§ 2145 — Rabies; services and expenses of suppression

§ 2145. Rabies; services and expenses of suppression. 1. The county\nhealth authority is responsible for the services and expenses necessary\nfor the suppression of human rabies. Suppression of human rabies shall\ninclude, but not be limited to:\n (a) availability at all times for prompt investigation of reports of\npossible exposures to rabies of people, pets, or domestic livestock\noccurring within the county, and to render authorization for human\npostexposure treatment,\n (b) making arrangements for appropriate disposition of the animals\ninvolved, including confinement and observation, quarantines,\nvaccination boosters, or euthanasia and testing,\n (c) collection, preparation and submission of animal specimens to a\nlaboratory approved by the commissioner for rabies diagnosis,\n (d) verifying terms of confinement, observation and quarantines,\n (e) authorized human postexposure treatment under the conditions\nhereinafter specified, except that third party coverage or\nindemnification shall first be applied against the cost of treatment,\nand\n (f) operation of rabies vaccination clinics free of charge for dogs,\ncats and domesticated ferrets owned by persons with local residence.\n 2. Under the conditions specified below, the county health authority\nis responsible for authorized human postexposure treatment for all\npersons exposed within the county, regardless of the location of the\nperson's residence; except in any case where the person's county of\nresidence has agreed to be responsible for such treatment in accordance\nwith the provisions of this title. In addition, for persons with local\nresidence who are exposed to rabies in New York city or out of state,\nthe county health authority is responsible for that portion of treatment\nthat occurs after such persons return to their local residences.\n 3. Human postexposure treatment specifically authorized by the county\nhealth authority shall be rendered by the provider or providers selected\nby the county health authority, located within the county or the\nvicinity thereof, and shall be considered sufficient authorization for\npre-approval by the person's health insurance carrier or managed care\nplan if pre-approval is required, and shall be approved, by the health\ninsurance carrier or managed care plan, provided that:\n (a) any person may, at his or her option, be treated at his or her own\nexpense by the health care provider of his or her choice without\napproval by the county health authority,\n (b) the county health authority may, at its option, assume financial\nresponsibility for necessary treatment rendered by other providers;\nprovided, however, that the county health authority shall not be\nobligated to assume financial responsibility if notified after the\ncompletion of treatment. If evidence of approval of the county health\nauthority has not been provided, health care providers must report\ninitiation of rabies postexposure prophylaxis within twenty-four hours\nof the first treatment,\n (c) the county shall authorize initial treatment from a provider or\nproviders geographically accessible to the location of the exposed\nperson at the time that treatment is determined to be necessary, and\n (d) the county shall authorize post-initial treatment from a provider\nor providers geographically accessible to the exposed person's residence\nif the person returns to his or her residence during the course of\ntreatment.\n 4. Consent by any person to human postexposure treatment authorized by\nthe county health authority shall constitute assignment of any third\nparty health benefits to the county health authority and permission for\nthe person's health care and insurance providers to release medical and\nfinancial information regarding the treatment to the county health\nauthority.\n 5. Health care and insurance providers shall comply with any requests\nby the county health authority for information regarding human\npostexposure treatment rendered to an enrollee whose treatment was\nauthorized by the county health authority.\n 5-a. Health care providers shall accept payments by the county health\nauthority for human postexposure treatment at a rate set by the\ncommissioner; provided that such reimbursement shall be no less than the\nMedicaid rate.\n 6. Under the terms of this title, the county health authority is not\nresponsible for:\n (a) services and expenses of human postexposure treatment that were\nnot specifically authorized by the county health authority, except for\ncompletion of treatment for their residents exposed and started on\nrabies treatment in New York city or elsewhere outside of New York\nstate. Treatment started in New York city shall be confirmed as\nnecessary treatment by the New York city department of health and mental\nhygiene, or the department,\n (b) services and expenses of medical treatment unrelated to the\nprevention of rabies infection such as wound suturing and measures to\ncontrol bacterial infection of bite wounds, and\n (c) expenses of preexposure rabies vaccination.\n 7. A clinic for rabies vaccination for dogs, cats and domesticated\nferrets of persons with local residence shall be conducted at least\nevery four months within the county under the direction of the county\ngovernment, by the health officials of the county and the several local\nhealth districts within a county. Donations may be requested but not\nrequired at the clinics. Any listing of costs in clinic announcements or\nadvertisements must indicate that vaccinations are available free of\ncharge, and that donations are optional. Counties may at their option\nprovide vaccination clinic services to persons without county residence,\nand may require a fee based on cost from these persons.\n 8. Claims for services and expenses, approved by the county shall be\npaid by the fiscal officer of the county from funds in his or her\ncustody upon presentation of such claim, without further or other audit\nor may be paid pursuant to the local finance law.\n