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High Risk/Risk Factors

Cross-Reference for HuBERT


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Keywords/Phrases
113, 121, 425, 428, 903, default, food package, foster care, high risk, nutrition assessment, processing standards, pseudo-cert, recumbent, report, risk factor, scheduling appointments


System Incorrectly Assigning Risk Factor 113 to Children 3-5 Years Old Measured Recumbent (TMP-169)

Description: The system is incorrectly auto-assigning Risk Factor 113, Obese (Children 2-5 Years of Age), to children who are 3-5 years old and are measured recumbent. These measurements are also not being plotted on the Y2-6 grids as they should be.

What You Should Do: This should affect a very limited number of children since most 3-5 year old children are measured standing. However, if risk factor 113 is incorrectly assigned, document that it should NOT have been assigned in a note.

Resolution: This issue has been added to the issue's queue.

Identified Issues - Posted 5/13/14

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System is Incorrectly Assigning High Risk to Full-Term Infants Whose Length Falls below Grid and Percentile is N/A (TMP-153)

Description: The system is incorrectly assigning high risk for Risk Factor 121 when it is assigned to full-term infants whose length measurement falls below the lowest line on the Growth Grid resulting in a Length/Age percentile of N/A.

What You Should Do: You can use the Resolve High Risk Designation function in the Assign Certification Risk Factors screen to remove the incorrect system-assigned high risk.

Please note that if the infant is high risk for other risk factors, using the Resolve High Risk Designation function will remove ALL high risk, which may not be appropriate.

Resolution: This issue has also been added to the issue's queue.

Identified Issues - Posted 3/18/14

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System is Incorrectly Assigning Risk Factor 142 to Children between 1-2 Years Old with Weeks Gestation of 37 Weeks (TMP-149)

Description: Risk Factor 142 should be assigned to children 1-2 years of age if their Gestation value in Health Information is 37 Weeks and 0 days. However, the system is incorrectly assigning Risk Factor 142 to children 1-2 years old and 37 weeks gestation regardless of the number of days. This occurs both in the Certification Guided Scripts and when pseudo-certs are generated in the Participant Folder.

What You Should Do: Remove the link between the child's and mom's records since the child is over one year old and the link is unnecessary.

Linked mom

To do this, simply remove the checkmark in the On WIC checkbox in the child's Health Information screen and save the change.

Unlinked

Once the link is removed, the system will remove the incorrectly assigned Risk Factor.

Resolution: This issue has also been added to the issue's queue.

Identified Issues - Posted 3/10/14

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For Children over Two Years Old, the System is Not Assigning Risk Factor 121 and if 121 Is Already Assigned It Is Removing it when a Pseudo-Cert is Created (TMP-132)

Description: For children over two years old, whose height is less than the 10th percentile, the system is not auto-assigning Risk Factor 121. If a pseudo-cert is created and Risk Factor 121 has been previously assigned, the system is removing the risk factor even though it may still be applicable.

What You Should Do: When this happens, document that Risk Factor 121 should be assigned in a note.

Resolution: This issue has been added to the issue's queue.

Identified Issues - Posted 2/24/14

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Pseudo-Certs and Risk Factors Assigned during Nutrition Assessment

Changes made to information in the Participant Folder cause the system to reassess risk factor assignment, such as when you add new height/weight measurements. When changes to risk factors occur, a pseudo-cert is created. Remember, a pseudo-cert is simply a modification to how the certification period displays in the Risk Factors tab in HuBERT.

If risk factors were initially assigned during Certification Guided Script (CGS) in the Nutrition Assessment screen (as indicated below with the blue “V”), they display under the initial certification period.

Risk Factors tab with initial cert information circled in red

If a pseudo-cert is created, and a more recent Nutrition Assessment has been performed, as you may see occurring more often with mid-certifications, the system will review the most recent Nutrition Assessment for risk factors. If no risk factors were assigned during the most recent Nutrition Assessment, the system will not carry any risk factors forward into the pseudo-cert (as shown below). NOTE: CPAs are only required to assign all applicable risk factors during actual certifications; not mid-certs.

Risk Factors tab showing the risk factors not forwarding to pseudo-cert

Although it may appear that the risk factors have been removed, always keep in mind that pseudo-certs are simply a change to the way the certification period is displayed, and that the risk factors assigned during the initial certification continue to be associated with that certification.

April 2013 HuBERT Hints #2

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Best Practice for Scheduling Appointments

Best practice for scheduling appointments is to see high risk applicants within 10 calendar days of their date of application and all others within 20 calendar days of date of application. We realize there are special circumstances (e.g., small WIC agencies that have limited number of WIC clinic days per month). In situations where your agency is routinely unable to meet the Processing Standards, we recommend consulting with your state WIC Regional Consultant to determine the best options for WIC applicants.

2/20/2013 Memo - Processing Standards: Guidance for HuBERT Release 2.17.07

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Can Create Manual Food Package if System Unable to Create Default Food Package

This is a reminder that you can create manual food packages in instances where the Default Food Package (DFP) is not available due to age category changes and you receive the following message:

Message: There are no risk factors on which to base a default food prescription.  The defaulting feature will not be functional.

To create manual food packages, you need to be familiar with the food packages, including the appropriate number of food items (such as two whole grain food items for children). Each food item would then need to be added individually.

To do this:

  • Click the Add button;
  • Click the Add Food Item button
  • Select each food category from the drop-down list; and

Add Food Item window

  • Select the appropriate food item(s)

Add Food Item window with Legumes selected

The system will still base the quantities on the participant’s WIC Category, Age Category and Breastfeeding Amount.

We encourage you to always use the DFP because it is a shortcut for food packages that provides the correct number, quantity and food items for a participant. If you need to add a Risk Factor in order to use the DFP, you can assign a "transitional" Risk Factor. For children, this is Risk Factor 425X – Child transitioning to new age category and for infants transitioning from infant to child, this is Risk Factor 428 – Dietary Risk Associated with Complementary Feeding Practices.

January 2013 HuBERT Hints #2+

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Risk Factor 903 (Foster Care) – Change to CPA-Assign Only

Risk Factor 903 (Foster Care) is being changed from both System-Assign and CPA-Assign to just CPA-Assign.

Currently, the system is set to system-assign this risk factor based on whether the Living with Foster Parent(s) checkbox is selected in the Demographics screen. However, Risk Factor 903 (Foster Care) should only be assigned if a participant has entered the foster care system during the previous six months or has moved from one foster care home to another during the previous six months. Since HuBERT cannot assess this criteria based on the checkbox, and the CPA cannot over-ride it when it is system-assigned, the risk factor will no longer be system-assigned.

This is accurately reflected in MOM, Exhibit 5-T, which indicates that this risk factor is not assigned by HuBERT.

NOTE! You should continue to select the checkbox to indicate a participant is in foster care but only assign Risk Factor 903 as appropriate based on the criteria.

November 2012 HuBERT Hints #3

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How the High Risk Checkbox Works in HuBERT

The functionality of the Risk Factor checkbox is not intuitive. The following is simply an explanation of how it works.

High Risk Checkbox on the Certification Guided Script (CGS) screen

This checkbox indicates if a high-risk Risk Factor has been auto-assigned by the system. It is always disabled and will be auto-selected by the system once a high-risk Risk Factor is assigned by the system.

High Risk Checkbox in the Assign Risk Factors screen of the CGS or Participant Folder

This checkbox indicates that a high-risk Risk Factor has been assigned by the CPA from within the Assign Risk Factors screen.

  • The checkbox will be enabled and unchecked even if the High Risk checkbox on the CGS screen is checked and disabled.
  • The checkbox will be automatically checked and disabled when a high-risk Risk Factor is added by the CPA.
  • CPAs can check the High Risk checkbox to indicate a participant is high risk even if none of the Risk Factors are high-risk. In this instance, the checkbox will be checked but will remain enabled.
  • If the system-assigned high-risk Risk Factors are removed and a pseudo-cert created, the High Risk checkbox in the CGS will continue to be checked because it indicates that a CPA-assigned Risk Factor was high-risk or that the CPA selected the checkbox to make the participant high risk in lieu of the assigned Risk Factors.

NOTE! The functionality of the High Risk checkboxes will change in Release 2.19.

October 2012 HuBERT Hints #1

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Upcoming High Risk Appointments Report – Requires Appointment Type(s) with Short Description IND PICKUP

Description: The Upcoming High Risk Appointments Report is a recertified report available in the Clinic module of the Reports Environment. Some agencies have indicated that whenever they print the report, it doesn’t display any records. This is due to the criteria the report uses to pull records. The report will only pull appointments that have Appointment Types with a short description of IND PICKUP. If none of your Appointment Types have this Short Description, no records will display on the report.

What You Should Do: If you want to use this report, you will need to change the Short Description of appropriate Appointment Types to: IND PICKUP. (The Short Description does not have to be unique for each Appointment Type; it can be the same for multiple different Appointment Types.)

NOTE: You cannot modify the Short Description for the System-Defined Appointment Types (High Risk Follow-Up, Mid Certification, Initial Certification and Subsequent Certification).

April 2012 HuBERT Hints #3

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