Ill. Admin. Code tit. 59 § 131.30

Current through Register Vol. 48, No. 49, December 6, 2024

Section 131.30 - Eligibility

A child eligible for services provided under this Part is:

a) An individual for whom DCFS is legally responsible;

b) An individual under 21 years of age who is enrolled, pursuant to 89 Ill. Adm. Code 118, 120, 123 or 125, in one of the medical programs administered by HFS, except that any child who is enrolled in a managed care organization is not eligible; or

c) Subject to funding that is appropriated and available to DHS-DMH for the SASS program, an individual who is under 18 years of age and who meets one of the following criteria:

1) An individual who, following submission of a completed application, does not qualify under subsection (b);

2) An individual who meets criteria for the DHS-DMH target population (see Appendix A) and requires intensive community-based services in the SASS program, has no other means of payment as determined by DHS-DMH, and is seeking public payment for services covered under this Part; or

3) An individual whose family is unable, unwilling, or refuses to apply for medical assistance (e.g., the family may not be able to comply with the requirement to gather the necessary information required to file an application for Medicaid or All Kids due to medical reasons, such as impending surgery or long term medical illness, or the family refuses to comply because family members are undocumented), or if the SASS agent, hospital or community mental health provider finds it impossible to assist the family in applying, may be permitted an exception to this requirement only in these instances. A request for an exception may be made by contacting DHS-DMH. A hospital or community mental health provider may report that it finds it impossible to assist the family in applying only if the family refuses to apply due to incapacitating medical or psychiatric illness reasons, or because family members are undocumented.

Ill. Admin. Code tit. 59, § 131.30

Amended at 31 Ill. Reg. 10635, effective July 13, 2007