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Effective: October 1, 2008 |
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11.05.05ar5 - Acceptable Documentation of U.S. Citizenship and Identity (Archive) |
Archived: March 1, 2010 |
The Centers for Medicare and Medicaid Services (CMS) established a hierarchy of documents that are acceptable as proof of U.S. citizenship and identity. People who are required to verify U.S. citizenship must also document their identity as part of this requirement.
Clients do not have to appear in person to submit documentation of U.S. citizenship and identity. However, it is recommended that if they are providing original documents, they bring them to the agency rather than mailing them.
Hierarchy of U.S. Citizenship Documentation.
Born or Previously Enrolled in MA in Another State.
Request original documents or copies certified by the issuing agency.
l Accept photocopies when they are mailed in. The law says that we need to look at original documents; however, do not ask clients to mail originals. Also accept faxed copies.
l Inform clients that they may have to provide the original documents at a later date.
l Make copies when the original is brought to the agency. Only copy the part of the document that is necessary for proof of citizenship or identity.
Identity can be documented with certain proofs or identifications such as a driver’s license. The Acceptable Documents of Identity form (DHS-4835) outlines the documents that can be used to verify identity.
Note: If U.S. citizenship is verified with a Level 1 document, the identity verification requirement is met. However, people who verify U.S. citizenship with documents from Levels 2-4 must also provide documentation of their identity.
There are four levels within the hierarchy, from Level 1 (most preferred) to Level 4 (least preferred). The Hierarchy of Citizenship Documentation form (DHS-4836) and the U.S. Citizenship Documentation for Collectively Naturalized Individuals from U.S. Territories form (DHS-4837) outline these levels, including the acceptable proofs for each.
Progress through the documentation hierarchy as quickly as possible:
l Start with Level 1, but do not delay moving to the next level if documentation from higher levels is not available.
l If documentation from higher levels of the hierarchy is not immediately available but the client is otherwise eligible, accept a lower level of documentation, such as affidavits, and approve eligibility.
l Clients remain eligible as long as they continue to cooperate with obtaining a higher-level document. However, if no higher-level documentation can be obtained, eligibility must continue based on the level of documentation the client is able to provide.
People who present documentation of U.S. citizenship from Level 1 do not have to provide separate documentation of their identity.
Note: People who were born outside the U.S. and were not U.S. citizens at birth must provide Level 1 documentation of U.S. citizenship to meet this requirement.
People who do not have Level 1 documentation of U.S. citizenship may provide a document from Level 2. They must also provide documentation of their identity (see DHS-4835).
One form of Level 2 documentation is the ”final adoption decree.” Children who were born in the United States and noncitizen children who were adopted by U.S. citizen parents receive a final adoption decree when the adoption is finalized. The noncitizen children automatically derive U.S. citizenship from their parents if they met all of the following on or after February 27, 2001:
n Have at least one U.S. citizen parent (by birth or naturalization).
n Are under age 18.
n Currently reside permanently in the U.S. with the U.S. citizen parent.
n Are lawful permanent residents (LPRs).
In such cases, the final adoption decree or a letter from the adoption agency is acceptable documentation of citizenship.
People may provide Level 3 documents if they do not have U.S. citizenship documentation from Levels 1 or 2. They must also provide documentation of their identity (see DHS-4835).
People may provide Level 4 documentation to prove their U.S. citizenship when they are not able to obtain documents from Levels 1-3. People may also provide Level 4 documentation when they request immediate coverage and documents from Level 1-3 are not immediately available to approve eligibility. Clients remain eligible as long as they cooperate with obtaining a higher-level document. Clients must also provide documentation of their identity (see DHS-4835).
One form of Level 4 documentation is affidavits. Affidavits are to be used in circumstances when a higher level of documentation is not immediately available and when no other form of documentation can be obtained. In order for affidavits to be acceptable documentation of U.S. citizenship, all of the following must be completed:
n The client must complete the Proof of U.S. Citizenship - Statement by Applicant/Enrollee form (DHS-4843A), explaining why documentary evidence of U.S. citizenship does not exist.
n Require the client to sign the Authorization to Request Birth Records (DHS-4841). This authorizes the agency to request a higher level of documentation from third parties.
n Obtain additional affidavits from at least two other people who are U.S. citizens and who have personal knowledge of the events establishing the client’s claim of citizenship. Use the Proof of U.S. Citizenship - Statement by Friend or Family Member form for these affidavits (DHS-4843B).
m At least one of the individuals making the affidavit must not be related to the client.
m These individuals must provide proof of their own U.S. citizenship and identity. A statement in the affidavit is sufficient proof.
m These individuals must state why documentary evidence of the client’s U.S. citizenship does not exist or cannot be obtained if they have knowledge of this information.
n All of the affidavits must be signed under penalty of perjury. Do not require notarization of the affidavits.
m Do not accept an affidavit to document identity if affidavits are used to document citizenship.
For clients who were born in Minnesota:
l Request documentation of identity and U.S. citizenship.
l If they do not have documentation of U.S. citizenship available, obtain birth records by sending the Minnesota Department of Health (MDH) form Minnesota Birth Record Application to MDH, or to a registrar’s office in your county.
DHS is working with the Minnesota Department of Health (MDH) on instituting an electronic data match for obtaining birth records of people born in Minnesota. Instructions will be provided when this becomes available.
Note: The process of obtaining birth records for clients born in Minnesota is expeditious, so a significant delay should not occur. However, clients who request immediate coverage must submit lower level documentation such as affidavits, while waiting for the birth records. Approve health care coverage using affidavits while waiting for the higher level of documentation if clients meet all other eligibility criteria.
Born or Previously Enrolled in MA in Another State
For clients who were born in another state:
l Request documentation of identity and U.S. citizenship.
l Require clients to sign the Authorization to Request Birth Records (DHS-4841) if they do not have documentation of U.S. citizenship available. This is a release of information form which authorizes the agency to request birth record documents from the state in which the clients were born.
l Request affidavits and approve health care coverage using the affidavits as documentation of U.S. citizenship if clients meet all other eligibility criteria while waiting to receive the higher-level documentation.
Note: If another state requests that a different form be used to request citizenship documentation, follow that state’s requirements.
l Information on obtaining records from other states is available through the National Center for Health Statistics.
For clients who were previously enrolled in MA in another state:
l Request documentation of identity and U.S. citizenship.
l Require clients to sign the Authorization to Request Birth Records (DHS-4841) if they do not have documentation of U.S. citizenship available. This is a release of information form which authorizes the agency to request birth record documents from the state in which the clients were born.
l Request affidavits and approve health care coverage using the affidavits as documentation of U.S. citizenship if clients meet all other eligibility criteria while waiting to receive the higher-level documentation.
l Once the release is signed, contact the state human services agency where the client previously resided to determine if citizenship and identity has been documented there.
l Request copies and indicate in case notes if the previous state has verified citizenship and identity. Approve health care program eligibility if all other criteria are met.
Example:
Suzanne and her two children recently moved to Minnesota from Missouri. Suzanne has been told it will take several months to obtain their birth certificates from Missouri. She has no other documents showing where they were born.
Suzanne signs the DHS-4841, giving permission to contact the Missouri vital records office to obtain their birth certificates. She also mails in affidavits to document citizenship.
Action:
Send a request to Missouri for the birth certificates. Approve health care coverage using affidavits as documentation of citizenship if all other eligibility criteria are met. Continue to pursue obtaining their birth records. Suzanne has fulfilled the citizenship documentation requirement.
For more information about U.S. citizenship and identity documentation requirements, see:
Process for Documentation of U.S. Citizenship and Identity.