Tenn. Comp. R. & Regs. 1200-15-02-.01 - DEFINITIONS

(1) The following definitions shall apply to this part and all contracts, guidelines, instructions, forms and other documents related hereto.

(a) " 7 CFR Part 246 " means the section of the Code of Federal Regulations (CFR) which governs the operation of the WIC Program.

(b) "Administrative review" means the process by which a vendor or participant may appeal adverse actions taken against them by the Department. All formal hearings will be held in accordance with the Uniform Administrative Procedures Act, T.C.A. § 4-5-101, et seq, and administrative reviews will be held in accordance with 7 CFR 246.18 and as provided in these rules.

(c) "Adjunctive eligibility" means automatic income eligibility for WIC, based on eligibility for another federal Program, as defined in 7 CFR Part 246.7(d)(2)(vi).

(d) "Approved foods" means types, brands, or varieties of foods meeting the Program requirements established under the federal regulations found in 7 CFR Part 246.10. Foods selected by the Department for the Program in Tennessee can be further limited due to cost, availability, packaging, or other reasons as defined in the current Tennessee Food Package Policy and as provided by Central Office to food manufacturers and other interested parties needing this information.

(e) "Breastfeeding woman" means a participant who is breastfeeding her baby up to twelve months after delivery.

(f) "Central Office" means the office site operated by the Department which is responsible for the overall operation of the Program.

(g) "Child" means a person five (5) years of age or younger.

(h) "Civil money penalty" means a monetary penalty assessed in lieu of disqualification.

(i) "Claim" means a request for reimbursement of Program funds realized by the Department resulting from the detection of any questionable voucher redeemed by a vendor, suspected vendor overcharges, or other errors by the vendor, either intentional or unintentional, or an intentional participant violation that affects the receipt of Program benefits by the participant.

(j) "Commissioner" means the Commissioner of the Tennessee Department of Health or the Commissioner's designee.

(k) "Competitive prices" means shelf prices for approved foods that are competitive with the WIC vendors in the same peer group and region within the state.

(l) "Department" means the Tennessee Department of Health.

(m) "Disqualification" means the withdrawal of authorization as a WIC vendor as a result of fraud, abuse, violation of federal regulations, or continued failure to meet Program requirements prior to the expiration of a WIC Vendor Agreement.

(n) "Dual participation" means simultaneous participation in either the Program in more than one clinic and/or region, or participation in the Program and in the Commodity Supplemental Food Program, or in another WIC Program in another state.

(o) "Food instrument" means a negotiable check with a limited period of validity used by a Program participant to purchase approved foods at an authorized WIC vendor.

(p) "Food package" means the types and amounts of approved foods based on the nutritional needs of the participant.

(q) "Grocery store" means a retail store, open to the general public, that derives the majority (i.e., greater than 50%) of its annual total gross sales from staple foods. Its purpose is to provide Program participants with a selection of Program approved foods that meets the Program's minimum stock requirement. It must also offer a full market basket of foods to provide the opportunity for price comparison shopping and for nutrition information comparison. At least one other form of payment (i.e., bank debit or credit card, personal check, or cash) must be accepted in addition to Food Stamp Program transactions and Tennessee WIC vouchers.

(r) "Income" means gross income before taxes. Source of income is further defined in the WIC Manual.

(s) "Infant" means a baby up to twelve (12) months of age.

(t) "Lock-in status" means vouchers must be presented to a vendor specified by the Program, on a specific day, mutually agreed upon between the Program and the participant.

(u) "Minimum stock requirement" means the types, varieties, brands, and quantities of approved foods a grocery store is required to keep available as established by the Department for the Program.

(v) "Nutritional risk" as defined by federal regulation means:

1. detrimental or abnormal nutritional conditions detectable by biochemical or anthropometric measurements; or

2. other documented nutritionally related medical conditions, such as

(i) dietary deficiencies that impair or endanger health; or

(ii) conditions that predispose persons to inadequate nutritional patterns or nutritionally related medical conditions.

(w) "Overcharge" means an act committed by a vendor of seeking and/or accepting more Program funds for approved foods than is permitted under the WIC Vendor Agreement. Such an act may result in a sanction whether it is intentional or unintentional.

(x) "Parent/caretaker" means a parent of an infant or child participant or a person other than a parent, who is responsible for the care of the infant or child and who enrolls them in the Program.

(y) "Participant" means a pregnant woman, breastfeeding woman, postpartum woman, infant, or child who is receiving supplemental foods or food instruments under the Program.

(z) "Participation" means a monthly count of persons who have received supplemental foods or food instruments.

(aa) "Pattern" means an act that occurs two (2) or more times.

(bb) "Peer group" means a group of WIC vendors who have common characteristics, including, but not limited to, type of business, type of ownership, total sales volume, and pricing of approved foods and are located in the same geographic region.

(cc) "Pharmacy" means a retail establishment licensed by the State of Tennessee to operate as a pharmacy. Its purpose for authorization in the Program is to provide Special Formulas defined in the WIC Manual. These formulas are issued to a participant when prescribed by written order from a physician or nurse clinician under physician supervision.

(dd) "Postpartum woman" means a participant who is not breastfeeding her baby, but may remain on the Program for up to six months after delivery.

(ee) "Program" means the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) authorized by Section 17 of the Child Nutrition Act of 1966, as amended.

(ff) "Proxy" means a person designated, in writing, by the participant or parent/caretaker to receive the vouchers when issued and shop for the supplemental foods issued on the voucher. Parents or caretakers applying on behalf of child and infant participants are not proxies.

(gg) "Redemption" means the procedure during which the vendor receives payment for vouchers previously submitted following the requirements of the WIC Vendor Agreement.

(hh) "Regional Office" means an administrative site operated by or under contract with the Department to provide Program services for its designated geographic area.

(ii) "Sanction" means a disciplinary action taken by the Department as described in sections 1200-15-2-.06 Participant Program Violations and 1200-15-2-.08 Vendor Program Violations.

(jj) "Staple Foods" means the variety of foods carried by an authorized WIC grocery store consisting of, but not limited to, infant formula and other baby food products, eggs, dairy products, bread and bakery products, pastas, fresh produce and vegetables, frozen and canned fruits and vegetables, frozen and canned juices, seafood, meat and poultry. Staple foods do not include any prepared foods or accessory foods such as candy, condiments, spices, tea, coffee, cocoa, or carbonated and uncarbonated drinks.

(kk) "Transaction" or "transacted" means the procedure during which the participant, parent/caretaker or proxy presents a voucher to an authorized WIC vendor in exchange for the approved foods listed on the voucher.

(ll) "USDA" means the United States Department of Agriculture.

(mm) "Vendor" means a retail grocery store or pharmacy that agrees to abide by applicable policies and procedures as delineated in 7 CFR Part 246.12, Department rules, the WIC Vendor Agreement, and the WIC Vendor Handbook. A vendor is authorized by the Department to accept vouchers and provide the supplemental foods issued on the voucher. A vendor encompasses both a business entity and the physical location of a business.

(nn) "Vendor Application for Authorization to Participate in the Tennessee WIC Program" means the standard application form and attachments required by the Department for a potential vendor to participate in the Program. The application must be signed by the Department's authorized designee, as well as an owner or an owner's authorized designee.

(oo) "Vendor Representative" means the regional office staff person who is responsible for contracting the WIC vendor and assuring compliance with the WIC Vendor Agreement.

(pp) "Violation" means each act of non-compliance that occurs or a series of acts that together equate to a violation.

(qq) "Voucher stamp" means a device provided by the Department which imprints the WIC vendor's name and assigned number on redeemed vouchers.

(rr) "Voucher" - see "Food instrument"

(ss) "WIC food"-see "Approved foods"

(tt) "WIC Food List" means the current list of approved foods as provided by the Department to participants and contracted grocery stores.

(uu) "WIC Grocer Price Report Card" means the form submitted by contracted grocery stores at time of application and then on a periodic basis as required by the Department to report prices of specific approved foods.

(vv) "WIC Manual" means the current publication produced by the Department that contains Program information, policies, procedures, sample reports, and forms for use by Program staff in the regional offices and local health department clinics.

(ww) "WIC Vendor Agreement" means the standard written departmental agreement that specifies the terms and conditions for a WIC vendor to participate in the Program. (The agreement must be signed by an owner or an owner's authorized designee and the Department's authorized designee. See Vendor Application.)

(xx) "WIC Vendor Handbook" means the current publication produced by the Department that contains Program information, policies, and procedures to be followed by WIC vendors.

(yy) "WIC Vendor Management Manual" means the current publication produced by the Department that contains Program information, policies, procedures, sample reports and forms for use by Program staff in the Central Office and the Regional Offices.

Notes

Tenn. Comp. R. & Regs. 1200-15-02-.01

Original rule filed June 20, 1985; effective July 20, 1985. Repealed and new rule filed August 24, 2000; effective November 7, 2000. Repeal and new rule filed February 8, 2002; effective April 24, 2002. Amendment filed July 1, 2004; effective September 14, 2004.

Authority: T.C.A. §§ 4-5-202, 4-5-204, and 68-1-106.