Revised 11-2022 Connecticut WIC Program Manual

WIC 200-04 SECTION: Certification

SUBJECT: Residency Requirement Federal Regulations: §246.7 (c)(2)(i) POLICY To be eligible for WIC program benefits the applicant must live in Connecticut. Determine if the applicant lives in Connecticut by asking the applicant to present documentation which lists the applicant’s name and street address and/or which verifies that the applicant resides in Connecticut. Acceptable documents include any one of the following: For Women

• Connecticut WIC certification/referral form with address imprint and health care provider signature • ConnectCard (Temporary Family Assistance, Supplemental Nutrition Assistance Program, and/or Medicaid) • Notice of eligibility for TFA, SNAP, and Medicaid • Pay stub with applicant’s name, no more than 60 days old • State of Connecticut Driver’s License (issued by DMV) • State of Connecticut Non-Driver Photo ID (issued by DMV) • State of Connecticut Learner’s Permit (issued by DMV) • Municipal ID • School ID • Canceled letter addressed to applicant • Utility bill or other current document that includes street address • Rent/Mortgage receipt • Bank Statement • W-2 form • Unemployment benefit notification letter or unemployment check • Tuition assistance document • Voter registration card • DMV Registration

For Infants/Children

• Connecticut WIC certification/referral form with address imprint and health care provider signature • ConnectCard issued in child’s name (Temporary Family Assistance, Supplemental Nutrition Assistance Program, and/or Medicaid) • Municipal ID • Notice of eligibility for Medicaid • Health Plan Card issued in child’s name • Utility bill or other current document that includes street address

Revised 11-2022 • Birth Certificate (long form or wallet size)

Special Situations The list above contains acceptable forms of residency documentation deemed acceptable by the State WIC agency. When local agency staff have exhausted all options listed above, consideration can be given to using information from an electronic medical record (EMR) or patient portal (the participant’s personal health record) to verify residency. This option should only be used when a barrier exists that prevents a participant from providing one of the preferred acceptable proofs of residency delineated above.

An applicant with NO proof of residency, such as a victim of theft, loss or disaster, a homeless individual, a migrant, or a person holding a verification of certification (VOC) card, may sign a statement attesting to his or her residency.

If the applicant does not present with proof of residency, review the identity and residency documentation form and determine if acceptable documentation is available. If all other eligibility criteria are met at certification, a local agency may permit an applicant/participant to self declare his/her address for a maximum of 30 days and one month of benefits can be issued. Instruct the applicant/participant to complete the self-declaration form. Inform the applicant/participant that if after 30 days, the necessary proof of residency is not provided the applicant/participant will be ineligible for WIC program benefits. If the applicant is a victim of theft, loss or disaster, a homeless individual, a migrant, or a person holding a Verification of Certification (VOC) card, use the Self-Declaration form to document this reason and ask the applicant to sign and date the form. This form is valid for 30 days. If the applicant/participant meets all other eligibility criteria, one month of benefits can be issued. Give the form to the Program Coordinator or designee for review. If the applicant is homeless, the address of a shelter or of a relative or a friend may be used. For applicants/participants who meet all other eligibility criteria at certification but have one of the above listed reasons for lacking proof of residency i.e. victim of theft, loss or disaster, a homeless individual, a migrant or a person holding a VOC card and indicates that an acceptable proof of residency is not available, provide the Verification form, review instructions for completion (request a reliable third party, such as a social service agency, church, legal aid society or an employer can confirm the individual’s residency) and advise the applicant/participant the completed Verification form must be returned at next appointment to continue WIC benefits. CT-WIC Documentation Document how state residency was established in the CT-WIC Family Information screen. For applicants/participants who are homeless and sheltered, document the living address of where they are sheltered. For applicants/participants who are homeless and unsheltered, local agency staff shall document the living address in CT-WIC as the WIC permanent site address for which the individual is participating in. Local agency staff must inform the individual that the zip code entered in CT-WIC will be used by the individual when registering the eWIC card for the first time and whenever they are accessing their benefits by calling the Interactive Voice Response system (IVR).