It is critical that all children in the United States have access to nutrition, healthcare, and other services to help them grow and thrive. Yet federal eligibility rules for immigrant children and mixed status families are complex and limit access for this rapidly growing population. Assistance with enrollment through community outreach and culturally competent services is key to ensuring that all eligible immigrant children and families are able to participate in these vital programs. These presentations from experts in the field provide an overview of the federal eligibility rules for immigrant children and mixed status families and the barriers to access, as well as strategies for improving access and increasing enrollment.

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

2. 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

3. Qualified Immigrants
 Lawful Permanent Residents (LPRs)
 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

4. Not Qualified Immigrants
ALL Other Non-citizens
(Even if have work authorization and are lawfully
present in U.S.)

5. Not Qualified Immigrants:
Programs Barred
Federal
“Public Benefits” barred
State or Local
“Public Benefits” barred
unless state passes new law

6. 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

7. Examples of HHS and other
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 (TANF)
 Supplemental Nutrition Assistance Program (SNAP)

8. 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
2. do not condition assistance on income or resources
3. are necessary to protect life or safety

9. 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

11. Affordable Care Act
• US citizens, nationals and lawfully present individuals
eligible for private health insurance in the individual
“marketplaces,” subsidies (premium tax credits and cost-
sharing reductions), Basic Health Plan
– Undocumented and DACAmented immigrants
ineligible even for full-price insurance in the individual
marketplace

12. Lawfully Present under ACA
• Lawful Permanent Residents (LPRs, aka green card holders),
including applicant for adjustment of status
• Refugees
• Conditional Entrants (pre-1980 status similar to refugee status)
• Asylees
• Withholding of Deportation/Removal under INA or CAT
• Applicants for Asyulm or Withholding of Deportation/Removal (if
granted employment authorization)
• Parolees of at least one year
• Cuban and Haitian entrants
• Temporary Protected Status (TPS)
• Deferred Enforced Departure
• Deferred Action (except DACA; DAPA exclusion expected)
• Special Immigrant Juveniles

13. Lawfully Present under ACA (cont’d)
• Certain domestic Violence Survivors and their children
• Trafficking victims and derivatives
• U visa holders
• Nonimmigrant visa holders
• Citizens of Micronesia, Marshall Islands and Palau (aka Compacts of
Free Association states)
• Lawful Temporary Residents and Applicants for Legalization under
IRCA
• Legalization under LIFE Act
• Applicants for Cancellation of Removal or Suspension of Deportation
• Order of Supervision
• Registry Applicants

14. 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

15. Public Charge
• A “public charge” is a person considered primarily dependent on the
government for subsistence, as demonstrated by:
– receipt of public cash assistance for income maintenance or
– institutionalization for long-term care at government expense
• A person who is found likely to become a public charge may be
denied:
– Admission to the U.S., or
– Lawful permanent resident status

16. Sponsor Deeming
Generally applies only to LPRs who immigrated via
a family-based petition (not humanitarian-based)
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.

17. No Public Charge Test for:
 Refugees, Granted Asylum or Withholding
 Trafficking Victims, U visa holders
 VAWA self-petitioners
 Cubans under Cuban Adjustment Act
 Haitians under Haitian Refugee Immigration Fairness Act
 NACARA Adjustment
 Registry applicants
 Special Immigrant Juveniles
 Certain Indo-Chinese, Eastern European parolees
applying for Adjustment
 Citizenship applicants

18. Non-cash benefits and “special purpose”
cash NOT considered
Examples of services that don’t affect public charge
decision:
 Medicaid, ACA, CHIP and other health insurance
programs
 Nutrition programs (SNAP, WIC, school meals)
 Housing Assistance, LIHEAP
 Child Care, Job Training, short-term rehab
 Disaster assistance
 “Special purpose” cash

19. Key Issues for Mixed-Status Families
• Undocumented individuals may apply for coverage on behalf of their
dependent family members
• Applications should distinguish between applicants (e.g., U.S. citizen
child) & non-applicants (e.g., undocumented parent)
• Non-applicants are not required to provide their immigration status
• Non-applicants without SSNs cannot be required to provide one
(and should never provide an SSN unless officially issued by the
Social Security Administration)
• Information provided on an application may be used ONLY to
determine eligibility for program.

20. Verification of Eligibility and Immigration
Status
• Key provisions of Sept 2000 Tri-Agency Guidance (CMS, ACF, USDA):
– Prohibits violation of Title VI Civil Rights Act of 1964 (based on
race, color and national origin)
– Prohibits denying benefits to those who do not disclose
information not required (i.e., SSN)
– Must inform when SSN is mandatory and how it will be used
– Cannot deny benefits to eligible individuals based on status of
other household members

21. What Advocates CAN DO:
• Document harm of restrictive policies and benefits of improving
access
• Monitor policies to ensure they are implemented properly
• Educate families about available services
• Help ensure that immigration and health policies respond to
families and public health needs
• Address the barriers that prevent eligible families from securing
care

23. Open Enrollment Season 2
5 enrollment + tax centers
9,410 enrollment assists
5,503 enrolled in Marketplace health insurance
Directly enrolled 4,135 & assisted 1,368 likely to enroll
$13,873,440 in Premium Tax Credits over 12 months
$11.6m for directly enrolled & $2.3m for likely to enroll
96% of those enrolled received Premium Tax Credits
Average $4,086/year

24. Who We Serve
61% Hispanic/Latino
22% White/Caucasian
10% African American/African/Black
5% Asian
2% Other
64% speak a language other than English
55% speak Spanish
90% have household income ≤ 250% FPL

25. Reaching the Uninsured
69% of households we enrolled in OE2 had at least one
parent who was currently uninsured
48% had been uninsured for at least one year
31% had been uninsured for 5 or more years

26. ACA Outreach
#1 Earned Media
#2 Referrals from trusted partners
-----------------------------------------------
#3 Advertisements on Univision TV
#4 Spokesperson endorsements on
Spanish talk radio

27. ACA Enrollment Challenges
1. Screening
2. Dealing with misinformation and bad actors
3. Determining eligibility for tax credits
(& the importance of understanding taxes)
4. Determining eligibility for credits below 100% FPL
5. Working in a non-expansion state
6. Assisting with post-enrollment challenges

28. Determining Eligibility for Tax Credits

30. Tool
for determining
eligibility for
tax credits
below 100% FPL
page 1

31. Tool
for determining
eligibility for
tax credits
below 100% FPL
page 2

32. Marketplace tips to get correct results for
immigrants eligible for tax credits
below 100% FPL

36. Elizabeth Colvin, JD
Director, Insure Central Texas
A program of Foundation Communities
Elizabeth.Colvin@foundcom.org
512-554-4409

37. Immigrant Access to Cash, Food
Security and Public Housing
First Focus: Coalition for Access and Opportunity
April 15, 2015
Stephanie Altman, Assistant Director Healthcare
Justice, Shriver Center
stephaniealtman@povertylaw.org

38. Temporary Assistance for Needy Families (TANF)
• Provides cash assistance to pregnant moms and families with
children 18 and under.
• States have a lot of flexibility to design their TANF programs.
• Federal law bars states from using federal TANF dollars to assist
most legal immigrants until they have been in the U.S. for at least
five years.
– Applies to cash assistance, work supports such as child care,
transportation, and job training too.
– States can choose to provide benefits to recent immigrants who are
subject to the five-year bar, but fewer than half do so.
– States can also choose to provide TANF to legal immigrants not subject
the five-year bar (because they arrived before the 1996 law or
have been in the country for at least five years) and nearly all states
do.

39. The Supplemental Nutrition Assistance Program (SNAP)
formerly known as the Food Stamp Program
• The average SNAP recipient received about $125 a month (or about $4.17 a day) in FY2014.
• Enrolled households receive an EBT card, which is loaded with benefits once a month.
• SNAP cannot be used to purchase alcoholic beverages, cigarettes, vitamin supplements, non-
food grocery items such as household supplies, diapers or hot foods.
• SNAP eligibility rules and benefit levels are, for the most part, set at the federal level and
uniform across the nation
• Under federal rules, before even considering immigration status, to qualify for SNAP benefits,
a household must meet three criteria (states do have flexibility to adjust limits):
1. Its gross monthly income generally must be at or below 130% FPL, or $2,144 (about
$25,700 a year) for a three-person family in fiscal year 2015. Households with an
elderly or disabled member need not meet this limit.
2. Its net monthly income, or income after deductions are applied for items such as high
housing costs and child care, must be less than or equal to the poverty line (about
$19,800 a year or $1,650 a month for a three-person family in fiscal year 2015).
3. Its assets must fall below certain limits: in fiscal year 2015 the limits are $2,250 for
households without an elderly or disabled member and $3,250 for those with an
elderly or disabled member.

40. SNAP Immigration Eligibility Rules
• Eligible immediately if: U.S. Citizen (by birth or naturalization), Refugee
(§207), Asylee (§208), Cuban/Haitian National admitted after 4/21/80, etc.
• Eligible after having status for 5 years of: Legal Permanent Resident (LPR);
Conditional entrant under §203(a)(7); Parolee; Abused spouse or child or
parent or child of abused person with petition pending under VAWA
• Eligible without 5 year wait if: Under 18, disabled or blind, Veteran, or
LPR with 40 quarters, AND Status of LPR, conditional entrant, parolee,
abused noncitizen, or special Iraqi/Afghan immigrant
• Undocumented immigrants are ineligible for SNAP. However, ineligible
immigrants are still considered a part of the household, and should be
listed on applications (and assets of an ineligible household member count
in full).

41. Federal Housing Assistance:
The Department of Housing and Urban Development (HUD) oversees three
major programs:
1. Housing Choice Vouchers:
– 75%of new households admitted each year must be “extremely low-income,”
with incomes not exceeding 30% of the local median or the poverty line,
whichever is higher. Other new households may have incomes up to 80% of
the area median. Housing agencies may set admissions preferences based on
housing need or other criteria.
2. Section 8 Project-Based Rental Assistance:
– A family must be “low-income” — meaning that its income may not exceed
80% of the local median income — in order to move into Section 8 PBRA
housing.
3. Public Housing:
– A family must be “low-income” in order to move into public housing. At least
40% of the new families that an agency admits each year must be “extremely
low-income”.

42. Federal Housing Assistance: Immigrant eligibility
• Citizens: A citizen born in the United States; A naturalized citizen;
• Qualified Immigrants:
– A lawful permanent resident,
– A registry immigrant (admitted for permanent residence by the U.S. Attorney General
and eligible for citizenship),
– A refugee or an asylee,
– A conditional entrant,
– A parolee,
– A withholding grantee,
– A person granted 1986 amnesty status,
– A resident of the Marshall Islands, Micronesia, Palau, or Guam,
– A victim of trafficking or relatives of such a victim.
• If one member of your household fits into any of the categories above, your whole family
can apply to all of the federal restricted programs. This person does not have to be the
head of household.
• Only household members who claim to be a US citizen or "eligible immigrant" have to verify a
valid Social Security Number. You should not have to give a Social Security number to a
program that does not verify citizenship or immigration status.

43. How does a federally-funded housing program that
restricts eligibility to U.S. citizens and "eligible
immigrants" figure out rent?
• It depends on the immigration status of the various family members.
• If everyone in the family is a U.S. citizen or an "eligible immigrant:" It
depends on the program. Some programs, such as the Low Income
Housing Tax Credit, charge all tenants in subsidized units the same rent
amount regardless of income. HUD-funded housing programs generally
base the rent amount on household income. When all members of the
family are U.S. citizens or "eligible immigrants," families in these programs
generally pay about 30% of their total income toward rent.
• If at least one person in the family is NOT a U.S. citizen or an "eligible
immigrant (called a "mixed family"):" the rent will be higher than if all
members were eligible. The landlord prorates, or figures out
proportionately, the rent based on the number of citizens or "eligible
immigrants" in the household.
• If no one in the family is a U.S. citizen or "eligible immigrant" by the 1-
year anniversary date: Federally-funded housing assistance will be cut
off. The family will get a certain deadline to leave their housing program.

44. General Application Rules for Mixed
Status Families
• Generally, parents who are undocumented or not
eligible for benefits may apply for public benefits
for their citizen or qualified immigrant child or
children.
• Whether the parents’ income is counted toward
the child’s eligibility is determined by program.
• SSN numbers are not required when applying for
public benefits for someone else such as your
child.

45. Some Helpful Resources
• Welfare Rules Database:
http://anfdata.urban.org/wrd/wrdwelcome.cfm
– Detailed information on state rules for cash assistance under
TANF
– Eligibility rules for different immigrant categories, including pre-
enactment qualified immigrants and nonqualified immigrants.
• http://www.fns.usda.gov/snap/snap-policy-non-citizen-
eligibility
• http://www.fns.usda.gov/snap/mobile/eligibility/non-
citizen-eligibility.html
• http://www.fns.usda.gov/sites/default/files/Non-
Citizen_Guidance_063011.pdf