DHHS → MECDC → Disease Prevention → WIC → Resources for Healthy Families
Maine WIC Nutrition Program
FFY2023 Policies
Breastfeeding Peer Counselor (click to expand)
- BFPC-1 Establishing BFPC Program (PDF)
- BFPC-2 BFPC Scope of Practice (PDF)
- BFPC-3 Training of Breastfeeding Peer Counselor (PDF)
- BFPC-4 Compensation (PDF)
- BFPC-5 BFPC Supervisor (PDF)
- BFPC-6 BFPC Supervisor Scope of Practice (PDF)
- BFPC-7 Referrals (PDF)
- Appendix BFPC-1-A BFPC Job Description (PDF)
- Appendix BFPC-1-B PC Recruit Flyer (PDF)
- Appendix BFPC-2-A BFPC Activity Log and Monthly Report (Excel)
- Appendix BFPC-2-B Confidentiality Statement (PDF)
- Appendix BFPC-4-A Financial Report (Excel)
- Appendix BFPC-4-B BFPC Allowable Costs (PDF)
- Appendix BFPC-5-A BFPC Supervisor Job Description (PDF)
- Appendix BFPC-6-A BFPC Participant Survey Results Form (PDF)
- Appendix BFPC-7-A Moms Helping Moms (PDF)
Breastfeeding Support and Promotion (click to expand)
- BF-1 Breastfeeding Friendly Environment (PDF)
- BF-2 Staff Breastfeeding Promotion (PDF)
- BF-3 Breastfeeding Coordinator (PDF)
- BF-4 Breastfeeding Contacts (PDF)
- BF-5 Breastfeeding Food Packages (PDF)
- BF-6 Provision of Electric Breastpumps (PDF)
- BF-7 Manual Pumps and Breastfeeding Aids (PDF)
- BF-8 Breastfeeding Contraindications (PDF)
- Appendix BF-2-A IBCLC Referral Log (Excel)
- Appendix BF-6-A Electric Breastpump Agreement Form (PDF) | or as Word
- Appendix BF-6-B Loaner Pump Agreement Form (PDF)
- Appendix BF-6-C Rental Electric Breastpump Stop Payment (PDF)
- Appendix BF-6-D State Certified Letter for Loaner EBP Return (Word)
- Appendix BF-8-A American Academy of Pediatric Breastfeeding Statement (PDF)
Caseload Management (click to expand)
Certification and Eligibility (click to expand)
- CE-1 Eligibility Application (PDF)
- CE-2 Income Eligibility Determination and Documentation (PDF)
- CE-3 Nutrition Risk Determination (PDF)
- CE-4 Certification Periods (PDF)
- CE-5 Transfer of Certification and VOCs (PDF)
- CE-6 Processing Standards (PDF)
- Appendix CE-1-A WIC Participant Booklet (PDF)
- Appendix CE-1-B Scanned ID Authorization (PDF)
- Appendix CE-1-C Rights and Responsibilities Signature Page
- Appendix CE-2-A Income Eligibility Guidelines (Word)
- Appendix CE-2-B Income Calculator (Excel)
- Appendix CE-2-C Declaration of Zero Income (PDF)
- Appendix CE-2-D Military Income Guide (PDF)
- Appendix CE-3-A Risk Factor Detail Guide (Excel)
- Appendix CE-3-B Refusal of Bloodwork (PDF)
- Appendix CE-3-C Release Nutrition Assessment (Word)
- Appendix CE-3-D Scale Calibration Instructions (PDF)
- Appendix CE-3-E Request for Information Infant and Child (PDF)
- Appendix CE-3-F Request for Information Women (PDF)
- Appendix CE-3-G Release HIV Status (Word)
Civil Rights (click to expand)
- CR-1 Public Notification (PDF)
- CR-2 Compliance (PDF)
- CR-3 Data Collection (PDF)
- CR-4 Complaint Process (PDF)
- CR-5 Training (PDF)
- CR-6 Language Access (PDF)
- CR-7 Special Populations (PDF)
- Appendix CR-4-A Civil Rights Log Template (Excel)
- Appendix CR-5-A Maine WIC Civil Rights Training Powerpoint (PPT)
- Appendix CR-5-B Maine WIC Civil Rights Training Facilitator Guide (PDF)
- Appendix CR-5-C Maine WIC Civil Rights Training Trainee Workbook (PDF)
- Appendix CR-5-D Maine WIC Civil Rights Training - Self-Paced (PDF)
- Appendix CR-5-E FNS Instruction for Civil Rights Compliance (PDF)
- Appendix CR-6-A Interpreter Sign (Word)
- Appendix CR-6-B Local Agency Interpreter Log (Excel)
- Appendix CR-7-A Language Accessibility Notice Tag Line (PDF)
Financial Management (click to expand)
- FM-1 State Agency Financial Management System (PDF)
- FM-2 State Agency WIC Expenditures and Drawdown Procedures (PDF)
- FM-3 State Agency Budget/Expenditure Plan (PDF)
- FM-4 State Agency Reporting Requirements (PDF)
- FM-5 Local Agency Funds Allocation and Budget Submission (PDF)
- FM-6 Local Agency Financial Management Systems (PDF)
- FM-7 State and Local Agency Access to Funds (PDF)
- FM-8 State and Local Agency Allowable Costs (PDF)
- FM-9 State and Local Agency Unallowable Costs (PDF)
- FM-10 Nutrition Education Costs (PDF)
- FM-11 Breastfeeding Promotion Costs (PDF)
- FM-12 Indirect Costs (PDF)
- FM-13 Shared (Allocable) Costs (PDF)
- FM-14 Program Income (PDF)
- FM-15 Local Agency Purchasing Procedures (PDF)
- FM-16 Property Management (PDF)
- FM-17 Participant Fees (PDF)
- FM-18 Cost Containment Measures (PDF)
- Appendix FM-4-A FNS-798 and Instructions (PDF)
- Appendix FM-4-B Financial Report SF-425 and Instructions (PDF)
- Appendix FM-5-A Cost Allocation Plan (PDF)
- Appendix FM-6-A Quarterly Financial Report (Excel)
- Appendix FM-8-A Allowable and Unallowable Costs (PDF)
- Appendix FM-10-A Food Purchase Log (Excel)
- Appendix FM-15-A Equipment Log and Inventory (Excel)
Farmer Market Nutrition Program (click to expand)
- FMNP-1 Farmer Selection and Authorization (PDF)
- FMNP-2 Farmer Training (PDF)
- FMNP-3 High Risk Farmer Identification Systems (PDF)
- FMNP-4 Farmer Monitoring (PDF)
- FMNP-5 Farmer Sanction System (PDF)
- FMNP-6 Administrative Review of State Agency Actions for Farmers (PDF)
- FMNP-7 Farmer Operations (PDF)
- FMNP-8 Local Agency Administration of WIC FMNP (PDF)
- Appendix FMNP-1-A Farmer Agreement (PDF)
Food Delivery (click to expand)
- FD-1 Food Delivery System Overview (PDF)
- FD-2 Food Benefits Pick-Up and Transaction (PDF)
- FD-3 Food Benefit Redemption and Disposition (PDF)
- FD-5 Proxy Assignment (PDF)
- FD-6 Return of Formula (PDF)
- Appendix FD-2-A Card Issuance Form (PDF)
- Appendix FD-3-A WIC Benefit Replacement Form (PDF)
- Appendix FD-7-A Formula Returned Log (Excel)
Information Systems (click to expand)
- IS-1 System Planning and Operations (PDF)
- IS-2 Participant Characteristics Minimum Data Set (PDF)
- IS-3 Functional Requirements Checklist (PDF)
- IS-4 Data Security (PDF)
- IS-5 Local Agency IT Requirements (PDF)
- Appendix IS-4-A Data Inventory Form (PDF)
- Appendix IS-4-B Data Use Plan (PDF)
- Appendix IS-4-C Release Unrestricted Data Request (PDF)
Monitoring and Audits (click to expand)
Nutrition Services (click to expand)
- NS-1 Nutrition Counseling (PDF)
- NS-2 Food Package Design (PDF)
- NS-3 Value Enhanced Nutrition Assessment (PDF)
- NS-4 Nutrition Coordinator (PDF)
- NS-5 Nutrition Services Referrals (PDF)
- NS-6 Medical High Risk (PDF)
- Appendix NS-1-A Infant Nutrition Guidance (PDF)
- Appendix NS-1-B Child Nutrition Guidance (PDF)
- Appendix NS-1-C Woman Nutrition Guidance (PDF)
- Appendix NS-1-D WIC Appointment Quick Reference Guide
- Appendix NS-2-A Food Package Design (PDF)
- Appendix NS-2-D Formula Reconstitution Monthly Maximum (Excel)
- Appendix NS-2-F Decision Cube Draft (PDF)
- Appendix NS-2-G Medical Formula Rx Form (PDF)
- Appendix NS-2-H Release Special Formula Prescriptions (PDF)
- Appendix NS-2-I Fax Coversheet GHS PA Form (PDF)
- Appendix NS-2-J Special Formula Voucher Sample (PDF)
- Appendix NS-2-K Troubleshooting Formula Access (PDF)
- Appendix NS-3-A VENA Competency Table (PDF)
- Appendix NS-4-A Medical Formula Log (Excel)
- Appendix NS-6-A Medical High Risk Log (Excel)
Organization and Management (click to expand)
- OM-1 State Staffing (PDF)
- OM-2 Selection of Local Agencies (PDF)
- OM-3 Local Agency Disqualification (PDF)
- OM-4 Local Agency Staffing (PDF)
- OM-5 Disaster Recovery (PDF)
- OM-6 Employee Fraud and Abuse (PDF)
- OM-7 Participant Fraud and Abuse (PDF)
- OM-8 Parental and Custodial Rights (PDF)
- OM-9 Dual Participation (PDF)
- OM-10 Participant Rights and Responsibilities (PDF)
- OM-11 Media Relations (PDF)
- OM-12 Staff Training and Continuing Education Requirements (PDF)
- OM-13 Community Provider Agreements (PDF)
- OM-14 Mandated Reporting (PDF)
- OM-15 Confidentiality and Privacy (PDF)
- OM-16 Fair Hearings (PDF)
- OM-17 Travel (PDF)
- OM-18 WIC Acronym (PDF)
- OM-19 Dietetic Intern Requests (PDF)
- OM-20 Occupational Exposure (PDF)
- OM-21 State Plan Notice (PDF)
- Appendix OM-1-A WIC State Agency Organization Chart (PDF)
- Appendix OM-4-A Employee Information Form (PDF)
- Appendix OM-6-A Separation of Duties File Review Form (Excel)
- Appendix OM-7-A Sample Formula Sale Letter (Word)
- Appendix OM-7-B Sample Participant Abuse Letter (Word)
- Appendix OM-7-C Repayment Agreement Form (PDF)
- Appendix OM-8-A Sample Custody Change Letter (Word)
- Appendix OM-12-A Time Study Training (PDF)
- Appendix OM-12-B Employee Conflict of Interest Statement (PDF)
- Appendix OM-12-C Continuing Education Log (Excel)
- Appendix OM-13-A Residential Facility Form for Local Agency Staff (Word)
- Appendix OM-14-A Mandated Reporter Worksheet (PDF)
- Appendix OM-15-A Health Information, Privacy and Security - Minimum Necessary (PDF)
- Appendix OM-15-B Health Information, Privacy and Security - HIPAA Uses and Disclosures (PDF)
- Appendix OM-15-C HIPAA Uses and Disclosures of Protected Health Information (PDF)
- Appendix OM-15-D HIV AIDS Confidentiality of Information (PDF)
- Appendix OM-15-E Confidentiality Agreement (PDF)
- Appendix OM-16-A Notification of Appeal Procedures (PDF)
- Appendix OM-16-B Fair Administrative Hearing Request Form (PDF)
- Appendix OM-19-A Sample Consent Form for Interns (Word)
Vendor Management (click to expand)
- VM-1 Vendor Selection and Authorization (PDF)
- VM-2 Vendor Training (PDF)
- VM-3 High-Risk Vendor Identification Systems (PDF)
- VM-4 Routine Monitoring (PDF)
- VM-5 Compliance Investigations (PDF)
- VM-6 Vendor Sanction System (PDF)
- VM-7 Administrative Review of State Agency Actions (PDF)
- VM-8 Coordination with the Supplemental Nutrition Assistance Program (SNAP) (PDF)
- VM-9 Staff Training on Vendor Management (PDF)
- VM-10 Confidentiality of Vendor and SNAP Retailer Information (PDF)
- VM-11 Vendor Price Lists (PDF)
- VM-12 Vendor Operations (PDF)
- VM-13 Conflict of Interest (PDF)
- VM-14 Vendor Claims (PDF)
- Appendix VM-1-A Minimum Inventory Requirements (PDF)
- Appendix VM-1-B Infant Formula Authorized List (PDF)
- Appendix VM-1-C Vendor Agreement (PDF)
- Appendix VM-1-D Vendor Application (PDF)
- Appendix VM-1-E_Maine Request for Application (PDF)
- Appendix VM-2-A WIC Vendor Training Log (PDF)
- Appendix VM-2-B Vendor Interactive Training Attended (PDF)
- Appendix VM-2-C Vendor Training Guide (PDF)
- Appendix VM-4-A On-Site Monitoring (PDF)
- Appendix VM-5-A Compliance Buys Reporting Form (PDF)
- Appendix VM-5-B Compliance Buy Card Log (PDF)
- Appendix VM-7-A Administrative Hearing Request Form (PDF)
Questions? Want to sign up? Contact your local WIC clinic.
York County Community Action Corp – York County
- Sanford: 207-459-2942
- Biddeford: 207-283-2402
The Opportunity Alliance – Cumberland County
- Portland: 207-553-5800
Western Maine Community Action – Androscoggin, Franklin, and Oxford Counties
- Auburn: 207-795-4016
- Wilton: 207-645-3764
Midcoast Maine Community Action – Lincoln, Knox, Waldo, and Sagadahoc Counties
- Bath: 207-442-7963
Maine General – Kennebec and Somerset Counties
- Augusta: 207-626-6350
- Waterville: 207-861-3580
- Skowhegan: 207-861-3593
Bangor Public Health & Community Services – Penobscot and Piscataquis Counties
- Bangor: 207-992-4570
Maine Family Planning – Washington and Hancock Counties
- Ellsworth: 207-667-5304
- Machias: 207-255-8280
- Calais: 207-454-3634
Aroostook County Action Program – Aroostook County
- Presque Isle: 207-768-3026
State Contacts for VOC Requests
State Agency Contact Information
- Monday - Friday 8am-5pm
- Phone: (207) 287-3991
In-state Toll Free:
1-800-437-9300
TTY: Maine relay 711
- Email:
Main: WIC.Maine@maine.gov
Vendor: WICVendor@maine.gov - Mailing address:
11 State House Station
Augusta, ME 04333