formula cost containment
contracts to include specific remedies to protect against disruptions
to the Program in the event of an infant formula recall. This rule
amends 7 CFR part 246 to codify the provisions of ABFA and implement
related changes which will strengthen WIC's ability to address
emergency periods and supply chain disruptions, particularly those
impacting infant formula. For the purpose of this rule:
emergency periods are defined as a public health emergency
declared by the Secretary of Health and Human Services and any renewal
of such a public health emergency; a presidentially declared major
disaster; or a presidentially declared emergency, in alignment with the
definition set forth in ABFA.1 2
---------------------------------------------------------------------------
\1\ Public Health Service Act, 42 U.S.C. 247d Sec. 319 (2003).
https://www.govinfo.gov/content/pkg/USCODE-2019-title42/pdf/USCODE-2019-title42-chap6A-subchapII-partB-sec247d.pdf.
\2\ Robert T. Stafford Disaster Relief and Emergency Assistance
Act, 42 U.S.C. 5121 et seq. Sec. 102 (1988). https://www.fema.gov/sites/default/files/documents/fema_stafford_act_2021_vol1.pdf.
---------------------------------------------------------------------------
supply chain disruption is defined as a shortage of WIC
supplemental foods, including infant formula, that limits WIC
participants' ability to reasonably purchase WIC supplemental foods
benefits within a State agency's jurisdiction, as determined, and
declared by the Secretary, in alignment with the definition set forth
in ABFA.\3\
---------------------------------------------------------------------------
\3\ FEMA, ``Disaster Declaration Process,'' May 2011. Available
online at: https://www.fema.gov/pdf/media/factsheets/dad_disaster_declaration.pdf.
---------------------------------------------------------------------------
Specifically, this rulemaking will:
(1) Codify permanent, expanded waiver authority of the Secretary to
help ensure continuity of WIC services during emergency periods and
supply chain disruptions impacting WIC.
(2) Codify requirements for WIC State agencies to include language
in their WIC infant formula cost containment contracts that describes
remedies in the event of an infant formula recall, including how an
infant formula manufacturer would protect against disruption to
supplemental food access by WIC participants.
(3) Add a new provision that WIC State agencies must include as a
part of the State Plan a ``plan of alternate operating procedures'' in
the event of an emergency period, supplemental food recall, or other
supply chain disruption.
In the development of this rule, the Department prioritized equity,
access, and nutrition security for WIC
[[Page 86546]]
applicants and participants.\4\ The Department also recognizes that the
rule may impact WIC State agencies, including Indian Tribal
Organizations (ITOs), local agencies, clinics, and WIC-authorized
vendors. Additionally, the Department recognizes that the rule may
impact infant formula manufacturers. While WIC is not designed to be a
disaster assistance program, this rule aims to improve the continuity
of services and Program benefits and access to supplemental foods for
participants during these unforeseen circumstances. Relatedly, customer
service, participation, and retention, as well as program integrity,
have also been considered in this rulemaking. To support WIC State
agencies in equitable implementation of this rulemaking, FNS plans to
provide WIC State agencies with technical assistance, which may include
guidance documents, memoranda, webinars, and/or presentations at
conferences. In addition, FNS will explore ways to support WIC State
agencies in providing alternative languages and formats and effective
communication of program changes, including with auxiliary aids and
services to participants and vendors.
---------------------------------------------------------------------------
\4\ U.S. Department of Agriculture, Food and Nutrition Service,
``Food and Nutrition Security.'' Available online at: https://
www.usda.gov/nutrition-
security#:~:text=Nutrition%20security%20means%20consistent%20access,T
ribal%20communities%20and%20Insular%20areas.
---------------------------------------------------------------------------
Given the need for swift implementation of ABFA following recent
disruptions to the supply chain and wide-ranging effects of the infant
formula recall, this is a final rule with request for comments pursuant
to the Administrative Procedure Act's exemption on matters relating to
agency management or personnel or to public property, loans, grants,
benefits, or contracts.\5\ It is imperative the provisions are
implemented as soon as is feasible so that FNS and WIC State agencies
have mechanisms in place to ensure continuity of operations and access
to Program benefits for WIC participants. The Department has requested
comments on specific topics in this rule that can inform future
rulemaking, policy, and/or guidance related to infant formula and will
consider comments on all aspects of the rule when developing guidance
and policy. Given the prescriptive nature of ABFA and the need for
swift implementation ultimately in the interest of WIC participants,
the Department believes this approach best serves the public interest.
The Department has collected, and will consider, input from
stakeholders to ensure the implementation of this rule supports the WIC
population and achieves the intended results. For example, FNS Regional
Operations and Support has collected feedback on FNS' response to the
infant formula recall and the Coronavirus Disease 2019 (COVID-19)
public health emergency from FNS Regional Offices and WIC State
agencies. FNS has considered this feedback in development of this rule
and will continue to do so when developing guidance and policy to
support the successful implementation of the rule. The Department
recognizes the value of stakeholder feedback and will continue to seek
and collect feedback to inform future technical assistance.
---------------------------------------------------------------------------
\5\ Administrative Procedure Act, 5 U.S.C. 553 (1966). https://uscode.house.gov/view.xhtml?req=granuleid:U.S.C.-prelim-title5-section553&num=0&edition=prelim.
---------------------------------------------------------------------------
II. Background
A. Overview of WIC
WIC is currently administered by 89 WIC State agencies, including
the 50 geographic states, the District of Columbia, 33 Indian Tribal
Organizations (ITOs), and five U.S. Territories (the Commonwealth of
the Northern Mariana Islands, American Samoa, Guam, Puerto Rico, and
the U.S. Virgin Islands). By providing supplemental foods, nutrition
education, including breastfeeding promotion and support, and referrals
to health and other social services, WIC addresses the nutritional
needs and safeguards the health of low-income pregnant and postpartum
participants, infants, and children up to 5 years of age who are at
nutritional risk.
According to their participant category and nutritional needs, WIC
participants receive supplemental foods on a monthly basis from one of
seven evidence-based food packages. The amounts and categories of foods
provided are intended to supplement participants' diets and provide
specific nutrients known to be lacking in the diets of WIC's target
population.
WIC participants typically access supplemental foods, including
infant formula, through a retail food delivery system. In such systems,
a WIC shopper goes to a WIC-authorized vendor (i.e., a retail store
authorized by the State agency), selects foods available in their
benefit balance, and uses a food instrument, typically an Electronic
Benefits Transfer (EBT) card, to purchase the items. Outside of a
retail food delivery system, some WIC participants access their
supplemental foods through a home food delivery or direct distribution
system operated by the WIC State agency. Additionally, WIC participants
with certain medical conditions who require exempt formulas or WIC-
eligible nutritionals may receive these as part of, or in addition to,
their WIC food package with appropriate documentation. These exempt
formulas and WIC-eligible nutritionals are procured outside of the
traditional WIC State agency cost-containment contracting process for
standard milk and soy-based infant formula and may be purchased at the
store like their other WIC items, or through other systems set up by
the WIC State agency, depending on availability and need for the
product(s).
B. WIC Program Waiver Authority
Historically, WIC has had limited authority to waive Program
requirements. However, since the onset of the COVID-19 public health
emergency, WIC has experienced a series of disruptions to Program
operations necessitating the ability for USDA's Food and Nutrition
Service (FNS) to have permanent waiver authority.
On February 17, 2022, a major infant formula manufacturer
voluntarily recalled certain powder infant formula, including exempt
infant formula. While recalls may be conducted because a mandatory
order has been issued by the U.S. Food and Drug Administration (FDA)
under statutory authority, they can also be conducted voluntarily by a
manufacturer, as in this case. This recall exacerbated existing supply
chain issues resulting from the ongoing COVID-19 public health
emergency. During its early response to the shortage, FNS used waiver
authority granted under Section 301 of the Robert T. Stafford Disaster
Relief and Emergency Assistance Act, (``Stafford Act,'' 42 U.S.C.
5121), to approve several waiver types for WIC State agencies to help
WIC participants obtain infant formula. This was possible because of
existing COVID-19 major disaster declarations covering the geographic
areas of all WIC State agencies, including States, ITOs, and
Territories.6 7
---------------------------------------------------------------------------
\6\ FEMA, ``COVID-19 Disaster Declarations,'' August 20, 2021.
Available online at: https://www.fema.gov/covid-19.
\7\ FEMA, ``FEMA Assistance for Tribal Governments,'' March 17,
2021. Available online at: https://www.fema.gov/fact-sheet/fema-
assistance-tribal-
governments#:~:text=Tribes%20that%20are%20Recipients%20will%20have%20
a%20direct,in%20the%20Tribal%20Declarations%20Pilot%20Guidance.%20Mor
e%20items.
---------------------------------------------------------------------------
Section 301 of the Stafford Act provides any Federal agency charged
with the administration of a federal
[[Page 86547]]
assistance program with the authority to modify or waive administrative
conditions for assistance that would otherwise prevent the giving of
assistance if the inability to meet such conditions is a result of the
major disaster. Activation of Section 301 of the Stafford Act requires
a State Governor's request and the President's approval. When approved,
these are referred to as Major Disaster Declarations. Section 301 of
the Stafford Act cannot be activated by emergency declarations, public
health emergencies, or supply chain disruptions. Prior to March 2020,
Section 301 of the Stafford Act was the only waiver authority available
to grant administrative flexibilities in WIC.
On March 13, 2020, the ongoing COVID-19 crisis was declared a
public health emergency of sufficient severity and magnitude to warrant
declaration of a nationwide public health emergency through the
Secretary of Health and Human Services. Over the next several weeks, in
response to the COVID-19 public health emergency, major disaster
declarations were put into place covering all WIC State agencies,
including States, Indian Tribal Organizations, and U.S. Territories,
pursuant to Section 501(b) of the Stafford Act. While the major
disaster declarations would eventually enable WIC State agencies to
request regulatory waivers under the Stafford Act's authority,
immediate and additional flexibilities were necessary to support WIC
State agencies.
Therefore, on March 18, 2020, the Families First Coronavirus
Response Act (FFCRA, Pub. L. 116-127) was signed into law to assist
with the COVID-19 public health emergency. USDA received temporary
authority to provide WIC State agencies with flexibilities necessary to
continue operations and safely provide Program benefits to
participants. Specifically, Section 2203 of FFCRA provided USDA with
the statutory waiver authority necessary to waive the physical presence
requirement for all applicants and participants seeking certification
or recertification in WIC; and defer anthropometric (i.e., height/
length and weight) and bloodwork requirements which are used to
determine nutritional risk. As a result, FNS waived the statutory
requirement for in-person WIC clinic visits, thereby encouraging social
distancing, during the COVID-19 public health emergency. Under Section
2204 of FFCRA, WIC State agencies could also request USDA to waive or
modify WIC regulations. Such requests could only be granted if the WIC
State agency (1) could not meet regular Program requirements due to
COVID-19, and (2) such waiver or modification was necessary to provide
assistance to WIC participants. As prescribed in FFCRA, the Department
had the authority to provide waivers through September 30, 2020, which
was then extended through September 30, 2021, through the Continuing
Appropriations Act, 2021 and Other Extensions Act (Pub. L. 116-159).
Certain WIC waivers granted prior to September 30, 2021, were then
extended through FNS' policy guidance until 90 days after the end of
the nationally declared public health emergency under Section 319 of
the Public Health Service Act,\8\ which ended on May 11, 2023, per
announcement from the U.S. Department of Health and Human Services
(HHS). FFCRA provided USDA with the necessary authority to provide WIC
State agencies with the flexibility to pivot operations and continue
serving Program participants during a public health emergency. However,
USDA's authority was temporary and designed to specifically address
COVID-19.
---------------------------------------------------------------------------
\8\ U.S. Department of Agriculture, Food and Nutrition Service,
``WIC Policy Memorandum #2021-10: Updated Expiration Schedule for
Existing FNS-Approved WIC COVID-19 Waivers,'' September 20, 2021.
Available online at: https://www.fns.usda.gov/wic/policy-memorandum-2021-10.
---------------------------------------------------------------------------
While the existing COVID-19 major disaster declarations and
resulting Stafford Act authority provided a vehicle through which FNS
could grant WIC State agencies waivers, under normal circumstances,
such waiver authority would not typically be available for the
Department to respond to an infant formula recall, nor could the
Department issue nationwide waivers. As a result, in direct response to
the infant formula recall, Congress recognized the need to provide USDA
with permanent authority to waive or modify certain statutory and
regulatory requirements when certain conditions are present.
ABFA amended Section 17 of the CNA (42 U.S.C. 1786) to (1)
establish waiver authority for the Secretary of Agriculture to address
certain emergencies, disasters, and supply chain disruptions impacting
WIC; and (2) require WIC State agency infant formula cost containment
contracts to include specific remedies to protect against disruptions
to the Program in the event of a recall. Unlike the Stafford Act, ABFA
provides USDA with the authority to issue waivers for one or more State
agencies, including nationwide, and does not require that each State
agency individually request specific waivers. As a result of ABFA, FNS
issued an implementing policy memorandum describing the infant formula
cost containment contract requirements and waiver authority.\9\ In
order to provide WIC State agencies with additional notice in
anticipation of the expiration of the major disaster declarations in
affected areas which formally ended May 11, 2023, FNS transferred
waivers originally approved under the Stafford Act and the existing
COVID-19 major disaster declaration for the affected area to approval
under the waiver authority granted by ABFA and the existing COVID-19
major disaster declaration for the affected area. Accordingly, to aid
WIC participants in purchasing infant formula using WIC benefits, FNS
extended waivers set to expire under the ABFA authority and established
a new expiration date for most waivers granted in response to the
infant formula recall through the earlier of either January 31, 2023,
or 60 days after the expiration of the COVID-19 major disaster
declaration in the affected area.\10\ This revised expiration schedule
applied to most waiver types, including those related to medical
documentation, maximum monthly allowances of infant formula, imported
formula authorization and issuance, and vendor substitutions.\11\ This
expiration date was again extended on December 19, 2022, in a letter
sent to WIC State agencies and formally implemented through FNS Policy
Memorandum #2023-3: Unwinding Formula Flexibilities in WIC on February
2, 2023. FNS communicated that revised expiration dates for the formula
waivers included rolling extensions for various waivers through June
30, 2023, based on the continued need for flexibility by the WIC State
agencies.\12\
---------------------------------------------------------------------------
\9\ U.S. Department of Agriculture, Food and Nutrition Service,
``WIC Policy Memorandum #2022-6: Implementation of the Access to
Baby Formula Act of 2022 Public Law 117-129,'' June 6, 2022.
Available online at: https://www.fns.usda.gov/wic/implementation-access-baby-formula-act-2022.
\10\ U.S. Department of Agriculture, Food and Nutrition Service,
``WIC Policy Memorandum #2023-1: Abbott Infant Formula Recall Waiver
Expiration Schedules,'' November 8, 2022. Available online at:
https://www.fns.usda.gov/resource/abbott-infant-formula-recall-waiver-expiration-memo#.
\11\ U.S. Department of Agriculture, Food and Nutrition Service,
``WIC Policy Memorandum #2022-6: Implementation of the Access to
Baby Formula Act of 2022 Public Law 117-129,'' June 6, 2022.
Available online at: https://www.fns.usda.gov/wic/implementation-access-baby-formula-act-2022.
\12\ U.S. Department of Agriculture, Food and Nutrition Service,
``WIC Policy Memorandum #2023-3: Unwinding Infant Formula
Flexibilities in WIC,'' February 1, 2023. Available online at:
https://www.fns.usda.gov/wic/policy-memorandum-2023-3-unwinding-infant-formula-flexibilities.
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[[Page 86548]]
C. WIC Disaster Planning
WIC State agencies are required to submit an annual plan for
Program operations. Program regulations at 7 CFR 246.4 define State
Plan requirements, but plans to address potential emergencies,
disasters, or significant disruptions in operations are not currently
one of the required elements. Nearly all State agencies already
voluntarily maintain a disaster plan; however, these plans are
typically part of a broader health department or other State agency
disaster plan and do not address WIC-specific Program operations during
emergencies nor do they typically address other operational disruptions
beyond natural disasters.
FNS provides information to help WIC State agencies plan for
meeting the needs of WIC participants and applicants prior to and
during a disaster response; plan for continued WIC benefits during
public health emergencies; and plan for other situations that disrupt
regular WIC operations through the guidance document, Guide to
Coordinating Special Supplemental Nutrition Program for Women, Infants,
and Children (WIC) Services When Regular Operations Are Disrupted.\13\
This guidance highlights operational flexibilities in WIC regulations
that WIC State agencies may implement quickly. The COVID-19 public
health emergency and the infant formula recall highlighted the need for
all State agencies to have formal contingency plans in place to ensure
the continuity of WIC operations during emergency periods (i.e.,
emergencies, disasters, and public health emergencies) and supply chain
disruptions, while ensuring access to Program benefits among low-income
pregnant and postpartum participants.
---------------------------------------------------------------------------
\13\ U.S. Department of Agriculture, Food and Nutrition Service,
``Guide to Coordinating Special Supplemental Nutrition Program for
Women, Infants, and Children (WIC) Services When Regular Operations
Are Disrupted,'' January 18, 2022. Available online at: https://www.fns.usda.gov/wic/guide-coordinating-wic-service-during-disasters.
---------------------------------------------------------------------------
D. Infant Formula Cost Containment Historical Background
In the 1980s WIC State agencies became increasingly interested in
cost containment initiatives due to rising food costs and their
potential to limit Program participation due to insufficient funding.
Infant formula represented a significant portion of WIC food costs so
there was specific interest in infant formula cost containment
contracts. Early initiatives by some State agencies were so successful
that in 1989, the Agriculture Appropriations Act of 1989 (Pub. L. 100-
460) directed all WIC State agencies to explore the feasibility of
cost-containment measures and implement such a measure if found to be
viable. Although the provisions of the Agriculture Appropriations Act
of 1989 expired on September 30, 1989, the Child Nutrition and WIC
Reauthorization Act of 1989 (Pub. L. 101-147) extended these provisions
and required the Secretary to prescribe regulations to carry out these
provisions. The Child Nutrition and WIC Reauthorization Act of 1989
also outlined exceptions to these provisions, notably for ITOs that
operate their own WIC Program and serve less than 1,000 participants.
The WIC Infant Formula Procurement Act of 1992 (Pub. L. 102-512)
amended the CNA to enhance competition among infant formula
manufacturers and reduce the per unit costs of infant formula purchased
by WIC. In 1996, FNS issued WIC Policy Memorandum #96-6: WIC Infant
Formula Rebate Reviews, which provides guidance to avoid rebate billing
discrepancies and can serve as a WIC State agency reference during the
procurement and contracting process.\14\ Congress also amended the CNA
through the Child Nutrition and WIC Reauthorization Act of 2004 (Pub.
L. 108-265) to include additional technical definitions that further
clarified how cost containment systems must be structured. FNS
established regulations to implement each of these laws and released
WIC Policy Memorandum #2004-4: Implementation of the Infant Formula
Cost Containment Provisions of P.L. 108-265 to address Public Law 108-
265.\15\
---------------------------------------------------------------------------
\14\ U.S. Department of Agriculture, Food and Nutrition Service,
``WIC Policy Memorandum #96-6: WIC Infant Formula Rebate Reviews,''
March 12, 1996. Available online at: https://www.fns.usda.gov/wic/infant-formula-rebate-reviews.
\15\ U.S. Department of Agriculture, Food and Nutrition Service,
``WIC Policy Memorandum #2004-4: Implementation of the Infant
Formula Cost Containment Provisions of P.L.aw 108-265,'' July 30,
2004. Available online at: https://www.fns.usda.gov/wic/
implementation-infant-formula-cost-containment-provisions-pl-108-
265#:~:text=This%20memorandum%20provides%20guidance%20on%20the%20impl
ementation%20of,2004%2C%20%28Reauthorization%20Act%29%20enacted%20on%
20June%2030%2C%202004.
---------------------------------------------------------------------------
During the onset of the nationwide infant formula shortage and
prior to the passage of ABFA, there were no federal requirements for
infant formula rebate contracts to include remedies in the event of a
recall. FNS used its limited waiver authority under the Stafford Act to
issue waivers to allow WIC State agencies to exceed the maximum monthly
allowance for infant formula and exempt infant formula and issue non-
contract brand formula without medical documentation (except in Food
Package III). Each WIC State agency had to come to an agreement with
the manufacturer holding their rebate contract on Program flexibilities
allowed under these waivers to protect against disruption to Program
participants. Additionally, the infant formula manufacturer whose
product was the subject of the voluntary recall voluntarily paid
rebates on competitive, non-contract brand infant formula in WIC State
agencies where they held the contract.
E. Infant Formula Cost Containment Contracts
The Child Nutrition Act of 1966, (CNA, 42 U.S.C.
1786(h)(8)(A)(i)(I)) and WIC Program regulations at 7 CFR 246.16a
require most WIC State agencies to continuously operate a cost
containment system for infant formula. WIC State agencies have
historically met this requirement through a competitive bidding process
that requires sealed bids, for single-supplier rebate contracts. WIC
State agencies solicit sealed bids and award a contract to the
manufacturer offering the lowest price. Contracted manufacturers
provide a rebate on each can of their infant formula purchased by
Program participants through authorized WIC vendors. The WIC State
agency invoices the manufacturer for payment directly to the WIC State
agency, which does not impact the payments to retail stores who accept
WIC transactions. The resulting rebate payments from manufacturers are
used to offset WIC food costs, allowing WIC State agencies to serve
more WIC participants. Each WIC State agency or alliance of State
agencies that solicits for a rebate contract manages their own
procurement and contracting process through execution and
implementation. WIC State agencies may implement an alternative cost
containment system; however, the system must provide a savings equal to
or greater than a single-supplier competitive system through the
process described in WIC regulations at 7 CFR 246.16a(d). To date, WIC
State agencies have not implemented any alternative cost containment
systems.
Once a contract is executed and implemented, the contract brand
milk and soy-based formulas are added to the WIC State agency's
Approved Product List (APL) and are made available for issuance and
redemption throughout the State agency's WIC Program. A competent
professional authority (CPA) in the WIC clinic setting is responsible
for completing a nutrition assessment for WIC participants, and then
[[Page 86549]]
prescribing and individually tailoring an appropriate food package. The
primary contract brand milk- or soy-based infant formula is considered
``first choice'' and will be issued as the default in the food packages
for infants who receive formula from WIC. Based on information from the
participant, including cultural or dietary preferences, and/or
nutrition assessment findings, an alternate formula, such as a soy-
based option or another milk-based option, within the rebate contract
(i.e., contract brand infant formula) may be deemed appropriate for
issuance. Medical documentation is generally not required for milk- and
soy-based contract brand infant formulas offered under the rebate
contract.
Infant formula rebate funds offset a significant amount of food
costs. In fiscal year 2022, infant formula rebate amounts totaled
approximately $1.5 billion, the cost of providing benefits to an
average of 1.32 million participants each month, or 21 percent of WIC
participants monthly, as indicated by the WIC Financial Management and
Participation Report (FNS-798).
III. Discussion of Regulatory Amendments
A. Add Waiver Authority Granted by the Access to Baby Formula Act
1. Add New Definitions (Sec. 246.2)
This rule adds definitions of Emergency period, Qualified
administrative requirement, Recall, and Supply chain disruption
consistent with ABFA statutory language.
a. This rule defines an Emergency period as a period during which
there exists: (1) a presidentially declared major disaster as defined
under Section 102 of the Robert T. Stafford Disaster Relief and
Emergency Assistance Act (42 U.S.C. 5121 et seq.), (2) a presidentially
declared emergency as defined under Section 102 of the Robert T.
Stafford Disaster Relief and Emergency Assistance Act (42 U.S.C. 5121
et seq.), (3) a public health emergency declared by the Secretary of
Health and Human Services under Section 319 of the Public Health
Service Act (42 U.S.C. 247d), or (4) a renewal of such a public health
emergency pursuant to Section 319. This aligns with the definition
provided by AFBA and does not include State-declared emergencies,
disasters, or public health emergencies.
b. This rule defines Qualified administrative requirement as (1) a
statutory requirement under Section 17 of the CNA (42 U.S.C. 1786), or
(2) a regulatory requirement issued pursuant to this section. This
aligns with the definition provided by ABFA and encompasses the scope
of Program requirements that may be waived or modified by the
Secretary.
c. This rule defines Recall as it is defined in the U.S. Food and
Drug Administration (FDA) regulations in 21 CFR 7.3(g) or any successor
regulation. FDA defines recall as a firm's removal or correction of a
marketed product that the FDA considers to be in violation of the laws
it administers and against which the agency would initiate legal action
(e.g., seizure). Recall does not include a market withdrawal, which is
defined at 21 CFR 7.3(j) as a firm's removal or correction of a
distributed product which involves a minor violation that would not be
subject to legal action by the FDA or which involves no violation
(e.g., normal stock rotation practices, routine equipment adjustments
and repairs, etc.) or a stock recovery, which is defined at 21 CFR
7.3(k) as a firm's removal or correction of a product that has not been
marketed or that has not left the direct control of the firm (i.e., the
product is located on premises owned by, or under the control of, the
firm and no portion of the lot has been released for sale or use). The
Department is committed to continued alignment with FDA's definition of
recall. Recalls may be conducted voluntarily by a manufacturer or may
be required by FDA.
d. This rule defines Supply chain disruption as a shortage of WIC
supplemental foods that limits WIC participants' ability to reasonably
purchase supplemental foods using WIC benefits within a State agency's
jurisdiction, as determined, and declared by the Secretary for the
purposes of WIC. This definition reflects ABFA statutory language and
clarifies that supply chain disruption declarations as defined in this
rulemaking are specifically for the purposes of WIC and do not impact
or extend authority to other programs or entities. Supply chain
disruptions can occur within any portion of a State agency's
jurisdiction, throughout the State agency's jurisdiction, or within
several State agencies' jurisdictions, including nationwide. In
accordance with ABFA, supply chain disruptions include those caused by
recalls of WIC supplemental foods. Other causes of supply chain
disruptions under ABFA may include but are not limited to, labor
shortages, temporary business disruptions, delays in the availability
of products across a wide range of industries, production issues, a
mismatch between supply and demand or other shortages impacting WIC
supplemental foods. The Department recognizes that unforeseen
circumstances beyond those described may also cause a shortage of WIC
supplemental foods that limits participants' ability to purchase such
foods using WIC benefits. However, not every potential cause described
here, or potential unforeseen circumstance may impede the transaction
and redemption of WIC benefits for supplemental foods. Therefore, the
definition of supply chain disruption is not limited to any specific
causes so that the Department maintains the flexibility to determine if
a supply chain disruption has occurred and is able to respond to any
future disruptions.
2. Specify Criteria for Establishing Waivers and Timeframes for Use
(Sec. 246.29)
This rule creates a new provision at Sec. 246.29 that specifies
the criteria under which a waiver or modification may be established,
information WIC State agencies must provide to FNS when requesting a
waiver, and the timeframes during which waivers will remain available
for use by WIC State agencies.
a. Requirements for Establishing a Waiver
This rule provides a non-exhaustive list of conditions that must be
met for the Secretary to waive a qualified administrative requirement
for one or multiple WIC State agencies during an emergency period or
supply chain disruption. In accordance with ABFA statutory provisions,
a waiver may be established when the following criteria are met (1) the
qualified administrative requirement cannot be implemented during any
part of the emergency period or supply chain disruption, (2) the waiver
is necessary to serve participants, and (3) the waiver does not
substantially weaken the nutritional quality of supplemental foods. If
the criteria are met, the Secretary may issue either nationwide waivers
available for WIC State agencies to opt into, or State agency-specific
waivers.
The Department is including additional specifications in this
rulemaking that the waiver or modification must:
(1) Not materially impair any statutory or regulatory right of
participants or potential participants as set forth at 7 CFR 246.8 and
7 CFR parts 15, 15a and 15b which includes all protected classes for
federally assisted programs in USDA;
(2) Not present an unreasonable barrier to participation;
(3) Not create new or additional eligibility requirements for
participation;
[[Page 86550]]
(4) Comply with 7 CFR 246.13(b) to ensure State agencies maintain
effective control over and accountability for all Program grants and
funds;
(5) Offer substitution options with similar nutritional quality,
that most closely provide the maximum monthly allowance of supplemental
foods, and that do not create new supplemental food categories as set
forth in 7 CFR 246.10(e)(12) Table 4; and
(6) Meet additional requirements for the request and approval as
determined necessary by FNS.
Including these requirements is intended to provide WIC State
agencies seeking waivers with basic parameters and to protect
participants and applicants. While this rule will allow for more
flexibilities in Program operations, the Department is committed to
continued equity, access, and nutrition security for WIC applicants and
participants and preventing unforeseen barriers to participation.
Further, the Department is committed to clear and timely communication
with State and local agency staff, WIC participants, and the public
when an emergency period or supply chain disruption has been declared.
b. Information Required From WIC State Agencies Requesting a Waiver
ABFA laid out certain requirements that must be met for a waiver to
be granted by FNS to a WIC State agency. A WIC State agency may request
that a qualified administrative requirement be waived or modified
through submission of a waiver request if the Secretary has not already
issued an applicable nationwide waiver available for a WIC State agency
to opt into. This rule establishes the minimum information a WIC State
agency must provide to FNS when requesting a waiver to ensure that
these criteria are met. Specifically, when submitting a request to FNS,
WIC State agencies must provide:
(i) The qualified administrative requirement the State agency is
requesting to waive or modify (including the statutory or regulatory
citation) and an explanation for why it cannot be met;
(ii) Justification for why the waiver is necessary to continue WIC
services;
(iii) An explanation that the waiver meets the conditions set forth
in new section 7 CFR 246.29(a);
(iv) The emergency period or supply chain disruption under which
the request is being made; and
(v) The period for which the flexibility is being requested.
The Department has deemed this the minimum information necessary to
confirm the WIC State agency's request meets the conditions required to
waive or modify a qualified administrative requirement during an
emergency period or supply chain disruption. However, contingent on the
specific situation, FNS maintains the right to require additional
information from a WIC State agency to support its waiver request. For
example, a WIC State agency seeking a waiver or waiver extension may be
required to provide justification, including, but not limited to, data
to support the request, how the waiver will be implemented, estimated
impact on WIC food funds for the time period being requested, or an
explanation of how the WIC State agency will track or monitor the
continued necessity for the waiver. The Department recognizes that each
emergency period and supply chain disruption is unique and therefore
State agencies may be asked to provide different types of information
relevant to the specific scenario. Additional information regarding the
waiver submission and review process will be provided through
subsequent policy guidance.
c. Duration of Waiver Availability
This rule codifies the timeframes during which waivers can be
available for use by WIC State agencies, as provided by ABFA. Waivers
may be established at any time during an emergency period or supply
chain disruption.
A waiver established during an emergency period may be available
for the duration of the emergency period and up to 60 days after the
end of the emergency period. A waiver established during a declared
supply chain disruption may be available for:
(i) a period of up to 45 days from a date determined by the
Secretary and renewed with at least 15 days' notice provided by the
Secretary, and
(ii) no more than 60 days after the supply chain disruption
declaration ceases to exist.
In accordance with ABFA, if the Secretary determines that a supply
chain disruption exists and issues a waiver, the Secretary will notify
each State agency affected by the disruption. Likewise, the Secretary
will notify each State agency affected by the disruption and granted a
waiver as a result of the disruption at least 15 days prior to the end
of the 45-day period if the supply chain disruption declaration has
been renewed. FNS will communicate any supply chain disruption renewals
as they occur and provide technical assistance on the process as
needed.
B. Update Requirements for State Agency Infant Formula Cost Containment
Contracts
1. Establish Minimum Required Remedies for Infant Formula Cost
Containment Contracts (Sec. 246.16a)
This rule establishes that a State agency must include remedies in
the event of a recall in their infant formula cost containment contract
to protect against disruption in infant formula supply to participants.
In accordance with applicable Program requirements and the infant
formula cost containment contract, the State agency will determine when
remedies take effect and remain in effect. At minimum, the State
agency's infant formula cost containment contract must:
(1) Allow infant formula to be issued in all unit sizes that may
exceed the maximum monthly allowance. The State agency and contracted
infant formula manufacturer must prioritize unit sizes that most
closely provide the maximum monthly allowance;
(2) Allow the issuance of non-contract brand formula without
medical documentation (except in Food Package III);
(3) When any contract brand infant formula of the contracted
manufacturer is the subject of a recall, require the contracted
manufacturer to:
(i) Provide the State agency with an action plan, within a
timeframe established within the contract, which includes supply data,
to meet infant formula demand and limit disruption to Program
participants in the affected jurisdiction(s) and
(ii) Pay rebates on competitive, non-contract brand infant formula
that meets the definition of infant formula at 7 CFR 246.2.
WIC State agencies may work with their legal counsel and
procurement offices to include additional remedies beyond these
regulatory minimum remedies in their infant formula contracts. WIC
State agencies may also negotiate flexibilities that are within
regulatory requirements and do not require Program waivers with their
contracted infant formula manufacturers.
As previously described, in response to the sustained nationwide
infant formula shortage--resulting from the February 17, 2022,
voluntary recall of a major source of powder infant formula, including
exempt infant formula--which exacerbated existing COVID-19 shortages,
FNS used its limited waiver authority under the Stafford Act to issue
waivers. This was possible because of existing COVID-19 major disaster
declarations covering the geographic
[[Page 86551]]
areas of all WIC State agencies, including States, ITOs, and
Territories. These waivers allowed WIC State agencies to benefit from
three specific remedies to: (1) exceed the maximum monthly allowance
for infant formula to allow for the purchase of larger unit sizes; (2)
issue non-contract brand formula without medical documentation (except
in Food Package III); and (3) receive rebates for non-contract brand
infant formula, when their contracted manufacturer's product was the
subject of the recall. As a result, State agencies were able to allow
for the purchase of available formula when the contract brand or size
was unavailable during shortages. Because these three specific remedies
assisted State agencies with meeting participants' needs during the
sustained nationwide infant formula shortage, such remedies were
included as suggestions in WIC Policy Memorandum #2022-6:
Implementation of the Access to Baby Formula Act of 2022-PL 117-129 and
are now being codified in this rulemaking.\16\ Exceeding the maximum
monthly allowance for infant formula to allow for the purchase of
larger unit sizes and issuing non-contract brand formula without
medical documentation (except in Food Package III) will continue to
require an approved waiver before a State agency can operationalize
these remedies, and must be operationalized within the active waivers'
timeframe in order to remain in compliance with Program requirements.
---------------------------------------------------------------------------
\16\ U.S. Department of Agriculture, Food and Nutrition Service,
``WIC Policy Memorandum #2022-6: Implementation of the Access to
Baby Formula Act of 2022 Pub. L. 117-129,'' June 6, 2022. Available
online at: https://www.fns.usda.gov/wic/implementation-access-baby-formula-act-2022.
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During the sustained nationwide infant formula shortage, State
agencies worked with their infant formula contracted manufacturer to
collect supply data in order to respond to participant needs. This data
proved valuable to State agencies' ability to respond to the shortages.
Thus, the provision of an action plan, which includes supply data, to
meet infant formula demand and limit disruption to Program participants
in the affected jurisdiction(s) when any contract brand infant formula
of the contracted manufacturer is the subject of a recall has been
included as a minimum remedy in this rule. The State agency and
contracted manufacturer must establish a timeframe by which the
manufacturer must provide the State agency with an action plan
following the recall of any contract brand infant formula of the
contracted manufacturer. The Department recommends that these action
plans be provided to State agencies within 48 hours following the
recall of any contract brand infant formula of the contracted
manufacturer.
In establishing the remedies, the Department considered requiring
manufacturers to maintain a stockpile of infant formula for use in the
event of a recall. The Department considered potential logistics
involved, such as: types and quantity of formula to stockpile,
potential locations, the level of stockpile maintenance necessary to
rotate stock, and development of a distribution plan related to
stockpiling. Ultimately, the Department determined that the cost and
administrative burden necessary to require manufacturers to maintain a
stockpile in excess of manufacturers' usual inventory would likely be
too extensive for practical implementation and would counteract any
potential benefits for the Program.
Currently, the Program provides infant formula in all three
physical forms available in the retail marketplace, which are powder,
liquid concentrate, and ready-to-feed.\17\ While 7 CFR 246.10(e)(1)(iv)
offers State agencies the flexibility to issue powder or concentrated
liquid, 7 CFR 246.16a(c)(4) requires infant formula manufacturers to
bid on all three physical forms. Currently powder is the predominant
form in the marketplace and some manufacturers do not produce liquid
concentrate. Requiring liquid concentrate in WIC could impact some
manufacturers' ability to competitively bid and meet contractual
requirements. Therefore, the Department is seeking public comment on
the operational and financial impacts to the Program of modifying the
requirement for infant formula manufacturers to bid on liquid
concentrate. Through this rulemaking, the Department is not making any
changes to the current bidding requirements at 7 CFR 246.16a(c)(4) or
the physical forms of infant formula that may be issued in accordance
with 7 CFR 246.10(e)(1)(iv).
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\17\ Ready-to-feed formulas may be authorized only under certain
circumstances, as specified at 7 CFR 246.10(e)(1)(iv).
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2. Clarify Terminology in Infant Formula Cost Containment Contracts
(Sec. 246.16a(c)(5))
This rule clarifies terminology at 7 CFR 246.16a(c)(5).
Specifically, the current terms ``responsive and responsible'' used in
the regulations to describe bidders are consolidated under this
rulemaking to ``responsive.'' Responsive is further defined for
clarification, consistent with the intent stated in a previous
rulemaking preamble, Requirements for and Evaluation of WIC Program Bid
Solicitations for Infant Formula Rebate Contracts (65 FR 51213-51229),
and WIC Policy Memorandum #99-3: Evaluation Criteria for Infant Formula
Rebate Contracts.18 19
---------------------------------------------------------------------------
\18\ U.S. Department of Agriculture, Food and Nutrition Service,
``Special Supplemental Nutrition Program for Women, Infants and
Children (WIC): Requirements for and Evaluation of WIC Program Bid
Solicitations for Infant Formula Rebate Contracts,'' 65 FR 51213-
51229. (August 23, 2000). Available online at: https://
www.federalregister.gov/documents/2000/08/23/00-21423/special-
supplemental-nutrition-program-for-women-infants-and-children-wic-
requirements-for-
and#:~:text=A%20key%20component%20to%20the%20success%20of%20infant,th
an%20savings%20generated%20by%20a%20competitive%20bidding%20system.
\19\ U.S. Department of Agriculture, Food and Nutrition Service,
``WIC Policy Memorandum #99-3: Evaluation Criteria for Infant
Formula Rebate Contracts,'' October 14, 1998. Available online at:
https://www.fns.usda.gov/wic/evaluation-criteria-infant-formula-rebate-contracts.
---------------------------------------------------------------------------
The inclusion of the terms responsive and responsible were
initially intended to help ensure WIC State agencies select formula
manufacturers that fully respond to the invitation to bid and meet
eligibility requirements in statute and regulation. However, since
these terms were not defined, they resulted in ambiguity in their
application. This rule removes the responsibility requirement and
defines the responsiveness requirement. Under the modified provision, a
bidder must submit a bid that conforms to the solicitation and meets
requirements at Sec. 246.16a to be considered responsive. The rule
adds language to clarify this meaning, which will provide consistent
application of the term and ensure that all responsive bids will
receive consideration.
C. Add Requirement for State Agency Plans of Alternate Operating
Procedures (Sec. 246.4(a))
This rule adds a new provision requiring WIC State agencies to
include a plan of alternate operating procedures, commonly referred to
as a disaster plan, as part of their State Plan. This provision will
ensure WIC State agencies have plans in place to support continuity of
operations in the event of a disruption of WIC services, including but
not limited to emergency periods, supplemental food recalls, and other
supply chain disruptions.
State Plans are submitted annually by WIC State agencies as a
prerequisite to receiving funds. State Plans must be updated as needed
to reflect substantive changes to the State agencies' Program design
and operation. Therefore, as a part of the State Plan, alternate
operating procedures must also be updated as needed to reflect any
[[Page 86552]]
substantive changes resulting from lessons learned as WIC State
agencies respond to emergency periods and supply chain disruptions.
Such updates will allow WIC State agencies to prepare and respond to
these events more effectively in the future. Additionally, FNS
encourages WIC State agencies to review their State Plans and ensure
they continue to meet the needs of Program stakeholders. State Plans
are a vehicle through which WIC State agencies can outline short- and
long-term goals necessary to improve Program design and operation. For
example, State agencies may include descriptions of goals and action
plans to facilitate continued improvement in the delivery of Program
benefits and service during Program disruptions as a part of their
alternate operating procedures.
Both the COVID-19 public health emergency and the 2022 infant
formula recall and sustained infant formula shortage required nearly
all WIC State agencies to quickly develop and implement alternative
plans for running their programs. While some WIC State agencies, such
as those with experience in dealing with natural disasters, may have
established alternative operations plans, these plans are typically
part of a broader health department or other State agency disaster plan
and do not address WIC-specific Program operations during disruptions
nor do they typically address other operational disruptions beyond
natural disasters. This resulted in ex post facto development of
policies and procedures and ultimately varying levels of Program
disruption during the COVID-19 public health emergency and the 2022
infant formula recall and sustained infant formula shortage. These two
events highlight the need for all WIC State agencies to be prepared to
continue operations when faced with a number of potential disruptions.
The FNS-required alternate operating procedures set baseline minimum
elements that must be included by all WIC State agencies, and in turn
provide greater transparency to FNS on actions each State agency will
take in the event of a disruption. The Department believes that
proactive State agency development of robust alternate operating
procedures will minimize the negative impact of such disruptions to WIC
operations and services, position State agencies to be better prepared
to adjust to unexpected situations, and ensure the availability of
authorized supplemental foods, including infant formula.
The Department recognizes that a variety of situations, including a
supplemental food recall, may prompt the Secretary to declare a supply
chain disruption. However, WIC State agencies must be prepared to
respond to supplemental food recalls whether or not an official supply
chain disruption declaration has been made. As such, WIC State
agencies' alternate operating procedures must specifically and directly
address supplemental food recalls, with an emphasis on infant formula
recalls, including specialty products, as part of the section
addressing supply chain disruptions as a whole. The Department is
committed to supporting WIC State agencies in prioritizing resources
and developing a separate plan for the distribution of specialty
formula.
The Department understands the same event may impact WIC State
agencies differently dependent upon their geographic location,
participant populations, and other factors. As such, the Department
encourages each WIC State agency to consider potential events unique to
their location and identify how the State agency will meet the needs of
their participant populations when developing alternate operating
procedures. To assist with anticipation of potential events, the
Department expects WIC State agencies to establish relationships with
relief agencies responsible for disaster and public health emergency
planning applicable to the State agency's jurisdiction and participants
and leverage these relationships as needed. Ultimately, the intent of
such relationships is for the WIC State agency to make data-informed
decisions in order to better meet the needs of their jurisdiction's
populations. Nevertheless, WIC State agencies must also consider the
unique and sudden nature of events that disrupt regular WIC operations
when developing alternate operating procedures.
Alternate operating procedures must describe the process by which
the WIC State agency will minimize the negative impact to WIC
operations and services and ensure the availability of authorized
supplemental foods, especially infant formula, to the extent feasible.
At a minimum, alternate operating procedures must include:
(i) A plan to address operation of specific Program areas
including:
a. Access to Program records;
b. Alternate certification and benefit issuance;
c. Verification of Certification (VOC) issuance;
d. Food package adjustments;
e. Vendor requirements;
f. Benefit redemption; and
g. Food delivery systems.
(ii) A plan to ensure continuity of WIC services and address the
needs of participants with documented qualifying conditions receiving
Food Package III, rural areas, tribal populations, and other priority
populations in the affected area, as applicable;
(iii) A designated emergency contact within the State agency for
emergency periods, supply chain disruptions, and supplemental food
recalls;
(iv) A designated emergency contact within the State agency to
address the needs of participants with documented qualifying conditions
receiving Food Package III;
(v) A plan to establish a relationship with relief agencies
responsible for disaster and public health emergency planning
applicable to the State agency's jurisdiction and participants to
support data-informed approaches when responding to emergency periods,
supplemental food recalls, and other supply chain disruptions;
(vi) A plan to limit the disruption of infant formula benefits in
the event of an emergency period, supplemental food recall, and other
supply chain disruption;
(vii) A communications plan to keep FNS, State and local agency
staff, authorized WIC vendors, WIC participants, and the public
informed during an emergency period, supplemental food recall, or other
supply chain disruption.
(viii) A plan to report to FNS on alternate operating procedures
implemented during an emergency period, supplemental food recall, and
other supply chain disruptions, which includes Program data and
information on the impact of benefit use and delivery.
(ix) A plan to adjust State agency specific minimum requirements
for the variety and quantity of supplemental foods that a vendor
applicant must stock to be authorized.
Minimum requirements outlined in this provision reflect current
guidance found in the Guide to Coordinating WIC Service During
Disasters.\20\ In developing and implementing the alternate procedures,
State agencies must take into account existing requirements for
technology projects in accordance with FNS Handbook 901.\21\ For
example, if a State agency decides
[[Page 86553]]
to take steps to integrate changes to their management information
system (MIS) to facilitate better service to participants during
Program disruptions, State agencies should consult FNS Handbook 901 to
secure approval and the requested funding, if applicable. Subsequent to
this rulemaking, FNS will issue updated guidance to WIC State agencies
outlining required components of the plan and continue to ensure the
existing guidance found in the Guide to Coordinating WIC Service During
Disasters is up to date and available for reference.\22\ This Guide
will also provide additional detail regarding provisions for WIC State
agency consideration in development of their disaster plans. For
example, additional alternate operating procedures may include:
---------------------------------------------------------------------------
\20\ U.S. Department of Agriculture, Food and Nutrition Service,
``Guide to Coordinating WIC Service During Disasters,'' January 18,
2022. Available online at: https://www.fns.usda.gov/wic/guide-coordinating-wic-service-during-disasters.
\21\ U.S. Department of Agriculture, Food and Nutrition Service,
``FNS Handbook 901,'' January 8, 2020. Available online at: https://www.fns.usda.gov/sso/fns-handbook-901-v2-advance-planning-documents.
\22\ U.S. Department of Agriculture, Food and Nutrition Service,
``Guide to Coordinating WIC Service During Disasters,'' January 18,
2022. Available online at: https://www.fns.usda.gov/wic/guide-coordinating-wic-service-during-disasters.
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designating alternate means and locations for
certification and benefit issuance for circumstances in which the
conventional means and locations are not possible or optimal;
establishing a plan to support individuals seeking WIC
services receiving a full nutrition assessment and appropriate
referrals;
establishing a plan with health care centers or other
providers of exempt infant formula and WIC-eligible nutritionals for
the distribution of these products to participants with documented
qualifying conditions receiving Food Package III
developing a WIC formula (infant formula, exempt infant
formula, or WIC-eligible nutritional) distribution plan; and,
if a WIC State agency already has a direct distribution or
home delivery system in place, updating policy to specifically include
provisions reasonable to institute during recalls and/or supplemental
food shortages.
Ultimately, this provision is intended to minimize adverse impacts
to WIC operations and the continuation of WIC benefits during an
emergency period, supplemental food recall, and other supply chain
disruptions impacting WIC's normal operations. Further, participants
living in rural areas, on Tribal lands, following cultural or religious
food practices, and/or having qualifying conditions and receiving Food
Package III are potentially most impacted during an emergency period,
supplemental food recall, and other supply chain disruptions. The
Department expects this rule to ensure more consistent and safe access
to the foods these most vulnerable participants need by anticipating
and preparing how to meet those needs before any potential Program
disruptions. This rule will allow for more flexibilities in Program
operations and will require WIC State agencies to develop plans to
address the needs of unique and vulnerable populations overall.
Finally, the Department recognizes WIC is not designed to be a
disaster assistance program and is not considered a first response
option for disaster survivors. As such, the Department continues to
encourage WIC State agencies to work with State and local emergency
services offices, as well as the Federal Emergency Management Agency
(FEMA), to the maximum extent practicable, to provide participants with
a coordinated disaster response during an emergency period.
IV. Implementation
Because the majority of the revisions described in this rulemaking
are introducing opportunities for increased flexibility for WIC State
agencies, this final rule will take effect 60 days after publication,
except for Sec. 246.4(a), which is the provision requiring WIC State
agencies to include, as a part of the State Plan, a plan of alternate
operating procedures, commonly referred to as a disaster plan, in
accordance with FNS guidance.
For Sec. 246.4(a), these changes are required to be implemented
with State agency FY 2025 State Plan submissions, due to FNS no later
than August 15, 2024. This timeline recognizes WIC State agencies will
need the time to develop and refine their alternate operating
procedures to meet the requirements of this provision.
Per WIC Policy Memorandum #2022-6: Implementation of the Access to
Baby Formula Act of 2022--PL 117-129, all contracts entered into or
renewed on or after May 21, 2022, the date of enactment of ABFA, are
expressly required by law to include language in their WIC infant
formula rebate contracts that describes remedies in the event of an
infant formula recall, including how an infant formula manufacturer
would protect against disruption to Program participants in the State
(i.e., ensure that WIC participants can purchase formula using WIC
benefits). Section 246.16a as amended codifies these requirements and
the provisions as described herein must be strictly applied to all
infant formula contracts entered into or renewed once the final rule
takes effect. FNS considers a new contract to be entered into upon
award after a competitively bid process.
The Department seeks comments from WIC State agencies on the type
and scope of administrative burden that may be associated with
implementing the provisions in this rule in this manner.
Procedural Matters
Executive Order 12866, 13563 and 14094
We have examined the impacts of this rule as required by Executive
Order 12866 on Regulatory Planning and Review (September 30, 1993),
Executive Order 13563 on Improving Regulation and Regulatory Review
(January 18, 2011), Executive Order 14094 entitled ``Modernizing
Regulatory Review'' (April 6, 2023), the Regulatory Flexibility Act
(RFA) (September 19, 1980, Pub. L. 96-354), section 1102(b) of the
Social Security Act, section 202 of the Unfunded Mandates Reform Act of
1995 (March 22, 1995; Pub. L. 104-4), Executive Order 13132 on
Federalism (August 4, 1999), and the Congressional Review Act (5 U.S.C.
804(2)).
Executive Orders 12866, 13563 and 13563 direct agencies to assess
all costs and benefits of available regulatory alternatives and, if
regulation is necessary, to select regulatory approaches that maximize
net benefits (including potential economic, environmental, public
health and safety effects, distributive impacts, and equity). The
Executive Order 14094 entitled ``Modernizing Regulatory Review''
(hereinafter, the Modernizing E.O.) amends section 3(f)(1) of Executive
Order 12866 (Regulatory Planning and Review). The amended section 3(f)
of Executive Order 12866 defines a ``significant regulatory action'' as
an action that is likely to result in a rule: (1) having an annual
effect on the economy of $200 million or more in any 1 year (adjusted
every 3 years by the Administrator of OIRA for changes in gross
domestic product), or adversely affect in a material way the economy, a
sector of the economy, productivity, competition, jobs, the
environment, public health or safety, or State, local, territorial, or
tribal governments or communities; (2) creating a serious inconsistency
or otherwise interfering with an action taken or planned by another
agency; (3) materially altering the budgetary impacts of entitlement
grants, user fees, or loan programs or the rights and obligations of
recipients thereof; or (4) raise legal or policy issues for which
centralized review would meaningfully further the President's
priorities or the principles set forth in the Executive Order, as
specifically authorized in a timely manner by the Administrator of OIRA
in each case.
[[Page 86554]]
A regulatory impact analysis (RIA) must be prepared for major rules
with significant regulatory action/s and/or with significant effects as
per section 3(f)(1) ($200 million or more in any 1 year). Based on our
estimates, OMB's Office of Information and Regulatory Affairs has
determined that this rulemaking is ``significant'' and not ``major''
under Subtitle E of the Small Business Regulatory Enforcement Fairness
Act of 1996 (also known as the Congressional Review Act).'' Therefore,
OMB has reviewed this final regulation, and the Department has provided
the following assessment of their impact.
Regulatory Impact Analysis
As required for all rules designated as Significant by the Office
of Management and Budget, an economic summary was developed for this
final rule. The following summarizes the conclusions of the regulatory
impact analysis:
Need for Action: As described in the preamble, this rulemaking
serves to amend the Special Supplemental Nutrition Program for Women,
Infants, and Children (WIC) Program regulations by incorporating
provisions of the Access to Baby Formula Act of 2022 (ABFA) and making
related amendments. ABFA establishes waiver authority for the Secretary
of Agriculture to address certain emergencies, disasters, and supply
chain disruptions impacting the WIC Program, and adds requirements to
State agency infant formula cost containment contracts to protect
against disruptions to the Program in the event of a recall. The
amendments made via this rule are expected to improve State agencies'
ability to ensure continuity of Program operations during emergencies,
disasters, and supply chain disruptions, while ensuring access to
Program benefits among low-income infants, children, and pregnant,
postpartum, and breastfeeding individuals.
Affected Parties: WIC participants and those involved in the
provision of infant formula to WIC participants, including the USDA
Food and Nutrition Service (FNS), State and local agencies, including
Indian Tribal Organizations (ITOs), clinics, infant formula
manufacturers, and retail vendors.
I. Statement of Need
On May 21, 2022, the Access to Baby Formula Act of 2022 (Pub. L.
117-129) was signed into law. ABFA amends Section 17 of the Child
Nutrition Act of 1966 (CNA, 42 U.S.C. 1786) to (1) establish waiver
authority to the Secretary of Agriculture to address certain
emergencies, disasters, and supply chain disruptions impacting the WIC
Program; and (2) require State agency infant formula cost containment
contracts to include specific remedies to protect against disruptions
to the Program in the event of a recall. This rule amends 7 CFR part
246 to codify the provisions of ABFA, which strengthens WIC's ability
to address emergencies, disasters, and supply chain disruptions,
particularly those impacting infant formula.
II. Background
Established in 1974, the mission of the Special Supplemental
Nutrition Program for Women, Infants, and Children (WIC) is to
safeguard the health of low-income pregnant, postpartum, and
breastfeeding individuals, infants, and children ages 1 through 4 years
who are at nutritional risk by providing nutritious foods to supplement
diets, nutrition education (to include breastfeeding promotion and
support), and referrals to health and other social services.
Participation in WIC is associated with improved pregnancy outcomes and
lower infant mortality. WIC participation is also associated with
improved diet quality.\23\ In Federal fiscal year (FY) 2022, WIC served
an average of 6.24 million infants, children, and pregnant,
breastfeeding, and postpartum individuals per month.\24\
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\23\ Caulfield, L., Bennett, W., Gross, S., Hurley, K.,
Ogunwole, S., Venkataramani, M., Lerman, J., Zhang, A., Sharma, R.,
Bass, E. (2022). Maternal and Child Outcomes Associated with the
Special Supplemental Nutrition Program for Women, Infants, and
Children (WIC). Comparative Effectiveness Review No. 253. Prepared
by the Johns Hopkins University Evidence-based Practice Center under
Contract No. 75Q80120D00003.) AHRQ Publication No. 22-EHC019.
Rockville, MD: Agency for Healthcare Research and Quality. DOI:
https://doi.org/10.23970/AHRQEPCCER253.
\24\ U.S. Department of Agriculture Food and Nutrition Service.
WIC Data Tables, 2021. Available online at: https://www.fns.usda.gov/pd/wic-program.
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On March 13, 2020, the President declared the ongoing COVID-19 a
public health emergency of sufficient severity and magnitude to warrant
declaration of a nationwide emergency. The President later approved
major disaster declarations for State agencies, including Indian Tribal
Organizations and U.S. Territories pursuant to section 501(b) of the
Stafford Act.
On March 18, 2020, the Families First Coronavirus Response Act
(FFCRA, Pub. L. 116-127) was signed into law to assist with the COVID-
19 public health emergency, which provided additional funding for WIC
and offered additional flexibilities by providing USDA with authority
to grant certain programmatic waivers to State agencies to enable WIC
to continue serving WIC participants in the midst of a public health
crisis (e.g., the physical presence requirement was waived to encourage
social distancing and reduce in-person visits to WIC clinics).
On February 17, 2022, a major infant formula manufacturer
voluntarily recalled certain powder infant formula, including exempt
infant formula. This recall exacerbated existing supply chain issues
resulting from the ongoing COVID-19 public health emergency. In
response to this recall, USDA used its limited waiver authority granted
under Section 301 of the Robert T. Stafford Disaster Relief and
Emergency Assistance Act, ``Stafford Act'' (42 U.S.C. 5121) to help WIC
participants obtain infant formula. This was possible because of
existing COVID-19 major disaster declarations in all WIC State
agencies, including States, Indian Tribal Organizations, and U.S.
Territories.
While the existing COVID-19 major disaster declaration and
resulting Stafford Act authority provided a vehicle through which USDA
could grant WIC State agencies waivers, under normal circumstances such
waiver authority would not typically be available for the Department to
respond to an infant formula recall, nor could the Department issue
nationwide waivers. As a result, Congress recognized the need to
provide long-term waiver flexibilities, and the President signed ABFA
into law on May 21, 2022, in direct response to the infant formula
recall. ABFA amended Section 17 of the Child Nutrition Act of 1966 (42
U.S.C. 1786) to (1) establish waiver authority to the Secretary of
Agriculture to address certain emergencies, disasters, and supply chain
disruptions impacting the WIC Program; and (2) require WIC State agency
infant formula cost containment contracts to include specific remedies
to protect against disruptions to the Program in the event of a recall.
This rule amends 7 CFR part 246 to codify the provisions of ABFA.
III. List of Rule Provisions and Impacts
Most of the provisions in this rule are required by ABFA; the
provisions added by the Secretary that go beyond ABFA's requirements
are noted below and include consolidating language in the regulations
to describe bidders to ``responsive'' and requiring State agencies to
create plans of alternate operating procedures. A list of the rule's
provisions and a discussion of their likely impacts to the WIC Program,
on Program cost, and on affected parties follows.
[[Page 86555]]
A. Add Waiver Authority Granted by the Access to Baby Formula Act
1. Add New Definitions
i. Program Impact: This rule adds definitions of Emergency period,
Qualified administrative requirement, Recall, and Supply chain
disruption in order to incorporate ABFA statutory language.
ii. Cost Impact: USDA estimates no change in cost associated with
this provision. This change merely adds definitions required for
operational clarity under ABFA.
iii. Impact on Affected Parties: USDA estimates no impact on
affected parties. Impacts on affected parties that arise due to other
provisions of this rule are discussed below.
2. Specify Criteria for Establishing Waivers or Modification and
Timeframes for Use
i. Program Impact: This rule creates a new provision at Sec.
246.29 that specifies (1) criteria under which a waiver or modification
may be established, (2) information State agencies must provide to FNS
when requesting a waiver, and (3) the timeframes during which waivers
will remain available for use by State agencies. One recent example of
a category of waivers is physical presence waivers.\25\ The Families
First Coronavirus Response Act gave USDA authority to grant waivers to
State agencies of the requirement that all individuals seeking to
enroll or re-enroll in WIC do so in person (i.e., physical presence).
This waiver also allowed State agencies to defer certain anthropometric
(i.e., height/length and weight) and bloodwork requirements used to
determine nutritional risk. The physical presence waiver allowed USDA
to encourage social distancing and decrease the spread of COVID-19
while ensuring continuity of operations for State and local WIC
agencies and for WIC participants.
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\25\ Almost all State agencies (88 of 89 State agencies) used a
physical presence waiver sometime during the COVID-19 pandemic. For
more information on physical presence waivers by State agency, see
https://www.fns.usda.gov/disaster/pandemic/covid-19/wic-physical-presence-waiver.
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A second recent example of a category of waivers are the food
package substitution waivers.\26\ These waivers allowed State agencies
to permit approved substitutes for the types and amounts of certain
WIC-prescribed foods if their availability is limited. For example, as
appropriate based on local food marketplace circumstances, State
agencies were approved, upon request, to allow participants to
substitute milk of any available fat content if prescribed varieties
are not available; substitute authorized whole grains in package sizes
up to 24 oz. when 16 oz. packages are not available; and/or substitute
18-count cartons of eggs when 12-count cartons are unavailable. These
waivers enabled WIC participants to continue to receive appropriate
supplemental foods during shortages of the specific products and/or
package sizes that were previously authorized by the State agencies.
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\26\ A large majority of State agencies (70 of 89) issued food
package substitution waivers for one or more food types. For more
information on food package substation waivers by State agency, see
https://www.fns.usda.gov/wic/food-package-substitution-waiver.
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ii. Cost Impact: USDA was unable to reliably estimate the change in
cost associated with this provision, beyond the very slight change in
burden hours (38 hours across all State agencies annually) associated
with this provision. Although USDA estimates a negligible increase in
burden hours due to this provision, USDA also notes that formalizing
the criteria for establishing waivers and timeframes for waiver use
makes the waiver process more predictable for both State agencies and
the Federal government and greatly decreases the likelihood of repeated
waiver revisions and submissions in order to meet waiver requirements.
USDA is unable to reliably quantify the costs of future waivers since
the types and scope/scale of future waivers will be in response to
unknown events. USDA notes that some waivers have the possibility to
increase or decrease the cost of the Program, though USDA generally
expects these possible cost impacts to be small. For example, it is
possible that the physical presence waiver either increased or
decreased administrative costs for some local WIC clinics, depending on
whether the local clinics increased or decreased staffing or office
space in response to moving to phone or online certification/
recertification of participants. Ninety-nine percent of State agencies
reported that the physical presence waivers were ``very'' or
``extremely important'' to ensuring quality services during the COVID-
19 pandemic, and some State agencies reported that the physical
presence waivers allowed them to serve more participants with fewer
staff or in less time, which points to potential cost savings generated
by the physical presence waivers.\27\ Similarly, food package
substitution waivers may increase or decrease food costs slightly,
depending on whether the food package substitutions are for items
slightly more or less expensive than those typically included in the
food package. Approximately 90 percent of State agencies reported that
the food substitution waivers were ``very important'' or ``extremely
important'' to ensuring quality services during the COVID-19 pandemic,
pointing to the waivers' contribution to ensuring continued operations
during the pandemic.\28\ Neither the physical presence waiver nor the
food package substitution waivers issued during the COVID-19 pandemic
were found to result in significant increases or decreases in WIC
spending at the Federal level.\29\ In FY2019, FY2020, and FY2021,
Federal spending on WIC was $5.3, $5.0, and $5.0 billion, respectively,
while participation during the same Fiscal Years was 6.4, 6.2, and 6.2
million individuals. Therefore, the effect of waivers in the aggregate
during the COVID-19 emergency does not appear to have had a significant
effect on Federal WIC costs, though it is possible that individual
waivers may have increased or decreased Federal WIC costs.
---------------------------------------------------------------------------
\27\ Unpublished data collected by USDA as a part of State
agency reporting on FFCRA waiver use. These data will be released in
an upcoming USDA report.
\28\ Ibid.
\29\ WIC program data for the periods before and during the
COVID-19 pandemic (available online at https://www.fns.usda.gov/pd/wic-program) do not show any substantial increase or decrease in WIC
spending, in spite of the hundreds of waivers in place during the
COVID-19 pandemic.
---------------------------------------------------------------------------
The use of waivers in the past has generally focused on ensuring
continued operation of the WIC Program as normally as possible under
temporary and extraordinary circumstances. Waiver authority as
authorized by ABFA must continue to be used primarily for this purpose;
therefore, USDA does not predict that the future use of waivers will
lead to either substantial costs or savings.
iii. Impact on Affected Parties: USDA estimates an increase in
burden on State agencies as a result of this provision, but this
provision will also clarify and standardize the steps that a State
agency must undertake in order to submit a waiver request, which could
save some State agencies effort in the long run by preventing State
agencies from having to resubmit waiver requests multiple times because
their initial requests do not meet the waiver requirements or do not
provide enough information for FNS to understand why the waiver is
necessary in order to continue Program operations. USDA also notes that
waiver authority has generally been granted to FNS programs when it was
needed in the past, and this provision does not make
[[Page 86556]]
the process for requesting a waiver more burdensome than it already was
when FNS implemented waivers during the COVID-19 public health
emergency. More generally, waiver authority allows USDA and State and
local WIC agencies to continue to operate the WIC Program as intended
during extraordinary times, without compromising the quality of WIC
services or supplemental nutrition and without increasing the burden on
WIC participants. Clear requirements and a simplified waiver process
will allow State agencies and USDA to put waivers in place more
quickly, enabling State agencies and USDA to rapidly respond to
emergency situations and meet waiver applicant and participant needs.
B. Update Requirements for State Agency Infant Formula Cost Containment
Contracts
1. Establish Minimum Required Remedies for Infant Formula Cost
Containment Contracts
i. Program Impact: While ABFA generally requires that infant
formula cost containment contracts include remedies to protect against
disruption to Program participants in the event of an infant formula
recall, this rulemaking codifies into regulations specific minimum
remedies that assisted State agencies with meeting participants' needs
during a major infant formula recall. The minimum remedies must include
(1) that infant formula issuance may exceed the maximum monthly
allowance to allow for the purchase of all unit sizes; (2) non-contract
brand formula can be issued without medical documentation (except in
Food Package III); and (3) when the contracted brand infant formula is
the subject of the recall, require the contracted infant formula
manufacturer to provide the State agency with an action plan, which
includes supply data, to meet infant formula demand and limit
disruption to Program participants in the affected jurisdiction(s)
within 10 calendar days of the recall, and pay rebates on competitive,
non-contract brand infant formula that meets the definition of infant
formula at 7 CFR 246.2. WIC State agencies may work with their legal
counsel and procurement offices to include additional remedies beyond
these regulatory minimum remedies in their infant formula contracts.
WIC State agencies may also negotiate flexibilities that are within
regulatory requirements and do not require Program waivers with their
contracted infant formula manufacturers.
ii. Cost Impact: USDA was unable to reliably estimate the change in
costs associated with this provision, beyond the small change in burden
hours (148 hours across all State agencies annually) associated with
this provision. Although USDA acknowledges that there will be cost
impacts associated with this provision in the event of future recalls,
at this time, USDA is unable to reliably quantify the costs of future
remedies, since the types and scope/scale of future remedies will be in
response to unknown events, and therefore, USDA does not include a
formal estimate of the 5-year cost of this provision. Instead, the
following section provides a historic look at the frequency, scale, and
cost of previous infant formula recalls for illustrative purposes as
well as an estimate of the cost impact that could result from even
modest changes to infant formula contract rebate rates.
The first two parts of the provision grant administrative
flexibilities to ensure continued formula supply to WIC participants
(1) by enabling State agencies to issue all unit sizes and, in some
cases, exceed the maximum monthly allowance for formula during issuance
if some package sizes are not available in the local marketplace (2) by
enabling State agencies to issue non-contract brand formula without
medical documentation (except in Food Package III) in the event that
the contract brand formula is unavailable.
The third part of the provision--that the contracted infant formula
manufacturer will pay rebates on competitive non-contract brand infant
formula when the contracted infant formula manufacturer's product is
the subject of the recall--has the potential to impose costs on infant
formula manufacturers. As described above, during the most recent major
infant formula recall, the infant formula manufacturer whose product
was the subject of the voluntary recall temporarily continued paying
rebates on competitive non-contract brand infant formula in the WIC
State agencies where they held the contract. Adding this remedy to
future infant formula cost containment contracts requires all infant
formula manufacturers to pay these rebates in the future when their
product is the subject of a recall, which in turn could pose an added
cost to the manufacturer subject to the recall while their product is
off the market.
In the event that a supply chain disruption necessitates issuing a
waiver to a State agency allowing the issuance of non-contract infant
formula without medical documentation, but where the contracted infant
formula manufacturer in that State agency is not the subject of a
recall and thus not obligated to pay rebates on non-contract products
as described above, then USDA expects to see a decrease in rebate
income relative to the amount of non-contract brand formula issued in
that State agency. Any decrease in rebate income relative to the amount
of non-contract brand formula issued would increase WIC food
expenditures on infant formula for USDA, as was the case in State
agencies without contracts with a specific major infant formula
manufacturer during the 2022 major infant formula recall. While the
Department is not able to estimate the scale of future recalls, a look
back at typical infant formula rebate amounts, prior to the 2022
voluntary recall by a major infant formula manufacturer of certain
powder infant formula, including exempt infant formula, provides a
helpful estimate of possible costs. USDA received approximately $1.6
billion in WIC infant formula rebates in FY 2021, while the monthly
average number of fully formula-fed infant participants was
approximately 962,000, and the monthly average number of partially
breastfed infant participants was approximately 329,000, resulting in
an average monthly rebate of $103.38 per infant receiving a WIC food
package with infant formula. As an example of scale, it would therefore
cost USDA around $10.3 million to cover the lost rebate amounts for
100,000 average infants receiving formula per month, based on FY 2021
costs.\30\
---------------------------------------------------------------------------
\30\ Analysis of FNS administrative data, available at https://www.fns.usda.gov/pd/wic-program.
---------------------------------------------------------------------------
Our analysis suggests that most infant formula recall events in the
past 20 years have been recalls of small amounts of products--usually
single batches or lot numbers, and almost all covering fewer than
around 100,000 cans of infant formula per recall--and would not require
the kind of large-scale intervention that the major infant formula
recall in 2022 required. One available list of infant formula recalls
from 1982-2005 showed no large nationwide recalls (except for one in
2001 that was a result of mislabeling, not product contamination).\31\
Similarly, a search of FDA's Enforcement Database
---------------------------------------------------------------------------
\31\ See https://flca.info/HTMLobj-154/Recalls.pdf. Accessed
December 7, 2022.
---------------------------------------------------------------------------
[[Page 86557]]
showed only small recalls of infant formula (fewer than 100,000 cans
per recall that likely did not disrupt the supply chain) from June 2012
through 2022, until the large major infant formula recall.\32\
---------------------------------------------------------------------------
\32\ Search available at https://www.fda.gov/safety/recalls-market-withdrawals-safety-alerts/enforcement-reports. Accessed
December 7, 2022.
---------------------------------------------------------------------------
Finally, USDA notes that these provisions may impact rebate amounts
offered on infant formula contracts moving forward. If this rule
changes the incentive for infant formula manufacturers to increase or
decrease rebate bids on infant formula contracts through the
competitive bidding process, it could increase or decrease the rebate
amounts offered by infant formula manufacturers to State Agencies. This
would consequently decrease or increase Federal WIC food costs.
However, when examining the limited number of infant formula contracts
awarded either (1) since the start of the major infant formula recall,
or (2) since the passage of ABFA, which included contracts that require
the three remedies outlined in this rule, USDA was not able to discern
a pattern of either increased or decreased formula rebate bids; some
offered rebate amounts increased slightly and others decreased
slightly, similar to how formula contracts have changed over time in
the past. Therefore, USDA is not able to estimate that these provisions
will have an impact on the rebates offered in future infant formula
contracts. However, to provide a sense of scale, USDA notes that WIC
received $1.6 billion in rebates from infant formula and food
manufacturers in FY2021; a nationwide 5 percent increase or decrease in
average infant formula rebate amounts offered to State agencies would
decrease or increase Federal WIC food spending by $80 million per year.
iii. Impact on Affected Parties: The extent to which other impacts
of these provisions will be realized largely depends on how often and
at what scale they are needed in responding to future recalls. In the
event that an infant formula manufacturer is never subject to a recall,
then the impact of these remedies on infant formula manufacturers will
be minimal.In the event of a recall, these provisions grant substantial
benefits to WIC State and local agencies, WIC vendors, and WIC
participants. The minimum remedies described above benefit WIC State
agencies by providing a substantially streamlined administrative
process to approve and issue new infant formula benefits in the event
of a recall. WIC vendors benefit from the certainty that WIC
participants will continue to be issued and be able to purchase infant
formula. Finally, these remedies are intended to protect WIC
participants from disruptions in access to infant formula during
product recalls. For infant formula manufacturers, if their product is
subject to a recall these provisions will require them to pay rebates
on non-contract infant formula in their contracted State agencies.
However, these provisions also provide certainty as to how all
stakeholders in the WIC infant formula supply chain--the Federal
Government, State and local WIC agencies, WIC vendors, WIC clinics, and
infant formula manufacturers--will respond and what responsibilities
they bear in the event of a formula recall.
2. Clarify Terminology in Infant Formula Cost Containment Contracts
i. Program Impact: This rule will clarify terminology at 7 CFR
246.16a(c)(5). Specifically, the current terms ``responsive and
responsible'' used in the regulations to describe bidders are
consolidated to ``responsive.'' Responsive is further defined for
clarification; to be responsive, a bidder must submit a bid that
conforms to the solicitation and must meet requirements at 246.16a. The
rule adds language to clarify this meaning, which will enhance
consistent application of the term and ensure that all responsive bids
will receive consideration. This provision is not required by ABFA.
ii. Cost Impact: USDA is not able to estimate a change in cost
associated with this provision. Improved clarity may slightly lower
administrative costs to State agencies or infant formula manufacturers.
iii. Impact on Affected Parties: This change improves the clarity
of the bidding process for infant formula contracts between State
agencies and infant formula manufacturers.
C. Add Requirement for State Agency Plans of Alternate Operating
Procedures
i. Program Impact: This rule will add a new provision that State
agencies must include as a part of the State Plan a plan of alternate
operating procedures, commonly referred to as disaster plans, in the
event of a disruption of WIC services. Requiring States to have these
plans in place prior to a disaster will help mitigate potential impacts
as States would have uniform baseline measures in place to address
potential barriers to Program operations and allow State agencies to
respond more quickly during these unforeseen events. This provision is
not required by ABFA.
ii. Cost Impact: USDA was unable to estimate the change in cost
associated with this provision, beyond the change in burden hours
(1,869 hours across all State agencies annually) associated with this
provision. Some State agencies may already include components of a plan
of alternate operating procedures in their State Plan; for these State
agencies, this provision poses a minimal additional burden to update
their procedures in accordance with regulations. Although there may be
a small increase in burden as State agencies write alternative
operating procedures to include in future State Plans, USDA anticipates
that having these plans in place may decrease burden on State agencies
and improve State agencies' responsiveness during a disaster, although
USDA is not able to quantify these potential benefits.
iii. Impact on Affected Parties: USDA anticipates a small increase
in burden on some State agencies. However, USDA expects that having
these plans in place will leave State agencies more prepared in the
event of a disaster and will help mitigate the disruptions WIC
participants might face in the event of a disaster.
IV. Summary of Impacts
A. Cost Impact
The costs of the rule that were able to be estimated are the result
of an increase in reporting and recordkeeping burden associated with
the provisions of the rule (an increase of 2,055 reporting and
recordkeeping hours annually across all State agencies), most of which
are due to the provision requiring alternative operating procedures in
State Plans. USDA estimates these costs to be $0.6 million to the State
agencies over the five years from FY 2024 to FY 2028.\33\
---------------------------------------------------------------------------
\33\ Costs associated with State agency burden hours are
calculated using the hourly total compensation for all State and
Local workers from the Bureau of Labor and Statistics (BLS) for FY
2021 and inflated according to the CPI-W increase in OMB's economic
assumptions for the FY2023 President's Budget for years FY2024-
FY2028 (https://data.bls.gov/timeseries/CMU3010000000000D).
[[Page 86558]]
Table 1--Estimated State Agency Costs Due to Change in Administrative \34\ Burden, FY 2024-2028
----------------------------------------------------------------------------------------------------------------
Fiscal year (millions)
-----------------------------------------------------------------------------
2024 2025 2026 2027 2028 Total
----------------------------------------------------------------------------------------------------------------
Increase in State Agency Reporting $ 0.1 $ 0.1 $ 0.1 $ 0.1 $ 0.1 $ 0.6
and Recordkeeping Burden.........
----------------------------------------------------------------------------------------------------------------
B. Benefit Impact
As discussed in detail above, the provisions of this rule
strengthen USDA and WIC State agencies' ability to address emergencies,
disasters and supply chain disruptions, particularly those impacting
infant formula by (1) codifying permanent, expanded waiver authority of
the Secretary to help ensure continuity of WIC services during certain
emergencies, disasters, and supply chain disruptions impacting the WIC
Program; (2) codifying requirements for State agencies to include
language in their WIC infant formula cost containment contracts that
describes remedies in the event of an infant formula recall, including
how an infant formula manufacturer would protect against disruption to
benefit access by WIC participants, and (3) requiring that State
agencies include as a part of their State Plans a ``plan of alternate
operating procedures'' in the event of an emergency period, supply
chain disruption, or supplemental food recall.
---------------------------------------------------------------------------
\34\ Amounts may not sum to the total shown due to rounding.
---------------------------------------------------------------------------
Although USDA is not able to quantify the benefits generated by
this rule, USDA expects for the provisions of this rule to improve the
Federal Government's and State agencies' readiness to respond to
emergencies, disasters, or supply chain disruptions. Improved readiness
should decrease uncertainty to State and local WIC agencies, WIC
clinics, infant formula manufacturers, WIC-authorized vendors, and WIC
participants and should improve the continued provision of WIC services
and benefits to WIC participants in the event of a emergencies,
disasters, or supply chain disruption.
C. Participation and Distributional Impacts
As noted in the above analysis, the Department does not project a
participation impact attributable to this rule; the changes made by
this rule are largely administrative in nature and strive to ensure
continued, smooth operation of WIC during extraordinary events. The
changes are unlikely to be visible to WIC-eligible individuals and WIC
participants in a way that affects their decision to participate or
continue to participate in the WIC Program.
Previous analyses have studied the effects that WIC has on
individuals who do not participate in WIC.\35\ The Department is unable
to reliably estimate an effect of this rule on non-WIC participants, as
the provisions of this rule that are non-administrative and not costed
(i.e., the non-administrative consequences of the waiver provisions and
the infant formula contract provisions) do not come into force except
in response to future, unpredictable events. Furthermore, the limited
datapoints the Department does have do not indicate that this rule is
likely to affect infant formula rebates in a meaningful way and,
therefore, is unlikely to affect the wider infant formula market. To
the extent that the provisions of this rule helps ensure continued
infant formula supply in the event of a supply chain disruption, this
rule could have positive spillover effects on non-WIC participants, as
the infant formula available for purchase to WIC participants will also
be available for purchase by non-WIC participants.
---------------------------------------------------------------------------
\35\ See, for example, Oliveira, V. and Fraz[atilde]o, E.
(2015), ``Painting a More Complete Picture of WIC: How WIC Impacts
Nonparticipants,'' available online at https://www.ers.usda.gov/amber-waves/2015/april/painting-a-more-complete-picture-of-wic-how-wic-impacts-nonparticipants/.
---------------------------------------------------------------------------
Regulatory Flexibility Act
The Regulatory Flexibility Act (5 U.S.C. 601-612) requires agencies
to analyze the impact of rulemaking on small entities and consider
alternatives that would minimize any significant impacts on a
substantial number of small entities. Pursuant to that review, it has
been certified this rule would not have a significant impact on a
substantial number of small entities.
This final rule would not have a significant economic impact on a
substantial number of small entities. This final rule would not have an
adverse impact of small entities in the WIC; the impact is not
significant as it allows for greater options and flexibilities to
support the continuation of WIC services during emergency periods and
supply chain disruptions. State agencies are already required to
continuously operate a cost containment system for infant formula, with
some exceptions. Notably, ITOs with 1,000 or fewer participants are
exempt from this provision. Further, the Department has encouraged WIC
State agencies to develop disaster plans in the event of disruptions to
Program operations. Of the 89 WIC State agencies, 82 State agencies
have disaster plans in place.
Factual Basis
The provisions of this final rule apply to small local agencies
operating the Special Supplemental Nutrition Program for Women, Infants
and Children, and to State agency staff who must monitor local agencies
in remote locations. These entities meet the definitions of ``small
governmental jurisdiction'' and ``small entity'' in the Regulatory
Flexibility Act. These entities will not be negatively impacted by the
changes and options in this rule.
Congressional Review Act
Pursuant to the Congressional Review Act (5 U.S.C. 801 et seq.),
the Office of Information and Regulatory Affairs designated this rule
as not a 'major rule' as defined by 5 U.S.C. 804(2).
Unfunded Mandates Reform Act
Title II of the Unfunded Mandates Reform Act of 1995 (UMRA), Public
Law 104-4, establishes requirements for Federal agencies to assess the
effects of their regulatory actions on State, local and tribal
governments, and the private sector. Under section 202 of the UMRA, the
Department generally must prepare a written statement, including a cost
benefit analysis, for proposed and final rules with ``Federal
mandates'' that may result in expenditures by State, local or tribal
governments, in the aggregate, or the private sector, of $177 million
or more in 2023 (when adjusted for inflation; GDP deflator source:
Table 1.1.9 at https://www.bea.gov/iTable) in any one year. When such a
statement is needed for a rule, Section 205 of the UMRA generally
requires the Department to identify and consider a reasonable number of
regulatory alternatives and adopt the most cost effective or least
burdensome alternative that achieves the objectives of the rule.
[[Page 86559]]
This final rule does not contain Federal mandates (under the
regulatory provisions of Title II of the UMRA) for State, local and
tribal governments, or the private sector of $146146177146146 million
or more in any one year. Thus, the rule is not subject to the
requirements of Sections 202 and 205 of the UMRA.
Executive Order 12372
The Special Supplemental Nutrition Program for Women, Infants, and
children (WIC) is listed in the Catalog of Federal Domestic Assistance
under Number 10.557 and is subject to Executive Order 12372, which
requires intergovernmental consultation with State and local officials.
(See 2 CFR chapter IV.)
Federalism Summary Impact Statement
Executive Order 13132 requires Federal agencies to consider the
impact of their regulatory actions on State and local governments.
Where such actions have federalism implications, agencies are directed
to provide a statement for inclusion in the preamble to the regulations
describing the agency's considerations in terms of the three categories
called for under Section (6)(b)(2)(B) of Executive Order 13132.
The Department has considered the impact of this rule on State and
local governments and has determined that this rule does not have
federalism implications. Therefore, under Section 6(b) of the Executive
Order, a federalism summary is not required.
Executive Order 12988, Civil Justice Reform
This final rule has been reviewed under Executive Order 12988,
Civil Justice Reform. This rule is intended to have preemptive effect
with respect to any State or local laws, regulations, or policies which
conflict with its provisions or which would otherwise impede its full
and timely implementation. This rule is not intended to have
retroactive effect unless so specified in the Effective Dates section
of the final rule. Prior to any judicial challenge to the provisions of
the final rule, all applicable administrative procedures must be
exhausted.
Civil Rights Impact Analysis
FNS has reviewed the final rule, in accordance with the Department
Regulation 4300-004 ``Civil Rights Impact Analysis,'' to identify and
address any major civil rights impacts the proposed rule might have on
participants on the basis of race, sex, national origin, disability,
and age. The requirements outlined in the final rule aim to remove
barriers to WIC food access. The changes would impact WIC State
agencies, including ITOs, WIC local agencies and clinics, participants
and WIC vendors in ways that are expected to increase equity and access
for WIC participants during times of disaster.
To mitigate potential impacts on Program access for LEP populations
and persons with disabilities, FNS will provide WIC State agencies with
technical assistance aimed at ensuring that communications about
program changes are available in appropriate languages and in
alternative formats for persons with disabilities. After reviewing the
potential impacts, FNS does not believe the rule would result in civil
rights impacts on protected groups of WIC participants and applicants.
However, the FNS CRD will propose further outreach and mitigation
strategies to alleviate any unforeseen impacts, if deemed necessary.
Executive Order 13175
Executive Order 13175 requires Federal agencies to consult and
coordinate with Tribes on a government-to-government basis on policies
that have Tribal implications, including regulations, legislative
comments or proposed legislation, and other policy statements or
actions that have substantial direct effects on one or more Indian
Tribes, on the relationship between the Federal Government and Indian
Tribes, or on the distribution of power and responsibilities between
the Federal Government and Indian Tribes. Tribal consultation regarding
this rule was conducted on November 8, 2022. FNS provided an
opportunity for consultation on the rule and Tribal leaders were
generally supportive. If a Tribe requests consultation on this
rulemaking in the future, FNS will work with USDA's Office of Tribal
Relations to ensure meaningful consultation is provided.
Paperwork Reduction Act
The Paperwork Reduction Act of 1995 (44 U.S.C. Chap. 35; 5 CFR part
1320) requires the Office of Management and Budget (OMB) approve all
collections of information by a Federal agency before they can be
implemented. Respondents are not required to respond to any collection
of information unless it displays a current valid OMB control number.
This final rule impacts existing information collection
requirements that are contained in OMB Control Number 0584-0043 Special
Supplemental Nutrition Program for Women, Infants, and Children (WIC)
Program Regulations--Reporting and Recordkeeping (expiration date
December 31, 2023) which are subject to review and approval by OMB in
accordance with the Paperwork Reduction Act of 1995. Additionally, the
waiver elements of this rule are already in effect but codified in this
rule and have been previously approved by OMB under OMB #0584-0687. Any
further public comment on the waiver information collection solicited
in response to this rule will be used to inform the next revision of
the information collection. Therefore, FNS is submitting for public
comment in this rule the changes in the information collection burdens
in OMB Control Numbers 0584-0043 that would result from adoption of
this rule. The information collection and recordkeeping requirements
included in this final rule have been submitted by the Agency to OMB
for approval which is currently pending. FNS will not collect any
information associated with this rule until the information collections
are approved by OMB.
Comments on the information collection for this final rule must be
received by February 12, 2024.
Comments may be sent to: Allison Post, Food and Nutrition Service,
U.S. Department of Agriculture, 1320 Braddock Place, 3rd Floor,
Alexandria, VA 22314. Comments will also be accepted through the
Federal eRulemaking Portal. Go to https://www.regulations.gov and follow
the online instructions for submitting comments electronically.
Comments are invited on: (a) whether the collection of information
is necessary for the proper performance of the functions of the
Department, including whether the information shall have practical
utility; (b) the accuracy of the Department's estimate of the burden of
the proposed collection of information, including the validity of the
methodology and assumptions used; (c) ways to enhance the quality,
utility, and clarity of the information to be collected; and (d) ways
to minimize the burden of the collection of information on those who
are to respond, including use of appropriate automated, electronic,
mechanical, or other technological collection techniques or other forms
of information technology.
All responses to this notice will be summarized and included in the
request for OMB approval. All comments will also become a matter of
public record.
[[Page 86560]]
a. Revisions to OMB Control Number 0584-0043
Title: Special Supplemental Nutrition Program for Women, Infants,
and Children (WIC) Program Regulations--Reporting and Recordkeeping
Burden.
OMB Number: 0584-0043.
Expiration Date: 12/31/2023.
Type of Request: Revision of a currently approved collection.
Abstract: This is a revision of existing information collection
requirements in the information collection under OMB Control Number
0584-0043 that are affected by this rulemaking. Under this rule, the
Department amends 7 CFR part 246 to codify the provisions of ABFA and
implement related changes which will strengthen WIC's ability to
address emergency periods and supply chain disruptions, particularly
those impacting infant formula. This final rule impacts the burden
associated with reporting and recordkeeping requirements for State
agencies. This final rule may also result in additional financial costs
to State agencies.
(i) Burden Revisions Related to State Plan Requirements
This rule requires WIC State agencies to include, as a part of the
State Plan, a plan of alternate operating procedures, commonly referred
to as a disaster plan in accordance with FNS guidance. Although current
WIC regulations do not require WIC State agencies to develop and
implement disaster plans, the Department has always encouraged WIC
State agencies to develop them. While many WIC State agencies have a
disaster plan, they are typically part of a broader health department
or other State agency disaster plan and do not address WIC-specific
Program operations during emergency periods and supply chain
disruptions.
FNS estimates that 82 WIC State agencies have a disaster plan, and
that it will take these State agencies an additional 16 hours to update
their existing disaster plans to conform with the added specific
requirements for these plans included in this rulemaking. Of the
remaining 7 WIC State agencies who do not have existing disaster plans,
FNS estimates that it will take these State agencies 80 hours to
develop disaster plans in accordance with this rulemaking. Therefore,
FNS estimates that this rule would result in an increase of 21 burden
hours to each State agency's reporting burden ((82 State agencies x 16
hours) + (7 State agencies x 80 hours)/89 State agencies = 21 burden
hours). This would increase the burden hours to submit an annual State
Plan from 134.62 to 155.62 which would increase the associated
reporting burden by 1,869 burden hours.
(ii) Burden Revision Related to Infant Formula Cost Containment
Contracts Remedies
This rule requires State agencies to include minimum required
remedies in infant formula cost containment contracts to ensure that,
in the event of an infant formula recall, any State agency for whom the
Secretary has issued a waiver(s) under the conditions described in
Sec. 246.29 will be able to enact remedies to protect against
disruption to Program participants. All State agencies must
continuously operate a cost containment system for infant formula, with
some exceptions. Notably, ITOs with 1,000 or fewer participants are
exempt from this provision. As such, 79 State agencies out of 89 WIC
State agencies have infant formula cost containment contracts.
Contracts that State agencies entered into after ABFA was enacted on
May 21, 2022 may already include some of the requirements specified in
this rule, as WIC Policy Memorandum #2022-6 suggested remedies that are
being codified in this rule. However, regardless of whether State
agencies have included some of the remedies into their contracts, this
rule includes greater specificity on the requirements outlined in WIC
Policy Memorandum #2022-6 and an additional requirement. Therefore,
incorporating the rule's minimum required remedies in infant formula
cost containment contracts would require an estimated one-time two-hour
burden per State agency. Therefore, FNS estimates that this rule would
result in a one-time increase in 148 burden hours to State agencies'
reporting burden (79 State agencies x 2 burden hours = 148 burden
hours).
Additionally, this rule requires infant formula manufacturers to
provide State agencies with an action plan to meet formula demand and
limit disruption to Program participants in the affected
jurisdiction(s) in the event of an infant formula recall. This plan
must include current supply data to assist the State agency in their
recall response. Based on the rarity of large-scale infant formula
recalls, FNS estimates that one State agency and one infant formula
manufacturer will be impacted by an infant formula recall each year,
and that it will take the infant formula manufacturer 4 hours to
provide the State agency with an action plan with current supply data.
Therefore, FNS estimates that this rule would result in an additional 4
burden hours to businesses' reporting burden (1 infant formula
manufacturer x 4 burden hours = 4 burden hours).
(iii) Burden Revisions Related to Emergency Period and Supply Chain
Disruption Recordkeeping
This rule requires State agencies establish a plan to report to FNS
on alternate operating procedures implemented during an emergency
period, supplemental food recall, and other supply chain disruptions,
which includes Program data and information on the impact of benefit
use and delivery. Additionally, this rule requires infant formula
manufacturers to provide State agencies with an action plan to meet
formula demand and limit disruption to program participants in the
affected jurisdiction(s) in the event of an infant formula recall. This
plan must include current supply data to assist the State agency in
their recall response. FNS estimates that 15 State agencies will
implement alternate operating procedures in the event of an emergency
period or supply chain disruption, including an infant formula recall,
each year. FNS estimates that it will take State agencies 2 hours to
record data related to alternate operating procedures implemented
during an emergency period or supply chain disruption, and supply data
from infant formula manufacturers in the event of an infant formula
recall. Therefore, FNS estimates that this rule would result in an
additional 30 burden hours to State agencies' recordkeeping burden (15
State agencies x 2 burden hours = 30 burden hours).
Respondents: State agencies, including Indian Tribal Organizations
and U.S. Territories (note that burden estimates for local agencies are
not affected by this rule).
Estimated Number of Respondents: 90.
Estimated Number of Responses per Respondent: 1.99.
Estimated Total Annual Burden on Respondents: 14,032.
[[Page 86561]]
Appendix I--WIC Burden Table
--------------------------------------------------------------------------------------------------------------------------------------------------------
Annual Number of Estimated Previous Difference
Estimated responses Total burden total submission due to
Regulatory section Information collected number of per annual hours per burden total hours program
respondents respondent responses request hours per person changes
--------------------------------------------------------------------------------------------------------------------------------------------------------
REPORTING BURDEN ESTIMATES
--------------------------------------------------------------------------------------------------------------------------------------------------------
Affected Public: State and Local
Agencies (including Indian Tribal
Organizations and U.S. Territories)
--------------------------------------------------------------------------------------------------------------------------------------------------------
246.4................................ State Plan.............. 89 1 89 155.62 13,850.18 11,981.18 1,869.00
246.16a(j)........................... Infant formula cost 74 1 74 2 148 0 * 148
containment contracts
remedies.
----------------------------------------------------------------------------------------
Subtotal Reporting: State and ........................ 89 2 163 85.88 13,998 11,981 2,017.00
Local Agencies.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Affected Public: Business: Retail Vendors (WIC-Authorized Food Stores)
--------------------------------------------------------------------------------------------------------------------------------------------------------
246.16a(j)........................... Infant formula 1 1 1 4 4 0 4
contractor action plan.
----------------------------------------------------------------------------------------
Subtotal Reporting: Retail 1....................... 1.00 1 4.00 4 0 4
Vendors *.
----------------------------------------------------------------------------------------
Grand Subtotal: Reporting.... 90...................... 1.82 164 85.38 14,002 11,981 2,021
--------------------------------------------------------------------------------------------------------------------------------------------------------
RECORDKEEPING BURDEN ESTIMATES
--------------------------------------------------------------------------------------------------------------------------------------------------------
Affected Public: State and Local Agencies (including Indian Tribal Organizations and U.S. Territories)
--------------------------------------------------------------------------------------------------------------------------------------------------------
246.4(a)(30); 246.16a(j)............. Emergency Period and 15 1 15 2 30 0 30
Supply Chain Disruption
Recordkeeping.
----------------------------------------------------------------------------------------
Subtotal: Recordkeeping.......... ........................ 15 1.00 15 2.00 30 0 30
----------------------------------------------------------------------------------------
Grand Total: Reporting and ........................ 90 1.99 179 78.39 14,032 11,981 2,051
Recordkeeping.
--------------------------------------------------------------------------------------------------------------------------------------------------------
* There is a one-time information collection burden associated with this provision.
Summary of Requested Burden Revisions:
Table 4--Summary of Requested Burden Revisions to #0584-0043
----------------------------------------------------------------------------------------------------------------
Responses Respondents Time burden
----------------------------------------------------------------------------------------------------------------
Current Inventory: * Total Burden............................... 48,798,800 6,913,189 4,547,099
Current Inventory: * Reporting.............................. 21,254,756 6,913,189 4,017,132
Current Inventory: * Recordkeeping.......................... 27,544,044 11,897 529,967
Total Burden Revision Requested................................. 48,798,890 6,913,190 4,549,150
Burden Revision Requested: Reporting........................ 21,254,831 6,913,190 4,019,153
Burden Revision Requested: Recordkeeping.................... 11,897 27,544,059 529,997
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Difference in Total Burden from Rulemaking.............. 90 1 2,051
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E-Government Act Compliance
The Department is committed to complying with the E-Government Act,
to promote the use of the internet and other information technologies
to provide increased opportunities for citizen access to Government
information and services, and for other purposes.
List of Subjects in 7 CFR Part 246
Administrative practice and procedure, Civil rights, Food
assistance programs, Grant programs--health, Grant programs--social
programs, Indians, Infants and children, Maternal and child health,
Nutrition, Penalties, Reporting and recordkeeping requirements, Women.
Accordingly, the Department amends 7 CFR part 246 as follows:
PART 246--SPECIAL SUPPLEMENTAL NUTRITION PROGRAM FOR WOMEN, INFANTS
AND CHILDREN
0
1. The authority citation for part 246 continues to read as follows:
Authority: 42 U.S.C. 1786.
0
2. Amend Sec. 246.2 by adding the definitions for ``Emergency
period,'' ``Qualified administration requirement,'' ``Recall'' and,
``Supply Chain
[[Page 86562]]
Disruption'' in alphabetical order to read as follows:
Sec. 246.2 Definitions.
* * * * *
Emergency period means a period during which there exists:
(1) A presidentially declared major disaster as defined under
section 102 of the Robert T. Stafford Disaster Relief and Emergency
Assistance Act (42 U.S.C. 5121 et seq.).
(2) A presidentially declared emergency as defined under section
102 of the Robert T. Stafford Disaster Relief and Emergency Assistance
Act (42 U.S.C. 5121 et seq.).
(3) A public health emergency declared by the Secretary of HHS
under section 319 of the Public Health Service Act (42 U.S.C. 247d).
(4) A renewal of such a public health emergency pursuant to section
319.
* * * * *
Qualified administrative requirement means a statutory requirement
under Section 17 of the Child Nutrition Act of 1966 (CNA; 42 U.S.C.
1786) or a regulatory requirement issued pursuant to this section.
* * * * *
Recall means recall as defined in 21 CFR 7.3(g) or any successor
regulation. Recalls may be conducted voluntarily by a manufacturer or
may be required by FDA.
* * * * *
Supply chain disruption means a shortage of WIC supplemental foods
that limits WIC participants' ability reasonably to purchase
supplemental foods using WIC benefits within a State agency's
jurisdiction, as determined, and declared by the Secretary for the
purposes of WIC.
* * * * *
0
3. Amend Sec. 246.4 by adding paragraph (a)(30) to read as follows:
Sec. 246.4 State plan.
(a) * * *
(30) Plans of alternate operating procedures, commonly referred to
as disaster plans, to support the continuation of WIC services during
an emergency period as defined at Sec. 246.2, supply chain disruption
as defined at Sec. 246.2, and supplemental food recall. State agencies
must consider the unique and sudden nature of an emergency period,
supplemental food recall, and other supply chain disruptions when
developing alternate operating procedures. Alternate procedures must
describe the process by which the State agency will minimize the
negative impact to WIC operations and services and ensure the
availability of authorized supplemental foods, especially infant
formula, to the extent feasible. At a minimum, alternate operating
procedures must include-
(i) A plan to address operation of specific Program areas
including-
(A) Access to Program records;
(B) Alternate certification and benefit issuance
(C) Verification of Certification (VOC) issuance
(D) Food package adjustments;
(E) Vendor requirements;
(F) Benefit redemption; and
(G) Food delivery systems.
(ii) A plan to ensure continuity of WIC services and address the
needs of participants with documented qualifying conditions receiving
Food Package III, rural areas, Indian tribal organizations, and other
priority populations in the affected area as applicable;
(iii) A designated emergency contact within the State agency for
emergency periods, supplemental food recalls, and other supply chain
disruptions;
(iv) A designated emergency contact within the State agency to
address the needs of participants with documented qualifying conditions
receiving Food Package III;
(v) A plan to establish relationships with relief agencies
responsible for disaster and public health emergency planning
applicable to the State agency's jurisdiction and participants to
support data-informed approaches when responding to emergency periods,
supplemental food recalls, and other supply chain disruptions;
(vi) A plan to limit the disruption of infant formula benefits in
the event of an emergency period, supplemental food recall, and other
supply chain disruptions;
(vii) A communications plan to keep FNS, State and local agency
staff, authorized WIC vendors, WIC participants, and the public
informed during an emergency period supplemental food recall, and other
supply chain disruptions;
(viii) A plan to report to FNS on alternate operating procedures
implemented during an emergency period, supplemental food recall, and
other supply chain disruptions which includes Program data and
information on the impact of benefit use and delivery; and
(ix) A plan to adjust State agency specific minimum requirements
for the variety and quantity of supplemental foods that a vendor
applicant must stock to be authorized.
* * * * *
0
4. In Sec. 246.16a:
0
a. Revise paragraph (c)(5); and
0
b. Add a new paragraph (n).
The revision and addition read as follows:
Sec. 246.16a Infant formula and authorized foods cost containment.
* * * * *
(c) * * *
(5) A State agency must award the contract(s) to the responsive
bidder(s) offering the lowest total monthly net price for infant
formula or the highest monthly rebate (subject to paragraph(c)(4)(ii)
of this section) for a standardized number of units of infant formula.
To be responsive, a bidder must submit a bid by the deadline set by the
State agency that conforms to the solicitation and must meet
requirements at 246.16a and set forth in the bid solicitation. The
State agency must calculate the lowest net price using the lowest
national wholesale cost per unit for a full truckload of the infant
formula on the date of the bid opening.
* * * * *
(n) What minimum recall-related provisions must be included in
infant formula cost containment contracts? A State agency must include
remedies in the event of a recall in their infant formula cost
containment contract to protect against disruption in infant formula
supply to participants. The State agency will determine when remedies
take effect and remain in effect, in accordance with applicable Program
requirements and the infant formula cost containment contract. At
minimum, recall remedies in the State agency's infant formula cost
containment contract must:
(1) Allow infant formula to be issued in all unit sizes that may
exceed the maximum monthly allowance. The State agency and contracted
infant formula manufacturer must prioritize unit sizes that most
closely provide the maximum monthly allowance;
(2) Allow the issuance of non-contract brand infant formulas
without medical documentation, with the exception of participants
receiving Food Package III as defined in section 246.10(e)(3) of this
Part; and
(3) When any contract brand infant formula of the contracted
manufacturer is the subject of a recall, require the contracted infant
formula manufacturer to:
(i) Provide the State agency with an action plan, within a timeline
established within the contract, which includes supply data, to meet
infant formula demand and limit disruption to Program participants in
the affected jurisdiction(s); and
[[Page 86563]]
(ii) Pay rebates on competitive, non-contract brand infant formula
that meets the definition of infant formula at 7 CFR 246.2.
0
5. Add Sec. 246.29 to read as follows:
Sec. 246.29 Waivers of program requirements.
(a) Required conditions. The Secretary may waive or modify any
qualified administrative requirement for one or more State agencies
during an emergency period or supply chain disruption. Waivers or
modifications may be issued following a State agency request or at the
discretion of the Secretary. To be considered, a waiver or modification
issued under this Section must meet the following requirements:
(1) The qualified administrative requirement cannot be implemented
during any part of the emergency period or supply chain disruption.
(2) The waiver or modification is necessary to serve participants
and does not substantially weaken the nutritional quality of
supplemental foods.
(3) The waiver or modification would not result in material
impairment of any statutory or regulatory rights of participants or
potential participants as set forth at 7 CFR 246.8 or 7 CFR parts 15,
15a and 15b.
(4) The waiver or modification would not create a barrier to
participation.
(5) The waiver or modification would not create additional
eligibility requirements for participation.
(6) The waiver or modification would comply with 7 CFR 246.13(b).
(7) The waiver or modification must offer substitution options with
similar nutritional quality, that most closely provide the maximum
monthly allowance of supplemental foods, and that do not create new
supplemental food categories as set forth in 7 CFR 246.10(e)(12) Table
4.
(8) A State agency that requests a waiver or modification meets
additional requirements for the request and approval as determined
necessary by FNS.
(b) Timeframes for waiver request and use. (1) Waiver starts. A
waiver or modification may be granted any time during an emergency
period or supply chain disruption.
(2) Waiver duration.
(i) A waiver or modification established during an emergency period
may be available for the emergency period and up to 60 days after the
end of the emergency period.
(ii) A waiver or modification established during a supply chain
disruption may be available for:
(A) a period of up to 45 days from the date of waiver issuance and
renewed with at least 15 days' notice provided by the Secretary; and
(B) no more than 60 days after the supply chain disruption
declaration ceases to exist.
(c) State agency waiver requests. State agencies shall submit
requests for a modification or waiver for USDA approval. Requests shall
include but not necessarily be limited to:
(1) The qualified administrative requirement the State agency is
requesting to modify or waive (including the statutory or regulatory
citation) and an explanation for why it cannot be met;
(2) Justification for why the waiver is necessary to continue WIC
services;
(3) An explanation that the waiver meets the conditions set forth
in 7 CFR 246.29(a);
(4) The emergency period or supply chain disruption under which the
request is being made;
(5) The period for which the flexibility is being requested.
Cynthia Long,
Administrator, Food and Nutrition Service.
[FR Doc. 2023-26641 Filed 12-13-23; 8:45 am]
BILLING CODE 3410-30-P