While a very public showdown looms in Washington, D.C., over health insurance for needy children, a much quieter, related issue is bubbling up for the women and children most in need of a good meal.

Higher dairy prices and a massive new infant formula contract are combining to push up the costs of the federally funded Women, Infants, and Children Program or WIC.

The program provides supplemental food, health care referrals and nutrition education for low-income pregnant, breast feeding, and non-breast feeding postpartum women, and to infants and children up to age 5.

And while state and federal officials take a wait-and-see approach to funding, county officials are concerned that program enrollment may have to be cut for the first time in more than a decade.

"I think our board needs to know what's happening so when we go into caseload management they don't get blindsided," said Doreen Radford, WIC director in Utah County.

The new 11-state formula contract begins Monday and was won by Avid, which bid lower than previous contractor Mead Johnson but was still higher than the current contract.

Mead Johnson declined to go into specifics of why their new bid was higher, other than to say that a number of factors go into the bidding process.

"Common sense would tell me any contract would be based on the number of babies, cost of goods, manufacturing costs and compliance costs," said spokeswoman Gail Wood.

One way the county is trying to cut back on costs is to encourage breast feeding, which saves substantial money and is something WIC client Sarah Verhoef insists on.

While she does breast feed, Verhoef also appreciates the help buying food staples.

"It provides you with things that you need like milk and eggs and cheese," she said. "It's so nice to be able to get that when it's so expensive."

When she came to Utah five and a half years ago, her family was just scraping by. Now, with three kids and one on the way, she was surprised to find out she still qualified.

"I wouldn't say that we're anywhere near poverty. We're not making tons of money or we wouldn't be in it," she said.

Verhoef said WIC classes shouldn't be overlooked, such as the one she took previously about kids' eating habits. Her daughter had suddenly refused to eat and Verhoef was getting worried.

"It eased my mind thinking 'My child isn't going to die.' It just kind of helps me that I don't have to force foods down their throats."

Those classes can be expensive to administer though, and Radford is looking to save money by offering them online or through other groups so that clients can take them whenever they like.

Radford is also trying to streamline the voucher scheduling process to trim from $1.5 million it takes to administer the program in the county in case additional money is needed to supplement millions spent on food.

Vouchers come three months at a time, but that's also when clients plan their next meeting. Since no one really knows what they'll be doing in three months, appointments are often missed. Open access would allow clients to call in several weeks before the voucher runs out to set an appointment that they can meet.

Radford is preparing for the worst, though state WIC Director Chris Furner says that while he acknowledges food and formula costs are going up, he won't go so far as to say there will be cuts.

"We currently do not have any budget information that would lead us to believe we would move toward caseload management," he said. "It's a true wait-and-see situation."

He expects it to take several months on the new formula contract to find budgeting trends.

The U.S. House Agriculture Appropriations Subcommittee, which handles WIC funding, is proposing an increased budget for 2008. To meet increased program costs due to rising food prices, the subcommittee has asked for an increase of $415 million more than 2007 in the massive $18.8 billion ag bill.

"These programs serve our country's most vulnerable populations" said Rosa L. DeLauro, D-Conn. "Working poor households should not have to choose between securing adequate food for their kids and other basics they need just to get by."

Related

• WIC numbers on the rise in Utah County