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92nd General Assembly

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Public Act 92-0047

HB0025 Enrolled                                LRB9200896DJgc

    AN ACT in relation to public aid.

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

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

    (305 ILCS 5/5-2) (from Ch. 23, par. 5-2)
    Sec.  5-2.  Classes   of   Persons   Eligible.    Medical
assistance  under  this  Article shall be available to any of
the following classes of persons in respect to  whom  a  plan
for  coverage  has  been  submitted  to  the  Governor by the
Illinois Department and approved by him:
    1.  Recipients of basic maintenance grants under Articles
III and IV.
    2.  Persons  otherwise  eligible  for  basic  maintenance
under Articles III and IV but who fail to qualify  thereunder
on  the  basis  of need, and who have insufficient income and
resources to  meet  the  costs  of  necessary  medical  care,
including but not limited to the following:
         (a)  All   persons   otherwise  eligible  for  basic
    maintenance under Article III but  who  fail  to  qualify
    under  that  Article  on  the  basis of need and who meet
    either of the following requirements:
              (i)  their  income,  as   determined   by   the
         Illinois  Department  in accordance with any federal
         requirements, is equal to or less than 70% in fiscal
         year 2001, equal to or less than 85% in fiscal  year
         2002,  and equal to or less than 100% in fiscal year
         2003 and thereafter of the nonfarm  income  official
         poverty  line,  as  defined by the federal Office of
         Management  and  Budget  and  revised  annually   in
         accordance with Section 673(2) of the Omnibus Budget
         Reconciliation  Act  of 1981, applicable to families
         of the same size; or
              (ii)  their  income,  after  the  deduction  of
         costs incurred for medical care and for other  types
         of  remedial  care,  is equal to or less than 70% in
         fiscal year 2001, equal  to  or  less  than  85%  in
         fiscal  year 2002, and equal to or less than 100% in
         fiscal year  2003  and  thereafter  of  the  nonfarm
         income official poverty line, as defined in item (i)
         of this subparagraph (a).
         (b)  All  persons  who  would be determined eligible
    for  such  basic  maintenance   under   Article   IV   by
    disregarding  the  maximum  earned  income  permitted  by
    federal law.
    3.  Persons  who  would  otherwise qualify for Aid to the
Medically Indigent under Article VII.
    4.  Persons not  eligible  under  any  of  the  preceding
paragraphs  who  fall  sick,  are injured, or die, not having
sufficient money, property or other  resources  to  meet  the
costs  of  necessary  medical  care  or  funeral  and  burial
expenses.
    5. (a)  Women   during   pregnancy,  after  the  fact  of
    pregnancy has been determined by medical  diagnosis,  and
    during the 60-day period beginning on the last day of the
    pregnancy,  together with their infants and children born
    after September 30, 1983, whose income and resources  are
    insufficient  to meet the costs of necessary medical care
    to the maximum extent possible under  Title  XIX  of  the
    Federal Social Security Act.
         (b)  The  Illinois Department and the Governor shall
    provide a plan for coverage of the persons eligible under
    paragraph 5(a) by April 1, 1990.  Such plan shall provide
    ambulatory prenatal  care  to  pregnant  women  during  a
    presumptive  eligibility  period  and establish an income
    eligibility standard that is equal to 133% of the nonfarm
    income official poverty line, as defined by  the  federal
    Office  of  Management and Budget and revised annually in
    accordance with Section  673(2)  of  the  Omnibus  Budget
    Reconciliation Act of 1981, applicable to families of the
    same  size, provided that costs incurred for medical care
    are not taken into account  in  determining  such  income
    eligibility.
         (c)  The   Illinois   Department   may   conduct   a
    demonstration  in  at  least one county that will provide
    medical assistance to pregnant women, together with their
    infants and children up to one year  of  age,  where  the
    income  eligibility  standard  is  set  up to 185% of the
    nonfarm income official poverty line, as defined  by  the
    federal  Office  of  Management and Budget.  The Illinois
    Department shall seek and obtain necessary  authorization
    provided   under   federal   law   to  implement  such  a
    demonstration.  Such demonstration may establish resource
    standards  that  are  not  more  restrictive  than  those
    established under Article IV of this Code.
    6.  Persons under the age of 18 who fail  to  qualify  as
dependent  under  Article IV and who have insufficient income
and resources to meet the costs of necessary medical care  to
the  maximum  extent permitted under Title XIX of the Federal
Social Security Act.
    7.  Persons who are 18 years of age or younger and  would
qualify as disabled as defined under the Federal Supplemental
Security  Income  Program,  provided medical service for such
persons   would   be   eligible   for    Federal    Financial
Participation,   and   provided   the   Illinois   Department
determines that:
         (a)  the person requires a level of care provided by
    a  hospital,  skilled  nursing  facility, or intermediate
    care facility, as determined by a physician  licensed  to
    practice medicine in all its branches;
         (b)  it  is appropriate to provide such care outside
    of an institution, as determined by a physician  licensed
    to practice medicine in all its branches;
         (c)  the  estimated  amount  which would be expended
    for care outside the institution is not greater than  the
    estimated   amount   which   would   be  expended  in  an
    institution.
    8.  Persons who become ineligible for  basic  maintenance
assistance   under  Article  IV  of  this  Code  in  programs
administered by the Illinois  Department  due  to  employment
earnings  and persons in assistance units comprised of adults
and children who  become  ineligible  for  basic  maintenance
assistance  under  Article  VI of this Code due to employment
earnings.  The plan for coverage for this  class  of  persons
shall:
         (a)  extend  the  medical assistance coverage for up
    to 12 months following termination of  basic  maintenance
    assistance; and
         (b)  offer  persons  who  have  initially received 6
    months of the coverage provided in paragraph  (a)  above,
    the  option  of  receiving  an  additional  6  months  of
    coverage, subject to the following:
              (i)  such   coverage   shall   be  pursuant  to
         provisions of the federal Social Security Act;
              (ii)  such coverage shall include all  services
         covered  while  the  person  was  eligible for basic
         maintenance assistance;
              (iii)  no premium shall  be  charged  for  such
         coverage; and
              (iv)  such  coverage  shall be suspended in the
         event of a person's failure without  good  cause  to
         file  in  a timely fashion reports required for this
         coverage under the Social Security Act and  coverage
         shall  be reinstated upon the filing of such reports
         if the person remains otherwise eligible.
    9.  Persons  with  acquired   immunodeficiency   syndrome
(AIDS)  or  with AIDS-related conditions with respect to whom
there  has  been  a  determination  that  but  for  home   or
community-based  services  such individuals would require the
level of care provided  in  an  inpatient  hospital,  skilled
nursing  facility  or  intermediate care facility the cost of
which is reimbursed under this Article.  Assistance shall  be
provided  to  such  persons  to  the maximum extent permitted
under Title XIX of the Federal Social Security Act.
    10.  Participants  in  the   long-term   care   insurance
partnership  program  established  under  the Partnership for
Long-Term Care Act who meet the qualifications for protection
of resources described in Section 25 of that Act.
    11.  Persons  with  disabilities  who  are  employed  and
eligible    for     Medicaid,     pursuant     to     Section
1902(a)(10)(A)(ii)(xv)   of   the  Social  Security  Act,  as
provided by the Illinois Department by rule.
    12.  Subject  to  federal  approval,  persons   who   are
eligible  for  medical  assistance  coverage under applicable
provisions of  the  federal  Social  Security   Act  and  the
federal  Breast  and Cervical Cancer Prevention and Treatment
Act of 2000.   Those eligible persons are defined to include,
but not be limited to, the following persons:
         (1)  persons who have been screened  for  breast  or
    cervical  cancer  under  the  U.S.  Centers  for  Disease
    Control and Prevention Breast and Cervical Cancer Program
    established  under  Title XV of the federal Public Health
    Services Act  in  accordance  with  the  requirements  of
    Section  1504 of that Act as administered by the Illinois
    Department of Public Health; and
         (2)  persons  whose  screenings  under   the   above
    program  were  funded  in  whole  or  in  part  by  funds
    appropriated  to the Illinois Department of Public Health
    for breast or cervical cancer screening.
"Medical  assistance"  under  this  paragraph  12  shall   be
identical to the benefits provided under the State's approved
plan  under  Title  XIX  of  the  Social  Security  Act.  The
Department  must  request  federal  approval  of the coverage
under this paragraph 12 within 30 days  after  the  effective
date of this amendatory Act of the 92nd General Assembly.
    The  Illinois Department and the Governor shall provide a
plan for coverage of the persons eligible under  paragraph  7
as soon as possible after July 1, 1984.
    The eligibility of any such person for medical assistance
under  this  Article  is  not  affected by the payment of any
grant under the Senior Citizens and Disabled Persons Property
Tax  Relief  and  Pharmaceutical  Assistance   Act   or   any
distributions or items of income described under subparagraph
(X)  of paragraph (2) of subsection (a) of Section 203 of the
Illinois Income  Tax  Act.   The  Department  shall  by  rule
establish   the  amounts  of  assets  to  be  disregarded  in
determining eligibility for medical assistance,  which  shall
at  a  minimum  equal the amounts to be disregarded under the
Federal Supplemental Security Income Program.  The amount  of
assets of a single person to be disregarded shall not be less
than  $2,000, and the amount of assets of a married couple to
be disregarded shall not be less than $3,000.
    To the extent permitted under  federal  law,  any  person
found  guilty of a second violation of Article VIIIA shall be
ineligible for medical  assistance  under  this  Article,  as
provided in Section 8A-8.
    The  eligibility  of  any  person  for medical assistance
under this Article shall not be affected by  the  receipt  by
the person of donations or benefits from fundraisers held for
the  person  in  cases of serious illness, as long as neither
the person nor members of the  person's  family  have  actual
control over the donations or benefits or the disbursement of
the donations or benefits.
(Source: P.A.  91-676,  eff.  12-23-99;  91-699, eff. 7-1-00;
91-712, eff. 7-1-00; revised 6-26-00.)

    Section 99.  Effective date.  This Act takes effect  upon
becoming law.
    Passed in the General Assembly May 01, 2001.
    Approved July 03, 2001.

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