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Maine Center for Disease Control and Prevention WIC Nutrition Program Effective: October 2, 2012 Policy No. IS-02 Revised: October 1, 2024 Participant Characteristics Data Set Authority 7CFR §246.4(a)(11)(i)

Policy 1. The State Agency shall compile the Participant Characteristic (PC) Data Set report in April of even numbered years. 2. The PC Data Set report shall be compiled from information entered in the Information System (IS) by Local Agency staff, and shall include the following Minimum Data Set (MDS) for all participants enrolled in the Maine CDC WIC Nutrition Program for the reporting month: 2.1. State Agency ID 2.2. Local Agency ID 2.3. Service Site ID 2.4. Case ID 2.5. Client Date of Birth, reported in MMDDYYYY format 2.6. Client Race/Ethnicity. Classified into one of five (5) racial/ethnic categories: 2.6.1 For ethnicity: 2.6.1.1 Hispanic or Latino; 2.6.1.2 Not Hispanic or Latino 2.6.2 For race: 2.6.2.1 American Indian or Alaskan Native; 2.6.2.2 Asian; 2.6.2.3 Black or African American; 2.6.2.4 Native Hawaiian or Other Pacific Islander; 2.6.2.5 White

2.7. Certification Category

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2.8. Expected Date of Delivery or Weeks Gestation: for pregnant women, the projected date of delivery (MMDDYYYY) format or the number of weeks since the last menstrual period as determined at Maine CDC WIC Program certification. 2.9. Date of Certification: the date the person was declared eligible for the most current Maine CDC WIC Program certification. Reported in MMDDYYYY format. 2.10. Sex: for infants and children, male or female 2.11. Risk Priority Code: Participant priority level for most recent Maine CDC WIC Program certification. 2.12. Participation in TANF, SNAP and/or MaineCare (Medicaid) 2.13. Migrant Status: Participant migrant status according to the Federal WIC Program definition of a migrant farm worker. 2.14. Number in Family/Economic Unit: the self-declared number of persons in the family/household or economic unit upon which WIC income eligibility was based. 2.15. Family/Economic Unit Income 2.15.1 For participants whose income was not required to be determined as part of the Maine CDC WIC Nutrition Program certification process, the self- reported income as the time of certification shall be used. 2.15.2 These participants include adjunctively income-eligible participants (due to TANF, SNAP, or MaineCare participation) and participants deemed income-eligible under options and procedures available to the State Agency in Federal WIC Regulations (means-tested programs identified by the State for automatic Maine CDC WIC Program eligibility, income eligibility of Indian and in-stream migrant farm work applicants). 2.16. Income Period: period covered by the amount described in Family/Economic Unit Income 2.17. Income Ranges: self-declared income for family/economic unit expressed in a dollar range for any participant whose income was not required to be determined as part of the WIC certification process. 2.18. Nutrition Risks Present at Certification: up to ten (10) highest priority nutrition risks present at WIC Program certification. 2.19. Hemoglobin or Hematocrit 2.19.1 Hemoglobin/hematocrit value is not required for infant participants who are less than nine (9) months old

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2.19.2 For children, if there is no blood measurement recorded for the current certification, the value for most recent certification that is available is to be provided. 2.20. Date of Blood Measurement: date of the blood measurement that was used during the most recent WIC Program certification in MMDDYYYY format (required for all participants reporting a blood measure). 2.21. Weight (reported in nearest quarter pound of participant’s weight) 2.22. Height (reported in nearest eighth of an inch of participant’s height/length) 2.23. Date of Height and Weight Measure in MMDDYYYY format. 2.24. Currently Breastfed: information is needed for all infant participants ages six (6) through thirteen (13) months, whether or not the infant is currently receiving breast milk. 2.25. Ever Breastfed: information is needed for all infant participants ages six (6) through thirteen (13) months, whether or not the infant was ever breastfed. 2.26. Length of Time Breastfed: for infants ages six (6) through thirteen (13) months who have ever breastfed are not currently receiving breastmilk, the number of weeks the infant received breast milk. 2.27. Date Breastfeeding Data Collected: for infants ages six (6) through thirteen (13) months, the date on which breastfeeding status was reported by mother in MMDDYYYY format. 2.28. Food Items and Quantities: the item codes and quantities for all food items prescribed for the participant during the reporting month.

3. As part of the Participant Characteristics Supplemental Data Set (SDS), the State Agency shall collect the following information: 3.1. Date of first Maine CDC WIC Program certification in MMDDYYYY format 3.1.1 Pregnant women: date of certification for current pregnancy 3.1.2 Breastfeeding and Postpartum women: date of certification for most recent pregnant 3.1.3 Infants and Children: date of first WIC certification 3.2. Education level (women participants): highest grade of school or college completed by participant 3.3. Number in family/household enrolled in WIC program: number of people in participant’s economic unit used for WIC certification who were enrolled during the reporting month

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3.4. Date previous pregnancy ended in MMDDYYYY format (Pregnant women only) 3.5. Total number of pregnancies (Pregnant women only): total number of times participant has been pregnant, including this pregnancy and any pregnancies resulting in birth, miscarriage, abortion or stillbirth 3.6. Total number of live births (Pregnant women only): total number of babies born alive to this participant, including any infants who may have died shortly after birth 3.7. Pre-pregnancy weight (Pregnant women only): participant’s weight immediately prior to pregnancy, reported in whole pounds 3.8. Participant’s weight gain during pregnancy (Breastfeeding and Postpartum women only): participant’s weight gain during most recent pregnancy, reported in whole pounds 3.9. Birth weight (Infant or Child only): infant’s or child’s birth weight, reported in pounds and ounces 3.10. Birth length (Infant or Child only): infant’s or child’s birth length, reported in nearest eighth of an inch 3.11. Household ID 3.12. EBT Card Number 3.13. Enrollee home ZIP Code 3.14. Record Reference date

EBT Data 4.1 Issued Benefits 4.2 Redeemed Benefits 4.3 Approved Product List (APL) 4.5 Vendor List Procedure Participant Characteristics Minimum Data Set

1. Zero (0) shall not be used to indicate income values that are missing or not available. Zero should only indicate an actual value of zero. 2. Participants’ weight shall be measured according to Maine CDC WIC Program standards and entered into the participant record in whole pounds and ounce(s). If weight is not

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collected in pounds and ounces, weight may be reported in grams. 3. Participants’ height (or length) shall be measured according to Maine CDC WIC Program standards and entered into the participant record in inches and closest one-eighth (1/8) inch. If height/length is not collected in inches and 1/8 inches, height/length may be reported in centimeters. Participant Characteristics Supplemental Data Set (SDS)

4. Date of First WIC Certification shall mean the date the participant was first certified for the WIC program in MMDDYYYY format. For pregnant, breastfeeding and postpartum women, this applies to the current or most recent pregnancy and not prior pregnancies. 5. For breastfeeding and postpartum women, educational level shall be considered the highest grade or year of school completed. 6. For infants and children, educational level shall be the highest grade or year of school completed by mother or primary caretaker.

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7. Number in Family/Household on WIC shall be the number of people in the participant’s family/household receiving WIC benefits. 8. For pregnant women, the total number of times a woman has been pregnant shall include this pregnancy, all live births and any pregnancies resulting in miscarriage, abortion or stillbirth. 9. For pregnant women, the total number of live births shall be total number of babies born alive to this woman, including those who may have died shortly after birth. 10. Pre-pregnancy weight may be reported in either pounds and ounces or grams and shall be the participant’s self-reported weight immediately prior to pregnancy. 11. For breastfeeding and postpartum women, Participant’s Weight Gain during Pregnancy shall be the participant’s weight gain during pregnancy as taken at or prior to delivery. Weight gain in pregnancy may be reported in either pounds and ounces or grams. 12. For infants and children, Birth Weight shall be the participant’s weight at birth measured according to Maine CDC WIC Nutrition Program standards (lbs/ounces). Birth weight may be reported in either pounds or ounces, or in grams. 13. For infants and children, Birth Length shall be the participant’s length measured according to Maine CDC WIC Nutrition Program standards (1/8 inches). Birth length may be reported in either inches and closest one-eighth inches or in centimeters. Security and Confidentiality of Records and Reports

14. The Case ID reported as part of the MDS may not be the same case number used in the State Agency’s Information System for the individual. Retention of Records and Reports

15. If any litigation, claim, negotiation, or audit or other action involving any record or report is initiated prior to the end of the three year period, any such report or record must be retained until all issues are resolved or until the three year period has expired, whichever is later.