Kansas Family Medical Assistance
Manual (KFMAM)
Eligibility Policy - 5/3/2024
02000 >>> 02040 >>> 2045 >>> 2045.04
2045.03
2045.04 Written Declaration of Citizenship - A written declaration may be used as verification of citizenship if no other documents are available. The EES Program Administrator/KanCare Clearinghouse Manager or designee must approve the declaration in order for it to be considered acceptable verification.
Declarations must be provided by at least two individuals, one of whom is not related to the individual, who have personal knowledge of the event(s) establishing the claim of citizenship. KDHE Eligibility Policy Appendix P-8, Third Party Declaration of Citizenship, may be used for this purpose. The person(s) making the declaration must:
(a) provide proof of his/her own citizenship and identity,
(b) provide information regarding why documentary evidence establishing the individual's claim of citizenship does not exist or cannot be readily obtained as part of the declaration, and
(c) sign the declaration under penalty of perjury in the presence of a witness.
When a declaration is used to document citizenship, the original must be retained in the case file indefinitely.