Results from the NWA Fruit and Vegetable CVV Redemption Survey CE 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 In the time that the Cash Value Vouchers have been implemented in the WIC program, what is the redemption trend in your state? Remained Flat 47.4% 0.0% Gone Up 52.6% 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 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? No 45.6% Yes 54.4% 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
Number of States Do Education Campaigns/Practices Improve Redemption Rates? 14 12 12 State, Grocer or Local Education Campaigns/Practices to Help Clients Use CVVs 11 11 10 8 9 9 6 6 4 2 0 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
Authorized Farmers Markets to Accept WIC CVVs Does your state authorize Farmers Markets to accept WIC Cash Value Vouchers? No 57.9% Yes 35.1% Yes No, but planning to do in the near future No No, but in near future 7.0%
State Agencies Using Split Tender Does your state allow participants to pay the difference if their purchase exceeds the value of the CVV? No 19.0% Yes (please provide feedback below, if any, that you have gotten from retailers or WIC customers about this practice) Yes 81.0% 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 Are you aware of stores in your state that offer pre-packaged bundles of fruits and vegetables in set dollar amounts for WIC consumers? No 60.3% Yes 39.7% 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 prepkg. 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 What do you see as the greatest obstacle to full Cash Value Voucher redemption? 70.0% 60.0% 50.0% 48.1% 59.3% 40.0% 30.0% 20.0% 10.0% 11.1% 20.4% 27.8% 0.0% Participant education Participant fear of error or overcharge at cash register Vendor training Need to weigh fresh produce Lack of EBT
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? 80.0% 70.0% 71.4% 60.0% 50.0% 40.0% 40.8% 32.7% 30.0% 20.0% 10.0% 0.0% Participant education Pre-packaged bundles of fruits and vegetables for specific dollar amounts EBT
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
Redemption Rate EBT Agency Rates 90 80 81.2 Redemption Rates of Agencies with EBT 79 77 70 60 63 71 71 50 40 30 20 10 0 1 2 3 4 5 6 State Agency
Conclusions There is not a one-size fits all model to solving this problem