Family and Children's Medicaid MA-3330 – ALIEN REQUIREMENTS

IV. QUALIFIED ALIENS

A. Introduction

Medicaid eligibility and the level of coverage for an alien is based on whether the alien is qualified or non-qualified, entered the U.S. before August 22, 1996, the number of years since qualified alien status obtained, and immigration status. Some qualified aliens are banned from receiving assistance until 5 years from the date they became a qualified alien, while others are exempt from this disqualification period. The Deficit Reduction Act of 2005 (P.L. 109-171) did not change the requirements for qualified and non-qualified aliens. See VII. for information on non-qualified aliens.

B. 5 Year Mandatory Disqualification Period (Five-Year Bar)

1. There is a 5-year mandatory disqualification period for certain qualified aliens if admitted on or after August 22, 1996. If the 5-year disqualification period applies, evaluate for emergency medical services only.

NOTE: The 5-year disqualification period does not apply to aliens applying only for emergency Medicaid services.

2. If an applicant is not a U.S. citizen, he may only receive full Medicaid if he is a qualified alien and exempt from the 5-year bar. After the 5-year disqualification period expires, qualified aliens are potentially eligible for full Medicaid just like U.S. citizens. Refer to the chart, Overview of Alien Eligibility For Medicaid, in IV. C. below, to determine the alien status and who is subject to or exempt from the 5-year bar.

REVISED 05/01/11 – CHANGE NO. 09-11

(IV.B.1.)

NOTE: If the five-year bar applies, the clock begins to run on the date that the person obtained qualified status; however, if the person entered the country prior to August 22, 1996, and remained continually present until they secured qualified immigrant status, the five-year bar does not apply. The person is eligible as soon as they obtained qualified immigrant status.

This rule applies equally to persons who were in the country without documents prior to August 22, 1996. Presence will likely be difficult to establish, but, can be verified through various forms of documentation including utility bills.

3. The Centers for Medicare and Medicaid Service (CMS) lists the following as exempt from the 5 year bar: refugees, asylees, Cuban and Haitian entrants, Amerasian immigrants, persons granted withholding of deportation, victims of trafficking, veterans and active duty military personnel and their spouses and children, as well as certain Native Americans.

4. Iraqi and Afghan SIV’s, are exempt from the 5-year mandatory disqualification period (bar) and may receive full Medicaid if otherwise eligible.

5. Qualified alien pregnant women and children under age 19 lawfully residing in the US who have not met the 5-year disqualification period (bar) are exempt from the 5-year mandatory disqualification period (bar) and may receive full Medicaid if otherwise eligible. See IX. below.

REVISED 05/01/11– CHANGE NO. 09-11

(IV)

C. OVERVIEW OF ALIEN ELIGIBILITY FOR MEDICAID

Verification of Alien Status Includes But May Not Be Limited To The Documents Below

REVISED 05/01/11– CHANGE NO. 09-11

(IV. C.)

Verification of Alien Status Includes But May Not Be Limited To The Documents Below

REVISED 05/01/11– CHANGE NO. 09-11

(IV. C.)

Verification of Alien Status Includes But May Not Be Limited To The Documents Below

REVISED 05/01/11– CHANGE NO. 09-11

(IV. C.)

Verification of Alien Status Includes But May Not Be Limited To The Documents Below

REVISED 05/01/11– CHANGE NO. 09-11

(IV. C.)

Verification of Alien Status Includes But May Not Be Limited To The Documents Below

NOTE: For battered aliens, the codes, types, and stamps in foreign passports or on the I-94 that demonstrates an approved petition or application under one of the provisions are too numerous to describe here. If an alien claiming pending or approved status, presents a code different than those listed, or if you cannot determine the class of admission from the I-551 stamp, send the SAVE, G-845S, Document Verification Request, along with a copy of the document(s) presented to USCIS.

REVISED 05/01/11– CHANGE NO. 09-11

(IV. C.)

Verification of Alien Status Includes But May Not Be Limited To The Documents Below

REVISED 05/01/11– CHANGE NO. 09-11

(IV. C.)

Verification of Alien Status Includes But May Not Be Limited To The Documents Below

REVISED 05/01/11– CHANGE NO. 09-11

(IV. C.)

Verification of Alien Status Includes But May Not Be Limited To The Documents Below

REVISED 05/01/11– CHANGE NO. 09-11

(IV. C.)

Verification of Alien Status Includes But May Not Be Limited To The Documents Below

REVISED 05/01/11 – CHANGE NO. 09-11

(IV. C.)

Verification of Alien Status Includes But May Not Be Limited To The Documents Below

The following 12 categories are referred to in the manual as “Special Aliens”

REVISED 05/01/11 – CHANGE NO. 09-11

(IV. C.)

Verification of Alien Status Includes But May Not Be Limited To The Documents Below

REVISED 05/01/11 – CHANGE NO. 09-11

(IV. C.)

Verification of Alien Status Includes But May Not Be Limited To The Documents Below

REVISED 05/01/11 – CHANGE NO. 09-11

(IV. C.)

Verification of Alien Status Includes But May Not Be Limited To The Documents Below

REVISED 05/01/11 – CHANGE NO. 09-11

(IV. C.)

Verification of Alien Status Includes But May Not Be Limited To The Documents Below

D. Lawful Permanent Resident (LPR)

1. An LPR is an alien who is legally admitted to the U.S. by the USCIS to live and work on a permanent basis. The majority of qualified aliens are LPR’s and often are referred to as a “resident aliens”. USCIS issues each LPR an I-551. This is known as a “green card”, even though it is not green. Aliens recently admitted to the U.S. as a LPR, or who have applied for a replacement I-551 may only have the I-94 with a temporary I-551 stamp. Other documents issued by USCIS for “resident aliens,” include the I-155 or I-94 stamped with AM-1, AM-2, AM-3, AM-6, AM-7, and AM-8.

2. LPR’s are potentially eligible for full Medicaid. Refer to the chart, Overview of Alien Eligibility For Medicaid, in IV C. above, to determine if the 5-year mandatory disqualification period applies.

Refer to F. for documentation of LPR status.

REVISED 05/01/11 – CHANGE NO. 09-11

(IV)

E. Exempt Aliens Who Adjust Status to LPR

1. Aliens who entered the U.S. in a status exempt from the 5-year bar remain exempt after they adjust to LPR status. These include: refugees, asylees, Cuban and Haitian entrants, Amerasian immigrants, persons granted withholding of deportation, victims of trafficking, veterans and active duty military personnel and their spouses and children, as well as certain Native Americans. They remain potentially eligible for full Medicaid without the 5-year bar.

2. Aliens can be legally admitted to the U.S. by the USCIS for many different reasons. For example, an individual may be admitted to the U.S. because he is fleeing persecution in his own country, or USCIS determines it is in the public interest for him to be admitted. Additionally, refugees who adjust their status to LPR and were originally admitted as a political admission, remain potentially eligible for Medicaid based on the original status when admitted. This is verified when the I-551 indicates a code of RE-6, RE-7, RE-8,or RE-9.

Example: An individual is admitted as refugee in January 1997. He adjusts his status to LPR in 1998. Regardless, he remains potentially eligible for full Medicaid based on being admitted as a refugee/asylee.

F. Procedures to Verify and Document Qualified Alien Status

Below are the procedures for verifying and documenting qualified alien status for applicants requesting medical assistance (applicants/recipients) except trafficking victims and battered aliens. Refer to I. and J. below, for trafficking victims and battered aliens procedures.

1. Verify the alien’s current status.

a. Request the alien's original USCIS documents (not copies) for current status. Verification of citizenship/alien status is required only for applicants for whom benefits are being requested.

b. Use documents listed in the chart, Overview of Alien Eligibility For Medicaid, in IV C. above, to verify the alien’s status. If the alien does not have one of these documents, he cannot be considered a qualified alien for Medicaid purposes.

REVISED 05/01/11– CHANGE NO. 09-11

(IV. F.)

c. If an applicant presents an expired document or is unable to present any immigration documentation evidencing his alien status, refer the applicant to the local USCIS Office to obtain documentation of his immigration status listed below:

United States Citizenship and Immigration Services

Charlotte Sub Office

6130 Tyvola Center Dr.

Charlotte, NC 28217

Telephone (800) 375-5283

d. Verify the authenticity of the alien document, and the date of admission using SAVE, Systematic Alien Verification for Entitlement Program. Follow procedures in EIS 1108, SAVE Verification Information System.

NOTE: DO NOT use SAVE as verification for trafficking victims. Follow procedures in H. to verify trafficking victims.

e. Under most circumstances, an automated check of SAVE records is the first step in the verification process. However, there are circumstances that require you to perform secondary verification immediately instead of checking SAVE. Refer to XI. below for a list of these circumstances.

While you are waiting on a response from the secondary verification, treat the applicant as a non-qualified alien and process for emergency medical services only. Proceed to X. below.

REVISED 05/01/11– CHANGE NO. 09-11

(IV. F 1.)

f. Document his current alien status on the application/ redetermination form. Attach a copy of the USCIS documentation to the a/r’s permanent record and return original document(s) to the a/r. Explain that when the person signs the form he certifies alien status for the applicant(s).

g. If the current documents verify he is a qualified alien as defined above, continue with these procedures.

2. Verify the date the alien entered the U.S.

A qualified alien who entered the U.S. before 8/22/96, and whose current alien status was granted after 8/22/96, may be able to provide a document (for example, a passport with an I-94 stamp) that shows that he was in an earlier status and the status was granted before 8/22/96. You must establish that he was continuously present in the U.S. until obtaining qualified alien status.

Potential sources of verification are tax returns, bills, rent receipts, or a letter from an employer. Any single absence from the U.S. of more than 30 days or a total of aggregate absences of more than 90 days should be considered to interrupt ‘continuous presence.’

NOTE: “Continuous presence” is measured between the alien’s last date of entry into the U.S. prior to 8/22/96 and the date qualified alien status is obtained. Therefore, if an alien entered the country on May 1, 1995, left on October 1, 1995, and returned on July 1, 1996, continuous presence is measured from July 1, 1996. The period between October 1, 1995, and July 1, 1996, is not counted as an absence.

If the individual is unable to provide a document, accept a written statement from a sponsor, family member, or as a last resort, the alien as verification. The statement must include when the alien entered the U.S., prior alien status, and the date that status was granted.

3. Determine whether the 5-year disqualification period applies or whether the qualified alien is exempt from the disqualification period. Refer to the chart, Overview of Alien Eligibility For Medicaid, in IV C. above.

4. Determine the appropriate citizenship/identity code 60-66 for refugee or alien status for immigrants. Refer to EIS 4000, Codes Appendix.

5. Re-verify alien status when the alien status is subject to change.

Examples of when alien status is subject to change include:

REVISED 05/01/11– CHANGE NO. 09-11

(IV. F. 5.)

a. An individual admitted under a temporary status may change to lawful permanent resident status.

b. An individual admitted under a temporary status that has expired may have updated his status.

c. A refugee may change his alien status to lawful permanent resident status.

d. An individual may meet the requirements as a battered alien or some other type of qualified alien status.

e. An illegal alien may change to a legal status.

Note: This is not an all-inclusive list. There may be other times when an individual’s alien status may change.

6. Reporting to USCIS

Individuals who apply for any Medicaid program or service are not subject to any USCIS reporting requirements and should not be reported to the USCIS.

Declining to provide documentation of alien status is not a valid reason for USCIS referral. The a/r who declines to present documentation of alien status or a SSN will only be able to receive emergency Medicaid, if otherwise eligible. Therefore, there is no reason to seek further verification of his alien status.

7. Confidentiality of Alien Status

All rules of confidentiality must be applied in regard to alien status. It is a breach of confidentiality to discuss the alien status of an individual with employers, landlords, etc.

G. Immigrants - Refugee Code, Date, Alien ID and Citizenship/Identity Codes

1. Enter a Refugee Code to designate the immigrant’s country of origin, date the individual entered the United States or the date the individual was assigned the immigrant/refugee status as applicable and an Alien ID number for each immigrant whose citizenship/identity code is 60-66. Key only the numeric parts of the Alien ID. Do not key the alpha “A.” Refer to EIS 4000, Codes Appendix.

REVISED 05/01/11– CHANGE NO. 09-11

(IV. G.)

2. For Lawful Permanent Residents (LPRs), other than Iraqi/Afghan Special Immigrants, key only citizenship/identity code 51. Alien ID and Refugee Codes, date the individual entered the United States or the date the individual was assigned the immigrant/refugee status are not required for LPRs. Refer to EIS Manual Section 4000, Codes Appendix.

H. Iraqi and Afghanistan Special Immigrants

The Department of Defense Appropriations Act, P.L. 111-118 signed into law on December 19, 2009, granted Iraqi and Afghan Special Immigrants (SIV’s) eligibility for resettlement assistance, federal benefits, and entitlements for the same time period as refugees. Like refugees, Iraqi/Afghan SIV’s are considered to be qualified aliens who are not subject to the 5-year bar, and they are no longer limited to an 8 month eligibility period following date of entry.

1. A Special Immigrant must meet all other Medicaid eligibility requirements. Follow all policy rules regarding eligibility, including the 3-month retroactive period. If he is found ineligible for Medicaid, he is automatically eligible to apply for Refugee Medical Assistance (RMA).

2. The Special Immigrant may apply for all Medicaid Programs/NCHC, including Medicaid for Pregnant Women (MPW). Automatic newborn coverage applies if the mother is authorized for Medicaid on the date of birth, or the mother is approved after the child’s birth and Medicaid authorization is effective no later than the date of birth. Continuous eligibility does not apply for children who receive Medicaid/NCHC under Special Immigrant status.

NOTE: The individual may also apply for TANF benefits and/or Maintenance of Effort (MOE) funded public benefits as well as Refugee Cash Assistance (RRF).

3. Refer to the chart, Overview of Alien Eligibility For Medicaid, in IV C. above, to determine Iraqi/Afghan Special Immigrant status of an individual. Refer to EIS 4000, Codes Appendix for citizen/identity code.

I. Trafficking Victims

A victim of a severe form of trafficking is an alien who has been forced into the international sex trade, prostitution, slavery and forced labor through coercion, threats of physical violence, psychological abuse, torture, and imprisonment.

An alien whose status as a trafficking victim has been verified with the Office of Refugee Resettlement (ORR) is potentially eligible for full Medicaid to the same extent as refugees. The five-year disqualification period does not apply.

REVISED 05/01/11– CHANGE NO. 09-11

(IV. I.)

1. Verify and document the alien’s status as a trafficking victim. ORR issues a certification letter for an adult who has been subjected to a severe form of trafficking and meets statutory certification requirements. In addition, ORR issues similar eligibility letters for children who have been found to be victims of a severe form of trafficking.

NOTE: Other agencies, such as the USCIS, may issue letters or other documents to victims of severe forms of trafficking. However, only the original ORR letter may be accepted as proof of certification. Do not require a victim of severe trafficking to provide any USCIS documentation.

2. To verify the status of trafficking victims:

a. Obtain the original certification letter for adults or eligibility letter for children issued by the ORR from the a/r. Place a copy of the letter in the file; and

b. Call the trafficking verification line at (202) 401-5510 to confirm the validity of the certification letter or eligibility letter for children and to inform ORR of the type of benefits for which the individual has applied.

NOTE: At this time, SAVE does not contain information about victims of severe forms of trafficking. Until further notice, do not contact SAVE concerning victims of severe forms of trafficking.

3. Contact the North Carolina State Refugee Office at (919) 733-7650 if you believe an adult or child may have been subjected to a severe form of trafficking and they have not applied for certification under the Trafficking Victims Protection Act.

J. Battered Alien (Violence Against Women Act)

An alien who has been battered or subjected to extreme cruelty and meets the requirements below is considered a qualified alien. The battered alien must be the spouse, former spouse, widow, child, or parent of a child of a U.S. citizen or LPR alien.

NOTE: If a parent is a battered alien, his child who lives with him also meets the criteria as a battered alien. If a child is a battered alien, his parent who lives with him also meets the criteria as a battered alien as long as the parent did not actively participate in the battery or extreme cruelty.

REVISED 05/01/11– CHANGE NO. 09-11

(IV. J.)

1. Battered aliens are potentially eligible for full Medicaid. The 5-year disqualification period applies if the battered alien was admitted on or after August 22, 1996. It does not apply to anyone who entered the U.S. before 8/22/96.

2. Verify and document the alien’s status as a battered alien. Refer to the chart, Overview of Alien Eligibility For Medicaid, in IV C. above, and also the chart, Battered Aliens Documentation, in IV. K below, for a list of documents and actions to take when an individual claims to be a battered alien and either has or does not have verification.

3. Verification of battered alien status consists of either an order granted by USCIS (such as an approval letter or prima facie determination) or a bona fide copy of a petition or application filed with USCIS or the Executive Office of Immigration Review (EOIR). EOIR is the office in the Department of Justice that oversees the Board of Immigration Appeals.

4. Confirm that:

a. USCIS or EOIR has either granted a petition of the applicant filed under the Violence Against Women Act (VAWA) or family-based petition, or

b. There is prima facie approval under the VAWA or a family-based petition.

5. Document the client’s current alien status in the case file.

NOTE: “Battered or subject to extreme cruelty” includes, but is not limited to, any act or threatened act of violence, including any forceful detention, which results or threatens to result in physical or mental injury. Psychological or sexual abuse or exploitation, including rape, molestation, incest (if the victim is a minor), or forced prostitution are considered acts of violence.

6. Verify that the alien or alien’s child has been battered or subject to extreme cruelty in the United States by a:

a. Spouse;

b. Parent of the alien; or

c. Member of the spouse’s or parent’s family residing in the same household.

“Member of the spouse or parent’s family” means any person related by blood, marriage, or adoption to the spouse or parent of the alien.

REVISED 05/01/11– CHANGE NO. 09-11

(IV. J.)

7. Corroborate, if possible, the claim of abuse, and document the corroboration used:

a. If the alien has a pending or approved petition filed under VAWA, there is no need to request additional proof. The USCIS or EOIR has already made a determination that the alien or the alien’s child has been battered and/or subject to extreme cruelty. There is no need to request additional proof to corroborate the claim of abuse.

b. If the alien has a pending or approved petition as a widow(er) of a U.S. citizen or petition for immediate relative status, attempt to corroborate the claim of abuse through one of the following documents:

(1) Reports or affidavits from police, judges and other court officials, medical personnel, school officials, clergy, Child Protective Services’ staff, or counseling, or mental health personnel;

(2) Any legal documents that document the abuse (protection orders, police reports, etc.);

(3) Evidence that indicates that the alien sought safe haven in a shelter for battered individuals or similar refuge because of battery;

(4) Statements by other people knowledgeable of the applicant’s circumstances; or

(5) Signed statement by the applicant.

8. In cases where an applicant’s child has been battered, the applicant must submit his statement indicating that he did not actively participate in the battery or extreme cruelty.

9. A substantial connection between battery (or extreme cruelty) and the need for Medicaid must exist. Any of the following circumstances may be considered to determine whether a substantial connection exists:

a. To enable the individual to become self-sufficient following separation from the abuser;

b. To obtain medical attention or mental health counseling caused by abuse;

c. To provide medical care during a pregnancy resulting from the abuser’s sexual assault or abuse of, or relationship with, the individual; or

REVISED 05/01/11– CHANGE NO. 09-11

(IV. J. 9.)

d. To replace medical coverage and/or health care services lost when the individual separated from the abuser.

This list is not intended to be all-inclusive. There may be other circumstances that could be considered reasonable for determining that this requirement is met.

10. In order to be a qualified alien based on battery or extreme cruelty, the battered individual must no longer be physically residing in the same household as the individual responsible for the battery or extreme cruelty. (See below if the alien is still living with the batterer.) Accept any of the following as verification:

a. Reports or affidavits from police, judges or other court officials, medical personnel, school officials, clergy, Child Protective Services’ staff, or counseling, or mental health personnel,

b. Signed statement from a staff member at a shelter for battered individuals or homeless persons,

c. Rental records or utility receipts in the battered alien’s name,

d. School records,

e. Statement by family member, friend, or other person knowledgeable of the battered alien’s circumstances; or

f. Signed statement by the battered alien.

11. If the battered individual resumes living with the batterer, he no longer meets the requirements as a battered alien beginning the month after the month in which they resume living together.

12. In cases where the a/r’s child or the a/r’s parent has been battered, the a/r and the battered individual must BOTH be residing in the same household apart from the batterer.

REVISED 05/01/11– CHANGE NO. 09-11

(IV. J)

13. Applicants who still reside with the batterer may need the assurance of the availability of benefits in order to leave their batterer and survive independently. If this is the case, complete the eligibility determination and allow the alien up to the 45th day processing deadline to verify that he has left the batterer. See IV. J. 10, above, for potential sources of verification. If on the 45th day the applicant has not left, do not allow any exemption as a battered alien.

14. Aliens who claim to have been battered may have documentation of their immigration status. The chart in IV K. below, Battered Aliens Documentation, gives the actions the caseworker must take based on the documents presented

REVISED 05/01/11 – CHANGE NO. 09-11

(IV)

K. BATTERED ALIENS DOCUMENTATION

Aliens who claim to have been battered may have the following documentation of their immigration status. The following chart gives the actions the caseworker must take based on the document presented.

Approved Petition

Evidence	Category	Action by the County
A. Form I-797 indicating: Case Type: I-130 Immigrant Petition for Relative, Finance(e), or Orphan Notice Type: Approval Notice Section: “Husband or wife of U.S. citizen (or LPR), or “Unmarried children under 21 of U.S. citizens (or LPRs), or “Unmarried children over 21 of LPRs”	Sec. 204(a)(1)(A)(i) or Sec. 204(a)(1)(B)(i)	1. Verify abuse, 2. Determine connection between battery and need for Medicaid, 3. Verify no longer lives with abuser.
B. Form I-797 indicating: Case Type: I-360 Notice Type: Approval Notice Section: Widow(er) of U.S. citizen to whom the alien had been married for at least 2 years at the time of the citizen’s death ______________________________________ C. Form I-797 indicating: Case Type: I-360 Notice Type: Approval Notice Section: Self-petitioning spouse or child of abusive U.S. citizen or LPR	Sec 204(a)(1)(A)(ii) ___________________ Sec.204(a)(1)(A)(iii) or Sec.204(a)(1)(B)(ii) or Sec.204(a)(1)(A)(IV.I) or Sec.204(a)(1)(B)(iii)	1. Verify abuse, 2. Determine connection between battery and need for Medicaid, 3. Verify no longer lives with abuser. NOTE: Abuser can be a family member. 1. Do not verify abuse, (Abuse has been determined by USCIS in this situation.) 2. Determine connection between battery and need for Medicaid, 3. Verify no longer lives with abuser.

REVISED 05/01/11 – CHANGE NO. 09-11

(IV. K.)

Approved Petition

Evidence	Category	Action by the County
D. Final Order of Immigration Judge or Board Of Immigration Appeals granting suspension of deportation under Sec. 244(a)(3) as in effect prior to 4/1/97 or cancellation of removal under Sec. 240A(b)(2)	Sec.244(a)(3)(before 4/1/97) or Sec.240A(b)(2)	1.If the order does not show under which INA provision relief was granted, verify through EOIR by faxing a DMA-5131 on county letterhead to (404) 221-4555 Executive Office for Immigration Review-Immigration Courts. Include a copy of any supporting documents provided by the individual, 2. Verify abuse, 3. Determine connection between battery and need for Medicaid, 4. Verify no longer lives with abuser.

Temporary Approval of Petition

Evidence	Category	Action by the County
A. Form I-797 indicating: Case Type: I-360, Petition for Amerasian, Widow, or Special Immigrant Section: Self-petitioning spouse or child of abusive U.S. citizen or LPR Body of Notice: “THIS PRIMA FACIE DETERMINATION IS VALID FOR A PERIOD OF 150 DAYS FROM THE NOTICE DATE SHOWN ABOVE, AND EXPIRES ON THE DATE INDICATED AT THE BOTTOM OF THE PAGE”	Sec. 204(a)(1)(A)(iii) or Sec. 204(a)(1)(B)(ii) or Sec. 204(a)(1)(A)(IV.I) or Sec. 204(a)(1)(b)(iii)	1. Consider the petition granted, but flag case for 150 days to verify final approval of petition, 2. Do not verify abuse, (Abuse has been determined by USCIS in this situation.) 3. Determine connection between battery and need for Medicaid, 4. Verify no longer lives with abuser.
B. Immigration Judge or Board Of Immigration Appeals Final Order indicating a prima facie case established for suspension of deportation under Sec. 244(a)(3) as in effect prior to 4/1/97 or cancellation of removal under Sec 240(b)(2)	Sec. 244(a)(3)(before 4/1/97) Or Sec. 240A(b)(2)	1. Consider the petition granted, but flag case for 150 days to verify final approval of petition, 2. Verify abuse, 3. Determine connection between battery and need for Medicaid, 4. Verify no longer lives with abuser.

REVISED 05/01/11 – CHANGE NO. 09-11

(IV. K.)

Petition Filed, No Evidence of Temporary Approval of Petition

Evidence	Category	Action by the County
A. Form I-797 indicating: Case Type: I-360, Petition for Amerasian, Widow, or Special Immigrant Notice Type: Receipt Notice Section: Self-petitioning spouse or child of abusive U.S. citizen or Self-petitioning spouse or child of an abusive LPR; or File-Stamped Copy of I-360 Petition for classification as “Self-petitioning Spouse (or Child) of Abusive U.S. Citizen or Lawful Permanent Resident”; or	Sec. 204(a)(1)(A)(iii) or Sec. 204(a)(1)(B)(ii) or Sec. 204(a)(1)(A)(IV.I) or Sec. 204(a)(1)(b)(iii)	1. If three weeks have elapsed since filing of petition, complete a DMA-5132, and FAX to USCIS Vermont Service Center FOR DETERMINATION OF STATUS, Fax: (802) 527-3252; Telephone: (802) 527-3160 2. Verify abuse, 3. Determine connection between battery and need for Medicaid, 4. Verify no longer lives with abuser.
Copy of I-360 petition of classification as “Self-Petitioning Spouse (or Child) of Abusive U.S. Citizen or Lawful Permanent Resident” and proof of mailing dated after 6/6/97		1.Complete a DMA-5132, and fax to USCIS Vermont Service Center to request USCIS expedite processing of petition or make a prima facie determination, Fax: (802) 527-3252; Telephone: (802) 527-3160 2. Verify abuse, 3. Determine connection between battery and need for Medicaid, 4. Verify no longer lives with abuser.

REVISED 05/01/11 – CHANGE NO. 09-11

(IV. K.)

Petition Filed, No Evidence of Temporary Approval of Petition

Evidence	Category	Action by the County
B. Form I-797 indicating: Case Type: I-130, Immigration Petition for Relative, Fiance(e), or Orphan Notice Type: Receipt Notice Section: “Husband or wife of U.S. citizen (or LPRs),” or “Unmarried children over 21 of LPRs” Or File-stamped Copy of I-130 or Cash register or computer-generated receipt indicating filing of I-130	Sec. 204(a)(1)(A)(i) or Sec. 204(a)(1)(B)(i)	1. Complete a DMA-5132, and fax to USCIS Vermont Service Center to request USCIS expedite processing of petition, Fax: (802) 527-3252; Telephone: (802) 527-3160 2. Verify abuse, 3. Determine connection between battery and need for Medicaid, 4. Verify no longer lives with abuser.
C. Form I-797 indicating: Case Type: I-360, Petition for Amerasian, Widow, or Special Immigrant Notice Type: Receipt Notice Section: Widow of a U.S. citizen to whom the alien had been married for at least 2 years at the time of the citizen’s death; or Cash register or computer-generated receipt indicating filing of such I-360	Sec. 204(a)(1)(A)(ii)	1. Complete a DMA-5132, and fax to USCIS Vermont Service Center to request USCIS expedite processing of petition, Fax: (802) 527-3252; Telephone: (802) 527-3160 2. Verify abuse, 3. Determine connection between battery and need for Medicaid, 4. Verify no longer lives with abuser. NOTE: Abuser can be a family member.

REVISED 05/01/11 – CHANGE NO. 09-11

(IV. K.)

Deportation/Removal Proceedings

Evidence	Category	Action by the County
Order to Show Cause • Notice to Appear • Notice of Hearing in Deportation Proceedings	In Deportation/Removal Proceedings and alien or child has been battered in the U.S., and has been in the U.S. for at least 3 years	1. Inform alien that he/she can file with EOIR for cancellation of removal, NOTE: Alien is not a battered alien if he/she does not file with EOIR for cancellation of removal. 2. Verify abuse, 3. Determine connection between battery and need for Medicaid, 4. Verify no longer lives with abuser.

Alleges Petition Filed

Evidence	Category	Action by the County
Some documentation or client is certain that petition has been filed		1. Complete and Fax a DMA-5132, to USCIS Vermont Service Center FOR A DETERMINATION OF STATUS, Fax: (802) 527-3252; Telephone: (802) 527-3160 2. Verify abuse, 3. Determine connection between battery and need for Medicaid, 4. Verify no longer lives with abuser.
Uncertain if petition filed		1. Refer alien to the National Domestic Violence Hotline (1-800-799-7233) so he can obtain assistance from a local domestic violence service provider and referrals to immigration attorneys, NOTE: Alien is not a battered alien unless provides proof petition is filed. 2. Verify abuse, 3. Determine connection between battery and need for Medicaid, 4. Verify no longer lives with abuser.

REVISED 05/01/11 – CHANGE NO. 09-11

(IV. K.)

No Petition; Has Basis To File

Evidence	Category	Action by the County
No petition filed, makes allegation or presents evidence of battery		1. Refer alien to the National Domestic Violence Hotline (1-800-799-7233) so he/she can obtain assistance from a local domestic violence service provider and referrals to immigration attorneys, NOTE: Alien is not a battered alien unless petition is filed. 2. Verify abuse, 3. Determine connection between battery and need for Medicaid, 4. Verify no longer lives with abuser.