Minnesota Office of the Legislative Auditor
Program Evaluation Division

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Public Health Care Eligibility Determination for Noncitizens

April 2006

Major Findings:

  • Over 70 percent of the eligibility determination cases we reviewed contained errors, and 18 percent had errors that affected eligibility for benefits.

  • In 50 percent of the cases we reviewed, county workers did not electronically validate applicants’ immigration status as required.

  • Five percent of the noncitizens who received public health care in fiscal year 2005 had sponsors (family members or organizations that agree to financially support a noncitizen).

  • In over 10 percent of all cases we reviewed, county case workers did not properly identify or count sponsors’ income when determining eligibility. This error affected eligibility in every case.

  • Almost 80 percent of the noncitizens who received MA, GAMC, and Refugee Medical Assistance in fiscal year 2005 were refugees, asylees, or lawful permanent residents.
Determining whether non-citizens are eligible for public health care is complicated, and we found a significant number of errors.

Recommendations:

  • The Department of Human Services should provide: (1) an updated and accurate Guide to Non-Citizen Eligibility; (2) more training on identifying and deeming sponsor income; and (3) clearer guidance on procedures for electronically validating immigration status.

  • The Department of Human Services should designate a noncitizen eligibility specialist.

Summary of Agency Response

In a letter dated April 5, 2006, Commissioner of Human Services Kevin Goodno wrote that "eligibility determination for public assistance programs is difficult. This is especially true when the complications of immigration status are added to the determination process." The commissioner indicated that since 2003, the department has included a review of immigration status as part of its Food Support Management Evaluation Review process. However, he agreed that "most of the recommendations in the report will help us improve eligibility determination in Minnesota." The commissioner said the department is "already working on [OLA’s] recommendation to update the Guide to Non-Citizen Eligibility" and expects it to be completed by the end of May 2006.

More Information

The Program Evaluation Division was directed to conduct this study by the Legislative Audit Commission in April 2005. For a copy of the full report, entitled "Public Health Care Eligibility Determination for Noncitizens," 29 pp., published in April 2006, please call 651/296-4708, e-mail Legislative.Auditor@state.mn.us, write to Office of the Legislative Auditor, Room 140, 658 Cedar St., St. Paul, MN 55155, or go to the webpage featuring the report. Staff who worked on this project were Judy Randall (project manager), and David Chein with the help of Kelly Lehr, Mark Mathison, Carrie Meyerhoff, and John Patterson.

Office of the Legislative Auditor ♦ Room 140, 658 Cedar St., St. Paul, MN 55155