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TITLE 16 HEALTH AND SAFETY DELAWARE ADMINISTRATIVE CODE 20 Form I-551 with the code S13; unexpired temporary I-551 stamp with code S13 in a Canadian passport or on Form I-94; satisfactory evidence of birth in Canada and a document that indicates the percentage of American Indian blood in the form of a birth certificate issued by the Canadian reservation or a record issued by the tribe; a membership card or other tribal document showing membership in the tribe that is on the list of recognized Indian tribes published annually by the Bureau of Indian Affairs in the Federal Register. L. Victims of Trafficking Form I-797 indicating Class T-1 Visa, T-2 (spouse), T-3 (child), T-4 (parent) or T-5 (unmarried sibling under age 18); letter of certification from the Office of Refugee Resettlement (ORR). Call the trafficking verification line at (202) 401-5510 to confirm the validity of the certification letter or similar letter for children and to notify ORR of the benefits for which the individual has applied. M. Iraqi and Afghan special immigrants Iraqi passport with an immigrant visa stamp SI1, SI2 (spouse), SI3 (unmarried child under age 21); an immigrant visa stamp SQ1, SQ2 (spouse), SQ3 (unmarried child under age 21); I-551 showing Iraqi nationality (or an Iraqi passport) with code S16 or SQ6, code S17 or SQ7 (spouse), code S19 or SQ9 (unmarried child under age 21). 13 DE Reg. 1540 (06/01/10) 14420 Verification of Alien Status The Systematic Alien Verification for Entitlements (SAVE) is a program established by USCIS that provides a process to verify the immigration status of aliens who apply for benefits. The documents provided by an alien applicant as verification of immigration status must be authenticated by using SAVE. Staff will institute primary verification to USCIS through the form "Record of Contact with ASVI Data Base" (SAVE-1). ASVI is the acronym for Alien Status Verification Index. A clear copy of the immigration document must be attached to the SAVE-1 form. If the response verifies alien status, the eligibility determination is completed using the information provided by USCIS. If the response states institute secondary verification, staff will complete Form G-845 and attach a copy of the immigration document. An alien registration number is required for both primary and secondary verifications. If the applicant provides an alien registration number but does not have the immigration document, complete Form G-845 including the alien registration number. If an applicant provides a receipt indicating that he or she has applied to USCIS for a replacement document, complete Form G-845 and attach a copy of the receipt. 13 DE Reg. 1540 (06/01/10) 14500 Criteria Affecting Specific Groups Certain eligibility groups have requirements that include age, household composition/filing unit, and medical eligibility/ disability. 14510 Age Some eligibility groups have certain age requirements. Refer to specific eligibility group for information specific to that program. 14520 Household Composition/Filing Unit Generally, related applicants, their needs, income and resources are grouped together when a family applies for Medicaid. The requirements are specific to each eligibility group. 14530 Medical Eligibility/Disability Certain eligibility groups require a medical professional to certify that an applicant meets the specific program definition of medical need or disability. Examples are: · pregnant women must have proof of pregnancy