2023 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  individuals  with  developmental disabilities 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  individuals  with
developmental  disabilities 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.