HAR §17-1714.1-27. Purpose

The purpose of this subchapter is to establish the types of acceptable documentary evidence of citizenship and non-citizen status that an individual or household shall meet to be eligible for Medicaid. [Eff 09/30/13] (Auth: HRS §346-14; 42 C.F.R. §§435.406, 435.407) (Imp: HRS §346- 14; 42 C.F.R. §§435.406, 435.407) §17-1714.1-28 Citizen and non-citizen eligibility. (a) The following individuals meet the citizenship and non-citizen requirements to be eligible for Medicaid: (1) A citizen of the U.S. who has declared that the individual is a citizen or national of the U.S., and the department has verified the declaration under section 17-1714.1-30. For purposes of this subchapter, a citizen of the U.S. includes naturalized citizens, members of a federally-recognized Indian Tribe, and individuals born in the fifty states, the District of Columbia, Puerto Rico, Guam, American Virgin Islands, American Samoa, Swain's Island, or the Commonwealth of the Northern Mariana Islands. (2) A qualified non-citizen: (A) Who is granted asylum under section 208 of the INA (8 U.S.C. § 1158); UNOFFICIAL 1714.1-13 (B) Who is admitted to the U.S. as a refugee under section 207 of the INA (8 U.S.C. § 1157); (C) Whose deportation is being withheld under section 243(h) of the INA (8 U.S.C. § 1253, as in effect immediately before the effective date of section 307 of division C of Public Law 104- 208) or section 241(b)(3) of the INA (8 U.S.C. §1231(b)(3), as amended by section 305(a) of division C of Public Law 104-208); or (D) Who is a Cuban or Haitian refugee or entrant as addressed in Title IV of the Immigration and Nationality Act and section 501 of the Refugee Education Assistance Act. (b) The following qualified non-citizen, who entered the U.S. on or after August 22, 1996, beginning five years after the individual’s entry into the U.S., who is a: (1) Legal permanent resident; (2) Non-citizen who is paroled into the U.S. under section 212(d)(5) of the INA (8 U.S.C. § 1182(d)(5)) for a period of at least one year; (3) Non-citizen who is granted conditional entry under section 203(a)(7) of the INA (8 U.S.C. § 1153(a)(7)) as in effect prior to April 1, 1980; (4) Non-citizen who has been battered or subjected to extreme cruelty in the U.S. by a spouse, parent, or household member with the spouse or parent’s consent or acquiescence, including a battered child and parent(s) of the battered child (without the active participation of the parent(s) in the battery or cruelty) as described in 8 U.S.C. § 1641(c), and has been approved for or has a petition pending that sets forth a prima facie case to be granted status by USCIS as a battered spouse, a child, or a parent of a UNOFFICIAL 1714.1-14 battered child under clauses (i), (ii), (iii) and (iv) of section 204(a)(1)(A) or clauses (i), (ii) and (iii) of section 204(a)(1)(B) of the INA, provided that the individual responsible for such battery does not reside in the same household as the individual subjected to the battery; or (5) An individual who has been granted nonimmigrant status under section 101(a)(15)(T) of the INA (8 U.S.C. §1101(a)(15)(T)) as a victim of a severe form of trafficking in individuals or who has a pending application that sets forth a prima facie case for eligibility for such nonimmigrant status, provided that the individual responsible for such cruelty does not reside in the same household as the individual subjected to the cruelty. (c) The following lawfully present non-citizen who is: (1) Admitted to the United States as an Amerasian immigrant pursuant to section 584 of the Foreign Operations, Export Financing, and Related Programs Appropriations Act, 1988 (as contained in section 101(e) of Public Law 100-202 and amended by the 9th proviso under Migration and Refugee Assistance in title II of the Foreign Operations, Export Financing, and Related Programs Appropriations Act, 1989, Public Law 100-461, as amended; (2) A legal permanent resident who has worked forty qualifying quarters of coverage as defined under title II of the Social Security Act and did not receive any federal means-tested public benefit, other than those listed in 8 U.S.C. §1613(c)(2) for any qualifying quarter after December 31, 1996; (3) An honorably discharged veteran or active member of the U.S. armed forces and the veteran or active member’s spouse or dependent child, or unremarried surviving UNOFFICIAL 1714.1-15 spouse of the deceased veteran, under 8 U.S.C. §1612(b)(2)(C); (4) An American Indian born in Canada subject to section 289 of the INA (8 U.S.C. § 1359), or who is a member of an Indian tribe as defined in 25 U.S.C. §450b(e); (5) In receipt of SSI, or determined to be blind or disabled by the SSA on August 22, 1996; (6) Issued a record of lawful admission for permanent residence under section 249 of the INA (8 U.S.C. § 1259); or (7) A lawfully present non-citizen, including a citizen of a COFA nation, who is under age nineteen years or a pregnant woman. [Eff 09/30/13] (Auth: HRS §§346-14, 346- 71; 42 C.F.R. §435.406; 8 U.S.C. §§1259, 1611, 1612, 1613, 1641) (Imp: HRS §§346-14, 346-71; 42 C.F.R. §435.406; 8 U.S.C. §§1259, 1611, 1612, 1613, 1641) §17-1714.1-29 Declaration of citizenship and non-citizen status. (a) The department shall provide Medicaid to an otherwise eligible individual who is a citizen: (1) Provided the individual has declared that the individual is a citizen or national of the United States, and the department has verified such declaration; (2) Except the following individuals are exempt from the verification requirement in this subsection: (A) An individual in receipt of foster care services or benefits under Title IV-B or Title IV-E of the Social Security Act; (B) An individual entitled to or enrolled in Medicare; (C) An individual in receipt of disability benefits under Title II of the Social Security Act; UNOFFICIAL 1714.1-16 (D) An SSI recipient under Title XVI of the Social Security Act; and (E) A newborn for the first year of life who is born to a Medicaid beneficiary mother. (b) The department shall provide Medicaid to an otherwise eligible qualified non-citizen provided that the individual has declared that the individual is a qualified non-citizen and has provided satisfactory documentary evidence of status as a qualified non- citizen, and the Department of Homeland Security has verified that the individual is in satisfactory immigration status. (c) For purposes of this section, “satisfactory immigration status” means an immigration status which does not make the individual ineligible for benefits under the applicable program. (d) The declaration of citizenship, national or immigration status and verification requirements for an individual under subsections (a) and (b) may be provided by the individual or an adult member of the individual’s household, an authorized representative, or if the individual is a minor or incapacitated, someone acting responsibly for the individual under a declaration signed under penalty of perjury. [Eff 09/30/13] (Auth: HRS §346-14; 42 C.F.R. §§435.406, 435.949, 435.956) (Imp: HRS §346-14; 42 C.F.R. §§435.406, 435.949, 435.956) §17-1714.1-30 Verification of citizenship and non-citizen immigration status. (a) The department shall verify citizenship or non-citizen immigration status through the federal electronic service under section 17-1714.1-12(b). (b) If the department is unable to verify citizenship or immigration status through the federal electronic service, the department shall: (1) Verify citizenship with acceptable documentary evidence and in accordance with section 17-1714.1-31. UNOFFICIAL 1714.1-17 (2) Verify immigration status in accordance with section 1137(d) of the Social Security Act (42 U.S.C. §1320b-7(d)(1)(B)(iii)) and the requirements of section 17-1714.1-31. (c) If the department is unable to promptly verify the citizenship or non-citizen immigration status of an individual in accordance with subsection (a), the department: (1) Shall provide the individual with a reasonable opportunity to obtain or provide the necessary information in accordance with subsections (e) through (i); and (2) May not delay, deny, reduce or terminate benefits for an individual who is otherwise eligible for Medicaid during the reasonable opportunity period. (d) The department shall maintain a record of having verified citizenship or non-citizen status for each individual, in an electronic database. The department may not re-verify or require an individual to re-verify citizenship or non-citizen status at a renewal or eligibility or subsequent application following a break in coverage. (e) The department shall notify the individual for whom the department is unable to promptly verify citizenship or satisfactory non-citizen status in accordance with chapter 1713.1. (f) During the reasonable opportunity period, the department shall, if relevant to verification of the individual’s status, assist the individual as follows: (1) Assist the individual in obtaining an SSN; (2) Attempt to resolve any inconsistencies between information provided by the individual and data from the electronic service, and resubmit corrected information; (3) Provide information on how to contact the source of the electronic data directly to resolve the issue; and (4) Permit the individual to provide other documentation of citizenship or immigration status. UNOFFICIAL 1714.1-18 (g) The reasonable opportunity period shall begin on and shall extend ninety days from date the individual receives notice from the department that the department was unable to verify citizenship or satisfactory immigration status. The notice is considered to be received by the individual five days after the date of the notice, unless the individual can show it was not received within the five day period. (h) At the department’s option, the reasonable opportunity period may be extended beyond ninety days if the individual provides evidence of a good faith effort to resolve the issue or the department requires additional time to complete the verification process. (i) At the end of the reasonable opportunity period, and any extensions granted by the department, if the individual’s citizenship or non-citizen status has not been verified in accordance with subsection (a), the department shall take action within thirty days to terminate eligibility, subject to the provisions of chapter 17-1703.1. [Eff 09/30/13] (Auth: HRS §346-14; 42 C.F.R. §§435.407, 435.956) (Imp: HRS §346-14; 42 C.F.R. §§435.407, 435.956) §17-1714.1-31 Documentary evidence of citizenship. (a) The following documentary evidence of citizenship is acceptable: (1) U.S. passport, including a U.S. Passport Card issued by the Department of State, without regard to any expiration date as long as the passport or Card was issued without limitation; (2) A certificate of U.S. citizenship; (3) A certificate of naturalization; (4) A valid state-issued driver’s license if the state issuing the license requires proof of U.S. citizenship, or obtains and verifies a social security number from the applicant who is a citizen before issuing such license. UNOFFICIAL 1714.1-19 (5) Documentary evidence issued by a federally recognized Indian Tribe, by the Bureau of Indian Affairs within the U.S. Department of the Interior, and including Tribes located in a State that has an international border which: (A) Identifies the federally recognized Indian Tribe that issued the document; (B) Identifies the individual by name; and (C) Confirms the individual’s membership, enrollment, or affiliation with the Tribe. (6) Documents described in paragraph (5) above include, but are not limited to: (A) A Tribal enrollment card; (B) A certificate of degree of Indian blood; (C) A Tribal census document; and (D) Documents on Tribal letterhead, issued under the signature of the appropriate Tribal official, that meet the requirements of paragraph (5). (b) If documentary evidence of citizenship described in subsection (a) are unavailable, the following shall be accepted as satisfactory evidence to establish citizenship if also accompanied by an identity document listed in section 17-1714.1-4: (1) U.S. public birth certificate showing birth in: (A) One of the fifty states; (B) The District of Columbia; (C) Guam; (D) American Samoa; (E) Swain’s Island; (F) Puerto Rico (if born on or after January 13,1941); (G) U.S. Virgin Islands (if born on or after January 17,1917); (H) The Commonwealth of Northern Mariana Islands (CNMI) (if born on or after November 4, 1986); UNOFFICIAL 1714.1-20 (I) If the birth record document issued by the State, commonwealth, territory or local jurisdiction shows the individual was born in Puerto Rico, the U.S. Virgin Islands or the CNMI before these areas became part of the U.S., the individual may be a collectively naturalized citizen. (2) Certification of report of birth, issued to a U.S. citizen who was born outside the U.S.; (3) Report of birth abroad of a U.S. citizen; (4) Certification of birth (5) U.S. citizen identification card; (6) Northern Marianas identification card, issued to a collectively naturalized citizen, who was born in the CNMI before November 4, 1986; (7) Documentation that a child meets the requirements of section 101 of the Child Citizenship Act of 2000 (8 U.S.C. §1431); (8) Final adoption decree or if an adoption is not final, a statement from a state-approved adoption agency with child’s name and U.S. place of birth; (9) Evidence of U.S. civil service employment by the U.S. government before June 1, 1976; (10) U.S. military record of service showing a U.S. place of birth; (11) Verification with the Department of Homeland Security’s Systematic Alien Verification for Entitlements (SAVE) database or any other process established by the Department of Homeland Security to verify an individual is a citizen; (12) Medical records, including, but not limited to, hospital, clinic, or doctor records or admission papers from a nursing facility, skilled care facility, or other institution that indicate a U.S. place of birth; (13) A life, health, or other insurance record that indicates a U.S. place of birth; UNOFFICIAL 1714.1-21 (14) An official religious record recorded in the U.S. showing the birth occurred in the U.S.; (15) School records, including pre-school, Head Start and daycare, showing the child’s name and a U.S. place of birth; (16) A federal or State census record showing U.S. citizenship or a U.S. place of birth; (17) At the department’s option, a cross match with a State department of vital statistics documenting a record of birth; (c) If the individual does not have one of the documents listed in subsections (a) or (b), submission of an affidavit signed by another individual who can reasonably attest to the individual’s citizenship shall be accepted. The affidavit shall be signed under penalty of perjury and contain the individual’s name, date of birth, place of U.S. birth, and does not have to be notarized. (d) The department may rely on a verification of citizenship made by a federal agency or another State agency, without further documentation of citizenship or identity, if such verification was done on or after July 1, 2006. (e) The department shall provide assistance to individuals who need assistance in securing satisfactory documentary evidence of citizenship in a timely manner. (f) A photocopy, facsimile, scanned or other copy of a document shall be accepted to the same extent as an original document under this section, unless information on the submitted document is inconsistent with other information available to the department or the department otherwise has reason to question the validity of the document or the information on the document. (g) An individual unable to furnish the required documents or an affidavit shall not be eligible for medical assistance. [Eff 09/30/13] (Auth: HRS §346-14; 42 C.F.R. §§435.406, 435.407, 435.912, 435.930) (Imp: HRS §346-14; 42 C.F.R. §§435.406, 435.407, 435.912, 435.930) UNOFFICIAL 1714.1-22 §