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Public Act 096-0181 |
HB0818 Enrolled |
LRB096 04019 DRJ 14057 b |
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AN ACT concerning public aid.
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Be it enacted by the People of the State of Illinois,
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represented in the General Assembly:
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Section 5. The Illinois Public Aid Code is amended by |
changing Section 5-2 as follows:
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(305 ILCS 5/5-2) (from Ch. 23, par. 5-2)
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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:
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1. Recipients of basic maintenance grants under |
Articles III and IV.
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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:
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(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:
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(i) their income, as determined by the |
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Illinois Department in
accordance with any federal |
requirements, is equal to or less than 70% in
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fiscal year 2001, equal to or less than 85% in |
fiscal year 2002 and until
a date to be determined |
by the Department by rule, and equal to or less
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than 100% beginning on the date determined by the |
Department by rule, 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
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(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
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fiscal year 2001, equal to or less than 85% in |
fiscal year 2002 and until
a date to be determined |
by the Department by rule, and equal to or less
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than 100% beginning on the date determined by the |
Department by rule, of the nonfarm income official |
poverty
line, as defined in item (i) of this |
subparagraph (a).
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(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.
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3. Persons who would otherwise qualify for Aid to the |
Medically
Indigent under Article VII.
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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
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expenses.
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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
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the maximum extent possible under Title XIX of the
Federal |
Social Security Act.
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(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
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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
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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 |
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are not taken into account in determining such income
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eligibility.
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(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
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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.
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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.
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7. Persons who are under 21 years of age and would
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qualify as
disabled as defined under the Federal |
Supplemental Security Income Program,
provided medical |
service for such persons would be eligible for Federal
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Financial Participation, and provided the Illinois |
Department determines that:
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(a) the person requires a level of care provided by |
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a hospital, skilled
nursing facility, or intermediate |
care facility, as determined by a physician
licensed to |
practice medicine in all its branches;
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(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;
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(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.
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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
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employment earnings. The plan for coverage for this class |
of persons shall:
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(a) extend the medical assistance coverage for up |
to 12 months following
termination of basic |
maintenance assistance; and
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(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:
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(i) such coverage shall be pursuant to |
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provisions of the federal
Social Security Act;
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(ii) such coverage shall include all services |
covered while the person
was eligible for basic |
maintenance assistance;
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(iii) no premium shall be charged for such |
coverage; and
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(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.
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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.
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10. Participants in the long-term care insurance |
partnership program
established under the Illinois |
Long-Term Care Partnership Program Act Partnership for |
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Long-Term Care Act who meet the
qualifications for |
protection of resources described in Section 15 25 of that
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Act.
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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, and, |
subject to federal approval, persons with a medically |
improved disability who are employed and eligible for |
Medicaid pursuant to Section 1902(a)(10)(A)(ii)(xvi) of |
the Social Security Act, as
provided by the Illinois |
Department by rule. In establishing eligibility standards |
under this paragraph 11, the Department shall, subject to |
federal approval: |
(a) set the income eligibility standard at not |
lower than 350% of the federal poverty level; |
(b) exempt retirement accounts that the person |
cannot access without penalty before the age
of 59 1/2, |
and medical savings accounts established pursuant to |
26 U.S.C. 220; |
(c) allow non-exempt assets up to $25,000 as to |
those assets accumulated during periods of eligibility |
under this paragraph 11; and
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(d) continue to apply subparagraphs (b) and (c) in |
determining the eligibility of the person under this |
Article even if the person loses eligibility under this |
paragraph 11.
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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:
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(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
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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
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(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.
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"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.
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13. Subject to appropriation and to federal approval, |
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persons living with HIV/AIDS who are not otherwise eligible |
under this Article and who qualify for services covered |
under Section 5-5.04 as provided by the Illinois Department |
by rule.
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14. Subject to the availability of funds for this |
purpose, the Department may provide coverage under this |
Article to persons who reside in Illinois who are not |
eligible under any of the preceding paragraphs and who meet |
the income guidelines of paragraph 2(a) of this Section and |
(i) have an application for asylum pending before the |
federal Department of Homeland Security or on appeal before |
a court of competent jurisdiction and are represented |
either by counsel or by an advocate accredited by the |
federal Department of Homeland Security and employed by a |
not-for-profit organization in regard to that application |
or appeal, or (ii) are receiving services through a |
federally funded torture treatment center. Medical |
coverage under this paragraph 14 may be provided for up to |
24 continuous months from the initial eligibility date so |
long as an individual continues to satisfy the criteria of |
this paragraph 14. If an individual has an appeal pending |
regarding an application for asylum before the Department |
of Homeland Security, eligibility under this paragraph 14 |
may be extended until a final decision is rendered on the |
appeal. The Department may adopt rules governing the |
implementation of this paragraph 14.
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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.
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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
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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.
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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.
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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 |