WIC 200-31 WIC Participant Rights and Responsibilities 5-2024 Connecticut WIC Program Manual

WIC 200-31 SECTION: Certification

SUBJECT: Participant Rights and Responsibilities

Federal Regulations: §246.7 (i) (10) and (j) (1-3) POLICY At a minimum, at each certification appointment an applicant or participant must read or have read to her the statements on the WIC Participants Rights and Responsibilities Form. It is expected that a WIC staff person will provide a summary of important points at the initial and all subsequent certifications, mid-certifications to ensure the applicant/participant is apprised of their rights and responsibilities under the Program. After reading the statements and/or an explanation from WIC staff the applicant/participant must sign the signature pad device. The signature must be saved in CT-WIC. A copy of the signed form must be provided to the applicant or participant. If services are provided in a hybrid manner, local agencies must ensure that the authorized person/applicant receives a signed copy of the Rights & Responsibilities form via a delivery method of their choice.

In instances where a hard copy of the form needs to be completed, i.e., CT-WIC is not operational, WIC Rights and Responsibilities Form can be completed. Note this form allows for multiple eligible family members to be included on one form. Each individual’s name must be recorded on the form. The Family ID number must also be recorded on the form. If a member of an existing WIC family applies and/or is recertified on a subsequent visit, another WIC Rights and Responsibilities Form must be completed, reflecting the certification date of that individual. (CT-WIC or hard copy)

The WIC Rights and Responsibilities Form is available in English, Spanish, Portuguese, Haitian Creole, Arabic and Pashto.