SB2328eng 94TH GENERAL ASSEMBLY



 


 
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1     AN ACT concerning 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 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
25             requirements, is equal to or less than 70% in
26             fiscal year 2001, equal to or less than 85% in
27             fiscal year 2002 and until a date to be determined
28             by the Department by rule, and equal to or less
29             than 100% beginning on the date determined by the
30             Department by rule, of the nonfarm income official
31             poverty line, as defined by the federal Office of
32             Management and Budget and revised annually in

 

 

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1             accordance with Section 673(2) of the Omnibus
2             Budget Reconciliation Act of 1981, applicable to
3             families of the same size; or
4                 (ii) their income, after the deduction of
5             costs incurred for medical care and for other types
6             of remedial care, is equal to or less than 70% in
7             fiscal year 2001, equal to or less than 85% in
8             fiscal year 2002 and until a date to be determined
9             by the Department by rule, and equal to or less
10             than 100% beginning on the date determined by the
11             Department by rule, of the nonfarm income official
12             poverty line, as defined in item (i) of this
13             subparagraph (a).
14             (b) All persons who would be determined eligible
15         for such basic maintenance under Article IV by
16         disregarding the maximum earned income permitted by
17         federal law.
18         3. Persons who would otherwise qualify for Aid to the
19     Medically Indigent under Article VII.
20         4. Persons not eligible under any of the preceding
21     paragraphs who fall sick, are injured, or die, not having
22     sufficient money, property or other resources to meet the
23     costs of necessary medical care or funeral and burial
24     expenses.
25         5.(a) Women during pregnancy, after the fact of
26     pregnancy has been determined by medical diagnosis, and
27     during the 60-day period beginning on the last day of the
28     pregnancy, together with their infants and children born
29     after September 30, 1983, whose income and resources are
30     insufficient to meet the costs of necessary medical care to
31     the maximum extent possible under Title XIX of the Federal
32     Social Security Act.
33         (b) The Illinois Department and the Governor shall
34     provide a plan for coverage of the persons eligible under
35     paragraph 5(a) by April 1, 1990. Such plan shall provide
36     ambulatory prenatal care to pregnant women during a

 

 

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1     presumptive eligibility period and establish an income
2     eligibility standard that is equal to 133% of the nonfarm
3     income official poverty line, as defined by the federal
4     Office of Management and Budget and revised annually in
5     accordance with Section 673(2) of the Omnibus Budget
6     Reconciliation Act of 1981, applicable to families of the
7     same size, provided that costs incurred for medical care
8     are not taken into account in determining such income
9     eligibility.
10         (c) The Illinois Department may conduct a
11     demonstration in at least one county that will provide
12     medical assistance to pregnant women, together with their
13     infants and children up to one year of age, where the
14     income eligibility standard is set up to 185% of the
15     nonfarm income official poverty line, as defined by the
16     federal Office of Management and Budget. The Illinois
17     Department shall seek and obtain necessary authorization
18     provided under federal law to implement such a
19     demonstration. Such demonstration may establish resource
20     standards that are not more restrictive than those
21     established under Article IV of this Code.
22         6. Persons under the age of 18 who fail to qualify as
23     dependent under Article IV and who have insufficient income
24     and resources to meet the costs of necessary medical care
25     to the maximum extent permitted under Title XIX of the
26     Federal Social Security Act.
27         7. Persons who are under 21 years of age and would
28     qualify as disabled as defined under the Federal
29     Supplemental Security Income Program, provided medical
30     service for such persons would be eligible for Federal
31     Financial Participation, and provided the Illinois
32     Department determines that:
33             (a) the person requires a level of care provided by
34         a hospital, skilled nursing facility, or intermediate
35         care facility, as determined by a physician licensed to
36         practice medicine in all its branches;

 

 

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1             (b) it is appropriate to provide such care outside
2         of an institution, as determined by a physician
3         licensed to practice medicine in all its branches;
4             (c) the estimated amount which would be expended
5         for care outside the institution is not greater than
6         the estimated amount which would be expended in an
7         institution.
8         8. Persons who become ineligible for basic maintenance
9     assistance under Article IV of this Code in programs
10     administered by the Illinois Department due to employment
11     earnings and persons in assistance units comprised of
12     adults and children who become ineligible for basic
13     maintenance assistance under Article VI of this Code due to
14     employment earnings. The plan for coverage for this class
15     of persons shall:
16             (a) extend the medical assistance coverage for up
17         to 12 months following termination of basic
18         maintenance assistance; and
19             (b) offer persons who have initially received 6
20         months of the coverage provided in paragraph (a) above,
21         the option of receiving an additional 6 months of
22         coverage, subject to the following:
23                 (i) such coverage shall be pursuant to
24             provisions of the federal Social Security Act;
25                 (ii) such coverage shall include all services
26             covered while the person was eligible for basic
27             maintenance assistance;
28                 (iii) no premium shall be charged for such
29             coverage; and
30                 (iv) such coverage shall be suspended in the
31             event of a person's failure without good cause to
32             file in a timely fashion reports required for this
33             coverage under the Social Security Act and
34             coverage shall be reinstated upon the filing of
35             such reports if the person remains otherwise
36             eligible.

 

 

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1         9. Persons with acquired immunodeficiency syndrome
2     (AIDS) or with AIDS-related conditions with respect to whom
3     there has been a determination that but for home or
4     community-based services such individuals would require
5     the level of care provided in an inpatient hospital,
6     skilled nursing facility or intermediate care facility the
7     cost of which is reimbursed under this Article. Assistance
8     shall be provided to such persons to the maximum extent
9     permitted under Title XIX of the Federal Social Security
10     Act.
11         10. Participants in the long-term care insurance
12     partnership program established under the Partnership for
13     Long-Term Care Act who meet the qualifications for
14     protection of resources described in Section 25 of that
15     Act.
16         11. Persons with disabilities who are employed and
17     eligible for Medicaid, pursuant to Section
18     1902(a)(10)(A)(ii)(xv) of the Social Security Act, as
19     provided by the Illinois Department by rule.
20         12. Subject to federal approval, persons who are
21     eligible for medical assistance coverage under applicable
22     provisions of the federal Social Security Act and the
23     federal Breast and Cervical Cancer Prevention and
24     Treatment Act of 2000. Those eligible persons are defined
25     to include, but not be limited to, the following persons:
26             (1) persons who have been screened for breast or
27         cervical cancer under the U.S. Centers for Disease
28         Control and Prevention Breast and Cervical Cancer
29         Program established under Title XV of the federal
30         Public Health Services Act in accordance with the
31         requirements of Section 1504 of that Act as
32         administered by the Illinois Department of Public
33         Health; and
34             (2) persons whose screenings under the above
35         program were funded in whole or in part by funds
36         appropriated to the Illinois Department of Public

 

 

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1         Health for breast or cervical cancer screening.
2         "Medical assistance" under this paragraph 12 shall be
3     identical to the benefits provided under the State's
4     approved plan under Title XIX of the Social Security Act.
5     The Department must request federal approval of the
6     coverage under this paragraph 12 within 30 days after the
7     effective date of this amendatory Act of the 92nd General
8     Assembly.
9         13. Subject to appropriation and to federal approval,
10     persons living with HIV/AIDS who are not otherwise eligible
11     under this Article and who qualify for services covered
12     under Section 5-5.04 as provided by the Illinois Department
13     by rule.
14         14. Persons who reside in Illinois who are not eligible
15     under any of the preceding paragraphs and who meet the
16     income guidelines of paragraph 2(a) of this Section and (i)
17     have a pending application for asylum with the federal
18     Department of Homeland Security and are represented by
19     counsel in regard to that application, or (ii) are
20     receiving services through a federally funded torture
21     treatment center, or (iii) can demonstrate, in accordance
22     with rules adopted by the Department of Healthcare and
23     Family Services, that they are seeking treatment for trauma
24     resulting from torture in their countries of origin or
25     previous countries of residence. Medical coverage under
26     this paragraph 14 shall be provided for up to 24 continuous
27     months from the initial eligibility date so long as an
28     individual continues to satisfy the criteria of this
29     paragraph 14.
30     The Illinois Department and the Governor shall provide a
31 plan for coverage of the persons eligible under paragraph 7 as
32 soon as possible after July 1, 1984.
33     The eligibility of any such person for medical assistance
34 under this Article is not affected by the payment of any grant
35 under the Senior Citizens and Disabled Persons Property Tax
36 Relief and Pharmaceutical Assistance Act or any distributions

 

 

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1 or items of income described under subparagraph (X) of
2 paragraph (2) of subsection (a) of Section 203 of the Illinois
3 Income Tax Act. The Department shall by rule establish the
4 amounts of assets to be disregarded in determining eligibility
5 for medical assistance, which shall at a minimum equal the
6 amounts to be disregarded under the Federal Supplemental
7 Security Income Program. The amount of assets of a single
8 person to be disregarded shall not be less than $2,000, and the
9 amount of assets of a married couple to be disregarded shall
10 not be less than $3,000.
11     To the extent permitted under federal law, any person found
12 guilty of a second violation of Article VIIIA shall be
13 ineligible for medical assistance under this Article, as
14 provided in Section 8A-8.
15     The eligibility of any person for medical assistance under
16 this Article shall not be affected by the receipt by the person
17 of donations or benefits from fundraisers held for the person
18 in cases of serious illness, as long as neither the person nor
19 members of the person's family have actual control over the
20 donations or benefits or the disbursement of the donations or
21 benefits.
22 (Source: P.A. 93-20, eff. 6-20-03; 94-629, eff. 1-1-06.)
 
23     Section 99. Effective date. This Act takes effect upon
24 becoming law.