1. November 2012

2. Agenda Overview of one year certification periods Rationale for change Procedures for one year certifications Timeline

3. Overview One-year certification periods New for Children Breastfeeding Women (Current but guidance new) Infants (current) Similar to requirements for one year certification of infants. Option for states to utilize. Transfers from other states may have 6 month certification periods

4. Certification Periods Infant: To the last day of the month the infant turns one year old Breastfeeding Woman: To the last day of the month in which her infant turns one year old or until the woman stops breastfeeding Child: Yearly ending with the last day of the month in which the child turns five years old

5. Why extend certification periods? Increase time spent on providing nutrition services Critical to achieving mission of WIC Program Prevent nutrition-related health problems Improve health status Not intended as a cost saving measure

6. Mid Certification Appointments One year certifications must include midpoint nutrition assessment Similar to infant mid certification

7. Components of Mid Certifications Anthropometric measurements Bloodwork (when necessary) Health and Nutrition Assessment Immunization check or follow up Nutrition counseling or education Referrals, if needed Food package changes, if needed

8. Not Required Proof of Income Proof of Address Proof of ID Rights and Responsibilities

9. Height and Weight Collect at mid certification Referral data less than 60 days old acceptable

10. Bloodwork According to bloodwork schedule Infants: screening between 9-12 months of age Children over 1: 6 months after infant test Around 15-18 months of age Most vulnerable time for children to manifest iron deficiency anemia 2-5 Years Old: Yearly, if normal Breastfeeding women: At Certification Follow up for low hemoglobin Referral data acceptable

11. Health and Diet Assessment Abbreviated assessment to identify major changes in health status Found at end of each VENA Tab listing of questions Includes Review of last certification information (1 st question) New concerns of participant New medical diagnosis Changes in eating pattern/food intake Changes in physical activity Check on immunizations, if appropriate Follow up on nutrition risks identified at certification

13. Other components Nutrition education Referrals Food Package

14. Enhancement to HuBERT Mid Certification Assessment screen Similar to CGS Only Height, Weight, Blood required link Others to help guide appointment

15. HuBERT Guidance Enter information via the participant folder Height, Weight and Blood Tab VENA Tab Referral, if needed Nutrition education Food package, if needed Benefit issuance

16. Timing of Mid Certifications Infants: at 9 months SAME Children: 6 th month of certification (5-7 month time frame) Breastfeeding women: 6 th month of certification OR with Infants mid-certification appointment

18. 1. Income verification is not a part of the mid certification appointment. 2. An infant certified on his birthday will be certified for one year. 3. The Infant Mid Cert appointment should take place at 6 months. 4. All of the questions asked at certification should also be asked at the mid certification appointment. 5. Bloodwork will never be required at a mid cert appointment.