SLO County Health Access Update
Connecting Children Ages 0-5 to Health Care
What does the final public charge rule mean for the families you work with?

This week, the Department of Homeland Security finalized changes to the public charge regulation. It is vital that we share accurate information with families to keep children and parents in all appropriate services while calming fears.  
The public charge test refers to the process of applying for legal permanent resident status (green card) through a consular process or through adjustment of status. The government tries to forecast whether a person would become a burden, or charge, to the public. The new rule changes how this is calculated, making it more difficult to get a green card if you have less income and education, are in poorer health, and use certain government programs.  

Key Facts:
  • Changes do not apply until October 15 (possibly later because lawsuits are being filed). Any government services being used before October 15 will not be considered under the new regulation. The old rules apply to people applying for a green card before October 15.
  • Use of services by children up to the age of 21 will not be considered under the new regulations.
  • Use of services by family members will not be considered under the new regulations.
  • Only Medi-Cal, CalFresh, Section 8/Federal Housing, and cash assistance will be considered. Other services will NOT be counted in the new public charge test and are safe to use. 
  • Emergency Medi-Cal, Medi-Cal for pregnant women and new mothers, and Medi-Cal for children under 21 will NOT be counted in the new public charge test.
  • The Medi-Cal expansion next year for undocumented young adults ages 18-25 will NOT be counted in the new public charge test because it will use state funds.
  • The new public charge rule ONLY affects applications for adjustment of status, legal permanent residence and entry visas, and those who have LPR status and leave the country for at least 180 days. It does not affect LPR renewals or citizenship applications, or people who are not intending to apply for LPR status. It also does not affect: refugees; asylees; survivors of trafficking, domestic violence, or other serious crimes (T or U visa applicants/holders); VAWA self-petitioners; and certain other groups. 

  • Even for families who want to apply for a green card and do not want to be seen as a public charge, benefits like Medi-Cal may still be worthwhile. The public charge test looks at all of a person's circumstances to guess whether they will use benefit programs in the future. So for example, if an adult stops using Medi-Cal but then becomes too sick to work, they would likely look worse on the public charge test than if they had used Medi-Cal and stayed healthy.
  • Each family's circumstances are different and they will need to make their own choices. Provide accurate information and encourage families to seek legal advice when possible.
  • The primary outcome of this rule change is fear, which stops people from using the services they need to stay healthy. Fight fear with facts and encourage a calm, thoughtful response.  

Let's Talk About Public Charge

Getting the Help You Need

These new information handouts for providers and families are currently only in English. Check back soon for Spanish versions on this website:

A short update on the Public Charge changes:
In Spanish:
In English: 

Legal Assistance
For individual cases, consult an immigration attorney or a BIA-accredited representative:
Catholic Charities:

Staff Training
Contact us if you would like staff training on the public charge rule. Email Becca at or call (805) 674-0776.

How Service Providers Can Support Access to Health, Nutrition, and Housing Programs 
What Can Your Organization Do to Help?

The Protecting Immigrant Families campaign recommends that service providers and local governments take the following actions to support immigrant access to health, nutrition, and housing programs:
  • Action #1: Ensure that families have access to timely and accurate information about the public charge rules, through front-line staff trainings, community outreach, and inter-agency coordination.
  • Action #2: Ensure that benefits programs protect immigrant privacy and that people are aware of privacy protections.
  • Action #3: Ensure that people impacted or potentially impacted by new public charge rules have access to accurate legal guidance. 
  • Action # 4: Monitor state/ local data for significant drops in enrollment for entitlement and safety-net programs to identify growing unmet needs in the community in real time.
Download this handout for details on how agencies can implement these actions: Key Actions to Support Immigrant Access.

Resources for Immigrant Families During Turbulent Times
Immigrant Rights and Health Handouts

Rapidly changing immigration enforcement, proposed policy changes, and rumors have created a climate of fear and confusion among SLO County's vulnerable immigrant families.

Visit the Immigration and Health page on the website to download our Immigrant Rights Resource List; use the embedded links in the list to access the resources for immigrant families. These resources, many available in both English and Spanish, include preparedness plans, "Know Your Rights" handouts, and other important documents.
While you're on the website, download and distribute handouts for parents on supporting immigrant children's mental health, all in Spanish and English and with local referral information.  

Health Access Information at
A First 5 SLO County Funded Program has a wealth of information to help you help families, with local resources related to:
   * Special Needs     
   * Behavioral Health
   * Immigration: safety and service access  
   * Dental
   * Prescriptions
   * Medi-Cal & Covered CA
   * Transportation
   * Parental Substance Use, and 
   * R esources to help parents advocate for services

General needs and system navigation:
Send families in need of help to their local Family Resource Center : 

Can't find an answer? 
Let us know and we will find you  the  informati on  you are looking for.  For general questions about health ac cess and health care refo rm,  contact:
Becca Carsel, Health Access Project Director,  
at (805) 674-0776 or .phone