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91_SB0677eng SB677 Engrossed LRB9103095DJcd 1 AN ACT to amend the Illinois Public Aid Code by changing 2 Section 5-2. 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 5-2 as follows: 7 (305 ILCS 5/5-2) (from Ch. 23, par. 5-2) 8 Sec. 5-2. Classes of Persons Eligible. Medical 9 assistance under this Article shall be available to any of 10 the following classes of persons in respect to whom a plan 11 for coverage has been submitted to the Governor by the 12 Illinois Department and approved by him: 13 1. Recipients of basic maintenance grants under Articles 14 III and IV. 15 2. Persons otherwise eligible for basic maintenance 16 under Articles III and IV but who fail to qualify thereunder 17 on the basis of need, and who have insufficient income and 18 resources to meet the costs of necessary medical care, 19 including but not limited to the following:,20 (a) All persons otherwise eligible for basic 21 maintenance under Article III but who fail to qualify 22 under that Article on the basis of need and who meet 23 either of the following requirements: 24 (i) their income, as determined by the 25 Illinois Department in accordance with any federal 26 requirements, is equal to or less than 70% in fiscal 27 year 2001, equal to or less than 85% in fiscal year 28 2002, and equal to or less than 100% in fiscal year 29 2003 and thereafter of the nonfarm income official 30 poverty line, as defined by the federal Office of 31 Management and Budget and revised annually in SB677 Engrossed -2- LRB9103095DJcd 1 accordance with Section 673(2) of the Omnibus Budget 2 Reconciliation Act of 1981, applicable to families 3 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 equal to or less than 100% in 9 fiscal year 2003 and thereafter of the nonfarm 10 income official poverty line, as defined in item (i) 11 of this subparagraph (a). 12 (b) All persons who would be determined eligible 13 for such basic maintenance under Article IV by 14 disregarding the maximum earned income permitted by 15 federal law. 16 3. Persons who would otherwise qualify for Aid to the 17 Medically Indigent under Article VII. 18 4. Persons not eligible under any of the preceding 19 paragraphs who fall sick, are injured, or die, not having 20 sufficient money, property or other resources to meet the 21 costs of necessary medical care or funeral and burial 22 expenses. 23 5. (a) Women during pregnancy, after the fact of 24 pregnancy has been determined by medical diagnosis, and 25 during the 60-day period beginning on the last day of the 26 pregnancy, together with their infants and children born 27 after September 30, 1983, whose income and resources are 28 insufficient to meet the costs of necessary medical care 29 to the maximum extent possible under Title XIX of the 30 Federal Social Security Act. 31 (b) The Illinois Department and the Governor shall 32 provide a plan for coverage of the persons eligible under 33 paragraph 5(a) by April 1, 1990. Such plan shall provide 34 ambulatory prenatal care to pregnant women during a SB677 Engrossed -3- LRB9103095DJcd 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 to 25 the maximum extent permitted under Title XIX of the Federal 26 Social Security Act. 27 7. Persons who are 18 years of age or younger and would 28 qualify as disabled as defined under the Federal Supplemental 29 Security Income Program, provided medical service for such 30 persons would be eligible for Federal Financial 31 Participation, and provided the Illinois Department 32 determines that: 33 (a) the person requires a level of care provided by 34 a hospital, skilled nursing facility, or intermediate SB677 Engrossed -4- LRB9103095DJcd 1 care facility, as determined by a physician licensed to 2 practice medicine in all its branches; 3 (b) it is appropriate to provide such care outside 4 of an institution, as determined by a physician licensed 5 to practice medicine in all its branches; 6 (c) the estimated amount which would be expended 7 for care outside the institution is not greater than the 8 estimated amount which would be expended in an 9 institution. 10 8. Persons who become ineligible for basic maintenance 11 assistance under Article IV of this Code in programs 12 administered by the Illinois Department due to employment 13 earnings and persons in assistance units comprised of adults 14 and children who become ineligible for basic maintenance 15 assistance under Article VI of this Code due to employment 16 earnings. The plan for coverage for this class of persons 17 shall: 18 (a) extend the medical assistance coverage for up 19 to 12 months following termination of basic maintenance 20 assistance; and 21 (b) offer persons who have initially received 6 22 months of the coverage provided in paragraph (a) above, 23 the option of receiving an additional 6 months of 24 coverage, subject to the following: 25 (i) such coverage shall be pursuant to 26 provisions of the federal Social Security Act; 27 (ii) such coverage shall include all services 28 covered while the person was eligible for basic 29 maintenance assistance; 30 (iii) no premium shall be charged for such 31 coverage; and 32 (iv) such coverage shall be suspended in the 33 event of a person's failure without good cause to 34 file in a timely fashion reports required for this SB677 Engrossed -5- LRB9103095DJcd 1 coverage under the Social Security Act and coverage 2 shall be reinstated upon the filing of such reports 3 if the person remains otherwise eligible. 4 9. Persons with acquired immunodeficiency syndrome 5 (AIDS) or with AIDS-related conditions with respect to whom 6 there has been a determination that but for home or 7 community-based services such individuals would require the 8 level of care provided in an inpatient hospital, skilled 9 nursing facility or intermediate care facility the cost of 10 which is reimbursed under this Article. Assistance shall be 11 provided to such persons to the maximum extent permitted 12 under Title XIX of the Federal Social Security Act. 13 10. Participants in the long-term care insurance 14 partnership program established under the Partnership for 15 Long-Term Care Act who meet the qualifications for protection 16 of resources described in Section 25 of that Act. 17 The Illinois Department and the Governor shall provide a 18 plan for coverage of the persons eligible under paragraph 7 19 as soon as possible after July 1, 1984. 20 The eligibility of any such person for medical assistance 21 under this Article is not affected by the payment of any 22 grant under the Senior Citizens and Disabled Persons Property 23 Tax Relief and Pharmaceutical Assistance Act. The Department 24 shall by rule establish the amounts of assets to be 25 disregarded in determining eligibility for medical 26 assistance, which shall at a minimum equal the amounts to be 27 disregarded under the Federal Supplemental Security Income 28 Program. The amount of assets of a single person to be 29 disregarded shall not be less than $2,000, and the amount of 30 assets of a married couple to be disregarded shall not be 31 less than $3,000. 32 To the extent permitted under federal law, any person 33 found guilty of a second violation of Article VIIIA shall be 34 ineligible for medical assistance under this Article, as SB677 Engrossed -6- LRB9103095DJcd 1 provided in Section 8A-8. 2 The eligibility of any person for medical assistance 3 under this Article shall not be affected by the receipt by 4 the person of donations or benefits from fundraisers held for 5 the person in cases of serious illness, as long as neither 6 the person nor members of the person's family have actual 7 control over the donations or benefits or the disbursement of 8 the donations or benefits. 9 (Source: P.A. 89-525, eff. 7-19-96.) 10 Section 99. Effective date. This Act takes effect upon 11 becoming law.