Article 5 Section 04 Aliens Table of Contents TITLE PG CITE Alien Status 050401 Scope of Services 050401A I688B USCIS Document 050401B Ineligible Aliens 050401C Eligible Alien Categories 050402 Legal Permanent Resident Alien LPR 050402A Conditional Permanent Resident CPR 050402B IRCA Amnesty Alien 050402C Other Eligible Alien Categories 050403 Asylees 050403A Deportation Categories 050403B Memorandum of Creation of Record of Lawful Permanent Residence 050403C Order of Supervision INA Section 242 050403D Parolee 050403E Refugees 050403F Registry Alien Status 050403G Voluntary Departure 050403H Additional Eligible Alien Categories 050403I Alien Status Verifications 050404 Alien Status Verification and Certification 050404A Systematic Alien Verification for Entitlements SAVE 050404B USCIS Forms and Documents Listing Appendix A 050401 Alien Status 050401 This section contains CMS policy for eligible aliens and the specific General Immigration status and documentation required to receive CMS benefits On March 1 2003 the Immigration and Naturalization Services INS became a department of the US Department of Homeland Security and was renamed the Bureau of Citizenship and Immigration Services BCIS On November 2003 the name was changed again to US Citizenship and Immigration Services USCIS 050401A All aliens who meet the eligibility requirements for CMS receive the Scope of same scope of services as all other CMS beneficiaries Services 050401B I688B USCIS Document Document I688B is issued for aliens who have been granted permission to work in the US The I688B by itself is NOT evidence of legal status and does NOT provide adequate verification for CMS eligibility However it does provide the provision of law that allows the alien to work which may indicate how the alien entered the country Some alien categories listed in 050403 shows the provisions of law identified to be on the I688B issued for a specific status 050401C Aliens who do not have the specific USCIS status AND documents Ineligible listed in 050402 and 050403 are NOT eligible to CMS This Aliens includes aliens who have a change of status and no longer meet the eligible alien criteria for CMS and those with expired documents CMS must never be certified beyond the expiration date of the document 050402 Eligible Alien Categories 050402A Legal Permanent Resident Alien LPR Below are tables that list the USCIS alien status and documents required for the CMS program ALERT USCIS uses many of the forms for purposes other than what is listed in the tables below The status or the terminology may appear similar on other forms However only the forms with the status notation and codes exactly as described are acceptable verification for CMS Definition Lawful Permanent Residents LPR are noncitizens who are lawfully admitted for permanent residence by USCIS These noncitizens may also have entered the country with an immigrant visa or adjusted their status after entering as a nonimmigrant refugee or asylee Rule Aliens with verified LPR status are eligible for CMS Only the USCIS status documents and codes listed below are acceptable verification for CMS USCIS Status USCIS Documents USCIS Codes SectionNotation Issued For This Period Of Time Legal Permanent Resident I551 There are numerous codes all are valid Older version of card has no expiration date and is acceptable as verification 10years must not be expired I151 There are numerous codes all are valid Has no expiration date I94 Processed for I551 Temporary evidence of lawful admission for permanent residence valid until Varies must not be expired Foreign Visa stamp that Passport verifies temporary evidence of LPR status I327 Reentry permit is given to an LPR when traveling outside of the US for an extended period of time Good one year from issue date AR3AR3a There are numerous codes all are valid Older version of I551 issued between 1941 and 1949 is acceptable as verification Has no expiration date 050402B Conditional Permanent Resident CPR 050402C IRCA Amnesty Alien Definition An alien granted a twoyear period of conditional permanent resident status based on a qualifying marriage to a US citizen or national or lawful permanent resident The conditional status expires after two years It is the responsibility of the CPR to obtain new immigration status from USCIS Rule Aliens who have CPR status are eligible for CMS benefits until the expiration date Expired CPR documents cannot be accepted as evidence of eligible alien status for CMS Only the USCIS status documents and codes listed below are acceptable verification for CMS USCIS Status USCIS Documents USCIS Codes SectionNotation Issued For This Period Of Time Conditional Permanent Resident CPR This status is identified by the twoyear I551 There are numerous codes all are valid 2 years and must not be expired I94 Notation that verifies temporary evidence of the CPR admitted status Cannot exceed 1 year from issue date must not be expired Foreign Stampnotation expiration date on the I551 Passport that verifies temporary evidence of the CPR admitted status NOTE Review documents carefully and do not confuse with LPR status Definition Unauthorized or illegal aliens who were given the opportunity to legalize their immigration status The Immigration Reform and Control Act IRCA was enacted in 1986 to grant certain individuals amnesty The IRCA Amnesty program has ended However there are still IRCA individuals whose USCIS status has not been resolved Rule IRCA Amnesty aliens granted temporary resident status who meets the eligibility requirements are entitled to CMS Only the USCIS status documents and codes listed below are acceptable verification for CMS Amnesty Temporary Resident I688 that is current and valid and has unexpired extension dates Sections 210 210A 245A Varies must not be expired Amnesty I551 S16 S26 W16 Legal W26 W36Ch6 Permanent 01M MP5 Residence 050403 Other Eligible Alien Categories 050403A Asylees Definition A person who has been granted asylum under Section 208 of the INA These individuals will have a letter with a written decision from USCIS or an immigration judge that states asylum has been granted Not all letters are the same but must specifically state that asylum has been granted Rule Individuals granted asylum are entitled to CMS if otherwise eligible Only the USCIS status and documents with the USCIS codes listed below are acceptable verification for CMS If asylum has been applied for but not yet granted the individual is not eligible for CMS USCIS Status USCIS Documents USCIS Codes SectionNotation Issued For This Period Of Time Alien granted asylum 194 annotated Asylum granted per Section 208 of the INA Document must not be expired A letter from USCIS or an immigration judge States asylum has been granted I766 annotated AND additional USCIS verification documents as listed above A5 1688B annotated Provision of law AND additional USCIS verification documents as listed above 274a12a5 NOTE Individuals granted asylum are eligible for RCA eight months from date of entry into the US they are not eligible for CMS during this period 050403B Deportation Categories Back to the top Definition Aliens who would otherwise be deported but are allowed to stay for any of the following reasons Granted an Indefinite Stay of Deportation due to humanitarian reasons Granted a Stay of Deportation for a specified period by Court order statute or regulation or by individual determination of USCIS in accordance with INA Section 106 Granted Suspension of Deportation in accordance with INA Section 244 Withholding of DeportationCancellation of Removal status is granted to aliens who can prove they would be prosecuted if returned to their country Rule For CMS all the Deportation categories listed above must be granted for a period of one year or more or an indefinite period Persons granted less than one year are not eligible for CMS Only the USCIS status and documents listed below are acceptable verification for CMS USCIS Status USCIS Documents USCIS Codes SectionNotation Issued For This Period Of Time Granted I94 Must state Indefinite Stay of Deportation Indefinite Indefinite Stay of Deportation Due to Humanitarian Reasons Letter from USCIS or Order from an USCIS administrative law judge Granted Stay I94 INA Section 106 Must state Stay of Deportation Must specify a period of one year or more AND of Deportation for a Specified Letter from USCIS or Order from an Period USCIS administrative law judge not be expired Granted Suspension of Deportation in Accordance with Section 244 Letter from USCIS or Order from an USCIS administrative law judge Must state granted Suspension of Deportation in accordance with Section 244 Granted Withholding of Deportation Cancellation of Removal Court order from immigration judge Must show deportation withheld or cancellation of removal under Section 243h or 241 b3 I766 annotated AND Court Order from immigration judge A10 I688B annotated AND additional USCIS verification documents as listed above Provision of law 27412a10 NOTE USCIS uses the above documents for other purposes and status than those listed above Review and ensure they contain the information exactly as stated above 050403C Memorandum of Creation of Record of Lawful Permanent Residence Definition A notification letter from USCIS issued when an alien has applied for or has been granted permanent LPR status Document I181a is issued when an aliens request for adjustment to LPR status is received Document I181b is issued when LPR status is granted This is a temporary identification document The individual should receive a permanent I551 within one year Rule Only those aliens who have an I181b that specifically states LPR has been granted are entitled to CMS Only the USCIS status and documents listed below are acceptable verification for CMS USCIS Status USCIS Documents USCIS Codes SectionNotation Issued For This Period Of Time Lawful Permanent Residence I181b Specifically states LPR status has been granted Document is good for one year from issue date unless there is a USCIS extension annotated NOTE If document is over one year old applicant must write an explanation why I551 has not been received and provide additional USCIS verification that status is still valid 050403D Order of Supervision INA Section 242 Definition Aliens found deportable who are not likely to actually be expelled because of their age physical condition humanitarian concerns or the availability of a country that will accept them Rule Only the USCIS status and documents listed below are acceptable verification for CMS Note When certifying CMS do NOT certify beyond the next reporting date which is considered the expiration date of the document USCIS Status USCIS Documents USCIS Codes SectionNotation Issued For This Period Of Time ORDER OF SUPERVISION I220B is only issued for this purpose I220B AND the handwritten attachment with entries made by USCIS officers that show individual has been meeting reporting requirements INA Section 242 If code does not appear on I220B form it is still a valid verification Handwritten attachments last entry will always show the next reporting date and will be initialed by an USCIS officer followed with S3 numbers or other USCIS ID code I688B annotated AND additional Provision of law 274a12c18 Must not be expired USCIS verification documents as listed above 050403E Parolee Definition Parolees are persons who normally would not be admissible to the US but are allowed to enter temporarily for humanitarian medical and legal reasons usually under emergency circumstances Aliens entering the US as Parolees are given the immigration status of Paroled as a Refugee or CubanHaitian Entrant or Humanitarian Parolee HP or Public Interest Parolee PIP Rule Parolees are allowed in the US either indefinitely or for a specific period of time Those allowed in the US for a specific period of time are NOT eligible for CMS Only the I94s issued for an indefinite period with the USCIS status and codes listed below are acceptable verification for CMS Parolees as defined in this section who have previously received CMS benefits and provided CMS with documentation of Parolee status for an indefinite period may have turned in the documentation to USCIS when adjusting their status to LPR They will remain eligible for CMS if they provide verification of their current pending LPR status and are otherwise eligible A copy of the I94 that verifies Parolee status was granted for an indefinite period must be in the case file before CMS benefits are approved USCIS Status USCIS Documents USCIS Codes SectionNotation Issued For This Period Of Time Humanitarian HP Public Interest Parolee PIP I94 Section 212d5 Notation that verifies status Must state indefinite I688B annotated AND additional USCIS verification documents as listed above Provision of law 274a12c11 Must not be expired Cuban I94 Section 212d5 Must state Haitian indefinite Entrant Notation that whose status verifies status has not been adjusted in accordance with Section 202 of the INA are included in the category 050403F Refugees Definition Refugees are persons who entered the US as a nonimmigrant or entered without inspections because of persecution or fear of persecution on account race religion or political opinion Refugees may convert to LPR status after one year of residence in the US Rule Only the USCIS status and documents with the USCIS codes listed below are acceptable verification for CMS USCIS Status USCIS Documents USCIS Codes SectionNotation Issued For This Period Of Time REFUGEE Lawfully 194 annotated Admitted as a refugee pursuant If no expiration date is annotated it is Admitted to USCIS form the US as I571 to Section 207 of good for 7 years a refugee Refugee the INA from date of since April Travel OR entry OR up to 1 1980 REFUGEE CONDITIONAL ENTRANT Document Admitted as a Refugee Conditional Entrant before April 1 1980 INA Section 203a7 the expiration date that is annotated on the document Lawfully Admitted to the US as a conditional entrant before April 1688B annotated AND other USCIS verification documentation as listed Provision of law 274a12a4 274a12a3 Must not be expired 1 1980 above NOTE Eligible for RCARMA eight months from date of entry Not eligible to CMS during this period as they are entitled to MediCal 050403G Registry Alien Status Definition Aliens who claim to have entered and continuously resided in the US before January 1 1972 Rule Must be evidenced by a fee receipt and an interview appointment letter from USCIS which specifically states that an application has been submitted for adjustments of status from illegal alien to lawful admission for permanent resident in accordance with INA Section 249 Only the USCIS status documents listed below are acceptable verification for CMS USCIS Status USCIS Documents USCIS Codes SectionNotation Issued For This Period Of Time Registry Alien USCIS Form G711 Individual Fee Register Receipt AND USCIS Form I468 Interview Appointment Letter USCIS Interview Appointment Letter must specifically state adjustment of status to lawful admission for permanent residence in accordance with INA Section 249 Good for 1 year from issue date If more than 1 year old must verify adjustment of status is currently valid I688B annotated AND additional USCIS verification documents as listed above Provision of law 274a12c 16 Must not be expired NOTE USCIS uses the above documents for other purposes and status than those listed above Review and ensure they contain the information exactly as stated above 050403H Definition Voluntary Departure is a status that entitles an alien to stay Voluntary in the US for either a specific period or indefinitely Aliens granted Departure Voluntary Departure for any of the reasons listed below may be eligible to CMS Aliens granted Voluntary Departure by USCIS before deportation proceedings have begun or by an Immigration Judge during deportation proceedings Aliens waiting issuance of a Visa in accordance with INA Section 212b who have been granted Voluntary Departure permission to leave at a later time until the Visa is ready Aliens on whose behalf an USCIS Form I130 Petition to Classify Status of Alien Relative for Issuance of Immigrant Visa has been filed with their families covered by the petition AND have been granted Voluntary Departure Aliens under the Family Unity Program Voluntary Departure provides protection from deportation to the spouses and children of amnesty aliens legalized under IRCA Section 301 who have been granted a temporary Stay of Deportation Aliens granted Indefinite Voluntary Departure in lieu of deportation Aliens granted Extended Voluntary Departure for a specified time due to conditions in their home countries Rule For CMS all the Voluntary Departure and Stay of Deportations categories listed above must be granted for a period of one year or more Persons granted less than one year are not eligible for CMS Only the USCIS status and documents listed below are acceptable verification for CMS USCIS Status USCIS Documents USCIS Codes SectionNotation Issued For This Period Of Time Granted Voluntary Departure I94 INA Section 242b Must specifically state the USCIS status as Voluntary Departure Must specify a period of one year or more AND not be expired I210 I668B annotated AND additional USCIS verification documents as Provision of law274a12c12 Must not be expired listed above Granted Indefinite I94 Must specifically state the USCIS Indefinite period Letter from Voluntary USCIS status as Departure or Order from Indefinite an USCIS Voluntary Administrative Departure law judge I668B annotated AND additional USCIS verification documents as listed above Provision of law274a12c12 Must not be expired Granted Extended Voluntary Departure I94 Must specifically state the USCIS status as Extended Voluntary Departure Must specify a period of one year or more AND not be expired I210 I688B annotated AND additional USCIS verification documents as listed above Provision of law 274a12a11 Must not be expired Granted Voluntary Departure or Stay of Deportation under the Family Unity Program I94 Must specifically state the USCIS status as Voluntary Departure OR Stay of Deportation OR Section 301 Family Unity Must specify a period of one year or more AND not be expired I797 Must be issued for Family Unity purposes only Must specifically state Application Petition I817 Application for Voluntary Departure Under the Family Unity Program Valid from to I688 annotated AND additional USCIS verification documents as listed above Provision of law247a12a13 Must not be expired NOTE USCIS uses the above documents for other purposes and status than those listed above Review and ensure they contain the information exactly as stated 050403I As of September 2007 the following additional alien categories have Additional been determined by County Counsel to meet the requirements as an Eligible alien eligible alien qualified to receive CMS Categories USCIS Status USCIS Documents USCIS Codes SectionNotation Issued For This Period Of Time Deferred I797 Notice SelfPetitioning 180 days from Action of Action Spouse of notice date status reflecting establishment of Prima Facie case under the self petitioning provisions of the Violence Against Women Act USC or LPR under the Violence Against Women Act Expiration date is used on the NOA Must not be expired County of San Diego Health and Human Services Agency HHSA County Medical Services Program Guide Alien Status Verification Number Page 050404 15 of 2 Revision Date 06012018 Background The applicant must present their USCIS documents at every initial application recertification or reapplication This section is revised to include information about eSAVE for secondary verification and remove references to form G845 Purpose To provide instructions for verifying an Aliens Satisfactory Immigration Status SIS Policy The USCIS document is viewed and scanned into the CMS IT System at initial application At recertification or reapplication if a copy of the same USCIS document is already in the case record view the document narrate in the case record what was viewed and the expiration date of the USCIS document A Alien Documentation with Expiration Dates Aliens with LPR status who have lost or have an expired I551 card may not be certified for CMS An expiration date is printed or stamped on many USCIS documents There is a possibility that USCIS may have revoked the alien status granted on the expired document If the Then expiration date has passed the document is not valid and cannot be accepted as proof of alien status alien does not provide a valid USCIS document CMS eligibility is denied document is due to expire within the normal six month certification period end the certification period the month the document expires In lieu of documents listed in 050402 and 050403 the applicant may submit a current dated within 30 days before the application date statement from USCIS that verifies eligible alien status as defined in 050402 and 050403 Note USCIS has a Fee Waiver program for individuals who meet certain criteria andor can demonstrate inability to pay the replacement or renewal fees County of San Diego Health and Human Services Agency HHSA County Medical Services Program Guide Alien Status Verification Number Page 050404 2 of 2 B Systematic Alien Verification for Entitlements SAVE SAVE enables USCIS to verify an aliens documentation of SIS through an automated system CMS does not have access to the Primary Verification System through CalWIN therefore the SAVE Secondary Verification System is used SAVE Secondary Verification System The SAVE Secondary Verification System is an automated process completed by USCIS and must be used when there are doubts about the identity immigration status of the alien or when there are discrepancies The CMS case remains in a pending status until a response regarding the immigration status of the applicant is received Procedure Photocopy the documentation front and back provided by the applicant and follow EOPG Systematic Alien Verification for Entitlements SAVE Secondary Verification procedures References MEDIL I 1714 Sunset Date This policy will be reviewed for continuance on or by 06302021 Appendix A USCIS Forms and Documents Listing Listing of USCIS Forms and Documents Workers are not to use this listing as a sole source of verification of eligible alien status for CMS Workers must refer to the section listed for specific instructions If a document is not on this list the worker must check to see if the applicant meets any of the eligible alien categories and documentation requirements listed in 0504 USCIS FORM DOCUMENT STATUS INA SECTION ANNOTATION REFERENCE SECTION I94 Legal Permanent Resident LPR Stamped Processed for I551 temporary evidence of lawful admission for permanent residence 050402A I94 Conditional Permanent Resident CPR Stamped Processed for I551 temporary evidence of lawful admission for permanent residence 050402B I94 Asylee Asylum granted 050403A I94 Deportation Annotated with words that refer to deportation 050403B I94 Parolee Cuban or Haitian Entrant 212d5 Humanitarian HP or Public Interest Parolee PIP 050403E I94 Refugee as of April 1 1980 Section 207 050403F I94 Refugee before April 1 1980 Section 203a7 050403F I94 Voluntary Departure Annotated with words that refer to Voluntary Departure 050403H I94 Voluntary Section 301 050403H Departure Family Unity I551 LPR 10 year expiration 050402A I551 CPR 2 year expiration 050402B I151 LPR 050402A AR3AR3a LPR 050402A I181a Pending adjustment of status 050403C I181b Granted LPR 050403C I210 Voluntary Departure Annotated with words that refer to Voluntary Departure 050403H I220B Order of Supervision 050403D I327 LPR 050402A I468 Registry Alien INA Section 249 050403G I571 Refugee Travel Document 050403F I688 Amnesty Alien 210 210A 245A 050402C I688B Must be accompanied by other documentation 050401B I688B Asylee 274a12a5 050403A I688B Deportation 274a12a10 050403B I688B Order of Supervision 274a12c18 050403D I688B Parolee 274a12c11 050403E I688B Refugee 274a12a4 040403F I688B Refugee 274a12a3 050403F I688B Registry Alien 274a12c16 050403G I688B Voluntary Departure 274a12c12 050403H I688B Voluntary Departure 274a12a11 050403H I688B Family Unity 274a12a13 050403H I766 Asylee A5 050403A I766 Deportation A10 050403B I797 Family Unity Annotated with words that refer 050403H to Family Unity Foreign Passport LPR Stamped as Temporary evidence that verifies having LPR status 050402A Foreign Passport CPR Stamped as Temporary evidence that verifies having CPR status 050402B