N.Y. Public Health Law § 2145: Rabies; services and expenses of suppression

§ 2145. Rabies; services and expenses of suppression. 1. The county

health authority is responsible for the services and expenses necessary

for the suppression of human rabies. Suppression of human rabies shall

include, but not be limited to:

(a) availability at all times for prompt investigation of reports of

possible exposures to rabies of people, pets, or domestic livestock

occurring within the county, and to render authorization for human

postexposure treatment,

(b) making arrangements for appropriate disposition of the animals

involved, including confinement and observation, quarantines,

vaccination boosters, or euthanasia and testing,

(c) collection, preparation and submission of animal specimens to a

laboratory approved by the commissioner for rabies diagnosis,

(d) verifying terms of confinement, observation and quarantines,

(e) authorized human postexposure treatment under the conditions

hereinafter specified, except that third party coverage or

indemnification shall first be applied against the cost of treatment,

and

(f) operation of rabies vaccination clinics free of charge for dogs,

cats and domesticated ferrets owned by persons with local residence.

2. Under the conditions specified below, the county health authority

is responsible for authorized human postexposure treatment for all

persons exposed within the county, regardless of the location of the

person's residence; except in any case where the person's county of

residence has agreed to be responsible for such treatment in accordance

with the provisions of this title. In addition, for persons with local

residence who are exposed to rabies in New York city or out of state,

the county health authority is responsible for that portion of treatment

that occurs after such persons return to their local residences.

3. Human postexposure treatment specifically authorized by the county

health authority shall be rendered by the provider or providers selected

by the county health authority, located within the county or the

vicinity thereof, and shall be considered sufficient authorization for

pre-approval by the person's health insurance carrier or managed care

plan if pre-approval is required, and shall be approved, by the health

insurance carrier or managed care plan, provided that:

(a) any person may, at his or her option, be treated at his or her own

expense by the health care provider of his or her choice without

approval by the county health authority,

(b) the county health authority may, at its option, assume financial

responsibility for necessary treatment rendered by other providers;

provided, however, that the county health authority shall not be

obligated to assume financial responsibility if notified after the

completion of treatment. If evidence of approval of the county health

authority has not been provided, health care providers must report

initiation of rabies postexposure prophylaxis within twenty-four hours

of the first treatment,

(c) the county shall authorize initial treatment from a provider or

providers geographically accessible to the location of the exposed

person at the time that treatment is determined to be necessary, and

(d) the county shall authorize post-initial treatment from a provider

or providers geographically accessible to the exposed person's residence

if the person returns to his or her residence during the course of

treatment.

4. Consent by any person to human postexposure treatment authorized by

the county health authority shall constitute assignment of any third

party health benefits to the county health authority and permission for

the person's health care and insurance providers to release medical and

financial information regarding the treatment to the county health

authority.

5. Health care and insurance providers shall comply with any requests

by the county health authority for information regarding human

postexposure treatment rendered to an enrollee whose treatment was

authorized by the county health authority.

5-a. Health care providers shall accept payments by the county health

authority for human postexposure treatment at a rate set by the

commissioner; provided that such reimbursement shall be no less than the

Medicaid rate.

6. Under the terms of this title, the county health authority is not

responsible for:

(a) services and expenses of human postexposure treatment that were

not specifically authorized by the county health authority, except for

completion of treatment for their residents exposed and started on

rabies treatment in New York city or elsewhere outside of New York

state. Treatment started in New York city shall be confirmed as

necessary treatment by the New York city department of health and mental

hygiene, or the department,

(b) services and expenses of medical treatment unrelated to the

prevention of rabies infection such as wound suturing and measures to

control bacterial infection of bite wounds, and

(c) expenses of preexposure rabies vaccination.

7. A clinic for rabies vaccination for dogs, cats and domesticated

ferrets of persons with local residence shall be conducted at least

every four months within the county under the direction of the county

government, by the health officials of the county and the several local

health districts within a county. Donations may be requested but not

required at the clinics. Any listing of costs in clinic announcements or

advertisements must indicate that vaccinations are available free of

charge, and that donations are optional. Counties may at their option

provide vaccination clinic services to persons without county residence,

and may require a fee based on cost from these persons.

8. Claims for services and expenses, approved by the county shall be

paid by the fiscal officer of the county from funds in his or her

custody upon presentation of such claim, without further or other audit

or may be paid pursuant to the local finance law.