Roanoke Times
Copyright (c) 1995, Landmark Communications, Inc.
DATE: SUNDAY, March 12, 1995 TAG: 9503130074
SECTION: VIRGINIA PAGE: B1 EDITION: METRO
SOURCE: LESLIE TAYLOR STAFF WRITER
DATELINE: LENGTH: Long
Damian Reams is as rambunctious as any 2-year-old, with a broad smile and a knack for flashing it whenever a camera is pointed in his direction.
He chatters, squirms when asked to sit still, and runs aimlessly - just to test, it seems, how far his tiny legs can take him.
Damian is small for his age. Born three weeks prematurely, he is borderline anemic. His mother must closely watch what he eats.
Damian is a child of WIC, the federal Special Supplemental Food Program for Women, Infants and Children.
Christie Reams, Damian's mother, enrolled in WIC the day she found out she was pregnant. She was young and newly married - and had no income.
WIC carried her through the pregnancy, giving her vouchers for nutritionally sound foods, ensuring that she ate them and testing to make sure she was taking her iron and vitamin pills.
``They tried to keep me healthy for the baby,'' the 20-year-old Salem resident said. ``If they didn't think I looked too good, they'd tell me I needed to start eating more of certain foods.''
Most WIC participants are low income, many of them working poor. They are considered at risk for poor nutritional habits.
Through nutrition and health education, health services and vouchers to buy specially selected foods, WIC ensures that its participants eat properly.
The program is aimed at reducing nutrition-related health problems during critical periods of children's growth and development. Its highest priority participants are pregnant women.
Recently, however, WIC has been lumped - unjustly, some program supporters say - in the welfare reform debate.
House Republicans, in their welfare reform plan, have proposed consolidating federal child nutrition programs, including WIC and the school lunch program, into block grants to states. And that has some WIC administrators, supporters and participants worried - or, at least, puzzled.
``It's hard for us to respond to it,'' said Barbara Mitchell, public information specialist for the Virginia WIC program. ``We are concerned about our children on the program, because WIC is such a vital part of their health. Until we see legislation, it's hard to know what the impact in Virginia will be.''
Virginia's WIC program is funded this fiscal year with a $64.5 million U.S. Department of Agriculture grant - $48.1 million for food, $14.4 million for health care services and administration, and $2 million in discretionary grants for special projects.
The state has a potential WIC caseload of 164,000 families. Participation is at more than 132,000, or about 80 percent of eligible families.
The USDA argues that the block grant proposal would put WIC at risk, potentially eroding its effectiveness.
How effective is WIC?
A Government Accounting Office study, released in 1992, found that the prenatal benefits of WIC resulted in cost savings to other federal, state and local programs over the first 18 years of the lives of children. The study concluded that, for every dollar spent on WIC, $3.50 was saved by averting medical and other related expenses.
In a 1990 study, the USDA showed that WIC spending on pregnant women was linked to substantial savings in Medicaid costs for newborns and their mothers during the first 60 days after birth. Every dollar spent on the prenatal component of WIC yielded an average savings of about $3 in Medicaid, the study concluded.
The Center on Hunger, Poverty and Nutrition Policy at Tufts University released a statement this year lauding WIC's high cost-effectiveness.
Yet, like other government assistance programs, WIC also has been linked to fraud and waste.
Four years ago, federal agents found stores in Chicago that paid cash for WIC vouchers, and county health employees who approved unqualified applicants in exchange for a share of vouchers.
In the 1993-94 fiscal year, 15 Virginia retailers were removed from the WIC program for violations, which can range from exchanging cash or credit for WIC foods to overcharging WIC customers for food.
But support for the block grant proposal is rooted not so much in eliminating fraud but in allowing states to do as they wish with federal dollars.
``If the [federal government] gives states a large amount of funds without a lot of regulations, they have more flexibility - and it cuts down on administrative costs,'' said Margaret Tate, director of the state Division of Public Health Nutrition. ``WIC is highly regulated, in terms of how the money is used. [Block grants] would give states a lot of flexibility.''
Robert Rector, senior policy analyst for welfare issues at the conservative Heritage Foundation in Washington, said more than a dozen federal food programs are running in the state of Virginia. That, he says, is too many.
``We don't need a dozen separate programs,'' Rector said. ``Republicans are trying to give states some flexibility to run the program more efficiently. That's not to say that the WIC program doesn't have real benefits.''
Christie Reams looked sheepishly at her shoes.
A nutritionist with the Alleghany Health District in Salem was asking about Damian's eating habits.
He'd had a small piece of steak, beans, potatoes, corn bread and a small glass of chocolate milk for supper, Reams said.
And after, nutritionist Denise Newberry asked?
Reams looked away, smiling but reluctant to speak.
``A candy bar?'' she whispered, in a tone that seemed to beg forgiveness.
Newberry nodded, explaining that everyone indulges in a little candy now and then - even nutritionists.
``I don't want people to come in and feel they have to apologize,'' Newberry said. ``We don't want them to feel like that. Most of us wouldn't pass WIC standards.''
The standards are strict. Only certain foods are eligible for WIC vouchers. They are chosen because they have certain nutrients that are often low in participants' diets or are needed in extra amounts for pregnant or nursing women and growing children, according to a WIC handbook.
WIC's nutrition education is an important program component, said Judy Garrett, public health nutritionist for the Alleghany Health District.
Why? What foods participants buy, how they cook them, and their food likes and dislikes affect their children's food habits, she explained.
Education ``is one of the things that makes WIC a unique program,'' Garrett said. ``We try to provide education along with foods that we provide. With food stamps, people don't get any education. You get food stamps, but you don't know how to buy the foods that provide the best nutrition.''
Education includes individual counseling sessions, group meetings, taste parties, movies and pamphlets.
Participants must recertify every six months. Income eligibility is verified. A nurse or health aide checks the weight and height of participants and their children and performs a simple blood test. A nutrition staff member discusses food and family health.
Christie Reams went off the WIC program for a few months after starting a job at a clothing outlet. Laid off, she was back at the Alleghany Health District's WIC clinic last week for recertification.
Now divorced, the vouchers help Reams with grocery bills. They help ``until I can get everything straightened out,'' she said.
``I'm trying to get to where I don't need any of these services.''
by CNB