Full Text of SB1855 96th General Assembly
SB1855 96TH GENERAL ASSEMBLY
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96TH GENERAL ASSEMBLY
State of Illinois
2009 and 2010 SB1855
Introduced 2/20/2009, by Sen. Jeffrey M. Schoenberg SYNOPSIS AS INTRODUCED: |
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305 ILCS 5/Art. V-F heading new |
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305 ILCS 5/5F-5 new |
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305 ILCS 5/5F-10 new |
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305 ILCS 5/5F-15 new |
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305 ILCS 5/5F-20 new |
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305 ILCS 5/6-11 |
from Ch. 23, par. 6-11 |
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Amends the Illinois Public Aid Code. Provides for medical assistance eligibility for persons who are: (i) age 50 through 64, or age 19 through 50 and meet certain requirements in connection with the Supplemental Security Income (SSI) program; (ii) have no medical insurance coverage; and (iii) have countable income equal to or less than 100% of the federal poverty income guidelines. Provides that these persons may be required to choose a medical home and a primary care provider. Provides that medical assistance under these provisions shall be identical to the benefits provided under the State's approved Medicaid plan, except that long-term care services shall not be covered. Requires the Department of Healthcare and Family Services to seek to maximize federal financial assistance. Effective January 1, 2010.
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A BILL FOR
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SB1855 |
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LRB096 05702 DRJ 15768 b |
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| AN ACT concerning public aid.
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| Be it enacted by the People of the State of Illinois,
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| represented in the General Assembly:
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| Section 5. The Illinois Public Aid Code is amended by | 5 |
| changing Section 6-11 and by adding the heading of Article V-F | 6 |
| and Sections 5F-5, 5F-10, 5F-15, and 5F-20 as follows: | 7 |
| (305 ILCS 5/Art. V-F heading new) | 8 |
| ARTICLE V-F. ACCESS TO MEDICAL ASSISTANCE | 9 |
| (305 ILCS 5/5F-5 new) | 10 |
| Sec. 5F-5. Purpose of Article. The purpose of this Article | 11 |
| V-F is to provide medical assistance to or in behalf of any | 12 |
| person who meets the eligibility conditions set forth in this | 13 |
| Article. | 14 |
| (305 ILCS 5/5F-10 new) | 15 |
| Sec. 5F-10. Eligibility. | 16 |
| (a) Any person who is not otherwise eligible for medical | 17 |
| assistance under this Code shall be eligible for medical | 18 |
| assistance under this Article if he or she meets all of the | 19 |
| following criteria: | 20 |
| (1) He or she is either: | 21 |
| (A) at least 50 years of age and not older than 64 |
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| years of age; or | 2 |
| (B) at least 19 years of age and not older than 50 | 3 |
| years of age, has applied for federal Supplemental | 4 |
| Security Income (SSI), has been determined by the | 5 |
| Department of Healthcare and Family Services to be | 6 |
| probably eligible for SSI on the basis of disability, | 7 |
| and has not received a final administrative decision | 8 |
| from the federal Social Security Administration on the | 9 |
| most recently filed application for SSI that he or she | 10 |
| is not disabled. | 11 |
| (2) He or she has no medical insurance coverage at the | 12 |
| time of application for medical assistance. | 13 |
| (3) He or she has countable income that is equal to or | 14 |
| less than 100% of the federal poverty income guidelines as | 15 |
| updated periodically in the Federal Register by the U.S. | 16 |
| Department of Health and Human Services. A person's | 17 |
| countable income shall be determined using the methodology | 18 |
| used to determine countable income under paragraph 1(a)(i) | 19 |
| of Section 5-2 that is in effect on the effective date of | 20 |
| this amendatory Act of the 96th General Assembly. | 21 |
| (b) Notwithstanding any other provisions of this Code, | 22 |
| eligible non-citizens, as defined in Section 1-11, may qualify | 23 |
| for medical assistance under this Article regardless of when | 24 |
| they entered the United States. | 25 |
| (305 ILCS 5/5F-15 new) |
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| Sec. 5F-15. Scope of coverage. The Department of Healthcare | 2 |
| and Family Services may require that persons enrolled under | 3 |
| this Article choose a medical home and a primary care provider. | 4 |
| Medical assistance under this Article shall be identical to the | 5 |
| benefits provided under the State's approved plan under Title | 6 |
| XIX of the Social Security Act, except that long-term care | 7 |
| services shall not be covered. For services provided to persons | 8 |
| for whom federal matching funds are not available, the | 9 |
| Department may establish rates of reimbursement for, and make | 10 |
| payments to, providers that are owned or operated by a State | 11 |
| agency, a State university, or a county with a population of | 12 |
| 3,000,000 or more that differ from rates otherwise established | 13 |
| under this Code. | 14 |
| (305 ILCS 5/5F-20 new) | 15 |
| Sec. 5F-20. Maximization of federal assistance. The | 16 |
| Department of Healthcare and Family Services shall undertake | 17 |
| all efforts to secure federal matching funds for the costs of | 18 |
| coverage under this Article, including, but not limited to, | 19 |
| requiring that all enrollees under this Article apply for all | 20 |
| federal benefits for which they may be entitled, including | 21 |
| Supplemental Security Income.
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| (305 ILCS 5/6-11) (from Ch. 23, par. 6-11)
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| Sec. 6-11. State funded General Assistance.
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| (a) Effective July 1, 1992, all State funded General |
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| Assistance and related
medical benefits shall be governed by | 2 |
| this Section , except that medical assistance for individuals | 3 |
| eligible under Article V-F of this Code shall be governed by | 4 |
| that Article . Other parts of this Code
or other laws related to | 5 |
| General Assistance shall remain in effect to the
extent they do | 6 |
| not conflict with the provisions of this Section. If any other
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| part of this Code or other laws of this State conflict with the | 8 |
| provisions of
this Section, the provisions of this Section | 9 |
| shall control.
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| (b) State funded General Assistance shall consist of 2 | 11 |
| separate
programs. One program shall be for adults with no | 12 |
| children and shall be
known as State Transitional Assistance. | 13 |
| The other program shall be for
families with children and for | 14 |
| pregnant women and shall be known as State
Family and Children | 15 |
| Assistance.
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| (c) (1) To be eligible for State Transitional Assistance on | 17 |
| or after July
1, 1992, an individual must be ineligible for | 18 |
| assistance under any other
Article of this Code, must be | 19 |
| determined chronically needy, and must be one of
the following:
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| (A) age 18 or over or
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| (B) married and living with a spouse, regardless of | 22 |
| age.
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| (2) The Illinois Department or the local governmental unit | 24 |
| shall determine
whether individuals are chronically needy as | 25 |
| follows:
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| (A) Individuals who have applied for Supplemental |
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| Security Income (SSI)
and are awaiting a decision on | 2 |
| eligibility for SSI who are determined disabled
by
the | 3 |
| Illinois Department using the SSI standard shall be | 4 |
| considered chronically
needy, except that individuals | 5 |
| whose disability is based solely on substance
addictions | 6 |
| (drug abuse and alcoholism) and whose disability would | 7 |
| cease were
their addictions to end shall be eligible only | 8 |
| for medical assistance and shall
not be eligible for cash | 9 |
| assistance under the State Transitional Assistance
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| program.
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| (B) If an individual has been denied SSI due to a | 12 |
| finding of "not
disabled" (either at the Administrative Law | 13 |
| Judge level or above, or at a lower
level if that | 14 |
| determination was not appealed), the Illinois Department | 15 |
| shall
adopt that finding and the individual shall not be | 16 |
| eligible for State
Transitional Assistance or any related | 17 |
| medical benefits. Such an individual
may not be determined | 18 |
| disabled by the Illinois Department for a period of 12
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| months, unless the individual shows that there has been a | 20 |
| substantial change in
his or her medical condition or that | 21 |
| there has been a substantial change in
other factors, such | 22 |
| as age or work experience, that might change the
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| determination of disability.
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| (C) The Illinois Department, by rule, may specify other | 25 |
| categories of
individuals as chronically needy; nothing in | 26 |
| this Section, however, shall be
deemed to require the |
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| inclusion of any specific category other than as
specified | 2 |
| in paragraphs (A) and (B).
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| (3) For individuals in State Transitional Assistance who | 4 |
| are not eligible for medical assistance under Article V-F of | 5 |
| this Code , medical assistance
shall be provided in an amount | 6 |
| and nature determined by the Department
of Healthcare and | 7 |
| Family Services by rule. The amount and nature of medical | 8 |
| assistance provided
need not be the
same as that provided under | 9 |
| paragraph (4) of subsection (d) of this Section,
and nothing in | 10 |
| this paragraph (3) shall be construed to require the coverage | 11 |
| of
any particular medical service. In addition, the amount and | 12 |
| nature of medical
assistance provided may be different for | 13 |
| different categories of individuals
determined chronically | 14 |
| needy.
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| (4) The Illinois Department shall determine, by rule, those | 16 |
| assistance
recipients under Article VI who shall be subject to | 17 |
| employment, training, or
education programs including | 18 |
| Earnfare, the content of those programs, and the
penalties for | 19 |
| failure to cooperate in those programs.
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| (5) The Illinois Department shall, by rule, establish | 21 |
| further eligibility
requirements, including but not limited to | 22 |
| residence, need, and the level of
payments.
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| (d) (1) To be eligible for State Family and Children | 24 |
| Assistance, a
family unit must be ineligible for assistance | 25 |
| under any other Article of
this Code and must contain a child | 26 |
| who is:
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| (A) under age 18 or
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| (B) age 18 and a full-time student in a secondary | 3 |
| school or the
equivalent level of vocational or technical | 4 |
| training, and who may
reasonably be expected to complete | 5 |
| the program before reaching age 19.
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| Those children shall be eligible for State Family and | 7 |
| Children Assistance.
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| (2) The natural or adoptive parents of the child living in | 9 |
| the same
household may be eligible for State Family and | 10 |
| Children Assistance.
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| (3) A pregnant woman whose pregnancy has been verified | 12 |
| shall be
eligible for income maintenance assistance under the | 13 |
| State Family and
Children Assistance program.
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| (4) The amount and nature of medical assistance provided | 15 |
| under the State
Family and Children Assistance program shall be | 16 |
| determined by the
Department of Healthcare and Family Services | 17 |
| by rule. The amount and nature of medical
assistance provided
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| need not be the same as that provided under paragraph (3) of
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| subsection (c) of this Section, and nothing in this paragraph | 20 |
| (4) shall be
construed to require the coverage of any | 21 |
| particular medical service.
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| (5) The Illinois Department shall, by rule, establish | 23 |
| further
eligibility requirements, including but not limited to | 24 |
| residence, need, and
the level of payments.
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| (e) A local governmental unit that chooses to participate | 26 |
| in a
General Assistance program under this Section shall |
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| provide
funding in accordance with Section 12-21.13 of this | 2 |
| Act.
Local governmental funds used to qualify for State funding | 3 |
| may only be
expended for clients eligible for assistance under | 4 |
| this Section 6-11 and
related administrative expenses.
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| (f) In order to qualify for State funding under this | 6 |
| Section, a local
governmental unit shall be subject to the | 7 |
| supervision and the rules and
regulations of the Illinois | 8 |
| Department.
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| (g) Notwithstanding any other provision in this Code, the | 10 |
| Illinois
Department is authorized to reduce payment levels used | 11 |
| to determine cash grants
provided to recipients of State | 12 |
| Transitional Assistance at any time within a
Fiscal Year in | 13 |
| order to ensure that cash benefits for State Transitional
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| Assistance do not exceed the amounts appropriated for those | 15 |
| cash benefits.
Changes in payment levels may be accomplished by | 16 |
| emergency rule under Section
5-45 of the Illinois | 17 |
| Administrative Procedure Act, except that the limitation
on the | 18 |
| number of emergency rules that may be adopted in a 24-month | 19 |
| period shall
not apply and the provisions of Sections 5-115 and | 20 |
| 5-125 of the Illinois
Administrative Procedure Act shall not | 21 |
| apply. This provision shall also be
applicable to any reduction | 22 |
| in payment levels made upon implementation of this
amendatory | 23 |
| Act of 1995.
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| (Source: P.A. 95-331, eff. 8-21-07.)
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| Section 99. Effective date. This Act takes effect January | 26 |
| 1, 2010.
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