Sec. 10.54.01.08. Nutritional Risk Determination Process

A. After an applicant is found to meet the Program’s income eligibility standards as specified in Regulation .07 of this chapter, in order for the applicant to receive WIC benefits, the applicant shall be found by the Program to be at nutritional risk.

B. In order to determine whether an applicant is at nutritional risk, a competent professional authority or a competent paraprofessional authority on the staff of the local agency shall perform a nutritional assessment based on either information gathered by the local agency or information provided by a competent professional authority not on the staff of the local agency.

C. A local agency may not compel an applicant to:

(1) Have the nutritional risk assessment completed by a specific medical provider; or

(2) Receive ongoing medical care under the local agency.

D. In conducting a nutritional risk assessment, a local agency, competent professional authority, or competent paraprofessional authority shall assess each applicant’s height (or length) and weight measurements at the time of certification by:

(1) Performing the measurements on each applicant;

(2) Requiring documentation of each applicant's measurements from a health care provider; or

(3) In its discretion, both §D(1) and (2) of this regulation.

E. Hematological Tests.

(1) In addition to the assessments set forth in §D of this regulation, a local agency, competent professional authority, or competent paraprofessional authority shall:

(a) Perform a hematological test for anemia such as a hemoglobin or hematocrit;

(b) Require documentation of the test from a health care provider at the time of certification for applicants with no other nutritional risk factor present; or

(c) In its discretion, both §E(1)(a) and (b) of this regulation.

(2) For applicants with a qualifying nutritional risk factor present at certification, a local agency, competent professional authority, or competent paraprofessional authority shall within 90 days of the certification:

(a) Perform a hematological test;

(b) Require documentation of the test from a health care provider; or

(c) In its discretion, both §E(2)(a) and (b) of this regulation.

(3) The local agency, competent professional authority, or competent paraprofessional authority shall perform or require documentation of the hematological test as follows:

(a) For a pregnant woman, during pregnancy;

(b) For a breastfeeding or postpartum woman, after the termination of pregnancy;

(c) For a breastfeeding woman 6-12 months postpartum, if a test was not performed after the termination of pregnancy or whose test result after pregnancy was below normal range;

(d) For an infant, 9-12 months old;

(e) For a child 12-24 months old, any time during that period, but, if possible, at 6 months after the infant test;

(f) For a child 2 years old or older, whose test result at the child's last certification is within the normal range, at least once every 12 months; and

(g) For a child 2 years old or older whose test result at the child’s last certification is below normal range, at 6 month intervals until the result is within normal range.

F. The local agency, competent professional authority, or competent paraprofessional authority shall obtain a [diet] nutrition history for each applicant.

G. Using the information gathered pursuant to §§D-F of this regulation, a competent professional authority or competent paraprofessional authority shall use the nutritional risk criteria found in Charts A and B in Regulation .11 of this chapter to determine if the applicant is at nutritional risk pursuant to the priority levels set forth in Regulation .09 of this chapter, and thus eligible for the Program.

H. A local agency:

(1) May determine a breastfeeding woman to be at nutritional risk if her breastfed infant has been determined to be at nutritional risk;

(2) May certify a breastfed infant to be at nutritional risk if the infant's mother is determined to be at nutritional risk;

(3) Shall place a breastfeeding mother and her infant in the highest priority level for which either is qualified;

(4) Shall place an applicant exhibiting more than one risk factor in the highest applicable priority level; and

(5) May not place an individual in successive certification periods whose only identified risk factor is possibility of regression of nutritional status.