NORTH DAKOTA DEPARTMENT OF HUMAN SERVICES
BISMARCK, NORTH DAKOTA
April 1, 2010

IM 5099

TO:		County Social Service Directors
Economic Assistance Policy Regional Representatives
Economic Assistance Policy Quality Control Reviewers

FROM:	Tove Mandigo, Director, Economic Assistance Policy
		Maggie Anderson, Director, Medical Services

SUBJECT:	Eligibility for Aliens 		 

PROGRAMS:	TANF, SNAP, Medicaid, Healthy Steps

EFFECTIVE:	See effective date within each policy section.	 

RETENTION: 	Until Manualized

SECTIONS 
AFFECTED:	TANF - 400-17-15-40 – Citizen and Alien Status 
		SNAP – 430-05-30-60-10 – Eligibility Criteria
		Healthy Steps -	510-07-25-38 	Qualified Aliens
		510-07-25-45 – Aliens Admitted for Lawful Permanent Residence on or After August 22, 1996
			Medicaid – 510-05-35-38	Qualified Aliens
			510-05-35-65 - Aliens Admitted for Lawful Permanent Residence on or After August 22, 1996

Several inquiries have been received regarding eligibility for Aliens.  Clarification has been received and is included below:

TANF
The clarification TANF Policy has received resulted in changes to TANF Policy regarding eligibility for Qualified Aliens and is effective February 1, 2010.   The changes include:

•	 Qualified Aliens who are exempt from the 5 year bar. The following have been added to the list of those exempt from the 5 year bar:
o	 Aliens, who have a past or current involvement with the United States Armed Forces, are exempt from the 5 year bar.  (These individuals include honorably discharged veterans, qualified aliens on active duty in the United States’ armed forces, and the spouse or unmarried dependent child(ren) of such individuals.) 

o	 Victims of Severe form of trafficking are exempt from the 5 year bar.

Note:  If TANF benefits were denied or closed for an individual identified in this section due to the individuals citizenship status, benefits must restored back to February 1, 2010. 

•	Qualified Aliens who are NOT exempt from the 5 year bar. The following have been added to the list of those who are NOT exempt from the 5 year bar:
o	 American Indians born in Canada, who established and maintained residence in the U.S. since his/her entry and are not exempt from the 5 year bar. 

o	 Hmong and Highland Laotian with immigration status that qualifies such as legal permanent residents are not exempt from the 5 year bar.

Note:  If individuals identified in this section are currently eligible, notice must be sent immediately to either remove the individual’s financial needs or, if appropriate, close the case.
 
•	Qualified Aliens who entered the US after August 22, 1996 will no longer need to meet the 40 qualifying quarters of employment, once their 5 year bar has expired.  Beginning the month following the month the 5 year bar expires, these individuals will be eligible provided they meet all other TANF eligibility requirements.
Note:  When processing new applications or ongoing cases, if an individual identified as a Qualified Alien who entered the US after August 22, 1996 fails for citizenship and is either exempt from the 5 year bar or has resided in the US for 5 years or more, the Vision system will set the Participation Code to ‘DA’.    These individuals may be eligible for TANF effective the latter of:
•	February 1, 2010; or 
•	The date of application; or 
•	The first day following the end of the 5 year period (for those not exempt from the 5 year bar.)   
Please contact TANF Policy for assistance with these cases.

•	 Qualified Aliens, who entered the US under one of the categories exempt from the 5 year bar, remain eligible for TANF when their alien status is converted to a category that is not exempt from the 5 year bar.  
Example:  An individual enters the US with a status of Refugee (exempt from the 5 year ban).  Two years later, their status changes from Refugee to Lawful Permanent Resident (LPR).  The status used when determining continued eligibility for TANF is Refugee (status as of date of entry) for the duration of the 5 year eligibility period.  

•	 Individuals who enter the US from the Republic of the Marshall Islands and the Federated States of Micronesia may reside, work and study in the United States, but they are not “Lawful Permanent Residents” under the Immigration and Nationality Act. Therefore, they are not eligible to receive benefits under the TANF program.

TANF Policy Manual at 400-17-25-40, Citizen and Alien Status will change as follows:

Citizen or Alien Status 400-17-15-40
Citizenship or immigration status affects eligibility. United States citizens are always eligible if they meet other eligibility criteria. U.S. citizens include anyone born in: 
•	The 50 states
•	District of Columbia
•	Guam
•	Virgin Islands
•	Puerto Rico
•	The Northern Mariana Islands
•	The Marshall Islands
•	American Samoa
•	Swain’s Island
•	A foreign country who is:
a.	Under 18 years of age, and
b.	Admitted to the US as a lawful permanent resident; and
c.	In the legal and physical custody of at least one parent who is a US citizen.
d.	This also applies to children adopted from a foreign country as long as the three conditions above are met.

For purposes of this section, ‘American Indian’ or ‘Native American’ is defined as a person having origins in any of the original peoples of the United States and Canada, except the Eskimos, Aleuts, and Inuits, who maintain tribal affiliation or community attachment.

Native Americans Indians if born in Canada, who possess at least 50 percent of blood of the American Indian race to whom the provisions of section 28902 (Lawful admission for permanent residence) apply, are regarded as lawfully admitted for permanent residence only if the individual has established and maintained residence in the U.S. since his/her entry. If so, then they may be regarded as lawful permanent resident and are not eligible for any federally funded TANF benefit for five-years from the date of entry.  A lawful permanent resident is a qualified alien. A Native American born in Canada does not include a person who is the spouse or child of such an Indian or a person whose membership in an Indian tribe or family is created by adoption, unless such person possesses at least 50 per cent or more of such blood. Each individual’s immigration status should be examined to determine whether they have an immigration status that qualifies.  

A non-citizen who was a not qualified alien when he or she entered the country on or after August 22, 1996, is not eligible for any federally funded TANF benefit for 5 years unless specifically exempted.  The five-year bar does not affect a qualified non-citizen who entered before August 22, 1996 with an immigration status. The five-year bar is effective on the date the individual entered the country as a qualified alien, or the date the individual becomes a qualified alien, whichever is later.  After the five-year period, their sponsor’s income and assets may be considered in determining eligibility until the individual attains citizenship or obtains 40 quarters of employment history. 
The following qualified aliens are exempted from the 5-year bar if all other conditions of eligibility are met:
•		Aliens who have a past or current involvement with the United States Armed Forces.  (These individuals include honorably discharged veterans, qualified aliens on active duty in the United States’ armed forces, and the spouse or unmarried dependent child(ren) of such individuals.);
•		An alien admitted to the United States as an Amerasian immigrant;
•		Refugees, including Iraqi and Afghani Special Immigrants who are considered refugees as of December 19, 2009;
•		Asylees;
•		Aliens whose deportation is being withheld;
•		Cuban/Haitian Entrants;
•		Victims of Severe form of trafficking;
•	Legal permanent residents who have worked forty qualifying quarters 
•	Hmong and Highland Laotian with immigration status that qualifies such as legal permanent residents or a veteran.
Legal permanent residents who have worked forty qualifying quarters, veterans, members of the military in active duty, and their spouse and unmarried dependent children are eligibility for TANF if all other conditions of eligibility are met.
Qualified Aliens who entered the US under one of the categories exempt from the 5 year ban, remain eligible for TANF when their alien status is converted to a category that is not exempt from the 5 year ban.  
Example:  An individual enters the US with a status of Refugee (exempt from the 5 year ban).  Two years later, their status changes from Refugee to Lawful Permanent Resident (LPR).  The status used when determining continued eligibility for TANF is Refugee (status as of date of entry) for the duration of the 5 year eligibility period.  
Military Criteria
Aliens may meet eligibility criteria if they have a past or current involvement with the United States Armed Forces and are lawfully admitted to the U.S. under INS status. Spouses and unmarried dependent children of an individual with past or current U.S. military involvement may also meet eligibility criteria.
1.	Individuals with the following INS status may be eligible based on military criteria:
a.	Refugees after five (5) years of U.S. residency.
b.	Asylees after five (5) years of U.S. residency.
c.	Entrants whose deportation is being withheld after seven years 		of U.S. residency.
d.	Cuban or Haitian entrants after five (5) years of U.S. residency.
e.	Amerasians after five (5) years of U.S. residency.
f.	Lawful permanent residents (LPR).
g.	Battered women and/or children.
h.	Conditional entrants.
i.	Parolees.

Past or Current U.S. Military Involvement is defined as:
1.	An individual on active duty for reasons other than training with any of the United States Armed Forces units. This applies to minimum active duty (24 months) or the period for which the person was called to active duty.
a.	An individual remains eligible if honorably discharged for reasons other than alien status who fulfills the minimum active duty service requirement including an individual who died in active military, naval or air service.
This includes an individual who served before July 1, 1946, in the organized military forces of the Government of the Commonwealth of the Philippines while such forces were in the service of the Armed Forces of the U.S. or in the Philippine Scouts.
b.	If active duty is for training such as National Guard or Army Reserve, the individual is not eligible.
c.	An individual honorably discharged from the U.S. Armed Forces. If the discharge was for alien status or for dishonorable service, the individual is not eligible.
2.	A Spouse or Unmarried Dependent Children of individual with U.S. Military Involvement:
a.	An individual must be married to the veteran/service individual or was married to the individual at the time of the individual's death and has not remarried.
b.	Eligibility for the re-married surviving spouse of a deceased veteran provided that the couple was married for at least one year or for any period if a child was born of the marriage or was born to the veteran and the spouse before the marriage and the spouse has not remarried.
i.	An individual would not be eligible if divorced from the veteran/service individual or has remarried since the veteran/service individual's death.
ii.	Eligibility exists for the alien spouse regardless of whether or not the veteran/service individual is a United States citizen.
iii.	Eligibility stops if the service individual is discharged from active duty for alien status or dishonorable service.
c.	Unmarried dependent child(ren) of the veteran/service individual are eligible if they are:
i.	A legally adopted or biological dependent child of an honorably discharged veteran or active duty member of the Armed Forces if the child is under the age of 18 or a full-time student under the age of 22.
ii.	A child under ages 18 or 22 if a fulltime student of a deceased veteran. A disabled child age 18 or older if the child was disabled and dependent on the active duty member or veteran prior to the child’s 18th birthday.
iii.	A child that is not residing with the veteran/service individual.
iv.	A child that marries is no longer a dependent, or the service individual is discharged from active duty for alien status or dishonorable service.
A non-citizen who was not a qualified alien when he or she entered the country on or after August 22, 1996 is not eligible for any federally funded TANF benefit, including individuals who enter the US from the Republic of the Marshall Islands and the Federated States of Micronesia. 

Establishing Quarters
 Qualifying quarters of coverage are determined by using the amount of earnings received by an individual (or their spouse or parents) for employment or self-employment income on which Social Security taxes must be paid. Individuals are credited a maximum of four quarters per year by the Social Security Administration. If an alien earns the 40 quarters of coverage prior to applying for TANF in that same quarter, the worker must allow that quarter toward the 40 qualifying quarters total.
 
Qualifying quarters of work not covered by Title II of the Social Security Act may be credited in determining eligibility. The mechanism used by Social Security Administration for calculating the amount of wages necessary to obtain a quarter of coverage is used, not the limitations on the types of employment in which the wages may be earned.

An alien must have earned 40 quarters of credit unless their spouse or parents can share quarters with them. Once the alien is credited with 40 qualifying quarters, non-citizen eligibility requirements have been met even though the individual is no longer employed. 

Any quarters earned from January 1997 and later must not be credited to an individual who received TANF, Food Stamps, Medicaid, or SSI (this includes benefits received in another state) in any month during that quarter. The worker must evaluate quarters of coverage and receipt of Federal means-tested programs on a calendar year basis.

Spousal Quarters
 Spousal quarters of work earned by each spouse during his or her marriage, separation, or while holding themselves out to the community as husband and wife can be credited to each other. Quarters earned prior to the marriage cannot be credited. Quarters from a deceased spouse are credited to the surviving spouse. Qualifying quarters may be credited to a non-citizen spouse even if the individual employed is a United States citizen. The only time quarters are removed is if an individual received quarters from a spouse and they divorced or no longer hold themselves out to the community as husband and wife. 

Parents/Children Quarters
The quarters of income earned by a natural, adoptive or stepparent, including a deceased parent, are credited as follows: 
1.	Qualifying quarters earned by parent(s) are credited:
a.	To children under age 18.
b.	If earned prior to the child's birth.
c.	Through the quarter the child turns 18.
d.	Qualifying quarters credited to a child cannot be taken away 	unless parental rights are terminated.  
e.	Quarters earned by parents while a child was under age 18 are 	credited to a child no matter what age the child may be.
2.	Qualifying quarters earned by adoptive parent(s) are credited as follows:
a.	From the date the adoption occurred. 
b.	Through the quarter the child turns 18.
Quarters from the biological parent(s) are not allowed when the adoption becomes final. 
3.	Qualifying quarters earned by a stepparent are credited as follows: 
a.	From the quarter of the marriage of the stepparent as long as the marriage occurred before the child attained age 18.
b.	Through the quarter the child turns age 18.
c.	Are not credited if the 40-quarter determination is made after a divorce or annulment.
d.	Quarters are credited if the natural or adoptive parent and stepparent are separated but not divorced.
•	If the 40-quarter determination is made prior to a divorce or annulment the quarters cannot be removed
•	A child can receive qualifying quarters from each parent as well as from themselves. 
•	Quarters earned by children cannot be deemed to their parents or siblings.
•	The same quarter may be applied to more than one individual.
•	Qualifying quarters credited to children are retained when they turn 18.

Verification of 40 Quarters Requirement
The following procedures provide guidance to workers in administering the 40 quarters determination. 
The applicant must provide the full name, social security number, date of birth, and sex of each individual (self, parent, or spouse) whose work history is relevant to the determination of eligibility. 
Workers can access information needed to determine if an alien has the 40 qualifying quarters of work history through the SVES in TECS. The qualifying quarter’s information is obtained through the TPQY inquiry screens. The quarter of coverage information is displayed on the TPQ3 the next day and is not retained on TECS. 

If an alien believes the information from Social Security Administration is inaccurate or incomplete, Social Security Administration will investigate the discrepancy. Depending on the problem, the worker may contact Social Security Administration directly or refer the applicant to Social Security Administration. If the applicant is referred to Social Security Administration, Social Security Administration will give the individual a document indicating the number of quarters under review. An alien who provides the worker with this document can continue to receive TANF benefits for six months from the date of Social Security Administration's initial response or until Social Security Administration has completed its review, whichever is earlier.

For wage matches, Social Security Administration will send the worker total quarters from 1930 through 1950 and information on quarters by year for 1951 through the most recent information. The most recent eight quarters may be missing from the information Social Security Administration provides. Social Security Administration will not investigate these quarters because they will be included in the course of the annual wage reporting operation. However, Social Security Administration will provide guidance on how to compute these quarters if the household needs them to meet the 40 qualifying quarters exemption. Social Security Administration will transmit, a quarter of coverage history display. 

If the worker is unable to obtain the work history from Social Security Administration, the worker must obtain verification of work from the applicant or other available data sources.

SNAP
Changes in policy:
•	SNAP received clarification from the regional office regarding the eligibility of an alien when their status is changed to a more limited one.  Previously, SNAP directive was to consider eligibility under the new status.  Clarification from the regional office indicates aliens can continue to be eligibility under the less rigorous status.  This change in policy as a result of this clarification is effective immediately.  Counties that discover or become aware of any aliens who were denied or determined ineligible, should reconsider those denials and eligibility using this current policy.
•	This IM also includes changes as a result of the final 2002 Farm Bill regulations.  These changes are included in the chart and are effective April 1, 2010.  

Eligibility Criteria 430-05-30-60-10
To determine if an individual is an eligible alien the individual must meet the criteria on the chart. 
Eligible immigration status stands alone for purposes of determining eligibility. Adjustment to a more limited status does not override eligibility based on an earlier less rigorous status. 
Example:
An individual enters the US with a status of Refugee and is eligible upon entry.  Two years later, their status changes from Refugee to Lawful Permanent Resident (LPR).  The individual remains eligible as a refugee as this status is more limited.
If eligibility expires in one eligible status, the alien may be eligible under another.
	Example:
Child turns age 18 and is no longer eligible under the child status.  If the child was been in the US for at least 5 years under lawful permanent residence status, the child is eligible.

IF THE ALIEN WAS ADMITTED AS:	SNAP ELIGIBILITY	ACCEPTABLE VERIFICATIONS OF IMMIGRANT/ALIEN STATUS	
Refugee under section 207 of the Immigration and Nationality Act (INA)

TECS Code - RE	Eligible upon entry.	- USCIS Form I-94 showing entry as refugee under Section 207 of the INA and date of entry into U.S. (The arrival date is the date used to determine entry date.); or
- USCIS Form I-688B annotated 274a.12(a)(3) (The arrival date is the date used to determine entry date.); or
- USCIS Form I-766 with code A3; or
- USCIS Form I-571; or
- USCIS Form I-551 or I-151 with codes RE1, RE2, RE3, RE4, RE5, RE6, RE7, RE8, RE8b, RE9, IC6 or IC7.	
Victim of Human
Trafficking

TECS Code - A	Eligible upon entry.	- Certification Document from the Office of Refugee Resettlement (ORR).	
Asylee under Section 208 of INA

TECS Code - A	Eligible upon entry.	- USCIS Form I-94 showing grant of asylum under section 208 (The arrival date is usually the date of designated status.); or 
- USCIS Form I-766 annotated A5; or 
- Grant letter from Asylum Office of the USCIS; or 
- Order from immigration judge granting asylum; or
- USCIS Form I-688B annotated 274.a12(a)(5) (The arrival date is usually the date of designated status.); or
- USCIS Form I-766 with code A5; or
- USCIS Form I-551 or I-151 with codes AS6, AS7, AS8, or AS9.	
Deportation withheld under section 243(h) of the INA as in effect prior to April 1, 1997 or whose removal is withheld under section 241(b)(3) of the INA.

TECS Code - A	Eligible upon entry. 	Individuals whose deportation has been withheld should have a court order. The date of the court order is the designated status date.
- Immigration Judge order showing deportation withheld under section 243(h) or 241(b)(3) of the INA & date of grant; or
- USCIS Form I-688B annotated 274a.12(a)(10); or
- USCIS Form I-766 with code A10.	
Conditional entrant under section 203(a)(7) of the INA as in effect prior to April 1, 1980.

TECS Code – A if eligible, IA if not eligible	Eligible upon entry.
-Eligible if resided in the US for 5 years with a conditional entrant status; or

-Meets the Military Criteria at 430-05-30-60-10-05	- USCIS Form I-94 showing admission under section 203(a)(7) Refugee-Conditional Entry in effect prior to 04/01/1980; or
- USCIS Form I-688B annotated 274a.12(a)(3); or
- USCIS Form I-766 annotated A3; or
- USCIS Form I-551 or I-151 with code R86.	
Cuban/Haitian Entrant as defined in section 501(e) of the Refugee Education Assistance Act of 1980.

TECS Code - A	Eligible upon entry.	- USCIS Form I-551 with code CU6, CU7, or CH7
- USCIS Form I-94 with code CU6 or CU7, or stamped Cuban/Haitian Entrant under Section 212(d)(5) of the INA (The arrival date is usually the date of designated status.)
- Unexpired temporary I-551 stamp in foreign passport.
-USCIS Form I-94 indicating the person was paroled into the US on or after 1/12/2010.	

Amerasian Entrant as defined in section 584 of PL 100-202, as amended by PL 100-461.

TECS Code - A	Eligible upon entry.	-USCIS Form I-551 with code AM6, AM7, or AM8
- USCIS Form I-94 with code AM1, AM2, or AM3 (The arrival date is usually the date of designated status.)
- Unexpired temporary I-551 stamp in foreign passport.	

Hmong or Highland Laotian

TECS Code - A	Eligible upon entry if:
- was a member at the time the tribe rendered assistance to the U.S. during the Vietnam era from 08/05/1964 through 05/07/1975; or 
- spouse or unmarried dependent child of Hmong/Highland Laotian, if they meet one of the following:
a.	Spouse remains married to the tribal member; or
b.	Was married to the member at the time of the member's death and has not remarried;
c.	An unmarried dependent child under the age of 18 or if they are a full-time student under the age of 22. This also applies if the parent is deceased provided that the child was dependent on the parent at the time of death. 
An unmarried disabled child age 18 or older if the child was disabled and dependent on the parent prior to the child’s 18th birthday.
Child in (c) above means biological or adopted. 	- States tribe meets Vietnam era involvement and has:
- USCIS Form I-94 showing entry as refugee under Section 207 of INA and date of entry into the U.S.; or
- USCIS Form I-551 or I-151 unless form is marked as admitted under Section 249 & entered after 01/01/72; or 
- On master list located in State Office. 	
Lawfully Admitted for Permanent Residence

TECS Code - LR	Eligible regardless of entry date if:
- meets the 40 quarters requirement; or
- has resided in the US for 5 years with a LPR status.	- USCIS Form I-551 or I-151 (Resident Alien card)
- If the individual was admitted under Section 249 and entered after January 1, 1972, no eligibility exists.
- Any status code on the I-551 is acceptable unless the I-551 is annotated with 1B6, 1B7, 1B8 and the individual does not meet battered alien criteria.
- Unexpired Temporary I-551 stamp in foreign passport or on the I-94 form also verifies the individual is admitted for lawful permanent residence.	
Parolee under section 212(d)(5) of the INA and status is granted for at least one year
TECS Code – A if eligible, IA if not eligible	Eligible upon entry.
Eligible if resided in the US for 5 years with a  parolee status; or 

Meets Military Criteria at 430-05-30-60-10-05	- USCIS Form I-94 stating admission under section 212(d)(5) of the INA.	
An alien who has been battered or subjected to extreme cruelty in the U.S. by a spouse or a parent or by a member of the spouse or parents’ family residing in the same household as the alien at the time of the abuse, an alien whose child has been battered or subjected to battery or cruelty, or an alien child whose parent has been battered. The battered spouse or child cannot be living with the family who battered them.

TECS Code – A if eligible, IA if not eligible	Eligible if resided in the US for 5 years with a qualified status; or

Meets Military Criteria at 430-05-30-60-10-05

- veteran or on active duty in U.S. armed forces or spouse or unmarried dependent child of veteran or person on active duty; and
- an alien who has been battered or subjected to extreme cruelty in the U.S. by a spouse or a parent or by a member of the spouse or parents’ family residing in the same household as the alien at the time of the abuse, an alien whose child has been battered or subjected to battery or cruelty, or an alien child whose parent has been battered. The battered spouse or child cannot be living with the family who battered them.	- I-551 annotated with 1B6, 1B7, 1B8; or
- Other USCIS documentation of battered status - contact State Office for clarification.	

Native Americans

TECS Code – A if eligible, IA if not eligible	Eligible if:
- Born in Canada who possesses at least 50% of blood of the American Indian race (Jay Treaty); or
- A member of an American Indian Tribe.
– Contact State Office if assistance is needed.	- Enrollment documents, birth records, affidavits from tribal officials, INS Form I-181 or I-551 annotated with KIC, KIP, or S13 or other acceptable documents can be used as verification of 50% American Indian blood. 
A Blood Quantum Letter containing information from the individual's Band, Tribe, Nation stating the individual’s blood quantum, which must be at least 50% aboriginal blood can also be used as verification of 50% American Indian blood.  The document may contain the following verbiage:
•	…at least 50% Aboriginal blood
•	…at least 50% Indigenous blood
•	…at least 50% North American Indian blood
•	…at least 50% American Indian blood	
Iraqi and Afghani Special Immigrants

TECS Code - RE	Eligible upon entry for:
 Iraqi - 8 months
 Afghani - 6 months	- Documentation verifying admission under section 101(a)(27) of the INA.
- Afghan passport with an immigrant visa stamp noting that the individual has been admitted under IV (Immigrant Visa) Category SQ1, SI1, SQ2, SI2, SQ3, SI3
- I-551 showing Afghan nationality with IV (Immigrant Visa) code of SQ6, SI6, SQ7, SI7, SQ9, SI9
- Iraqi passport with immigrant visa stamp noting the individual has been admitted under IV (Immigrant Visa) Category SQ1, SQ2, SQ3 and stamp or notation on passport or I-94 showing date of entry
- I-551 showing Iraqi nationality or Iraqi passport, with an IV (Immigrant Visa) code of SQ6, SQ7, SQ9	

An individual who meets the SNAP definition of disabled regardless of INS status
TECS Code - A	Eligible upon entry	-  See definition of disabled at 430-05-10	
An individual who on August 22, 1996 was lawfully residing in the US and was born on or before August 22, 1931
TECS Code - A	Eligible upon entry	- Verification of age if questionable
- Verification of LPR status	
An individual who is under 18 years of age regardless of INS status.

TECS Code - A	Eligible upon entry	- Verification of age if questionable	

Medicaid and Healthy Steps 
Treatment of aliens under Medicaid and Healthy Steps remains unchanged. 
Treatment is the same for both programs.
For clarification, however, we have moved the qualified aliens to a new section entitled ‘Qualified Aliens’ for both Medicaid and Healthy Steps.  We have also added ‘certain battered aliens’, and ‘aliens paroled into the United States’ to the list of qualified aliens and have added a clarification regarding refugees who now have a Lawful Permanent Resident Status.  Additions to current policy are underlined in the text below

Qualified Aliens 510-05-35-58 and 510-07-25-38

The term “qualified alien” means an alien who, at the time the alien applies for, receives, or attempts to receive Medicaid/Healthy Steps falls within one of the categories listed below.  The appropriate codes for these aliens are included below. These qualified aliens may be eligible for Medicaid/Healthy Steps if they meet all other Medicaid/Healthy Steps criteria (Forms indicated below are USCIS or INS forms and the sections refer to the Immigration and Nationality Act (INA):
1.	Aliens who are lawfully admitted for permanent residence (LPR) who have met the 5 year ban and the 40 quarters requirement as described in 510-05-35-65 and 510-07-25-45;
•	Form I-551 or I-151 (Resident Alien Card);
•	Foreign passport stamped LPR or I-551:
2.	Honorably discharged veterans, aliens on active duty in the United States’ armed forces, and the spouse or unmarried dependent child(ren) of such individuals;
•	Verification of honorable  US military discharge (such as a DD214)  and of relationship of family members;
3.	Refugees;
•	Form I-94 (Arrival Departure Record) showing “207” or “REFUG” or s codes RE1, RE2, RE3, RE4; or RE5;
•	Form I-688B (Temporary Resident Card) annotated 274a.12(a)(3);
•	Form I-766 (Employment Authorization Document) with code A3;
•	Form I-571 (Refugee Travel Document); 
•	Form I-551 or I-151 (Permanent Resident Card) with codes R8-6; RE6, RE7, RE8, RE9;
4.	Asylees who have been granted asylum (not applicants for asylum);
•	Form I-94 showing “208” or “asylee” and/or codes of AS1, AS2, or AS3);
•	Form I-688B annotated 274.a12(a)(5);
•	Form I-766 annotated A5;
•	Grant letter from Asylum office of USCIS;
•	Order from immigration judge granting asylum;
•	Form I-571;
•	Form I-551 or I-551 with codes AS6, AS7, AS8, AS9, GA-6 to GA-8;	
5.	Cuban and Haitian Entrants;
•	Form I-94 showing “Cuban/Haitian Entrant”  or “parole” under Section 212(d)(5) or codes CU6, or CU7 or “OOE” or” outstanding orders of exclusion”;
•	Form I-151 or I-551 with National of Cuba or Haiti and codes CH6, CNP, CU0, CU-6, CU-7, CU-8, CU-9, CUP, HA-6 to HA-9; HB-6 to HB-9; HD-6 to HD-9; HE-6 to HE-9, or  NC-6 to NC-9;
6.	Victims of a severe form of trafficking;
•	I-94 showing codes T-1 or T-2;
•	I-688B or I-766 showing 247a.12(a)(16), A16, 274a.12(c)(25) or C25;
7.	Aliens whose deportation was withheld under Section 243(h) of the Immigration and Naturalization Act (INA);
•	I-94 or foreign passport showing “243(h)” or “241(b)(3)”;
•	I-688B or I-766 with code of “274a.12(a)(10)  or A10;
•	I-571:
8.	Aliens admitted as an Amerasion immigrant; 
•	I-94 showing National of Vietnam and AM1, AM2, or AM3;
•	I-151 or I-551 showing  National of Vietnam and AM-1, AM-2, AM-3, AM-6 ,AM-7; or AM-8;
9.	American Indians born in Canada as described in 510-05-35-50;
•	I-551 showing National of Canada and S1-3 or S-13;
10.	Aliens paroled into the United States under Section 212(d)(5) of the Immigration and Nationality Act for a period of at least 1 year; 
•	I-94 showing “212(d)(5)” or “parolee” or “PIP”;
•	Form I-688B or I-766 with code such as 274a.12(a)(4), or A4, or 274a.12(c)(11);
•	Cuban-Haitian entrants with parole status are considered Cuban-Haitian entrants;
11.	Certain battered aliens; battered alien children; and the parents of such children; and
•	I-551 showing B2-1, B2-3, B2-6, or B2-8:
12.	Iraqi and Afghan Special Immigrants and their families. 
•	I-94 with a stamp of “IV” and category SQ 1, SQ2, SQ3, SI1, SI2 or SI3 and date of entry;
•	Afghan  or Iraqi passport with a stamp of “IV” and category SQ 1, SQ2, SQ3, SI1, SI2 or SI3 and DHS stamp or notation on passport showing date of entry;
•	I-551 showing national of Afghanistan or Iraq with “IV” code of SQ6, SQ7, SQ9, SI6, SI7, SI9.

Aliens Lawfully Admitted for Permanent Residence on or After August 22, 1996 (510-05-35-65 and 510-07-25-45)
Aliens who entered the United States for permanent residence on or after August 22, 1996, and who meet all other Medicaid criteria may be eligible for Medicaid as qualified aliens.

1.	Aliens admitted for Permanent Residence on or after August 22, 1996 are banned from Medicaid, except for emergency services, for five years from the date they entered the United States. After the five-year ban, aliens who are lawful permanent residents who can be credited with forty qualifying quarters of social security coverage may be eligible for Medicaid.
A refugee who has been adjusted to LPR status and has an I-551 form with the code RE-6, RE-7, RE-8, or RE-9, is still considered to be a refugee.   (510-05-35-58/510-07-25-38)

2.	Qualifying quarters of social security coverage determined by Social Security can be obtained using the Third Party Query (TPQY) information system. Earnings of some federal civilian employees hired before 1984, earnings of employees of some state and local governments, and certain agricultural and domestic earnings are not calculated by Social Security. These earnings count in establishing qualifying quarters of social security coverage and must be determined using the same process used by Social Security. If an alien claims to have work history that may qualify, but that the TPQY does not support, gather the information regarding the amount of earnings by quarter and contact the Medicaid Eligibility unit for further assistance.
a.	When determining the number of qualifying quarters an individual has, count:
i.	All qualifying quarters the alien has due to work;
ii.	All qualifying quarters worked by the alien’s spouse during their marriage, if the alien remains married to such spouse or the spouse is deceased; and
iii.	All qualifying quarters worked by a natural, adoptive, or stepparent of such alien while the alien was under age 18. Qualifying quarters of an adoptive parent count from the quarter of the adoption. Qualifying quarters of a stepparent count from the quarter of marriage to the alien’s parent.
b.	Do not count qualifying quarters for any quarter in which TANF, Food Stamp, Medicaid, or SSI benefits were received (including benefits received in another state), or from any parent whose parental rights have been terminated.

Child Care Assistance
Treatment of aliens under Child Care Assistance remains unchanged.  Policy can be found at 400-26-10-17, Residence and 400-26-10-01, Eligible Children.

LIHEAP  
The policy on refugees is if the individual has any documentation that he /she is in this country legally, the individual is eligible for LIHEAP benefits.

If you have questions, please contact your Regional Representative.