Contributors

Introduction

Changes to US Government

Rights of Noncitizens

Basic Rules of Working with Noncitizens Living with HIV/AIDS

Learning the System: Basic Immigration Concepts

Part One: Understanding Your Client's Immigration Status

Part Two: Understanding the Impact of HIV on Immigration Status

Part Three: Gaining Legal Immigration Status and Becoming a US Citizen

Part Four: Understanding Your Client's Eligibility for Public Benefits

Congress frequently changes the laws on who is eligible for public benefits. For an update, check with a local immigration or benefits advocate and the website of the National Immigration Law Center (NILC) at www.nilc.org.

An HIV positive noncitizen client walks into your office asking for information. What services can you offer him or her immediately? What help might he or she be eligible for, either now or eventually? Of course the answers depend on each client's unique situation, but there are several areas in which many HIV positive noncitizens may need assistance and face special barriers, including:

• HIV testing
• Medications
• Health care
• Food
• Housing
• Disability benefits

This section should equip you to answer questions relating to these services (and others.) We will revisit these questions at the end of Part 4.

Introduction to Noncitizens and Public Benefits

Never has figuring out noncitizens' eligibility for public benefits seemed more confusing than in recent years. It is not as simple as determining if an individual is in need of medicine, food, or shelter; rather, first you must determine if this person is a citizen, a national, or a noncitizen. If he is a noncitizen, is he "qualified" or "not qualified?" If he is "qualified," when did he enter the US or, in some cases, when did he become "qualified?" But you're still not done. You must now analyze whether or not he is subject to penalties imposed upon recently arrived legal immigrants or if he happens to fall into another exempt category. If not exempt, does he qualify for a state benefit program instead? This section will try to help you answer all these questions so you can help noncitizens who may be eligible for public benefits.

The Personal Responsibility and Work Opportunity Reconciliation Act of 1996 (PRWORA), also known as "welfare reform," significantly restricted which noncitizens may receive public assistance from government agencies. It contradicts the principle that all people are created equal and established a hierarchy of second and third class humans when it comes to public benefits. Noncitizens no longer have access to the same safety net as citizens despite the fact that they contribute to the safety net system. Despite numerous studies showing that noncitizens contribute more in tax dollars than they use in government services, Congress targeted the poorest noncitizens for cuts in welfare spending. The law and ensuing cuts sparked massive protests and organizing among immigrant communities, health care providers, advocates for seniors and persons with disabilities, anti-hunger organizations, and advocates for noncitizens, who documented the harsh situations facing noncitizens and encouraged states to provide a safety net for legal immigrants. Many states responded to fill the gap left by the cutoff in federal public benefits, at least temporarily, although the states that responded did so in their own way. Meanwhile, Congress has slowly but surely acknowledged the inequities of welfare "reform," by partially restoring Supplemental Security Insurance (SSI) for seniors and persons with disabilities and Food Stamps for children.

Despite these changes, Congress has not gone far enough to restore benefits to the neediest populations. Many of the refugees, asylees, and others granted legal status for humanitarian reasons after 1996 who were eligible for federal benefits upon arrival in the US, have now reached the seven-year cutoff mark set by Congress for SSI benefits. If they have not yet become US citizens, the government is systematically cutting them off from SSI, even if that is their sole source of income. Many refugees find it difficult to naturalize because they are elderly, have limited English proficiency, or are disabled. Others are hampered by system delays. According to a January 2004 report by the Government Accounting Office (GAO), over the last two years there has been a 59% increase in the processing backlog of immigration applications, including applications for citizenship. Many other noncitizens who have been working with authorization and paying taxes continue to be ineligible for SSI, Temporary Assistance for Needy Families (TANF), SCHIP, Medicaid, and Food Stamps.

This section will first summarize the 1996 welfare and immigration reform and explain the benefits terminology and concepts related to noncitizens created by these laws. Next, it will review the partial benefits restorations that occurred between 1997 and 2003 and their impact on noncitizens and federal public benefits. It will review the federal benefits left untouched by Congress in 1996 and discuss how states have replaced gaps caused by this legislation. It will address verification and reporting requirements of public benefits programs. Finally, it will suggest strategies advocates may use to expand benefits options for their noncitizens clients.

Welfare and Immigration Reform

The 1996 welfare and immigration reform laws did three major things that continue to harm noncitizens needing assistance. First, they severely restrict who may receive several major federal benefits. Secondly, they encourage states to also restrict both state and federal benefits. Thirdly, they limit access to most federal benefits for many new immigrants. The ability of noncitizen to access public assistance benefits depends on numerous factors - including when they received legal immigration status and when they sought the public benefit. Not all noncitizens with the same immigration status are eligible for the same benefits.

The 1996 Welfare Law: Personal Responsibility and Work Opportunity Reconciliation Act (PRWORA) of 1996 - August 22, 1996

• Created "qualified" and "not qualified" designations of noncitizens;
• Barred "not qualified" noncitizens from most federal programs;
• Barred most "qualified" noncitizens from SSI and food stamps;
• Barred recently-arrived "qualified" noncitizens from access to certain "federal means-tested public benefits" for the first five years;
• Barred many lawful permanent residents with a financial sponsor from federal benefits until they gain citizenship or credit for forty qualifying quarters of work history.

The 1996 Immigration Law: Illegal Immigration Reform and Immigrant Responsibility Act (IIRIRA) of 1996 - September 30, 1996

• Required sponsors of many immigrants to meet minimum income requirements and be legally liable for certain benefits used by the sponsored immigrant, using Affidavit of Support Form I-864;
• Expanded "sponsor-deeming," or counting sponsor income to determine eligibility for public benefits.

Public Benefits Concepts

These definitions include selected public benefits concepts and are not intended to be comprehensive. Please consult the National Immigration Law Center's Guide to Immigrant Eligibility for Public Benefits for a comprehensive resource on immigrants and public benefits.

"Qualified" versus "Not Qualified" Noncitizens
"Qualified" noncitizens include (some) abused immigrants, asylees, conditional entrants, Cuban/Haitian entrants, lawful permanent residents (green card holders), persons paroled into the US for at least one year, refugees, and those granted withholding of deportation or removal. Qualified noncitizens may have entered the US before, on, or after effective date of welfare reform law (August 22, 1996).

Qualified noncitizens who entered the US before August 22, 1996, are not subject to the first-five-years bar. Qualified noncitizens who entered the US on or after August 22, 1996, are subject to the first-five-years bar.

"Not qualified" noncitizens include everyone else, including other noncitizens lawfully present in the US, immigrants considered PRUCOL (Permanently Residing Under Color of Law), and the undocumented.

Exception: Trafficking victims. The "trafficking" classification of noncitizens is new and did not exist when the definitions of "qualified" and "not qualified" were originally developed; therefore, technically, victims of trafficking are "not qualified." However, there are special laws for victims of trafficking and their derivative beneficiaries that make them eligible for most federal benefits.

The "First-Five-Years" Bar
Noncitizens who physically entered the United States on or after August 22, 1996, will not be able to access the following five federal programs during their first five years in qualified status: non-emergency Medicaid, SCHIP, SSI, TANF and Food Stamps. There are additional restrictions in the SSI program. The Food Stamp rules are slightly different. Children and a few other groups may receive Food Stamps regardless of their date of entry into the US. Some states have attempted to impose additional restrictions in non-emergency Medicaid or TANF (a choice which has subjected at least one state to litigation), while others have chosen to provide state-funded benefits to those who are ineligible for federally funded services.

Noncitizens Exempt From "First-Five-Years" Bar
If the following noncitizens entered the U.S on or after August 22, 1996, they may still be eligible for these federal benefits:

• refugees and asylees; those granted withholding of deportation or removal; Cuban/Haitian entrants; and Amerasians; lawful permanent residents who gained status because they were refugees or asylees
• veterans, active duty service members, and their "qualified" spouses and children
• victims of trafficking
• a few other groups, depending on the benefit (Click here for NILC eligibility chart.)

The "Sponsor Deeming" Bar
Even after the first five years have passed, many lawful permanent residents may not qualify for public benefits because of "sponsor deeming." Sponsor deeming means that the income and resources of the relatives who filed immigration applications for their family members (the "sponsor") will be counted ("deemed") as the noncitizen's own income. Usually only people with income below the federal poverty level qualify for public assistance benefits. Since affidavits of support require that the sponsor show a family income of at least 125% of the federal poverty guidelines, adding on the sponsor's income will probably make most applicants financially ineligible for benefits. Sponsor deeming generally lasts until the noncitizen becomes a citizen or has credit for forty qualifying quarters of work history in the US. (See the section on gaining legal immigration status for more information on sponsors and affidavits of support.)

Sponsor deeming rules, however, have not been implemented in all programs or in all states. Check with the National Immigration Law Center if you have questions about whether sponsor deeming applies to your noncitizen client.

Noncitizens Exempt From "Sponsor Deeming"
The only new (post-welfare reform) lawful permanent residents who will not be affected by the sponsor deeming requirements are those who were not required to file an enforceable affidavit of support (e.g., refugees, asylees, battered immigrants, etc.; these are often applicants who are not subject to the public charge ground of inadmissibility), those who have credit for forty qualifying quarters of work, and those who would be homeless or hungry without assistance. States may apply the same sponsor deeming rules for state-funded programs; they may also create additional exceptions to deeming rules. Again, not all states or programs have implemented sponsor deeming rules. Check with the National Immigration Law Center if you have questions about whether sponsor deeming applies to your noncitizen client.

Counting 'Quarters'
The federal SSI and Food Stamps benefits programs make an exception for lawful permanent residents who have forty quarters of work. A "quarter" is three months; there are four quarters in a year. For a quarter to "qualify," a worker must have earned a specific minimum amount and been paying into the Social Security system. Noncitizens may accrue quarters before they become lawful permanent residents, as long as they have lawful permanent residence status at the time they apply for the benefit. For this purpose, LPRs can count quarters earned by parents (before the immigrant was 18 years old, including the time before birth) and spouses (during a marriage), and quarters earned without a valid Social Security number. Asking to be credited for quarters worked without authorization, however, may bring applicants to the attention of the Internal Revenue Service (IRS) or to the Department of Homeland Security. Check with a local immigration attorney or advocate to find out how likely this is and what the consequences would be. Noncitizens credited with forty quarters of work who entered the US on or after August 22, 1996, generally must wait until they have been in qualified status for five years before applying for certain benefits. Contact a local benefits advocate to obtain the forms and guidelines for crediting quarters to a valid account. See Counting 'Quarters' Part Two for special rules about counting quarters for Social Security and related benefits.

"Lawfully Present" for Benefits Purposes
"Lawfully present" is a benefits concept used primarily in the context of Social Security and Medicare benefits. Many of us do not think of social security programs, such as Social Security Disability Insurance (SSDI) and Medicare, as "benefits" because a portion of every paycheck (the "FICA" deduction) goes directly into them. Moreover, prior to welfare reform, immigration status was irrelevant as long as someone met Social Security's other requirements. Nevertheless, Congress chose to eliminate these benefits for some noncitizens who have paid into the system. Most noncitizens working with authorization should still be covered, however, as long as they have paid in the necessary qualifying quarters. [New requirement: For applications based on Social Security numbers issued on or after Jan. 1, 2004, immigrants must have been assigned a Social Security number that was, at the time assigned or at any later time, valid for work purposes. Alternatively, they must have been admitted to the US temporarily for business or as a crewman when the relevant work quarters were earned.]

For Social Security and Medicare, "lawfully present" noncitizens include:

• "qualified" noncitizens, as previously defined,

and the following "not qualified" categories:

• applicants for asylum, withholding of deportation or removal, or Convention Against Torture (CAT), with work authorization,
• parolees (except those paroled in specifically for an immigration court hearing),
• non-immigrants,
• adjustment applicants who are spouses or children of US citizens,
• noncitizens granted Temporary Protected Status or Deferred Enforced Departure,
• noncitizens granted Family Unity status,
• lawful temporary residents (the legalization program), and
• noncitizens granted deferred action status.

These categories cover most noncitizens working with DHS authorization. Unfortunately, two significant groups of noncitizens are not included: those with voluntary departure and applicants for suspension of deportation/cancellation of removal. HIV positive noncitizens have been eligible in the past for both of these kinds of immigration status. HIV positive noncitizens with voluntary departure and those waiting for a determination on their suspension cases may be working with DHS authorization. After April 1, 1997, voluntary departure and seven-year suspensions were no longer available, but some noncitizen clients may be able to apply for ten-year cancellation of removal. Until cancellation applicants gain lawful permanent residence or another "lawfully present" status, they will be unable to get Social Security Disability Insurance (SSDI), Social Security, or Medicare.

Although the rules allow many noncitizens to collect SSDI, Social Security and Medicare, the Social Security Administration may not have made this sufficiently clear to benefits administrators. Contact local administrators to find out if they understand all of the categories and the documentation needed to prove a noncitizen's eligibility. If a client who fits in a "lawfully present" category is denied SSDI or Medicare, challenge that determination. If it is based on lack of necessary qualifying quarters, help the applicant determine if he or she has gotten credit for all work. Your client may qualify for more quarters than he or she realizes.

Counting 'Quarters' Part Two:
The Social Security Administration uses a different method of counting quarters for purposes of SSDI, Social Security, and Medicare. It is more complicated than the method of counting quarters for SSI or Food Stamps benefits, previously described in this manual. If you want more details on counting quarters for purposes of SSDI, Social Security, and Medicare, contact the National Immigration Law Center.

Partial Restorations after Welfare "Reform"

By enacting the 1996 welfare and immigration reform laws, Congress intentionally set up barriers to public assistance benefits for immigrants arriving in the United States or obtaining immigration status on or after August 22, 1996. In general, clients who had a qualifying status before August 22, 1996, were in a much better position than those who did not. Fortunately, Congress has passed a series of partial benefits restorations. These laws expanded noncitizens' eligibility for SSI (and related Medicaid) and Food Stamps, and created the SCHIP program to provide health care for uninsured, low-income children in families earning above the Medicaid limits.

Summary of Laws
The partial restoration of benefits has occurred in phases and affected whole categories of noncitizens previously left out. Only the restorative changes are summarized below; please see here for complete chart of noncitizen eligibility for federal public benefits.

SSI (and related Medicaid).
SSI and related Medicaid (in states that link Medicaid eligibility to SSI) have been restored to immigrant seniors and immigrants with disabilities who were receiving benefits on August 22, 1996, as well as to "qualified" disabled or blind noncitizens who were "lawfully present" on August 22, 1996. The SSI cutoff period for refugees, asylees, persons granted withholding of deportation or removal, Cuban/Haitian entrants, Amerasians and victims of trafficking, has been extended from five to seven years after the person received the relevant status. This means a refugee, for instance, who receives SSI and has not yet naturalized, is cut off from receiving SSI after seven years. Proposals to extend this period for an additional 1-2 years are currently pending in Congress. These laws change frequently. Please consult the National Immigration Law Center for the most up-to-date information on noncitizen eligibility for public benefits.

Food Stamps.
Food Stamps are now available to all "qualified" noncitizen (1) children (under the age of 18), (2) people receiving disability benefits, and (3) people who have lived in the United States in qualified status for five years or more. Food Stamps are also available to "qualified" noncitizens who were lawfully residing on August 22, 1996, and were 65 years or older on that date. There is no longer any time limit on food stamps for refugees, asylees, persons granted withholding of deportation, Amerasians, and Cuban or Haitian entrants, or victims of trafficking.

State Children Health Insurance Program (SCHIP).
The federal government created SCHIP to provide health care for uninsured, low-income children in families earning more than the Medicaid income limits. SCHIP monies are distributed via block grants to individual states. US citizen and qualified immigrant children are eligible, but qualified immigrant children who do not meet an exemption are subject to the first-five-years bar.

An amendment to the SCHIP regulations allows states to provide prenatal health care to the fetuses of noncitizen women, regardless of the mother's immigration status. The scope of coverage for pregnant women is not clear. Advocates continue to press Congress to provide health services to pregnant women directly regardless of when they came into the country. For an analysis of issues to consider in your state, read the National Immigration Law Center's issue brief on this topic at the following link: NILC - Prenatal coverage through SCHIP.

Federal Public Benefits

Unrestricted Federal Public Benefits
Congress specifically exempted certain programs from the 1996 welfare law's immigration status restrictions and gave the US Attorney General the power to designate other federal benefits programs as exempt. Congress also gave states the option to provide WIC (Women, Infants, and Children, better known as WIC, is a nutrition program for pregnant women) to all noncitizens, including the undocumented. All 50 states have adopted this option and provide WIC to mothers and children, regardless of immigration status.

The welfare law exempts:

• Emergency Medicaid (including labor and delivery during childbirth, but not organ transplants),
• immunizations (outside of the Medicaid program),
• testing and treatment for symptoms of communicable diseases (outside of the Medicaid program),
• school breakfast and lunch programs for children,
• certain housing or community development assistance programs that the person was receiving as of August 22, 1996,
• benefits under Title II of the Social Security Act (i.e., Old Age, Survivors, and Disability Insurance), provided that the alien is lawfully present in the United States or qualifies for payment via an international totalization agreement, and
• short-term, in-kind, non-cash emergency disaster relief.

It also exempts certain services designated by the Attorney General as necessary to protect life or safety (see below) and confirms that elementary and secondary public education remains available to children regardless of their immigration status. The welfare law also limits restrictions to programs defined as “federal public benefits.” Programs that do not fall into the definition of federal public benefits, such as the Ryan White/CARE Act, are also available to those living with HIV/AIDS.

The Attorney General's List of Exempt Programs
The programs that the Attorney General designates as "exempt" must (1) deliver in-kind services at the community level, (2) not condition assistance on the recipient's income or resources, and (3) be necessary for the protection of life or safety.

In 2001, the Attorney General issued a memorandum containing principles to guide federal agencies that must determine which specific programs are exempt. The memo specifies:

• crisis counseling and intervention programs; services and assistance relating to child protection, adult protective services, violence and abuse prevention, victims of domestic violence or other criminal activity; or treatment of mental illness or substance abuse;
• short-term shelter or housing assistance for the homeless, victims of domestic violence, or for runaway, abused, or abandoned children;
• programs, services, or assistance to help individuals during periods of heat, cold, or other adverse weather conditions;
• soup kitchens, community food banks, senior nutrition programs such as meals-on-wheels, and other such community nutritional services for people requiring special assistance;
• medical and public health services (including treatment and prevention of disease and injuries), and mental health, disability, or substance abuse assistance necessary to protect life or safety;
• activities designed to protect the life or safety of workers, children and youths, or community residents; and
• any other programs, services, or assistance necessary for the protection of life or safety.

All Other Federal Public Benefits
The law limits all other "federal public benefits" to "qualified aliens." "Federal public benefits" are defined as:

any grant, contract, loan, professional license, or commercial license provided by an agency of the United States or by appropriated funds of the United States; and

any retirement, welfare, health, disability, public or assisted housing, postsecondary education, food assistance, unemployment benefit, or any other similar benefit for which payments or assistance are provided to an individual, household, or family eligibility unit by an agency of the United States or by appropriated funds of the United States.

Many federal public benefits are open to all "qualified" noncitizens, regardless of date of entry, and are not subject to the first-five-years bar. (Programs like Social Security and subsidized housing have their own eligibility rules.) Several federal public benefits are considered “means-tested,” which means they impose additional restrictions on noncitizens.

What Are Federal "Means-Tested" Public Benefits?
Federal "means-tested" public benefits are a subset of federal public benefits. Congress imposed additional immigration restrictions on certain federal public benefits. These restrictions include the first-five-years bar. The only programs that have been designated as federal "means-tested" benefits are the following five programs: non-emergency Medicaid, SCHIP, SSI, TANF and Food Stamps.

Public housing and in fact all HUD programs have been specifically declared NOT means-tested by HUD.

How Do I Know If A Program Is Considered A Federal Public Benefit?
This is a vague and confusing part of the law. Most federal agencies have not defined which of their programs are federal public benefits. The US Department of Health and Human Services (HHS) is an exception, one of a handful of federal agencies that has defined its federal public benefits programs. HHS issued a list of thirty-two HHS programs that provide federal public benefits, which are therefore only open to "qualified" noncitizens. If a program funded by HHS does not appear on the HHS federal public benefits list, it is not subject to the immigration restrictions.

To compound the confusion, however, some programs or services may be only partially funded by restricted money; the rest of the money may be exempt and have no immigration strings attached. This makes it hard to predict what will happen from year to year, but also allows advocates to influence its interpretation. This is especially true for federal funding for people living with HIV/AIDS. How state and local governments administer this money may have drastic consequences for noncitizens. See the advocacy section for more on this concern.

The Federal Benefits Analysis below should help you determine whether an immigrant is eligible for a specific program:

Federal Benefits Analysis
Before deciding whether or not a client will be disqualified from receiving a particular federal benefit, ask the following questions:

1. Is the benefit on the list of unrestricted federal benefits or similar to one of those benefits? Note that treatment and testing for HIV should be exempt as long as it is not Medicaid-funded.
2. Is the benefit on the Attorney General's list or similar to of the benefits on that list?
3. Is the benefit necessary for protection of life and safety and
   • community - based and
   • "in-kind" - not cash and
   • not based on financial status - not "means-tested"?

If the answer to questions 1, 2, or 3, is "yes" the benefit should be available to everyone regardless of their immigration status. Besides the specific exemptions listed in the law and by the Attorney General, advocates should argue that not all benefits, especially those administered at the state or local level, are federal public benefits and thus off-limits to all but qualified noncitizens.

• Is the benefit administered by a non-profit organization?

If the answer to this question is "yes" the noncitizen may argue he or she should be able to get the benefit regardless of immigration status because non-profit organizations are exempt from the immigration verification requirements. If the answer to all of the questions so far is "no" then a noncitizen may need to be a "qualified alien" to get it. Consult the National Immigration Law Center's chart on immigrant eligibility for public benefits.

• Find out more about the person's status:
  • Is the noncitizen on the list of "qualified aliens"?
  • If yes, when did he or she enter the US?

If the noncitizen is "qualified" and entered the US before August 22, 1996, then it is possible, but not definite, that he or she can access the benefit. Consult the National Immigration Law Center's chart on immigrant eligibility for public benefits.

If the noncitizen is "qualified" but entered the US on or after August 22, 1996 then the next question is whether the first-five-years bar applies:

• Is the benefit one of the five benefits that have a first-five-years bar?
• Is the noncitizen in an immigration status exempt from the first-five-years bar?

If the answer to all of the above questions is "no," then a noncitizen who entered the U.S on or after August 22, 1996, probably is disqualified from getting the benefit for five years. Consult the National Immigration Law Center's chart on immigrant eligibility for public benefits.

To find out if they will continue to be disqualified by sponsor deeming after the five years runs out, ask:

• Did the "qualified" noncitizen have a "sponsor" who filled out an enforceable affidavit of support, Form I-864?

If "yes," federal means-tested benefit programs may count the income and other financial assets of an immigrant's sponsor when determining whether that person meets the income eligibility requirements. If the sponsor did not fill out an affidavit of support committing him or her to pay back public benefits used by the sponsored immigrant, sponsor deeming should not apply. Consult the National Immigration Law Center's chart on immigrant eligibility for public benefits.

Example: HIV testing
Is HIV testing on the list of unrestricted federal benefits or the Attorney General's list? Yes. The law specifically exempts testing and treatment for symptoms of communicable diseases from any immigration restrictions. This means any noncitizen should be able to be tested for HIV, as long as it is not Medicaid-funded.

Advocacy Strategies on "Other" Benefits
It may be possible to advocate for changes in the ways some benefits programs are locally administered so that they do not disqualify new immigrants. Here are some questions to help determine if this is possible:

• Could the program be administered by a non-profit, so that checking immigration status is not required?
• Could the program be restructured so that it meets the Attorney General's test (i.e. community-based, in-kind, not means-tested, and necessary for protection of life and safety)?
• Does federal money fund only part of the program? Could local or state money be used to help those who are disqualified from the federal money?
• Could the program be changed so that access is based on something other than financial need so that it might fit under the Attorney General's "life and safety" exemption?

State "Alternative" Benefits Programs
One result of the welfare law and subsequent restorations has been the transfer of power from the federal government to state and local governments. When the 1996 Personal Responsibility and Work Opportunity Reconciliation Act passed, advocates feared that the effects on noncitizens would be devastating. State-level advocacy, however, was at least partially successful in many states. These states elected to develop alternative "replacement" programs for some noncitizens who did not qualify for federal public benefits. Many of these alternative programs parallel a federal public benefit. For example, federal Medicaid placed major limits on the eligibility of noncitizens. In response, at least twenty-six states initially created state-funded medical assistance programs as safety nets for certain noncitizens no longer eligible for federal Medicaid, though many have since cut back on these programs.

Many state alternative programs may place restrictions on noncitizens, but these vary by state. For example, one state may offer its medical assistance program to all noncitizen children, regardless of immigration status; another may offer it only to immigrant survivors of domestic violence; a third may cover anyone of whose presence the DHS is aware and is not trying to deport or remove. Check with local or state advocacy groups for up-to-date information about which categories of noncitizens are covered by your state's alternative benefits programs. NILC's Guide to Immigrant Eligibility for Federal Programs also includes a section on state programs.

State policies are inconsistent and constantly changing. They remain confusing to both clients and service providers alike. Many states set program enrollment caps. When states face budget crises, immigrant-friendly programs often are the first they place on the chopping block. These cuts, in turn, create a waiting-list system for benefits, similar to the waiting lists that plague the federal immigration system. These cuts result in impoverishment, homelessness and inadequate medical care, foster unnecessary emergency room care, help spread communicable diseases, and harm public health in general.

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