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Coordination between the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) and Medicaid has been an important component to ensuring access to primary care services for WIC clients. This study examines how increased use of managed care in the Medicaid program has affected WIC program coordination efforts. According to the study sample, 72 percent of State Medicaid agencies report that Managed Care Organizations (MCOs) are required to inform their members about WIC. About 43 percent of State WIC agencies sampled in the study have a formal agreement with a State Medicaid agency, generally revolving around data sharing, referrals, and provision of special metabolic infant formulas. The agreements often lack specific details on how services should be coordinated, however. Some local WIC agencies and MCOs have implemented innovative approaches to coordination. These approaches include Medicaid staff atWIC clinics to help clients with enrollment, sharing information to promote targeted outreach efforts, helping clients identify providers and resources, and MCOs paying transportation costs of WIC clients to attend WIC appointments.

All States in a recent study undertook at least one "re-engineering" activity in their Food Stamp Programs (FSPs) as a result of the Personal Responsibility and Work Opportunity Reconciliation Act of 1996 (PRWORA). In addition, 35 States implemented changes in 3 or more re-engineering categories, while 24 States planned changes for fiscal year (FY) 2000 in 2 or more categories. PRWORA dramatically changed the systems that provide cash assistance and food stamps to low-income Americans. Along with mandatory changes in food stamp eligibility, States were given greater flexibility to administer their programs to meet their unique needs. While States had begun changing the way program services were delivered before passage of welfare reform legislation, PRWORA provided additional opportunities for them to "re-engineer" FSPs. The purpose of the study was to examine State-level administrative changes to FSPs as a result of PRWORA, both those made before FY 2000 and those planned for FY 2000. This report provides the study results. For the State data collection instrument, see Re-engineering the Welfare System-A Study of Administrative Changes to the Food Stamp Program: State Data Collection Instrument at http://www.ers.usda.gov/publications/efan01009.