Public Act 095-1055
 
SB1415 Enrolled LRB095 11023 DRJ 31338 b

    AN ACT concerning public aid.
 
    Be it enacted by the People of the State of Illinois,
represented in the General Assembly:
 
    Section 5. The Illinois Public Aid Code is amended by
changing Sections 4-2, 5-2, and 12-4.11 as follows:
 
    (305 ILCS 5/4-2)  (from Ch. 23, par. 4-2)
    Sec. 4-2. Amount of aid.
    (a) The amount and nature of financial aid shall be
determined in accordance with the grant amounts, rules and
regulations of the Illinois Department. Due regard shall be
given to the self-sufficiency requirements of the family and to
the income, money contributions and other support and resources
available, from whatever source. However, the amount and nature
of any financial aid is not affected by the payment of any
grant under the "Senior Citizens and Disabled Persons Property
Tax Relief and Pharmaceutical Assistance Act" or any
distributions or items of income described under subparagraph
(X) of paragraph (2) of subsection (a) of Section 203 of the
Illinois Income Tax Act. The aid shall be sufficient, when
added to all other income, money contributions and support to
provide the family with a grant in the amount established by
Department regulation.
    Subject to appropriation, beginning on July 1, 2008, the
Department of Human Services shall increase TANF grant amounts
in effect on June 30, 2008 by 15%. The Department is authorized
to administer this increase but may not otherwise adopt any
rule to implement this increase.
    (b) The Illinois Department may conduct special projects,
which may be known as Grant Diversion Projects, under which
recipients of financial aid under this Article are placed in
jobs and their grants are diverted to the employer who in turn
makes payments to the recipients in the form of salary or other
employment benefits. The Illinois Department shall by rule
specify the terms and conditions of such Grant Diversion
Projects. Such projects shall take into consideration and be
coordinated with the programs administered under the Illinois
Emergency Employment Development Act.
    (c) The amount and nature of the financial aid for a child
requiring care outside his own home shall be determined in
accordance with the rules and regulations of the Illinois
Department, with due regard to the needs and requirements of
the child in the foster home or institution in which he has
been placed.
    (d) If the Department establishes grants for family units
consisting exclusively of a pregnant woman with no dependent
child or including her husband if living with her, the grant
amount for such a unit shall be equal to the grant amount for
an assistance unit consisting of one adult, or 2 persons if the
husband is included. Other than as herein described, an unborn
child shall not be counted in determining the size of an
assistance unit or for calculating grants.
    Payments for basic maintenance requirements of a child or
children and the relative with whom the child or children are
living shall be prescribed, by rule, by the Illinois
Department.
    Grants under this Article shall not be supplemented by
General Assistance provided under Article VI.
    (e) Grants shall be paid to the parent or other person with
whom the child or children are living, except for such amount
as is paid in behalf of the child or his parent or other
relative to other persons or agencies pursuant to this Code or
the rules and regulations of the Illinois Department.
    (f) Subject to subsection (f-5), an assistance unit,
receiving financial aid under this Article or temporarily
ineligible to receive aid under this Article under a penalty
imposed by the Illinois Department for failure to comply with
the eligibility requirements or that voluntarily requests
termination of financial assistance under this Article and
becomes subsequently eligible for assistance within 9 months,
shall not receive any increase in the amount of aid solely on
account of the birth of a child; except that an increase is not
prohibited when the birth is (i) of a child of a pregnant woman
who became eligible for aid under this Article during the
pregnancy, or (ii) of a child born within 10 months after the
date of implementation of this subsection, or (iii) of a child
conceived after a family became ineligible for assistance due
to income or marriage and at least 3 months of ineligibility
expired before any reapplication for assistance. This
subsection does not, however, prevent a unit from receiving a
general increase in the amount of aid that is provided to all
recipients of aid under this Article.
    The Illinois Department is authorized to transfer funds,
and shall use any budgetary savings attributable to not
increasing the grants due to the births of additional children,
to supplement existing funding for employment and training
services for recipients of aid under this Article IV. The
Illinois Department shall target, to the extent the
supplemental funding allows, employment and training services
to the families who do not receive a grant increase after the
birth of a child. In addition, the Illinois Department shall
provide, to the extent the supplemental funding allows, such
families with up to 24 months of transitional child care
pursuant to Illinois Department rules. All remaining
supplemental funds shall be used for employment and training
services or transitional child care support.
    In making the transfers authorized by this subsection, the
Illinois Department shall first determine, pursuant to
regulations adopted by the Illinois Department for this
purpose, the amount of savings attributable to not increasing
the grants due to the births of additional children. Transfers
may be made from General Revenue Fund appropriations for
distributive purposes authorized by Article IV of this Code
only to General Revenue Fund appropriations for employability
development services including operating and administrative
costs and related distributive purposes under Article IXA of
this Code. The Director, with the approval of the Governor,
shall certify the amount and affected line item appropriations
to the State Comptroller.
    Nothing in this subsection shall be construed to prohibit
the Illinois Department from using funds under this Article IV
to provide assistance in the form of vouchers that may be used
to pay for goods and services deemed by the Illinois
Department, by rule, as suitable for the care of the child such
as diapers, clothing, school supplies, and cribs.
    (f-5) Subsection (f) shall not apply to affect the monthly
assistance amount of any family as a result of the birth of a
child on or after January 1, 2004. As resources permit after
January 1, 2004, the Department may cease applying subsection
(f) to limit assistance to families receiving assistance under
this Article on January 1, 2004, with respect to children born
prior to that date. In any event, subsection (f) shall be
completely inoperative on and after July 1, 2007.
    (g) (Blank).
    (h) Notwithstanding any other provision of this Code, the
Illinois Department is authorized to reduce payment levels used
to determine cash grants under this Article after December 31
of any fiscal year if the Illinois Department determines that
the caseload upon which the appropriations for the current
fiscal year are based have increased by more than 5% and the
appropriation is not sufficient to ensure that cash benefits
under this Article do not exceed the amounts appropriated for
those cash benefits. Reductions in payment levels may be
accomplished by emergency rule under Section 5-45 of the
Illinois Administrative Procedure Act, except that the
limitation on the number of emergency rules that may be adopted
in a 24-month period shall not apply and the provisions of
Sections 5-115 and 5-125 of the Illinois Administrative
Procedure Act shall not apply. Increases in payment levels
shall be accomplished only in accordance with Section 5-40 of
the Illinois Administrative Procedure Act. Before any rule to
increase payment levels promulgated under this Section shall
become effective, a joint resolution approving the rule must be
adopted by a roll call vote by a majority of the members
elected to each chamber of the General Assembly.
(Source: P.A. 92-111, eff. 1-1-02; 93-598, eff. 8-26-03.)
 
    (305 ILCS 5/5-2)  (from Ch. 23, par. 5-2)
    Sec. 5-2. Classes of Persons Eligible. Medical assistance
under this Article shall be available to any of the following
classes of persons in respect to whom a plan for coverage has
been submitted to the Governor by the Illinois Department and
approved by him:
        1. Recipients of basic maintenance grants under
    Articles III and IV.
        2. Persons otherwise eligible for basic maintenance
    under Articles III and IV but who fail to qualify
    thereunder on the basis of need, and who have insufficient
    income and resources to meet the costs of necessary medical
    care, including but not limited to the following:
            (a) All persons otherwise eligible for basic
        maintenance under Article III but who fail to qualify
        under that Article on the basis of need and who meet
        either of the following requirements:
                (i) their income, as determined by the
            Illinois Department in accordance with any federal
            requirements, is equal to or less than 70% in
            fiscal year 2001, equal to or less than 85% in
            fiscal year 2002 and until a date to be determined
            by the Department by rule, and equal to or less
            than 100% beginning on the date determined by the
            Department by rule, of the nonfarm income official
            poverty line, as defined by the federal Office of
            Management and Budget and revised annually in
            accordance with Section 673(2) of the Omnibus
            Budget Reconciliation Act of 1981, applicable to
            families of the same size; or
                (ii) their income, after the deduction of
            costs incurred for medical care and for other types
            of remedial care, is equal to or less than 70% in
            fiscal year 2001, equal to or less than 85% in
            fiscal year 2002 and until a date to be determined
            by the Department by rule, and equal to or less
            than 100% beginning on the date determined by the
            Department by rule, of the nonfarm income official
            poverty line, as defined in item (i) of this
            subparagraph (a).
            (b) All persons who would be determined eligible
        for such basic maintenance under Article IV by
        disregarding the maximum earned income permitted by
        federal law.
        3. Persons who would otherwise qualify for Aid to the
    Medically Indigent under Article VII.
        4. Persons not eligible under any of the preceding
    paragraphs who fall sick, are injured, or die, not having
    sufficient money, property or other resources to meet the
    costs of necessary medical care or funeral and burial
    expenses.
        5.(a) Women during pregnancy, after the fact of
    pregnancy has been determined by medical diagnosis, and
    during the 60-day period beginning on the last day of the
    pregnancy, together with their infants and children born
    after September 30, 1983, whose income and resources are
    insufficient to meet the costs of necessary medical care to
    the maximum extent possible under Title XIX of the Federal
    Social Security Act.
        (b) The Illinois Department and the Governor shall
    provide a plan for coverage of the persons eligible under
    paragraph 5(a) by April 1, 1990. Such plan shall provide
    ambulatory prenatal care to pregnant women during a
    presumptive eligibility period and establish an income
    eligibility standard that is equal to 133% of the nonfarm
    income official poverty line, as defined by the federal
    Office of Management and Budget and revised annually in
    accordance with Section 673(2) of the Omnibus Budget
    Reconciliation Act of 1981, applicable to families of the
    same size, provided that costs incurred for medical care
    are not taken into account in determining such income
    eligibility.
        (c) The Illinois Department may conduct a
    demonstration in at least one county that will provide
    medical assistance to pregnant women, together with their
    infants and children up to one year of age, where the
    income eligibility standard is set up to 185% of the
    nonfarm income official poverty line, as defined by the
    federal Office of Management and Budget. The Illinois
    Department shall seek and obtain necessary authorization
    provided under federal law to implement such a
    demonstration. Such demonstration may establish resource
    standards that are not more restrictive than those
    established under Article IV of this Code.
        6. Persons under the age of 18 who fail to qualify as
    dependent under Article IV and who have insufficient income
    and resources to meet the costs of necessary medical care
    to the maximum extent permitted under Title XIX of the
    Federal Social Security Act.
        7. Persons who are under 21 years of age and would
    qualify as disabled as defined under the Federal
    Supplemental Security Income Program, provided medical
    service for such persons would be eligible for Federal
    Financial Participation, and provided the Illinois
    Department determines that:
            (a) the person requires a level of care provided by
        a hospital, skilled nursing facility, or intermediate
        care facility, as determined by a physician licensed to
        practice medicine in all its branches;
            (b) it is appropriate to provide such care outside
        of an institution, as determined by a physician
        licensed to practice medicine in all its branches;
            (c) the estimated amount which would be expended
        for care outside the institution is not greater than
        the estimated amount which would be expended in an
        institution.
        8. Persons who become ineligible for basic maintenance
    assistance under Article IV of this Code in programs
    administered by the Illinois Department due to employment
    earnings and persons in assistance units comprised of
    adults and children who become ineligible for basic
    maintenance assistance under Article VI of this Code due to
    employment earnings. The plan for coverage for this class
    of persons shall:
            (a) extend the medical assistance coverage for up
        to 12 months following termination of basic
        maintenance assistance; and
            (b) offer persons who have initially received 6
        months of the coverage provided in paragraph (a) above,
        the option of receiving an additional 6 months of
        coverage, subject to the following:
                (i) such coverage shall be pursuant to
            provisions of the federal Social Security Act;
                (ii) such coverage shall include all services
            covered while the person was eligible for basic
            maintenance assistance;
                (iii) no premium shall be charged for such
            coverage; and
                (iv) such coverage shall be suspended in the
            event of a person's failure without good cause to
            file in a timely fashion reports required for this
            coverage under the Social Security Act and
            coverage shall be reinstated upon the filing of
            such reports if the person remains otherwise
            eligible.
        9. Persons with acquired immunodeficiency syndrome
    (AIDS) or with AIDS-related conditions with respect to whom
    there has been a determination that but for home or
    community-based services such individuals would require
    the level of care provided in an inpatient hospital,
    skilled nursing facility or intermediate care facility the
    cost of which is reimbursed under this Article. Assistance
    shall be provided to such persons to the maximum extent
    permitted under Title XIX of the Federal Social Security
    Act.
        10. Participants in the long-term care insurance
    partnership program established under the Illinois
    Long-Term Care Partnership Program Act Partnership for
    Long-Term Care Act who meet the qualifications for
    protection of resources described in Section 15 25 of that
    Act.
        11. Persons with disabilities who are employed and
    eligible for Medicaid, pursuant to Section
    1902(a)(10)(A)(ii)(xv) of the Social Security Act, as
    provided by the Illinois Department by rule. In
    establishing eligibility standards under this paragraph
    11, the Department shall, subject to federal approval:
            (a) set the income eligibility standard at not
        lower than 350% of the federal poverty level;
            (b) exempt retirement accounts that the person
        cannot access without penalty before the age of 59 1/2,
        and medical savings accounts established pursuant to
        26 U.S.C. 220;
            (c) allow non-exempt assets up to $25,000 as to
        those assets accumulated during periods of eligibility
        under this paragraph 11; and
            (d) continue to apply subparagraphs (b) and (c) in
        determining the eligibility of the person under this
        Article even if the person loses eligibility under this
        paragraph 11.
        12. Subject to federal approval, persons who are
    eligible for medical assistance coverage under applicable
    provisions of the federal Social Security Act and the
    federal Breast and Cervical Cancer Prevention and
    Treatment Act of 2000. Those eligible persons are defined
    to include, but not be limited to, the following persons:
            (1) persons who have been screened for breast or
        cervical cancer under the U.S. Centers for Disease
        Control and Prevention Breast and Cervical Cancer
        Program established under Title XV of the federal
        Public Health Services Act in accordance with the
        requirements of Section 1504 of that Act as
        administered by the Illinois Department of Public
        Health; and
            (2) persons whose screenings under the above
        program were funded in whole or in part by funds
        appropriated to the Illinois Department of Public
        Health for breast or cervical cancer screening.
        "Medical assistance" under this paragraph 12 shall be
    identical to the benefits provided under the State's
    approved plan under Title XIX of the Social Security Act.
    The Department must request federal approval of the
    coverage under this paragraph 12 within 30 days after the
    effective date of this amendatory Act of the 92nd General
    Assembly.
        13. Subject to appropriation and to federal approval,
    persons living with HIV/AIDS who are not otherwise eligible
    under this Article and who qualify for services covered
    under Section 5-5.04 as provided by the Illinois Department
    by rule.
        14. Subject to the availability of funds for this
    purpose, the Department may provide coverage under this
    Article to persons who reside in Illinois who are not
    eligible under any of the preceding paragraphs and who meet
    the income guidelines of paragraph 2(a) of this Section and
    (i) have an application for asylum pending before the
    federal Department of Homeland Security or on appeal before
    a court of competent jurisdiction and are represented
    either by counsel or by an advocate accredited by the
    federal Department of Homeland Security and employed by a
    not-for-profit organization in regard to that application
    or appeal, or (ii) are receiving services through a
    federally funded torture treatment center. Medical
    coverage under this paragraph 14 may be provided for up to
    24 continuous months from the initial eligibility date so
    long as an individual continues to satisfy the criteria of
    this paragraph 14. If an individual has an appeal pending
    regarding an application for asylum before the Department
    of Homeland Security, eligibility under this paragraph 14
    may be extended until a final decision is rendered on the
    appeal. The Department may adopt rules governing the
    implementation of this paragraph 14.
        15. Family Care Eligibility.
            (a) A caretaker relative who is 19 years of age or
        older when countable income is at or below 185% of the
        Federal Poverty Level Guidelines, as published
        annually in the Federal Register, for the appropriate
        family size. A person may not spend down to become
        eligible under this paragraph 15.
            (b) Eligibility shall be reviewed annually.
            (c) Caretaker relatives enrolled under this
        paragraph 15 in families with countable income above
        150% and at or below 185% of the Federal Poverty Level
        Guidelines shall be counted as family members and pay
        premiums as established under the Children's Health
        Insurance Program Act.
            (d) Premiums shall be billed by and payable to the
        Department or its authorized agent, on a monthly basis.
            (e) The premium due date is the last day of the
        month preceding the month of coverage.
            (f) Individuals shall have a grace period through
        the month of coverage to pay the premium.
            (g) Failure to pay the full monthly premium by the
        last day of the grace period shall result in
        termination of coverage.
            (h) Partial premium payments shall not be
        refunded.
            (i) Following termination of an individual's
        coverage under this paragraph 15, the following action
        is required before the individual can be re-enrolled:
                (1) A new application must be completed and the
            individual must be determined otherwise eligible.
                (2) There must be full payment of premiums due
            under this Code, the Children's Health Insurance
            Program Act, the Covering ALL KIDS Health
            Insurance Act, or any other healthcare program
            administered by the Department for periods in
            which a premium was owed and not paid for the
            individual.
                (3) The first month's premium must be paid if
            there was an unpaid premium on the date the
            individual's previous coverage was canceled.
        The Department is authorized to implement the
    provisions of this amendatory Act of the 95th General
    Assembly by adopting the medical assistance rules in effect
    as of October 1, 2007, at 89 Ill. Admin. Code 125, along
    with only those changes necessary to conform to federal
    Medicaid requirements. The Department may not otherwise
    adopt any rule to implement this increase except as
    authorized by law, to meet the eligibility standards
    authorized by the federal government in the Medicaid State
    Plan or the Title XXI Plan, or to meet an order from the
    federal government or any court.
    The Illinois Department and the Governor shall provide a
plan for coverage of the persons eligible under paragraph 7 as
soon as possible after July 1, 1984.
    The eligibility of any such person for medical assistance
under this Article is not affected by the payment of any grant
under the Senior Citizens and Disabled Persons Property Tax
Relief and Pharmaceutical Assistance Act or any distributions
or items of income described under subparagraph (X) of
paragraph (2) of subsection (a) of Section 203 of the Illinois
Income Tax Act. The Department shall by rule establish the
amounts of assets to be disregarded in determining eligibility
for medical assistance, which shall at a minimum equal the
amounts to be disregarded under the Federal Supplemental
Security Income Program. The amount of assets of a single
person to be disregarded shall not be less than $2,000, and the
amount of assets of a married couple to be disregarded shall
not be less than $3,000.
    To the extent permitted under federal law, any person found
guilty of a second violation of Article VIIIA shall be
ineligible for medical assistance under this Article, as
provided in Section 8A-8.
    The eligibility of any person for medical assistance under
this Article shall not be affected by the receipt by the person
of donations or benefits from fundraisers held for the person
in cases of serious illness, as long as neither the person nor
members of the person's family have actual control over the
donations or benefits or the disbursement of the donations or
benefits.
(Source: P.A. 94-629, eff. 1-1-06; 94-1043, eff. 7-24-06;
95-546, eff. 8-29-07; revised 1-22-08.)
 
    (305 ILCS 5/12-4.11)  (from Ch. 23, par. 12-4.11)
    Sec. 12-4.11. Grant amounts. The Department, with due
regard for and subject to budgetary limitations, shall
establish grant amounts for each of the programs, by
regulation. The grant amounts may vary by program, size of
assistance unit and geographic area.
    Aid payments shall not be reduced except: (1) for changes
in the cost of items included in the grant amounts, or (2) for
changes in the expenses of the recipient, or (3) for changes in
the income or resources available to the recipient, or (4) for
changes in grants resulting from adoption of a consolidated
grant amount.
    Subject to appropriation, beginning on July 1, 2008, the
Department of Human Services shall increase TANF grant amounts
in effect on June 30, 2008 by 15%. The Department is authorized
to administer this increase but may not otherwise adopt any
rule to implement this increase.
    In fixing standards to govern payments or reimbursements
for funeral and burial expenses, the Department shall establish
a minimum allowable amount of not less than $1,000 for
Department payment of funeral services and not less than $500
for Department payment of burial or cremation services. On
January 1, 2006, July 1, 2006, and July 1, 2007, the Department
shall increase the minimum reimbursement amount for funeral and
burial expenses under this Section by a percentage equal to the
percentage increase in the Consumer Price Index for All Urban
Consumers, if any, during the 12 months immediately preceding
that January 1 or July 1. In establishing the minimum allowable
amount, the Department shall take into account the services
essential to a dignified, low-cost (i) funeral and (ii) burial
or cremation, including reasonable amounts that may be
necessary for burial space and cemetery charges, and any
applicable taxes or other required governmental fees or
charges. If no person has agreed to pay the total cost of the
(i) funeral and (ii) burial or cremation charges, the
Department shall pay the vendor the actual costs of the (i)
funeral and (ii) burial or cremation, or the minimum allowable
amount for each service as established by the Department,
whichever is less, provided that the Department reduces its
payments by the amount available from the following sources:
the decedent's assets and available resources and the
anticipated amounts of any death benefits available to the
decedent's estate, and amounts paid and arranged to be paid by
the decedent's legally responsible relatives. A legally
responsible relative is expected to pay (i) funeral and (ii)
burial or cremation expenses unless financially unable to do
so.
    Nothing contained in this Section or in any other Section
of this Code shall be construed to prohibit the Illinois
Department (1) from consolidating existing standards on the
basis of any standards which are or were in effect on, or
subsequent to July 1, 1969, or (2) from employing any
consolidated standards in determining need for public aid and
the amount of money payment or grant for individual recipients
or recipient families.
(Source: P.A. 94-669, eff. 8-23-05.)
 
    Section 99. Effective date. This Act takes effect upon
becoming law.