Revised August 19, 2008

Purpose: Citizenship requirements for adult applicant and recipients of GAX.

GAX Adult Citizenship Requirements

Adults 19 or older must provide approved citizenship and identity documentation prior to approval of GA-X medical (see approved documents list). Applicants can not be approved for GA-X medical using the Citizenship Documentation and Identity Declaration Form (DSHS 13-789).

Applicants age 18 (GA-R) unable to verify citizenship and identity can be approved with the Citizenship Documentation and Identity Declaration Form (DSHS 13-789) and will need to cooperate with the CCU in getting documentation.

If the GA-U applicant does not have acceptable proof of citizenship they must fully complete, sign and date the Citizenship Documentation and Identity Declaration Form (DSHS 13-789) for the CCU to request an out of state birth certificate. If the applicant has proof of citizenship or identity at home do not send request to CCU for identity or out of state birth certificate. The FSS must give the client a pend letter for the verification.

NOTE:

If GA-U applicants do not verify citizenship and identity or complete the form this will not delay or deny GA-U cash and medical once the incapacity is approved. Citizenship verification is not a requirement for GAU cash or medical.

Due to delays to receive out of state birth certificates worker should review with client the possibility of T3 or T4 verification (see attached check list) before requesting an out of state birth certificate. If client thinks they have T3/T4 verification send a request to the CCU following T3/T4 instructions below.

ACES DEM2 Coding

	Citizenship	Identity
19 or older unable to verify	FR*	R*
18 year old (GA-R)	AF**	D**

*Will issue GAU medical only.

** Will issue CN medical

All GAU applicants 19 or older unable to verify citizenship/identity must be coded with the FR or R above.

GA-X Approval Received

Financial worker codes clients DEM2 screen with disability approval source “PX”. Prior to approving GA-X medical the FSS must review citizenship and identity coding and make sure verification is in the record.
- If citizenship is coded T1, T2, T3, T4 or EW and identity is coded V or E then ACES will sprout to GA-X medical.
- If citizenship FR or identity coded R ACES will not sprout to GA-X medical and the client will continue to receive GAU medical.

When the CCU receives acceptable verification on GAU clients with citizenship coded “FR” or identity coded “R”, the CCU will update ACES with the correct citizenship and identity codes. CCU will review for GA-X approval coding and process all eligible GA-X months.

EXAMPLE

Single adult age 25 applies for GAU due to mental health issues. Client has WA Id card was born in Texas but has no birth certificate or any other acceptable documentation (including T3 or T4). Client must complete, sign and date the Citizenship and Identity Declaration form and FSS will forward to CCU to request out of state BC. FSS receives GAU incapacity approval. The FSS authorizes GAU cash and medical with the following citizenship and identity coding:

Citizenship FR (has no proof of citizenship)

Identity V (WA ID)

Once citizenship verification is received the CCU will code correct citizenship valid value and process all eligible GA-X months.

T3 or T4 Requests

FSS must get completed Citizenship Documentation and Identity Declaration Form (DSHS 13-789) even if referring for T3/T4 process and send to DMS for imaging (this will be used if client ends up not being able to provide this level).

DMS tickler to CCU with subject line T3/T4 request is sent to CCU pool (site127 @CCU).
Details in tickler need to tell CCU which requirement the client says they can get.
CCU will send letter requesting documents or affidavits.
CCU will code ACES when citizenship and identity verification is received and process all eligible GA-X months if disability approval is coded, or request declaration for out of state BC if unable to provide acceptable T3/T4.

Identity and Birth Certificate Request Requirements

For a birth certificate request:

Citizenship Documentation and Identity Declaration Form (DSHS 13-789) must be signed, dated and have all sections completed.

DMS tickler with subject “Out of State BC request” is sent to CCU Pool (site 127 @CCU).

Declaration is faxed to CCU (800- 374-5313).
For identity verification FSS will send a DMS tickler with subject “ID verification request” to CCU Pool (site 127@CCU).
CCU will code ACES when citizenship and identity verification is received and process all eligible GA-X months if disability approval is coded.

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GA-X Approval Received

T3 or T4 Requests