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State of Wisconsin |
HISTORY |
The policy on this page is from a previous version of the handbook.
4.2. Documenting Citizenship and Identity
4.2.2 Reserved
4.2.3 Reserved
4.2.4 Hierarchy of Documentation
4.2.5 Agencies Paying for Documentation
4.2.6 Policy For Special Populations
4.2.7 Situations which require Special Documentation Processing
4.2.7.2 Presumptive Eligibility/Express Enrollment (EE)
4.2.7.3 Individuals Without Verification and Affect on Household Eligibility
4.2.7.4 Child Citizenship Act 2000
4.2.7.6 Individuals in Institutional Care Facilities
The Federal Deficit Reduction Act of 2005 requires persons applying for or receiving Medicaid (MA), BadgerCare Plus, or Family Planning Only Services (FPOS) benefits, who have declared that they are a U.S. citizen, to provide documentation of their U.S. citizenship and identity. Agencies must comply with the BadgerCare Plus requirement to document citizenship and identity in order for the State to obtain Federal matching funds. As part of on-going DHS quality assurance initiatives, periodic quality control reviews will be done on randomly selected cases throughout the state to monitor agency compliance. Cases will be examined to determine if proper documentation was used to verify citizenship/identity and if the proper verification code was used. The Department will work with non-compliant agencies to achieve compliance. 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. In addition, any document used to establish identity must show identifying information that relates to the person named on the document. For a list of all the allowable documentation, see the Acceptable Citizenship and Identity Documentation. If an individual has provided proof of citizenship in a state other than WI, the IM worker can either request that the individual resubmit the documentation or request and obtain a copy or electronic copy of the original documentation reviewed by the other state to keep on file in WI. Agencies may accept citizenship and identity documents from a woman whose last name has changed due to marriage or divorce if the documentation matches in every way with the exception of the last name. If there is any doubt, the agency may request that the individual provide an official document verifying the change such as a marriage license or divorce decree. If an individual has changed his or her first and last name, he or she must produce documentation from a court or governing agency documenting the change. Applicants who are otherwise eligible and are only pending for verification of citizenship and identity must be certified for health care benefits, within the normal application processing timeframe (30 days from the filing date ), as long as the applicant has notified the worker that he or she is taking steps to obtain the necessary documentation or has asked for the worker’s assistance to obtain it. The applicant will have 95 days after the request for verification to provide the requested documentation. If the requested verification is not provided by the end of the 95 days, the eligibility will be terminated with Adverse Action notice, unless the eligibility worker believes a good-faith effort is being made by the applicant/member and the worker chooses to extend the good-faith period. This 95 day period applies to applications, reviews and person adds. An individual can only receive one 95 day good-faith effort period in his or her lifetime. Once the citizenship and identity requirement is met, it need not be applied again, even if the person loses Medicaid at some point and later re-applies. A person should ordinarily be required to submit evidence of citizenship and identification only once, unless other information is received causing the evidence to be questionable. Note: Do not re-verify identity for a person who has had his or her identity verified through the signing of a Statement of Identity for Children Under 18 Years of Age, F-10154. Documentation submitted by the applicant or member to satisfy the requirement must be maintained in the case record. See Process Help Chapter 68.1 for tools that IM workers can use to assist clients and applicants in meeting this requirement.
The citizenship and identity documentation requirement covers all non-exempt applicants and members of:
The following populations are exempt from the citizenship and identity documentation requirement:
Former SSI and Medicare Recipients
States cannot consider individuals who received Medicare or SSI in the past to be exempt. An individual is not required to be a citizen to receive these benefits. Since SSA does not share information regarding the reason benefits were lost, it is not possible to determine if the termination was due to citizenship status or not. Note: Confirm the receipt of SSI, SSDI, and Medicare through SOLQ or DXSA. Note: Qualified providers who conduct BadgerCare Plus express enrollment determinations must not apply the citizenship and identification documentation requirement to persons seeking eligibility through express enrollment. Persons determined eligible for BadgerCare Plus through express enrollment are not subject to the documentation requirement until they file a formal application with the local Income Maintenance Agency.
The list of valid documents used to verify citizenship and identity is divided into five levels in accordance with federal regulations. Level 1 consists of documents of the highest reliability and can prove both citizenship and identity. Levels 2 through 4 consists of documents that can prove citizenship only with Level 2 being the most reliable and Level 4 the least reliable. Level 5 consists of documents that can prove identity only. Applicants and members must provide documentation from the highest level available that can be obtained during the reasonable opportunity period. If an individual needs to verify citizenship and/or identity at the point of application or renewal he or she should try to fulfill the requirement with proof he or she already has available. If an applicant/member contacts the agency, work with him or her to check Documentation Levels 1 through 5 to determine if anything on the list is readily available to the applicant/member. If an applicant/member was born in Wisconsin, use the online Birth Query to verify citizenship. In certain circumstances the agency can authorize payment of documentation for an applicant/member. See the 4.2.5, Agencies Paying for Documentation. Level 1 - Evidence of Citizenship and Identity Primary evidence documents both citizenship and identity. Primary evidence of citizenship and identity is the most reliable way to establish that the person is a U.S. citizen. If an individual presents documents from level 1, no other information is required; however, relatively few BadgerCare Plus applicants and members may be able to provide documents from this group.
Level 2 - Evidence of Citizenship
Secondary evidence of citizenship is the next most reliable way to establish someone is a US citizen. Many BadgerCare Plus applicants and members will be able to present documents from level 2 during the reasonable opportunity period and should be encouraged to do so. Note, however, that a document from this group is evidence of U.S. citizenship only and must be accompanied by evidence of identity. Note: Completing an on-line birth query (level 2 documentation) can be done for all persons born in Wisconsin. Enter tran code MNOS on CARES mainframe screen, hit enter, then F2. There is no cost to the agency to use this method of verification.
Level 3 - Evidence of Citizenship
Third level evidence of U.S. citizenship is acceptable and may be presented by applicants and members who are unable to obtain level 1 or level 2 evidence during the reasonable opportunity period. As with level 2 evidence, a document from this group is evidence of U.S. citizenship only and must be accompanied by evidence of identity.
Level 4 - Evidence of Citizenship
Fourth level evidence of U.S. citizenship is acceptable evidence of the lowest reliability. While most BadgerCare Plus applicants and members will be able to present documents at this level, they should do so only if unable to obtain evidence of citizenship from the other levels during the reasonable opportunity period. As with second and third level evidence, a document from this group is evidence of U.S. citizenship only and must be accompanied by evidence of identity.
Level 5 - Evidence of Identity
Level 5 documentation can only be used to verify identity. Documentation of citizenship from levels two through four must be accompanied by evidence of the applicant’s or member’s identity from Level 5. The applicant may provide three or more corroborating documents, such as a marriage license, divorce decree, high school or college diploma, property deed/title, death certificate, or employer ID card, to prove identity. This option can only be used if the applicant submitted level 2 or 3, not level 4, citizenship documentation. The applicant may not use a document that was also used for citizenship verification.
Naturalized Citizens
Naturalized citizens must provide level 1 or 2 citizenship documentation. The Citizenship Affidavit is also available for this population if no document from level 1 or 2 is available. This group cannot use level 3 or 4 documentation.
The worker can authorize payment for a birth certificate from the state where the applicant was born and/or a WI State ID if an applicant/member:
Note: If a member has obtained and already paid for his or her own documentation and later asks the IM agency for reimbursement of those costs, the IM agency should not provide reimbursement. If an individual has requested and paid for documentation before applying but does not yet have the documentation, do not confirm program eligibility for this individual. Eligibility can only be granted once the individual receives documentation and provides it to the agency.
If an individual was born in Wisconsin and not found in the Wisconsin online birth query, agencies may authorize payment for a WI birth certificate to verify citizenship. IM agencies should pay for a birth certificate or state ID card before using the "Special Populations" option (4.2.6). If there is an opportunity to obtain a document that meets federal guidelines then that should be pursued. However, when an applicant/member lacks any identity documentation needed to apply for a birth certificate or lacks any citizenship documentation to be able to apply for an ID card, it is appropriate to consider using the Written Affidavit for citizenship and/or "Special Populations Policy. In order to obtain birth certificates or state ID cards for applicants/members, agencies need to follow the process outlined in Chapter (68.2.5) of Process Help.
It is expected that all non-exempt individuals requesting or receiving BadgerCare Plus provide acceptable documentation to verify citizenship and identity from the federally approved Levels 1 through 5 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 1-5, once it is determined that the person is unable to produce any Level 1-5 documentation. This policy only applies when it is determined that an individual within a special population is in a situation where he or she does not have the ability to obtain citizenship or identity documentation from Level 1-5 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:
There are two ways for individuals in special populations to meet the citizenship and identity documentation requirement:
"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:
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:
| Example 1: Due to their religious practices, an Amish family is not able to present a birth certificate for their child because the child was not born in a traditional hospital setting and no record of the child’s birth exists within the state system. In addition, the child is home schooled so there is no school identification card to present for identification verification. However, the family is able to produce a signed letter from their church leader that states the child’s birth place and birth date. This document can be used to satisfy the citizenship and identification requirement under the policy for Special Populations. |
This form can be completed by a related or unrelated individual who knows the applicant/member, an authorized representative , an IM Agency worker, a worker for a housing agency who is aware of the individual’s living situation, a BadgerCare Plus provider for a minor, etc. Additional requirements concerning the Statement of Citizenship and/or Identity for Special Populations form 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 Only Services 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 1-5. In this case, an F-10161 can be signed by a Family Planning Only Services program provider on the behalf of a minor female to verify her identity and meet the federal requirement. |
Note: A Statement of Citizenship and/or Identity for Special Populations form can be signed by the authorized representative of an individual who is not able to procure any other documents on his or her own. While an IM worker is obligated to assist an applicant or member who asks for help in meeting the citizenship and identity requirement, this does not necessarily mean the IM worker must sign the Statement of Citizenship and/or Identity for Special Populations form. The signatory to the Statement of Citizenship and/or Identity for Special Populations form must know and be able to truthfully attest to the applicant/member’s citizenship or identity. If an IM worker can do this for an applicant/member, then he or she 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 Statement of Citizenship and/or Identity for Special Populations form or another document was used to verify citizenship and identity. Note: An individual who met the citizenship requirement by using documents obtained under the Special Populations policy or by using the Statement of Citizenship and/or Identity for Special Populations form 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 BadgerCare Plus application has been denied or eligibility has ended because of his or her inability to provide acceptable documentation, contact the individual to see if the Special Populations policies may be applied. See Documentation Level 7 Acceptable Citizenship and Identity Documentation.
A person being added to a case is subject to the verification requirement at the time of his or her application. Inform the applicant of the documentation requirement and give him or her the "reasonable opportunity period” to comply. Do not grant eligibility for the individual until he/she has submitted valid documentation. If documentation is not received timely, deny Medicaid for that individual only. Do not require other non-exempt household members to submit citizenship or identification documentation until their next review.
Qualified providers who conduct BadgerCare Plus presumptive eligibility/express enrollment determinations must not apply the citizenship and identification documentation requirement to persons seeking presumptive eligibility. Persons determined presumptively eligible for BadgerCare Plus are not subject to the documentation requirement until they file a formal application with the local Income Maintenance agency.
IM workers should not delay an individual household member’s eligibility when awaiting another household members’ citizenship or identity verification. The individual pending for citizenship/identity should be counted as part of the group when determining eligibility for other group members. See Process Help Chapter 68.2 for processing instructions.
Certain foreign-born individuals have derivative U.S. citizenship as a result of the Child Citizenship Act (CCA). Within the context of the BadgerCare Plus citizenship verification requirement, this means that for any applicant or member claiming citizenship through the CCA, IM workers should not request documentation for that person. In these cases, IM workers need to acquire documentation proving the citizenship and identity of at least one U.S. citizen parent. The parent’s U.S. citizenship is the basis for the child receiving derivative citizenship. For persons who meet the citizenship verification requirement through the means allowed in the CCA, this is considered level 2 evidence. Therefore this counts for citizenship only and the individual needs to provide another document to verify identity. The code <CA> should be used in the BadgerCare Plus Citizenship Verification field. See 4.1.1 Child Citizenship Act of 2000
As a reminder, do not request or require citizenship and identity documentation from individuals who have not declared that they are citizens. Non-citizens who apply for IM programs are not subject to this policy. Legal non-citizens are subject to the verification process through FDSH and SAVE, and undocumented non-citizens do not have any status that can be verified. (See Process Help Section 44.2.2.11 Immigrant/Refugee Verification for instructions on using FDSH and Process Help Chapter 82 for instructions on using SAVE .) Undocumented non-citizens can apply for Emergency Medicaid or BadgerCare Plus Prenatal Program and should not be subject to the citizenship and identification verification policy. When an individual who had legal non-citizen status subsequently gains U.S. citizenship, this is recorded in SAVE. Therefore SAVE can be used to verify these individuals' citizenship. The verification result from SAVE will be used to verify these individuals' citizenship. The verification result from SAVE will be "individual is a US Citizen." Use the <SV> code in the Medicaid Citizenship verification field when using SAVE for this population. These individuals do still need proof of identity since the SAVE verification is considered to be Level 2 citizenship documentation.
Disabled individuals in institutional care facilities may have their identity attested to by the facility director or administrator when nothing else is available. Use the Statement of Identity for Persons In Institutional Care Facilities, F-10175, for this purpose. A medical institution can be, but is not limited to, skilled nursing facilities (SNF), intermediate care facilities, IMDs, and hospitals.
This page last updated in Release Number: 17-04
Release Date: 12/13/2017
Effective Date: 12/13/2017
The information concerning the BadgerCare Plus program provided in this handbook release is published in accordance with: Titles XI, XIX and XXI of the Social Security Act; Parts 430 through 481 of Title 42 of the Code of Federal Regulations; Chapter 49 of the Wisconsin Statutes; and Chapters HA 3, DHS 2 and 101 through 109 of the Wisconsin Administrative Code.
Publication Number: P-10171