WIC 200-12 WIC Nutrition Assessment Screens and Guidance Policy 6-23-2023 Connecticut WIC Program Manual

WIC 200-12 SECTION: Certification

SUBJECT: Nutrition Assessment Screens and Guidance

Federal Regulations: § 246.7; WIC Policy Memorandum 2011-05: WIC Nutrition Risk Criteria WIC Nutrition Services Standards: Standard 6: Nutrition Assessment Standard 7: Nutrition Education and Counseling Standard 8: Breastfeeding Education, Promotion and Support Standard 9: Breastfeeding Peer Counseling Standard 11: Participant Referrals Standard 12: WIC Food Selection and Authorization Standard 13: Food Package Prescriptions Standard 14: Nutrition Services Documentation Standard 15: Breastfeeding Data Collection Standard 16: Quality Improvement VENA Guidance Document: VENA: Value Enhanced Nutrition Assessment in the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) (usda.gov) OR; https://wicworks.fns.usda.gov/sites/default/files/media/document/vena-guidance.pdf POLICY In CT-WIC, the Guided Script has the following screens which are required to complete a WIC nutrition assessment and confer Program eligibility: Lab, Breastfeeding, Health (Pregnancy Information and Health Information Tabs) and Nutrition screens. The questions in CT-WIC are to be used to engage the participant in dialogue regarding health, medical, clinical, and nutritional issues. Bolded questions and fields labeled with an asterisk (*) are required for CT-WIC processing and data collection; and are also relevant to collect for CT-WIC to determine objective health, medical, clinical, and/or dietary risks. Connecticut’s Value Enhanced Nutrition Assessment (VENA) committee developed the non-bolded questions to facilitate a more conversational approach to assessment, using the health outcome- based model and consider these questions essential to providing a complete nutrition assessment. Staff should use the questions as a guide to begin a conversation about parental concerns, mealtime behaviors and common health/nutrition practices. Refer to the revised CT-WIC Nutrition Assessment Guidance for more details. Per professional judgment, all the non-bolded questions on the CT-WIC Assessment Screens (Lab, Breastfeeding, Health, Nutrition, and Referrals) do not have to be obtained for each participant. A Value Enhanced Nutrition Assessment allows the Competent Professional Authority (CPA) to use the Guided Script’s assessment screens to plan a personalized nutrition intervention guided by the

WIC 200-12 WIC Nutrition Assessment Screens and Guidance Policy 6-23-2023 individual needs of the participant. See each of the category specific nutrition assessment guidance for more information. The preferred method for conducting a WIC Value Enhanced Nutrition Assessment is through a primarily verbal interview or conversation with the participant to assist both staff and the participant in a more participant-centered approach to assessment. Specific inappropriate nutrition practice(s) identified through the nutrition/dietary assessment process must be documented in CT-WIC. For participants with multiple risk factors, the CPA should document what risk factor(s) was/were discussed with the participant at the time of certification (indicate if it was a participant selected concern) and document (as needed) the plan to address other identified risk factors on subsequent clinic visits. If a participant is certified for the presumptive or predisposing risk factors (CT-WIC USDA/FNS Nutrition Risk Criteria # 401 (Women, Children aged 2+) and #428 Infants and children <2 years) documentation in CT-WIC (Notes tab under Nutrition Screen) must include what was discussed; for continuity of care purposes i.e., anticipatory guidance, counseling and or referrals provided. The nutrition assessment and interview shall be conducted by a nutritionist, or another local agency CPA trained and certified as competent in the six areas as outlined in the VENA guidance and supervised by the Program Nutritionist. Guidance

Refer to 200-22 Disposition of Certification Files for the electronic documents that are required in all CT-WIC participant files. Local agencies may want to establish a daily file to maintain any papers received by participants or signed by participants in an effort to assist with quality assurance. All applicable data, Nutrition Risk Criteria and CPA initials must be recorded on the appropriate CT-WIC Screens.

If ineligible, complete and issue a Notice of Participant Action form. Give a copy to the applicant and scan a copy of the form into the participant’s file (existing participant).

Refer to Connecticut WIC Policy 200-08 Nutrition Assessment and Risk Determination; 200-13 Completion of Certification Form and 300-09 Nutrition Services Documentation for more details on the nutrition assessment, nutrition risk determination and documentation processes.