093_HB0012eng HB0012 Engrossed LRB093 02054 DRJ 02055 b 1 AN ACT in relation to persons with disabilities. 2 Be it enacted by the People of the State of Illinois, 3 represented in the General Assembly: 4 Section 5. The Mental Health and Developmental 5 Disabilities Administrative Act is amended by changing 6 Section 57 as follows: 7 (20 ILCS 1705/57) (from Ch. 91 1/2, par. 100-57) 8 Sec. 57. In order to identify the service needs of 9 persons with autism, the Department shall study the needs of 10 the population. The Department shall submit service needs 11 reports to the General Assembly annually which shall 12 supplement the report submitted in accordance with Public Act 13 84-1291. The reports shall include an analysis of progress 14 made since the submission of that report in the areas 15 outlined in that report, with emphasis on the following 16 areas: 17 a. Early intervention services for children with autism 18 and their parents; 19 b. Enhancement of family support mechanisms to enable 20 persons with autism to remain in a family home environment. 21 The Department shall include in the report a plan to provide 22 family support mechanisms to enable persons with autism to 23 remain in a family home environment; 24 c. Services for adequate transition for people with 25 autism from public school programs to adult work and day 26 programs; and 27 d. Facilitation of placement of persons with autism in 28 the least restrictive community setting. 29 For the purpose of this service needs review, autism 30 means a severely incapacitating life-long developmental 31 disability which: HB0012 Engrossed -2- LRB093 02054 DRJ 02055 b 1 a. may be manifested before a person is 30 months of 2 age, 3 b. may be caused by physical disorders of the brain, and 4 c. is characterized by uneven intellectual development 5 and a combination of disturbances in the rates and sequences 6 of cognitive, affective, psychomotor, language and speech 7 development. This syndrome is further evidenced by abnormal 8 responses to sensory stimuli, problems in developing social 9 relationships, and ritualistic and compulsive behavior. 10 (Source: P.A. 85-971.) 11 Section 10. The Illinois Public Aid Code is amended by 12 changing Section 5-2 as follows: 13 (305 ILCS 5/5-2) (from Ch. 23, par. 5-2) 14 Sec. 5-2. Classes of Persons Eligible. Medical 15 assistance under this Article shall be available to any of 16 the following classes of persons in respect to whom a plan 17 for coverage has been submitted to the Governor by the 18 Illinois Department and approved by him: 19 1. Recipients of basic maintenance grants under Articles 20 III and IV. 21 2. Persons otherwise eligible for basic maintenance 22 under Articles III and IV but who fail to qualify thereunder 23 on the basis of need, and who have insufficient income and 24 resources to meet the costs of necessary medical care, 25 including but not limited to the following: 26 (a) All persons otherwise eligible for basic 27 maintenance under Article III but who fail to qualify 28 under that Article on the basis of need and who meet 29 either of the following requirements: 30 (i) their income, as determined by the 31 Illinois Department in accordance with any federal 32 requirements, is equal to or less than 70% in fiscal HB0012 Engrossed -3- LRB093 02054 DRJ 02055 b 1 year 2001, equal to or less than 85% in fiscal year 2 2002 and until a date to be determined by the 3 Department by rule, and equal to or less than 100% 4 beginning on the date determined by the Department 5 by rule, of the nonfarm income official poverty 6 line, as defined by the federal Office of Management 7 and Budget and revised annually in accordance with 8 Section 673(2) of the Omnibus Budget Reconciliation 9 Act of 1981, applicable to families of the same 10 size; or 11 (ii) their income, after the deduction of 12 costs incurred for medical care and for other types 13 of remedial care, is equal to or less than 70% in 14 fiscal year 2001, equal to or less than 85% in 15 fiscal year 2002 and until a date to be determined 16 by the Department by rule, and equal to or less than 17 100% beginning on the date determined by the 18 Department by rule, of the nonfarm income official 19 poverty line, as defined in item (i) of this 20 subparagraph (a). 21 (b) All persons who would be determined eligible 22 for such basic maintenance under Article IV by 23 disregarding the maximum earned income permitted by 24 federal law. 25 3. Persons who would otherwise qualify for Aid to the 26 Medically Indigent under Article VII. 27 4. Persons not eligible under any of the preceding 28 paragraphs who fall sick, are injured, or die, not having 29 sufficient money, property or other resources to meet the 30 costs of necessary medical care or funeral and burial 31 expenses. 32 5. (a) Women during pregnancy, after the fact of 33 pregnancy has been determined by medical diagnosis, and 34 during the 60-day period beginning on the last day of the HB0012 Engrossed -4- LRB093 02054 DRJ 02055 b 1 pregnancy, together with their infants and children born 2 after September 30, 1983, whose income and resources are 3 insufficient to meet the costs of necessary medical care 4 to the maximum extent possible under Title XIX of the 5 Federal Social Security Act. 6 (b) The Illinois Department and the Governor shall 7 provide a plan for coverage of the persons eligible under 8 paragraph 5(a) by April 1, 1990. Such plan shall provide 9 ambulatory prenatal care to pregnant women during a 10 presumptive eligibility period and establish an income 11 eligibility standard that is equal to 133% of the nonfarm 12 income official poverty line, as defined by the federal 13 Office of Management and Budget and revised annually in 14 accordance with Section 673(2) of the Omnibus Budget 15 Reconciliation Act of 1981, applicable to families of the 16 same size, provided that costs incurred for medical care 17 are not taken into account in determining such income 18 eligibility. 19 (c) The Illinois Department may conduct a 20 demonstration in at least one county that will provide 21 medical assistance to pregnant women, together with their 22 infants and children up to one year of age, where the 23 income eligibility standard is set up to 185% of the 24 nonfarm income official poverty line, as defined by the 25 federal Office of Management and Budget. The Illinois 26 Department shall seek and obtain necessary authorization 27 provided under federal law to implement such a 28 demonstration. Such demonstration may establish resource 29 standards that are not more restrictive than those 30 established under Article IV of this Code. 31 6. Persons under the age of 18 who fail to qualify as 32 dependent under Article IV and who have insufficient income 33 and resources to meet the costs of necessary medical care to 34 the maximum extent permitted under Title XIX of the Federal HB0012 Engrossed -5- LRB093 02054 DRJ 02055 b 1 Social Security Act. 2 7. Persons who are 18 years of age or younger and would 3 qualify as disabled as defined under the Federal Supplemental 4 Security Income Program, provided medical service for such 5 persons would be eligible for Federal Financial 6 Participation, and provided the Illinois Department 7 determines that: 8 (a) the person requires a level of care provided by 9 a hospital, skilled nursing facility, or intermediate 10 care facility, as determined by a physician licensed to 11 practice medicine in all its branches; 12 (b) it is appropriate to provide such care outside 13 of an institution, as determined by a physician licensed 14 to practice medicine in all its branches; 15 (c) the estimated amount which would be expended 16 for care outside the institution is not greater than the 17 estimated amount which would be expended in an 18 institution. 19 8. Persons who become ineligible for basic maintenance 20 assistance under Article IV of this Code in programs 21 administered by the Illinois Department due to employment 22 earnings and persons in assistance units comprised of adults 23 and children who become ineligible for basic maintenance 24 assistance under Article VI of this Code due to employment 25 earnings. The plan for coverage for this class of persons 26 shall: 27 (a) extend the medical assistance coverage for up 28 to 12 months following termination of basic maintenance 29 assistance; and 30 (b) offer persons who have initially received 6 31 months of the coverage provided in paragraph (a) above, 32 the option of receiving an additional 6 months of 33 coverage, subject to the following: 34 (i) such coverage shall be pursuant to HB0012 Engrossed -6- LRB093 02054 DRJ 02055 b 1 provisions of the federal Social Security Act; 2 (ii) such coverage shall include all services 3 covered while the person was eligible for basic 4 maintenance assistance; 5 (iii) no premium shall be charged for such 6 coverage; and 7 (iv) such coverage shall be suspended in the 8 event of a person's failure without good cause to 9 file in a timely fashion reports required for this 10 coverage under the Social Security Act and coverage 11 shall be reinstated upon the filing of such reports 12 if the person remains otherwise eligible. 13 9. Persons with acquired immunodeficiency syndrome 14 (AIDS) or with AIDS-related conditions with respect to whom 15 there has been a determination that but for home or 16 community-based services such individuals would require the 17 level of care provided in an inpatient hospital, skilled 18 nursing facility or intermediate care facility the cost of 19 which is reimbursed under this Article. Assistance shall be 20 provided to such persons to the maximum extent permitted 21 under Title XIX of the Federal Social Security Act. 22 10. Participants in the long-term care insurance 23 partnership program established under the Partnership for 24 Long-Term Care Act who meet the qualifications for protection 25 of resources described in Section 25 of that Act. 26 11. Persons with disabilities who are employed and 27 eligible for Medicaid, pursuant to Section 28 1902(a)(10)(A)(ii)(xv) of the Social Security Act, as 29 provided by the Illinois Department by rule. 30 12. Subject to federal approval, persons who are 31 eligible for medical assistance coverage under applicable 32 provisions of the federal Social Security Act and the federal 33 Breast and Cervical Cancer Prevention and Treatment Act of 34 2000. Those eligible persons are defined to include, but not HB0012 Engrossed -7- LRB093 02054 DRJ 02055 b 1 be limited to, the following persons: 2 (1) persons who have been screened for breast or 3 cervical cancer under the U.S. Centers for Disease 4 Control and Prevention Breast and Cervical Cancer Program 5 established under Title XV of the federal Public Health 6 Services Act in accordance with the requirements of 7 Section 1504 of that Act as administered by the Illinois 8 Department of Public Health; and 9 (2) persons whose screenings under the above 10 program were funded in whole or in part by funds 11 appropriated to the Illinois Department of Public Health 12 for breast or cervical cancer screening. 13 "Medical assistance" under this paragraph 12 shall be 14 identical to the benefits provided under the State's approved 15 plan under Title XIX of the Social Security Act. The 16 Department must request federal approval of the coverage 17 under this paragraph 12 within 30 days after the effective 18 date of this amendatory Act of the 92nd General Assembly. 19 13. Persons who are older than 18 years of age and have 20 received benefits under paragraph 7 of this Section shall 21 remain eligible for continued benefits at the same level of 22 care, provided that a physician, licensed to practice 23 medicine in all its branches, annually determines that the 24 person requires the level of care provided by a hospital, 25 skilled nursing facility, or intermediate care facility. 26 Continued benefits shall not be dependent on the person 27 meeting eligibility requirements for federal financial 28 participation. The Department of Human Services must make an 29 annual report to the Governor and the General Assembly with 30 respect to the class of persons eligible for medical 31 assistance under this paragraph 13. The report is due on 32 January 1 of each year and must cover the State fiscal year 33 ending on June 30 of the preceding year. The first report is 34 due on January 1, 2005. The report must include the following HB0012 Engrossed -8- LRB093 02054 DRJ 02055 b 1 information for the fiscal year covered by the report: 2 (a) The number of persons eligible for medical 3 assistance under this paragraph 13. 4 (b) The number of persons who applied for medical 5 assistance under this paragraph 13. 6 (c) The number of persons who received medical 7 assistance under this paragraph 13. 8 (d) The number of persons who were denied medical 9 assistance under this paragraph 13, together with the 10 reasons for the denial of assistance. 11 (e) The nature, scope, and cost of services provided 12 under this paragraph 13. 13 (f) The comparative cost of providing those services 14 in a hospital, skilled nursing facility, or intermediate 15 care facility. 16 The Illinois Department and the Governor shall provide a 17 plan for coverage of the persons eligible under paragraph 7 18 as soon as possible after July 1, 1984. 19 The eligibility of any such person for medical assistance 20 under this Article is not affected by the payment of any 21 grant under the Senior Citizens and Disabled Persons Property 22 Tax Relief and Pharmaceutical Assistance Act or any 23 distributions or items of income described under subparagraph 24 (X) of paragraph (2) of subsection (a) of Section 203 of the 25 Illinois Income Tax Act. The Department shall by rule 26 establish the amounts of assets to be disregarded in 27 determining eligibility for medical assistance, which shall 28 at a minimum equal the amounts to be disregarded under the 29 Federal Supplemental Security Income Program. The amount of 30 assets of a single person to be disregarded shall not be less 31 than $2,000, and the amount of assets of a married couple to 32 be disregarded shall not be less than $3,000. 33 To the extent permitted under federal law, any person 34 found guilty of a second violation of Article VIIIA shall be HB0012 Engrossed -9- LRB093 02054 DRJ 02055 b 1 ineligible for medical assistance under this Article, as 2 provided in Section 8A-8. 3 The eligibility of any person for medical assistance 4 under this Article shall not be affected by the receipt by 5 the person of donations or benefits from fundraisers held for 6 the person in cases of serious illness, as long as neither 7 the person nor members of the person's family have actual 8 control over the donations or benefits or the disbursement of 9 the donations or benefits. 10 (Source: P.A. 91-676, eff. 12-23-99; 91-699, eff. 7-1-00; 11 91-712, eff. 7-1-00; 92-16, eff. 6-28-01; 92-47, eff. 7-3-01; 12 92-597, eff. 6-28-02.) 13 Section 99. Effective date. This Act takes effect upon 14 becoming law.