Connecticut WIC Program Manual

WIC 200-24 SECTION: Certification

SUBJECT: Phenylketonuria or Metabolic Disorders with Nutrition Implications POLICY The certification and enrollment of eligible children who have Phenylketonuria (PKU), or women with Maternal PKU (MPKU), in the WIC program is accomplished through the coordination efforts of the WIC local agency, the PKU clinics, the WIC state agency, Genetics Programs and the primary care providers. • The medical/nutritional assessments shall be completed at the clinic facility where the client receives medical care.

• Using guidelines supplied by the WIC state office, the State Genetics Program Coordinator does preliminary income screening.

• A medical/nutritional assessment is completed by the clinic physician, nurse/or dietitian or the primary care physician.

• The PKU dietitian completes a nutrition assessment, determines the diet prescription and forwards a copy of both to the WIC local agency.

• To determine the diet prescription the PKU dietitian will take a diet recall and assess the blood phenylalanine level.

• The clinic staff mails the certification form to the appropriate WIC local agency. The WIC local agency completes the initial and subsequent certification.

• In cooperation with the PKU dietitian, the local agency Program Nutritionist develops a nutrition care plan for women and children with PKU.

• Copies of the PKU dietitian’s completed WIC certification form, the current nutrition assessment form and/or nutrition progress note and growth chart will be maintained on file at the medical facility. The original forms and nutrition assessment documentation will be forwarded to the local WIC agency.

• Upon receipt of the completed certification form and nutrition assessment/note, certification records for all WIC/PKU participants are maintained (scanned) in CT-WIC.

• Other metabolic disorders with nutritional implications shall be handled in the same manner as PKU.