Immigrants’ Eligibility For Benefits In California FPL33RSS AIDS Legal Referral Panel Access To Health Care And Immigrants Power Point

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IMMIGRANT ELIGIBILITY FOR
HEALTH CARE AND PUBLIC
BENEFITS IN CALIFORNIA
AIDS Legal Referral Panel
June 4, 2013
Tanya Broder

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Issues Affecting Access to Benefits
 Immigrant eligibility rules
 State residency and other eligibility rules
 Privacy, Confidentiality and Verification
 Concerns about “Public charge”
 Concerns about Sponsors
 Linguistic and Cultural Competence
 Logistical Barriers
 The “Climate”

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State Residency: Medi-Cal
Live in CA with intent to remain permanently

or for an indefinite period, or

Live in CA and entered State with job commitment

or to seek employment, whether or not currently
employed.

In 2014, federal rules will use “reside” instead

of remain, and will eliminate “permanently” and
“indefinite period.” But not intended for visitors or
those coming solely for medical care to be eligible.

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Immigrant Benefit
Classifications
 U.S. Citizens
 “Qualified” immigrants
 Entering the U.S. before 8/22/96
 Entering the U.S. on or after 8/22/96
 “Not Qualified” immigrants
 PRUCOL (Permanently Residing Under Color of Law)
 Other lawfully present non-citizens

 Undocumented immigrants

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Qualified Immigrants
 Lawful Permanent Residents (LPR)
 Refugees, Granted Asylum, Withholding of

Deportation/Removal, or Conditional
Entrant status

 Paroled into U.S. for at least 1 Year
 Cuban and Haitian Entrants
 Certain Battered Spouses and Children
 Certain Survivors of Trafficking

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Qualified Battered Immigrants
Must have prima facie case or approved:
 Visa petition filed by U.S. citizen or LPR

spouse/parent

 Self-petition under VAWA, or
 Application for cancellation of removal/suspension of

deportation under VAWA

Parent of battered child and child of battered spouse also
considered “qualified”

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Survivors of Severe Form of Trafficking
 If 18 or over, must be certified by HHS
 Children under 18 need HHS “eligibility letter”
 Eligible for federal benefits to the same extent as

refugees.

 Derivative beneficiaries of “T” visas also eligible for federal

benefits.

 Survivors with approved/prima facie case for T visa are
“qualified” - but other trafficking victims also are eligible
for benefits.

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Not Qualified Immigrants
ALL Other Non-citizens

… even if have work authorization and
are lawfully present in U.S.

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PRUCOL
Permanently Residing Under Color of Law - not an
immigration status, but a benefit eligibility category

May include persons:
 with approved immediate relative visa petition
 who filed application for adjustment to LPR status
 granted deferred action
 granted Family Unity status

 granted a stay of deportation
 who have lived in the US continuously since before Jan. 1, 1972
 who are survivors of domestic violence (certain immigrants)
 Other persons in the US with the knowledge of DHS

whose departure that agency does not contemplate
enforcing.

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Not Qualified Immigrants:
Programs Barred
Federal

“Public Benefits” barred
State or Local

“Public Benefits” barred
unless state passes new law

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Not Qualified Immigrants:
Federal Program Bar
Bar on Federal “Public Benefits”

“Public Benefits” to be defined by federal agencies (only HHS,
FEMA and a few others have done so)
•Examples of “public benefit” in law
 Grants, Contracts, Loans, Professional or Commercial
Licenses provided by government
 Retirement, Welfare, Health & Disability, Housing, PostSecondary Education, Food Assistance, Unemployment
Benefit, FEMA, or any “similar benefit,” AND
 Assistance provided to individual, household, or
family unit, by an agency/funds of federal government

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Examples of HHS

Federal Public Benefits
 Adoption Assistance
 Child Care and Development Fund
 Foster Care
 Independent Living
 Low Income Home Energy Assistance Program









(LIHEAP)(weatherization of single unit buildings)
Medicare
Medicaid (except emergency medical)
Mental Health Clinical Training Grants
Refugee benefits (Cash, Medical, Social Services)
Social Services Block Grant (SSBG)
Children’s Health Insurance Program (CHIP)
Temporary Assistance for Needy Families

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Programs Exempt from
Federal Bar
 Emergency Medicaid and other emergency medical services
 Immunizations, testing and treatment for symptoms of

communicable diseases (outside of Medicaid)
 Short-term non-cash disaster relief
 Certain housing assistance if receiving on 8/22/96
 School Lunch and School Breakfast
 State option to provide WIC
AND
1.
2.
3.

programs
delivered at the community level, that...
do not condition assistance on income or resources
are necessary to protect life or safety

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AG’s List of Programs
“Necessary to Protect Life or Safety”
 Child protection & adult

protective services

 Violence and abuse

prevention, including
domestic violence

 Mental illness or substance

abuse treatment

 Short-term shelter or housing

assistance

 Programs during adverse

weather conditions

 Soup kitchens, food banks,

senior nutrition programs

 Medical & public health services

& mental health, disability,

 Substance abuse services

necessary to protect life or safety

 Programs to protect life & safety

of workers, children & youth, or
community residents

 Other services necessary for the

protection of life or safety

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Non-Profit Agencies
•Non-profit charitable organizations are

not required to determine, verify or
otherwise ask for proof of an immigrant’s
status

 applies to immigrant restrictions in the 1996 welfare

and immigration laws

 Non-profits can create a safe environment for

immigrants and their family members who are
seeking services

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CA Programs Available Regardless of
Status
 Emergency Medi-Cal
 Prenatal care (Medi-Cal)
 Access for Infants and Mothers

(AIM)
 Long-term care
 Early Breast Cancer Detection
and Breast and Cervical Cancer
Treatment
 California Children’s Services
(CCS)
 Healthy Kids (Children’s Health
Initiatives)
 Health Programs in some
counties (Healthy SF)

 Community clinics
 Child Health and Disability

Prevention Program
(CHDP) and CHDP
“Gateway”
 Family PACT
 Minor consent services
 Mental health services
 MRMIP
 Regional Center Services
 Women Infants and
Children (WIC)
 School lunch/breakfast

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Angie and Nadia
Angie works in a health clinic, a non-profit
organization that receives federal funds.
Patients can be treated at the clinic, regardless
of their income.
Nadia, an undocumented woman with HIV,
seeks treatment at the clinic.
1. Does the clinic provide a federal public benefit?
2. Is Nadia eligible for treatment?
3. Is Angie required to verify Nadia’s immigration status?
4. Is Angie required to report Nadia to the

Department of Homeland Security?

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Candace and Tara
 Candace is undocumented. Her daughter, Tara, was

born in the U.S. An earthquake destroyed the
home they rented in Southern California, and they
were evacuated to Northern California. They lost
their housing and all of their possessions, have no
money or identification documents. Which benefits
or services can they receive?

 Candace started a business. Can she get child care while

she works?

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Immigrant Eligibility for Major
California Programs
Full-Scope Medi-Cal
Qualified immigrants &
PRUCOL

CalWORKs
Qualified immigrants
& PRUCOL. Deeming rules apply

•CalFresh/California Food

Assistance Program (CFAP)
Qualified immigrants (plus)
Deeming rules apply.

•SSI/Cash Assistance

Program for Immigrants
(CAPI) and IHSS
Qualified Immigrants and
PRUCOL. Deeming rules apply.

NOTE: Immigrants on next slide
are eligible for all state & local
programs

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Andrea
Andrea applied to become an LPR based on
her marriage to a U.S. citizen, but does not
have her green card. She has a disability.
Which services can she receive?

What if her husband is abusive?

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Elena
Elena is an undocumented woman with no children. She
has a disability. She has a VAWA “prima facie” letter from
USCIS. Does she qualify for full-scope Medi-Cal?

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Survivors of Trafficking and other
Serious Crimes in CA:
Trafficking

Survivors can get
state and local
benefits before
certified for federal
benefits

12 months, extended if

T visa application or
Continued Presence
request filed

U visa applicants/

holders get state and
local benefits

 Continues unless U status

finally denied

 State RMA, RCA and

RSS available for
trafficking survivors & U
visa applicants/holders

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Refugee Cash, Medical and Social Services
For persons not linked to Medi-Cal or CalWORKS (e.g.,
single adults w/o disabilities) who are:
 Refugees
 Asylees
 Amerasian

immigrants
 Cuban or Haitian
Entrants

 Paroled as refugees

or as asylees
 Iraqi or Afghan
special immigrants
 Trafficking
survivors

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State-funded RCA, RMA, RSS
Applicants for U non-

immigrant status and
individuals with U
status

Up to 8 months of

state funded RMA/RCA

 Pre-certified

trafficking victims may
receive up to 8 mos.
of state RCA/RMA

 Up to 8 mos. of

federal RCA/RMA if
certified by ORR or
get T status

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Clare, Mike and Tyler
 Clare and her boyfriend Tom are undocumented. Tom

is in jail due to domestic violence. Clare has two
children, Mike, an undocumented teenager, and Tyler, a
six-year old, born in the U.S. Clare is pregnant. Which
benefits can they receive?

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SSI Eligibility
 Receiving SSI or

application pending on
August 22, 1996

 Qualified immigrants

with disabilities, who
were lawfully present
in the U.S. on 8/22/96

 LPRs with credit for 40

quarters of work
history. Post 8/22/96
entrants must wait until in
qualified status for five
years.

Refugees, asylees, granted

withholding of deportation/
removal, Cuban/Haitian
entrants, Amerasian
immigrants, Iraqi and Afghan
Special Immigrants, trafficking
victims, during first 7 years

after obtaining status
 Veterans, active duty military,

spouses, surviving spouses, &
children
 Members of federally recognized

Indian tribes or American Indians
born in Canada

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Cash Assistance Program for
Immigrants (CAPI)
 Cash assistance for immigrant seniors and

immigrants with disabilities who would have been
eligible for SSI under the pre-8/22/96 rules for
immigrants

 SSI rules generally apply, except that individuals get

$10/mo. less and couples get $20/mo. less than
SSI/SSP

 But, unlike SSI, can also get CalFresh or CFAP if

qualified and otherwise eligible

 Sponsor deeming rules pose barriers

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Sponsor Deeming
Generally applies only to LPRs who

immigrated via a family-based petition

Income/resources of sponsor may be added to

immigrant’s in determining eligibility

Can render immigrant over-income for the

benefit, even if receive nothing from sponsor

Exceptions to deeming may include domestic

violence, indigence or others, depending on the
program.

No deeming in CA health care programs.

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Veronica
 Veronica obtained T non-immigrant status in

September 2005, and became a lawful permanent
resident (LPR) in 2009. She has a disability. Which
benefits can she receive?

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Public Housing and §8
“Eligible” immigrants:
 Lawful permanent residents
 Lawful temporary residents
 Refugees, granted asylum or withholding of
deportation/removal, trafficking victims
 Parolees
 Citizens of Micronesia, Marshall Islands, and
Palau
 Others?

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Public Housing and §8:
Mixed Status Households
 Family may reside in housing if at least one

member has an eligible status

 Those declaring an eligible status must provide

proof of status and SSNs

 Those choosing not to declare an eligible status

are not required to show proof of status or SSN

 Subsidy is pro-rated based on the portion of

eligible household members

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Kim and her Family
 Kim is a 28-year-old mom with one child, age

6. Both are LPRs who entered the U.S. in 2010.
Kim lost her job. Are mom and child eligible for
CalFresh? What else can they receive?

 Kim’s mother travels to U.S. from Korea to visit.

When her visa expires, she overstays. Grandma
slips, breaks her arm, and is taken to the
emergency room. Is she eligible for Medicaid?

 Can the family apply to live in public housing?

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Health Care Reform
 Medicaid expansion for single adults (up

to 138% FPL)

 New state-based health insurance

marketplaces (Exchanges) – Covered
California

 Premium tax credits for families earning

up to <400% FPL, and cost-sharing
reductions for <250% FPL

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Health Reform: Immigrants
Access to exchange at full cost
Lawfully present immigrants only
Access to subsidies for exchange
Lawfully present immigrants

Access to federal Medicaid
 5 year + waiting period for “qualified” immigrants
maintained. Eligibility varies by state.
Employer incentives and safety net

remain important

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Resources
Immigrants & Public Benefits:
 National Immigration Law Center:
www.nilc.org
 California Immigrant Policy Center (CIPC):

www.caimmigrant.org

Individual legal assistance for health care:
www.healthconsumer.org
Legal Services:
www.lawhelpcalifornia.org

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Questions
Tanya Broder
broder@nilc.org

National Immigration Law Center
www.nilc.org

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Title                           : Immigrants’ Eligibility for Benefits in California
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