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, Post-
Secondary 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
programs
1. delivered at the community level, that...
2. do not condition assistance on income or resources
3. 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
NOTE: Immigrants on next slide
are eligible for all state & local
programs
•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.
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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
Refugees
Asylees
Amerasian
immigrants
Cuban or Haitian
Entrants
Paroled as refugees
or as asylees
Iraqi or Afghan
special immigrants
Trafficking
survivors
For persons not linked to Medi-Cal or CalWORKS (e.g.,
single adults w/o disabilities) who are:
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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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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
Public Housing and §8:
Mixed Status Households
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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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