Low-income women and children in Pennsylvania risk potentially increased exposure to COVID-19 because the commonwealth requires mothers to show up in person, rather than online, to access food benefits from a widely popular program, say advocates who work with families in poverty.

The state Department of Health, which administers the federal program known as WIC (the Special Supplemental Nutrition Program for Women, Infants and Children), uses a system that issues benefits to clients on EBT (electronics benefit transfer) cards that cannot be reloaded virtually, like SNAP cards. SNAP stands for Supplemental Nutrition Assistance Program, formerly known as food stamps.

This means, advocates say, that mothers must travel to WIC offices, often on public transportation and with children in tow, to hand over their so-called offline eWIC cards to agency workers who can then reload them every three months.

Pennsylvania is one of just nine states that chose an offline EBT system, according to the Food Research and Action Center in Washington, the largest anti-hunger lobby in the United States. Forty-one others picked an online system that allows for cards to be reloaded virtually.

“It does not make any sense,” said Geraldine Henchy, director of nutrition policy and early childhood programs for FRAC, and a national expert on WIC. “They spent money for an EBT system but bought the backwards version. It’s ill-suited.”

To be fair, Henchy added, the system — completed in 2019 — was in place before the pandemic hit. “Still,” she said, “the idea should have been to pick something that was most convenient for clients, and this isn’t. That’s why very few states chose it.”

A result is that a swath of Americans already greatly encumbered by the pandemic are again being disadvantaged, advocates say.

“The parents of young children are suffering a disproportionate share of employment instability and economic hardship, so they need easy and reliable access to WIC more than ever,” said Kathy Fisher, program manager with the Greater Philadelphia Coalition Against Hunger.

She pointed out that recent U.S. Census Pulse data show that 26.3% of Pennsylvania families with children face food insecurity, defined as not having enough food to sustain a healthy life. For Black families, it’s 43.8%, and for Hispanic families, 34.4%.

Fisher continued, “This issue with the WIC card is a sad reminder of one thing that hasn’t changed: The burdens remain greatest upon those who are struggling the most.”

In response, a spokesperson for the Pennsylvania Department of Health said in a written statement, “We would not and did not put women and children at risk by making them go into a clinic to reload their card.”

The spokesperson went on to say that DOH is making sure the state’s 900 WIC clinics are using best practices when clients show up to reload their cards, such as “proper social distancing, sanitation, limited touch points, and universal masking.” Some clinics have created drive-up access, while others have utilized drop-off systems that allow participants to drop off the card, have it reloaded, then mailed back, the spokesperson said.

The spokesperson concluded, “The USDA requires states to eliminate barriers to participation and based on the state of PA’s infrastructure and the desire to reduce burden on retailers and encourage participation in the WIC program, for our participants, grantees and retailers, the decision was made to stay offline as opposed to an online system in Pennsylvania.”

Asked the cost of the offline system, the spokesperson did not answer directly, instead directing a reporter to a state website containing contract-bidding data in which price was not immediately apparent.

Whose needs were put first?

The state WIC program has been heavily criticized for putting the needs of retailers who accept eWIC cards (also called SmartCards) over clients in choosing the offline system.

The spokesperson acknowledged that “consideration was given to the cost online systems would pose to retailers, who were surveyed and expressed preference for the offline system.” The spokesperson offered no details on what the costs are for retailers, who accept WIC in 1,233 stores throughout the state.

The spokesperson’s statement about retailer card preference has caused some confusion in the food industry. “I’m not aware of any opposition to utilizing this [offline EBT] card,” said Alex Baloga, president and CEO of the Pennsylvania Food Merchants Association.

Ultimately, people who work in WIC offices say, low-income women should have been given greater consideration than grocers.

“The fact is attention wasn’t paid to client needs, wants, and expectations,” said Patricia Fonzi, president and CEO of Family Health Council of Central PA, an agency that provides WIC services in 11 counties. “We need to think about what works for everybody, and that wasn’t considered here.”

Participation is dropping

Advocates believe that WIC recipients are so worried about contracting COVID-19, they would rather leave WIC altogether than reload their cards in WIC offices. One woman in the Poconos gave up WIC after she had to drive 45 minutes one way just to reload, according to Ann Sanders, public policy advocate for Just Harvest, an anti-hunger nonprofit in Pittsburgh.

Linda Kilby, executive director of N.O.R.T.H. Inc., the Philadelphia WIC program, said that over the last year, 4,000 of the 48,000 WIC clients in the city have chosen “not to come and pick WIC cards up in our 10 offices, or they’ve chosen not to go to the store.” She said she’s concerned the offline EBT card may be a cause.

While use of WIC increased nearly 4% across America during the pandemic between February and September of 2020, it’s gone down almost 8% in Pennsylvania alone, according to figures from the U.S. Department of Agriculture, which administers WIC.

Pennsylvania’s WIC numbers had been declining for a variety of reasons since before the pandemic, from 237,205 in 2016 to 186,459 last year, WIC experts say. In some cases, poverty has been decreasing. In others, low-income immigrant mothers have been avoiding WIC because they fear deportation, or the loss of their children, a still potent remnant of the Trump administration, advocates said.

“The statement that WIC is losing clients because of being offline is conjecture,” said the DOH spokesperson.

Regardless, people familiar with WIC say, fears about possible COVID-19 exposure are real.

Tianna Gaines-Turner, 42, a mother of four, including a year-old boy, who lives in Northeast Philadelphia and uses WIC, said, “It’s a mess with COVID.” A housing specialist with the West Philadelphia nonprofit Eddie’s House, Gaines-Turner added: “I’m not comfortable and it’s not safe for me to bring my son to the WIC office. It’s not like SNAP that loads itself. They didn’t think that far ahead when they made this system.”

RoDena Lloyd, 33, a home-health aide and WIC-using mother of five who lives in Morton, Delaware County, agreed: Some struggling mothers I know don’t have anybody to watch their baby, and they have to bring the baby out to reload the card during COVID,” she said. “That’s stressful. It’s hairy out there.”

Along with food, WIC provides nutrition education, breastfeeding support, and health-care referrals for low-income women who are pregnant, or postpartum, and low-income women with infants and children up to age 5. Until 2019, the WIC program consisted of paper vouchers mothers used in stores, much like prescriptions, to acquire specific weights and sizes of products such as milk and cheese.

Normally, children must be brought to WIC offices on occasion to be weighed and undergo other health checks, but the USDA waived that rule during the pandemic, allowing tele-medicine visits.

Also during the pandemic, the USDA waived the rule that stipulates EBT cards must be reloaded every three months. Now, the cards can be reloaded every four months, decreasing the frequency families have to visit WIC offices.

Unlike several other offline EBT states that require in-person loading, Pennsylvania is not using the four-month waiver, advocates say.

The DOH spokesperson did not say why.

The Philadelphia Inquirer is one of more than 20 news organizations producing Broke in Philly, a collaborative reporting project on solutions to poverty and the city’s push toward economic justice. See all of our reporting at brokeinphilly.org.