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| [ Introduced ] | [ House Amendment 001 ] |
91_HB4269eng HB4269 Engrossed LRB9111636SMks 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 1.5. Non-custodial parents of children in families that 16 receive basic maintenance grants under Article IV, to the 17 extent that the non-custodial parents are defined as part of 18 the family for purposes of this Section by the Department of 19 Human Services and to the extent that federal matching funds 20 are available for covering the non-custodial parents. If a 21 waiver of federal law is necessary in order to obtain federal 22 matching funds for coverage of the non-custodial parents, the 23 Department shall promptly seek the waiver and promptly 24 implement the coverage upon approval of the waiver. The 25 obligation of non-custodial parents to meet a spend-down 26 requirement shall be calculated according to the income and 27 other circumstances in the non-custodial parent's own 28 household. 29 2. Persons otherwise eligible for basic maintenance 30 under Articles III and IV but who fail to qualify thereunder 31 on the basis of need, and who have insufficient income and Hb4269 Engrossed -2- LRB9111636SMks 1 resources to meet the costs of necessary medical care, 2 including but not limited to, all persons who would be 3 determined eligible for such basic maintenance under Article 4 IV by disregarding the maximum earned income permitted by 5 federal law. 6 3. Persons who would otherwise qualify for Aid to the 7 Medically Indigent under Article VII. 8 4. Persons not eligible under any of the preceding 9 paragraphs who fall sick, are injured, or die, not having 10 sufficient money, property or other resources to meet the 11 costs of necessary medical care or funeral and burial 12 expenses. 13 5. (a) Women during pregnancy, after the fact of 14 pregnancy has been determined by medical diagnosis, and 15 during the 60-day period beginning on the last day of the 16 pregnancy, together with their infants and children born 17 after September 30, 1983, whose income and resources are 18 insufficient to meet the costs of necessary medical care 19 to the maximum extent possible under Title XIX of the 20 Federal Social Security Act. 21 (b) The Illinois Department and the Governor shall 22 provide a plan for coverage of the persons eligible under 23 paragraph 5(a) by April 1, 1990. Such plan shall provide 24 ambulatory prenatal care to pregnant women during a 25 presumptive eligibility period and establish an income 26 eligibility standard that is equal to 133% of the nonfarm 27 income official poverty line, as defined by the federal 28 Office of Management and Budget and revised annually in 29 accordance with Section 673(2) of the Omnibus Budget 30 Reconciliation Act of 1981, applicable to families of the 31 same size, provided that costs incurred for medical care 32 are not taken into account in determining such income 33 eligibility. 34 (c) The Illinois Department may conduct a Hb4269 Engrossed -3- LRB9111636SMks 1 demonstration in at least one county that will provide 2 medical assistance to pregnant women, together with their 3 infants and children up to one year of age, where the 4 income eligibility standard is set up to 185% of the 5 nonfarm income official poverty line, as defined by the 6 federal Office of Management and Budget. The Illinois 7 Department shall seek and obtain necessary authorization 8 provided under federal law to implement such a 9 demonstration. Such demonstration may establish resource 10 standards that are not more restrictive than those 11 established under Article IV of this Code. 12 6. Persons under the age of 18 who fail to qualify as 13 dependent under Article IV and who have insufficient income 14 and resources to meet the costs of necessary medical care to 15 the maximum extent permitted under Title XIX of the Federal 16 Social Security Act. 17 7. Persons who are 18 years of age or younger and would 18 qualify as disabled as defined under the Federal Supplemental 19 Security Income Program, provided medical service for such 20 persons would be eligible for Federal Financial 21 Participation, and provided the Illinois Department 22 determines that: 23 (a) the person requires a level of care provided by 24 a hospital, skilled nursing facility, or intermediate 25 care facility, as determined by a physician licensed to 26 practice medicine in all its branches; 27 (b) it is appropriate to provide such care outside 28 of an institution, as determined by a physician licensed 29 to practice medicine in all its branches; 30 (c) the estimated amount which would be expended 31 for care outside the institution is not greater than the 32 estimated amount which would be expended in an 33 institution. 34 8. Persons who become ineligible for basic maintenance Hb4269 Engrossed -4- LRB9111636SMks 1 assistance under Article IV of this Code in programs 2 administered by the Illinois Department due to employment 3 earnings and persons in assistance units comprised of adults 4 and children who become ineligible for basic maintenance 5 assistance under Article VI of this Code due to employment 6 earnings. The plan for coverage for this class of persons 7 shall: 8 (a) extend the medical assistance coverage for up 9 to 12 months following termination of basic maintenance 10 assistance; and 11 (b) offer persons who have initially received 6 12 months of the coverage provided in paragraph (a) above, 13 the option of receiving an additional 6 months of 14 coverage, subject to the following: 15 (i) such coverage shall be pursuant to 16 provisions of the federal Social Security Act; 17 (ii) such coverage shall include all services 18 covered while the person was eligible for basic 19 maintenance assistance; 20 (iii) no premium shall be charged for such 21 coverage; and 22 (iv) such coverage shall be suspended in the 23 event of a person's failure without good cause to 24 file in a timely fashion reports required for this 25 coverage under the Social Security Act and coverage 26 shall be reinstated upon the filing of such reports 27 if the person remains otherwise eligible. 28 9. Persons with acquired immunodeficiency syndrome 29 (AIDS) or with AIDS-related conditions with respect to whom 30 there has been a determination that but for home or 31 community-based services such individuals would require the 32 level of care provided in an inpatient hospital, skilled 33 nursing facility or intermediate care facility the cost of 34 which is reimbursed under this Article. Assistance shall be Hb4269 Engrossed -5- LRB9111636SMks 1 provided to such persons to the maximum extent permitted 2 under Title XIX of the Federal Social Security Act. 3 10. Participants in the long-term care insurance 4 partnership program established under the Partnership for 5 Long-Term Care Act who meet the qualifications for protection 6 of resources described in Section 25 of that Act. 7 The Illinois Department and the Governor shall provide a 8 plan for coverage of the persons eligible under paragraph 7 9 as soon as possible after July 1, 1984. 10 The eligibility of any such person for medical assistance 11 under this Article is not affected by the payment of any 12 grant under the Senior Citizens and Disabled Persons Property 13 Tax Relief and Pharmaceutical Assistance Act or any 14 distributions or items of income described under subparagraph 15 (X) of paragraph (2) of subsection (a) of Section 203 of the 16 Illinois Income Tax Act. The Department shall by rule 17 establish the amounts of assets to be disregarded in 18 determining eligibility for medical assistance, which shall 19 at a minimum equal the amounts to be disregarded under the 20 Federal Supplemental Security Income Program. The amount of 21 assets of a single person to be disregarded shall not be less 22 than $2,000, and the amount of assets of a married couple to 23 be disregarded shall not be less than $3,000. 24 To the extent permitted under federal law, any person 25 found guilty of a second violation of Article VIIIA shall be 26 ineligible for medical assistance under this Article, as 27 provided in Section 8A-8. 28 The eligibility of any person for medical assistance 29 under this Article shall not be affected by the receipt by 30 the person of donations or benefits from fundraisers held for 31 the person in cases of serious illness, as long as neither 32 the person nor members of the person's family have actual 33 control over the donations or benefits or the disbursement of 34 the donations or benefits. Hb4269 Engrossed -6- LRB9111636SMks 1 (Source: P.A. 91-676, eff. 12-23-99.) 2 Section 99. Effective date. This Act takes effect upon 3 becoming law.