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Education Document The school record must show a U.S. birthplace and the name of the child. Evidence of civil service employment by U.S. government The document must show employment by the U.S. government before June 1, 1976. Persons employed with the U.S. Government prior to that date had to be U.S. citizens. Hospital record Extract of a hospital record on hospital letterhead established at the time of the person’s birth and that indicates a U.S. place of birth. This is not a souvenir “birth certificate” issued by the hospital. Life, health or other insurance record Must show a U.S. place of birth. Medicaid Birth Claim

When the Wisconsin Medicaid program pays the costs associated with the birth of an infant who either: • Did not qualify as a CEN, • Was a CEN, but born before July 1, 2006, The infant will be considered a U.S. citizen who has met the citizenship documentation requirement. If citizenship is not verified through a data exchange, identity documentation is still required. Medical record (doctor, clinic, hospital) The document must show a U.S. birthplace. An immunization record is not considered a medical record for purposes of establishing U.S. citizenship. Official Military record of service The document must show a U.S. birthplace. Admission papers from nursing home, skilled nursing care facility or other institution The document must show a U.S. birthplace. Other MA Program Verified Citizenship An individual has already provided proof of citizenship while they were receiving Wisconsin Medicaid outside of CARES. For example, use this for members previously enrolled through the Katie Beckett program. Birth Certificate Paid by IM Agency A U.S. public birth certificate (paid for by the Income Maintenance agency) showing birth in one of the 50 States, the District of Columbia, Puerto Rico (if born on or after January 13, 1941), Guam, the Virgin Islands of the U.S. (on or after January 17, 1917), American Samoa, Swain’s Island, or the Northern Mariana Islands (after November 4, 1986). The birth record document may be recorded