Unaccompanied Refugee Minor (URM)

DHCS provides zero SOC MC to youth in the URM program if otherwise eligible. URM youth receive fee-for-service MC or optional managed care. They may enroll in managed care but a Health Care Options (HCO) packet will not be mailed to them unless one is requested.

An Unaccompanied Refugee Minor (URM) is a youth who enters the United States (U.S.) unaccompanied by:

A Parent,
An immediate adult relative,
An adult having legal evidence of custody.

Eligibility

The Office of Refugee Resettlement (ORR) approves eligibility to minors identified as being one of the following:

Cuban/Haitian entrant
Non-Citizen victims of domestic violence and other serious crimes who have been granted a U visa
Asylee,
Victim of human trafficking who has an eligibility letter from the ORR, or
Minor who has received a Special Immigrant Juvenile Status (SIJS) VISA while in ORR’s custody.

These youth are placed into the care and control of Provider Agencies that provide Foster Care services.

Eligibility for the program can be verified by receipt of:

Asylee identification,
A Letter of designation from the ORR, or
A Refugee identification document (I-94 or I-511).

Note: At this time, California has three URM Program Service Providers, Catholic Charities of Santa Clara County (CCSCC), Crittenton Services for Children and Families (Crittenton) in Orange County and International Christina Adoptions (ICA) in Sacramento.

Application

Social Workers from CCSW, Crittenton, or ICA acting as the designated Authorized Representative (AR), will apply for MC on behalf of the URM. The agency will complete and submit the forms and required verifications to apply.

Because URM youth are to be treated like foster care children for Medi-Cal eligibility purposes, the Medi-Cal application must include the following:

A completed MC250/MC250A form
A copy of the URM Designation letter from ORR or URM approval letter from CDSS

Note: The ORR does not provide URM youth who are in refugee status with an approval letter. The social worker will provide a verification letter from the California Department of Social Services (CDSS) as proof of the URM Program eligibility for refugee.

Other information needed for the case record includes:

Verification of Social Security Number (SSN)
Verification of immigration status

Immigration Status Information

The EW must attempt to verify the individual's immigration status using the Systematic Alien Verification for Entitlements (SAVE) and/or the Federal Hub prior to requesting verification from the client.

Individuals in the URM program are eligible for full scope Medi-Cal regardless of immigration status. However, if verification of immigration status is not received the EW must contact the Refugees Programs Bureau at (916)654-4356 or at URM@dss.ca.gov.

URM Eligibility Criteria

Verification of URM status, residency, and placement with a Foster Care Provider Agency are the only requirements for establishing MC. URMs are not subject to income or asset test, therefore, verification of such is not required.

URM Duration of Eligibility

A URM continues to meet the definition of an “unaccompanied minor” and is eligible for MC Aid Code 45 until the minor is:

Reunited with a parent,
United with a relative or non-relative willing and able to care for the child to whom legal custody and/or guardianship is granted under State law, or
Attains 18 years of age (unless eligible for extended foster care for URM Youth)

If a URM is reunited with a parent or united with a relative or non-relative, the URM is eligible for Continuous Eligibility for Children (CEC) under Aid Code 7J/7K until either the next MC redetermination date (RD) or the youth turns 19 years old, whichever occurs first.

Extended Foster Care for URM Youth

URM youth are eligible for the URM version of extended foster care if they are between the ages of 18-21 and meet all eligibility requirements. URM youth who meet extended foster care eligibility requirements should remain under aid code 45 for Medi-Cal purposes.

Former Foster Youth Program (FFY) for URM Youth

URM who meet FFY program eligibility requirements are eligible to receive full scope Medi-Cal under the FFY program until the age of 26. These individuals should be granted aid code 4M.

URM Redetermination

URM redetermination requirements mirror that of Medi-Cal Foster Care and FFY annual redetermination rules.

Note: All URM cases are handled by the FC bureau.

At annual redetermination, the EW must contact the URM service provider for individuals who are not in the FFY program.

This includes:

URM Program certified youth who are under 18 years of age and receiving MC benefits under aid code 45.
URM youth 18 to under 21 years of age that have elected to participate in extended foster care placement as designated by Catholic Charities.

CCSCC, Crittenton or ICA must verify URM Program eligibility status prior to completing an annual redetermination.

Change in Circumstance

When the eligibility worker is notified of a change in circumstance resulting in a youth exiting URM foster care placement between the ages of 18-21 the MC 250A form will be utilized and the individual will be transitioned to aid code 4M.

Once transitioned into aid code 4M, the Notice of Action MC 239 FFY-4 must be mailed to inform the individual of their continued Med-Cal eligibility. This NOA must also be used to inform youth exiting foster care at age 18 that they have been automatically moved into the FFY program.

Notice of Action

When an individual is transitioned into aid code 4M they must receive the MC 239 FFY-4 at annual redetermination advising them of their ongoing eligibility.

If the notice is received back as returned mail the individual is to be left active under aid code 4M until they reach the age of 26 . When there is loss of contact with a FFY individual they must be moved into fee for service MC by submitting the request to the Medi-Cal Managed Care Division Office of the Ombudsman.

Retro-MC

Eligibility for retroactive MC for URM must be reviewed per the established process and policy. URMs are eligible to apply for retroactive benefits provided that they were eligible to the URM program in the month of the retro-request.

Inter-County Transfers

An Inter-County transfer (ICT) must be initiated when a URM recipient becomes a resident of a new county. The ICT process for URMs must mirror the existing ICT process.

County of Responsibility

The county of responsibility for URM youth is the county in which the youth resides. The instructions on the back of the MC 250 form which requires the MC 250 to be sent to the county in which the foster care agency is located does not apply to URM cases.

Termination of URM

Eligibility for aid codes 45 or 4M should not be terminated for the URM individual prior to the age of 26 unless the individual is:

deceased or
not a resident of California

Note: If the URM youth becomes an inmate of a public institution while on MC, his/her benefits are to be suspended.