GEORGIA WIC PROGRAM PROCEDURES MANUAL VM Vendor Application and Authorization Process Policy No. VM- 100.01 Effective Date: October 1, 2016

No. of Pages: 8

Page 1 of 8

Policy Federal regulations require that Georgia WIC establish standards for vendor authorization to secure a sufficient number and distribution of vendors that will ensure reasonable participant access and permit effective management of the program. Georgia WIC may establish criteria to limit the number of stores it authorizes as long as the limiting criteria are applied consistently. The Georgia Women, Infants and Children Program shall not discriminate against an applicant or vendor on the basis of race, color, national origin, age, sex, handicap, disability or other impermissible basis as set forth in applicable state or federal law. The State agency must develop and implement criteria to select stores for authorization. The State agency must apply its selection criteria consistently throughout its jurisdiction. The State agency may reassess any authorized vendor at any time during the vendor's agreement period using the vendor selection criteria in effect at the time of the reassessment and must terminate the agreements with those vendors that fail to meet them. The vendor selection criteria must be included in the State Plan in accordance with § 246.4(a)(14)(ii).

Purpose The WIC program is funded by federal tax dollars. Because of this, serving as an authorized WIC vendor is a public trust. Vendor authorization is the process by which the State Agency assesses, selects, and enters into agreements with stores that apply or subsequently reapply to be authorized as WIC vendors. Authorization to participate in the program as a vendor is a privilege, not a right. As a steward of public funds, Georgia WIC must balance the need for participant access with the duty to obtain the lowest fair prices for WIC foods and to prevent fraud. The State Agency shall contract with a sufficient number of Vendors to serve all Georgia WIC participants. The State Agency may limit the number of vendors to enable the State Agency to effectively manage the program.

Procedures I. Number and Distribution of Authorized Vendors

The primary method of regulating the number of authorized vendors is through the use of a vendor-to-participant ratio. The vendor-to-participant ratios are determined prior to each application/authorization period. For vendor authorization, exceptions to the vendor-to- participant ratio conclusions may be considered under the following circumstances:

GEORGIA WIC PROGRAM PROCEDURES MANUAL VM Vendor Application and Authorization Process Policy No. VM- 100.01 Effective Date: October 1, 2016

No. of Pages: 8

Page 2 of 8

A. The need to ensure that each food instrument issuance clinic site in the state has an authorized vendor within a 10 mile radius. B. The need to provide adequate service to participants in a population center of at least ten (10) individuals who have no access to an authorized vendor within a 10 mile radius of the population center.

C. The need to provide adequate service to participants when circumstances make it necessary. Those circumstances may include, but are not limited to, the following:

1. New clinic site opening; 2. Participant caseload increases; 3. New participant population center recognized; 4. Store closings, either voluntary or due to catastrophe; 5. Problems with WIC Program compliance; 6. Problems caused by non-compliance with Food Stamp regulations.

II. Applications for WIC vendor authorization are accepted during the following periods of each federal fiscal year:

A. October 1st to December 31st B. March 1st to May 31st

III. Application Denial

If an application for authorization is denied, the applicant will be barred from reapplication for period of one (1) year with the exception of the Denial Reasons listed below. Denial periods vary based on the reason that an application is denied. At the time that a notification of Denial is issued, applicants will be notified of their reapplication date. Irrespective of the reason for denial, once denied, an applicant who wishes to be reconsidered must allow their Denial Period to expire and re-submit a new application after that date has passed. Applications are not re-considered until new application materials have been submitted.

A. Accepting WIC vouchers prior to Authorization: The denial period is three (3) years. B. Business Integrity and Related Denials: For Business Integrity or Integrity-related reasons, the denial period will be two (2) years.

GEORGIA WIC PROGRAM PROCEDURES MANUAL VM Vendor Application and Authorization Process Policy No. VM- 100.01 Effective Date: October 1, 2016

No. of Pages: 8

Page 3 of 8

C. All Other Reasons for Denial: The denial period is one (1) year. IV. Application Materials All authorization documents are located on the Vendor Information website http://dph.georgia.gov/vendor-information. Applicants are required to retrieve and complete all applicable documents to be considered for authorization as a vendor for Georgia WIC.

V. Categories of Vendors and Length of Agreements

Georgia WIC categorizes applicant/vendors based on the number of stores owned by a singular corporate entity. Vendors owning one (1) store under one (1) corporate entity are identified as ‘non-corporate’ and given a two (2) year agreement term upon authorization. Vendors owning two (2) or more stores under (1) corporate entity are identified as ‘corporate’ and given a three (3) year agreement term upon authorization.

An organization identified as a candidate for a 3 year agreement may request to establish separate 2 year agreements for each store location.

Application procedures vary marginally between the two term categories.

A. Non-Corporate/ Two Year Agreement Applicants

1. Non-corporate retail stores applying for WIC authorization shall submit all required application forms to the Office of Vendor Management (OVM) for review. Required documents include: vendor application, W-9 form, sales tax certificate, corporate information form, food sales establishment license, Supplemental Nutrition Assistance Program (SNAP) permit, lease, deed, or bill of sale, RD 1062 disclosure authorization form, and ACH form. All application forms must be completed, signed by an appropriate vendor representative and submitted within an open submission period.

2. Incomplete applications will be returned to all applicants, which may delay processing of the application. Once the applicant is notified of an incomplete application, the applicant must submit the missing information to OVM within seven (7) days of the written request. Failure to return missing information within seven (7) days will result in an application expiration.

GEORGIA WIC PROGRAM PROCEDURES MANUAL VM Vendor Application and Authorization Process Policy No. VM- 100.01 Effective Date: October 1, 2016

No. of Pages: 8

Page 4 of 8

3. Once all documentation is reviewed for accuracy and alignment with the selection criteria, applicants will be scheduled to attend face-to-face authorization training. Representatives attending training must complete the post evaluation with a score of 80% or better and complete a training checklist to proceed to the preapproval phase of the authorization process.

4. Once training is completed successfully, the application packet will be forwarded to the Georgia DPH Office of the Inspector General (OIG) to schedule an on-site pre approval visit. OIG will coordinate an onsite visit at a time agreed upon by both parties. See policy/procedure OIG Policy and Procedure Manual, Pre-Approvals for details concerning the onsite pre approval visit. Additionally, OIG will conduct a desk audit, which entails a business integrity assessment of the business owners inclusive of background checks. The facility with be assessed based on information provided in the vendor application packet, including adherence to minimum inventory requirements. Once the on-site pre approval visit has been completed, OIG will compile findings from the onsite visit and the desk audit into a comprehensive report that is forwarded to the OVM Vendor Relations Unit.

5. If the applicant meets all applicable selection criteria, authorization will be completed. See Vendor Selection and Limiting Criteria Policy for specific details and guidance.

If the applicant does not meet the minimum inventory requirement, a second visit may be requested by the applicant. Failure to successfully meet minimum inventory requirements on the second visit will result in denial of the vendor application (See Application Denial for denial reasons and period of denial).

6. When all selection criteria are met, the applicant will be mailed two copies of a 2 year agreement for signature.

a. Once a signed agreement is received Authorization is designated by the issuance of a fully executed Vendor Agreement (signed by both Georgia WIC and the vendor approval authorities and issuance of one (1) self-inking vendor stamp. The non-corporate Vendor Agreement term is a fixed length of two (2) federal fiscal years, regardless of the actual authorization date within that two year timeframe. All

GEORGIA WIC PROGRAM PROCEDURES MANUAL VM Vendor Application and Authorization Process Policy No. VM- 100.01 Effective Date: October 1, 2016

No. of Pages: 8

Page 5 of 8

documents and stamps are mailed via UPS next day delivery with delivery confirmation methods. b. For non-corporate vendors, the Vendor Agreement, stamp, shelf talkers, and window decals will be mailed to the individual store via UPS next day mail. Unless corporate and store addresses differ. c. Vendor stamps shall not be reproduced. i. If the vendor stamp is lost, stolen, or damaged, Georgia WIC must be notified immediately to reduce opportunities of fraud and abuse towards the program. Georgia WIC maintains surplus stamps on hand. If stamps are not on hand, Vendor Relations can order a replacement stamp with a guaranteed delivery within ten (10) business days. Once received the stamp will be mailed via UPS next day. ii. The vendor stamp is invalid upon agreement termination, disqualifications or voluntary withdrawal from the Program.

B. Corporate / Three Year Agreement Applicants

1. Corporate retail stores applying for WIC authorization shall submit all required application forms to the Office of Vendor Management (OVM) for review. Corporate applicants must submit a vendor application and corporate information form which contains information related to the corporate entity. In addition to the vendor application and corporate information form, applicants must submit the following documents for each store: corporate attachment, W-9 form, sales tax certificate, corporate information form, food sales establishment license, Supplemental Nutrition Assistance Program permit, lease, deed, or bill of sale, RD 1062 disclosure authorization form, and ACH form. All application forms must be complete, signed by an appropriate vendor representatives and submitted within open submission periods.

2. Incomplete applications will be returned to vendor which may delay processing of your application. Once the vendor is notified of an incomplete application, the applicant must submit the missing information to OVM within seven (7) days of the written request. Failure to return missing information within seven (7) days will result in application expiration.

3. Once all documentation is reviewed for accuracy and alignment with selection criteria, corporate vendors will be required to complete and submit a Corporate Training Checklist certifying store personnel has been trained by the corporation’s designated internal training coordinator in lieu

GEORGIA WIC PROGRAM PROCEDURES MANUAL VM Vendor Application and Authorization Process Policy No. VM- 100.01 Effective Date: October 1, 2016

No. of Pages: 8

Page 6 of 8

of face-to-face training. The completed training checklist must be returned to the OVM prior to authorization.

4. Corporate, Peer Group C vendors, may proceed with an on-site pre approval visit once all required documentation has been accurately completed.

5. For corporate vendors, once successful training is complete, the application will be forwarded for an on-site pre approval visit conducted by representatives of the Georgia WIC Program. The representative with coordinate a date and time to complete an onsite visit at a time agreed upon by both parties. Representatives will assess owners for business integrity and complete background checks. The facility with be assessed based on information provided in the vendor application, including minimum inventory requirements. Once the on-site pre approval visits has been completed, Georgia WIC authorized representatives will compile findings into a concise report and forward to the Office of Vendor Management – Vendor Relations.

6. If the applicant meets all requirements, authorization will be completed. See Vendor Selection and Limiting Criteria Policy for specific details and guidance. If the applicant does not meet requirements due to a failure to meet minimum inventory requirements, a second visit may be requested by the applicant. Failure to successfully meet minimum inventory requirements during the second, scheduled visit will result in a denial of the vendor application. The application denial period is from one (1) to three (3) years depending on the reason(s) for a denial.

7. Once all selection criteria are met, including the successful completion of authorization training and the pre-approval visit, the vendor will be extended a vendor agreement.

a. Two copies of the vendor agreement are mailed to the responsible party of record for signature. Both signed, dated agreements must be returned to the Program. b. Both copies of the agreement are signed, dated by the Director of the Georgia WIC Program after they have been signed and returned by the applicant. c. Welcome packets are created for the authorized vendor. The corporate office will receive a packet which includes 1 copy of the fully executed agreement and 1 copy of the completed corporate attachment form,

GEORGIA WIC PROGRAM PROCEDURES MANUAL VM Vendor Application and Authorization Process Policy No. VM- 100.01 Effective Date: October 1, 2016

No. of Pages: 8

Page 7 of 8

mailed to the corporate address as listed on the application via UPS next day mail with delivery confirmation methods.

The assigned vendor stamp, shelf talkers, and window decals will be mailed to each individual store listed on the corporate attachment via UPS next day mail with delivery confirmation methods.

8. Authorization is designated by the issuance of a fully executed Vendor Agreement (signed by both Georgia WIC and the vendor approval authorities), as well as the issuance of one (1) self-inking vendor stamp to each approved store location. The corporate Vendor Agreement term is for three (3) federal fiscal years regardless of when the vendor is approved during this term.

VI. Expiration of Vendor Agreement - Reauthorization

Upon expiration of the Vendor Agreement, all vendors (corporate and non-corporate), must complete all authorization documents if they intend to continue offering WIC approved food items. Applicants will be required to reapply to Georgia WIC as a new vendor for assessment including submission of all required documentation, successful completion of authorization training via face-to-face training or completion of a training checklist and pre approval visits. See Categories of Vendors and Length of Agreements section for required steps to complete reauthorization upon expiration of Vendor Agreement.

Authority 7 C.F.R. §§ 246.12(g), (h), and (i) 7 C.F.R. § 246.4(a)(14)(ii)

Definitions/Supporting Information VM-100.05 Number and Distribution of Vendors VM-100.02 Vendor Selection and Limiting Criteria VM-110.01 Vendor Training VM-100.04 Vendor Peer Group Criteria Corporate Vendor Agreement – 3 Year Non Corporate Vendor Agreement – 2 Year

GEORGIA WIC PROGRAM PROCEDURES MANUAL VM Vendor Application and Authorization Process Policy No. VM- 100.01 Effective Date: October 1, 2016

No. of Pages: 8

Page 8 of 8

Contact Information Georgia Department of Public Health Georgia WIC Program Office of Vendor Management – Vendor Relations and Adm. Unit 2 Peachtree Street, NW, 10th Floor Atlanta, Georgia 30303