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State Plan Checklist - CERTIFICATION, ELIGIBILITY & COORDINATION OF SERVICES 8/14/2026 Page 25

Written literature on the WIC Program X X

d. The State agency has a system in place to monitor the extent to which WIC participants are using other health or social services (check all that apply): [ ] Yes [X] No

e. The State agency requires local agencies to monitor referrals to determine the extent of health or social services utilization in addition to State monitoring systems. Yes No ADDITIONAL DETAIL: Certification and Eligibility Appendix and/or Procedure Manual (citation):

f. To facilitate referrals to the Medicaid Program, the State agency provides each local agency a chart showing the maximum income limits, according to family size, applicable to pregnant women, infants, and children up to age 5 under the Medicaid Program.

Yes No g. The State agency assures that each local agency operating the Program within a hospital, and/or that has a cooperative arrangement with a hospital, advises potentially eligible individuals that receive inpatient or outpatient prenatal, maternity, or postpartum services, or that accompany a child under the age of 5 who receives well-child services, of the availability of Program services.

Yes No

h. The State agency ensures that, to the extent possible, local agencies provide an opportunity for individuals who may be eligible to be certified within the hospital for participation in WIC. Yes No