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92_HB0025eng HB0025 Engrossed LRB9200896DJgc 1 AN ACT in relation to 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 8 assistance under this Article shall be available to any of 9 the following classes of persons in respect to whom a plan 10 for coverage has been submitted to the Governor by the 11 Illinois Department and approved by him: 12 1. Recipients of basic maintenance grants under Articles 13 III and IV. 14 2. Persons otherwise eligible for basic maintenance 15 under Articles III and IV but who fail to qualify thereunder 16 on the basis of need, and who have insufficient income and 17 resources to meet the costs of necessary medical care, 18 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 fiscal 26 year 2001, equal to or less than 85% in fiscal year 27 2002, and equal to or less than 100% in fiscal year 28 2003 and thereafter of the nonfarm income official 29 poverty line, as defined by the federal Office of 30 Management and Budget and revised annually in 31 accordance with Section 673(2) of the Omnibus Budget HB0025 Engrossed -2- LRB9200896DJgc 1 Reconciliation Act of 1981, applicable to families 2 of the same size; or 3 (ii) their income, after the deduction of 4 costs incurred for medical care and for other types 5 of remedial care, is equal to or less than 70% in 6 fiscal year 2001, equal to or less than 85% in 7 fiscal year 2002, and equal to or less than 100% in 8 fiscal year 2003 and thereafter of the nonfarm 9 income official poverty line, as defined in item (i) 10 of this subparagraph (a). 11 (b) All persons who would be determined eligible 12 for such basic maintenance under Article IV by 13 disregarding the maximum earned income permitted by 14 federal law. 15 3. Persons who would otherwise qualify for Aid to the 16 Medically Indigent under Article VII. 17 4. Persons not eligible under any of the preceding 18 paragraphs who fall sick, are injured, or die, not having 19 sufficient money, property or other resources to meet the 20 costs of necessary medical care or funeral and burial 21 expenses. 22 5. (a) Women during pregnancy, after the fact of 23 pregnancy has been determined by medical diagnosis, and 24 during the 60-day period beginning on the last day of the 25 pregnancy, together with their infants and children born 26 after September 30, 1983, whose income and resources are 27 insufficient to meet the costs of necessary medical care 28 to the maximum extent possible under Title XIX of the 29 Federal Social Security Act. 30 (b) The Illinois Department and the Governor shall 31 provide a plan for coverage of the persons eligible under 32 paragraph 5(a) by April 1, 1990. Such plan shall provide 33 ambulatory prenatal care to pregnant women during a 34 presumptive eligibility period and establish an income HB0025 Engrossed -3- LRB9200896DJgc 1 eligibility standard that is equal to 133% of the nonfarm 2 income official poverty line, as defined by the federal 3 Office of Management and Budget and revised annually in 4 accordance with Section 673(2) of the Omnibus Budget 5 Reconciliation Act of 1981, applicable to families of the 6 same size, provided that costs incurred for medical care 7 are not taken into account in determining such income 8 eligibility. 9 (c) The Illinois Department may conduct a 10 demonstration in at least one county that will provide 11 medical assistance to pregnant women, together with their 12 infants and children up to one year of age, where the 13 income eligibility standard is set up to 185% of the 14 nonfarm income official poverty line, as defined by the 15 federal Office of Management and Budget. The Illinois 16 Department shall seek and obtain necessary authorization 17 provided under federal law to implement such a 18 demonstration. Such demonstration may establish resource 19 standards that are not more restrictive than those 20 established under Article IV of this Code. 21 6. Persons under the age of 18 who fail to qualify as 22 dependent under Article IV and who have insufficient income 23 and resources to meet the costs of necessary medical care to 24 the maximum extent permitted under Title XIX of the Federal 25 Social Security Act. 26 7. Persons who are 18 years of age or younger and would 27 qualify as disabled as defined under the Federal Supplemental 28 Security Income Program, provided medical service for such 29 persons would be eligible for Federal Financial 30 Participation, and provided the Illinois Department 31 determines that: 32 (a) the person requires a level of care provided by 33 a hospital, skilled nursing facility, or intermediate 34 care facility, as determined by a physician licensed to HB0025 Engrossed -4- LRB9200896DJgc 1 practice medicine in all its branches; 2 (b) it is appropriate to provide such care outside 3 of an institution, as determined by a physician licensed 4 to practice medicine in all its branches; 5 (c) the estimated amount which would be expended 6 for care outside the institution is not greater than the 7 estimated amount which would be expended in an 8 institution. 9 8. Persons who become ineligible for basic maintenance 10 assistance under Article IV of this Code in programs 11 administered by the Illinois Department due to employment 12 earnings and persons in assistance units comprised of adults 13 and children who become ineligible for basic maintenance 14 assistance under Article VI of this Code due to employment 15 earnings. The plan for coverage for this class of persons 16 shall: 17 (a) extend the medical assistance coverage for up 18 to 12 months following termination of basic maintenance 19 assistance; and 20 (b) offer persons who have initially received 6 21 months of the coverage provided in paragraph (a) above, 22 the option of receiving an additional 6 months of 23 coverage, subject to the following: 24 (i) such coverage shall be pursuant to 25 provisions of the federal Social Security Act; 26 (ii) such coverage shall include all services 27 covered while the person was eligible for basic 28 maintenance assistance; 29 (iii) no premium shall be charged for such 30 coverage; and 31 (iv) such coverage shall be suspended in the 32 event of a person's failure without good cause to 33 file in a timely fashion reports required for this 34 coverage under the Social Security Act and coverage HB0025 Engrossed -5- LRB9200896DJgc 1 shall be reinstated upon the filing of such reports 2 if the person remains otherwise eligible. 3 9. Persons with acquired immunodeficiency syndrome 4 (AIDS) or with AIDS-related conditions with respect to whom 5 there has been a determination that but for home or 6 community-based services such individuals would require the 7 level of care provided in an inpatient hospital, skilled 8 nursing facility or intermediate care facility the cost of 9 which is reimbursed under this Article. Assistance shall be 10 provided to such persons to the maximum extent permitted 11 under Title XIX of the Federal Social Security Act. 12 10. Participants in the long-term care insurance 13 partnership program established under the Partnership for 14 Long-Term Care Act who meet the qualifications for protection 15 of resources described in Section 25 of that 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 Treatment 24 Act of 2000. Those eligible persons are defined to include, 25 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 Program 29 established under Title XV of the federal Public Health 30 Services Act in accordance with the requirements of 31 Section 1504 of that Act as administered by the Illinois 32 Department of Public Health; and 33 (2) persons whose screenings under the above 34 program were funded in whole or in part by funds HB0025 Engrossed -6- LRB9200896DJgc 1 appropriated to the Illinois Department of Public Health 2 for breast or cervical cancer screening. 3 "Medical assistance" under this paragraph 12 shall be 4 identical to the benefits provided under the State's approved 5 plan under Title XIX of the Social Security Act. The 6 Department must request federal approval of the coverage 7 under this paragraph 12 within 30 days after the effective 8 date of this amendatory Act of the 92nd General Assembly. 9 The Illinois Department and the Governor shall provide a 10 plan for coverage of the persons eligible under paragraph 7 11 as soon as possible after July 1, 1984. 12 The eligibility of any such person for medical assistance 13 under this Article is not affected by the payment of any 14 grant under the Senior Citizens and Disabled Persons Property 15 Tax Relief and Pharmaceutical Assistance Act or any 16 distributions or items of income described under subparagraph 17 (X) of paragraph (2) of subsection (a) of Section 203 of the 18 Illinois Income Tax Act. The Department shall by rule 19 establish the amounts of assets to be disregarded in 20 determining eligibility for medical assistance, which shall 21 at a minimum equal the amounts to be disregarded under the 22 Federal Supplemental Security Income Program. The amount of 23 assets of a single person to be disregarded shall not be less 24 than $2,000, and the amount of assets of a married couple to 25 be disregarded shall not be less than $3,000. 26 To the extent permitted under federal law, any person 27 found guilty of a second violation of Article VIIIA shall be 28 ineligible for medical assistance under this Article, as 29 provided in Section 8A-8. 30 The eligibility of any person for medical assistance 31 under this Article shall not be affected by the receipt by 32 the person of donations or benefits from fundraisers held for 33 the person in cases of serious illness, as long as neither 34 the person nor members of the person's family have actual HB0025 Engrossed -7- LRB9200896DJgc 1 control over the donations or benefits or the disbursement of 2 the donations or benefits. 3 (Source: P.A. 91-676, eff. 12-23-99; 91-699, eff. 7-1-00; 4 91-712, eff. 7-1-00; revised 6-26-00.) 5 Section 99. Effective date. This Act takes effect upon 6 becoming law.