State of Illinois
91st General Assembly

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 1        AN ACT to amend the Illinois Public Aid Code by  changing
 2    Section 5-2.

 3        Be  it  enacted  by  the People of the State of Illinois,
 4    represented in the General Assembly:

 5        Section 5. The Illinois Public Aid  Code  is  amended  by
 6    changing Section 5-2 as follows:

 7        (305 ILCS 5/5-2) (from Ch. 23, par. 5-2)
 8        Sec.   5-2.  Classes   of   Persons   Eligible.   Medical
 9    assistance under this Article shall be available  to  any  of
10    the  following  classes  of persons in respect to whom a plan
11    for coverage has  been  submitted  to  the  Governor  by  the
12    Illinois Department and approved by him:
13        1.  Recipients of basic maintenance grants under Articles
14    III and IV.
15        2.  Persons  otherwise  eligible  for  basic  maintenance
16    under  Articles III and IV but who fail to qualify thereunder
17    on the basis of need, and who have  insufficient  income  and
18    resources  to  meet  the  costs  of  necessary  medical care,
19    including but not  limited  to,  all  persons  who  would  be
20    determined  eligible for such basic maintenance under Article
21    IV by disregarding the maximum  earned  income  permitted  by
22    federal  law.  Notwithstanding  any  other  provision of this
23    Code, a person described in this paragraph  2  who  is  aged,
24    blind,  or  disabled  as  defined in Section 3-1 shall not be
25    required to incur any minimum amount of  medical  care  costs
26    (including costs of prescription medications) or be otherwise
27    subject  to  any "spend-down" requirement based on the amount
28    of the person's income and medical care  costs  before  being
29    determined   eligible   for  medical  assistance  under  this
30    Article.
31        3.  Persons who would otherwise qualify for  Aid  to  the
                            -2-                LRB9113047DJcd
 1    Medically Indigent under Article VII.
 2        4.  Persons  not  eligible  under  any  of  the preceding
 3    paragraphs who fall sick, are injured,  or  die,  not  having
 4    sufficient  money,  property  or  other resources to meet the
 5    costs  of  necessary  medical  care  or  funeral  and  burial
 6    expenses.
 7        5. (a)  Women  during  pregnancy,  after  the   fact   of
 8        pregnancy  has  been determined by medical diagnosis, and
 9        during the 60-day period beginning on the last day of the
10        pregnancy, together with their infants and children  born
11        after  September 30, 1983, whose income and resources are
12        insufficient to meet the costs of necessary medical  care
13        to  the  maximum  extent  possible under Title XIX of the
14        Federal Social Security Act.
15             (b)  The Illinois Department and the Governor  shall
16        provide a plan for coverage of the persons eligible under
17        paragraph 5(a) by April 1, 1990.  Such plan shall provide
18        ambulatory  prenatal  care  to  pregnant  women  during a
19        presumptive eligibility period and  establish  an  income
20        eligibility standard that is equal to 133% of the nonfarm
21        income  official  poverty line, as defined by the federal
22        Office of Management and Budget and revised  annually  in
23        accordance  with  Section  673(2)  of  the Omnibus Budget
24        Reconciliation Act of 1981, applicable to families of the
25        same size, provided that costs incurred for medical  care
26        are  not  taken  into  account in determining such income
27        eligibility.
28             (c)  The   Illinois   Department   may   conduct   a
29        demonstration in at least one county  that  will  provide
30        medical assistance to pregnant women, together with their
31        infants  and  children  up  to one year of age, where the
32        income eligibility standard is set  up  to  185%  of  the
33        nonfarm  income  official poverty line, as defined by the
34        federal Office of Management and Budget.    The  Illinois
                            -3-                LRB9113047DJcd
 1        Department  shall seek and obtain necessary authorization
 2        provided  under  federal  law   to   implement   such   a
 3        demonstration.  Such demonstration may establish resource
 4        standards  that  are  not  more  restrictive  than  those
 5        established under Article IV of this Code.
 6        6.  Persons  under  the  age of 18 who fail to qualify as
 7    dependent under Article IV and who have  insufficient  income
 8    and  resources to meet the costs of necessary medical care to
 9    the maximum extent permitted under Title XIX of  the  Federal
10    Social Security Act.
11        7.  Persons  who are 18 years of age or younger and would
12    qualify as disabled as defined under the Federal Supplemental
13    Security Income Program, provided medical  service  for  such
14    persons    would    be   eligible   for   Federal   Financial
15    Participation,   and   provided   the   Illinois   Department
16    determines that:
17             (a)  the person requires a level of care provided by
18        a hospital, skilled  nursing  facility,  or  intermediate
19        care  facility,  as determined by a physician licensed to
20        practice medicine in all its branches;
21             (b)  it is appropriate to provide such care  outside
22        of  an institution, as determined by a physician licensed
23        to practice medicine in all its branches;
24             (c)  the estimated amount which  would  be  expended
25        for  care outside the institution is not greater than the
26        estimated  amount  which  would   be   expended   in   an
27        institution.
28        8.  Persons  who  become ineligible for basic maintenance
29    assistance  under  Article  IV  of  this  Code  in   programs
30    administered  by  the  Illinois  Department due to employment
31    earnings and persons in assistance units comprised of  adults
32    and  children  who  become  ineligible  for basic maintenance
33    assistance under Article VI of this Code  due  to  employment
34    earnings.   The  plan  for coverage for this class of persons
                            -4-                LRB9113047DJcd
 1    shall:
 2             (a)  extend the medical assistance coverage  for  up
 3        to  12  months following termination of basic maintenance
 4        assistance; and
 5             (b)  offer persons who  have  initially  received  6
 6        months  of  the coverage provided in paragraph (a) above,
 7        the  option  of  receiving  an  additional  6  months  of
 8        coverage, subject to the following:
 9                  (i)  such  coverage  shall   be   pursuant   to
10             provisions of the federal Social Security Act;
11                  (ii)  such  coverage shall include all services
12             covered while the  person  was  eligible  for  basic
13             maintenance assistance;
14                  (iii)  no  premium  shall  be  charged for such
15             coverage; and
16                  (iv)  such coverage shall be suspended  in  the
17             event  of  a  person's failure without good cause to
18             file in a timely fashion reports required  for  this
19             coverage  under the Social Security Act and coverage
20             shall be reinstated upon the filing of such  reports
21             if the person remains otherwise eligible.
22        9.  Persons   with   acquired  immunodeficiency  syndrome
23    (AIDS) or with AIDS-related conditions with respect  to  whom
24    there   has  been  a  determination  that  but  for  home  or
25    community-based services such individuals would  require  the
26    level  of  care  provided  in  an inpatient hospital, skilled
27    nursing facility or intermediate care facility  the  cost  of
28    which  is reimbursed under this Article.  Assistance shall be
29    provided to such persons  to  the  maximum  extent  permitted
30    under Title XIX of the Federal Social Security Act.
31        10.  Participants   in   the   long-term  care  insurance
32    partnership program established  under  the  Partnership  for
33    Long-Term Care Act who meet the qualifications for protection
34    of resources described in Section 25 of that Act.
                            -5-                LRB9113047DJcd
 1        The  Illinois Department and the Governor shall provide a
 2    plan for coverage of the persons eligible under  paragraph  7
 3    as soon as possible after July 1, 1984.
 4        The eligibility of any such person for medical assistance
 5    under  this  Article  is  not  affected by the payment of any
 6    grant under the Senior Citizens and Disabled Persons Property
 7    Tax  Relief  and  Pharmaceutical  Assistance   Act   or   any
 8    distributions or items of income described under subparagraph
 9    (X)  of paragraph (2) of subsection (a) of Section 203 of the
10    Illinois Income  Tax  Act.   The  Department  shall  by  rule
11    establish   the  amounts  of  assets  to  be  disregarded  in
12    determining eligibility for medical assistance,  which  shall
13    at  a  minimum  equal the amounts to be disregarded under the
14    Federal Supplemental Security Income Program.  The amount  of
15    assets of a single person to be disregarded shall not be less
16    than  $2,000, and the amount of assets of a married couple to
17    be disregarded shall not be less than $3,000.
18        To the extent permitted under  federal  law,  any  person
19    found  guilty of a second violation of Article VIIIA shall be
20    ineligible for medical  assistance  under  this  Article,  as
21    provided in Section 8A-8.
22        The  eligibility  of  any  person  for medical assistance
23    under this Article shall not be affected by  the  receipt  by
24    the person of donations or benefits from fundraisers held for
25    the  person  in  cases of serious illness, as long as neither
26    the person nor members of the  person's  family  have  actual
27    control over the donations or benefits or the disbursement of
28    the donations or benefits.
29    (Source: P.A. 91-676, eff. 12-23-99.)

30        Section  99.   Effective  date.  This Act takes effect on
31    July 1, 2000.

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