NY Soc Serv L § 365 (2021)
2021 New York Laws SOS - Social Services Article 5 - Assistance and Care Title 11 - Medical Assistance for Needy Persons 365 - Responsibility for Assistance.

§ 365. Responsibility for assistance. 1. Subject to supervision by the department:  (a)  each  public  welfare  district  shall furnish medical assistance to the persons eligible therefor who reside in its territory, except to persons for whom another  public  welfare  district  would  be responsible  under  the provisions of paragraphs (b), (c), (d) or (g) of subdivision five of section  sixty-two  and  other  provisions  of  this chapter, and except to persons for whom provision is made hereinafter in subdivision two. Temporary absence, within or without the state, of such persons  from such territory shall not effect their eligibility for such assistance;  (b) each  public  welfare  district  shall  also  be  responsible  for furnishing   medical   assistance  to  eligible  persons  found  in  its territory, who are temporarily in the state;  (c) each public welfare district, in any case in which the appropriate medical care and services are not available within such district,  shall make    appropriate    arrangements,    including   the   provision   of transportation, for obtaining such medical  care  and  services  outside such district;  (d)  each  public  welfare district may furnish all or any part of the medical assistance required to be  furnished  pursuant  to  this  title, either directly or by contract or agreement.   2.   Any   inconsistent   provision  of  this  chapter  or  other  law notwithstanding, the department  shall  be  responsible  for  furnishing medical assistance to eligible individuals: (a) who are sixty-five years of  age  or older and who are patients in either state hospitals for the mentally disabled operated by the state department of mental hygiene  or state  hospitals  for the treatment of tuberculosis operated pursuant to the provisions of the public health law; (b) who  are  under  twenty-one years  of  age  and who are receiving psychiatric services in such state hospitals for the mentally disabled which services conform to the  state plan  implementive  of  this  title  and  which  a  team  consisting  of physicians and other qualified personnel has determined are necessary on an in-patient basis and  can  reasonably  be  expected  to  improve  the condition  requiring  such  services  to the extent that eventually such services will no longer be necessary; in  the  case  of  a  person  who, during the course of hospitalization attains the age of twenty-one, such services  may  continue  until he reaches the age of twenty-two; (c) who are patients in that part of a public institution operated for the  care of  the  mentally  retarded  that has been approved pursuant to law as a hospital or nursing home; (d) who are under care and treatment for  drug dependence  in  a  facility,  or  part thereof, operated pursuant to the provisions of the mental hygiene law if and so long as  federal  aid  is available  therefor; (e) who are under care in a hospital while they are on release from an institution in the state department of mental hygiene or who are drug dependent persons under care in a  hospital  while  they are  on  release  from  a  drug abuse treatment facility or part thereof operated in compliance with applicable provisions of law and  supervised by  the  state  division of substance abuse services, for the purpose of receiving care in such  hospital.  The  department  may  at  its  option discharge  such  responsibility,  in  whole  or  in part, through social services districts designated to act as agents of the department.  While so  designated,  a  social  services  district shall act as agent of the department and shall be entitled to reimbursement as provided in section three hundred sixty-eight-a of this title.   3.  Any  inconsistent  provision  of  this  chapter   or   other   law notwithstanding,  the  department  shall  be  responsible for furnishing medical assistance to eligible veterans and their dependents (a) in that part of the New York state home for veterans  and  their  dependents  at  Oxford that has been approved pursuant to law as a nursing home, and (b) in  a  hospital  while  on  release  from  that  home for the purpose of receiving care in such  hospital.  The  department  may  at  its  option discharge  such  responsibility,  in  whole  or  in part, through social services districts designated to act as agents of the department.  While so  designated,  a  social  services  district shall act as agent of the department and shall be entitled to reimbursement as provided in section three hundred sixty-eight-a of this title.   4.  Any  inconsistent  provision  of  this  chapter   or   other   law notwithstanding,  the  department  shall  be  responsible for furnishing medical assistance to eligible individuals: (a) who are patients in that part of a public institution operated  for  the  care  of  the  mentally retarded  that has been approved pursuant to law as an intermediate care facility  or  who  are  participating  in  a  program  operated  by  the department of mental hygiene or by a voluntary agency under an agreement with  such  department,  in  that  part of such a facility that has been approved as a day treatment program in accordance with  the  regulations of  the  state  commissioner of mental hygiene; (b) who are veterans and their dependents in that part of the New York state  home  for  veterans and their dependents at Oxford that has been approved pursuant to law as an intermediate care facility; (c) such persons under care in a hospital while  they  are  on release from such home for the purpose of receiving care in such hospital; and (d) who are included in  either  one  of  the model  waivers or the general waiver described in subdivisions seven and nine of section three hundred sixty-six of this chapter. The  department may,  at its option, discharge such responsibility, in whole or in part, through social services districts designated to act  as  agents  of  the department. While so designated, a social services district shall act as agent  of  the  department  and  shall  be entitled to reimbursements as provided in section three hundred sixty-eight-a of this chapter.   5.  Any  inconsistent  provision  of  this  chapter   or   other   law notwithstanding  the  department  shall  be  responsible for determining eligibility of and furnishing medical  assistance  to  eligible  persons when such person is in need of such medical assistance at the time he is discharged or released or conditionally released from a state department of  mental  hygiene facility pursuant to the mental hygiene law and when such person was admitted to such facility and has been a patient therein for a continuous period of five or more years prior to his discharge  or release. For purposes of determining whether a person has been a patient in  such  a facility for a continuous period of five years or more, if a person who has been discharged or  released  from  such  a  facility  is thereafter  returned  to  such  a  facility  within  ninety  days of the discharge or release, the period  of  time  between  such  discharge  or release  and  such  return  shall not constitute an interruption of, and shall be counted as part of, the continuous period. The department  may, at   its   option,   discharge   its   responsibility   for  eligibility determinations or for providing medical assistance or both, in whole  or in   part,  through  designated  social  services  districts.  While  so designated, a social  services  district  shall  act  as  agent  of  the department  and  shall  be  entitled to reimbursement of the full amount expended on behalf of  the  department  as  provided  in  section  three hundred sixty-eight-a of this article.   6.   Any   inconsistent  provisions  of  this  chapter  or  other  law notwithstanding, the department shall  be  responsible  for  determining eligibility  for  medical assistance for a person for whom the full cost of such assistance is reimbursable by the state and who is  in  need  of such   assistance   at   the  time  he  is  discharged  or  released  or conditionally released from a state hospital operated by the  office  of  mental  health  or a facility operated by the division of alcoholism and alcohol abuse located on the grounds of such  hospital.  The  department may  at  its  option discharge such responsibility, in whole or in part, through  social  services  districts  designated to act as agents of the department. While so designated, a social services district shall act as agent of the department  and  shall  be  entitled  to  reimbursement  as provided in section three hundred sixty-eight-a of this title.   7.   Any   inconsistent   provision  of  this  chapter  or  other  law notwithstanding,  the  department  may,  with   the   consent   of   the commissioner  of mental health, designate the office of mental health as its  agent  to  discharge  its  responsibility,  or  so  much   of   its responsibility   as   is  permitted  by  federal  law,  for  determining eligibility for medical assistance pursuant to subdivisions  two,  five, six and eight of this section.   8.   Any   inconsistent   provision  of  this  chapter  or  other  law notwithstanding, the department shall  be  responsible  for  determining eligibility of and furnishing medical assistance to eligible persons who reside  in  residential  care centers for adults or community residences operated by the office of mental health.  The  department  may,  at  its option,  discharge  its responsibility for eligibility determinations or for providing medical assistance or both, in whole or in  part,  through designated  social  services  districts.  While  so designated, a social services district shall act as agent of  the  department  and  shall  be entitled   to   reimbursement  as  provided  in  section  three  hundred sixty-eight-a of this article.   9.  Any  inconsistent  provision  of  this  chapter   or   other   law notwithstanding, the social services district in which an eligible major public  general  hospital is physically located shall be responsible for the supplementary bad debt and charity care adjustment component of  the rate of payment for such major public general hospital (as determined in accordance  with  subdivision fourteen-a of section twenty-eight hundred seven-c of the public health law) for all  inpatient  hospital  services provided  by  such  major  public  general  hospital  in accordance with section three  hundred  sixty-five-a  of  this  article,  regardless  of whether another social services district or the department may otherwise be responsible for furnishing medical assistance to the eligible persons receiving such inpatient services.   10.   Any   inconsistent  provision  of  this  chapter  or  other  law notwithstanding, the social  services  district  in  which  an  eligible public  general  hospital is physically located shall be responsible for the supplementary low income patient adjustment component of the rate of payment for such public general hospital (as  determined  in  accordance with  subdivision  fourteen-d of section twenty-eight hundred seven-c of the public health law) for all inpatient hospital services  provided  by such  public  general  hospital in accordance with section three hundred sixty-five-a of this  article,  regardless  of  whether  another  social services  district  or  the  department may otherwise be responsible for furnishing medical assistance to the  eligible  persons  receiving  such inpatient services.   11.   Any   inconsistent  provision  of  this  chapter  or  other  law notwithstanding, the social  services  district  in  which  an  eligible public  residential  health care facility is physically located shall be responsible for the adjustment component of the payments for such public residential health  care  facility  as  determined  in  accordance  with subdivision  twelve  of section twenty-eight hundred eight of the public health law for all residential health care facility services provided by such public residential health care facility in accordance with  section three  hundred  sixty-five-a  of  this  article,  regardless  of whether  another social services district or  the  department  may  otherwise  be responsible  for  furnishing  medical assistance to the eligible persons receiving such services.   12.   Any   inconsistent  provision  of  this  chapter  or  other  law notwithstanding, the social  services  district  in  which  an  eligible public  general  hospital is physically located shall be responsible for the public general hospital indigent care adjustment  component  of  the payments  to  such  public general hospital (as determined in accordance with subdivision fourteen-f of section twenty-eight hundred  seven-c  of the  public  health law) for all inpatient hospital services provided by such public general hospital in accordance with  section  three  hundred sixty-five-a  of  this  article,  regardless  of  whether another social services district or the department may  otherwise  be  responsible  for furnishing  medical  assistance  to  the eligible persons receiving such inpatient services.