093_HB0012eng

 
HB0012 Engrossed                     LRB093 02054 DRJ 02055 b

 1        AN ACT in relation to persons with disabilities.

 2        Be it enacted by the People of  the  State  of  Illinois,
 3    represented in the General Assembly:

 4        Section   5.    The   Mental   Health  and  Developmental
 5    Disabilities  Administrative  Act  is  amended  by   changing
 6    Section 57 as follows:

 7        (20 ILCS 1705/57) (from Ch. 91 1/2, par. 100-57)
 8        Sec.  57.   In  order  to  identify  the service needs of
 9    persons with autism, the Department shall study the needs  of
10    the  population.    The Department shall submit service needs
11    reports  to  the  General  Assembly  annually   which   shall
12    supplement the report submitted in accordance with Public Act
13    84-1291.   The  reports shall include an analysis of progress
14    made since  the  submission  of  that  report  in  the  areas
15    outlined  in  that  report,  with  emphasis  on the following
16    areas:
17        a.  Early intervention services for children with  autism
18    and their parents;
19        b.   Enhancement  of  family support mechanisms to enable
20    persons with autism to remain in a family  home  environment.
21    The  Department shall include in the report a plan to provide
22    family support  mechanisms to enable persons with  autism  to
23    remain in a family home environment;
24        c.   Services  for  adequate  transition  for people with
25    autism from public school programs  to  adult  work  and  day
26    programs; and
27        d.  Facilitation  of  placement of persons with autism in
28    the least restrictive community setting.
29        For the purpose of  this  service  needs  review,  autism
30    means   a  severely  incapacitating  life-long  developmental
31    disability which:
 
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 1        a.  may be manifested before a person  is  30  months  of
 2    age,
 3        b.  may be caused by physical disorders of the brain, and
 4        c.  is  characterized  by uneven intellectual development
 5    and a combination of disturbances in the rates and  sequences
 6    of  cognitive,  affective,  psychomotor,  language and speech
 7    development.  This syndrome is further evidenced by  abnormal
 8    responses  to  sensory stimuli, problems in developing social
 9    relationships, and ritualistic and compulsive behavior.
10    (Source: P.A. 85-971.)

11        Section 10.  The Illinois Public Aid Code is  amended  by
12    changing  Section 5-2 as follows:

13        (305 ILCS 5/5-2) (from Ch. 23, par. 5-2)
14        Sec.   5-2.  Classes   of   Persons   Eligible.   Medical
15    assistance under this Article shall be available  to  any  of
16    the  following  classes  of persons in respect to whom a plan
17    for coverage has  been  submitted  to  the  Governor  by  the
18    Illinois Department and approved by him:
19        1.  Recipients of basic maintenance grants under Articles
20    III and IV.
21        2.  Persons  otherwise  eligible  for  basic  maintenance
22    under  Articles III and IV but who fail to qualify thereunder
23    on the basis of need, and who have  insufficient  income  and
24    resources  to  meet  the  costs  of  necessary  medical care,
25    including but not limited to the following:
26             (a)  All  persons  otherwise  eligible   for   basic
27        maintenance  under  Article  III  but who fail to qualify
28        under that Article on the basis  of  need  and  who  meet
29        either of the following requirements:
30                  (i)  their   income,   as   determined  by  the
31             Illinois Department in accordance with  any  federal
32             requirements, is equal to or less than 70% in fiscal
 
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 1             year  2001, equal to or less than 85% in fiscal year
 2             2002 and until  a  date  to  be  determined  by  the
 3             Department  by  rule, and equal to or less than 100%
 4             beginning on the date determined by  the  Department
 5             by  rule,  of  the  nonfarm  income official poverty
 6             line, as defined by the federal Office of Management
 7             and Budget and revised annually in  accordance  with
 8             Section  673(2) of the Omnibus Budget Reconciliation
 9             Act of 1981, applicable  to  families  of  the  same
10             size; or
11                  (ii)  their  income,  after  the  deduction  of
12             costs  incurred for medical care and for other types
13             of remedial care, is equal to or less  than  70%  in
14             fiscal  year  2001,  equal  to  or  less than 85% in
15             fiscal year 2002 and until a date to  be  determined
16             by the Department by rule, and equal to or less than
17             100%   beginning  on  the  date  determined  by  the
18             Department by rule, of the nonfarm  income  official
19             poverty  line,  as  defined  in  item  (i)  of  this
20             subparagraph (a).
21             (b)  All  persons  who  would be determined eligible
22        for  such  basic  maintenance   under   Article   IV   by
23        disregarding  the  maximum  earned  income  permitted  by
24        federal law.
25        3.  Persons  who  would  otherwise qualify for Aid to the
26    Medically Indigent under Article VII.
27        4.  Persons not  eligible  under  any  of  the  preceding
28    paragraphs  who  fall  sick,  are injured, or die, not having
29    sufficient money, property or other  resources  to  meet  the
30    costs  of  necessary  medical  care  or  funeral  and  burial
31    expenses.
32        5. (a)  Women   during   pregnancy,  after  the  fact  of
33        pregnancy has been determined by medical  diagnosis,  and
34        during the 60-day period beginning on the last day of the
 
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 1        pregnancy,  together with their infants and children born
 2        after September 30, 1983, whose income and resources  are
 3        insufficient  to meet the costs of necessary medical care
 4        to the maximum extent possible under  Title  XIX  of  the
 5        Federal Social Security Act.
 6             (b)  The  Illinois Department and the Governor shall
 7        provide a plan for coverage of the persons eligible under
 8        paragraph 5(a) by April 1, 1990.  Such plan shall provide
 9        ambulatory prenatal  care  to  pregnant  women  during  a
10        presumptive  eligibility  period  and establish an income
11        eligibility standard that is equal to 133% of the nonfarm
12        income official poverty line, as defined by  the  federal
13        Office  of  Management and Budget and revised annually in
14        accordance with Section  673(2)  of  the  Omnibus  Budget
15        Reconciliation Act of 1981, applicable to families of the
16        same  size, provided that costs incurred for medical care
17        are not taken into account  in  determining  such  income
18        eligibility.
19             (c)  The   Illinois   Department   may   conduct   a
20        demonstration  in  at  least one county that will provide
21        medical assistance to pregnant women, together with their
22        infants and children up to one year  of  age,  where  the
23        income  eligibility  standard  is  set  up to 185% of the
24        nonfarm income official poverty line, as defined  by  the
25        federal  Office  of  Management  and Budget. The Illinois
26        Department shall seek and obtain necessary  authorization
27        provided   under   federal   law   to  implement  such  a
28        demonstration.  Such demonstration may establish resource
29        standards  that  are  not  more  restrictive  than  those
30        established under Article IV of this Code.
31        6.  Persons under the age of 18 who fail  to  qualify  as
32    dependent  under  Article IV and who have insufficient income
33    and resources to meet the costs of necessary medical care  to
34    the  maximum  extent permitted under Title XIX of the Federal
 
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 1    Social Security Act.
 2        7.  Persons who are 18 years of age or younger and  would
 3    qualify as disabled as defined under the Federal Supplemental
 4    Security  Income  Program,  provided medical service for such
 5    persons   would   be   eligible   for    Federal    Financial
 6    Participation,   and   provided   the   Illinois   Department
 7    determines that:
 8             (a)  the person requires a level of care provided by
 9        a  hospital,  skilled  nursing  facility, or intermediate
10        care facility, as determined by a physician  licensed  to
11        practice medicine in all its branches;
12             (b)  it  is appropriate to provide such care outside
13        of an institution, as determined by a physician  licensed
14        to practice medicine in all its branches;
15             (c)  the  estimated  amount  which would be expended
16        for care outside the institution is not greater than  the
17        estimated   amount   which   would   be  expended  in  an
18        institution.
19        8.  Persons who become ineligible for  basic  maintenance
20    assistance   under  Article  IV  of  this  Code  in  programs
21    administered by the Illinois  Department  due  to  employment
22    earnings  and persons in assistance units comprised of adults
23    and children who  become  ineligible  for  basic  maintenance
24    assistance  under  Article  VI of this Code due to employment
25    earnings.  The plan for coverage for this  class  of  persons
26    shall:
27             (a)  extend  the  medical assistance coverage for up
28        to 12 months following termination of  basic  maintenance
29        assistance; and
30             (b)  offer  persons  who  have  initially received 6
31        months of the coverage provided in paragraph  (a)  above,
32        the  option  of  receiving  an  additional  6  months  of
33        coverage, subject to the following:
34                  (i)  such   coverage   shall   be  pursuant  to
 
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 1             provisions of the federal Social Security Act;
 2                  (ii)  such coverage shall include all  services
 3             covered  while  the  person  was  eligible for basic
 4             maintenance assistance;
 5                  (iii)  no premium shall  be  charged  for  such
 6             coverage; and
 7                  (iv)  such  coverage  shall be suspended in the
 8             event of a person's failure without  good  cause  to
 9             file  in  a timely fashion reports required for this
10             coverage under the Social Security Act and  coverage
11             shall  be reinstated upon the filing of such reports
12             if the person remains otherwise eligible.
13        9.  Persons  with  acquired   immunodeficiency   syndrome
14    (AIDS)  or  with AIDS-related conditions with respect to whom
15    there  has  been  a  determination  that  but  for  home   or
16    community-based  services  such individuals would require the
17    level of care provided  in  an  inpatient  hospital,  skilled
18    nursing  facility  or  intermediate care facility the cost of
19    which is reimbursed under this Article.  Assistance shall  be
20    provided  to  such  persons  to  the maximum extent permitted
21    under Title XIX of the Federal Social Security Act.
22        10.  Participants  in  the   long-term   care   insurance
23    partnership  program  established  under  the Partnership for
24    Long-Term Care Act who meet the qualifications for protection
25    of resources described in Section 25 of that Act.
26        11.  Persons  with  disabilities  who  are  employed  and
27    eligible    for     Medicaid,     pursuant     to     Section
28    1902(a)(10)(A)(ii)(xv)   of   the  Social  Security  Act,  as
29    provided by the Illinois Department by rule.
30        12.  Subject  to  federal  approval,  persons   who   are
31    eligible  for  medical  assistance  coverage under applicable
32    provisions of the federal Social Security Act and the federal
33    Breast and Cervical Cancer Prevention and  Treatment  Act  of
34    2000.  Those eligible persons are defined to include, but not
 
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 1    be limited to, the following persons:
 2             (1)  persons  who  have  been screened for breast or
 3        cervical  cancer  under  the  U.S.  Centers  for  Disease
 4        Control and Prevention Breast and Cervical Cancer Program
 5        established under Title XV of the federal  Public  Health
 6        Services  Act  in  accordance  with  the  requirements of
 7        Section 1504 of that Act as administered by the  Illinois
 8        Department of Public Health; and
 9             (2)  persons   whose   screenings  under  the  above
10        program  were  funded  in  whole  or  in  part  by  funds
11        appropriated to the Illinois Department of Public  Health
12        for breast or cervical cancer screening.
13    "Medical   assistance"  under  this  paragraph  12  shall  be
14    identical to the benefits provided under the State's approved
15    plan under  Title  XIX  of  the  Social  Security  Act.   The
16    Department  must  request  federal  approval  of the coverage
17    under this paragraph 12 within 30 days  after  the  effective
18    date of this amendatory Act of the 92nd General Assembly.
19        13.  Persons  who are older than 18 years of age and have
20    received benefits under paragraph 7  of  this  Section  shall
21    remain  eligible  for continued benefits at the same level of
22    care,  provided  that  a  physician,  licensed  to   practice
23    medicine  in  all  its branches, annually determines that the
24    person requires the level of care  provided  by  a  hospital,
25    skilled  nursing  facility,  or  intermediate  care facility.
26    Continued benefits shall  not  be  dependent  on  the  person
27    meeting   eligibility   requirements  for  federal  financial
28    participation.  The Department of Human Services must make an
29    annual report to the Governor and the General  Assembly  with
30    respect   to  the  class  of  persons  eligible  for  medical
31    assistance under this paragraph 13.  The  report  is  due  on
32    January  1  of each year and must cover the State fiscal year
33    ending on June 30 of the preceding year. The first report  is
34    due on January 1, 2005. The report must include the following
 
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 1    information for the fiscal year covered by the report:
 2             (a)  The  number  of  persons  eligible  for medical
 3        assistance under this paragraph 13.
 4             (b) The number of persons who  applied  for  medical
 5        assistance under this paragraph 13.
 6             (c)  The  number  of  persons  who  received medical
 7        assistance under this paragraph 13.
 8             (d) The number of persons who  were  denied  medical
 9        assistance  under  this  paragraph  13, together with the
10        reasons for the denial of assistance.
11             (e) The nature, scope, and cost of services provided
12        under this paragraph 13.
13             (f) The comparative cost of providing those services
14        in a hospital, skilled nursing facility, or  intermediate
15        care facility.
16        The  Illinois Department and the Governor shall provide a
17    plan for coverage of the persons eligible under  paragraph  7
18    as soon as possible after July 1, 1984.
19        The eligibility of any such person for medical assistance
20    under  this  Article  is  not  affected by the payment of any
21    grant under the Senior Citizens and Disabled Persons Property
22    Tax  Relief  and  Pharmaceutical  Assistance   Act   or   any
23    distributions or items of income described under subparagraph
24    (X)  of paragraph (2) of subsection (a) of Section 203 of the
25    Illinois Income  Tax  Act.   The  Department  shall  by  rule
26    establish   the  amounts  of  assets  to  be  disregarded  in
27    determining eligibility for medical assistance,  which  shall
28    at  a  minimum  equal the amounts to be disregarded under the
29    Federal Supplemental Security Income Program.  The amount  of
30    assets of a single person to be disregarded shall not be less
31    than  $2,000, and the amount of assets of a married couple to
32    be disregarded shall not be less than $3,000.
33        To the extent permitted under  federal  law,  any  person
34    found  guilty of a second violation of Article VIIIA shall be
 
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 1    ineligible for medical  assistance  under  this  Article,  as
 2    provided in Section 8A-8.
 3        The  eligibility  of  any  person  for medical assistance
 4    under this Article shall not be affected by  the  receipt  by
 5    the person of donations or benefits from fundraisers held for
 6    the  person  in  cases of serious illness, as long as neither
 7    the person nor members of the  person's  family  have  actual
 8    control over the donations or benefits or the disbursement of
 9    the donations or benefits.
10    (Source: P.A.  91-676,  eff.  12-23-99;  91-699, eff. 7-1-00;
11    91-712, eff. 7-1-00; 92-16, eff. 6-28-01; 92-47, eff. 7-3-01;
12    92-597, eff. 6-28-02.)

13        Section 99.  Effective date.  This Act takes effect  upon
14    becoming law.