Subject: Clinic Closure - Relocation Policy: ADM 11.1 Reference: C.F.R. § 246.8 Effective: August 1, 2016 Supersedes: N/A

I. Policy: It is required by USDA that a Civil Rights Impact Analysis Form be completed before closing and/or relocating a local agency clinic. The form shall be submitted to the State WIC Office (SWO) at least 90 days in advance of closure and/or relocation.

II. Procedure(s):

A. Complete the Civil Rights Impact Analysis Form (WIC-351)

B. Submit the form to the State Office’s Local Agency Technical Assistance Supervisor for approval prior to the closing and/or relocation of the clinic(s)

C. Once SWO approval has been received, establish the new clinic in Crossroads

D. Transfer all participants and inventory from the closing clinic to the new clinic or to other WIC clinic(s)

E. Submit an updated WIC Services Plan (WSP) to include the new clinic’s hours of operation

Retention: Refer to policy ADM 11.0

Division of Community Nutrition