PENNSYLVANIA DEPARTMENT OF HEALTH WIC State Agency Policy and Procedure Number: 3.01 USDA Approval Date: July 24, 2023 Effective Date: October 23, 2023 Page 1 of 4

POLICY MANUAL

3. CLINIC OPERATIONS

3.01 Mobile Clinics

A. POLICY OVERVIEW: A mobile clinic is defined as a vehicle used to complete WIC certifications and other appointment types for participants in hard-to-reach areas that may be underserved by traditional brick-and-mortar WIC clinics. However, a secondary purpose of mobile clinics is conducting outreach or other program activities. The goal of mobile clinics is to ultimately increase access to and participation in WIC.

B. POLICY:

1. Requirements For Mobile Clinics

a. Provide sufficient space for:

(1) At least two WIC staff and up to a family of four to provide the required range of WIC services

(2) Appropriate and convenient placement of computer equipment and participant records

b. Be organizationally designed to:

(1) Be conducive to efficient operation and clinic flow

(2) Provide participant privacy and confidentiality of those served

c. Be climate controlled for the comfort of participants and staff.

d. Be clean, orderly, and well maintained in appearance both inside and out as well as mechanically maintained.

e. Have sufficient exterior lighting to allow ease of identification and for safety precautions.

f. Display the WIC logo and other applicable graphics to the exterior of the vehicle to further promote WIC in the community.

2. Procurement and Requests for Approval of New Mobile Clinics

a. Pursuant to Paragraph 37, A. of the Pennsylvania Department of Health Standard General Terms and Conditions (Rev. 2/21), local agencies shall procure mobile clinics at the lowest practicable cost and to purchase by means of a system of competitive bidding. At a minimum, local agencies shall follow the below minimum criteria:

(1) Local agencies must make a good faith effort to secure three quotes of similar size and features that include all ancillary costs necessary to deploy

PENNSYLVANIA DEPARTMENT OF HEALTH WIC State Agency Policy and Procedure Number: 3.01 USDA Approval Date: July 24, 2023 Effective Date: October 23, 2023 Page 2 of 4

the mobile clinic.

(2) Although the lowest quote is the most reasonable by default, if the vendor cannot meet the scope of work, it’s reasonable to consider a higher quote. Decisions to not select the lowest bidder must be fully described in the request for approval.

(3) The final preferred quote must be a firm fixed price guaranteed for at least 6 months from the date of submission to the State agency, to allow time for the approval process and issuance of funding.

(4) The final purchase price cannot exceed the amount approved by USDA.

b. Mobile clinics are classified as equipment under 2 CFR 200.313 and require approval of both the State agency and the US Department of Agriculture (USDA) if the unit cost exceeds $24,999.

c. Local agencies must submit requests for approval to their project officer by May 1st and must include the following:

(1) Narrative of the objectives specific to the local agency service area including how the mobile clinic will be utilized and evaluated

(2) Budget, which captures all costs

(3) Three vendor quotes which capture all costs

(4) Prints to illustrate the design of the preferred vendor

(5) USDA Policy Memo SFP 10-017 Attachment A (relating to real property) needs completed for all mobile clinics

d. The State agency will forward requests to USDA by May 15th but no later than June 30th for final approval.

e. Exterior vehicle graphics shall be approved by the project officer and state outreach coordinator or their designees prior to printing and application.

3. Operations

a. Pursuant to Paragraph 37, D. of the Pennsylvania Department of Health Standard General Terms and Conditions (Rev. 2/21), local agencies shall maintain and administer, in accordance with sound business practices, a program for the maintenance, repair, protection, preservation and insurance of the mobile clinic so as to assure its full availability and usefulness.

b. Local agencies will submit a Clinic Input Document (CID) form to their project officer for each mobile clinic utilized to have a unique clinic identification number assigned for tracking and data collection and will resubmit forms as needed to keep information current according to Policy 3.00, Clinic Operations. Each clinic title will include “Mobile Clinic” for easy identification.

c. Locations, dates, and times of mobile clinic use must be planned to reach underserved populations and reported to the State agency in advance:

PENNSYLVANIA DEPARTMENT OF HEALTH WIC State Agency Policy and Procedure Number: 3.01 USDA Approval Date: July 24, 2023 Effective Date: October 23, 2023 Page 3 of 4

(1) A title and address of mobile clinic locations will be entered into the shaded heading of the PENN scheduler to identify clinic locations and allow for data collection.

(2) Provide a list of mobile unit locations to include clinic name, address, dates of operation, hours, active/inactive, end date at a location specified by the project officer.

(3) When mobile clinics are used for outreach or other program activities, the above reporting is not required.

(4) Mailing labels or similar method will be used to correct next appointment PENN appointment notices printed at the conclusion of WIC appointments.

d. Locations should include space for participant parking and convenient access to a public restroom, if the mobile clinic is not equipped with a restroom.

e. If a mobile clinic is not accessible to participants with disabilities, a written local agency policy shall be developed that describes how reasonable accommodations will be provided to the disabled.

(1) These alternative service provisions may include, but are not limited to, service in other accessible locations outside the mobile clinic or at other clinic sites. In choosing among available methods, the local agency shall give priority to those methods that offer programs and activities to qualified disabled persons in the most integrated setting appropriate to obtain the full benefits of the programs.

f. WIC staff must follow all WIC Policies when operating a mobile clinic, the same as in a brick-and-mortar location, unless specifically excluded by the State agency.

4. Disposition

a. The decision to dispose of a mobile clinic requires the approval of both the State agency and USDA in accordance with 2 CFR 200.313(e) and Paragraph 37 of the Pennsylvania Department of Health Standard General Terms and Conditions (Rev. 2/21).

b. Local agencies will submit a Capital Equipment Disposal Request form to their project officer to initiate the disposition process according to Policy 2.05, Equipment Purchase, Inventory and Disposition.

PENNSYLVANIA DEPARTMENT OF HEALTH WIC State Agency Policy and Procedure Number: 3.01 USDA Approval Date: July 24, 2023 Effective Date: October 23, 2023 Page 4 of 4

POLICY MANUAL

3. CLINIC OPERATION

3.01. Mobile Clinics

Reference(s): 1. USDA Memo 10-017. 2. WIC Regulations: 2 CFR 200.313 3. Department of Health Standard General Terms and Conditions (Rev. 2/21)