Citizen Verification Process

For more information refer to Applications.

IF...	AND...	THEN...
Client Declares U.S. Citizenship,	Client is not exempt from DRA requirement, proof of citizenship is not on file, and no data is on [INQE] screen in MEDS,	The citizenship must be verified. Note: Once Citizenship verification is provided or verified electronically, it does not need to be requested again, even if the client moves from another county in CA.
EW attempts to verify citizenship via the Federal Hub,	The results from the Federal Hub are reasonably compatible,	The citizenship documentation requirement is met.
Citizenship is not verified via the Federal Hub,	A successful SSN data match is found (INQE after 2 business days), OR A successful Electronic Birth Match (California born individuals) is updated INQE	The citizenship documentation requirement is met. Note:A successful SSN data match fulfills the citizenship AND identity requirements.
Citizenship is not verified via Federal Hub,	Cannot be verified via an Electronic Birth Match or SSN Data Match,	The client is eligible for full-scope MC benefits, if all other eligibility requirements are met, while making a good faith effort to provide citizenship verification.
SSN Data Match is unsuccessful,	The EW checked for correctable errors (i.e. typographical errors, confirms SSN, etc) and the mismatch cannot be resolved,	The EW refers the client to the Social Security Administration via MC 194 to have the inconsistency resolved.
The client is unable to provide one of the acceptable documents,	The client was born outside of California, or was born in California but an Electronic Birth Match was unsuccessful,	The EW must request a certified copy of the client’s birth certificate from the agency in the state where the client was born using the “Verification of Birth, Death, Marriage, Divorce” (SCD 109).
The Reasonable Opportunity Period Ends,	The client is otherwise eligible and has not provided DRA citizenship/identity documentation,	Medi-Cal benefits must be reduced to restricted-scope benefits (emergency, pregnancy-related, state-only Long Term Care benefits) with a timely 10-day NOA. Note: The EW must clearly document the reason for the determination that the individual is not making a good faith effort to obtain verification.
Documents are provided within one year of the application date,	The client has good cause for not providing documentation sooner,	Full-scope MC benefits must be restored starting from the month that the limited benefits began.
Documents are provided within one year of the application date,	The client does not have good cause for not providing documentation sooner,	The EW must grant full-scope MC benefits

Single Point of Entry Applications

When an application is received from Single Point of Entry (SPE), children may have presumptive eligibility under Accelerated Enrollment or CHDP Gateway; however, citizenship/identity requirements must be met during the application process when the EW determines ongoing eligibility for MC. (Deemed Eligible Infants are exempt from DRA requirements.) Although SB75 grants full-scope MC to all children, the DRA requirements still apply and verifications requested, however, the MC benefit will not be affected if the client cannot provide verification up to age 26. If an individual turns 26 years old and does not have appropriate DRA documentation the benefits will reduce from full-scope MC to restricted-scope MC benefits.

Note: The EW must send the “Proof of Citizenship and Identity” (DHCS 0002) to the client to inform them of the citizenship/identity requirements along with the other required Intake informing notices when processing an SPE application.

If the application includes a copy of the child’s birth certificate, along with a completed DHCS 0005 that was signed by a CAA from Health and Hospital Systems certifying the original birth certificate was viewed, no further documentation is required. The application, signed under penalty of perjury is sufficient to meet the identity requirement for the child.
If a birth certificate is not included with the application, and MEDS [INQE] does not contain citizenship information, the EW must explain acceptable verification of citizenship and identity and give an ROP to provide it.
If the child is under 18 and there was a MEDS birth record match or citizenship information is on the MEDS [INQE], no further documentation is required because the application, signed under penalty of perjury is sufficient to meet the identity requirement for the child.
If the child is 18 or older and there was a MEDS birth record match or citizenship information is on the MEDS [INQE] screen, the parent or guardian must still provide proof of identity for the child.
If the client is unable to provide acceptable documents and the birth record match is unsuccessful, the EW must complete the SCD 109 to request a certified copy of the birth certificate.

Reminder: An affidavit is not acceptable to document the identity of a child 18 or older.

CalWORKs Cases

The CalWORKs citizenship and identity verification requirements fulfill the MC requirements while clients are receiving CalWORKs. Once a client transitions to an MC only program, citizenship and identity verification must be reported to MEDS via AP19 or a birth record match must be requested if the MEDS [INQE] screen fields are blank. Therefore, it is recommended to report citizenship and identity verification to MEDS for all CalWORKs clients whenever possible, as once verified, it will not need to be requested again if CalWORKs benefits end.

Medi-Cal Performance Standards

The 45-day (for regular applications) or 90-day (for applications based on disability) requirement is considered to be met if the EW has completed the eligibility determination, except for citizenship/identity verification within 45 or 90 days.

Annual redeterminations (RD) are considered complete for purposes of performance standards if the RD has been completed, except for the citizenship/identity verification.

Processing Intake Applications

The following outlines procedures when clients have not already provided acceptable citizenship/identity documents.

Face-to-face Interview

For non-exempt applicants who apply in person, the Intake EW follows the steps below to verify citizenship/identity at intake:

Reviews the intake application and updates CalSAWS appropriately.
1. Searches prior case records for Citizenship/Identity verification
2. Reviews for exemptions to Citizenship/Identity requirements
3. Reviews MEDS [INQE] for Citizenship/Identity coding
  1. NOTE: If MEDS shows the client was active in another county and no data is present on [INQE], contact the other county to request Citizenship/Identity document(s).
4. If verification is:
  1. E-Verified
    1. Confirms that DRA information is sent to MEDS.
    2. Enters appropriate citizenship/immigration information into CalSAWS[Refer to UGSS Chapter 2.8.1 “Batch AP19 Process,” ]
  2. Provided
    1. Completes DHCS 0011 and send to IDM to confirm that the EW reviewed the documentation.
    2. Confirms that DRA information/coding is sent to MEDS
  3. Not E-Verified and Not Provided
    1. Checks [INQE] after 2 business days to see if the client has a successful SSN data match result (DOC TYPE = 2Z). Refer to SSN Data Match for Citizenship / Identity.
    2. If the client claims to have an acceptable document, allows an additional 10 days if verifications are not provided within the original 10-day due date.
    3. If verifications are still not provided or client is unable to obtain documents, completes the SCD109 to request a certified copy of the client's birth certificate and/or DL 937 to request a CA ID. A copy of the SCD 109 must be scanned into IDM under Permanent Verifications.
    4. Ensures all contacts are documented in Journal section.
      1. Note: Cases must not be transferred out of Intake without either an SSN Data Match, a California Birth Record Match, acceptable citizenship/identity documents or an SCD 109/DL 937 on file.
Approves full-scope MC benefits, if otherwise eligible.

Mail-In Applications

For non-exempt applicants using the mail-in process follow the steps below to verify citizenship/identity documents at intake:

Applicant:
1. Requests MC in person or by phone.
CST:
1. Completes SAWS 1/SC 41 process.
2. Gives/mails complete intake packet with SCD 1481/DHCS 0001 to client.
3. Informs client of Mail-In option or scheduling an appointment.
4. Complete CalSAWS/MEDS File Clearance process.
5. Prints MEDS INQE screen and other necessary screens for each person.
6. Completes application registration process.
Applicant:
1. Chooses to mail in the application.
2. Receives intake packet with 10 day due date.
3. Returns application.
Intake EW:
1. Reviews application to determine which household members are citizens
2. Searches IDM/case record for Citizenship/Identity verification
3. Reviews for citizenship/identity exemptions
4. Reviews [INQE] for Citizenship/Identity coding
5. Processes Mail-In application, updates CalSAWS queue as needed
6. Approves full-scope MC benefits if otherwise eligible.
  1. Note: If there is no data on [INQE] and MEDS shows client was active in another county, contact the other county to request Citizenship/Identity documents.
7. If verification is:
  1. E-Verified
    1. Confirms that DRA information is sent to MEDS.
    2. Enters appropriate citizenship/immigration information into CalSAWS[Refer to UGSS Chapter 2.8.1 “Batch AP19 Process,” ]
  2. Provided
    1. Completes DHCS 0011 and send to IDM to confirm that the EW reviewed the documentation.
    2. Confirms that DRA information/coding is sent to MEDS
  3. Not E-Verified and Not Provided
    1. Checks [INQE] after 2 business days to see if the client has a successful SSN data match result (DOC TYPE = 2Z). Refer to SSN Data Match for Citizenship / Identity.
    2. If the client claims to have an acceptable document, allows an additional 10 days if verifications are not provided within the original 10-day due date.
    3. If verifications are still not provided or client is unable to obtain documents, completes the SCD109 to request a certified copy of the client's birth certificate and/or DL 937 to request a CA ID. A copy of the SCD 109 must be scanned into IDM under Permanent Verifications.
    4. Ensures all contacts are documented in Journal section.
      1. Important: Cases must not be transferred out of Intake without either an SSN Data Match, a California Birth Record Match, acceptable citizenship/identity documents or an SCD 109/DL 937 on file.

Processing Annual Redeterminations

Face-to-Face Annual RD; CalWORKs/CalFresh/MC

Citizenship/Identity at Redetermination Face‐To‐Face:

EW:
1. Prior to Face-to-Face Interview:
  1. Searches IDM and prior case files for citizenship/identity verification on file
  2. Reviews for Citizenship/Identity exemptions
  3. Reviews MEDS INQE for Citizenship/Identity coding
    1. Note: If verification is not found and MEDS shows the client previously active in another county, the EW must contact the other county to request documents.
  4. Reviews and updates RRR Appointment Letter (CSC 35) indicating which case members need to provide Citizenship/Identity documents
  5. Mails RD packet with DHCS 0002 included.
Client:
1. Requests a Face-to-Face appointment.
EW:
1. Updates the CalSAWS windows as needed.
2. If verification is:
  1. E-Verified
    1. Confirms that DRA information is sent to MEDS.
    2. Enters appropriate citizenship/immigration information into CalSAWS[Refer to UGSS Chapter 2.8.1 “Batch AP19 Process,” ]
  2. Provided
    1. Completes DHCS 0011 and send to IDM to confirm that the EW reviewed the documentation.
    2. Confirms that DRA information/coding is sent to MEDS.
  3. Not E-Verified and Not Provided
    1. Checks [INQE] after 2 business days to see if the client has a successful SSN data match result (DOC TYPE = 2Z). Refer to SSN Data Match for Citizenship / Identity.
    2. If the client claims to have an acceptable document, allows an additional 10 days if verifications are not provided within the original 10-day due date.
    3. If verifications are still not provided or client is unable to obtain documents, completes the SCD109 to request a certified copy of the client's birth certificate and/or DL 937 to request a CA ID. A copy of the SCD 109 must be scanned into IDM under Permanent Verifications.
    4. Ensures all contacts are documented in Journal section.
      1. Important: Cases must not be transferred out of Intake without either an SSN Data Match, a California Birth Record Match, acceptable citizenship/identity documents or an SCD 109/DL 937 on file.

Note: If the client does not keep the scheduled appointment for the CalWORKs/Food Stamps face-to-face interview, the EW must mail the MC Application packet to the client with a 10-day due date

Mail in Redeterminations - Non-BSC

If the client does not keep the scheduled appointment for the CalWORKs/Food Stamps face-to-face interview, the EW must mail the MC Application packet to the client with a 10-day due date.

If the client brings in original documents to the district office, follow the steps below to verify citizenship/identity at Redetermination (not BSC) :

Clerical:
1. Follows standard procedure to notify the EW.
CST:
1. Completes the DHCS 0005 to verify that original documents were received.
2. Makes a copy of each document and date stamps the copy.
  1. Important: Do not date stamp the original Citizenship/Identity documents.
3. Returns originals to the client immediately along with the DHCS 0005.
EW:
1. Follows the Report Citizenship/Identity Data CalSAWS process to send confirmation to MEDS that the original documents were verified and recorded by the county.
2. Completes the DHCS 0011 to verify that the documents were reviewed and accepted.

Mail In Originals

If the client mails in original documents, follow the steps below to verify citizenship/identity documents:

Clerical:
1. Receives the RD packet and/or original documents in the mail room.
2. Immediately makes a copy and date stamps the copy.
  1. Important: Do not date stamp the original Citizenship/Identity documents.
3. Complete the DHCS 0005 to verify that original documents were received.
4. Scans the DHCS 0005 and copies of the documents into IDM.
5. Provides the original DHCS 0005 and the original documents to the EW.
EW:
1. Completes the DHCS 0011 to verify that the documents were reviewed and accepted.
2. Returns original(s) and DHCS 0011 to the client via Certified Mail with a return receipt.
3. Follows the process to send confirmation to MEDS that the original documents were verified and recorded by the county.
  1. Note: The document(s) and a copy of the DHCS 0011 must be scanned into IDM under Permanent Verifications.

Adding a Person

When adding a person to the MC case, follow the steps below to verify citizenship/identity:

Clerical:
1. Calls the EW to add a person (excluding DE newborns)
EW:
1. Searches IDM and prior case files for citizenship/identity verification on file
2. Reviews for Citizenship/Identity exemptions
3. Reviews MEDS INQE for Citizenship/Identity coding
4. Approves full-scope MC benefits if otherwise eligible.
  1. Note: If verification is not found and MEDS shows the client previously active in another county, the EW must contact the other county to request documents.
5. If verification is:
  1. E-Verified
    1. Confirms that DRA information is sent to MEDS.
    2. Enters appropriate citizenship/immigration information into CalSAWS[Refer to UGSS Chapter 2.8.1 “Batch AP19 Process,” ]
  2. Provided
    1. Completes DHCS 0011 and send to IDM to confirm that the EW reviewed the documentation.
    2. Confirms that DRA information/coding is sent to MEDS.
  3. Not E-Verified and Not Provided
    1. Checks [INQE] after 2 business days to see if the client has a successful SSN data match result (DOC TYPE = 2Z). Refer to SSN Data Match for Citizenship / Identity.
    2. If the client claims to have an acceptable document, allows an additional 10 days if verifications are not provided within the original 10-day due date.
    3. If verifications are still not provided or client is unable to obtain documents, completes the SCD109 to request a certified copy of the client's birth certificate and/or DL 937 to request a CA ID. A copy of the SCD 109 must be scanned into IDM under Permanent Verifications.
    4. Ensures all contacts are documented in Journal section.
      1. Important: Cases must not be transferred out of Intake without either an SSN Data Match, a California Birth Record Match, acceptable citizenship/identity documents or an SCD 109/DL 937 on file.

Client at Outstation Office

If the client is scheduled for a face-to-face interview with an Outstation EW to bring in proof of citizenship/identity follow the steps below:

Client:
1. Provides Citizenship/Identity documents.
Outstation EW:
1. Completes and signs the DHCS 0005 and gives a copy to the client.
2. Makes copies of the original Citizenship/Identity documents.
3. Date stamps the COPIES.
4. Returns the originals to the client immediately along with the DHCS 0005.
5. Places in basket to be returned to BSC for scanning.
6. Schedules another appointment with the client if there are still missing Citizenship/Identity documents.
Clerical:
1. Assigns RD packet and/or Citizenship/Identity verifications to EW for document processing.
EW:
1. Enters appropriate citizenship/immigration information into CalSAWS[Refer to UGSS Chapter 2.8.1 “Batch AP19 Process,” ]
2. Completes and updates the RRR in CalSAWS.
Outstation EW or EW:
1. Completes the DHCS 0011 to certify client provided acceptable documents.
2. Completes SCD 109 and/or DL 937 if client is unable to provide acceptable documents from Tiers 1-5.
  1. Important: The DHCS 0011, SCD 109 and DL 937 must be scanned into IDM under Permanent Verifications.

Documents Received by Mail

If the client mails in proof of citizenship/identity, follow the steps below:

Clerical:
1. Completes the DHCS 0005 and makes a copy.
2. Makes copies of original Citizenship/Identity documents.
3. Date stamps the COPIES.
4. Mails the original Citizenship/Identity documents and DHCS 0005 back to the client via certified mail with a return receipt.
EW:
1. Reviews copies of documents.
2. Follows process to record Citizenship/Identity Documents to MEDS for all case members.

Follow Up Process for Pending Verifications

The following process applies to both Intake and Continuing when Citizenship/Identity verifications are pending: The EW:

Sends DHCS 0006 with list of acceptable documents with a 10-day due date if phone contact is not successful.
Makes another attempt to contact the client by phone if documents are not provided and/or there is no contact from the client.
Extends the Reasonable Opportunity Period (ROP) if the client is making a Good Faith Effort to obtain documents and/or the Certified copy of the Birth Certificate is not yet received.
Documents all contacts made in Journal along with any reasonable information provided by the client which shows they are attempting to obtain the required Citizenship/Identity verifications.