3.27.1 Introduction
3.27.2 References
3.27.3 Scope
3.27.4 Did you know…?
3.27.5 Definitions
3.27.6 Objectives
3.27.7 Procedures
3.27.7-A: Who is eligible to receive public behavioral health services with verification of U.S. citizenship/lawful presence?
3.27.7-B: Who is eligible to receive public behavioral health services without verification?
3.27.7-C: Completing an AHCCCS Eligibility Determination Screening as part of the verification process
3.27.7-D: Documentation Requirements
 

3.27.1 Introduction
In the State of Arizona, verification of United States (U.S.) Citizenship or Lawful Presence of non-citizens is mandatory prior to a person being able to receive public health benefits (A.R.S.1-502).

In addition to citizenship/lawful presence, the Arizona Health Care Cost Containment Service (AHCCCS) requires verification of a person’s identification in order to determine eligibility.

A person who has verified both citizenship/lawful presence and identification and has been found eligible for AHCCCS may:

• Be eligible for Title XIX (Medicaid) or Title XXI (KidsCare) covered services, Not qualify for Title XIX/XXI entitlements, but be eligible for services as a person determined to have a Serious Mental Illness (SMI) (See PM 3.21, Service Package for Non-Title XIX/XXI Persons Determined to Have a Serious Mental Illness); or
• Not qualify for Title XIX/XXI entitlements, but be eligible for services.

Tribal and Regional Behavioral Health Authorities (T/RBHAs) and T/RBHA providers must verify U.S. citizenship or lawful presence in the U.S. of all persons applying for publicly funded behavioral health services.

3.27.2 References
The following citations can serve as additional resources for this content area:

• 42 CFR Part 400
• 42 CFR Part 403
• 42 CFR Part 411
• 42 CFR Part 417
• 42 CFR Part 422
• 42 CFR Part 423
• A.R.S. § 1-502
• A.R.S. § 36-3408
• AHCCCS/ADHS Contracts
• ADHS/RBHA Contracts
• ADHS/TRBHA Intergovernmental Agreements (IGAs)
• Section 3.1, Eligibility Screening for AHCCCS Health Insurance, Medicare Part D Prescription Drug Coverage and the Limited Income Subsidy Program
• Section 3.4, Co-payments
• Section 3.10, SMI Eligibility Determination
• Section 3.19, Special Populations
• Section 3.21, Service Package for Non-Title XIX/XXI Persons Determined to Have a Serious Mental Illness (SMI)
• Section 4.1, Disclosure of Behavioral Health Information
• Section 4.2, Behavioral Health Medical Record Standards
• Assisting Behavioral Health Recipients with AHCCCS Eligibility Manual
• Health-e-Arizona

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3.27.3 Scope
To whom does this apply?

T/RBHA providers must obtain documentation to verify citizenship/lawful presence for persons who are:

• Potentially eligible for AHCCCS (Title XIX or Title XXI) behavioral health services; and
• Not eligible for AHCCCS, but who may be eligible for services as a person determined to have SMI (see Section 3.21, Service Package for Non-Title XIX/XXI Persons Determined to Have a Serious Mental Illness (SMI));
• The required U.S. citizenship/lawful presence documents are considered “permanent documents”. Permanent documents include proof of age, Social Security Number, U.S. citizenship or immigration status. These are eligibility factors that typically do not change and only need to be verified once.¹
• Temporary documents include proof of income, expenses, assets or pregnancy.

3.27.4 Did you know?
Persons who present for crisis services in the public behavioral health system are not required to verify U.S. Citizenship/Lawful Presence to receive needed services.

If a person is currently enrolled with AHCCCS and has been assigned to a T/RBHA, verification of citizenship/lawful presence has already been completed.

The Arizona Health Care Cost Containment System’s (AHCCCS) online application for Health Insurance titled Health-e-Arizona, (see the Assisting Behavioral Health Recipients with AHCCCS Eligibility Manual) was designed to simplify the application process. Applicants can complete an application and verify U.S. citizenship/lawful presence with the assistance of a provider using the subscriber version of the Health-e-Arizona online application. Once completed, the application will be routed to the correct eligibility determination agency. The application also permits a person to apply for all AHCCCS programs and other public benefits for all family members on one application form. As such, all family members will be required to verify citizenship/lawful presence and identification through the same application.

As part of the eligibility process, applicants must submit verification of documents requested by the Health-e-Arizona program based on their individual living and financial situations. The requested information is saved in the Health-e-Arizona system for future review.

Persons who are able but refuse to participate in the screening and/or application process using Health-e-Arizona are not eligible for behavioral health services (A.R.S. § 36-3408). See PM Section 3.1, Eligibility Screening for AHCCCS Health Insurance, Medicare Part D Prescription Drug Coverage, and the Limited Income Subsidy Program, Subsection 3.1.6-D, for more information. .

3.27.5 Definitions
Lawful Presence

U.S. Citizen

3.27.6 Objectives

• To describe the procedures to verify U.S. citizenship/lawful presence through Health-e- Arizona, and to assist behavioral health recipients with applying for AHCCCS health insurance, when indicated;
• To identify methods for determining if a person has previously verified U.S. citizenship/lawful presence and identification;
• To determine what documents are accepted as verification of citizenship/lawful presence and identification for AHCCCS eligibility; and
• To describe expectations for assisting persons in obtaining the necessary documents to verify citizenship/lawful presence and/or identity.

3.27.7 Procedures

3.27.7-A. Who is eligible to receive public behavioral health services with verification of U.S. citizenship/lawful presence?
The following individuals are eligible for public behavioral health services:

• Persons determined to be eligible for AHCCCS.
• Persons not eligible for AHCCCS but determined to have a Serious Mental Illness (SMI) AND can provide documentation of citizenship/lawful presence. (see Section 3.21, Service Package for Non-Title XIX/XXI Persons Determined to Have a Serious Mental Illness (SMI))

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3.27.7-B. Who is eligible to receive public behavioral health services without verification?
Persons not eligible for AHCCCS and NOT determined as SMI but who qualify to receive behavioral health services funded through the Substance Abuse Prevention and Treatment (SAPT) Block Grant or the Projects for Assistance in Transition from Homelessness (PATH) Program are eligible to receive services in accordance with Provider Manual Section 3.19, Special Populations. However, persons receiving services funded by SAPT or PATH must still be screened for AHCCCS eligibility in accordance with Provider Manual Section 3.1, Eligibility Screening for AHCCCS Health Insurance, Medicare Part D Prescription Drug Coverage and the Limited Income Subsidy Program.

Persons presenting for and receiving crisis services are not required to provide documentation of eligibility with AHCCCS nor are they required to verify U.S. citizenship/lawful presence prior to or in order to receive crisis services.