WIC Rights and Responsibilities

• Show proof of income, address, and identification.
• Give information about my or my child’s medical history and the foods I or my child eat.
• Have my or my child’s height, weight, and blood checked by finger or heel prick.

• Give information to WIC that is true and correct to the best of my knowledge. WIC staff may verify this information.
• Call the WIC office right away if I lose my eWIC card or someone steals it.
• Only buy WIC-authorized foods with my eWIC card.
• Let the WIC staff know if I can’t keep my appointment or if my phone number or address changes.
• Be removed from the program if I do not receive food benefits for two months in a row.
• Treat WIC staff and grocery store staff with respect.

• The WIC program does not discriminate on the basis of race, color, national origin, religion, age, disability, sex, family/parental status, political beliefs, status with respect to marriage or public assistance.
• I have the right to make a complaint if I feel I have been treated unfairly.
• I have a right to a fair hearing if I disagree with the WIC staff about my eligibility within 60 days.
• WIC will make health services, nutrition education, and breastfeeding support available to me, and I am encouraged to participate in these services.
• The WIC foods are intended for me and/or my child and should not be shared with others.

I understand that the State Health Officer allows some of my or my child’s information to be shared with other programs that serve similar families as WIC. This is to make it easier for my family to receive other services if I choose, like to see if I’m eligible and reduce the application process, to help me learn more about these programs and to help improve my family’s health, education and well-being. I will allow WIC to share information, only name, birth date, address, phone number, income, height, weight, hemoglobin, immunization status, and appointment times, about me or my child with these programs. I understand that some WIC health data may be used to evaluate how well the WIC program and the North Dakota Health & Human Services are meeting participants’ health care needs. I’ve been asked by WIC staff about whether or not I consent to disclose information to my healthcare provider. This information is recorded on the Nutrition Interview in the WIC system, eWIC LegeNDS. My consent or denial, yes or no, does not affect my WIC eligibility. No other information can be given to anyone without my permission.

I have read my Rights and Responsibilities. I realize that WIC is a Federal program. I understand that I can be taken off the program and may be required to pay back the value of the WIC food, formula, or breast pump issued to me, and may be prosecuted under Federal and State law if:

• I lie or hide facts to get WIC benefits
• I sell, exchange, or give away my WIC foods, formula, or breast pump, if received.
• I miss coming to WIC two months in a row.
• I participate in more than once WIC program in any one month. I understand that dual participation is illegal.
• I am physically or verbally abusive to WIC staff or store staff.

If you do not like the decision about your eligibility for the WIC Program, you may ask for a fair hearing.

To request a WIC fair hearing, please inquire with the state office at 1-800-472-2286. Please include your name, address, phone number, and the reason for the fair hearing request. A fair hearing can be requested within 60 days from the date the agency mails or gives you the notice of adverse action.

In accordance with Federal civil rights law and U.S. Department of Agriculture (USDA) civil rights regulations and policies, the USDA, its Agencies, offices, and employees, and institutions participating in or administering USDA programs are prohibited from discriminating based on race, color, national origin, religion, sex, disability, age, marital status, family/parental status, income derived from a public assistance program, political beliefs, or reprisal or retaliation for prior civil rights activity, in any program or activity conducted or funded by USDA. Not all bases apply to all programs. Remedies and complaint filing deadlines vary by program or incident.

Persons with disabilities who require alternative means of communication for program information (e.g., Braille, large print, audiotape, American Sign Language, etc.) should contact the State or local Agency that administers the program or contact USDA through the Telecommunications Relay Service at 711, voice and TTY. Additionally, program information may be made available in languages other than English.

To file a program discrimination complaint, complete the USDA Program Discrimination Complaint Form, AD-3027, found online at How to File a Program Discrimination Complaint and at any USDA office or write a letter addressed to USDA and provide in the letter all of the information requested in the form. To request a copy of the complaint form, call (866) 632-9992. Submit your completed form or letter to USDA by: (1) mail: U.S. Department of Agriculture, Office of the Assistant Secretary for Civil Rights, 1400 Independence Avenue, SW, Mail Stop 9410, Washington, D.C. 20250-9410; (2) fax: (202) 690-7442; or (3) email: program.intake@usda.gov.

USDA is an equal opportunity provider, employer, and lender.

In accordance with Federal law and North Dakota state law, the Department of Health and Human Services (HHS) is prohibited from discriminating on the basis of race, color, national origin, religion, sex, disability, age, or status with respect to marriage or public assistance. In accordance with the USDA, HHS is also prohibited from discriminating based on family/parental status, political beliefs or reprisal or retaliation for prior civil rights activity in any program or activity conducted or funded by the USDA.

Persons with disabilities who require alternative means of communication for program information should contact HHS or the local Human Service Zone office. Program information may be made available in languages other than English.

To file a program discrimination complaint, complete the Civil Rights Complaint Form, SFN 143, found online at North Dakota eforms, or write a letter addressed to HHS and provide in the letter all the information requested in the form.

To request a copy of the complaint form, contact the Legal Division Office of Civil Rights at the email or phone number listed below.

Submit your completed complaint form or letter to HHS by email, fax, or mail to:

Legal Division Office of Civil Rights 
Dept. of Health & Human Services 
600 East Boulevard Ave.
Dept. 325 Bismarck, ND 58505-0250

Phone; (701) 328-2311 or 1 (800) 472-2622
TTY: 711
Fax: (701) 328-2173
Email: dhslau@nd.gov

For more information visit: ND HHS Nondiscrimination

WIC Rights and Responsibilities