MR #17.19: Medical Benefits for Non-Citizen Victims of Trafficking, Torture or Other Serious Crimes

12/13/17

Summary:

• Effective 01/01/18, a non-citizen victim of trafficking, torture or other serious crimes and their derivative family members may be eligible for state funded medical assistance if they have applied for "T" Non-immigrant status, "U" Non-immigrant status, or Asylum status, or are preparing to file an application with the U.S. Citizenship and Immigration Services (USCIS) for such status.
• To qualify for this program, persons cannot be otherwise eligible for medical assistance.
• Additionally, a person must have countable monthly income at or below the regular AABD MANG community income standard (100% of the FPL), and have non-exempt resources at or below the AABD community medical resource disregard level. 
• Eligible persons must be certified for this "Medical Benefits for Victims of Trafficking, Torture, or Other Crimes" (VTTC) program using the "Medical Benefits for Asylum Applicants and Torture Victims" (AATV) screens until IES is programmed with eligibility rules specific to VTTC.
• This release adds information about how a person is enrolled into the AATV program in IES and how eligibility is redetermined in IES.

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1. Special Non-Financial Eligibility Requirements
   1. T Non-immigrant Status
   2. U Non-immigrant Status
   3. Asylum Status
   4. Verifying That a Person Filed for Status
   5. Verifying that a Person is Preparing to File for Status
2. Additional Non-financial Eligibility Requirements:
3. Financial Eligibility Requirements
   1. Determining Financial Eligibility
4. Application Process
5. Renewals
6. Non-citizen Status Changes
   1. T Visa Approved
   2. U Visa approved
   3. Asylum Application Filed
   4. Asylum Application Approved
7. Ending Eligibility
8. MANUAL REVISIONS

Effective January 1, 2018, foreign born victims of trafficking, torture or other serious crimes and their derivative family members may qualify for state funded medical assistance under the Survivor Support and Trafficking Prevention Act (PA 99-870).  To qualify for medical benefits, otherwise ineligible non-citizens must have applied for, or are preparing to file, an application with USCIS for, "T" Non-immigrant status, "U" Non-immigrant status, or Asylum status.

"Derivative Family Member" means a person who is the spouse, child, parent, or sibling under age 18 of the principal victim who is eligible, or potentially eligible, for one of the above statuses. A spouse must have been married to the principal victim before the principal victim entered the United States.

Persons applying for or receiving VTTC medical benefits are entitled to appeal rights as described in PM 01-07.

Special Non-Financial Eligibility Requirements

T Non-immigrant Status

The "T" non-immigrant status, also known as the T Visa, was created to provide immigration protection to victims of a severe form of human trafficking. Under Federal law, the term "severe forms of trafficking" can be broken into two categories:

1. Sex trafficking: recruitment, harboring, transportation, provision or obtaining of a person for the purpose of a commercial sex act where the commercial sex act is induced by force, fraud or coercion, or the person being induced to perform such act is under 18 years of age.
2. Labor trafficking: recruitment, harboring, transportation, provision or obtaining of a person for labor or services through the use of force, fraud, or coercion for the purpose of involuntary servitude, peonage, debt bondage, or slavery.

U Non-immigrant Status

The "U" non-immigrant status, or U Visa, is designated for victims of certain crimes who have suffered mental or physical abuse because of the crime and who are willing to assist law enforcement and government officials in the investigation of the criminal activity. Examples of qualifying criminal activities include, but are not limited to, the following activities:

Asylum Status

A non-citizen may apply for asylum if they are unable or unwilling to return to their country of origin due to a well-founded fear of persecution on account of race, religion, nationality, membership in a particular social group or political opinion.

Verifying That a Person Filed for Status

Accept the following documentation to verify that an individual has filed for T, U or asylum status with the USCIS:

• Form I-797, "Notice of Action", as a receipt for their application for T, U or asylum status. The I-797 will include a case number that applicants can use to check the status of their cases online at https://egov.uscis.gov/casestatus/landing.do  (This form is also used for other purposes.)
• Printouts of case status queries from the USCIS web site,
• Acceptable proof of a pending asylum application described in WAG 03-01-04-a, or
• Other correspondence from USCIS regarding applications, such as appointment notices and requests for evidence (RFEs).

Note: Since a person qualifies for VTTC only if they do not qualify for another medical program, a person who has a pending asylum application may qualify for medical benefits under AATV rather than VTTC. 

Verifying that a Person is Preparing to File for Status

When an applicant is preparing to file for one of the above statuses, the following proofs are required from the applicant or their approved representative:

1. A sworn written statement that he or she is a victim of one of the crimes listed above, or is a witness to one of the above crimes and is cooperating with law enforcement authorities investigating or prosecuting these crimes, and at least one item of additional credible evidence, including but not limited to any of the following:
   1. police, government agency, or court records or files,
   2. news articles,
   3. documentation from a social services, trafficking, domestic violence program or rape crisis center, or a legal, clinical, medical professional, or other professional from whom the applicant or recipient has sought assistance in dealing with the crime,
   4. a written statement from any other individual with knowledge of the circumstances that provided the basis for the claim,
   5. physical evidence,
   6. a copy of a completed visa application (I-914, Application for T Non-immigrant Status, I-914, Supplement A, Application for Immediate Family Member, I-918, Petition for U Non-immigrant Status, I-918, Supplement A, Petition for Qualifying Family Member of U-1 Recipient, or I-589, Application for Asylum and for Withholding of Removal).
   7. a written notice from the federal agency of receipt of the visa application.
2. If a person who has provided a sworn statement is unable to provide any of the additional credible evidence listed above, medical benefits may be provided under this program if the Department has determined that the individual is credible. Supervisory approval is required and the reason for approval must be documented in case notes.

Additional Non-financial Eligibility Requirements:

An individual must also meet the following non-financial requirements:

• Cooperate in establishing eligibility as described in PM 01-02-00.
• Be an Illinois resident as described in PM 03-02-00.
• Be age 19 or older.
• Is not otherwise eligible for any other federally or state funded medical assistance program.

Individuals under this program are exempt from citizenship/immigration and social security number (SSN) requirements.

Financial Eligibility Requirements

An individual must meet the following financial requirements:

• Have countable monthly income at or below the AABD community medical standard (see PM 15-06-02-a), and
• Have non-exempt resources at or below the AABD community medical resource disregard level (see PM 07-02-01).

Determining Financial Eligibility

The earned and unearned income of the following persons shall be counted when determining eligibility:

• Income of the individual.
• Income of the spouse.
• Unearned income of a dependent child under the age of 18 years who is included in the income standard because it is to the advantage of the individual.
• Monthly earned and unearned income shall be considered as specified for AABD community medical, including work related expenses that are allowed as deductions (see PM 08-02-00).

Application Process

The application date shall be the date a signed application is received by the Department as described in PM 02-04-06, and can be no sooner than January 1, 2018. A person cannot receive VTTC medical benefits for a month prior to January 2018. Otherwise, eligibility may be backdated up to three months prior to the month of application if the applicant would have met the criteria for the backdated months.

Eligible persons must be certified for benefits under the AATV program until IES is programmed with eligibility rules for the VTTC program. A non-citizen who does not qualify for another medical program is progressed to AATV when one of the following questions is answered on the Aliens Detail screen under 'Asylum Torture Victim Information':

1. 'Yes' to 'Individual has a pending asylum application', or
2. 'Yes' to 'Individual is receiving federally funded torture treatment services'.

To enroll a person for VTTC using the AATV screens, answer the questions in the following manner:

USCIS Status	Response to Question	Program
Preparing to apply for T Visa, U Visa or Asylum	'yes' to torture treatment question	VTTC - add case notes
Applied for T or U Visa	'yes' to pending asylum application question	VTTC - add case notes
Applied for Asylum status	'yes' to pending asylum application question	AATV - if within eligibility period VTTC - add case notes if maximum AATV eligibility reached

When answering 'yes' to one of the above questions, the worker must select one of the verifications that relate to the AATV program. Since the VTTC verifications received will not match the verifications selected in IES, it is important to document in case notes that the person qualifies under the VTTC program. 

In IES, a person receiving AATV benefits appears to be in an AABD medical EDG with an AATV indicator (that is, the EDG Summary screen shows the 'Special Approval Type' is 'Asylum Torture Victim'). A person who qualifies for VTTC will appear in IES the same way.

Note: The only way we can identify that a person qualifies for medical benefits under VTTC rather than AATV is by viewing the IES case notes and supporting verifications. Persons enrolled in VTTC will have the same MANG P code "TV" in MMIS as AATV recipients. This MANG P code indicates that the person is enrolled in a state funded medical program.

Renewals 

Eligibility for VTTC medical benefits must be redetermined every 12 months or when a change is reported. VTTC and AATV are not subject to auto-REDE (process A) in IES. All financial and non-financial criteria, including immigration status, must be reviewed.

Verifications required at REDE are:

• proof of income for the last 30 days,
• Illinois residence, and
• proof of current immigration status.

If the client reports a change in immigration status at the redetermination, or at any time, ask for documentation. If an Alien ID number is provided, run the Verify Lawful Presence (VLP) clearance. Complete a SAVE inquiry if necessary.

Accept information reported on a redetermination form declaring that their resources are below the resource standard for the program, unless questionable (Simplified Processing as described in PM 19-02-03-b applies).

Since persons are certified for VTTC medical benefits through the AATV screens, the redetermination form that the client receives will contain the following AATV related questions:

• Do you have a pending asylum application? _ Yes _ No
• Has the immigration status for you or your family members changed? _ Yes _ No
  • If yes, attach a current letter of confirmation from your attorney or legal representative.
  • If no, attach proof of your current immigration status.
• Are you receiving federally funded torture treatment services? _ Yes _ No
  • If yes, attach a current letter of confirmation from the torture treatment center
• Do you have an asylum appeal pending? _ Yes _ No
  • If yes, attach a Form EOIR-26 Notice of Appeal with Filing Receipt for Appeal or Petition for Review of a Board of Immigration Appeals Decision stamped by the U.S. Court of Appeals of the Seventh Circuit.

Note: These questions will not appear in "Manage My Case" (MMC) until IES is updated. When possible, advise the client to return the REDE form with required documentation. Otherwise, a VCL to request the information will be needed.

When a person continues to qualify for VTTC, respond to the IES question in the same manner as described above under 'Application Process'. Remember, the only way we can identify that a person qualifies for medical benefits under VTTC rather than AATV is by viewing the IES case notes and supporting verifications.

Non-citizen Status Changes 

Review eligibility when a change in immigration status is reported at REDE, or any other time during the certification period.

T Visa Approved

A person who is approved for a T Visa meets federal Medicaid Qualifying Non-citizen criteria as a trafficking victim per PM 03-01-02-d. The worker must update their immigration status and determine eligibility for another medical program.

U Visa approved

A person who is approved for a U Visa does not meet federal Medicaid Qualifying Non-citizen criteria and continues to qualify for VTTC as long as they meet all other eligibility criteria.

Asylum Application Filed

When a person provides documentation that verifies that they have a pending asylum application, they may qualify for the AATV program. However, a person whose asylum application is still pending with USCIS by the time they reach the maximum eligibility period for AATV per PM 06-21-04, may again qualify for VTTC benefits.

Asylum Application Approved

A person who is approved for Asylum status meets federal Medicaid Qualifying Non-citizen criteria per PM 03-01-02-d. Their immigration status must be updated and eligibility determined for another medical program.

Ending Eligibility

An individual shall no longer be eligible if:

1. there is a final denial of the principal victim's visa or asylum application, or
2. if the principal victim has not filed a formal application for status within one year after the date of his or her application for medical benefits, unless the worker with supervisory approval determines that during the year of initial VTTC eligibility the individual:
   • experienced a health crisis,
   • has been unable, after reasonable attempts, to obtain necessary information from a third party, or
   • has other extenuating circumstances that prevented the person from completing his or her application for status.

If the principal victim no longer meets the VTTC eligibility criteria, the principal victim and his derivative family members must be evaluated for medical eligibility under other programs.

MANUAL REVISIONS

[signed copy on file]

James T. Dimas

Secretary, Illinois Department of Human Services 

Felicia F. Norwood

Director, Illinois Department of Healthcare and Family Services