Kansas Automated Risk Factor Update - PDF Document

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  1. Kansas Automated Risk Factor Update – July 2018 There are several pending federally-required risk factor changes. The new and revised risk factors that are automated in KWIC will take effect July 16, 2018 with the release of KWIC Version 3.4. This update provides training on the automated risk factors. See also policy CRT 07.00.00 Nutritional Eligibility. The remaining revised risk factors take effect October 1, 2018. The State Agency will release details in September with other FFY2019 PPM changes. Note: The State Agency will not release revised Risk Factor Manuals until September so local staff can have all the revisions at once. Until then, use this Update along with the existing manuals. Watch for more information with the other FFY2019 PPM changes. http://www.kansaswic.org/local_agencies/risk_factors.html Even though KWIC will automatically assign many risk factors, certifying staff members should still be knowledgeable about the risk factor definitions. Notice that some of the automated risk factors contain a warning that conditions might exist in which the certifying staff member might need to assign the risk factor manually, e.g. a woman with a history of preterm birth who has never been on WIC in Kansas. During nutrition assessment/certification, the certifying staff member should thoughtfully review the entire list of risk factors, including the ones that are auto-assigned. Staff should: oNotice that, as before, automated risk factors in the Nutrition Risk Manuals are identified with the symbol . The definition describes the auto-assignment in detail. oReview which risk factors require documentation of a physician’s diagnosis and open the auto-assigned risk factor to mark the “Based on MD Diagnosis” checkbox. At the end of each manual, Table 3 lists all the risk factors that require documentation of a physician’s diagnosis. oTreat the auto-assigned risk factors like those that are manually assigned. If notes are needed to clarify severity, treatment, etc., either make a risk note, or document in the regular KWIC Notes. Details about new automated risk factors are included in the following table. The Definition and Notes column contains the definition with particular text about automation highlighted in yellow. Risk Factor Update, July 2018 Page 1

  2. Risk Level Risk Category Definition & Notes Priority USDA # Infant and Children – New & Revised Automated Risk Factors  Slowed/Faltering Growth Pattern I < 6 mon.  New 1 High 135 Infants Birth to 2 weeks Excessive weight loss after birth, defined as > 7% birth weight Slowed/Faltering Growth Pattern Infants 2 weeks to 6 months Any weight loss. Use two separate weight measurements taken at least eight weeks apart. This can include birth weight. KWIC will auto-calculate based on the infant’s current age and age of anthropometric measures.   Preterm Delivery Revised Infant 1 Low 142  Infant born ≤ 36 6/7 weeks gestation. & Preterm Delivery   Preterm Delivery Previous title: Prematurity Child < 24 mon.  Child < 24 months of age and born ≤ 36 6/7 weeks gestation. 3 Low (Previous cut-off: ≤ 37 weeks) KWIC will auto-calculate based on the infant’s gestational age in whole weeks as entered into KWIC by staff (Anthropometric Measures screen.) Risk Factor Update, July 2018 Page 2

  3. Risk Level Risk Category Definition & Notes Priority USDA # New 1 Low 142   Early Term Delivery Infant  Early Term Delivery Infant born > 37 0/7 and < 38 6/7 weeks gestation. &   Early Term Delivery Child < 24 mon. Child < 24 months of age and born > 37 0/7 and < 38 6/7 weeks gestation. 3 Low KWIC will auto-calculate based on the gestational age in whole weeks as entered into KWIC by staff (Anthropometric Measures screen.) Pregnant, Breastfeeding and Postpartum Women – New & Revised Automated Risk Factors  * History of Preterm Delivery Any history of delivery of an infant born ≤ 36 6/7 weeks gestation. KWIC will auto-calculate if the woman has ever had History of Preterm Delivery or Preterm Delivery at Last Delivery risk factor assigned for any previous certification. *Staff must assess and manually assign if the woman was not previously enrolled in the Kansas WIC Program or previous data is not recorded in KWIC. Revised PG 1 Low 311 History of Preterm Delivery  * History of Early Term Delivery New PG 1 Low 311 History of Early Term Delivery Any history of delivery of an infant born > 37 0/7 and < 38 6/7 weeks gestation. Risk Factor Update, July 2018 Page 3

  4. Risk Level Risk Category Definition & Notes Priority USDA # KWIC will auto-calculate if the woman has ever had History of Early Term Delivery or Early Term at Last Delivery risk factor assigned for any previous certification. *Staff must assess and manually assign if the woman was not previously enrolled in the Kansas WIC Program or previous data is not recorded in KWIC.  * Preterm Delivery at Last Delivery Delivery of an infant born ≤ 36 6/7 weeks gestation at the most recent delivery. KWIC will auto-calculate if weeks gestation at delivery is ≤ 36 6/7 weeks for most recent pregnancy. Revised BF & PP BF-1 PP-5 Low 311 Preterm Delivery At Last Delivery This is based on calculation between the Estimated Due Date and Pregnancy End Date on the mother’s record to determine the weeks gestation at birth for the most recent pregnancy. It is important to update the Estimated Due Date during pregnancy if the mother reports a change. *Staff must assess and manually assign if the woman was not enrolled in the Kansas WIC Program during pregnancy because there is no entry to Estimated Due Date. If in review of the risk factors, the auto-assigned risk factor is incorrect, be sure to remove the risk factor before saving. This currently does not auto-calculate in the unusual occurrence of using “Add New Group Member” instead of recording the infant’s birth on Record End of Pregnancy. Risk Factor Update, July 2018 Page 4

  5. Risk Level Risk Category Definition & Notes Priority USDA #  * Early Term at Last Delivery Delivery of an infant born > 37 0/7 and < 38 6/7 weeks gestation at the most recent delivery. KWIC will auto-calculate if weeks gestation at delivery is > 37 0/7 and < 38 6/7 weeks for most recent pregnancy. New BF & PP BF-1 Low 311 PP-6 Early Term At Last Delivery This assignment is based on calculation between the Estimated Due Date and Pregnancy End Date on the mother’s record to determine the weeks gestation at birth for the most recent pregnancy. It is important to update the Estimated Due Date during pregnancy if the mother reports a change. *Staff must assess and manually assign if the woman was not enrolled in the Kansas WIC Program during pregnancy because there is no entry for Estimated Due Date. If in review of the risk factors, the auto-assigned risk factor is incorrect, be sure to remove the risk factor before saving. This currently does not auto-calculate in the unusual occurrence of using “Add New Group Member” instead of recording the infant’s birth on Record End of Pregnancy. Risk Factor Update, July 2018 Page 5