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Section 5.10: Mid-Certification 4/2020 References: 7CFR 246.7 (g) (1); 7CFR 246.11(e) (3); USDA Guidance for Providing Quality WIC Nutrition Services during Extended Certification Periods, August 2011 Policy: Participants with a certification period greater than 6 months require a mid- certification assessment. Purpose: To ensure participants certified for a period greater than 6 months continue to receive quality nutrition services and education. Procedures Timing of mid-certification appointment by category ▪ Infants: around 9 months of age ▪ Children: 6th month of certification (5-7 month time frame) ▪ Breastfeeding women: 6th month of certification or with infant’s mid-certification appointment Mid-certification assessment components To ensure that health and nutrition services are not diminished by an extended certification period, the mid-certification assessment must include: ▪ Anthropometric measurements ▪ Bloodwork (follow WIC bloodwork schedule, Section 5.3.2: Hematologic Assessment) ▪ Update health and nutrition assessment – an abbreviated assessment is necessary to identify any major changes in health status. It includes: ▪ Review information obtained at last certification to adequately compare previous and current screenings, nutrition education and referrals. ▪ New concerns of participant ▪ New medical diagnosis ▪ Changes in eating pattern/food intake ▪ Changes in physical activity

5 . 1 0 : M I D - C E R T I F I C A T I O N 2 ▪ Check on immunization, if appropriate ▪ Nutrition counseling or education ▪ Food package review and change, if needed ▪ Breastfeeding promotion and support ▪ Referrals, if needed Use the Mid-Certification Assessment Question resources as guides: ▪ Midcertification Assessment Questions - Infant ▪ Midcertification Assessment Questions - Child ▪ Midcertification Assessment Questions - Breastfeeding Woman The following components are not required at mid-certification: ▪ Proof of income ▪ Proof of address ▪ Proof of ID ▪ Physical presence ▪ Reviewing WIC Rights and Responsibilities If a mid-certification appointment is missed, local agency staff may issue only one month of benefits and reschedule the mid-certification appointment for the following month. Guidance ▪ Schedule infants’ mid-certification at, or after, the “9 month birthday” to correlate with the WIC bloodwork schedule, Section 5.3.2: Hematologic Assessment. ▪ Bloodwork must be done at or after nine months of age. ▪ In the very rare occasions when an infant’s mid-certification occurs before they are nine months of age, do not test the blood at the mid-certification. Instead, do bloodwork at the next certification (usually at approximately one year of age). ▪ Participants certified for a period of 6 months or less do not require a mid-certification. However, CPAs should follow-up on ht/wt/hgb measurements based on the individual’s nutrition and health status. For example, a premature infant certified at 6 months of age could benefit from a hgb measurement and evaluation around 9 months of age. ▪ Use this mid-certification appointment time to verify address & phone number.

5 . 1 0 : M I D - C E R T I F I C A T I O N 3 Reference – Complete Listing of Hyperlinks Section 5.3.2: Hematologic Assessment (https://www.health.state.mn.us/docs/people/wic/localagency/program/mom/chsctns/ch5/sct n5_3_2.pdf) Midcertification Assessment Questions - Infant (https://www.health.state.mn.us/docs/people/wic/localagency/training/pcs/assessment/mcain fant.pdf) Midcertification Assessment Questions - Child (https://www.health.state.mn.us/docs/people/wic/localagency/training/pcs/assessment/mcac hild.pdf) Midcertification Assessment Questions - Breastfeeding Woman (https://www.health.state.mn.us/docs/people/wic/localagency/training/pcs/assessment/mcab f.pdf) Minnesota Department of Health - WIC Program 625 Robert St N, PO BOX 64975, ST PAUL MN 55164-0975; 1-800-657-3942, health.wic@state.mn.us, www.health.state.mn.us. To obtain this information in a different format, call: 1-800-657-3942 This institution is an equal opportunity provider.