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Section 5.3: Nutrition Risk Assessment 12/2023 5.3.3: Health and Nutrition Information References: Immunization Screening and Referral in WIC Policy: Local Agency CPAs must assess a participant’s health and nutrition status at certification, recertification, and mid-certifications. Purpose: To ensure all applicants receive a standardized assessment of their medical/health/nutrition status that is based on currently accepted practice and Value Enhanced Nutrition Assessment (VENA) guidelines. Procedures Follow the Nutrition Assessment Process for a comprehensive screening of the participant’s health/medical/nutrition status. Nutrition Assessment Process 1. Only after completing an anthropometric and hematologic assessment, assess the participant’s medical/health/nutrition status. 2. Use the appropriate Nutrition Assessment Tool as a guide for collecting and evaluating relevant information about the participant’s health and diet and eating/feeding patterns. Collect adequate information to assess for all possible risk codes for the participant’s category, including risk assessment for postpartum/perinatal depression. 3. Clarify and synthesize information as needed. 4. Identify and assign all applicable risk codes. 5. Document the health/medical/nutrition assessment. 6. After all components of the assessment are complete (anthropometric, hematologic, health, diet, and breastfeeding) and all applicable risk codes assigned, provide education based on prioritized needs. Screening and Referral for Immunizations ▪ Assess immunization status of infants and children. Use the appropriate Nutrition Assessment Tool as a guide:

S E C T I O N 5 . 3 . 3 : H E A L T H A N D N U T R I T I O N I N F O R M A T I O N 2 ▪ At a minimum, ask if the child’s immunizations are up-to-date. Refer to Are Your Kids Ready? Minnesota K-12 Immunization Law for the current recommendations. ▪ Indicate in the Information System when the participant is not up-to-date for age by current recommendations ▪ If a child’s immunization status is not current, refer to immunization program(s). Document the referral in the Information System Referrals or in a note. If the family declines an immunization referral, note that in the participant record. ▪ Coordinate with public health immunization program staff to ensure infants’ and children’s immunization status is assessed and appropriate referrals are made. Screening and Referral for Blood Lead Testing ▪ Assess blood lead testing status of infants and children. Use the appropriate Nutrition Assessment Tool as a guide: ▪ Ask if the child has had a blood lead test. Refer to Minnesota Childhood Blood Lead Screening Guidelines for the current recommendations ▪ Indicate in the Information System when the participant has not had a blood lead test per current recommendations ▪ If a child’s blood lead testing is not current, refer to blood lead testing program(s). Document the referral in the Information System Referrals or in a note. If the family declines a blood lead test referral, document that in the participant record. Guidance ▪ Use a participatory, interactive approach when collecting health and diet/breastfeeding information: ▪ CPAs may ask the assessment questions in any order. ▪ CPAs may rephrase questions, provided the intent of each question is not changed. ▪ Actively involve the participant through dialogue, information exchange, listening and feedback. ▪ Clarify information by using probing, open-ended questions. ▪ Keep discussion at a level appropriate to participants’ level of education. ▪ Avoid judgmental language. ▪ Conduct the assessment with respect and warmth to aid in building rapport. ▪ Refer to VENA for more information. ▪ PCS training materials and tools are available to develop CPA skills. ▪ Refer to Nutrition Assessment Tools for further information.

S E C T I O N 5 . 3 . 3 : H E A L T H A N D N U T R I T I O N I N F O R M A T I O N 3 ▪ Ensure the privacy of each participant when gathering and discussing information. See Section 1.7: Data Privacy. Reference – Complete Listing of Hyperlinks Immunization Screening and Referral in WIC (https://www.fns.usda.gov/wic/immunization- screening-referral) Nutrition Assessment Tool (https://www.health.state.mn.us/people/wic/localagency/training/na.html#NaN) Are Your Kids Ready? Minnesota K-12 Immunization Law (https://www.health.state.mn.us/people/immunize/basics/readyk12.pdf) Minnesota Childhood Blood Lead Screening Guidelines (https://www.health.state.mn.us/communities/environment/lead/docs/reports/leadscreengui de.pdf) VENA (https://wicworks.fns.usda.gov/resources/value-enhanced-nutrition-assessment-vena- guidance) PCS training and tools (https://www.health.state.mn.us/people/wic/localagency/training/pcs/index.html) Section 1.7: Data Privacy (https://www.health.state.mn.us/docs/people/wic/localagency/program/mom/chsctns/ch1/sct n1_7.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.