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[ House Amendment 001 ] |
92_HB0025ham002 LRB9200896DJgcam05 1 AMENDMENT TO HOUSE BILL 25 2 AMENDMENT NO. . Amend House Bill 25, AS AMENDED, by 3 replacing the title with the following: 4 "AN ACT in relation to public aid."; and 5 by replacing everything after the enacting clause with the 6 following: 7 "Section 5. The Illinois Public Aid Code is amended by 8 changing Section 5-2 as follows: 9 (305 ILCS 5/5-2) (from Ch. 23, par. 5-2) 10 Sec. 5-2. Classes of Persons Eligible. Medical 11 assistance under this Article shall be available to any of 12 the following classes of persons in respect to whom a plan 13 for coverage has been submitted to the Governor by the 14 Illinois Department and approved by him: 15 1. Recipients of basic maintenance grants under Articles 16 III and IV. 17 2. Persons otherwise eligible for basic maintenance 18 under Articles III and IV but who fail to qualify thereunder 19 on the basis of need, and who have insufficient income and 20 resources to meet the costs of necessary medical care, 21 including but not limited to the following: -2- LRB9200896DJgcam05 1 (a) All persons otherwise eligible for basic 2 maintenance under Article III but who fail to qualify 3 under that Article on the basis of need and who meet 4 either of the following requirements: 5 (i) their income, as determined by the 6 Illinois Department in accordance with any federal 7 requirements, is equal to or less than 70% in fiscal 8 year 2001, equal to or less than 85% in fiscal year 9 2002, and equal to or less than 100% in fiscal year 10 2003 and thereafter of the nonfarm income official 11 poverty line, as defined by the federal Office of 12 Management and Budget and revised annually in 13 accordance with Section 673(2) of the Omnibus Budget 14 Reconciliation Act of 1981, applicable to families 15 of the same size; or 16 (ii) their income, after the deduction of 17 costs incurred for medical care and for other types 18 of remedial care, is equal to or less than 70% in 19 fiscal year 2001, equal to or less than 85% in 20 fiscal year 2002, and equal to or less than 100% in 21 fiscal year 2003 and thereafter of the nonfarm 22 income official poverty line, as defined in item (i) 23 of this subparagraph (a). 24 (b) All persons who would be determined eligible 25 for such basic maintenance under Article IV by 26 disregarding the maximum earned income permitted by 27 federal law. 28 3. Persons who would otherwise qualify for Aid to the 29 Medically Indigent under Article VII. 30 4. Persons not eligible under any of the preceding 31 paragraphs who fall sick, are injured, or die, not having 32 sufficient money, property or other resources to meet the 33 costs of necessary medical care or funeral and burial 34 expenses. -3- LRB9200896DJgcam05 1 5. (a) Women during pregnancy, after the fact of 2 pregnancy has been determined by medical diagnosis, and 3 during the 60-day period beginning on the last day of the 4 pregnancy, together with their infants and children born 5 after September 30, 1983, whose income and resources are 6 insufficient to meet the costs of necessary medical care 7 to the maximum extent possible under Title XIX of the 8 Federal Social Security Act. 9 (b) The Illinois Department and the Governor shall 10 provide a plan for coverage of the persons eligible under 11 paragraph 5(a) by April 1, 1990. Such plan shall provide 12 ambulatory prenatal care to pregnant women during a 13 presumptive eligibility period and establish an income 14 eligibility standard that is equal to 133% of the nonfarm 15 income official poverty line, as defined by the federal 16 Office of Management and Budget and revised annually in 17 accordance with Section 673(2) of the Omnibus Budget 18 Reconciliation Act of 1981, applicable to families of the 19 same size, provided that costs incurred for medical care 20 are not taken into account in determining such income 21 eligibility. 22 (c) The Illinois Department may conduct a 23 demonstration in at least one county that will provide 24 medical assistance to pregnant women, together with their 25 infants and children up to one year of age, where the 26 income eligibility standard is set up to 185% of the 27 nonfarm income official poverty line, as defined by the 28 federal Office of Management and Budget. The Illinois 29 Department shall seek and obtain necessary authorization 30 provided under federal law to implement such a 31 demonstration. Such demonstration may establish resource 32 standards that are not more restrictive than those 33 established under Article IV of this Code. 34 6. Persons under the age of 18 who fail to qualify as -4- LRB9200896DJgcam05 1 dependent under Article IV and who have insufficient income 2 and resources to meet the costs of necessary medical care to 3 the maximum extent permitted under Title XIX of the Federal 4 Social Security Act. 5 7. Persons who are 18 years of age or younger and would 6 qualify as disabled as defined under the Federal Supplemental 7 Security Income Program, provided medical service for such 8 persons would be eligible for Federal Financial 9 Participation, and provided the Illinois Department 10 determines that: 11 (a) the person requires a level of care provided by 12 a hospital, skilled nursing facility, or intermediate 13 care facility, as determined by a physician licensed to 14 practice medicine in all its branches; 15 (b) it is appropriate to provide such care outside 16 of an institution, as determined by a physician licensed 17 to practice medicine in all its branches; 18 (c) the estimated amount which would be expended 19 for care outside the institution is not greater than the 20 estimated amount which would be expended in an 21 institution. 22 8. Persons who become ineligible for basic maintenance 23 assistance under Article IV of this Code in programs 24 administered by the Illinois Department due to employment 25 earnings and persons in assistance units comprised of adults 26 and children who become ineligible for basic maintenance 27 assistance under Article VI of this Code due to employment 28 earnings. The plan for coverage for this class of persons 29 shall: 30 (a) extend the medical assistance coverage for up 31 to 12 months following termination of basic maintenance 32 assistance; and 33 (b) offer persons who have initially received 6 34 months of the coverage provided in paragraph (a) above, -5- LRB9200896DJgcam05 1 the option of receiving an additional 6 months of 2 coverage, subject to the following: 3 (i) such coverage shall be pursuant to 4 provisions of the federal Social Security Act; 5 (ii) such coverage shall include all services 6 covered while the person was eligible for basic 7 maintenance assistance; 8 (iii) no premium shall be charged for such 9 coverage; and 10 (iv) such coverage shall be suspended in the 11 event of a person's failure without good cause to 12 file in a timely fashion reports required for this 13 coverage under the Social Security Act and coverage 14 shall be reinstated upon the filing of such reports 15 if the person remains otherwise eligible. 16 9. Persons with acquired immunodeficiency syndrome 17 (AIDS) or with AIDS-related conditions with respect to whom 18 there has been a determination that but for home or 19 community-based services such individuals would require the 20 level of care provided in an inpatient hospital, skilled 21 nursing facility or intermediate care facility the cost of 22 which is reimbursed under this Article. Assistance shall be 23 provided to such persons to the maximum extent permitted 24 under Title XIX of the Federal Social Security Act. 25 10. Participants in the long-term care insurance 26 partnership program established under the Partnership for 27 Long-Term Care Act who meet the qualifications for protection 28 of resources described in Section 25 of that Act. 29 11. Persons with disabilities who are employed and 30 eligible for Medicaid, pursuant to Section 31 1902(a)(10)(A)(ii)(xv) of the Social Security Act, as 32 provided by the Illinois Department by rule. 33 12. Subject to federal approval, persons who are 34 eligible for medical assistance coverage under applicable -6- LRB9200896DJgcam05 1 provisions of the federal Social Security Act and the 2 federal Breast and Cervical Cancer Prevention and Treatment 3 Act of 2000. Those eligible persons are defined to include, 4 but not be limited to, the following persons: 5 (1) persons who have been screened for breast or 6 cervical cancer under the U.S. Centers for Disease 7 Control and Prevention breast and cervical cancer program 8 established under Title XV of the federal Public Health 9 Services Act in accordance with the requirements of 10 Section 1504 of that Act as administered by the Illinois 11 Department of Public Health; and 12 (2) persons whose screenings under the above 13 program were funded in whole or in part by funds 14 appropriated to the Illinois Department of Public Health 15 for breast or cervical cancer screening. 16 "Medical assistance" under this paragraph 12 shall be 17 identical to the benefits provided under the State's approved 18 plan under Title XIX of the Social Security Act. The 19 Department must request federal approval of the coverage 20 under this paragraph 12 within 30 days after the effective 21 date of this amendatory Act of the 92nd General Assembly. 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 or any 29 distributions or items of income described under subparagraph 30 (X) of paragraph (2) of subsection (a) of Section 203 of the 31 Illinois Income Tax Act. The Department shall by rule 32 establish the amounts of assets to be disregarded in 33 determining eligibility for medical assistance, which shall 34 at a minimum equal the amounts to be disregarded under the -7- LRB9200896DJgcam05 1 Federal Supplemental Security Income Program. The amount of 2 assets of a single person to be disregarded shall not be less 3 than $2,000, and the amount of assets of a married couple to 4 be disregarded shall not be less than $3,000. 5 To the extent permitted under federal law, any person 6 found guilty of a second violation of Article VIIIA shall be 7 ineligible for medical assistance under this Article, as 8 provided in Section 8A-8. 9 The eligibility of any person for medical assistance 10 under this Article shall not be affected by the receipt by 11 the person of donations or benefits from fundraisers held for 12 the person in cases of serious illness, as long as neither 13 the person nor members of the person's family have actual 14 control over the donations or benefits or the disbursement of 15 the donations or benefits. 16 (Source: P.A. 91-676, eff. 12-23-99; 91-699, eff. 7-1-00; 17 91-712, eff. 7-1-00; revised 6-26-00.) 18 Section 99. Effective date. This Act takes effect upon 19 becoming law.".