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| [ House Amendment 001 ] |
91_HB1246
LRB9101530SMpc
1 AN ACT to amend the Illinois Public Aid Code by changing
2 Section 9A-4 and adding Section 9A-4.5.
3 Be it enacted by the People of the State of Illinois,
4 represented in the General Assembly:
5 Section 5. The Illinois Public Aid Code is amended by
6 changing Section 9A-4 and adding Section 9A-4.5 as follows:
7 (305 ILCS 5/9A-4) (from Ch. 23, par. 9A-4)
8 Sec. 9A-4. Participation.
9 (a) Except for those exempted under subsection (b)
10 below, and to the extent resources permit, the Illinois
11 Department as a condition of eligibility for public aid, may,
12 as provided by rule, require all recipients to participate in
13 an education, training, and employment program, which shall
14 include accepting suitable employment and refraining from
15 terminating employment or reducing earnings without good
16 cause.
17 (b) A recipient Recipients shall be exempt from the
18 requirement of participation in the education, training, and
19 employment program if he or she is determined by the
20 Department to be exempt because he or she is:
21 (1) a person who is ill, incapacitated, 60 years of
22 age or older, or deemed to be disabled under Section
23 9A-4.5;
24 (2) a child who is under 16 years of age or under
25 the age of 19 and attending a secondary, vocational, or
26 technical school full-time;
27 (3) a person whose presence in the home is required
28 because of the illness or incapacity of another member of
29 the household, provided that, to the extent the person is
30 providing care for another member of the household for
31 the number of hours required in subsection (n) of Section
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1 9A-9, that person shall be deemed to be participating in
2 community service;
3 (4) a parent or other relative of a child under one
4 year of age who is personally providing care for the
5 child for a maximum period of 12 months;
6 (5) a woman who is pregnant, beginning 30 days
7 prior to the medically verified date of delivery of her
8 child. in the following circumstances:
9 (1) The recipient is a person over age 60; or
10 (2) The recipient is a person with a child under
11 age one.
12 (Source: P.A. 89-6, eff. 3-6-95; 90-17, eff. 7-1-97.)
13 (305 ILCS 5/9A-4.5 new)
14 Sec. 9A-4.5. Disability program.
15 (a) Upon application for or redetermination of
16 eligibility for public assistance benefits, or whenever the
17 Department has reason to believe that a physical or mental
18 impairment may prevent the individual from fully engaging in
19 work activities, the Department shall inquire whether the
20 individual has any medical condition which would limit the
21 individual's ability to participate in work activities under
22 this Code.
23 (b) Under the circumstances set forth in subsection (a),
24 notice shall be provided to the individual of the opportunity
25 to provide, within 10 calendar days, any relevant medical
26 documentation, including but not limited to drug
27 prescriptions and reports of the individual's treating health
28 care practitioner, if any. The documentation must contain a
29 specific diagnosis as evidenced by medically appropriate
30 tests or evaluations and must particularize any work related
31 limitations as a result of the diagnosis. If, prior to
32 submitting his or her medical documentation, the individual
33 is referred to a health care practitioner certified by the
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1 Department for an examination under subsection (d), that
2 individual shall make best efforts to bring such
3 documentation to the examination, and in no case shall
4 provide such records to the Department later than 4 business
5 days after the examination; provided that the individual may
6 demonstrate good cause as defined in Section 9A-7, for
7 failure to provide such records within the specific time
8 periods.
9 (c) The Department may in its sole discretion accept
10 such documentation as sufficient evidence that the individual
11 cannot fully engage in work activities and in such case shall
12 modify work assignments consistent with the findings in the
13 medical documents.
14 (d) In instances where the Department determines either
15 that the documentation is insufficient to support an
16 exemption from or limitation on work activities or that
17 further medical evaluation is appropriate, the individual
18 shall be referred to a health care practitioner certified by
19 the Department for an examination of that individual's
20 medical condition. The health care practitioner who performs
21 the examination of the individual shall:
22 (1) review and consider all records or information
23 provided by the individual or his or her treating health
24 care practitioner that are pertinent to the claimed
25 medical condition;
26 (2) make a specific diagnosis as evidenced by
27 medically appropriate tests or evaluations in
28 determination of the individual's claimed condition;
29 (3) render to the individual and the Department, an
30 opinion, particularizing the presence or absence of the
31 alleged condition; and
32 (4) in the event that he or she identifies a
33 condition, other than the alleged condition, that may
34 interfere with the individual's ability to fully engage
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1 in work activities, the practitioner shall report that
2 condition; and
3 (5) determine whether the individual is:
4 (A) disabled and unable to engage in work
5 activities under this Article for a stated period of
6 time, in which case the applicant shall be exempt in
7 accordance with subdivision (b)(1) of Section 9A-4;
8 (B) for a stated period of time, not disabled,
9 but work-limited, and able to engage in work
10 activities under this Title, with stated
11 limitations, or
12 (C) neither disabled nor work-limited.
13 (e) When an applicant or recipient has requested or a
14 Department official has directed a determination under this
15 Section, no assignment to work activities may be made until
16 completion of the determination, unless the applicant or
17 recipient agrees to a limited work assignment not
18 inconsistent with the medical condition alleged by such
19 person.
20 (f) When an applicant or recipient receives notification
21 of the examining medical professional's disability
22 determination, he or she shall also be notified of his or her
23 right to request a fair hearing within 10 days of the notice.
24 If the applicant timely requests a fair hearing, no
25 assignment to work activities under this Article may be made
26 pending the hearing and determination unless the applicant or
27 recipient agrees to a limited work assignment not
28 inconsistent with the medical condition alleged by him or
29 her. However, if the Department has reason to believe that
30 the recipient or applicant does not actually suffer from a
31 work-limiting condition, the Department shall provide the
32 applicant or recipient with notice of potential sanctions
33 under Section 9A-7, and notice that recipients will be
34 subject to sanctions under Section 9A-7 if the Department
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1 determines, based on clear medical evidence, that there is no
2 basis for the individual's claim that he or she is unable to
3 fully engage in work activities and that the individual
4 intentionally misrepresented his or her medical condition.
5 (g) Any applicant or recipient determined to be
6 work-limited pursuant to this Section may be assigned to work
7 activities only if the assignment is consistent with the
8 individual's treatment plan and is determined to be
9 appropriate by the Department official who is satisfied that
10 the person is able to perform the work assigned and that the
11 assignment will assist the individual's transition to
12 self-sufficiency. If the assignment is not part of the
13 individual's treatment plan, the individual shall be deemed
14 to be engaged in work if he or she is complying with the
15 requirements of his or her treatment plan. If no treatment
16 plan exists, the assigned work activities must be consistent
17 with the individual's mental and physical limitations.
18 Section 99. Effective date. This Act takes effect upon
19 becoming law.