12.016 - 1 Administrative Procedures Revised August 2019 XII. Administrative Procedures – Application Process for New Local Agencies and/or New Site Locations PROCEDURE 12.016 Implementing Office: Community Health Administration (CHA) Revised August 2019 Approved by: _______________________ LaQuandra S. Nesbitt MD, MPH; Agency Director Review by Legal Counsel: ____________________ Phillip Husband, Esq.; General Counsel Effective Date: 01/01/2017 I. Authority USDA II. Reason for the Policy CFR § 246.5 Application for New Local Agency III. Applicability DC WIC State Agency and Local Agency Staff IV. Policy Statement When an organization expresses interest in becoming a WIC Local Agency (LA), the State Agency (SA) will send information regarding the DC WIC program and the responsibilities of being a WIC agency. The SA will instruct the potential new agency to complete the DC Health WIC Program Application for New Local Agencies (see appendix 12.016A), which should be completed and returned to the SA via email at info.wic@dc.gov. Current DC WIC Local Agencies may use the same application when seeking approval to open additional site(s). A copy of the DC Health WIC Program Application for Local Agencies can also be found on the DC WIC Website (dcwic.org). NOTE: Grant agreements start at the beginning of a FFY (October 1st). A new agency to WIC will not start their online training until October 1st and will not provide actual WIC services for clients until a later date to be determined. The SA will acknowledge receipt of an application within 20 days. If any additional information is needed or the application is completed incorrectly, the SA will inform the organization of the deficiencies within 20 days. After receipt of corrections or additional information, the SA will analyze the request and inform the organization of the approval or disapproval of the request within 90 days.

12.016 - 2 Administrative Procedures Revised August 2019 VI. Procedures An organization who would like to be a new WIC Local Agency (or – a current LA wishing to open a new site) must provide the following information to the State Agency: 1. Notify the SA of the desire to be a new WIC LA, or the desire to open new site(s) in conjunction with a currently contracted DC WIC LA 2. Provide a letter stating the reason why the organization would like to become a WIC Local Agency 3. Provide pictures of the exterior and interior of where WIC services would be performed 4. Complete the DC WIC Application for New Local Agency Form (Appendix 12.016A) 5. Review the Proposed WIC site Checklist (Appendix 12.016B) 6. Provide documents requested in bullets 2 thru 6 above via email to the State Agency at info.wic@dc.gov a. Subject Lines: i. New Local Agencies – “Application for new WIC Local Agency” ii. Current LA, new Site – “(LA Name) Application for new WIC Site” VII. Appendix 12.016A DC Health WIC Program Application for New Local Agencies 12.016B Proposed Site Checklist VIII. Reference N/A