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91_HB0462ham001 LRB9101665SMdvam01 1 AMENDMENT TO HOUSE BILL 462 2 AMENDMENT NO. . Amend House Bill 462 by replacing 3 the title with the following: 4 "AN ACT regarding person with disabilities, amending 5 named Acts."; and 6 by replacing everything after the enacting clause with the 7 following: 8 "Section 5. The Mental Health and Developmental 9 Disabilities Administrative Act is amended by changing 10 Section 57 as follows: 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 -2- LRB9101665SMdvam01 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.) 25 Section 10. The Illinois Public Aid Code is amended by 26 changing Section 5-2 as follows: 27 (305 ILCS 5/5-2) (from Ch. 23, par. 5-2) 28 Sec. 5-2. Classes of Persons Eligible. Medical 29 assistance under this Article shall be available to any of 30 the following classes of persons in respect to whom a plan 31 for coverage has been submitted to the Governor by the 32 Illinois Department and approved by him: -3- LRB9101665SMdvam01 1 1. Recipients of basic maintenance grants under Articles 2 III and IV. 3 2. Persons otherwise eligible for basic maintenance 4 under Articles III and IV but who fail to qualify thereunder 5 on the basis of need, and who have insufficient income and 6 resources to meet the costs of necessary medical care, 7 including but not limited to, all persons who would be 8 determined eligible for such basic maintenance under Article 9 IV by disregarding the maximum earned income permitted by 10 federal law. 11 3. Persons who would otherwise qualify for Aid to the 12 Medically Indigent under Article VII. 13 4. Persons not eligible under any of the preceding 14 paragraphs who fall sick, are injured, or die, not having 15 sufficient money, property or other resources to meet the 16 costs of necessary medical care or funeral and burial 17 expenses. 18 5. (a) Women during pregnancy, after the fact of 19 pregnancy has been determined by medical diagnosis, and 20 during the 60-day period beginning on the last day of the 21 pregnancy, together with their infants and children born 22 after September 30, 1983, whose income and resources are 23 insufficient to meet the costs of necessary medical care 24 to the maximum extent possible under Title XIX of the 25 Federal Social Security Act. 26 (b) The Illinois Department and the Governor shall 27 provide a plan for coverage of the persons eligible under 28 paragraph 5(a) by April 1, 1990. Such plan shall provide 29 ambulatory prenatal care to pregnant women during a 30 presumptive eligibility period and establish an income 31 eligibility standard that is equal to 133% of the nonfarm 32 income official poverty line, as defined by the federal 33 Office of Management and Budget and revised annually in 34 accordance with Section 673(2) of the Omnibus Budget -4- LRB9101665SMdvam01 1 Reconciliation Act of 1981, applicable to families of the 2 same size, provided that costs incurred for medical care 3 are not taken into account in determining such income 4 eligibility. 5 (c) The Illinois Department may conduct a 6 demonstration in at least one county that will provide 7 medical assistance to pregnant women, together with their 8 infants and children up to one year of age, where the 9 income eligibility standard is set up to 185% of the 10 nonfarm income official poverty line, as defined by the 11 federal Office of Management and Budget. The Illinois 12 Department shall seek and obtain necessary authorization 13 provided under federal law to implement such a 14 demonstration. Such demonstration may establish resource 15 standards that are not more restrictive than those 16 established under Article IV of this Code. 17 6. Persons under the age of 18 who fail to qualify as 18 dependent under Article IV and who have insufficient income 19 and resources to meet the costs of necessary medical care to 20 the maximum extent permitted under Title XIX of the Federal 21 Social Security Act. 22 7. Persons who are 18 years of age or younger and would 23 qualify as disabled as defined under the Federal Supplemental 24 Security Income Program, provided medical service for such 25 persons would be eligible for Federal Financial 26 Participation, and provided the Illinois Department 27 determines that: 28 (a) the person requires a level of care provided by 29 a hospital, skilled nursing facility, or intermediate 30 care facility, as determined by a physician licensed to 31 practice medicine in all its branches; 32 (b) it is appropriate to provide such care outside 33 of an institution, as determined by a physician licensed 34 to practice medicine in all its branches; -5- LRB9101665SMdvam01 1 (c) the estimated amount which would be expended 2 for care outside the institution is not greater than the 3 estimated amount which would be expended in an 4 institution. 5 8. Persons who become ineligible for basic maintenance 6 assistance under Article IV of this Code in programs 7 administered by the Illinois Department due to employment 8 earnings and persons in assistance units comprised of adults 9 and children who become ineligible for basic maintenance 10 assistance under Article VI of this Code due to employment 11 earnings. The plan for coverage for this class of persons 12 shall: 13 (a) extend the medical assistance coverage for up 14 to 12 months following termination of basic maintenance 15 assistance; and 16 (b) offer persons who have initially received 6 17 months of the coverage provided in paragraph (a) above, 18 the option of receiving an additional 6 months of 19 coverage, subject to the following: 20 (i) such coverage shall be pursuant to 21 provisions of the federal Social Security Act; 22 (ii) such coverage shall include all services 23 covered while the person was eligible for basic 24 maintenance assistance; 25 (iii) no premium shall be charged for such 26 coverage; and 27 (iv) such coverage shall be suspended in the 28 event of a person's failure without good cause to 29 file in a timely fashion reports required for this 30 coverage under the Social Security Act and coverage 31 shall be reinstated upon the filing of such reports 32 if the person remains otherwise eligible. 33 9. Persons with acquired immunodeficiency syndrome 34 (AIDS) or with AIDS-related conditions with respect to whom -6- LRB9101665SMdvam01 1 there has been a determination that but for home or 2 community-based services such individuals would require the 3 level of care provided in an inpatient hospital, skilled 4 nursing facility or intermediate care facility the cost of 5 which is reimbursed under this Article. Assistance shall be 6 provided to such persons to the maximum extent permitted 7 under Title XIX of the Federal Social Security Act. 8 10. Participants in the long-term care insurance 9 partnership program established under the Partnership for 10 Long-Term Care Act who meet the qualifications for protection 11 of resources described in Section 25 of that Act. 12 11. Persons who are older than 18 years of age and have 13 been receiving benefits under paragraph 7 of this Section 14 shall remain eligible for continued benefits at the same 15 level of care, provided that a physician, licensed to 16 practice medicine in all its branches, annually determines 17 that the person requires the level of care provided by a 18 hospital, skilled nursing facility, or intermediate care 19 facility. Continued benefits shall not be dependent on the 20 person meeting eligibility requirements for federal financial 21 participation. 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 -7- LRB9101665SMdvam01 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.)".