ParaRegs-Medi-Cal-Citizenship-Aliens-Residency

 

Code

Effective

ParaReg Text

420-1

 

 

To be eligible under the MN or MI Programs, an applicant or beneficiary shall be a California resident, as specified in §50320, who is one of the following:

 

(1)        A citizen of the United States.

 

(2)        A national of the United States from American Samoa or Swain's Island.

 

(3)        An alien lawfully admitted for permanent residence.

 

(4)        An alien permanently residing in the United States under color of law

(PRUCOL).

 

Certain amnesty aliens.

 

(§50301(b))

420-2

 

 

The CDHS has determined that it is not necessary to obtain an MC 13 (the Statement of Citizenship, Alienage and Immigration Status form) from U.S. Citizens or U.S. Nationals if an applicant makes that declaration and declares his or her place of birth on any form signed under penalty of perjury during the Medi-Cal application process.  In addition, counties must not deny, delay or reduce Medi-Cal eligibility for failure to provide an MC 13 if an applicant or beneficiary claims U.S. Citizenship or U.S. National status and provides information about his or her place of birth on any form signed under penalty of perjury as part of the Medi-Cal application process.  (All-County Welfare Directors Letter No. 03-14, April 11, 2003)

420-3

 

 

For Medi-Cal eligibility purposes, persons born in any of the following locations are U.S. Citizens:

 

>          The 50 states

 

>          The District of Columbia

 

>          Puerto Rico

 

>          Guam

 

>          The U.S. Virgin Islands

 

>          The Northern Mariana Islands.

 

(All-County Welfare Directors Letter No. 03-14, April 11, 2003)

421-1

ADDED 9/07

 

Pursuant to federal law, satisfactory documentation of citizenship/national status and identity must be obtained for:

 

            Most U.S. citizen/U.S. national applicants at the time of application; and

 

            Most U.S. citizen/U.S. national beneficiaries at the time of their next annual redetermination on or after the date of this ACWDL.

 

(ACWDL 07-12, June 4, 2007)

421-1A

ADDED 9/07

 

Assembly Bill 1807 (Chapter 74, Statutes of 2006) amended Welfare and Institutions Code Section 14011.2 to provide authority to implement the new documentation of citizenship/identity requirements of the Deficit Reduction Act. The new law requires the California Department of Health Services (CDHS) to implement the federal documentation of citizenship/identity requirement with as much flexibility as is allowed under federal law and policy. (ACWDL 07-12, June 4, 2007)

421-1B

ADDED 9/07

 

State law requires counties to assist applicants and beneficiaries who are required to provide evidence of citizenship/identity. State law further specifies that individuals who have been determined otherwise eligible, but are determined ineligible for full-scope Medi-Cal for failing to meet the citizenship/identity requirements within the reasonable opportunity period, will receive restricted services (including Medi-Cal emergency services and pregnancy-related care and state-only long-term care). (ACWDL 07-12, June 4, 2007)

421-1C

ADDED 9/07

 

Documentation of citizenship and identity is a one-time activity. Once documentation is provided, it will not be collected again, even if the beneficiary moves from one county to another, has a break in aid, or can show that he or she has already documented citizenship in another state’s Medicaid program (ACWDL 07-12, June 4, 2007)

421-1D

ADDED 9/07

 

Under the federal guidance, new applicants are treated differently from ongoing beneficiaries. New applicants declaring their U.S. citizenship who meet all other eligibility requirements are not eligible for Medi-Cal until acceptable documentation of citizenship and identity is provided (in which case they receive full-scope Medi-Cal back to the date of application and any retroactive eligibility period) or, if they stop making a good faith effort to provide it, they are only eligible to receive restricted Medi-Cal. (ACWDL 07-12, June 4, 2007)

421-2

REVISED 9/08

 

Applicants or beneficiaries in any of the following groups are exempt from the citizenship and identity requirements described in this letter:

 

·         Supplemental Security Income (SSI) beneficiaries (current)

 

·         Social Security Disability Insurance (SSDI – Title II) beneficiaries

 

·         Social Security Retirement and Survivors Insurance (RSI – Title II) beneficiaries who receive those benefits based on their own disability.

 

·         Medicare beneficiaries

 

·         Deemed eligible infants who are born in the U.S. and who therefore are citizens (includes children born to non-citizen mothers and whose delivery was covered by Medi-Cal)

 

·         Minor Consent applicants and beneficiaries

 

·         Children receiving adoption or foster care assistance, including Kinship Guardianship Assistance Payment (Kin-GAP) recipients

 

·         Infants eligible under the Abandoned Baby Program who are also born in the U.S. and have no documentation.

 

(ACWDL 07-12, June 4, 2007; ACWDL 08-29, July 9, 2008)

421-2A

ADDED 9/08

 

The Centers for Medicare and Medicaid Services (CMS) issued final federal regulations implementing the Deficit Reduction Act (DRA) Medicaid citizenship requirements in July of 2007.

 

The final regulations clarify that current SSI and Medicare beneficiaries are exempted

from the DRA citizenship and identity requirements under Section 1903 (x)(2) of the

Social Security Act. However, former SSI or Medicare recipients are not exempt because the Social Security Administration does not make available to CMS the bases for denial or discontinuance of SSI or Medicare.

 

Accordingly, effective the date of this letter, counties cannot exempt a Medi-Cal applicant or beneficiary from the DRA citizenship/identity requirements solely on the basis of their former receipt of SSI or their former enrollment in Medicare. However, current status in either will suffice. For example, if the individual no longer receives SSI, but is currently enrolled in Medicare, he or she can be exempted on the latter basis. (ACWDL 08-29, July 9, 2008)

421-3

ADDED 9/07

 

The new federal requirement to document U.S. citizenship/national status does not apply to individuals at the time presumptive eligibility or accelerated enrollment is established. These programs include:

 

·         Presumptive Eligibility for Pregnant Women,

 

·         Presumptive Medi-Cal Eligibility under the Breast and Cervical Cancer Treatment Program,

 

·         Child Health and Disability Prevention (CHDP) Gateway,

 

·         Medi-Cal Accelerated Enrollment at the Single Point of Entry

 

·         School Lunch Program, and

 

·         the joint Healthy Families/Medi-Cal application.

 

However, the evidence of citizenship/identity requirements are applicable when the individual’s ongoing Medi-Cal eligibility is determined, unless he or she is specifically exempted from these requirements. (ACWDL 07-12, June 4, 2007)

421-4

ADDED 9/07

 

Counties must provide:

 

·         To all applicants, the “U.S. Citizens and Nationals Applying for Medi-Cal Must Show Proof of Citizenship and Identity” (DHCS 0001); and

 

·         To all beneficiaries, the “Proof of Citizenship and Identity: New Requirements for Medi-Cal Beneficiaries Who Are U.S. Citizens or Nationals” (DHCS 0002).

 

(ACWDL 07-12, June 4, 2007)

421-4A

ADDED 9/07

 

The federal guidelines defining acceptable evidence of citizenship and identity include a five-tier “hierarchy” of evidence.

 

·         Tier one (or level one) evidence is the most reliable and establishes both citizenship and identity.

 

·         Tiers two through four include successively less reliable groups of documentation of citizenship only.

 

·         Tier five includes acceptable documentation of identity only.

 

Citizens or nationals who provide evidence of citizenship from Tiers Two through Four must also provide an identity document from Tier Five to meet the documentation of citizenship/identity requirement.

 

(ACWDL 07-12, June 4, 2007)

421-4B

ADDED 9/07

 

 

Evidence of Highest Reliability← ------------------------------------→ Evidence of Lowest Reliability

Primary Documents

(Tier 1)

These documents prove Citizenship and Identity

Secondary Documents

(Tier 2)

Must be Provided with Identity

Document from Table 2

Third Level Documents

(Tier 3)

Must be Provided with Identity

Document from Table 2

Fourth Level Documents

(Tier 4)

Must be Provided with Identity

Document from Table 2

s  United States passport issued without limitation, current or expired. Passports issued through 1980 may show more than one person.

 

s  Certificate of Naturalization (DHS Form N-550 or N-570)

 

s  Certificate of Citizenship (DHS Form N-560 or N-561)

 

s  U.S. Public Birth Record issued before age 5 1

 

s  Certification of Report of Birth (DS-1350)

 

s  Certification of Birth issued by the Department of State (Form FS-545 or DS-1350)

 

s  Report of Birth Abroad of a U.S. Citizen (FS-240)

 

s  U.S. Citizen I.D. Card (Form I-197 or I-179)

 

s  American Indian Card (I-872)

 

s  Northern Mariana Identification Card (I-873)

 

s  Final Adoption Decree2

 

s  Evidence of civil service employment by U.S. Government showing employment before 6/1/76

 

s  U.S. Military Record 2

 

s  Extract of a hospital record on hospital letterhead established at the time of birth.2,3

 

s  Life or health or other insurance record 2,3

s  Federal or State census record showing U.S. citizenship or a U.S. place of birth (Generally for persons born 1900-1950)4

 

s  Seneca Indian tribal census record 2,3

 

s  Bureau of Indian Affairs tribal census record of the Navaho Indians 2,3

 

s  U.S. State Vital Statistics official notification of birth registration 2,3

 

s  Amended U.S. public birth record, amended more than 5 years after the person’s birth 2,3

 

s  Statement signed by the physician or midwife who was in atten