3.0.8 TEMPORARY POLICY FOR SPECIAL POPULATIONS

It is expected that all non-exempt individuals requesting or receiving MA provide acceptable documentation to verify citizenship and identity from the federally approved Levels 1 through 5 or the state-defined Level 6 identity documentation, at application or review.  However, certain special populations may be particularly disadvantaged with regard to providing the required documentation.  For some persons within a special population, it will be allowable to accept other documents besides those listed in Levels 1-6, once it is determined that the person is unable to produce any Level 1-6 documentation.

NOTE :The following policy is in effect on a temporary basis pending the release of final federal regulations regarding the citizenship and identity requirement.  

This policy only applies when it is determined that an individual within a special population is in a situation where s/he does not have the ability to obtain citizenship or identity documentation from Level 1-6.  This policy should be used with discretion and only when an individual has no other means of meeting the requirement.  

Examples of individuals in special populations include, but are not limited to, persons who:
 

• Are physically or mentally incapacitated and whose condition renders them unable to provide necessary documentation.

• Are chronically homeless and whose living arrangement makes it extremely difficult to provide the necessary documentation.

• Are minors.

• Have religious beliefs that prevent them from securing the documentation.

There are two ways for individuals in special populations to meet the citizenship and identity documentation requirement:
 

1. Present other documents besides those listed in Levels 1-6 to meet the requirement as long as the document meets the general documentation requirement stated here:
    

“Any document used to establish U.S. citizenship must show either a birthplace in the U.S. or that the person is otherwise a U.S. citizen.  Any document used to establish identity must show identifying information that relates to the person named on the document.”

Some examples of documents that could be used to establish citizenship for special populations as long the document shows a birthplace in the U.S. or that the person is otherwise a U.S. citizen are:
 

• Hospital “souvenir” birth certificate

• • Baptismal certificate

  • Native American documentation

Below are examples of documents that could be used to establish identity for special populations as long the document shows some identifying information (e.g., name, address, telephone number, etc.) that relates to the individual:

• • Social Security Card

  • Driver education course completion certificate

  • School record or transcript

  • Credit card with signature

  • Voter registration materials

  • Permanent Resident card

2. The newly developed Statement of Citizenship and/or Identity for Special Populations form (HCF10161) can be used to meet the new requirement only when no other documentation is available from Levels 1-6 or item #1 above.
    

This form can be completed by a related or unrelated individual who knows the applicant/recipient, an authorized representative, an IM Agency worker, a worker for a housing agency who is aware of the individual’s living situation, a MA provider for a minor, etc.  Additional requirements concerning the HCF10161 are as follows:

• • The person completing the form attesting to another person’s citizenship must be a US citizen.

  • IM agencies are not required to verify the citizenship of the person signing the form.

  • Do not accept a form attesting to the citizenship of another individual when you know the person completing the form is not a US citizen.
    
     

    Example 2:  A 15 year old minor female applies for the Family Planning Waiver Program.  She does not have a copy of her birth certificate, but because she was born in Wisconsin , the IM worker is able to complete an online birth query to verify her citizenship.  The applicant does not have a driver license.  She does not have a school ID because the school district in which she lives does not issue a school identification card.  Further, she does not have nor is she able to provide any other acceptable document from Levels 1-6.  In this case, an HCF10161 can be signed by a Family Planning Waiver Program provider on the behalf of a minor female to verify her identity and meet the new federal requirement.

NOTE: An HCF10161 can be signed by the authorized representative of an individual who is not able to procure any other documents on his/her own.

While an IM worker is obligated to assist an applicant or recipient who asks for help in meeting the citizenship and identity requirement, this does not necessarily mean the IM worker must sign the HCF10161.  The signatory to the HCF10161 must know and be able to truthfully attest to the applicant/recipient’s citizenship or identity.  If an IM worker can do this for an applicant/recipient, then s/he may sign the form.

Maintain copies of any documents secured under this temporary policy in the case record.  Enter Case Comments to document why this policy was used and note whether the HCF10161 or another document was used to verify citizenship and identity.

NOTE:  An Individual who met the new citizenship requirement by using documents obtained under the new Level 6 or S+pecial Populations policy has complied with the federal requirement and is not required to provide other documentation at his/her next review.

If you are aware of an individual who meets the special population category outlined above and whose MA application has been denied or eligibility has ended because of his/her inability to provide acceptable documentation, contact the individual to see if the new temporary policies may be applied.  See Documentation Level 7 Citizenship and Documentation Requirement Updated list.

This page last updated in Release Number: 07-07

Release Date: 08/30/07

Effective Date: 08/30/07