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90_SB1372ham002
LRB9010778DJmgam05
1 AMENDMENT TO SENATE BILL 1372
2 AMENDMENT NO. . Amend Senate Bill 1372, AS AMENDED,
3 as follows:
4 by replacing the introductory clause of Section 2 with the
5 following:
6 "Section 2. The Mental Health and Developmental
7 Disabilities Administrative Act is amended by adding Section
8 31b and changing Section 57 as follows:"; and
9 in Section 2, after the last line of Sec. 31b, by inserting
10 the following:
11 "(20 ILCS 1705/57) (from Ch. 91 1/2, par. 100-57)
12 Sec. 57. In order to identify the service needs of
13 persons with autism, the Department shall study the needs of
14 the population. The Department shall submit service needs
15 reports to the General Assembly annually which shall
16 supplement the report submitted in accordance with Public Act
17 84-1291. The reports shall include an analysis of progress
18 made since the submission of that report in the areas
19 outlined in that report, with emphasis on the following
20 areas:
21 a. Early intervention services for children with autism
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1 and their parents;
2 b. Enhancement of family support mechanisms to enable
3 persons with autism to remain in a family home environment.
4 The Department shall include in the report a plan to provide
5 family support mechanisms to enable persons with autism to
6 remain in a family home environment;
7 c. Services for adequate transition for people with
8 autism from public school programs to adult work and day
9 programs; and
10 d. Facilitation of placement of persons with autism in
11 the least restrictive community setting.
12 For the purpose of this service needs review, autism
13 means a severely incapacitating life-long developmental
14 disability which:
15 a. may be manifested before a person is 30 months of
16 age,
17 b. may be caused by physical disorders of the brain, and
18 c. is characterized by uneven intellectual development
19 and a combination of disturbances in the rates and sequences
20 of cognitive, affective, psychomotor, language and speech
21 development. This syndrome is further evidenced by abnormal
22 responses to sensory stimuli, problems in developing social
23 relationships, and ritualistic and compulsive behavior.
24 (Source: P.A. 85-971.)"; and
25 by replacing the introductory clause of Section 5 with the
26 following:
27 "Section 5. The Illinois Public Aid Code is amended by
28 changing Sections 5-2 and 5-5.01a as follows:
29 (305 ILCS 5/5-2) (from Ch. 23, par. 5-2)
30 Sec. 5-2. Classes of Persons Eligible. Medical
31 assistance under this Article shall be available to any of
32 the following classes of persons in respect to whom a plan
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1 for coverage has been submitted to the Governor by the
2 Illinois Department and approved by him:
3 1. Recipients of basic maintenance grants under Articles
4 III and IV.
5 2. Persons otherwise eligible for basic maintenance
6 under Articles III and IV but who fail to qualify thereunder
7 on the basis of need, and who have insufficient income and
8 resources to meet the costs of necessary medical care,
9 including but not limited to, all persons who would be
10 determined eligible for such basic maintenance under Article
11 IV by disregarding the maximum earned income permitted by
12 federal law.
13 3. Persons who would otherwise qualify for Aid to the
14 Medically Indigent under Article VII.
15 4. Persons not eligible under any of the preceding
16 paragraphs who fall sick, are injured, or die, not having
17 sufficient money, property or other resources to meet the
18 costs of necessary medical care or funeral and burial
19 expenses.
20 5. (a) Women during pregnancy, after the fact of
21 pregnancy has been determined by medical diagnosis, and
22 during the 60-day period beginning on the last day of the
23 pregnancy, together with their infants and children born
24 after September 30, 1983, whose income and resources are
25 insufficient to meet the costs of necessary medical care
26 to the maximum extent possible under Title XIX of the
27 Federal Social Security Act.
28 (b) The Illinois Department and the Governor shall
29 provide a plan for coverage of the persons eligible under
30 paragraph 5(a) by April 1, 1990. Such plan shall provide
31 ambulatory prenatal care to pregnant women during a
32 presumptive eligibility period and establish an income
33 eligibility standard that is equal to 133% of the nonfarm
34 income official poverty line, as defined by the federal
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1 Office of Management and Budget and revised annually in
2 accordance with Section 673(2) of the Omnibus Budget
3 Reconciliation Act of 1981, applicable to families of the
4 same size, provided that costs incurred for medical care
5 are not taken into account in determining such income
6 eligibility.
7 (c) The Illinois Department may conduct a
8 demonstration in at least one county that will provide
9 medical assistance to pregnant women, together with their
10 infants and children up to one year of age, where the
11 income eligibility standard is set up to 185% of the
12 nonfarm income official poverty line, as defined by the
13 federal Office of Management and Budget. The Illinois
14 Department shall seek and obtain necessary authorization
15 provided under federal law to implement such a
16 demonstration. Such demonstration may establish resource
17 standards that are not more restrictive than those
18 established under Article IV of this Code.
19 6. Persons under the age of 18 who fail to qualify as
20 dependent under Article IV and who have insufficient income
21 and resources to meet the costs of necessary medical care to
22 the maximum extent permitted under Title XIX of the Federal
23 Social Security Act.
24 7. Persons who are 18 years of age or younger and would
25 qualify as disabled as defined under the Federal Supplemental
26 Security Income Program, provided medical service for such
27 persons would be eligible for Federal Financial
28 Participation, and provided the Illinois Department
29 determines that:
30 (a) the person requires a level of care provided by
31 a hospital, skilled nursing facility, or intermediate
32 care facility, as determined by a physician licensed to
33 practice medicine in all its branches;
34 (b) it is appropriate to provide such care outside
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1 of an institution, as determined by a physician licensed
2 to practice medicine in all its branches;
3 (c) the estimated amount which would be expended
4 for care outside the institution is not greater than the
5 estimated amount which would be expended in an
6 institution.
7 7.5. Persons who meet all of the following requirements:
8 (a) the person is 21 years of age or older;
9 (b) on or after January 1, 1998, the person has been
10 receiving benefits under paragraph 7 of this Section as
11 an alternative to inpatient hospitalization; and
12 (c) the University of Illinois Division of
13 Specialized Care for Children and the Department of
14 Public Aid, or their designees, determine that, during a
15 particular fiscal year, the person requires the type of
16 care that he or she has been receiving under paragraph 7,
17 and also determine that the services available through
18 the Home and Community Based Services Waiver for the
19 Disabled for the person are not medically adequate.
20 Assistance shall not be dependent on the person meeting
21 eligibility requirements for Federal Financial Participation.
22 The Illinois Department shall by rule adopt the criteria,
23 standards, and amount of assistance which the Illinois
24 Department shall provide under this paragraph 7.5 to
25 qualified recipients. The Illinois Department shall not
26 approve future enrollments under this paragraph 7.5 for any
27 fiscal year if it determines that aggregate expenditures
28 under this paragraph 7.5 will exceed $200,000 during that
29 fiscal year. The amount and nature of assistance shall be
30 determined in accordance with the standards and rules of the
31 Illinois Department. Due regard shall be given to the
32 self-sufficiency requirements of the family and to the
33 income, money contributions, and other support and resources
34 available, from whatever source. However, the amount and
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1 nature of any assistance is not affected by the payment of
2 any grant under the Senior Citizens and Disabled Persons
3 Property Tax Relief and Pharmaceutical Assistance Act. The
4 assistance shall be sufficient, when added to all other
5 income, money contributions, and support, to provide the
6 family with the amount of assistance established by Illinois
7 Department rule.
8 The Illinois Department of Public Aid may implement this
9 amendatory Act of 1998 through the use of emergency rules in
10 accordance with Section 5-45 of the Illinois Administrative
11 Procedure Act. For purposes of that amendatory Act of 1998,
12 the adoption of rules to implement this Act is deemed an
13 emergency and necessary for the public interest, safety, and
14 welfare.
15 8. Persons who become ineligible for basic maintenance
16 assistance under Article IV of this Code in programs
17 administered by the Illinois Department due to employment
18 earnings and persons in assistance units comprised of adults
19 and children who become ineligible for basic maintenance
20 assistance under Article VI of this Code due to employment
21 earnings. The plan for coverage for this class of persons
22 shall:
23 (a) extend the medical assistance coverage for up
24 to 12 months following termination of basic maintenance
25 assistance; and
26 (b) offer persons who have initially received 6
27 months of the coverage provided in paragraph (a) above,
28 the option of receiving an additional 6 months of
29 coverage, subject to the following:
30 (i) such coverage shall be pursuant to
31 provisions of the federal Social Security Act;
32 (ii) such coverage shall include all services
33 covered while the person was eligible for basic
34 maintenance assistance;
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1 (iii) no premium shall be charged for such
2 coverage; and
3 (iv) such coverage shall be suspended in the
4 event of a person's failure without good cause to
5 file in a timely fashion reports required for this
6 coverage under the Social Security Act and coverage
7 shall be reinstated upon the filing of such reports
8 if the person remains otherwise eligible.
9 9. Persons with acquired immunodeficiency syndrome
10 (AIDS) or with AIDS-related conditions with respect to whom
11 there has been a determination that but for home or
12 community-based services such individuals would require the
13 level of care provided in an inpatient hospital, skilled
14 nursing facility or intermediate care facility the cost of
15 which is reimbursed under this Article. Assistance shall be
16 provided to such persons to the maximum extent permitted
17 under Title XIX of the Federal Social Security Act.
18 10. Participants in the long-term care insurance
19 partnership program established under the Partnership for
20 Long-Term Care Act who meet the qualifications for protection
21 of resources described in Section 25 of that Act.
22 The Illinois Department and the Governor shall provide a
23 plan for coverage of the persons eligible under paragraph 7
24 as soon as possible after July 1, 1984.
25 The eligibility of any such person for medical assistance
26 under this Article is not affected by the payment of any
27 grant under the Senior Citizens and Disabled Persons Property
28 Tax Relief and Pharmaceutical Assistance Act. The Department
29 shall by rule establish the amounts of assets to be
30 disregarded in determining eligibility for medical
31 assistance, which shall at a minimum equal the amounts to be
32 disregarded under the Federal Supplemental Security Income
33 Program. The amount of assets of a single person to be
34 disregarded shall not be less than $2,000, and the amount of
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1 assets of a married couple to be disregarded shall not be
2 less than $3,000.
3 To the extent permitted under federal law, any person
4 found guilty of a second violation of Article VIIIA shall be
5 ineligible for medical assistance under this Article, as
6 provided in Section 8A-8.
7 The eligibility of any person for medical assistance
8 under this Article shall not be affected by the receipt by
9 the person of donations or benefits from fundraisers held for
10 the person in cases of serious illness, as long as neither
11 the person nor members of the person's family have actual
12 control over the donations or benefits or the disbursement of
13 the donations or benefits.
14 (Source: P.A. 89-525, eff. 7-19-96.)".