2215 Citizenship / Immigration / Identity | Medicaid

Georgia Division of Family and Children Services
Medicaid Policy Manual

Policy Title:

Citizenship / Immigration / Identity

Effective Date:

November 2023

Chapter:

2200

Policy Number:

2215

Previous Policy Number(s):

MT 69

Updated or Reviewed in MT:

MT-71

Requirements

An individual must be a U.S. citizen or establish Department of Homeland Security (DHS) status as a lawfully admitted qualified immigrant to be eligible for Medical Assistance.

An individual determined ineligible for Medicaid solely because s/he does not meet the citizenship/immigration requirement is potentially eligible for Emergency Medical Assistance. Refer to 2054 Emergency Medical Assistance.

Basic Considerations

Citizenship/immigration status determines the benefits to which a person may be entitled.

Definition of Citizenship

A U.S. citizen is an individual who is one of the following:

born in one of the 50 states, District of Columbia, Puerto Rico, Guam, U.S. Virgin Islands (St. Thomas, St. Croix, and St. John), Northern Mariana Islands (Saipan, Rota, and Tinian), American Samoa, or Swains Island.
a child adopted by a U.S. citizen (Refer to the Child Citizenship Act).
a minor child born in another country to a non-U.S. citizen becomes a citizen when the parent resides in the U.S. for the required period of time and becomes a naturalized citizen.
born in another country to a U.S. citizen.
has fulfilled the requirements and completed the process of naturalization.

The Child Citizenship Act, which became effective February 27, 2001, amended the Immigration and Nationality Act (INA) to provide U.S. citizenship automatically to adopted or biological children born out of the United States when all required criteria are satisfied:

At least one parent is a U.S. citizen by either birth or naturalization,
The child is under 18 years of age,
The child is residing in the United States in the legal and physical custody of the U.S. citizen parent,
The child is admitted to the United States as an immigrant, and
If the child is adopted, a full and final adoption of the child.

Verification of U.S. Citizenship

Verification of citizenship/immigration is not a requirement for an individual who is not a recipient in the Medical Assistance AU, but who is included in the Medical Assistance budget group (BG) only.

Citizenship and identity must be verified at the following:

at initial application
when an individual is added to an AU
when the agency becomes aware of a discrepancy
at renewal if not previously verified

Citizenship status does not have to be verified for an individual to receive EMA.

Deemed Newborns

Children born to a mother eligible for Medicaid or PeachCare for Kids® (PCK) at the time of the child’s birth are considered “deemed newborns”. No additional verification of Citizenship (including identity) is required.

A child who is deemed Newborn is considered to have provided satisfactory proof of citizenship and is not required to provide any additional verification at CMD or future application for another Medical Assistance COA. If a child is determined to meet “deemed newborn” status then document Client level case notes, “child deemed newborn” and include the Case ID of the Medical Assistance case in which the child’s mother was enrolled at the time of birth.

Verification of Citizenship may be submitted in person, by mail, by guardian, by authorized representative, or by an authorized agency. See 2215-10 below for a list of authorized agencies.

Copies of citizenship documents must be maintained in the case record or State eligibility system and must be made available for compliance audits (DCH MEQC, PERM, etc.). Documentation in Gateway should clearly state what documentary evidence was used; including, but not limited to, the documents assigned number and the information on the document.

A hierarchical approach should be used in verifying citizenship. At application provide each head of household or authorized representative with a copy of “Providing Verification of Citizenship for Medicaid”. Use Form 218, “Citizenship/Identity Verification Checklist” to give to the applicant/member or representative when actual verifications are requested. Both forms are found in Appendix F, Forms.

When requesting verification, do not indicate the specific types of documents for applicants/recipients to provide, e.g., do not request “Birth Certificate”. Request any missing citizenship verification with the Form 173 and include Form 218 Citizenship/Identity Verification Checklist.

If an applicant or recipient presents evidence from the listing of primary documents, no other information will be required. When such evidence cannot be obtained, the next tier of acceptable forms of verification should be used. An attempt to obtain primary documentation should be made before continuing to secondary or tertiary lists. The second, third, and fourth level documentation also require verification of identity.

Primary Documents

Current or expired U.S. passport (not limited passports)
Certificate of Naturalization (N-550 or N-570)
Certificate of Citizenship (N-560 or N-561)

Secondary Documents (also requires verification of identity)

U.S. public birth record showing birth in one of the U.S. states, District of Columbia, American Samoa, Swain’s Island, Puerto Rico if born on or after January 13, 1941, Virgin Islands of the U.S. if born on or after January 17, 1917, Northern Mariana Islands if born after November 4, 1986, or Guam if born on or after April 10, 1899
A U.S. birth certificate or data match with a State Vital Statistics Agency (refer to 2215-15 for instructions for accessing GA Vital Records)
Certification of Report of Birth (DS-1350) issued by the Dept. of State.
Consular Report of Birth Abroad of a Citizen of the United States of America (FS- 240) Certification of Birth Abroad (FS-545)
United States Citizen Identification Card (I-197 or I-179)
American Indian Card (I-872) issued by the Department of Homeland Security with the classification code “KIC”. (Issued by DHS to identify U.S. citizen members of the Texas Band of Kickapoos living near the U.S./Mexican border).
Northern Mariana Identification Card (I-873) or Collective Naturalization for those who lived in the Northern Mariana Islands
Final Adoption Decree
Evidence of civil service employment by the U.S. government before June 1, 1976
Official military record showing a U.S. place of birth
SAVE-Systematic Alien Verification Entitlements Program for Naturalized Citizens (See WEB1).
The Child Citizenship Act (2215-1) must obtain documentary evidence that verifies on or after February 27, 2001, the conditions were met.

Third Level Documents (also requires verification of identity)

Extract of hospital record on hospital letterhead indicating a U.S. place of birth established at the time of the person’s birth and was created at least 5 years before the initial application date (for children under 16, the document must have been created near the time of birth or 5 years before the date of application)

Do not accept a souvenir birth certificate issued by the hospital.
Life or health or other insurance record showing a U.S. place of birth and was created at least 5 years before the initial application date
Religious record recorded in the U.S. within 3 months of birth showing the birth occurred in the U.S. and showing either the date of the birth or the individual’s age at the time the record was made. The record must be an official record recorded with the religious organization. (Entries in a family Bible are not considered religious records.)
Early school record showing a U.S. place of birth. The school record must show the name of the child, the date of admission to the school, the date of birth, and name(s) and place(s) of birth of the applicant’s parents.

Fourth Level Documents (also requires verification of identity)

This level of documents should only be used in extremely rare of circumstances when either Primary, Secondary, or Third Level documents are unavailable; document the situation in Gateway.

Federal or State census record showing U.S citizenship or U.S. place of birth (generally for persons born 1900 through 1950). The census record must also show the applicant’s age. To secure this information the applicant, member or worker should complete a Form BC-600, Application for Search of Census Records for Proof of Age. Add in the remarks portion “U.S. citizenship data requested”. Also add that the purpose is for Medicaid eligibility. This form requires a fee. The BC-600 is also available online at: www.census.gov/history/pdf/bc-600-2013.pdf
Institutional admission papers from a nursing home, skilled nursing care facility or other institution indicating a U.S. place of birth and was created at least 5 years before the initial application date
Medical (clinic, doctor, or hospital) record indicating a U.S. place of birth and was created at least 5 years before the initial application date

The Form 3231 immunization from the Department of Public Health (DPH) is acceptable if an immunization date on the form was documented before the individual’s 16^th birthday.
Other document that shows a U.S. place of birth and that was created at least five years before the application for Medical Assistance (or for children under 16 near the time of birth). These documents are a Seneca Indian tribal census record, Bureau of Indian Affairs tribal census records of the Navajo Indians, a U.S. State Vital Statistics official notification of birth registration, a delayed U.S. public birth record that was recorded more than 5 years after the person’s birth, a statement signed by the physician or midwife who was in attendance at the time of birth, and the Bureau of Indian Affairs Roll of Alaska Natives.
Form 219 Citizenship or Identity Affidavit (only used in rare circumstances as a last resort) by two individuals of whom one is not related to the applicant/recipient and who have personal knowledge of the event(s) establishing the applicants or recipient’s claim of citizenship. The person(s) making the affidavit must be able to provide verification of his/her own citizenship and identity for the affidavit to be accepted. (A copy of the verification should be maintained in the case record.) A third affidavit from the applicant/recipient or other knowledgeable individual must also be obtained explaining why documentary evidence does not exist or cannot be obtained.

An affidavit may be used to verify citizenship of anyone or identity of a child, but not both.

Verification of Identity (when required)

Evidence of Identity (Any form of identity verification listed below is acceptable. The hierarchical approach is not required.)

Proof of identity is not required for qualified or undocumented immigrants.

A state driver’s license, Georgia Identification card or the Georgia Identification Card for Voting Purposes issued by the Department of Driver’s Services
Certificate of Indian Blood or other U.S. American Indian/Alaska Native tribal document
U.S. military card or draft record (must contain photo or other identifying information
Identification card issued by federal, state, or local government agencies or entities either containing a picture or identifying information such as name, date of birth, sex, height, color of eyes, and address (includes the Georgia Identification card issued by the County Voter Registrar’s office). Military dependent’s identification card if it contains a photograph or other identifying information
United States Coast Guard Merchant Mariner Card
School identification card with a photograph
U.S. passport issued with limitations
Data matches or documents from law enforcement or corrections agencies, such as police departments, sheriff’s departments, parole office, DJJ and Youth Detention Centers. Information such as height, race, date of birth, weight, eye color and/or other identifying information should be included. A print-out from their data system with identifying information would verify identity. Identifying information for former inmates can be accessed through the Georgia Department of Corrections at gdc.ga.gov/GDC/Offender/Query.
Form 3231 Immunization Record if an immunization date on the form was documented before the individual’s 16^th birthday. Refer to Appendix J for procedures for accessing the Georgia Registry of immunization Transactions and Services (GRITS) system.
3 or more documents that together reasonably corroborate the identity of an individual provided such documents have not been used to establish the individual’s citizenship and the individual submitted second or third tier evidence of citizenship. The worker must first ensure that no other evidence of identity is available to the individual prior to accepting such documents and document situation. Such documents must at a minimum contain the individual’s name, plus any additional information establishing the individual’s identity. All documents used must contain consistent identifying information, i.e., if a document is accepted that contains the name, DOB and address of the applicant/member, the other documents should contain the name, DOB and address of the applicant/recipient; or contain either the name and DOB; or the name and address. Identifying information includes full name, height, weight, eye color, DOB, current residential address, and photo identification. These documents include employer identification cards, high school and college diplomas from accredited institutions (including general education and high school equivalency diplomas), marriage certificates, divorce decrees and property deeds/titles. Data matches with the marriage, divorce, or death records of the state vital records index are also acceptable.
Disabled individuals in residential care facilities may have their identity attested to by the facility director or administrator when the individual does not have or cannot get any document on the preceding lists. Again, the affidavit is signed under penalty, but need not be notarized.

For individuals under age 16 who are unable to produce a document listed above, the following documents are acceptable to establish identity:

School record including report card, daycare, or nursery school record. (Must verify record with issuing school).
Clinic, doctor, or hospital record showing date of birth,
Form DMA-550 (Newborn certification) if it was created within 3 months of the child’s birth and is signed by a provider.
Form 219 Citizenship or Identity Affidavit (only used in rare circumstances as a last resort). Affidavit signed under penalty of perjury by a parent or guardian, stating the date and place of birth of the child and attesting to the identity of the child.

A signed Form 216 “Declaration of Citizenship” that includes the above information can be accepted to verify the child’s identity if he/she is under the age of 16. The identity remains verified even after the age of sixteen (16) and the applicant/recipient should not be asked to verify identity again if the Form 216 is in the current case record and documented.

An individual cannot use an affidavit for identity if he or she also submitted an affidavit for proof of birth or nationality.

Verification of identity is not required for deemed Newborns and is not required for EMA. A child who is deemed newborn is considered to have provided satisfactory proof of identity and is not required to provide any additional verification at CMD or future application for another Medical Assistance COA.

Verification of identity for adults and children can be verified by the following interfaces:

FDSH
SOLQ
SDX
BENDEX
DDS

State Verification Exchange System (SVES)

The 2009 Children’s Health Insurance Program Reauthorization Act (CHIPRA) amended the Social Security Act to provide an optional process for verifying the citizenship/ID or nationality of Medicaid or CHIP applicants declaring to be U.S. citizens or nationals using the State Verification Exchange System (SVES). A State may submit to the Social Security Administration (SSA) an applicant’s name, Social Security Number (SSN), and date of birth (DOB) for comparison with information that SSA has in its Master File of SSN Holders (“Numident”). A response from SSA that confirms the data submitted by the State is consistent with SSA data, including citizenship or nationality, meets the citizenship/ID verification requirements. No further action is required for the State or individual and no additional verification of either citizenship or identity is required.

A SVES match is submitted in nightly batch for all newly active or pending A/Rs. SSA will return a results file in 48 to 72 hours. Gateway will automatically update valid values for citizenship, identity and original for A/Rs for whom SSA returns a citizenship match. If the SVES match does not return a citizen match, the existing valid values will not be overwritten.

The following valid values will be entered automatically upon verification of citizenship via SVES:

Citizenship field - “U.S. Citizen/National” for citizenship; Verification – “Electronically verified by SVES” for “verified SSA interface”

Since SVES is tied to federally verified SSNs, if the SSN is changed a new SVES match will take place. Individuals for whom SVES does not return a match will be submitted for the match again if their demographic information (e.g., name, DOB or SSN) is updated in GA Gateway.

SVES verification constitutes the highest level of citizenship/ID verification.

SVES at Application

Complete the following on applications for Medical Assistance:

Step 1

Screen the applicant(s) in Gateway to ensure his/her SSN has been federally verified electronically verified by SVES– if NOT, use the SSN correction process to resolve any discrepancies (verification of citizenship through SVES is directly tied to federal verification of the SSN)

Step 2

Check if the A/R has previously verified citizenship/ID,

if yes, do not request again (SVES match will be submitted)
if no, was the A/R ever eligible for Medicaid as a “deemed newborn”?
1. if yes, do not request citizenship/ID again (SVES match will be submitted)
2. if no, go to the next step

Step 3

For an AU that will be interviewed or ready for a determination prior to a SVES match being returned, request verification of Citizenship/ID following Reasonable Opportunity policy below.

Step 4

If an SVES citizenship match is returned, no additional action is needed, and the A/R will not appear on the ROP report.

Step 5

If the SVES citizenship match is not returned, follow ROP policy below.

If the A/R has verified citizenship through paper documentation, review the SSN Discrepancy report ENR-018-WLY and resolve any discrepancies.

An applicant/recipient is not required to provide documentation of citizenship/identity again unless documentation previously submitted is questionable.

Reasonable Opportunity to Provide Verification

Individuals who declare they are U.S. citizens, under penalty of perjury, must be given a reasonable opportunity to provide required proof of citizenship/identity without Medical Assistance benefits being denied, delayed, or terminated. If an applicant/recipient provides all other verification necessary to determine eligibility, but does not provide proof of citizenship/identity, the case should be approved. The applicant/recipient will be given until the end of the third month following the month of approval to provide verification.

Prior months are not considered part of the reasonable opportunity period. Prior month coverage should be approved with the application month and any intervening months.

Each applicant will be allowed one reasonable opportunity period (ROP) per year. This year will run twelve (12) consecutive calendar months beginning the first day of the month following the end of the ROP and will continue regardless of whether the Medicaid case remains active or not.

Verification is NOT Returned

Reasonable opportunity applies to each individual AU member rather than the entire AU. If an applicant/recipient does not return verification of citizenship/identity by the beginning of the third month following the month of approval, the individual for whom citizenship/identity has not been verified should be penalized (an adult) or excluded (a child) from the Medical Assistance AU at the end of the ROP. Refer to 2657 Penalized Individuals. The change must be completed in time for timely notice to expire no later than the end of the third month.

If verification for the penalized or excluded applicant/recipient is returned after the closure but before the end of the third month, the individual should be reinstated. Citizenship/identity verification for a penalized or excluded AU member who received an ROP can be provided at any time during the 12-month period following the expiration of the ROP. No new application is required when removing the penalty or adding the child back to the original Medical Assistance AU. The previously penalized or excluded A/R should be added back to the Medical Assistance AU effective the first day of the month that verification is provided.

In the following situations, a new application is required if verification of citizenship/identity is provided during the 12-month period following the ROP.

A Medical Assistance case in which there is only one AU member
A Parent/Caretaker case that contains only one eligible child and the child’s verification of citizenship/identity is not provided. In this situation, the case would have closed as there would be no qualifying child in the AU under 19.

Definition of Immigrant

An immigrant is an individual who is not a U.S. citizen but resides in the U.S. or its territories. Visitors, tourists, foreign students, and diplomats are not eligible for benefits.

Immigrant status determines the benefits to which an immigrant may be entitled.

Date of Entry

The recognized date of entry into the U.S. is the date recognized by DHS as opposed to the actual, physical date of entry.

An immigrant who entered the U.S. on or after August 22, 1996, is not eligible for Medical Assistance, except under EMA procedures, for a period of five years from the date of entry into the U.S., unless s/he is a Qualified immigrant and meets one of the criteria in Chart 2215.1.

An immigrant who entered the U.S. for permanent lawful residence prior to August 22, 1996, meets the citizenship/immigration criteria for any Family or ABD Medical Assistance COA.

An immigrant who entered the U.S. for permanent lawful residence prior to August 22, 1996, and who is not potentially eligible for SSI based on the criteria in Chart 2215.1, meets the citizenship/immigration criteria for any ABD Medical Assistance COA.

An immigrant who entered the U.S. for permanent lawful residence after August 22, 1996, and who has lived in the U.S. for at least 5 years meets the citizenship/immigration criteria for any Family or ABD Medical Assistance COA.

All pregnant women and children under the age of 19 with a valid immigration status that are lawfully residing in the U.S. will not be subjected to meet any specified time period (5-year bar) to be considered a qualified immigrant and will meet the citizenship/immigration criteria for any Family or ABD Medical Assistance COA. Also, qualified immigrant children who are eligible for title IV-E retain their categorical eligibility for Medicaid under title XIX, regardless of how long they have been in the United States.

According to the Personal Responsibility and Work Opportunity Reconciliation Act (PRWORA) of 1996 and subsequent legislation, a Qualified Immigrant is an immigrant who, at the time of Medical Assistance application or approval, is one of the following:

Immigrants lawfully admitted for permanent residence under the Immigration and Nationality Act (INA), 8 USC 1101 et seq.; This includes Special Immigrant Juvenile Status (SIJS) granted to an undocumented foster child that has petitioned U.S. Citizenship and Immigration Services and been granted SIJ status and is classified as a lawful permanent resident.
Refugees admitted under Section 207 of the INA
Immigrants granted asylum under Section 208 of the INA
Cuban and Haitian entrants (as defined in section 501(e) of the Refugee Education Assistance Act of 1980),
Immigrants granted parole for at least one year under Section 212(d)(5) of the INA
Immigrants whose deportation is being withheld under (1) Section 243(h) of the INA as in effect prior to April 1, 1997: or (2) Section 241(b)(3) of the INA as amended
Immigrants granted conditional entry under Section 203(a)(7) of the INA in effect before April 1, 1980
Battered immigrants, who meet the conditions set forth in Section 431(c) of PRWORA, as added by Section 501 of the Illegal Immigration Reform and Immigration Responsibility Act of 1996, P.L. 104-208 (IIRIRA), and amended by Section 5571 of the Balanced Budget Act of 1997, P.L. 105-33 (BBA), and Section 1508 of the Violence Against Women Act of 2000, P.L. 106-386. Section 431 (c) of PRWORA, as amended, is codified at 8 USC 1641 (c)
Victims of a severe form of trafficking, in accordance with Section107(b)(1) of the Trafficking Victims Protection Act of 2000, P.L. 106-386. The Office of Refugee Resettlement (ORR) provides victims of trafficking with a “Certification Letter” if 18 or over or an “Eligibility Letter” if under 18.
- Accept the ORR letter.
- Call the ORR trafficking verification line (1-866-401-5510) to confirm the validity of the letter and to notify ORR that the individual has applied for benefits.
- Instruct the individual to apply for a Social Security Number (SSN) if not already obtained. Assist the applicant, if necessary, in obtaining a number. Do not delay, deny or discontinue benefits for not having a SSN
- At each renewal, call the ORR trafficking verification line (1-866-401-5510) to verify that the member continues to be certified as a victim of trafficking to remain eligible for Medical Assistance

Non-Immigrants (temporary residents)

Non-immigrants may be legally admitted to the U.S., but only for a temporary or specified period of time. These immigrants are INELIGIBLE for full Medical Assistance or emergency medical services because they do not meet the Georgia residency requirement.

An immigrant admitted for a limited period of time who does not leave the U.S. when the period of time expires becomes an undocumented immigrant. If he/she then establishes Georgia residency, he/she may be eligible for Emergency Medical Assistance only.

Examples of legal non-immigrants include:

Foreign government representatives on official business and their families and servants.
Visitors for business or pleasure, including exchange visitors.
Immigrants in travel status while traveling directly through the U.S.
Ship crewmen on shore leave
Treaty traders and investors and their families
Foreign students
International organization representatives and personnel and their families and servants,
Temporary workers including agricultural contract workers
Members of foreign press, radio, film, or other information media and their families.

Medical Assistance applicants must declare, under penalty of perjury, their citizenship or immigration status at the following times:

at initial application
when an individual is added to an AU
when the agency becomes aware of a discrepancy

Declaration of Citizenship/Immigrant Status

A separate declaration is not required if the application/renewal form was completed and signed under penalty of perjury by an adult assistance unit (AU) member or Authorized Representative (AREP). Applications cannot be denied, and renewals cannot be terminated for failure to provide the Declaration of Citizenship form 216 when these conditions have been met. The Declaration of Citizenship form 216 can be used, when necessary, as a standalone form if citizenship of an applicant/recipient cannot be verified by electronic data sources and was not declared previously by an adult AU member or AREP who can attest to the individual’s citizenship.

A parent or guardian applying for Medical Assistance may declare citizenship or immigration status on behalf of a child or ward 18 years of age or younger.

Effective November 30, 2016, any other individual 18 years of age or older included in the application for Medical Assistance does not have to sign the application or a separate declaration of citizenship (Form 216) unless the applicant does not have knowledge of the person’s citizenship or immigration status.

Examples of individuals who might have knowledge of another person’s citizenship or immigration status and can make declaration on another person’s behalf include:

Parent
Spouse
Friend
An Adult Family Member
Acquaintance who can attest to knowing the person’s status.

This list is not inclusive.

Declaration of Citizenship/Immigration status/Identity Form 216 is not required if the A/R has declared their citizenship or immigrations status on the eligibility application (94, 94A, 297, 508, 700, or via Gateway Customer Portal application) and signed application under penalty of perjury. Also, declaration of citizenship/immigration status/identity is not required if the A/R is determined under EMA procedures.

EXCEPTIONS:

Children who meet “deemed newborn” status do not have to have a written declaration of citizenship until the next redetermination of eligibility or change in Class of Assistance (COA).
Do not require a written declaration of citizenship/immigrant status for a foster care or adoption assistance child.
Do not require a written declaration of citizenship/immigrant status for any applicant who indicates inability or unwillingness to do so. Failure to complete a declaration of citizenship will result in a citizen being ineligible for Medical Assistance. Classify a qualified immigrant as a non-qualified immigrant and consider eligibility only for EMA. Refer to 2054 Emergency Medical Assistance.
EMA applicants/recipients are not required to declare citizenship/immigration status.

Procedures

Verification of Citizenship and Identity

Review the applicants in Gateway. If the A/R was previously known to Gateway:

Ensure his/her SSN has been federally verified– if it has NOT been federally verified, use the SSN correction process to resolve any discrepancies; verification of citizenship through SVES is directly tied to federal verification of the SSN
If the A/R has previously verified citizenship/ID, do not request again (SVES match will be submitted)
If the A/R has not previously verified citizenship/ID, check to see if the A/R was ever eligible for Medicaid as a “deemed newborn”,
1. If so, do not request citizenship/ID again (SVES match will be submitted)
2. If not, go to next step
For A/Rs not found in EMPI or the A/R was never eligible for Medicaid as a “deemed newborn” and not previously verified citizenship/ID, request verification of Citizenship – follow Reasonable Opportunity policy for Medical Assistance and Good Cause policy for Food Stamps and TANF. If a SVES citizenship match is returned, the A/R will not appear on the ROP report, no additional action is needed.

When there is no SVES match, additional documentary evidence for citizenship or identity must be requested.

Effective May 1, 2016, original documentation of citizenship or identity is no longer required for Medicaid or PeachCare for Kids® eligibility determinations. When documents are provided, file the copy of the document in the case record or Document Imaging System (DIS). For DIS, the document should be tagged with both the Client ID of the client for whom it is for and the AU ID(s) of the case(s) impacted. Document GATEWAY where the verification is located, either in the case record or DIS.

Although some documents contain a statement, DO NOT COPY, authorizing agencies may copy and file these documents in the case file for the official purpose of establishing Medical Assistance eligibility.

The following agencies are authorized to make copy of citizenship/identity documents:

Department of Community Health (DCH)
Division of Family and Children Services (DFCS)
Right from the Start Medicaid (RSM)
Department of Public Health (DPH) including Women, Infants and Children (WIC)
Qualified Provider (QP). QPs include Federally Qualified Health Centers and Rural Health Centers.
MAXIMUS
Georgia Cares
CHIPRA Grantees

Authorized agencies are not limited to the State of Georgia; other state and federal agencies, outside of Georgia, which are reasonably equivalent to those noted above, are considered authorized.

Authorized agencies do not include cost recovery agencies; schools; nonprofit agencies such as March of Dimes or American Lung Association; faith-based organizations such as a church; Healthy Mothers/Healthy Babies, etc.

If DFCS staff has any doubts about the copy, they should request that the individual send in or bring in the original documents for verification.

If an individual receives Medical Assistance, and it is determined that documents are inconsistent with pre-existing information, are counterfeit or altered, the Division of Family and Children Services shall investigate for potential fraud and abuse and refer to Special Investigations Unit with Office of Inspector General; in Metro Atlanta (404) 463-7590, and statewide at (1-800-533-0686). However, if the case is denied because the citizenship criteria was not met or income discrepancies could not be resolved, then no referral is required. If an applicant or recipient tries to present documentation but is unable to do so because the documents are not available, the eligibility worker should assist the individual in securing evidence of citizenship.

The following groups are exempt from further citizenship/identity verification requirements:

Persons entitled to or enrolled in Medicare
Persons currently receiving, or have received, SSI cash benefits as long as the citizenship indicator on SDX states they are a citizen or qualified immigrant
Individuals on Social Security disability, including a disabled child, widow, or widower receiving disability benefits on the account of a worker
Children receiving Title IV-B Foster Care benefits
Children receiving Title IV-E Foster Care benefits
Children receiving Title IV-E Subsidized Adoption benefits
Children who meet deemed newborn status

Any assistance unit (AU) member who fails or refuses to cooperate in determining his/her own citizenship/immigration/identity status is ineligible for any ABD or Family Medical Assistance COA.

Situations where individuals provide documents verifying citizenship and identity but for whom SVES does not return a match should be investigated to ensure that the SSN, first and last names, and date of birth have been entered correctly in Gateway.

Verifying Immigrant Status

Qualified Immigrants must provide satisfactory documentary evidence to verify the declaration of immigration status and identity.

Data verification with the Systematic Alien Verification for Entitlements (SAVE) Program must be used to verify qualified immigration status through WEB1.

Non-Qualified Immigrants are not required to declare immigration status, cooperate with the enumeration process nor provide any immigration status and/or identity verification. These individuals are potentially eligible for Emergency Medical Assistance (EMA) services only.

Verify immigrant status for all AU members who are not U.S. citizens. Use DHS documents and Chart 2215.1 to determine immigrant status and potential eligibility for Medical Assistance.

Reasonable Opportunity Period for Qualified Immigrants

Individuals who declare they are Qualified Immigrants, under penalty of perjury, must be given a reasonable opportunity to provide required proof of Qualified Immigration status without Medical Assistance benefits being denied, delayed, or terminated. Apply the same procedures for ROP for Citizens found beginning on page 10 above when providing ROP for Qualified Immigrants.

Qualified Immigrants, that have an expired ROP period, are entitled to fair hearing rights if they request a fair hearing in writing within thirty (30) days from the adverse action notification.

Refugees may not have identity documentation at application but should have identity documentation within 30 days of resettlement.

Verifying Qualified Immigrant Status

Do not require verification of immigrant status for an immigrant that meets all of these criteria:

Immigrant is unable or unwilling to provide verification
Immigrant has a date of entry less than 5 years prior to application date
Immigrant does not meet any of the exemptions from the 5-year rule.

An immigrant that meets all of the above criteria should be classified as an undocumented immigrant and would only be eligible for EMA.

A qualified immigrant who meets the 5-year requirement but does not provide proof of his/her immigrant status is not eligible for Medical Assistance. This includes EMA.

Additional documents may be requested from DHS only with the immigrant’s written permission. Reconsider an immigrant for inclusion in the AU if DHS immigrant status verification is later received. Refer to Chapters 2500, ABD Responsibility Budgeting, 2600, Family Medicaid AUs/BGs and 2650, Family Medicaid Budgeting.

Document the following:

AU’s statement of immigrant status
source of verification
WEB-1 verification

WEB-1 VIS/CPS Immigrant Verification

The Verification Information System (VIS), Customer Processing System (CPS) is provided by DHS to verify the immigration status of non-citizens who are applying for benefits. The WEB-1 Access Method is designed to assist government agencies with eligibility determinations for federal, state and/or local public benefits.

WEB-1 establishes the legitimacy of immigrant documentation and provides verification of the status under which an immigrant has been admitted to the U.S. WEB-1 access is available at: save.uscis.gov/save/app/client/ui/home?JS=YES.

A tutorial for the system is available from the main screen once the login is completed. Complete WEB-1 procedures in the following situations:

To establish the immigration status of ALL non-citizens

Do not verify immigration status for EMA determinations. Refer to 2054 Emergency Medical Assistance for additional information.
To verify the legitimacy of an immigrant’s documentation
To determine the status of an immigrant whose documentation has been lost or has expired
To determine if DHS has assigned a new immigration status

If secondary verification is required, send a copy of the G-845 and copies of DHS documents to USCIS at: USCIS, 2150 Parklake Drive NE, Atlanta, GA 30345. Continue with the eligibility determination while awaiting secondary verification. Allow timely notice and deny Medical Assistance case if secondary verification indicates the immigrant is unqualified. If WEB-1 does not show the applicant’s documents as legitimate, or if the system does not give a response and does not require secondary verification for the documents in question, the immigrant should be considered unqualified. Consider EMA.

Determining 40 Qualifying Quarters

Lawful permanent residents who can be credited with 40 qualifying quarters of employment meet the citizenship/immigration requirement. No five (5) year waiting period is required.

To establish 40 qualifying quarters, complete the following process:

Step 1

Obtain the name, SSN, date of birth and gender of each wage earner whose quarters are being used to establish eligibility.

The wage earner may be:

the immigrant (self)

Not an undocumented immigrant.
a current spouse (consider only quarters worked during the marriage)
a deceased spouse whose credited quarters were worked during the marriage
A parent (deceased or divorced) whose children (biological or adopted) are/were under age 18 at the time the credited quarters are/were worked.

Quarters earned prior to birth of the child may be used.

A stepparent, if at the time the credited quarters were worked the child was under age 18, unmarried and there was a marital relationship with the child’s parent.

If the marital relationship ends for reasons other than death, credited quarters of a stepparent may not be used
A child’s quarters of employment cannot be used by a parent to meet this requirement.

Step 2

Accept the applicant/member’s or wage earner’s statement of quarters worked if:

Alone or in combination with parents and/or spouse the immigrant has sufficient time in the U.S. to have acquired 40 quarters.
DHS documents verify that the dates of entry are consistent with 40 credited quarters or more.
The immigrant, spouse, parent, or a combination of both have sufficient quarters to meet the requirement. The same quarters may be used to meet the requirement for more than one immigrant.

Step 3

Use the WEB-1 system interface with SSA to obtain verification needed to establish credit quarters.

Have each wage earner whose quarters are being used to establish eligibility complete and sign Form SSA-3288, SSA Consent for Release Information, and to provide a statement if his/her work history as outlined in Step 2.

The wage earner may be an immigrant or U.S. citizen by birth or naturalization. The wage earner does not have to have paid Social Security taxes or have earned quarters under the SSA.

Step 4

Exclude as a credit quarter any quarter in which the wage earner received federal public assistance on or after January 1, 1997. The result is the total qualifying quarters and must equal or exceed 40 for the lawful permanent resident to be eligible for Medicaid.

Public assistance is defined as Food Stamp benefits, housing, TANF, employment services, support services, childcare subsidy, federal energy assistance, subsidized utilities, SSI or Medicaid (other than EMA). This list is not inclusive.

Public assistance does not include EMA, public health assistance, foster care, adoption assistance, soup kitchen meals, crisis counseling, short term shelter, educational assistance, WIA, disaster relief, or Head Start. This list is not inclusive.

Step 5

Determine the number of credited quarters, as follows and document calculations in the case record.

Prior to 1978: If earnings totaled at least $50 per quarter (January through March, April through June, July through September, or October through December), a quarter was credited to the wage earner.
On or after January 1, 1978: Credited quarters are based on the total yearly earnings. To determine the number of credited quarters, divide the total yearly earnings by the figures listed below for that year. The result (up to 4), minus the number of quarters public assistance was received, is the number of credit quarters.

1978	$250	1987	$460	1996	$640	2005	$920	2014	$1200	2023 $1640
1979	$260	1988	$470	1997	$670	2006	$970	2015	$1220
1980	$290	1989	$500	1998	$700	2007	$1000	2016	$1260
1981	$310	1990	$520	1999	$740	2008	$1050	2017	$1300
1982	$340	1991	$540	2000	$780	2009	$1090	2018	$1320
1983	$370	1992	$570	2001	$830	2010	$1120	2019	$1360
1984	$390	1993	$590	2002	$870	2011	$1120	2020	$1410
1985	$410	1994	$620	2003	$890	2012	$1130	2021	$1470
1986	$440	1995	$630	2004	$900	2013	$1160	2022	$1510

Step 6

Document calculations in the case record. The chart below provides each DHS status, which is routinely applicable to eligibility determinations. This chart is not all-inclusive. DHS has the discretion to change documents or codes to allow any immigrant or group of immigrants to stay in the U.S. for an indefinite period. Service agencies may not be aware of these changes prior to implementation.

Additionally, documents issued by the DHS vary by local DHS office. For example, two immigrants with the same immigration status may not have the same document to verify the same status. Letters of decision from immigration judges may identify DHS status, also. Direct questions regarding documents to the appropriate policy help desk.

Chart 2215.1 – Determination of Immigrant Status

IF the applicant/recipient’s Immigration DHS status is:

THEN the applicant / recipient meets the Citizenship / Immigration eligibility criteria for the following COAs:

Verify with one of the following DHS documents:

Lawful Permanent Resident with 40 qualifying quarters of coverage who enters the U.S.

prior to 8/22/96

SSI, Any Family or ABD COA.

Resident Alien Card

Passport, Visa, I-94, I-181, DHS AR-3a or other DHS documentation stating the “Processed for I-551, Temporary Evidence of Lawful Residence”

on or after 8/22/96

Any Family or ABD COA, beginning from the date of entry.

No waiting period applies.

Lawful Permanent Resident without 40 qualifying quarters of coverage who entered the U.S.

Prior to 8/22/96

SSI, Any Family or ABD COA.

On or after 8/22/96

Any Family or ABD COA, beginning 5 years after the date of entry.

Pregnant women through the end of their postpartum period or children under the age of 19, no waiting period applies. For all other individuals EMA, beginning from the date of entry.

Lawful Permanent Resident who was lawfully residing in U.S. on or prior to 8/22/96 and who is, or becomes disabled or blind

SSI, any Family or ABD COA.

Resident Alien Card

Passport, Visa, I-94, I-181, DHS AR-3a or other DHS documentation bearing the endorsement “Processed for I- 551, Temporary Evidence of Lawful Residence”

Lawful Permanent Resident who was lawfully residing in U.S. on or prior to 8/22/96 and was 65 years or older at that time

Ineligible for SSI, unless disabled or having 40 qualifying quarters. Refer to SSA to make application for SSI if appropriate. Eligible for any Family COA or ABD COA based on age.

Any SSI recipient who applied for SSI before 1979

SSI, Any ABD COA

Any DHS status or any documentation establishing that the immigrant applied for SSI prior to 1979

An immigrant granted asylum status under Section 208 of INA who entered the U.S.

Prior to 8/22/96

Any Family or ABD COA

SSI for 7 years from date asylee status is granted, regardless of current DHS status

I-94 annotated with Section 208 asylum codes of AS1, AS2, AS3, AS6, AS7, AS8

On or after 8/22/96

Any Family or ABD COA

SSI for 7 years from date asylee status is granted, regardless of current DHS status

Other DHS documents with asylum codes of AS1, AS2, AS3, AS6, AS7, AS8

An American Indian born outside the US, but recognized as a Lawful Permanent Resident if living along the Canadian border

SSI

Any Family or ABD COA

Same as above or 50% blood is that of an American Indian or is a member of a federally recognized tribe.

An immigrant paroled for at least one year under Section 212(d)(5) who entered the U.S.

prior to 8/22/96

Any Family or ABD COA

I-688B annotated 274a.12(a)(4) or c(11), I-94 annotated with 212(d)(5an), I-512 annotated with Section 212(d)(5)

on or after 8/22/96

Any Family or ABD COA, beginning 5 years from the entry date

Pregnant women through the end of their postpartum period or children under the age of 19, no waiting period applies. For all other individuals EMA for 5 years beginning from the date granted parolee status.

A Cuban and Haitian entrant admitted under Section 501(3) of Refugee Education Assistance Act of 1980 (as of 11/98)

SSI for 7 years from date of entering into U.S.

Any Family or ABD COA

I-94 annotated with paroled as refugee, Section 207 or married Cuban, I-551 or I-151 with CH6, CNP, CU6 or 7

An immigrant with Amerasian DHS status who entered the U.S. either prior or on or after 8/22/96.

SSI for 7 years from date of entry into the U.S. regardless of current status

Any Family or ABD COA

I-95 annotated with AM1, AM2, AM3 I-551 annotated with AM6, AM7, AM8, Vietnamese Exit Visa, Vietnamese Passport, or U.S. Passport stamped AM1, AM2, AM3

Any above listed immigrant and considered a battered spouse or child and who is no longer living with the batterer.

Any Family or ABD COA, beginning 5 years after the date of entry.

Pregnant women through the end of their postpartum period or children under the age of 19, no waiting period applies. For all other individuals EMA, beginning from the date of entry.

Any DHS document that established a spouse or child(ren) as lawfully residing in the U.S. and considers them as a battered spouse or child(ren).

A qualified immigrant with any documented status if the immigrant is:

a veteran who has been honorably discharged for reasons other than immigration,

OR
on active military duty (other than active duty for training)

AND
a qualified immigrant spouse and unmarried children (natural, adoptive or step) under 18 of the veteran or military personnel on active duty

SSI

Any Family or ABD COA

Any DHS document that establishes that the immigrant is lawfully residing in the U.S. (Spouse and any unmarried children [natural, adoptive, or step] under 18, must also be documented as lawfully residing in the U.S.

A refugee admitted under Section 207 of Immigration & Naturalization Act (INA)

SSI for 7 years from date of entry into U.S., regardless of current status, Any Family or ABD COA

Immigrant whose deportation is being withheld under Section 243(h) or 241(b) of the INA

SSI for 7 years from date of withholding deportation

Any Family or ABD COA

I-94 annotated with Section 243(h)

Other DHS documentation from an immigration judge showing that deportation has been withheld

Conditional entrants under Section 203(a)(7) of the INA in effect prior to 4/1/80 who entered the U.S.

Prior to 8/22/96

Any Family or ABD COA

I-94 annotated with Section 203(a)(7)

Conditional entrants under Section 203(a)(7) of the INA in effect prior to 4/1/80 who entered the U.S.

On or After 8/22/96

EMA for 5 years beginning from the date of entry

THEN

Any Family or ABD COA

Pregnant women through the end of their postpartum period or children under the age of 19, no waiting period applies. For all other individuals EMA, beginning from the date of entry.

I-94 annotated with Section 203(a)(7)

Iraqi and Afghani Special Immigrants (Public Law 110-161)

Any Family or ABD COA beginning the date the A/R is granted the Special Immigrant status. The date the status is granted must be 12/26/07 or later.

For dates prior to 12/26/07, these groups would only be eligible for EMA.

Iraqi or Afghani passport with an immigrant visa stamp noting that the individual has been admitted under IV (Immigrant Visa) category SI1, SI2, or SI3, and DHS stamp or notation on passport or I-94 showing date of entry.

Iraqi passport with an immigrant visa stamp noting that the individual has been admitted under IV (Immigrant Visa) category SQ1, SQ2, or SQ3, and DHS stamp or notation on passport or I-94 showing date of entry. DHS Form I-551 showing Iraqi or Afghan nationality (or Iraqi or Afghan passport) with an IV (Immigrant Visa) code of SI6, SI7, or SI9.

DHS Form I-551 showing Iraqi nationality (or Iraqi passport) with an IV (Immigrant Visa) code of SQ6, SQ7, or SQ9.

Persons from the Compact of Free Association States, which include the Federated States of Micronesia, Republic of the Marshall Islands, and the Republic of Palau.

Citizens of the Compact of Free Association States have a special status with the U.S. that allows them to enter the country, work here and acquire a Social Security number without obtaining an immigration status from the Department of Homeland Security. They are known as Compact of Free Association (COFA) migrants (compact citizens) and are to be considered “qualified non-citizens”. Effective 12/27/2020, they are eligible for Medical Assistance (does not extend to PCK) and are not required to meet the 5-year waiting period required of other non-citizen immigrants.

Any documentation stating, they are a citizen of one of the Compact of Free Association States.

Immigration status for COFA migrants may be verified by Federal Data Services Hub (FDSH) or other established pathways.

Ukrainian national who enters between 2/24/2022 and 9/30/2023 as parolee

Medicaid or PCK to the same extent as refugees, without a 5-year waiting period and are considered “qualified non-citizens” for purposes of Medicaid and PCK.

Form I-94 with Ukrainian Humanitarian Parole (UHP) Class of Admission (COA); Foreign passport with parole stamp that includes a UHP COA; or Form I-766 with C11 category

Ukrainian national who are paroled after 9/30/2023 and are the spouse of child or parolee, or the parent, legal guardian, or primary caregiver of parolee described above who is determined to be an unaccompanied minor

Medicaid or PCK to the same extent as refugees

Ukrainian granted Temporary Protected Status (TPS) or has a pending application for TPS and who has been granted employment authorization

Not eligible for Medicaid or PCK and are not considered as “qualified non-citizens”

Ukrainian non-citizens

Eligible for EMA if they do not qualify for full Medicaid based on their immigration status

Deferred Action for Childhood Arrivals (DACA)

Any Medical Assistance COA using EMA procedures except PCK, P4HB, Pathways

N/A

All other immigrants

Any Medical Assistance COA using EMA procedures except PCK, P4HB and Pathways

N/A

Instructions for Vital Records Inquiry

ACTIVITY

SCREEN DISPLAYS

From the GO screen, type DHR and press Enter. (This function is not available from DHR8).

The DFCS Integrated Systems Sign On menu appears. The cursor will appear in the selected field.

Type 1 (for $TARS) In the selection field and press Tab. Type your RACF User ID in the RACF ID field and press Tab. Type your RACF password in the password field and press enter.

The following message appears: “DFHCE3549 Sign-on is complete”.

Clear the screen.

A blank screen appears.

Type SIBI and press Enter for Birth Index Inquiry OR

SIDT and press Enter for Death Index Search OR

SIDV and press Enter for Divorce Index Search OR

SIMI and press Enter for Marriage Index Search

The Birth Index Inquiry Screen appears.

The Death Index Search Screen appears.

The Divorce Index Search Screen appears.

The Marriage Index Search

Screen appears.

Type the year and last name. To narrow the search, type the month and day if known. Press Enter to complete the inquiry.

If match appears on the Birth Index, tab down to the line with the match, type an “S” and press Enter.

To go from one Vital Record Inquiry to another, clear the screen after the inquiry is completed and type the next index screen desired.

Vital Record information on file (if any) will appear.

A screen with the person’s full name, birth date and parent’s names will appear. This screen can be copied and pasted into Gateway.

DO NOT PRINT VITAL RECORD SCREENS.

Clear the screen. Type CESF LOGOFF to exit

The GO screen will appear.

Do not print Vital Record Screens. The information is confidential. Document case files but do not put screen print in case records.