[ Search ] [ Legislation ]
[ Home ] [ Back ] [ Bottom ]
91_SB1124
LRB9105668DJsb
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. In determining whether persons who fail to
23 qualify for basic assistance under Article IV on the basis of
24 need have insufficient income and resources to meet the costs
25 of necessary medical care, the Illinois Department shall
26 first allocate an amount of income equal to the federal
27 poverty level for the family size to meet non-medical needs.
28 3. Persons who would otherwise qualify for Aid to the
29 Medically Indigent under Article VII.
30 4. Persons not eligible under any of the preceding
31 paragraphs who fall sick, are injured, or die, not having
-2- LRB9105668DJsb
1 sufficient money, property or other resources to meet the
2 costs of necessary medical care or funeral and burial
3 expenses.
4 5. (a) Women during pregnancy, after the fact of
5 pregnancy has been determined by medical diagnosis, and
6 during the 60-day period beginning on the last day of the
7 pregnancy, together with their infants and children born
8 after September 30, 1983, whose income and resources are
9 insufficient to meet the costs of necessary medical care
10 to the maximum extent possible under Title XIX of the
11 Federal Social Security Act.
12 (b) The Illinois Department and the Governor shall
13 provide a plan for coverage of the persons eligible under
14 paragraph 5(a) by April 1, 1990. Such plan shall provide
15 ambulatory prenatal care to pregnant women during a
16 presumptive eligibility period and establish an income
17 eligibility standard that is equal to 133% of the nonfarm
18 income official poverty line, as defined by the federal
19 Office of Management and Budget and revised annually in
20 accordance with Section 673(2) of the Omnibus Budget
21 Reconciliation Act of 1981, applicable to families of the
22 same size, provided that costs incurred for medical care
23 are not taken into account in determining such income
24 eligibility.
25 (c) The Illinois Department may conduct a
26 demonstration in at least one county that will provide
27 medical assistance to pregnant women, together with their
28 infants and children up to one year of age, where the
29 income eligibility standard is set up to 185% of the
30 nonfarm income official poverty line, as defined by the
31 federal Office of Management and Budget. The Illinois
32 Department shall seek and obtain necessary authorization
33 provided under federal law to implement such a
34 demonstration. Such demonstration may establish resource
-3- LRB9105668DJsb
1 standards that are not more restrictive than those
2 established under Article IV of this Code.
3 6. Persons under the age of 18 who fail to qualify as
4 dependent under Article IV and who have insufficient income
5 and resources to meet the costs of necessary medical care to
6 the maximum extent permitted under Title XIX of the Federal
7 Social Security Act.
8 7. Persons who are 18 years of age or younger and would
9 qualify as disabled as defined under the Federal Supplemental
10 Security Income Program, provided medical service for such
11 persons would be eligible for Federal Financial
12 Participation, and provided the Illinois Department
13 determines that:
14 (a) the person requires a level of care provided by
15 a hospital, skilled nursing facility, or intermediate
16 care facility, as determined by a physician licensed to
17 practice medicine in all its branches;
18 (b) it is appropriate to provide such care outside
19 of an institution, as determined by a physician licensed
20 to practice medicine in all its branches;
21 (c) the estimated amount which would be expended
22 for care outside the institution is not greater than the
23 estimated amount which would be expended in an
24 institution.
25 8. Persons who become ineligible for basic maintenance
26 assistance under Article IV of this Code in programs
27 administered by the Illinois Department due to employment
28 earnings and persons in assistance units comprised of adults
29 and children who become ineligible for basic maintenance
30 assistance under Article VI of this Code due to employment
31 earnings. The plan for coverage for this class of persons
32 shall:
33 (a) extend the medical assistance coverage for up
34 to 12 months following termination of basic maintenance
-4- LRB9105668DJsb
1 assistance; and
2 (b) offer persons who have initially received 6
3 months of the coverage provided in paragraph (a) above,
4 the option of receiving an additional 6 months of
5 coverage, subject to the following:
6 (i) such coverage shall be pursuant to
7 provisions of the federal Social Security Act;
8 (ii) such coverage shall include all services
9 covered while the person was eligible for basic
10 maintenance assistance;
11 (iii) no premium shall be charged for such
12 coverage; and
13 (iv) such coverage shall be suspended in the
14 event of a person's failure without good cause to
15 file in a timely fashion reports required for this
16 coverage under the Social Security Act and coverage
17 shall be reinstated upon the filing of such reports
18 if the person remains otherwise eligible.
19 9. Persons with acquired immunodeficiency syndrome
20 (AIDS) or with AIDS-related conditions with respect to whom
21 there has been a determination that but for home or
22 community-based services such individuals would require the
23 level of care provided in an inpatient hospital, skilled
24 nursing facility or intermediate care facility the cost of
25 which is reimbursed under this Article. Assistance shall be
26 provided to such persons to the maximum extent permitted
27 under Title XIX of the Federal Social Security Act.
28 10. Participants in the long-term care insurance
29 partnership program established under the Partnership for
30 Long-Term Care Act who meet the qualifications for protection
31 of resources described in Section 25 of that Act.
32 The Illinois Department and the Governor shall provide a
33 plan for coverage of the persons eligible under paragraph 7
34 as soon as possible after July 1, 1984.
-5- LRB9105668DJsb
1 The eligibility of any such person for medical assistance
2 under this Article is not affected by the payment of any
3 grant under the Senior Citizens and Disabled Persons Property
4 Tax Relief and Pharmaceutical Assistance Act. The Department
5 shall by rule establish the amounts of assets to be
6 disregarded in determining eligibility for medical
7 assistance, which shall at a minimum equal the amounts to be
8 disregarded under the Federal Supplemental Security Income
9 Program. The amount of assets of a single person to be
10 disregarded shall not be less than $2,000, and the amount of
11 assets of a married couple to be disregarded shall not be
12 less than $3,000.
13 To the extent permitted under federal law, any person
14 found guilty of a second violation of Article VIIIA shall be
15 ineligible for medical assistance under this Article, as
16 provided in Section 8A-8.
17 The eligibility of any person for medical assistance
18 under this Article shall not be affected by the receipt by
19 the person of donations or benefits from fundraisers held for
20 the person in cases of serious illness, as long as neither
21 the person nor members of the person's family have actual
22 control over the donations or benefits or the disbursement of
23 the donations or benefits.
24 (Source: P.A. 89-525, eff. 7-19-96.)
25 Section 99. Effective date. This Act takes effect upon
26 becoming law.