OBSOLETE POLICY CHIP MANUAL |
Effective: November 1, 2010
Individuals eligible to receive CHIP include the following.
U.S. Citizens. See section 202-1
Qualified aliens. See section 202-2
SSI recipients living in the U.S. on August 22, 1996 and meet the criteria for one of the grandfathered SSI recipient alien gross. See 2C below.
As of January 1, 2010, U.S. Citizens must document their Citizenship and Identity to be eligible for CHIP. (See Table IV.)
Applicants: Do not delay or deny benefits when an individual declares to be a U.S. Citizen or U.S. National, and there is no evidence that contradicts their claim.
If otherwise eligible, allow CHIP coverage and give the client reasonable time to provide the documentation by the end of the time frame given, or provide proof they are working to obtain the documentation.
“Reasonable time” is defined as (at least) 30 days. A client needs to either provide the documentation by the end of the time frame given, or provide proof that they are working to obtain the documentation. If the client still needs more time, give them at least another 30 days to obtain it.
If the client has been given reasonable time and does not provide the documentation or proof that they are working on obtaining it, remove the child from the CHIP coverage with proper notice.
EXAMPLES
Enrollees: Request Citizenship/ID verification of CHIP enrollees at their first review after January 1, 2010. If Citizenship verification is not available to complete the renewal, do not delay or deny benefits when an individual declares to be a U.S. Citizen or U.S. National and there is no evidence that contradicts their claim. Follow the “reasonable time” policy in #B above.
Citizenship/Identity Documentation Exceptions
The following individuals are EXEMPT and do not have to meet the Cit/ID documentation requirement. If the individual loses an exempt status they must meet the Cit/ID requirement at their next scheduled review.
SSI recipients and those in an SSI Protected group
SS-DI recipients
Medicare recipients
Children in receipt of Title IV-B or Title IV-E Subsidized Adoption Assistance
Children in receipt of Title IV-B or Title IV-E Foster Care Payments
Qualifying Aliens
Household members who are not receiving CHIP benefits.
Children Born to a Medicaid Eligible Mom
A child born to a mother who verifies she was on Medicaid at the time of the child’s birth is deemed to have met the Cit/Id documentation requirement. Workers can make a collateral contact with the applicable State Medicaid agency to verify the mother’s claim.
The mother could have received Medicaid in any U.S. State, District of Columbia or U.S. Territory.
Once the agency has verification of the mother’s eligibility, the child never has to provide Cit/ID documentation again. See Table IV, Chart 1 for acceptable verification.
EXAMPLES
Documentation Requirements:
States must obtain satisfactory documentary evidence of an applicant’s, or enrollee’s citizenship and identity.
Table IV (Charts 1, 2, 3, and 4) outlines a descending order of acceptable citizenship documentation based on the reliability of the documentation source. Attempt to get documentation from the highest source the client can access.
Chart 5 on Table IV describes the acceptable sources of Identity Documentation.
States are allowed to match with the State Verification and Exchange System (SVES) via the Social Security Administration (SSA) interface. A match satisfies the citizenship and identity requirement. (See #3 C. below for additional information.)
States are allowed to match with the State Vital Statistics to obtain birth verification.
When a client born in Utah does not have an original birth certificate, workers are to do an electronic search for birth years that have been computerized. For years that have not been computerized, they are to submit a Form 125 to Utah State Vital Records to obtain verification that a birth record is on file with the state.
Authentication of documents:
Workers are required to see original documentation, photocopy it and then authenticate each page of a document, if multiple pages. Each document is to be separately authenticated. For a document to be “authenticated,” it must have a permanent notation on the document that the worker certifies the photocopy is made from the original document, the date the copy was made, and the worker’s name.
The authentication must be readable and not cover up or obscure pertinent information on the document.
Only authenticate original Cit/ID documents that are being returned to the client. Electronic matches with Utah State Vital Records, Form 125, SAVE interface through eFIND, and Form 61-IC do not have to be authenticated.
Copies, notarized copies and facsimile copies CANNOT be authenticated.
The originals may be provided in person by the client or designee. Originals may be mailed in, though this is not encouraged because of risk of loss of the document in the mail.
Only employees of DCFS working with Child and Family Services or Juvenile Justice Services, DOH, and DWS have authority to authenticate Citizenship/ID documents. The only exception is when the Department of Health or DWS has given authority to other specific individuals to act as the agency’s authorized representative to receive verifications from clients. Those authorized representatives must have specific permission from the department and have no conflict of interest regarding CHIP eligibility. For example, a DSPD case manager is not authorized to see the original Citizenship document, photocopy it and authenticate it for the CHIP eligibility worker.
State Verification and Exchange System (SVES)
1) SVES verifies information regarding the person's claim of U.S. citizenship or nationality.
a) The client's name, SSN and date of birth compares with data in the SSA Master File of SSN Holders (Numident).
b) The interface is daily and responses are received the next day.
c) One of three responses is possible: positive, inconsistency with SSA records and no match with SSA records.
2) A positive response satisfies the Citizenship and Identity requirement. (See Table IV, Chart 1.)
a) The data submitted is consistent with SSA records.
b) No additional information is required from the client.
3) An inconsistency or no match response indicates the data submitted to SSA does not match; (i.e. misspelled name, incorrect SSN, incorrect DOB or incorrect citizenship declaration.)
a) The agency first makes a reasonable effort to identify and resolve the cause of the inconsistency. For example, typographical or other clerical error.
b) When an inconsistency is identified and corrected, resubmit the request.
c) When an inconsistency is not found by the agency, OR if the second request result is the same, the client has 90 days to provide proper citizenship documentation.
i. The 90 days starts with the date the client receives the notice.
ii. CHIP benefits remain open during the 90 day verification period.
iii. If the case closes for any reason during the 90 day verification period, the 90 days continues to run.
iv. Once the 90 day verification period has expired, it cannot be extended or repeated.
d) If proper citizenship documentation has not been provided by the end of the 90 day verification period, remove the individual from coverage at the end of the month for which 10-day notice can be given.