There are two forms which must be filled out by all groups using the Combined Application.  The first form, the Immigration and Citizenship Initial Declaration Form (see Exhibit IV-1), provides a list of the immigration categories in which non-citizens must fall in order to be eligible for TANF, FS, GC, IDA, or Medicaid (except emergency services).  That is, the form lists all 'qualified' immigration categories as well as the three immigration categories described in Section 7.3.1:  Exceptions in this Chapter.  The PI must fill out this form and attest to which of the following groups each household member belongs:

• U.S. citizen or national;
• not a U.S. citizen or national and individual’s immigration status falls into one of the categories listed on the form (which means that s/he is potentially eligible for benefits); or 
• not a U.S. citizen or national and individual’s immigration status does not fall into one of the categories listed on the form (which means that s/he is not eligible for TANF, FS, GC IDA, or Medicaid, except emergency Medicaid services).

Example 1

Ms. Hernandez and her two children, Maria (14) and Jose (4), apply for TANF, FS, and Medicaid.  Mrs. Hernandez must fill out an Immigration and Citizenship Initial Declaration Form listing herself and her two children.  On the form, she indicates that she and Maria are not citizens or nationals and their immigration status does not match any of the categories listed on the form.  On the form, she indicates that Jose is a U.S. citizen.  Based on this information,   Ms. Hernandez does not need to fill out a CAD form..  Jose, who is a citizen,  is the only member of the family that meets the immigration-related requirements of the three programs, other than Emergency Medicaid.  The SSR should not ask Ms. Hernandez any further questions about her immigration status or that of Maria.

Example 2

Mr. Pak, his daughter, and his severely disabled sister apply for Medicaid and FS.  Mr. Pak must fill out an Immigration and Citizenship Initial Declaration Form that lists all three members of the household since under FS rules they would generally all be included in the FS unit since they all purchase and prepare food together.  Mr. Pak indicates that he and his daughter are not citizens or nationals and that their immigration status matches one of those listed on the form.  He indicates that his sister’s immigration status does not match one of those listed on the form.  The CAD form he fills out should list only himself and his daughter, not his sister.

When PRWORA created categories of immigrants who could qualify for Federal means tested public benefits, such as TANF, Medicaid, and Food Stamps, it also imposed requirements that restricted the eligibility of those qualified immigrants. Among those mandates is a requirement to deem a sponsor’s income and resources to some non-citizens when determining their eligibility for and amount of their benefits.  A sponsor is anyone who executed an affidavit of support on behalf of an immigrant as a condition of the immigrant’s entry into the U.S.   Because courts had held that the affidavits of support in use at the time PRWORA was enacted were not legally binding contracts between the sponsor and the U.S. government, the Illegal Immigration Reform and Immigrant Responsibility Act of 1996 and the Balanced Budget Act of 1997, amended PRWORA  requiring creation of a new affidavit of support for sponsors of certain lawful immigrants and new rules for deeming income and resources from the sponsor to the sponsored immigrant.  A new legally enforceable affidavit of support,  INS Form I-864, Affidavit of Support Under Section 213A of the (Immigration and Nationality) Act, otherwise known as, an I-864 Affidavit, was instituted and took effect on December 19, 1997. 

 

Households that include sponsored immigrants who have been determined as indigent may opt into sponsor deeming and have their benefits determined based upon the income and resources that would be deemed, if the immigrant was not indigent.