Bill Text: IL SB1855 | 2009-2010 | 96th General Assembly | Introduced
Bill Title: 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.
Spectrum: Partisan Bill (Democrat 4-0)
Status: (Introduced - Dead) 2009-08-15 - Pursuant to Senate Rule 3-9(b) / Referred to Assignments [SB1855 Detail]
Download: Illinois-2009-SB1855-Introduced.html
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1 | AN ACT concerning public aid.
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2 | Be it enacted by the People of the State of Illinois,
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3 | represented in the General Assembly:
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4 | 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:
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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.
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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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1 | 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.
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25 | (305 ILCS 5/5F-15 new) |
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1 | 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.
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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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22 | (305 ILCS 5/6-11) (from Ch. 23, par. 6-11)
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23 | Sec. 6-11. State funded General Assistance.
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24 | (a) Effective July 1, 1992, all State funded General |
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1 | 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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7 | 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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10 | (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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16 | (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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20 | (A) age 18 or over or
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21 | (B) married and living with a spouse, regardless of | ||||||
22 | age.
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23 | (2) The Illinois Department or the local governmental unit | ||||||
24 | shall determine
whether individuals are chronically needy as | ||||||
25 | follows:
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26 | (A) Individuals who have applied for Supplemental |
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1 | 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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10 | program.
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11 | (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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19 | 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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23 | determination of disability.
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24 | (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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1 | inclusion of any specific category other than as
specified | ||||||
2 | in paragraphs (A) and (B).
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3 | (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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15 | (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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20 | (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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23 | (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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1 | (A) under age 18 or
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2 | (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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6 | Those children shall be eligible for State Family and | ||||||
7 | Children Assistance.
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8 | (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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11 | (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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14 | (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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18 | need not be the same as that provided under paragraph (3) of
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19 | 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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22 | (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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25 | (e) A local governmental unit that chooses to participate | ||||||
26 | in a
General Assistance program under this Section shall |
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1 | 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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5 | (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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9 | (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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14 | 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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24 | (Source: P.A. 95-331, eff. 8-21-07.)
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25 | Section 99. Effective date. This Act takes effect January | ||||||
26 | 1, 2010.
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