093_SB0220

 
                                     LRB093 03471 DRJ 03499 b

 1        AN ACT in relation to public aid.

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

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

 6        (305 ILCS 5/5-2) (from Ch. 23, par. 5-2)
 7        Sec.   5-2.  Classes   of   Persons   Eligible.   Medical
 8    assistance under this Article shall be available  to  any  of
 9    the  following  classes  of persons in respect to whom a plan
10    for coverage has  been  submitted  to  the  Governor  by  the
11    Illinois Department and approved by him:
12        1.  Recipients of basic maintenance grants under Articles
13    III and IV.
14        2.  Persons  otherwise  eligible  for  basic  maintenance
15    under  Articles III and IV but who fail to qualify thereunder
16    on the basis of need, and who have  insufficient  income  and
17    resources  to  meet  the  costs  of  necessary  medical care,
18    including but not limited to the following:
19             (a)  All  persons  otherwise  eligible   for   basic
20        maintenance  under  Article  III  but who fail to qualify
21        under that Article on the basis  of  need  and  who  meet
22        either of the following requirements:
23                  (i)  their   income,   as   determined  by  the
24             Illinois Department in accordance with  any  federal
25             requirements, is equal to or less than 70% in fiscal
26             year  2001, equal to or less than 85% in fiscal year
27             2002 and until  a  date  to  be  determined  by  the
28             Department  by  rule, and equal to or less than 100%
29             beginning on the date determined by  the  Department
30             by  rule,  of  the  nonfarm  income official poverty
31             line, as defined by the federal Office of Management
 
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 1             and Budget and revised annually in  accordance  with
 2             Section  673(2) of the Omnibus Budget Reconciliation
 3             Act of 1981, applicable  to  families  of  the  same
 4             size; or
 5                  (ii)  their  income,  after  the  deduction  of
 6             costs  incurred for medical care and for other types
 7             of remedial care, is equal to or less  than  70%  in
 8             fiscal  year  2001,  equal  to  or  less than 85% in
 9             fiscal year 2002 and until a date to  be  determined
10             by the Department by rule, and equal to or less than
11             100%   beginning  on  the  date  determined  by  the
12             Department by rule, of the nonfarm  income  official
13             poverty  line,  as  defined  in  item  (i)  of  this
14             subparagraph (a).
15             (b)  All  persons  who  would be determined eligible
16        for  such  basic  maintenance   under   Article   IV   by
17        disregarding  the  maximum  earned  income  permitted  by
18        federal law.
19        3.  Persons  who  would  otherwise qualify for Aid to the
20    Medically Indigent under Article VII.
21        4.  Persons not  eligible  under  any  of  the  preceding
22    paragraphs  who  fall  sick,  are injured, or die, not having
23    sufficient money, property or other  resources  to  meet  the
24    costs  of  necessary  medical  care  or  funeral  and  burial
25    expenses.
26        5. (a)  Women   during   pregnancy,  after  the  fact  of
27        pregnancy has been determined by medical  diagnosis,  and
28        during the 60-day period beginning on the last day of the
29        pregnancy,  together with their infants and children born
30        after September 30, 1983, whose income and resources  are
31        insufficient  to meet the costs of necessary medical care
32        to the maximum extent possible under  Title  XIX  of  the
33        Federal Social Security Act.
34             (b)  The  Illinois Department and the Governor shall
 
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 1        provide a plan for coverage of the persons eligible under
 2        paragraph 5(a) by April 1, 1990.  Such plan shall provide
 3        ambulatory prenatal  care  to  pregnant  women  during  a
 4        presumptive  eligibility  period  and establish an income
 5        eligibility standard that is equal to 133% of the nonfarm
 6        income official poverty line, as defined by  the  federal
 7        Office  of  Management and Budget and revised annually in
 8        accordance with Section  673(2)  of  the  Omnibus  Budget
 9        Reconciliation Act of 1981, applicable to families of the
10        same  size, provided that costs incurred for medical care
11        are not taken into account  in  determining  such  income
12        eligibility.
13             (c)  The   Illinois   Department   may   conduct   a
14        demonstration  in  at  least one county that will provide
15        medical assistance to pregnant women, together with their
16        infants and children up to one year  of  age,  where  the
17        income  eligibility  standard  is  set  up to 185% of the
18        nonfarm income official poverty line, as defined  by  the
19        federal  Office  of  Management  and Budget. The Illinois
20        Department shall seek and obtain necessary  authorization
21        provided   under   federal   law   to  implement  such  a
22        demonstration.  Such demonstration may establish resource
23        standards  that  are  not  more  restrictive  than  those
24        established under Article IV of this Code.
25        6.  Persons under the age of 18 who fail  to  qualify  as
26    dependent  under  Article IV and who have insufficient income
27    and resources to meet the costs of necessary medical care  to
28    the  maximum  extent permitted under Title XIX of the Federal
29    Social Security Act.
30        7.  Persons who are 18 years of age or younger and  would
31    qualify as disabled as defined under the Federal Supplemental
32    Security  Income  Program,  provided medical service for such
33    persons   would   be   eligible   for    Federal    Financial
34    Participation,   and   provided   the   Illinois   Department
 
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 1    determines that:
 2             (a)  the person requires a level of care provided by
 3        a  hospital,  skilled  nursing  facility, or intermediate
 4        care facility, as determined by a physician  licensed  to
 5        practice medicine in all its branches;
 6             (b)  it  is appropriate to provide such care outside
 7        of an institution, as determined by a physician  licensed
 8        to practice medicine in all its branches;
 9             (c)  the  estimated  amount  which would be expended
10        for care outside the institution is not greater than  the
11        estimated   amount   which   would   be  expended  in  an
12        institution.
13        8.  Persons who become ineligible for  basic  maintenance
14    assistance   under  Article  IV  of  this  Code  in  programs
15    administered by the Illinois  Department  due  to  employment
16    earnings  and persons in assistance units comprised of adults
17    and children who  become  ineligible  for  basic  maintenance
18    assistance  under  Article  VI of this Code due to employment
19    earnings.  The plan for coverage for this  class  of  persons
20    shall:
21             (a)  extend  the  medical assistance coverage for up
22        to 12 months following termination of  basic  maintenance
23        assistance; and
24             (b)  offer  persons  who  have  initially received 6
25        months of the coverage provided in paragraph  (a)  above,
26        the  option  of  receiving  an  additional  6  months  of
27        coverage, subject to the following:
28                  (i)  such   coverage   shall   be  pursuant  to
29             provisions of the federal Social Security Act;
30                  (ii)  such coverage shall include all  services
31             covered  while  the  person  was  eligible for basic
32             maintenance assistance;
33                  (iii)  no premium shall  be  charged  for  such
34             coverage; and
 
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 1                  (iv)  such  coverage  shall be suspended in the
 2             event of a person's failure without  good  cause  to
 3             file  in  a timely fashion reports required for this
 4             coverage under the Social Security Act and  coverage
 5             shall  be reinstated upon the filing of such reports
 6             if the person remains otherwise eligible.
 7        9.  Persons  with  acquired   immunodeficiency   syndrome
 8    (AIDS)  or  with AIDS-related conditions with respect to whom
 9    there  has  been  a  determination  that  but  for  home   or
10    community-based  services  such individuals would require the
11    level of care provided  in  an  inpatient  hospital,  skilled
12    nursing  facility  or  intermediate care facility the cost of
13    which is reimbursed under this Article.  Assistance shall  be
14    provided  to  such  persons  to  the maximum extent permitted
15    under Title XIX of the Federal Social Security Act.
16        10.  Participants  in  the   long-term   care   insurance
17    partnership  program  established  under  the Partnership for
18    Long-Term Care Act who meet the qualifications for protection
19    of resources described in Section 25 of that Act.
20        11.  Persons  with  disabilities  who  are  employed  and
21    eligible    for     Medicaid,     pursuant     to     Section
22    1902(a)(10)(A)(ii)(xv)   of   the  Social  Security  Act,  as
23    provided by the Illinois Department by rule.  The  Department
24    of  Public Aid's rules must authorize eligibility for medical
25    assistance under this paragraph 11 for persons  whose  income
26    is  less  than  or  equal  to  400% of the poverty guidelines
27    updated annually in the Federal Register by the United States
28    Department of Health and Human Services  under  authority  of
29    section  673(2)  of  the Omnibus Budget Reconciliation Act of
30    1981. The Department may authorize  eligibility  for  persons
31    whose   income   is   greater  than  400%  of  those  poverty
32    guidelines.
33        12.  Subject  to  federal  approval,  persons   who   are
34    eligible  for  medical  assistance  coverage under applicable
 
                            -6-      LRB093 03471 DRJ 03499 b
 1    provisions of the federal Social Security Act and the federal
 2    Breast and Cervical Cancer Prevention and  Treatment  Act  of
 3    2000.  Those eligible persons are defined to include, but not
 4    be limited to, the following persons:
 5             (1)  persons  who  have  been screened for breast or
 6        cervical  cancer  under  the  U.S.  Centers  for  Disease
 7        Control and Prevention Breast and Cervical Cancer Program
 8        established under Title XV of the federal  Public  Health
 9        Services  Act  in  accordance  with  the  requirements of
10        Section 1504 of that Act as administered by the  Illinois
11        Department of Public Health; and
12             (2)  persons   whose   screenings  under  the  above
13        program  were  funded  in  whole  or  in  part  by  funds
14        appropriated to the Illinois Department of Public  Health
15        for breast or cervical cancer screening.
16    "Medical   assistance"  under  this  paragraph  12  shall  be
17    identical to the benefits provided under the State's approved
18    plan under  Title  XIX  of  the  Social  Security  Act.   The
19    Department  must  request  federal  approval  of the coverage
20    under this paragraph 12 within 30 days  after  the  effective
21    date of this amendatory Act of the 92nd General Assembly.
22        The  Illinois Department and the Governor shall provide a
23    plan for coverage of the persons eligible under  paragraph  7
24    as soon as possible after July 1, 1984.
25        The eligibility of any such person for medical assistance
26    under  this  Article  is  not  affected by the payment of any
27    grant under the Senior Citizens and Disabled Persons Property
28    Tax  Relief  and  Pharmaceutical  Assistance   Act   or   any
29    distributions or items of income described under subparagraph
30    (X)  of paragraph (2) of subsection (a) of Section 203 of the
31    Illinois Income  Tax  Act.   The  Department  shall  by  rule
32    establish   the  amounts  of  assets  to  be  disregarded  in
33    determining eligibility for medical assistance,  which  shall
34    at  a  minimum  equal the amounts to be disregarded under the
 
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 1    Federal Supplemental Security Income Program.  The amount  of
 2    assets of a single person to be disregarded shall not be less
 3    than  $2,000, and the amount of assets of a married couple to
 4    be disregarded shall not be less than $3,000.
 5        To the extent permitted under  federal  law,  any  person
 6    found  guilty of a second violation of Article VIIIA shall be
 7    ineligible for medical  assistance  under  this  Article,  as
 8    provided in Section 8A-8.
 9        The  eligibility  of  any  person  for medical assistance
10    under this Article shall not be affected by  the  receipt  by
11    the person of donations or benefits from fundraisers held for
12    the  person  in  cases of serious illness, as long as neither
13    the person nor members of the  person's  family  have  actual
14    control over the donations or benefits or the disbursement of
15    the donations or benefits.
16    (Source: P.A.  91-676,  eff.  12-23-99;  91-699, eff. 7-1-00;
17    91-712, eff. 7-1-00; 92-16, eff. 6-28-01; 92-47, eff. 7-3-01;
18    92-597, eff. 6-28-02.)

19        Section 99.  Effective date.  This Act takes effect  upon
20    becoming law.