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91_HB4269eng
HB4269 Engrossed LRB9111636SMks
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 1.5. Non-custodial parents of children in families that
16 receive basic maintenance grants under Article IV, to the
17 extent that the non-custodial parents are defined as part of
18 the family for purposes of this Section by the Department of
19 Human Services and to the extent that federal matching funds
20 are available for covering the non-custodial parents. If a
21 waiver of federal law is necessary in order to obtain federal
22 matching funds for coverage of the non-custodial parents, the
23 Department shall promptly seek the waiver and promptly
24 implement the coverage upon approval of the waiver. The
25 obligation of non-custodial parents to meet a spend-down
26 requirement shall be calculated according to the income and
27 other circumstances in the non-custodial parent's own
28 household.
29 2. Persons otherwise eligible for basic maintenance
30 under Articles III and IV but who fail to qualify thereunder
31 on the basis of need, and who have insufficient income and
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1 resources to meet the costs of necessary medical care,
2 including but not limited to, all persons who would be
3 determined eligible for such basic maintenance under Article
4 IV by disregarding the maximum earned income permitted by
5 federal law.
6 3. Persons who would otherwise qualify for Aid to the
7 Medically Indigent under Article VII.
8 4. Persons not eligible under any of the preceding
9 paragraphs who fall sick, are injured, or die, not having
10 sufficient money, property or other resources to meet the
11 costs of necessary medical care or funeral and burial
12 expenses.
13 5. (a) Women during pregnancy, after the fact of
14 pregnancy has been determined by medical diagnosis, and
15 during the 60-day period beginning on the last day of the
16 pregnancy, together with their infants and children born
17 after September 30, 1983, whose income and resources are
18 insufficient to meet the costs of necessary medical care
19 to the maximum extent possible under Title XIX of the
20 Federal Social Security Act.
21 (b) The Illinois Department and the Governor shall
22 provide a plan for coverage of the persons eligible under
23 paragraph 5(a) by April 1, 1990. Such plan shall provide
24 ambulatory prenatal care to pregnant women during a
25 presumptive eligibility period and establish an income
26 eligibility standard that is equal to 133% of the nonfarm
27 income official poverty line, as defined by the federal
28 Office of Management and Budget and revised annually in
29 accordance with Section 673(2) of the Omnibus Budget
30 Reconciliation Act of 1981, applicable to families of the
31 same size, provided that costs incurred for medical care
32 are not taken into account in determining such income
33 eligibility.
34 (c) The Illinois Department may conduct a
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1 demonstration in at least one county that will provide
2 medical assistance to pregnant women, together with their
3 infants and children up to one year of age, where the
4 income eligibility standard is set up to 185% of the
5 nonfarm income official poverty line, as defined by the
6 federal Office of Management and Budget. The Illinois
7 Department shall seek and obtain necessary authorization
8 provided under federal law to implement such a
9 demonstration. Such demonstration may establish resource
10 standards that are not more restrictive than those
11 established under Article IV of this Code.
12 6. Persons under the age of 18 who fail to qualify as
13 dependent under Article IV and who have insufficient income
14 and resources to meet the costs of necessary medical care to
15 the maximum extent permitted under Title XIX of the Federal
16 Social Security Act.
17 7. Persons who are 18 years of age or younger and would
18 qualify as disabled as defined under the Federal Supplemental
19 Security Income Program, provided medical service for such
20 persons would be eligible for Federal Financial
21 Participation, and provided the Illinois Department
22 determines that:
23 (a) the person requires a level of care provided by
24 a hospital, skilled nursing facility, or intermediate
25 care facility, as determined by a physician licensed to
26 practice medicine in all its branches;
27 (b) it is appropriate to provide such care outside
28 of an institution, as determined by a physician licensed
29 to practice medicine in all its branches;
30 (c) the estimated amount which would be expended
31 for care outside the institution is not greater than the
32 estimated amount which would be expended in an
33 institution.
34 8. Persons who become ineligible for basic maintenance
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1 assistance under Article IV of this Code in programs
2 administered by the Illinois Department due to employment
3 earnings and persons in assistance units comprised of adults
4 and children who become ineligible for basic maintenance
5 assistance under Article VI of this Code due to employment
6 earnings. The plan for coverage for this class of persons
7 shall:
8 (a) extend the medical assistance coverage for up
9 to 12 months following termination of basic maintenance
10 assistance; and
11 (b) offer persons who have initially received 6
12 months of the coverage provided in paragraph (a) above,
13 the option of receiving an additional 6 months of
14 coverage, subject to the following:
15 (i) such coverage shall be pursuant to
16 provisions of the federal Social Security Act;
17 (ii) such coverage shall include all services
18 covered while the person was eligible for basic
19 maintenance assistance;
20 (iii) no premium shall be charged for such
21 coverage; and
22 (iv) such coverage shall be suspended in the
23 event of a person's failure without good cause to
24 file in a timely fashion reports required for this
25 coverage under the Social Security Act and coverage
26 shall be reinstated upon the filing of such reports
27 if the person remains otherwise eligible.
28 9. Persons with acquired immunodeficiency syndrome
29 (AIDS) or with AIDS-related conditions with respect to whom
30 there has been a determination that but for home or
31 community-based services such individuals would require the
32 level of care provided in an inpatient hospital, skilled
33 nursing facility or intermediate care facility the cost of
34 which is reimbursed under this Article. Assistance shall be
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1 provided to such persons to the maximum extent permitted
2 under Title XIX of the Federal Social Security Act.
3 10. Participants in the long-term care insurance
4 partnership program established under the Partnership for
5 Long-Term Care Act who meet the qualifications for protection
6 of resources described in Section 25 of that Act.
7 The Illinois Department and the Governor shall provide a
8 plan for coverage of the persons eligible under paragraph 7
9 as soon as possible after July 1, 1984.
10 The eligibility of any such person for medical assistance
11 under this Article is not affected by the payment of any
12 grant under the Senior Citizens and Disabled Persons Property
13 Tax Relief and Pharmaceutical Assistance Act or any
14 distributions or items of income described under subparagraph
15 (X) of paragraph (2) of subsection (a) of Section 203 of the
16 Illinois Income Tax Act. The Department shall by rule
17 establish the amounts of assets to be disregarded in
18 determining eligibility for medical assistance, which shall
19 at a minimum equal the amounts to be disregarded under the
20 Federal Supplemental Security Income Program. The amount of
21 assets of a single person to be disregarded shall not be less
22 than $2,000, and the amount of assets of a married couple to
23 be disregarded shall not be less than $3,000.
24 To the extent permitted under federal law, any person
25 found guilty of a second violation of Article VIIIA shall be
26 ineligible for medical assistance under this Article, as
27 provided in Section 8A-8.
28 The eligibility of any person for medical assistance
29 under this Article shall not be affected by the receipt by
30 the person of donations or benefits from fundraisers held for
31 the person in cases of serious illness, as long as neither
32 the person nor members of the person's family have actual
33 control over the donations or benefits or the disbursement of
34 the donations or benefits.
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1 (Source: P.A. 91-676, eff. 12-23-99.)
2 Section 99. Effective date. This Act takes effect upon
3 becoming law.
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