VIII. Certification August 2021 8.004 - 1 8.004 Categorical Eligibility CFR 246.7 (C) Eligibility Criteria I. Policy Statement To qualify for the Program, infants, children, and pregnant, postpartum, and breastfeeding women must reside within the jurisdiction of the District of Columbia and meet the income and nutritional risk criteria as outlined in Policies 8.005, 8.006 and 8.007, respectively. II. Categories for Eligibility

Category Description Pregnant Woman A pregnant woman. Proof of pregnancy is not required. If there is reason to suspect that a participant has falsely claimed to be pregnant, the Local Agency can request proof of pregnancy be provided within 60 days of certification. Staff will have to choose “bi-monthly issuance” in the Issuance tab under the Benefits screen in HANDS. Breastfeeding Woman A woman who breastfeeds an infant at least one time per day, up to infant’s first birthday or until she completely stops breastfeeding before the infant turns one year old.

A breastfeeding assessment shall be done before the issuance of food benefits at each certification, mid-cert assessment, when a breast pump is issued, and/or whenever the amount of formula the woman is requesting changes. The results of the assessment shall be documented in Notes in TGIF format, be used to provide individualized breastfeeding support, and to determine the appropriate food packages for her and her infant.

NOTE: When a breastfeeding woman who is more than 6 months postpartum stops breastfeeding, she becomes categorically ineligible. Postpartum Woman Postpartum non-breastfeeding women up to 6 months after the birth or the end of the pregnancy.

See below for more information on categorical eligibility for women who present after fetal or neonatal loss. Infant An infant until their 1st birthday (age one).

Child A child between the ages of one year and the last day of the month in which the child turns five (5) years old. NOTE: Participants shall be verbally informed of the length of certification at the time of certification. If the length of certification changes (i.e. change to estimated or actual delivery date) or if the category changes (i.e. breastfeeding category change), participants shall be verbally informed of the revised length of certification when it occurs.

VIII. Certification August 2021 8.004 - 2 III. Cases of Fetal or Neonatal Loss If a woman presents with a case of spontaneous abortion (miscarriage), induced abortion, fetal death or neonatal death, the applicant/participant may receive 6 months of food benefits from the date of loss. Definitions: • Fetal Death – Spontaneous termination of gestation at > 20 weeks • Induced Abortion – Elective termination of pregnancy • Neonatal Death – The death of an infant within 0-28 days of life • Spontaneous abortion – Spontaneous termination of a gestation at < 20 weeks, or a fetus that weighs < 500 grams Policies related to classifying women with fetal or neonatal loss as Postpartum Woman: • Proof of loss (i.e. doctors note) is preferable, and can be mandatory at the LA’s discretion. • A participant arriving to the LA post-loss may be recertified as a Postpartum Woman to receive benefits up to 6 months from the date of loss, as noted on proof of loss or as stated by the participant if no proof is available. • LAs reserve the right to refuse benefits and services to participants with suspected, or with a past history, of Program abuse. • If the participant was certified as pregnant without proof, and then returns to certify as post- loss, proof of either pregnancy or loss will be required. • Risk Code 321 shall be assigned to women who have had a spontaneous abortion, fetal death, or neonatal death. These participants are considered high-risk; refer to policy 8.007 for guidance on high-risk participants.

IV. Participants who misrepresent themselves as pregnant or postpartum

Policy 8.015 – Participant Violations and Sanctions indicates that misrepresenting oneself as pregnant and/or as having incurred the loss of a pregnancy (or infant) is considered a misrepresentation of health status - the participant could be sanctioned with having to repay the monetary value of benefits received and incur a one-year disqualification from Program eligibility.

VIII. Certification August 2021 8.004 - 3 Table 1. Summary of HANDS participant category codes Pt Code Description PG1 Pregnant woman < 18 years old

PG2 Pregnant woman > 18 years old

P Post Partum Woman

PN+ Woman Partially Nursing Plus (more formula provided than PN) PN Woman Partially Nursing

EN Woman Exclusively Nursing

IEN Infant Exclusively Nursing

IPN Infant Partially Nursing

IPN+ Infant Partially Nursing Plus (More formula provided than PN) IFF Infant Fully Formula Feeding

C1 Child 12-23 months old

C2

Child 24-35 months old C3

Child 36-47 months old C4

Child 48-59 months old