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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 13

(Must be present within the past 6 months). Common acute diseases include: •Hepatitis A •Hepatitis E •Meningitis (Bacterial/Viral) •Parasitic infections •Listeriosis •Pneumonia •Bronchitis (3 episodes in last 6 months)

352b Chronic Infectious Diseases: Conditions likely lasting a lifetime and require long-term management of symptoms. Diseases include: •Human Immunodeficiency Virus (HIV) •Acquired Immunodeficiency Syndrome (AIDS) •Hepatitis B •Hepatitis C •Hepatitis D

NOTE: May be considered High Risk at CPA discretion. Crossroads. Document condition and treatment plan, if applicable, on Care Plan Summary – Nutrition Assessment in Crossroads.

Refer to the WIC Procedure Manual Ch. 6 Breastfeeding Promotion and Support for breastfeeding support for those with infectious disease.

353 (SA/CPA) PG [1] BF [1] NBF [3-6] Infants [1] Child [3] Food Allergies: Adverse health effects arising from a specific immune response that occurs reproducibly on exposure to a given food.

NOTE: May be assigned High Risk at CPA discretion. Presence of food allergies diagnosed, documented, or reported by a physician or by someone working under physician’s orders, or as self- reported by applicant/participant/caregiver. Document on Health Information screen (health conditions slider) in Crossroads. Document specific foods, reactions and treatment plan, if applicable, on Care Plan Summary – Nutrition Assessment in Crossroads. 354 (SA/CPA)

PG [1] BF [1] NBF [3-6] Infants [1] Child [3] Celiac Disease: An autoimmune disease precipitated by the ingestion of gluten (a protein in wheat, rye, and barley) that results in damage to the small intestine and malabsorption of the nutrients from food. Also known as Celiac Sprue, Gluten-sensitive Enteropathy, and Non-tropical Sprue. NOTE: May be considered High Risk at CPA discretion. Presence of condition diagnosed, documented, or reported by a physician or someone working under physician’s orders, or as self-reported by applicant/participant/caregiver. Document on Health Information screen (health conditions slider) in Crossroads. 355 (SA/CPA) PG [1] BF [1] Lactose Intolerance: The syndrome of one or more of the following: diarrhea, abdominal pain, flatulence, and/or bloating, Presence of condition diagnosed, documented, or reported by physician or someone working under