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Results from the NWA Fruit and Vegetable CVV Redemption Survey

Cecilia Richardson, MS, RD, LD Washington Leadership Conference March 5, 2013 crichardson@nwica.org

Why We Did a Survey

• We were hearing that not all state agencies had high redemption rates

• “Public Health Value” of unredeemed benefits is being left on the table

Survey Details

• Survey sent to all 90 WIC state agencies in October 2012

• Results were collected between October 2012 – February 2013

• Questions asked:

– CVV redemption rates and trends

– Barriers and Opportunities

Survey Response

• Total Returned: 58

• 47 Geographic States

• The District of Columbia

• 10 ITOs

• 1 U.S. Territory

Results

Agencies CVV Data Collection

• 36 agencies collected CVV data

• 22 agencies did not

2012 Monthly CVV Redemption Rate

• High: 98%

• Low: 17%

• Mean: 79%

• Median: 78%

From the survey results, it was estimated

that in FY 2012, there were $68 million in

unredeemed benefits from the

responding state agencies; and an

estimated $100 million in unredeemed

benefits nationally.

Redemption Rates Have Leveled

or Increased Over Time

Gone

Up

52.6%

0.0%

Remained

Flat

47.4%

In the time that the Cash Value Vouchers have been

implemented in the WIC program, what is the redemption

trend in your state?

Redemption rates

have gone up over

time

Redemption rates

have gone down

over time

Redemption rates

have remained flat

over time

Helping the WIC Client Redeem

Full Value of Vouchers

Yes

54.4%

No

45.6%

Has your state agency, any local agencies in your state, or any

retail grocers in your state implemented campaigns or

practices to help WIC clients redeem the full value of their

vouchers?

Yes (please specify

below)

No

Helping the WIC Client Redeem

Full Value of Vouchers (cont.)

Has your state agency, any local agencies in your state, or any retail grocers in your state implemented campaigns or practices to help WIC clients redeem the full value of their vouchers?

If Yes, please specify:

• “Nutrition education coupled with posters in the stores showing the prices and weights so participants can reach the maximums on the vouchers”

• “Some retailers have prepackaged items for even dollars”

• “In May, 2012, Nebraska allowed participants to pay the difference if their

purchase exceeds the value of the CVV”

• Provided an insert with a chart on number of pounds x price per pound = total”

• “We have scales at each clinic to teach clients how to weigh produce, a pricing guide on our food card and have created several handouts to help

clients identify which items are approved”

Do Education Campaigns/Practices Improve

Redemption Rates?

Campaigns/Practices and Higher

Redemption Rates

Campaigns/Practices and Lower

Redemption Rates

No Campaigns/Practices

and Higher Redemption Rates

No Campaigns/Practices

and Lower Redemption Rates

Campaigns/Practices and Does Not Collect

Redemption Rate Data

No Campaigns/Practices and Does Not Collect

Redemption Rate Data

Series1 12 9 9 6 11 11

12

9 9

6

11 11

0

2

4

6

8

10

12

14

Nu

mb

er

of

Sta

tes

State, Grocer or Local Education Campaigns/Practices to Help Clients Use CVVs

Authorized Farmers’ Markets to Accept WIC

CVVs

Yes

35.1%

No, but in

near future

7.0%

No

57.9%

Does your state authorize Farmers’ Markets to accept

WIC Cash Value Vouchers?

Yes

No, but planning to

do in the near future

No

State Agencies Using Split Tender

Yes

81.0%

No

19.0%

Does your state allow participants to pay the difference if their

purchase exceeds the value of the CVV?

Yes (please provide feedback

below, if any, that you have

gotten from retailers or WIC

customers about this practice)

No

State Agencies Using Split Tender (cont.)

Does your state allow participants to pay the difference if their

purchase exceeds the value of the CVV?

If Yes, please provide feedback below, if any, that you have

received from retailers or WIC customers about this practice:

• “Initial concerns by vendors, but very positive after implementation”

• “Vendors initially had some questions but with increased training it is working well. Some vendors had to reprogram their POS”

• “Retailers report clients don't often use this option”

• “Positive from both categories”

• “Cashier training is difficult”

• “[patients] seem hesitant to exceed the total and therefore, tend to

under redeem”

Grocers Pre-bundling Fruits and Vegetables

Yes

39.7% No

60.3%

Are you aware of stores in your state that offer pre-packaged

bundles of fruits and vegetables in set dollar amounts for WIC

consumers?

Yes (If data is available,

please specify below if

there is a correlation

between this practice and

higher redemption rates)

No

Grocers Pre-bundle Fruits and Vegetables (cont.)

Comments:

• “Yes, the WIC only stores do this. This specific

practice increases redemption rates.”

• “No correlation - <25% actually purchase the pre-

pkg. fixed dollar amount f & v.”

• “We had stores that did this and then participants

refused to use them because then people would know they are on WIC.”

Reported Obstacles to Full CVV Redemption

48.1%

59.3%

11.1%

20.4%

27.8%

0.0%

10.0%

20.0%

30.0%

40.0%

50.0%

60.0%

70.0%

Participant

education

Participant fear of

error or

overcharge at

cash register

Vendor training Need to weigh

fresh produce

Lack of EBT

What do you see as the greatest obstacle to full

Cash Value Voucher redemption?

Reported Opportunities to Improve

Full CVV Redemption

71.4%

40.8%

32.7%

0.0%

10.0%

20.0%

30.0%

40.0%

50.0%

60.0%

70.0%

80.0%

Participant education Pre-packaged bundles

of fruits and vegetables

for specific dollar

amounts

EBT

Which of the Items below do you think may help overcome the

obstacles to full Cash Value Voucher redemption?

Reported Opportunities to Improve

Full CVV Redemption

Which of the items below do you think may help overcome the obstacles to full Cash Value Voucher redemption?

Other (please specify):

• “Some clients don't want the quantity of fruits & veggies

available”

• “EBT helps with the increase in redemption”

• “EBT does not necessarily ensure maximizing of this benefit”

• “More appealing displays of fruits and vegetables at small

vendors”

• “We find that families either spend the entire benefit or none

at all, it isn't a question of under-redeeming their benefit”

EBT Agency Rates

81.2

63

79 77

71 71

0

10

20

30

40

50

60

70

80

90

1 2 3 4 5 6

Re

de

mp

tio

n R

ate

State Agency

Redemption Rates of Agencies with EBT

Conclusions

There is not a one-size fits all model to solving this problem