West Virginia WIC Policy & Procedure 2.01 2.01 Certification of WIC Participants Effective Date: March 21, 2025 POLICY:

To qualify for the West Virginia WIC Program, infants, children, and pregnant, postpartum and breastfeeding women must:

1. Reside within the jurisdiction of the State (see Policy 2.04 Residency Requirements);

2. Meet the income criteria specified (see Policy 2.06 Income Eligibility Requirements);

3. Meet the nutrition risk criteria specified (see Policy 2.11 Nutrition Risk Criteria).

4. Be physically present unless there is an allowable exception (see 2.22 Emergency Certification and Section I below)

Note: infants are defined as persons under one year of age; children are defined as persons who have had their first birthday but have not yet attained their fifth birthday; pregnant women are defined as women determined to have one or more embryos or fetuses in utero; postpartum women are defined as women up to six months after end of pregnancy; and breastfeeding women are defined as women up to one year postpartum who are breastfeeding their infants.

PROCEDURE:

A. Applicant/Participant Certification Information

1. Applicant/participant certification information will be entered into the appropriate Crossroads Computer System screens.

B. Notification of Participant Rights and Responsibilities (Participant Agreement Form)

1. At certification appointments, each Program participant, parent/guardian or caretaker must read, or have read to him or her, the Participant Agreement Form (WIC-05), which outlines their Program rights and responsibilities (see Policy 2.10 Participant Rights and Responsibilities).

a. If the Participant Agreement Form (WIC-05) is unable to be electronically signed, the participant, parent/guardian or caretaker will sign a paper copy of the form. This must be scanned into the Income Information Screen in Crossroads.

C. Applicant Screening

1. Verification documents may be submitted in advance of or at the time of appointment in person, via fax, or via electronic means. If they prefer, participant(s) can email, text, or fax the required documentation for the appointment. The Local Agency will require each applicant to present the following verification documentation in person, via fax or electronically:

a. Proof of residency (see Policy 2.04 Residency Requirements); 1

West Virginia WIC Policy & Procedure 2.01 2.01 Certification of WIC Participants Effective Date: March 21, 2025 b. Proof of identity (see Policy 2.17 Verification of Identification of WIC Applicant/Participant and Parent, Guardian or Caretaker); and c. Proof of income eligibility (see Policy 2.06 Income Eligibility Requirements). Note: A shortened, thirty (30) day certification period, also referred to as a temporary certification, will be given to any applicant who is missing one of the three above required components of determining Program eligibility. See Policy 2.22 Temporary Certifications

2. The Nutritionist/Nutrition Associate (CPA) will determine if the applicant/participant is at nutritional risk through a client-centered nutritional assessment (see Policy 2.11 Nutrition Risk Criteria).

D. Proof of Pregnancy

1. Proof of pregnancy is required for eligibility but will not create a barrier to participation.

a. If pregnancy can be visually determined, written proof is not required.

b. Proof of pregnancy must include the participant’s name and the date of the test and/or exam.

i. Proof of pregnancy can include a positive pregnancy test statement from a healthcare provider or facility, or an ultrasound photo.

ii. Proof of pregnancy can be verified by the original (hard copy) or on an electronic device.

c. Home pregnancy tests will not be accepted as proof of pregnancy.

d. Proof of pregnancy will be documented on the Health Information Screen.

i. Proof of pregnancy will not be scanned into the Crossroads Computer System.

2. Pregnant women who are not visibly pregnant and do not have documented proof of pregnancy at the time of certification will be certified using Risk Code 503 – Presumptive Eligibility and issued benefits for 60 days if all other eligibility criteria are met. Crossroads automatically creates the certification period for 60 days and creates a family alert titled ‘Presumptive Eligibility for Pregnant Woman’ with the description ‘Participant is presumptively eligible pending completion of the eligibility determination process. Risk Factor 503 is assigned.’

a. Once proof of pregnancy is provided and documented on the Health Information screen in Crossroads, staff will navigate to the risk factor screen and save new risk codes, the Certification Summary screen now has a ‘Complete Assessment’ enabled. Clicking the ‘Complete Assessment’ button completes the certification assessment and provides the woman with the full certification period 2

West Virginia WIC Policy & Procedure 2.01 2.01 Certification of WIC Participants Effective Date: March 21, 2025

b. If proof of pregnancy is not obtained within sixty (60) days of the certification date, the participant will be terminated during the certification period due to insufficient information available (see Policy 2.09 Notification of Ineligibility).

i. A new certification, including new anthropometric measurements and hematological testing, will be required after the participant is terminated.

c. Proof of pregnancy will be required prior to benefit issuance for an applicant whose past status as a pregnant WIC participant was not verified.

3. WIC certification will be performed at no cost to the applicant. WIC personnel should ensure that pregnant applicants have prenatal care services that include pregnancy testing at no cost to the applicant if done to establish WIC eligibility.

E. Breastfeeding Women

1. Breastfeeding women are defined as women up to one year postpartum who are breastfeeding their WIC-eligible infant(s).

2. Breastfeeding is the practice of feeding breast milk to her infant on an average of at least once a day.

3. Non-birth mothers, who are breastfeeding a WIC-eligible infant, and who are otherwise WIC-eligible, will be certified as breastfeeding.

a. Examples of a non-birth mother include: a wet nurse, an adoptive mother, or a foster mother. Note: a foster mother must have prior approval by a foster care special service supervisor or child welfare supervisor.

b. This does not include women who donate breast milk to a milk bank.

c. The CPA must contact the State Help Desk for unique infant-mother dyad circumstances outside the scope of Crossroads

4. When a woman has a nutritional risk condition that contraindicates breastfeeding an infant a nutrition assessment based on reported diagnosis, guidance and education will be provided. Based on the results of this assessment, it is at the CPA’s discretion to provide a referral or follow up with the health care provider as necessary prior to certifying the woman as breastfeeding.

a. The postpartum birth mother who meets WIC eligibility criteria may receive benefits, as a non-breastfeeding, postpartum participant.

F. Postpartum Women

1. Postpartum women will be certified as a WIC participant up to six (6) months after end of pregnancy. 3

West Virginia WIC Policy & Procedure 2.01 2.01 Certification of WIC Participants Effective Date: March 21, 2025

a. A woman will be certified to receive postpartum benefits regardless of the reason of the termination or duration of pregnancy.

2. Women who are certified as breastfeeding and discontinue breastfeeding before six (6) months postpartum, will be certified as non-breastfeeding, postpartum.

G. Infants

1. Infants are defined as persons under one year of age.

2. Infants must be physically present at the WIC clinic for their certification appointment.

H. Children

1. Children are defined as persons who have had their first birthday but have not yet attained their fifth birthday.

2. A child must be physically present at the WIC clinic during each certification appointment.

I. Exceptions to Physical Presence

1. An exception to physical presence will be granted to applicants/participants with disabilities who are unable to be physically present at the WIC clinic because of their disabilities. Examples of such situations include:

a. A medical condition that necessitates the use of medical equipment that is not easily transportable;

b. A medical condition that requires confinement to bed rest; and

c. A serious illness that may be exacerbated by coming into the WIC clinic.

2. The parent/guardian or caretaker of a WIC applicant/participant who is not able to attend WIC clinic because of a qualifying condition will attend the scheduled certification appointments, and will provide certification eligibility information and the following documentation on a healthcare provider’s letterhead or prescription pad:

a. The diagnosis or reason for confinement and duration of confinement;

b. Anthropometric measurements that are less than sixty (60) days old;

c. Hemoglobin data, if age one (1) or older, that is less than ninety (90) days old. The blood value date must meet the criteria as established in Policy 2.13 Hematological Testing.

d. The medical excuse must be scanned into Crossroads on the Income Information Screen.

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West Virginia WIC Policy & Procedure 2.01 2.01 Certification of WIC Participants Effective Date: March 21, 2025 3. WIC personnel will document the physical presence exemption reason on the Crossroads Participant Demographics Screen.

a. Anthropometric measurements and hemoglobin data will be entered into the Anthro/Lab Screen.

4. The parent/guardian or Caretaker will complete a nutrition assessment for the WIC applicant/participant.

5. A WIC applicant/participant with a short-term illness will be rescheduled and attend WIC clinic at a later date.

REFERENCES:

1. WIC Regulations 7 CFR 246.2 Definitions 2. WIC Regulations 7 CFR 246.7 Certification of Participants 3. Final WIC Policy Memorandum 96-1, Non-Birth Mothers Certified as Breastfeeding Women 4. Final WIC Policy Memorandum 2001-2, WIC Blood Work Requirements 5. SFP 09-046, WIC Hematological Data Requirements: Clarification 6. West Virginia WIC Participant Agreement, WIC-05 7. USDA BF Policy and Guidance, July 2016, Chapter 1 8. USDA - Certification and Eligibility Resource and Best Practices Guide 5