Human Services Committee

Adopted in House Comm. on Apr 19, 2006

 

 


 

 


 
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1
AMENDMENT TO SENATE BILL 2328

2     AMENDMENT NO. ______. Amend Senate Bill 2328 by replacing
3 everything after the enacting clause with the following:
 
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 assistance
8 under this Article shall be available to any of the following
9 classes of persons in respect to whom a plan for coverage has
10 been submitted to the Governor by the Illinois Department and
11 approved by him:
12         1. Recipients of basic maintenance grants under
13     Articles III and IV.
14         2. Persons otherwise eligible for basic maintenance
15     under Articles III and IV but who fail to qualify
16     thereunder on the basis of need, and who have insufficient
17     income and resources to meet the costs of necessary medical
18     care, 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

 

 

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1             requirements, is equal to or less than 70% in
2             fiscal year 2001, equal to or less than 85% in
3             fiscal year 2002 and until a date to be determined
4             by the Department by rule, and equal to or less
5             than 100% beginning on the date determined by the
6             Department by rule, of the nonfarm income official
7             poverty line, as defined by the federal Office of
8             Management and Budget and revised annually in
9             accordance with Section 673(2) of the Omnibus
10             Budget Reconciliation Act of 1981, applicable to
11             families of the same size; or
12                 (ii) their income, after the deduction of
13             costs incurred for medical care and for other types
14             of remedial care, is equal to or less than 70% in
15             fiscal year 2001, equal to or less than 85% in
16             fiscal year 2002 and until a date to be determined
17             by the Department by rule, and equal to or less
18             than 100% beginning on the date determined by the
19             Department by rule, of the nonfarm income official
20             poverty line, as defined in item (i) of this
21             subparagraph (a).
22             (b) All persons who would be determined eligible
23         for such basic maintenance under Article IV by
24         disregarding the maximum earned income permitted by
25         federal law.
26         3. Persons who would otherwise qualify for Aid to the
27     Medically Indigent under Article VII.
28         4. Persons not eligible under any of the preceding
29     paragraphs who fall sick, are injured, or die, not having
30     sufficient money, property or other resources to meet the
31     costs of necessary medical care or funeral and burial
32     expenses.
33         5.(a) Women during pregnancy, after the fact of
34     pregnancy has been determined by medical diagnosis, and

 

 

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1     during the 60-day period beginning on the last day of the
2     pregnancy, together with their infants and children born
3     after September 30, 1983, whose income and resources are
4     insufficient to meet the costs of necessary medical care to
5     the maximum extent possible under Title XIX of the Federal
6     Social Security Act.
7         (b) The Illinois Department and the Governor shall
8     provide a plan for coverage of the persons eligible under
9     paragraph 5(a) by April 1, 1990. Such plan shall provide
10     ambulatory prenatal care to pregnant women during a
11     presumptive eligibility period and establish an income
12     eligibility standard that is equal to 133% of the nonfarm
13     income official poverty line, as defined by the federal
14     Office of Management and Budget and revised annually in
15     accordance with Section 673(2) of the Omnibus Budget
16     Reconciliation Act of 1981, applicable to families of the
17     same size, provided that costs incurred for medical care
18     are not taken into account in determining such income
19     eligibility.
20         (c) The Illinois Department may conduct a
21     demonstration in at least one county that will provide
22     medical assistance to pregnant women, together with their
23     infants and children up to one year of age, where the
24     income eligibility standard is set up to 185% of the
25     nonfarm income official poverty line, as defined by the
26     federal Office of Management and Budget. The Illinois
27     Department shall seek and obtain necessary authorization
28     provided under federal law to implement such a
29     demonstration. Such demonstration may establish resource
30     standards that are not more restrictive than those
31     established under Article IV of this Code.
32         6. Persons under the age of 18 who fail to qualify as
33     dependent under Article IV and who have insufficient income
34     and resources to meet the costs of necessary medical care

 

 

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1     to the maximum extent permitted under Title XIX of the
2     Federal Social Security Act.
3         7. Persons who are under 21 years of age and would
4     qualify as disabled as defined under the Federal
5     Supplemental Security Income Program, provided medical
6     service for such persons would be eligible for Federal
7     Financial Participation, and provided the Illinois
8     Department determines that:
9             (a) the person requires a level of care provided by
10         a hospital, skilled nursing facility, or intermediate
11         care facility, as determined by a physician licensed to
12         practice medicine in all its branches;
13             (b) it is appropriate to provide such care outside
14         of an institution, as determined by a physician
15         licensed to practice medicine in all its branches;
16             (c) the estimated amount which would be expended
17         for care outside the institution is not greater than
18         the estimated amount which would be expended in an
19         institution.
20         8. Persons who become ineligible for basic maintenance
21     assistance under Article IV of this Code in programs
22     administered by the Illinois Department due to employment
23     earnings and persons in assistance units comprised of
24     adults and children who become ineligible for basic
25     maintenance assistance under Article VI of this Code due to
26     employment earnings. The plan for coverage for this class
27     of persons shall:
28             (a) extend the medical assistance coverage for up
29         to 12 months following termination of basic
30         maintenance assistance; and
31             (b) offer persons who have initially received 6
32         months of the coverage provided in paragraph (a) above,
33         the option of receiving an additional 6 months of
34         coverage, subject to the following:

 

 

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1                 (i) such coverage shall be pursuant to
2             provisions of the federal Social Security Act;
3                 (ii) such coverage shall include all services
4             covered while the person was eligible for basic
5             maintenance assistance;
6                 (iii) no premium shall be charged for such
7             coverage; and
8                 (iv) such coverage shall be suspended in the
9             event of a person's failure without good cause to
10             file in a timely fashion reports required for this
11             coverage under the Social Security Act and
12             coverage shall be reinstated upon the filing of
13             such reports if the person remains otherwise
14             eligible.
15         9. Persons with acquired immunodeficiency syndrome
16     (AIDS) or with AIDS-related conditions with respect to whom
17     there has been a determination that but for home or
18     community-based services such individuals would require
19     the level of care provided in an inpatient hospital,
20     skilled nursing facility or intermediate care facility the
21     cost of which is reimbursed under this Article. Assistance
22     shall be provided to such persons to the maximum extent
23     permitted under Title XIX of the Federal Social Security
24     Act.
25         10. Participants in the long-term care insurance
26     partnership program established under the Partnership for
27     Long-Term Care Act who meet the qualifications for
28     protection of resources described in Section 25 of that
29     Act.
30         11. Persons with disabilities who are employed and
31     eligible for Medicaid, pursuant to Section
32     1902(a)(10)(A)(ii)(xv) of the Social Security Act, as
33     provided by the Illinois Department by rule.
34         12. Subject to federal approval, persons who are

 

 

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1     eligible for medical assistance coverage under applicable
2     provisions of the federal Social Security Act and the
3     federal Breast and Cervical Cancer Prevention and
4     Treatment Act of 2000. Those eligible persons are defined
5     to include, but not be limited to, the following persons:
6             (1) persons who have been screened for breast or
7         cervical cancer under the U.S. Centers for Disease
8         Control and Prevention Breast and Cervical Cancer
9         Program established under Title XV of the federal
10         Public Health Services Act in accordance with the
11         requirements of Section 1504 of that Act as
12         administered by the Illinois Department of Public
13         Health; and
14             (2) persons whose screenings under the above
15         program were funded in whole or in part by funds
16         appropriated to the Illinois Department of Public
17         Health for breast or cervical cancer screening.
18         "Medical assistance" under this paragraph 12 shall be
19     identical to the benefits provided under the State's
20     approved plan under Title XIX of the Social Security Act.
21     The Department must request federal approval of the
22     coverage under this paragraph 12 within 30 days after the
23     effective date of this amendatory Act of the 92nd General
24     Assembly.
25         13. Subject to appropriation and to federal approval,
26     persons living with HIV/AIDS who are not otherwise eligible
27     under this Article and who qualify for services covered
28     under Section 5-5.04 as provided by the Illinois Department
29     by rule.
30         14. Subject to the availability of funds for this
31     purpose, the Department may provide coverage under this
32     Article to persons who reside in Illinois who are not
33     eligible under any of the preceding paragraphs and who meet
34     the income guidelines of paragraph 2(a) of this Section and

 

 

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1     (i) have an application for asylum pending before the
2     federal Department of Homeland Security or on appeal before
3     a court of competent jurisdiction and are represented
4     either by counsel or by an advocate accredited by the
5     federal Department of Homeland Security and employed by a
6     not-for-profit organization in regard to that application
7     or appeal, or (ii) are receiving services through a
8     federally funded torture treatment center. Medical
9     coverage under this paragraph 14 may be provided for up to
10     24 continuous months from the initial eligibility date so
11     long as an individual continues to satisfy the criteria of
12     this paragraph 14. If an individual has an appeal pending
13     regarding an application for asylum before the Department
14     of Homeland Security, eligibility under this paragraph 14
15     may be extended until a final decision is rendered on the
16     appeal. The Department may adopt rules governing the
17     implementation of this paragraph 14.
18     The Illinois Department and the Governor shall provide a
19 plan for coverage of the persons eligible under paragraph 7 as
20 soon as possible after July 1, 1984.
21     The eligibility of any such person for medical assistance
22 under this Article is not affected by the payment of any grant
23 under the Senior Citizens and Disabled Persons Property Tax
24 Relief and Pharmaceutical Assistance Act or any distributions
25 or items of income described under subparagraph (X) of
26 paragraph (2) of subsection (a) of Section 203 of the Illinois
27 Income Tax Act. The Department shall by rule establish the
28 amounts of assets to be disregarded in determining eligibility
29 for medical assistance, which shall at a minimum equal the
30 amounts to be disregarded under the Federal Supplemental
31 Security Income Program. The amount of assets of a single
32 person to be disregarded shall not be less than $2,000, and the
33 amount of assets of a married couple to be disregarded shall
34 not be less than $3,000.

 

 

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1     To the extent permitted under federal law, any person found
2 guilty of a second violation of Article VIIIA shall be
3 ineligible for medical assistance under this Article, as
4 provided in Section 8A-8.
5     The eligibility of any person for medical assistance under
6 this Article shall not be affected by the receipt by the person
7 of donations or benefits from fundraisers held for the person
8 in cases of serious illness, as long as neither the person nor
9 members of the person's family have actual control over the
10 donations or benefits or the disbursement of the donations or
11 benefits.
12 (Source: P.A. 93-20, eff. 6-20-03; 94-629, eff. 1-1-06.)
 
13     Section 99. Effective date. This Act takes effect upon
14 becoming law.".