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Page 3 of 5 § 10:70-3.2 Citizenship and alien status 12. Certain aliens who are victims of domestic violence as specified in (b)12 above, but only after the alien has been present in the United States for five years. (d) Any alien who is not an eligible alien as specified in (b) and (c) above is ineligible for Medically Needy benefits. Any such alien, if a resident of New Jersey and if he or she meets all other Medically Needy eligibility requirements contained in this chapter, is entitled to Medically Needy coverage for the treatment of an emergency medical condition only. This coverage is limited to those emergency services which would otherwise be covered by Medically Needy. This coverage does not include inpatient hospital services. 1. An emergency medical condition is one of sudden onset that manifests itself by acute symptoms of sufficient severity (including severe pain) such that the absence of immediate medical attention could reasonably be expected to result in: i. Placing the patient's health in serious jeopardy; ii. Serious impairment to bodily functions; or iii. Serious dysfunction of any bodily organ or part. 2. An emergency medical condition shall include all labor and delivery for a pregnant woman, but shall not include routine prenatal or routine post-partum care. 3. Services related to an organ transplant procedure are not covered under services available for treatment of an emergency medical condition. (e) Persons claiming to be citizens and eligible aliens shall provide the county board of social services with documentation of citizenship or alien status, in accordance with (f) below. (f) As a condition of eligibility, all applicants for the Medically Needy program, (except those applying solely for services related to the treatment of an emergency medical condition or for services related to labor and delivery for pregnant women) shall sign a declaration under penalty of perjury that they are a citizen of the United States or an alien in a satisfactory immigration status. In the case of a child or incompetent applicant, another individual on the applicant's behalf shall complete the same written declaration under penalty of perjury. 1. The following are acceptable documentation of United States citizenship: i. A birth certificate; ii. A religious record of birth recorded in the United States or its territories within three months of birth. The document must show either the date of birth or the individual's age at the time the record was created; iii. A United States passport (not including limited passports which are issued for periods of less than five years); iv. A Report of Birth Abroad of a Citizen of the U.S. (Form FS-240); v. A U.S. Citizen I.D. Card (INS Form-197), Naturalization Certificate (INS Form N-550 or N-570); vi. A Certificate of Citizenship (INS Forms N-560 or N-561); vii. A Northern Mariana Identification Card (issued by the INS to a collectively naturalized citizen of the United States who was born in the United States before November 3, 1986); viii. An American Indian Card with a classification code "KIC" (issued by the INS to identify U.S. citizen members of the Texas Band of Kickapoos); or ix. A contemporaneous hospital record of birth in one of the 50 states, the District of Columbia, Puerto Rico (on or after January 13, 1941), Guam (on or after April 10, 1899), the U.S. Virgin Islands (on or after January 17, 1917), American Samoa, Swain's Island, or the Northern Mariana Islands (unless the person was born to foreign diplomats residing in any of these jurisdictions).