Updated 10-2019 Connecticut WIC Program Manual

WIC 200-17 SECTION: Certification

SUBJECT: Certification periods

Federal Regulations: §246.7(g) http://edocket.access.gpo.gov/cfr_2010/janqtr/pdf/7cfr246.7.pdfgulations: POLICY WIC local agency staff shall adhere to established certification schedules for each participant category. When possible, certification schedules should be coordinated with medical visits. The standard length of the certification period is 1 year from the date of certification. This applies for all participants except those whose certification period is pre-designated, such as pregnant women who are certified until six weeks from expected delivery date and postpartum women who are certified up to 6 months after pregnancy ends. When participants become categorically ineligible for program benefits, complete and issue a Notice of Participant Action form. All data used to determine nutritional risk of pregnant, postpartum and breastfeeding women shall be reflective of their categorical status at the time of certification. Pregnant women shall be certified only once for the duration of their pregnancy and up to six weeks postpartum. Postpartum women shall be certified once after the six-week postpartum visit and up to six months after the date pregnancy ended. Breastfeeding women shall be certified once after the postpartum visit and up to last day of month in which her infant turns one year old or until the woman ceases breastfeeding, whichever occurs first. However, in order to ensure that the quality and accessibility of health care services are not diminished for the breastfeeding woman, a mid- certification health/nutrition assessment shall be conducted. Guidance for Mid-Certifications for Breastfeeding Women

At a minimum, the breastfeeding woman’s weight should be obtained and applicable weight loss goals should be discussed during this visit. Additionally, an assessment of the breastfeeding dyad’s breastfeeding goals should also be conducted. *If a woman stops breastfeeding BEFORE her infant is six months old, she is re-categorized as a postpartum woman. If a woman stops breastfeeding AFTER her infant is six months old, then she is ineligible to continue program benefits. However, if a woman is breastfeeding at least once a day, but chooses to receive a full formula package for her infant, she may remain as an active participant

Updated 10-2019 on the program and receive nutrition education benefits, but will not receive a supplemental food package. Infants shall be certified up to their first birthday. In order to ensure that the quality and accessibility of health care services are not diminished for infants, a mid- certification health/nutrition assessment shall be conducted, including an assessment of the parent or caretaker’s access to quality health care for the infant. Children shall be certified up to one year. However, in order to ensure that the quality and accessibility of health care services are not diminished for children, a mid- certification health and nutrition assessment shall be conducted, including an assessment of the parent or caretaker’s access to quality health care for the child.

Children are no longer eligible at the end of the month when they reach their fifth birthday. The parent/guardian should be notified of this fact at the time of the last re-certification.

Guidance for Mid-Certifications for Infants and Children

At a minimum, the infant’s and child’s length/height and weight and the following relevant documentation shall be obtained:

 A WIC certification form or other referral form signed by the health care provider (HCP) or a Competent Professional Authority (CPA) or the provider’s staff, or

 An infant/child health record that indicates that his/her immunizations are up-to-date;

 If applicable, a letter signed by the HCP indicating that the infant/child has been receiving ongoing health care.

For infants, at the time of mid-certification health/nutrition assessment, the parent, guardian or caretaker shall be informed that a blood test for anemia is required between 9-12 months of age, unless the infant’s HCP determines that it should be done between 6-9 months of age. For children, at the time of the mid-certification health/nutrition assessment, the parent, guardian or caretaker shall be informed that a blood test for anemia is required 6 months after the infant test (between 15- 18 months) and annually from 2-4 years of age.

Guidance for Coordinating Family WIC Appointments The WIC CPA may extend a participant’s certification period by up to one month, or (re)certify a child up to 30 days prior to his/her termination date, to coincide with well child visits or in cases where there is difficulty scheduling an appointment. A 30 day extension may be granted to an Out of State (OST) participant when coordination of care with a provider and appointment scheduling poses a barrier.