(1) An "administrative appeal" is an appeal in accordance with Section .0800 of this Subchapter through which a local WIC agency, potential local WIC agency, authorized WIC vendor or potential authorized WIC vendor may appeal the adverse actions listed in 7 C.F.R. 246.18(a)(1)(i), (a)(1)(ii) and (a)(3)(i).

(2) An "authorized store representative" includes an owner, manager, assistant manager, head cashier, or chief fiscal officer.

(3) An "authorized WIC vendor" is a food retailer or free-standing pharmacy that has executed a currently effective North Carolina WIC Vendor Agreement DHHS Form 2768.

(4) A "chain store" is a store that is owned or operated by a corporation, partnership, cooperative association, or other business entity that has 20 or more stores owned or operated by the business entity.

(5) A "competent health professional" is a physician, registered nurse, nutritionist, registered dietitian, or nutrition trainee or home economist (who is under the supervision of a nutritionist), or other qualified individuals approved by the Nutrition Services Branch. These individuals must be on the staff of the local WIC agency or designated by the local WIC agency in order to certify and prescribe the food package.

(6) A "fair hearing" is the informal dispute resolution process in Section .0900 of this Subchapter through which any individual may appeal a state or local agency action which results in a claim against the individual for repayment of the cash value of improperly issued benefits or results in the individual's denial of participation or disqualification from the WIC Program. This process must be complied with prior to making a formal appeal in accordance with G.S. 150B.

(7) A "food instrument" means a voucher, check, electronic benefits transfer card (EBT), coupon or other document which is used to obtain supplemental foods.

(8) "FNS" means the Food and Nutrition Service of the U.S. Department of Agriculture.

(9) "Free-standing pharmacy" means a pharmacy that does not operate within another retail store. Free-standing pharmacy includes free-standing pharmacies that are chain stores and free-standing pharmacies participating under a WIC corporate agreement.

(10) The "local WIC agency" is the local agency which enters into an agreement with the Division of Public Health to operate the Special Supplemental Nutrition Program for Women, Infants and Children.

(11) A "local WIC program plan" is a written compilation of information on the local WIC agency policies concerning program operation, including administration, nutrition education, personnel functions, costs and other information prepared by the local WIC agency and submitted to the Nutrition Services Branch in accordance with instructions issued by the Branch.

(12) "Redemption" is the process by which a vendor deposits a food instrument for payment and the state agency (or its financial agent) makes payment to the vendor for the food instrument.

(13) "Shelf price" is the price a vendor charges a non-WIC customer for a WIC supplemental food.

(14) The "state agency" is the Nutrition Services Branch, Women's and Children's Health Section, Division of Public Health, Department of Health and Human Services.

(15) "Store" means the physical building located at a permanent and fixed site that operates as a food retailer or free-standing pharmacy.

(16) "Supplemental food" or "WIC supplemental food" is a food which satisfies the requirements of 15A NCAC 21D .0501 and is included in the WIC Vendor Manual.

(17) "Support costs" are clinic costs, administrative costs, and nutrition education costs.

(18) "Transaction" is the process by which a WIC customer tenders a food instrument to a vendor in exchange for authorized supplemental foods.

(19) "Vendor applicant" is a store that is not yet authorized as a WIC vendor.

(20) A "vendor overcharge" is intentionally or unintentionally charging more for supplemental food provided to a WIC customer than to a non-WIC customer or charging more than the current shelf price for supplemental food provided to a WIC customer.

(21) A "WIC corporate agreement" is a single WIC Vendor Agreement with a corporate entity that has twenty or more stores authorized as WIC vendors under the Agreement.

(22) "WIC customer" means a WIC participant, parent or caretaker of an infant or child participant, proxy or compliance investigator who tenders a food instrument to a vendor in exchange for WIC supplemental food.

(23) "WIC program" means the special supplemental nutrition program for women, infants and children authorized by 42 U.S.C. 1786 of the Child Nutrition Act of 1966 as amended.

(1) Exchanging food instruments or supplemental food for cash;

(2) Exchanging food instruments or supplemental food for alcohol, alcoholic beverages, tobacco products, firearms, ammunition, explosives, or controlled substances as defined in 21 U.S.C. 802;

(3) A claim for dual participation resulting from intentional misrepresentation;

(4) Intentionally making false or misleading statements or intentionally misrepresenting, concealing, or withholding facts to obtain Program benefits;

(5) Any participant violation for which a claim of one hundred dollars ($100.00) or more is assessed;

(6) A second or subsequent claim assessed for any participant violation, regardless of the dollar amount. The second or subsequent claim does not have to be for the same participant violation as the initial claim to result in a one-year disqualification; and

(7) Physical harm to clinic or vendor staff.

(1) Exchanging food instruments or supplemental food for credit;

(2) Exchanging food instruments or supplemental food for non-food items, other than alcohol, alcoholic beverages, tobacco products, firearms, ammunition, explosives, or controlled substances as defined in 21 U.S.C. 802; and

(3) Exchanging food instruments or supplemental food for unauthorized food items, including supplemental foods in excess of those listed on the participant's food instrument.

(1) shredded cheese;

(2) eggs other than grade A large or extra-large fresh and "cholesterol reducing";

(3) infant cereal-fruit and cereal-formula combinations;

(4) cheese in excess of four pounds per month, unless a physician documents that the recipient is lactose intolerant, or is a postpartum woman who is breast feeding exclusively;

(5) all formulas other than standard milk-based iron fortified infant formulas, unless a physician prescribes a formula and documents the presence of a medical condition, the reason for the specific formula prescribed, and the duration of its use;

(6) if the WIC program executes a sole source contract for an infant formula, that formula shall be specified in the vendor agreement and on the food instrument, and all other formulas shall be excluded from the food package, unless a physician prescribes a different formula and documents the presence of a medical condition, the reason for the specific formula prescribed, and the duration of its use;

(7) infant juice;

(8) peanut butter other than plain, smooth, crunchy or whipped;

(9) dried beans and peas other than mature and unflavored;

(10) tuna other than chunk light in water; and

(11) carrots other than raw, canned or frozen.

(1) the instrument has not been legibly imprinted with an authorized WIC vendor stamp;

(2) the instrument has been counterfeited or the signature forged;

(3) the instrument has been mutilated, defaced or otherwise tampered with or altered;

(4) the instrument is not deposited in the vendor's bank within 60 days of the "date of issue" assigned to the instrument;

(5) the "pay exactly" amount (i.e. purchase price) is not recorded on the food instrument;

(6) the "pay exactly" amount (i.e. purchase price) exceeds the maximum price set by the state agency for the food instrument;

(8) the "date transacted" entered on the instrument is not on or between the "date of issue" and "participant must use by" dates assigned to the instrument;

(9) the instrument is not completed in indelible ink.

(1) the "pay exactly" amount has been altered and the vendor provides a receipt that confirms the altered amount is the correct "pay exactly" amount; or

(2) the food instrument is not deposited in the vendor's bank within 60 days of the "date of issue" assigned to the instrument and the State WIC office gives approval to the local WIC agency to revalidate.

(1) When annual WIC supplemental food sales are not yet available, vendor applicants and authorized vendors, excluding chain stores, stores under a WIC corporate agreement, military commissaries, and free-standing pharmacies, will be placed into peer groups based on the number of cash registers in the store until annual WIC supplemental food sales become available. The following are the peer groups based on the number of cash registers in the store:

(2) Authorized vendors for which annual WIC supplemental food sales is available, and chain stores, stores under a WIC corporate agreement, military commissaries, and free-standing pharmacies, will be placed into peer groups as follows, except as provided in Subparagraph (a)(6) of this Rule.

(3) Annual WIC supplemental food sales is the dollar amount in sales of WIC supplemental foods at the store within a 12-month period.

(4) In determining a vendor's peer group designation based on annual WIC supplemental food sales, the state agency will look at the most recent 12-month period for which sales data is available. If the most recent available 12-month period of WIC sales data begins more than one year prior to the time of designation, the peer group designation will be based on the number of cash registers in the store.

(5) The state agency may reassess an authorized vendor's peer group designation at any time during the vendor's agreement period and place the vendor in a different peer group if upon reassessment the state agency determines that the vendor is no longer in the appropriate peer group.

(6) A vendor applicant that is being reauthorized following the nonrenewal or termination of its Agreement or disqualification from the WIC Program will be placed into the peer group the store was in at the time of the nonrenewal, termination or disqualification, provided that no more than one year has passed since the nonrenewal, termination or disqualification. All other vendor applicants will be placed into peer groups in accordance with Subparagraphs (a)(1) and (a)(2) of this Rule.

(1) Accurately complete a WIC Vendor Application, a WIC Price List, and a WIC Vendor Agreement. A vendor applicant must submit its current highest shelf price for each WIC supplemental food listed on the WIC Price List;

(2) At the time of application and throughout the term of authorization, submit all completed forms to the local WIC program, except that a corporate entity operating under a WIC corporate agreement shall submit one completed WIC corporate agreement and the WIC Price Lists to the state agency and a separate WIC Vendor Application for each store to the local WIC agency. A corporate entity operating under a WIC corporate agreement may submit a single WIC Price List for those stores that have the same prices for WIC supplemental foods in each store, rather than submitting a separate WIC Price List for each store;

(3) A vendor applicant's current highest shelf price for each WIC supplemental food listed on the WIC Price List must not exceed the maximum price set by the State agency for each supplemental food within that vendor applicant's peer group, except as provided in Part (b)(3)(B) of this Rule;

(4) Pass a monitoring review by the local WIC program to determine whether the store has minimum inventory of supplemental foods as specified in Subparagraph (c)(24) of this Rule. A vendor applicant who fails this review shall be allowed a second opportunity for an unannounced monitoring review within 14 days. If the applicant fails both reviews, the applicant shall wait 90 days from the date of the second monitoring review before submitting a new application;

(5) Attend, or cause a manager or other authorized store representative to attend, WIC Vendor Training provided by the local WIC Program prior to authorization and ensure that the applicant's employees receive instruction in WIC program procedures and requirements;

(6) Mark the current shelf prices of all WIC supplemental foods clearly on the foods or have the prices posted on the shelf or display case at all times;

(7) The store shall be located at a permanent and fixed location within the State of North Carolina. The store shall be located at the address indicated on the WIC vendor application and shall be the site at which WIC supplemental foods are selected by the WIC customer;

(8) The store shall be open throughout the year for business with the public at least six days a week for a minimum of 40 hours per week between 8:00 a.m. and 11:00 p.m.;

(9) A vendor applicant shall not submit false, erroneous, or misleading information in an application to become an authorized WIC vendor or in subsequent documents submitted to the state or local agency;

(10) The owner(s), officer(s) or manager(s) of a vendor applicant shall not be employed, or have a spouse, child, or parent who is employed by the state WIC program or the local WIC program serving the county in which the vendor applicant conducts business. A vendor applicant shall not have an employee who handles, transacts, deposits, or stores WIC food instruments who is employed, or has a spouse, child, or parent who is employed by the state WIC program or the local WIC program serving the county in which the vendor applicant conducts business;

(11) WIC vendor authorization shall be denied if in the last six years any of the vendor applicant's current owners, officers, or managers have been convicted of or had a civil judgment entered against them for any activity indicating a lack of business integrity, including, but not limited to, fraud, antitrust violations, embezzlement, theft, forgery, bribery, falsification or destruction of records, making false statements, receiving stolen property, making false claims, and obstruction of justice;

(12) A vendor applicant shall not be authorized if it is currently disqualified from the Food Stamp Program or it has been assessed a Food Stamp Program civil money penalty for hardship and the disqualification period that otherwise would have been imposed has not expired;

(13) A vendor applicant, excluding chain stores and stores under a WIC corporate agreement that have a separate manager on site for each store, shall not have an owner who holds a financial interest in any of the following:

The requirements of Subparagraph (b)(13) shall not be met by the transfer or conveyance of financial interest during the period of disqualification. Additionally, the requirements of Subparagraph (b)(13) shall not be met even if such transfer or conveyance of financial interest in a Food Stamp vendor under Subparagraph (b)(13)(A) prematurely ends the disqualification period applicable to that Food Stamp vendor. The requirements of this Subparagraph will apply until the time the Food Stamp vendor disqualification otherwise would have expired;

(14) A vendor applicant, excluding free-standing pharmacies, must have Food Stamp Program authorization for the store as a prerequisite for WIC vendor authorization and must provide its Food Stamp Program authorization number to the state agency; and

(15) A vendor applicant shall not become authorized as a WIC vendor if the store has been disqualified from participation in the WIC Program and the disqualification period has not expired.

(1) Process WIC program food instruments in accordance with the terms of this agreement, state and federal WIC program rules, and applicable law;

(2) Accept WIC program food instruments in exchange for WIC supplemental foods; Supplemental foods are those foods which satisfy the requirements of 15A NCAC 21D .0501. The foods, specifications and product identification are described in the WIC Vendor Manual;

(3) Provide only the authorized supplemental foods listed on the food instrument, accurately determine the charges to the WIC program, and clearly complete the "Pay Exactly" box on the food instrument prior to obtaining the countersignature of the WIC customer; The WIC customer is not required to get all of the supplemental foods listed on the food instrument;

(4) Enter in the "Pay Exactly" box on the food instrument only the total amount of the current shelf prices, or less than the current shelf prices, for the supplemental food actually provided and shall not charge or collect sales taxes for the supplemental food provided;

(5) Charge no more for supplemental food provided to a WIC customer than to a non-WIC customer or no more than the current shelf price, whichever is less;

(6) Accept payment from the state WIC Program only up to the maximum price set by the state agency for each food instrument within that vendor's peer group. The maximum price for each food instrument will be based on the maximum prices set by the state agency for each supplemental food, as described in Part (b)(3)(A) of this Rule, listed on the food instrument. A food instrument deposited by a vendor for payment which exceeds the maximum price will be invalid and returned to the vendor. The vendor may receive a replacement food instrument through the local agency for up to the maximum price set by the state agency for that food instrument;

(7) Not charge the state WIC Program more than the maximum price set by the state agency under Part (b)(3)(A) of this Rule for each supplemental food within the vendor's peer group;

(8) For exempt infant formulas and WIC-eligible medical foods, accept payment from the state WIC Program only up to the maximum price established by the state agency using the Medicaid Durable Medical Equipment Fee Schedule published by the North Carolina Division of Medical Assistance;

(9) For non-contract brand milk-based and soy-based infant formulas, excluding exempt infant formulas, accept payment from the state WIC Program only up to the maximum price established for contract brand infant formulas under Part (b)(3)(A) of this Rule for the vendor's peer group;

(10) For free-standing pharmacies, provide only infant formula and WIC-eligible medical foods;

(11) Excluding free-standing pharmacies, redeem at least two thousand dollars ($2,000) annually in WIC supplemental food sales. Failure to redeem at least two thousand dollars ($2,000) annually in WIC supplemental food sales shall result in termination of the WIC Vendor Agreement. The store must wait 180 days to reapply for authorization;

(12) Accept WIC program food instruments only on or between the "Date of Issue" and the "Participant Must Use By" dates;

(13) Prior to obtaining the countersignature, enter in the "Date Transacted" box the month, day and year the WIC food instrument is exchanged for supplemental food;

(14) Ensure that the food instrument is countersigned in the presence of the cashier;

(15) Refuse acceptance of any food instrument on which quantities, signatures or dates have been altered;

(16) Not transact food instruments in whole or in part for cash, credit, unauthorized foods, or non-food items;

(17) Not provide refunds or permit exchanges for authorized supplemental foods obtained with food instruments, except for exchanges of an identical authorized supplemental food when the original authorized supplemental food is defective, spoiled, or has exceeded its "sell by," "best if used by," or other date limiting the sale or use of the food. An identical authorized supplemental food means the exact brand, type and size as the original authorized supplemental food obtained and returned by the WIC customer;

(18) Clearly imprint the authorized WIC vendor stamp in the "Pay the Authorized WIC Vendor Stamped Here" box on the face of the food instrument;

(19) Clearly imprint the vendor's bank deposit stamp or the vendor's name, address and bank account number in the "Authorized WIC Vendor Stamp" box in the endorsement;

(20) Promptly deposit WIC program food instruments in the vendor's bank. All North Carolina WIC program food instruments must be deposited in the vendor's bank within 60 days of the "Date of Issue" on the food instrument;

(21) Ensure that the authorized WIC vendor stamp is used only for the purpose and in the manner authorized by this agreement and assume full responsibility for the unauthorized use of the authorized WIC vendor stamp;

(22) Maintain secure storage for the authorized WIC vendor stamp and immediately report loss of this stamp to the local agency;

(23) Notify the local agency of misuse (attempted or actual) of the WIC program food instrument(s);

(24) Maintain a minimum inventory of supplemental foods in the store for purchase. Supplemental foods that are outside of the manufacturer's expiration date do not count towards meeting the minimum inventory requirement. The following items and sizes constitute the minimum inventory of supplemental foods for vendors in Peer Groups I through III of Subparagraph (a)(1) and vendors in Peer Groups I through V of Subparagraph (a)(2) of this Rule:

All vendors in Peer Groups I through III of Subparagraph (a)(1) and in Peer Groups I through VI of Subparagraph (a)(2) of this Rule shall supply milk, soy based, or lactose-free infant formula in 32 oz. ready-to-feed or powder within 48 hours of request by the state or local agency;

(25) Ensure that all supplemental foods in the store for purchase are within the manufacturer's expiration date;

(26) Permit the purchase of supplemental food without requiring other purchases;

(27) Attend, or cause a manager or other authorized store representative to attend, annual vendor training class upon notification of class by the local agency;

(28) Inform and train vendor's employees in WIC procedures and regulations;

(29) Be accountable for the actions of its owners, officers, managers, agents, and employees who commit vendor violations;

(30) Allow reasonable monitoring and inspection of the store premises and procedures to ensure compliance with this agreement and state and federal WIC Program rules, regulations and policies. This includes, but shall not be limited to, allowance of access to all WIC food instruments at the store and vendor records pertinent to the purchase of WIC supplemental foods, vendor records of all deductions and exemptions allowed by law or claimed in filing sales and use tax returns, and vendor records of all WIC supplemental foods purchased by the vendor, including invoices, copies of purchase orders, and any other proofs of purchase. These records must be retained by the vendor for a period of three years or until any audit pertaining to these records is resolved, whichever is later. Failure or inability to provide these records, or providing false records for an inventory audit shall be deemed a violation of 7 C.F.R. 246.12(l)(1)(iii)(B) and Part (g)(2)(A) of this Rule;

(31) Submit a current accurately completed WIC Price List when signing this agreement, and by January 1 and July 1 of each year. The vendor also agrees to submit a WIC Price List within one week of any written request by the state or local agency. Failure to submit a WIC Price List as required by this Subparagraph within 30 days of the required submission date shall result in disqualification of the vendor from the WIC Program in accordance with Part (h)(1)(D) of this Rule;

(32) Reimburse the state agency within 30 days of written notification of a claim assessed due to a vendor violation that affects payment to the vendor. The state agency has the authority to deny payment or assess a claim in the amount of the full purchase price of each food instrument affected by the vendor violation. Denial of payment by the state agency or payment of a claim by the vendor for a vendor violation(s) shall not absolve the vendor of the violation(s). The vendor will also be subject to any vendor sanctions authorized under this Rule for the vendor violation(s);

(33) Not seek restitution from the WIC customer for reimbursement paid by the vendor to the state agency or for WIC food instruments not paid or partially paid by the state agency. Additionally, the vendor may not charge the WIC customer for authorized supplemental foods obtained with food instruments;

(34) Not contact a WIC customer outside the store regarding the transaction or redemption of WIC food instruments;

(35) Notify the local agency in writing at least 30 days prior to a change of ownership, change in location, cessation of operations, or withdrawal from the WIC Program. Change of ownership, change in location of more than three miles from the vendor's previous location, cessation of operations, withdrawal from the WIC Program and disqualification from the WIC Program shall result in termination of the WIC Vendor Agreement by the state agency. Change of ownership, change in location, ceasing operations, withdrawal from the WIC Program or nonrenewal of the WIC Vendor Agreement shall not terminate a disqualification period applicable to the store;

(36) Return the authorized WIC vendor stamp to the local agency upon termination of this agreement or disqualification from the WIC Program;

(37) Offer WIC customers the same courtesies as offered to other customers;

(38) The WIC Vendor Agreement does not constitute a license or a property interest. A vendor must reapply to continue to be authorized beyond the period of its current WIC Vendor Agreement. Additionally, a store must reapply to become authorized following the expiration of a disqualification period or termination of the Agreement. In all cases, the vendor applicant will be subject to the vendor selection criteria of Paragraph (b) of this Rule; and

(39) Comply with all the requirements for vendor applicants of Subparagraphs (b)(3) and (b)(6) through (b)(14) of this Rule throughout the term of authorization. The state agency may reassess a vendor at any time during the vendor's period of authorization to determine compliance with these requirements. The state agency shall terminate the WIC Vendor Agreement of any vendor that fails to comply with Subparagraphs (b)(3), (b)(7), (b)(8), (b)(10), (b)(11) or (b)(13) during the vendor's period of authorization, and sanction and/or terminate the Agreement of any vendor that fails to comply with Subparagraphs (b)(6), (b)(9), (b)(12) or (b)(14) during the vendor's period of authorization.

(1) Provide at a minimum annual vendor training classes on WIC procedures and regulations;

(2) Monitor the vendor's performance under this agreement in a reasonable manner to ensure compliance with the agreement, state and federal WIC program rules, regulations and policies, and applicable law. A minimum of one-third of all authorized vendors shall be monitored within a state fiscal year (July 1 through June 30) and all vendors shall be monitored at least once within three consecutive state fiscal years. Any vendor shall be monitored within one week of written request by the state agency;

(3) Provide vendors with the North Carolina WIC Vendor Manual, all Vendor Manual amendments, blank WIC Price Lists, and the authorized WIC vendor stamp indicated on the signature page of the WIC Vendor Agreement;

(4) Assist the vendor with questions which may arise under this agreement or the vendor's participation in the WIC Program; and

(5) Keep records of the transactions between the parties under this agreement pursuant to 15A NCAC 21D .0206.

(1) In accordance with 7 CFR 246.12(l)(1)(i), the State agency shall not allow imposition of a civil money penalty in lieu of disqualification for a vendor permanently disqualified.

(2) A pattern, as referenced in 7 C.F.R. 246.12(l)(1)(iii)(B) through (F) and 246.12(1)(2)(iv), shall be established as follows:

(1) When a vendor commits any of the following violations, the state-established disqualification period shall be:

(2) When a vendor commits any of the following violations, the vendor shall be assessed sanction points as follows for each occurrence:

(3) For the violations listed in Subparagraph (h)(2) of this Rule, all sanction points assessed against a vendor remain on the vendor's record for 12 months or until the vendor is disqualified as a result of those points. If a vendor accumulates 15 or more points, the vendor shall be disqualified. The nature of the violation(s) and the number of violations, as represented by the points assigned in Subparagraph (h)(2), are used to calculate the period of disqualification. The formula used to calculate the disqualification period is: the number of points of the worst offense multiplied by 18 days. 18 days shall be added to the disqualification period for each point over 15 points.

(1) Compliance buy(s) conducted by undercover investigators within a 12-month period to detect the following violations:

(2) Monitoring reviews of a vendor conducted by WIC staff within a 12-month period which detect the following violations:

(3) Any other method used by the State or local agency to detect the following violations by a vendor within a 12-month period:

(1) The civil money penalty formula in 07 C.F.R. 246.12(l)(l)(x) is incorporated by reference with all subsequent amendments and editions, provided that the vendor's average monthly redemptions shall be calculated by using the six-month period ending with the month immediately preceding the month during which the notice of administrative action is dated.

(2) The State agency may also impose civil money penalties in accordance with G.S. 130A-22(c1) in lieu of disqualification of a vendor for the state-established violations listed in Paragraph (h) of this Rule when the State agency determines that disqualification of a vendor would result in undue participant hardship in accordance with Subparagraph (l)(3) of this Rule.

(3) In determining whether to disqualify a WIC vendor for the state-established violations listed in Paragraph (h) of this Rule, the agency shall not consider other indicators of hardship if any of the following factors, which conclusively show lack of undue hardship, are found to exist:

(4) The provisions for failure to pay a civil money penalty in 7 C.F.R. 246.12(l)(6) are incorporated by reference with all subsequent amendments and editions.

(1) in writing at the time of application;

(2) in writing whenever they are determined ineligible;

(3) in writing if disqualified due to abuse of the program;

(4) in writing at the time of assessment of a claim for repayment of the cash value of improperly issued Program benefits; and

(5) orally or in writing at least 15 days before the expiration of each certification period.

(1) a statement of the right to a fair hearing;

(2) the method by which a fair hearing may be requested, including the time limit; and

(3) who may represent the individual.

(1) notice of right to a fair hearing;

(2) a simplified explanation of the definition and purpose of a fair hearing;

(3) the method by which a fair hearing may be requested, including the time limit; and

(4) who may represent the individual at the fair hearing and in requesting a fair hearing.

(1) the agency official;

(2) the agency director of the local WIC agency;

(3) the WIC director of the local WIC agency; or

(4) any person serving in one of the above three roles in the absence of the agency official, agency director or WIC director.

(1) If the original request is made in writing, the individual receiving the request shall retain a photocopy and send the original to the agency official immediately following the telephone call.

(2) If a verbal request is received, the individual receiving the request shall document the request in writing, including as a minimum:

(1) the request is not received within 60 days of the date of notification of the action;

(2) the request is withdrawn in writing by the appellant or their representative;

(3) the request is verbally withdrawn by the appellant or the appellant's parent, caretaker, or any other person acting on their behalf during conversation with the agency official. Within 10 days of this verbal withdrawal request the agency official shall send a letter to the appellant and the local WIC agency summarizing the events which lead to the withdrawal of the request. This letter shall include notification of the appellant's right to reinstate the request for a fair hearing;

(4) the appellant or the appellant's parent, caretaker, or any other person acting on their behalf fails to appear at the scheduled hearing;

(5) the request is made in reference to the tailoring of the food package;

(6) the initial action assessing a claim for the cash value of improperly issued Program benefits or denying participation or disqualifying from the program has been reversed by the local WIC agency or the state agency, resulting in the provision of program benefits to the appellant.

(1) disqualification from the program for abuse during a certification period;

(2) determination of ineligibility during a certification period due to categorical ineligibility or residential ineligibility; or

(3) other terminations during a certification period.

(1) in any of the situations in Paragraph (a) of this Rule if the request is made more than 15 days after the date of notification; or

(2) by applicants who are denied benefits at the initial or subsequent determination of WIC eligibility if the previous certification period has expired.

(1) a simplified explanation of the procedure for the hearing;

(2) a statement of the date, hour, place and nature of the hearing;

(3) a reference to the particular sections of the statutes and rules involved;

(4) a short and plain statement of the factual allegations.

(1) preside over the informal proceeding;

(2) ensure that all relevant issues are considered;

(3) request, receive and insert into the hearing record all evidence determined necessary to reach a decision;

(4) conduct the meeting in accordance with due process and ensure an orderly hearing; and

(5) order, if relevant and necessary, an independent medical assessment or professional evaluation for the appellant from a source mutually satisfactory to all parties to the hearing;

(6) issue a decision.