CERTIFICATION WPPM #210-02 Subject: Eligibility Criteria Item: Adjunctive Eligibility Criteria

PURPOSE: To describe the circumstances under which an applicant qualifies as adjunctively income eligible to receive WIC Program benefits, the procedures local agency (LA) staff must follow when making such a determination, and the documentation required. POLICY: I. To be adjunctively income eligible for WIC Program benefits, an applicant must meet one of the following criteria: A. Individual certified as fully eligible to receive Medi-Cal benefits. B. Individual certified as fully eligible to receive CalFresh (SNAP) benefits. C. Individual certified as fully eligible to receive CalWORKs (TANF) benefits. D. A member of a family in which any family member is certified as fully eligible to receive CalWORKs benefits. E. A member of a family in which any infant or pregnant woman is certified as fully eligible to receive Medi-Cal benefits. F. A participant in the Food Distribution Program on Indian Reservations (FDPIR). G. An infant less than or equal to 60 days of age, whose mother is verified as receiving Medi-Cal at the time of birth. The infant remains adjunctively eligible for WIC benefits until the one-year recertification and is not required to provide proof of active Medi-Cal. Infants deemed adjunctively eligible due to mother having Medi-Cal at the time of birth cannot qualify other family members as adjunctively eligible. H. Presumptively eligible pregnant applicants for Medi-Cal or CalWORKs are adjunctively eligible for WIC for the extent of their certification and are not required to provide proof of active Medi-Cal or CalWORKs. Documentation of presumptive eligibility is required. Presumptively eligible applicants cannot qualify other family members as adjunctively eligible. II. Proof of Income Not Required A. Applicants who are adjunctively eligible are not subject to income limits established by CDPH/WIC. Applicants are required to provide an estimate of their income, but proof of income is not required. PROCEDURES: I. LA staff must ensure that applicant eligibility is properly documented in WIC WISE when determining adjunctive eligibility. Acceptable sources of proof for adjunctive Revised California WIC Policy and Procedure Manual Page 1 of 3 Dec 15, 2021

CERTIFICATION WPPM #210-02 Subject: Eligibility Criteria Item: Adjunctive Eligibility Criteria

Revised California WIC Policy and Procedure Manual Page 2 of 3 Dec 15, 2021 eligibility can be provided in physical form, displayed in-person via electronic format (e.g., emails, cell phones, tablets, pictures, etc.), or obtained remotely. For acceptable means of obtaining documents remotely, refer to WPPM 220-30. A. When Medi-Cal Eligibility Data (MEDS) Can Be Used to Verify Eligibility 1. Medi-Cal Acceptable Documentation a. Return of “Y” in the Medi-Cal field in MEDS. The Medi-Cal eligibility aid code obtained via MEDS is used by WIC WISE to identify whether the applicant is income eligible for WIC. (Refer to WPPM 980-1070). b. An aid notification letter if unable to verify with MEDS to show current program participation. c. A presumptive eligibility letter (Pregnant category only). d. Verification by a county eligibility worker. 2. CalFresh Acceptable Documentation a. Return of “Y” in the CalFresh field of MEDS. b. An aid notification letter if unable to verify with MEDS to show current program participation. c. Verification by a county eligibility worker. 3. CalWORKS Acceptable Documentation a. Return of a “Y” in the CalWORKS field of MEDS. b. An aid notification letter if unable to verify with MEDS to show current program participation. c. A current CalWORKS check stub or remittance advice. d. Verification by a county eligibility worker. 4. Infant Deemed Eligible Acceptable Documentation a. Review the recent prenatal WIC WISE adjunctive eligibility history. b. An aid notification letter confirming that the mother had Medi-Cal at the time of birth. c. Reminder – an infant deemed eligible due to mother having Medi-Cal at the time of birth cannot be used to CONFER other family members as adjunctively eligible for WIC. B. When MEDS Cannot Be Used to Verify Eligibility 1. When MEDS cannot be used to verify participation in Medi-Cal, CalFresh, CalWORKS, LA staff must document adjunctive eligibility in WIC WISE under the following circumstances:

CERTIFICATION WPPM #210-02 Subject: Eligibility Criteria Item: Adjunctive Eligibility Criteria

Revised California WIC Policy and Procedure Manual Page 3 of 3 Dec 15, 2021 a. A familial relationship qualifies the applicant as adjunctively eligible (LA staff must use the “CONFER” pop-up in WIC WISE). b. Participation in FDPIR qualifies the applicant as adjunctively eligible. The FDPIR provides an alternative to CalFresh for households living on or near reservations. An applicant who participates in FDPIR must provide documentation of participation. c. Pregnant applicant presumptively eligible for Medi-Cal or CalWORKs. Documentation of presumptive eligibility is required. AUTHORITY 7 CFR §246.7(d)(2)(v) 7 CFR §246.7(d)(2)(vi) 22 CCR 560262.3 Continued Eligibility Program for Pregnant/Postpartum Women and Infants CROSS REFERENCE: WPPM 980-1070 Medi-Cal Eligibility Codes