Citizenship and Alienage 510-05-35-45

(Revised 7/1/09 ML #3183)

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(N.D.A.C. Section 75-02-02.1-18)

 

  1. As a condition of eligibility, applicants or recipients must be a United States citizen or an alien lawfully admitted for permanent residence. Verification of citizenship, naturalization, or lawful alien status must be documented. This section addresses:

  1. Exceptions to verification of citizenship;

  2. Newborn children;

  3. Verification requirements;

  4. Acceptable documentation for US citizens and naturalized citizens; and

  5. Individuals born in Puerto Rico, Guam, the Virgin Islands, the Northern Mariana Islands, and Nationals from American Samoa.

For aliens, apply the appropriate policy identified in sections 510-05-35-50 through 510-05-35-70.

  1. Exceptions to verification of citizenship. The following individuals are exempt from the citizenship verification requirements:

  1. SSI recipients who claim that they are US Citizens and that claim is not questionable (can prove using SDX or TPQY SSI match);

  2. Medicare beneficiaries who claim that they are US Citizens and that claim is not questionable (can prove using TPQY SSA match);

  3. Individuals receiving SSA disability insurance benefits based on their own disability;

  4. Individuals receiving Foster Care maintenance payments;

  5. Individuals receiving Subsidized Adoption payments; and

  6. Individuals receiving Subsidized Guardianship payments.

  1. Newborn children. A child, born to a woman who has applied for and been determined Medicaid eligible and is in receipt of Medicaid when the child is born, may be eligible without verifying citizenship for up to one year as long as the Mother is eligible or would remain eligible if she were pregnant and as long as the child remains in the Mother's household. Citizenship verification for the child must be supplied at the next redetermination of eligibility. This provision also applies in instances where labor and delivery services were furnished prior to the date of the Medicaid application and covered based on retroactive eligibility.

Children who are born to a woman who is not eligible for regular Medicaid must comply with the verification requirements if Medicaid is requested.

  1. Verification Requirements:  Applicants must provide satisfactory documentary evidence of citizenship or naturalization.   

  1. The only acceptable verifications from individuals must be either originals or copies certified by the issuing agency.  Photocopies or notarized copies may not be accepted; however, a photocopy of the original document must be maintained in the casefile.

  2. Verifications may be accepted from another state agency that may have already verified citizenship, but a photocopy must be obtained for the casefile.

  3. Once an individual's citizenship is documented and recorded, subsequent changes in eligibility do not require repeating the documentation unless questionable, or there is no verification in the casefile.

Example:  John Doe applies for Medicaid and supplies his citizenship verifications and his case closes.  If his casefile is purged after the three year retention period and he reapplies, he will need to again provide his verifications so that his casefile is complete.

  1. If an individual has made a good faith effort to obtain verifications, but cannot obtain them within the processing timeframes , or because the documents are not available, assistance must be provided to the individual in securing evidence of citizenship.  Matches with other agencies may be used to assist the individual.

  2. Acceptable documentation for US citizens and naturalized citizens.

  1. There are three documents that may be accepted as proof of both citizenship and identity because each contains a photograph of the individual named in the document and either the US or a state government has established the citizenship and identity of the individual.  These three documents are considered to be the primary (Level 1) and preferred verification documents.

 

Primary Verifications

(Level 1)

   

These Documents Verify both Citizenship and Identity:

Explanatory Information:

US Passport

  • Issued by the Department of State

  • Does not have to be currently valid, as long as it was issued without limitation; (any passport issued with a limitation cannot be used to verify citizenship, but CAN be used to verify identity)

  • Through 1980, spouses and children were often included on one passport; after that each person is issued his own passport.

Certificate of Naturalization (DHS/INS Forms N-550 or N-570)

  • Department of Homeland Security or Immigration and Naturalization Service (INS) issues for naturalization.

Certificate of US Citizenship (DHS/INS Forms N-560 or N-561)

  • Department of Homeland Security or INS issues certificates of citizenship to individuals who derive citizenship through a parent.

 

  1. If an individual does not have one of the primary verifications, the individual must supply one document from one of the Citizenship lists (Levels 2, 3, or 4) and one document from the Identity lists (Levels 2, 3, or 4).

The verifications are listed in levels and the levels indicate the degree of reliability of the verifications. Level 1 has the highest reliability and is the preferred verification. Level 4 has the lowest reliability and those verifications should be used only when documents from levels 1-3 are not available. The verifications in level 1 must be requested prior to requesting those in level 2, those in level 2 must be requested prior to requesting those in level 3, and so on.

Verification documents must be presented in their official and original form as received from the issuing agencies. Photocopies or notarized copies are not acceptable. Once an original document is presented, a photocopy must be made and maintained in the casefile.

 

Secondary Verification of Citizenship

(Level 2)

   

Acceptable Verifications:

Explanatory Information:

Certificate of Birth in the United States

  • Must have the embossed seal of the issuing agency

  • North Dakota only issues certified copies.  If it does not have the raised seal, it is not a certified copy - i.e. the old black and white prints

  • The original must have been recorded before the person was 5 years of age.  (For issuance date, use the "Date received by Local Registrar".)  If recorded at or after 5 years of age, it is a 4th level verification.

  • Must show birth in one of the 50 states, or the District of Columbia

  • Persons born to foreign diplomats are not citizens of the United States

  • An electronic match with the ND vital statistics agency showing the individual's place of birth will suffice

Report of Birth Abroad of a Citizen of the United States (FS-240) aka Consular Report of a Birth Abroad of a Citizen of the United States

  • Prepared by the Department of State Consular office

  • Can only be prepared at an American Consular office overseas while the child is under age 18

  • Children born outside the US to US military personnel usually have one of these

Certificate of Birth Abroad (FS-545 or Form DS-1350) aka Certificate of Report of Birth or Certification of Birth Abroad

  • For those who were born outside the US and acquired US Citizenship at birth and is based on FS-240

  • FS-545 issued prior to November 1, 1990

  • DS-1350 issued on and after November 1, 1990

  • Is issued only within the US

United States Citizen Identification Card (I-197 or I-179)

  • Issued by the Immigration and Naturalization Service from 1960-1973 as I-179; Issued to naturalized US Citizens living near the Canadian or Mexican border who needed it for frequent border crossings

  • Issued as I-197 from 1973-1983

  • No longer currently used, but still valid

American Indian Card (I-872) with the classification code "KIC" and a statement on the back

  • Issued by the Department of Homeland Security to identify US citizen members of the Texas Band of Kickapoos living near the US / Mexican border

Evidence of Civil Service Employment

  • Must show employment by the US Government prior to June 1, 1976

Official Military record of service

  • Including a DD-214

  • Must show a US place of birth

A data verification with the Systematic Alien Verification for Entitlements (SAVE) Program for naturalized citizens

  • Determines if someone is a naturalized citizen

  • May need to provide the individual's alien registration number

Adopted or biological children born outside the US may establish their automatic citizenship if verification is provided

  • Showing at least one parent is a US citizen by either birth or naturalization

  • Child is under age 18

  • Child is residing in the US in the legal and physical custody of the US citizen parent

  • Child was admitted to the US for lawful permanent residence

  • If adopted, the child must be a lawful permanent resident as an IR-3 (child adopted outside the US) or as IR-4 (child coming to the US to be adopted); with the final adoption having subsequently occurred.

 

Third Level Verification of Citizenship

(Level 3)

   

Acceptable Verifications:

Explanatory Information:

Extract of hospital record on hospital letterhead established at the time of birth and created at least 5 years prior to the Medicaid application

  • It must indicate a US place of birth

  • A souvenir 'birth certificate' issued by the hospital cannot be accepted

  • For children under 16 the document must have been created near the time of birth or 5 years prior to the Medicaid application.

Life or health or other insurance record

  • Showing a US place of birth for the individual

  • Created at least 5 years before the initial application date

Official religious record (recorded with the religious organization) recorded in the US within 3 months of birth

  • Must show a US place of birth

  • Must show the individual's date of birth or age at the time the record was made

  • In questionable cases, such as where the child's religious record was recorded near a US international border and the child may have been born outside the US, the worker must verify the religious record with the religious organization and verify that the mother was in the US at the time of birth

Early school record showing a US place of birth

  • Must show the name, date of birth, and US place of birth of the child

  • Must show the date of school admission

  • Must show the name(s) and place(s) of birth of the applicant's parents

 

Fourth Level Verification of Citizenship

(Level 4)

   

Acceptable Verifications:

Explanatory Information:

Federal or state census record showing US citizenship or a US place of birth - (generally for persons born 1900-1950)

  • Must also show the applicant's age

  • Census records from 1900 through 1950 contain citizenship information

  • To obtain this information the applicant or recipient should complete a Form BC-600, "Application for Search of Census Records for Proof of Age", adding in the remarks portion, "US Citizenship data requested for Medicaid eligibility."  This form can be obtained online at:

http://www.census.gov/genealogy/www/bc-600.pdf

  • A fee will be charged

Seneca Indian tribal census record

  • Must be created at least 5 years prior to initial Medicaid application; and

  • Must show a US place of birth

Bureau of Indian Affairs tribal census records of the Navajo Indians

  • Must be created at least 5 years prior to initial Medicaid application; and

  • Must show a US place of birth

 

US State Vital Statistics official notification of birth registration

  • Must be created at least 5 years prior to initial Medicaid application; and

  • Must show a US place of birth

 

Delayed US public birth record that is amended more than 5 years after the person's birth

  • Must be created at least 5 years prior to initial Medicaid application; and

  • Must show a US place of birth

 

Statement signed by the physician or midwife who was in attendance at the time of birth

  • Must be created at least 5 years prior to initial Medicaid application; and

  • Must show a US place of birth

 

Institutional admission papers from a nursing home, skilled care facility or other institution

  • Must be created at least 5 years prior to initial Medicaid application; and

  • Must show a US place of birth

 

Medical (clinic, doctor or hospital) record (An immunization record is NOT considered a medical record for establishing citizenship)

  • Must be created at least 5 years prior to initial Medicaid application (or near the time of birth, if a child under age 16 only); and

  • Must show a US place of birth

 

Written affidavit, made under penalty of perjury, by at least two individuals--one of which is not a relative--showing they have personal knowledge of the event(s) establishing the applicant's claim of citizenship (date and place). These individuals must provide proof of their own citizenship and identity

  • It must also state a reasonable basis of personal knowledge that an applicant or recipient who cannot produce documentary evidence of citizenship is a citizen. SFN 707, "Affidavit of Citizenship," has been created for convenience.  

  • A second affidavit from the applicant/recipient or other knowledgeable individual explaining why the information cannot be obtained must also be supplied.  SFN 706, "Affidavit of Explanation why Citizenship Cannot be Supplied," has been created for convenience.  

  • Use only in rare circumstances

 

 

  1. Individuals born in Puerto Rico, Guam, the Virgin Islands, the Northern Mariana Islands, and Nationals from American Samoa. For purposes of qualifying as a United States citizen, individuals born in Puerto Rico, Guam, the Virgin Island, the Northern Marian Islands and Nationals from American Samoa may qualify as follows:

  1. Puerto Rico:

  1.  Guam:

  1. The US Virgin Islands:

  1. Northern Mariana Islands (NMI) (formerly part of the Trust Territory of the Pacific Islands (TTPI)):

  1.  Nationals from American Samoa or Swain's Islands:

  1. Persons born to foreign diplomats while residing in one of the preceding jurisdictions of the US are not citizens of the United States.