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WIC Nutrition Risk Criteria

System Assigned (SA); System or CPA Assigned (SA/CPA); CPA Assigned (CPA); Automatic High Risk* (HR) Code Category [Priority] Risk Criteria/Definition Required Documentation 8

321 (SA) PG [1] BF [1] NBF [3-6] History of Spontaneous Abortion, Fetal or Neonatal Death: Pregnant Woman: Any history of fetal or neonatal death or 2 or more spontaneous abortions. Non-Breastfeeding Woman: Spontaneous abortion, fetal or neonatal loss in most recent pregnancy. Breastfeeding Woman: Most recent pregnancy in which there was a multifetal gestation with one or more fetal or neonatal deaths but with one or more infants still living. Spontaneous Abortion (SAB) is the spontaneous termination of a gestation at < 20 weeks or of a fetus weighing < 500 gm. Fetal Death is the spontaneous termination of a gestation at > 20 weeks. Neonatal Death is the death of an infant within 0-28 days of life. NOTE: Elected abortion not included.

Presence of condition diagnosed, documented, or reported by physician or someone working under physician’s orders, or as self-reported by applicant/participant/caregiver. Document on Health Information screen (outcome dropdown list on pregnancy history tab) in Crossroads. 331 (SA) PG [1] BF [1] NBF [3-6] Pregnancy at a Young Age: Conception at < 20 years of age. Pregnant Woman: Current pregnancy BF/Non-BF Woman: Most recent pregnancy DOB documented on Family/Participant Demographics Screen; weeks gestation and delivery date for current pregnancy documented on Health Information Screen in Crossroads. 332 (SA)

PG [1] BF [1] NBF [3-6] Short Interpregnancy Interval: Interpregnancy interval of less than 18 months from the date of a live birth to the conception of the subsequent pregnancy. Pregnant Woman: Current pregnancy BF/Non-BF Woman: Most recent pregnancy NOTE: Only applicable for live births.

Self-reported documented on Health Information screen (pregnancy history tab) in Crossroads compared to delivery date, current pregnancy. 334 (SA) PG [1] Lack of or Inadequate Prenatal Care: Prenatal care beginning after the 1st trimester (after 13th week), or based on an inadequate Prenatal Care Index: Weeks Gestation # of Prenatal Visits 14-21 0 or unknown 22-29 1 or less 30-31 2 or less 32-33 3 or less 34 or more 4 or less

Assigned based on number of prenatal healthcare visits entered on Health Information Screen in Crossroads. Self- reported date of first prenatal visit entered on the Health Information screen.