State of Illinois

Ninety-Fifth General Assembly

House of Representative




Offered by Representative Lisa M. Dugan




    WHEREAS, The Illinois Public Aid Code (305 ILCS 5/) sets



out criteria, standards and procedures governing the Medical



Assistance (Medicaid) Program that pays for the medical care



for elderly and disabled persons whose needs may best be met by



qualified long term care providers; and



    WHEREAS, Eligibility for the Medical Assistance Program



includes a determination of the financial resources available



to the applicants to cover the cost of care, and a finding by



the Department of Healthcare and Family Services together with



the Department of Human Services regarding applicants'



responsibility for payment for care; and



    WHEREAS, The Medical Assistance Program pays for the care



to the extent that an applicant's or recipient's financial



resources are not sufficient to cover this cost; and



    WHEREAS, There have been instances in which the Department



of Healthcare and Family Services together with the Department



of Human Services has committed errors in the eligibility



determination process, including but limited to incorrect



processing and evaluation of the applications and the financial



information provided on behalf of the applicant or recipient,



incorrect assessment of the applicant's or recipient's payment




or spenddown responsibility, and failure to correct these



errors on a timely basis; and



    WHEREAS, Errors in the determinations of eligibility and



the assessment of the financial resources of applicants or



recipients who require long term care can incorrectly result in



the qualification and disqualification of persons, or in



excessive personal liability of the applicant or recipient; and



    WHEREAS, It is critical that the eligibility determination



process function effectively to ensure the proper expenditure



of public funds, as well as coverage for those persons who are



in need of and entitled to assistance; therefore, be it









the Auditor General of the State of Illinois is directed to



audit the Medical Assistance Program jointly administered by



the Illinois Departments of Healthcare and Family Services and



Human Services with respect to the accuracy and impact of



eligibility determination standards and procedures regarding



persons applying for or receiving assistance for long term



care, with particular emphasis on the nature and scope of



errors in the assessment of the financial resources and



financial liability of the applicants and recipients; and be it






    RESOLVED, That the Department of Healthcare and Family



Services, the Department of Human Services, and any other State



agency, entity or person that may have information relevant to



this audit cooperate fully and promptly with the Auditor



General's Office in its conduct; and be it further



    RESOLVED, That the Auditor General report the conclusions



of this audit as soon as possible and make public the findings



and recommendations upon completion in accordance with the



provisions of Section 3-14 of the Illinois State Auditing Act;



and be it further



    RESOLVED, That copies of this resolution be delivered to



the Auditor General, the Director of Healthcare and Family



Services, and the Secretary of Human Services.



Adopted by the House of Representatives on May 28, 2008