N.Y. Social Services Law § 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.