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State of Illinois

Ninety-Fifth General Assembly

House of Representative

HOUSE RESOLUTION No. 1295

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
 

    RESOLVED, BY THE HOUSE OF REPRESENTATIVES OF THE

NINETY-FIFTH GENERAL ASSEMBLY OF THE STATE OF ILLINOIS, that

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

further
 

    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