§ 365 — Responsibility for assistance

New York § 365

• Jurisdiction: New York
• Law SOS: Social Services
• Title 11: Medical Assistance For Needy Persons
• Art. 5: Assistance and Care

Text

§ 365. Responsibility for assistance. 1. Subject to supervision by the\ndepartment: (a) each public welfare district shall furnish medical\nassistance to the persons eligible therefor who reside in its territory,\nexcept to persons for whom another public welfare district would be\nresponsible under the provisions of paragraphs (b), (c), (d) or (g) of\nsubdivision five of section sixty-two and other provisions of this\nchapter, and except to persons for whom provision is made hereinafter in\nsubdivision two. Temporary absence, within or without the state, of such\npersons from such territory shall not effect their eligibility for such\nassistance;\n (b) each public welfare district shall also be responsible for\nfurnishing medical assistance to eligible persons found in its\nterritory, who are temporarily in the state;\n (c) each public welfare district, in any case in which the appropriate\nmedical care and services are not available within such district, shall\nmake appropriate arrangements, including the provision of\ntransportation, for obtaining such medical care and services outside\nsuch district;\n (d) each public welfare district may furnish all or any part of the\nmedical assistance required to be furnished pursuant to this title,\neither directly or by contract or agreement.\n 2. Any inconsistent provision of this chapter or other law\nnotwithstanding, the department shall be responsible for furnishing\nmedical assistance to eligible individuals: (a) who are sixty-five years\nof age or older and who are patients in either state hospitals for the\nmentally disabled operated by the state department of mental hygiene or\nstate hospitals for the treatment of tuberculosis operated pursuant to\nthe provisions of the public health law; (b) who are under twenty-one\nyears of age and who are receiving psychiatric services in such state\nhospitals for the mentally disabled which services conform to the state\nplan implementive of this title and which a team consisting of\nphysicians and other qualified personnel has determined are necessary on\nan in-patient basis and can reasonably be expected to improve the\ncondition requiring such services to the extent that eventually such\nservices will no longer be necessary; in the case of a person who,\nduring the course of hospitalization attains the age of twenty-one, such\nservices may continue until he reaches the age of twenty-two; (c) who\nare patients in that part of a public institution operated for the care\nof individuals with developmental disabilities that has been approved\npursuant to law as a hospital or nursing home; (d) who are under care\nand treatment for drug dependence in a facility, or part thereof,\noperated pursuant to the provisions of the mental hygiene law if and so\nlong as federal aid is available therefor; (e) who are under care in a\nhospital while they are on release from an institution in the state\ndepartment of mental hygiene or who are drug dependent persons under\ncare in a hospital while they are on release from a drug abuse treatment\nfacility or part thereof operated in compliance with applicable\nprovisions of law and supervised by the state division of substance\nabuse services, for the purpose of receiving care in such hospital. The\ndepartment may at its option discharge such responsibility, in whole or\nin part, through social services districts designated to act as agents\nof the department. While so designated, a social services district shall\nact as agent of the department and shall be entitled to reimbursement as\nprovided in section three hundred sixty-eight-a of this title.\n 3. Any inconsistent provision of this chapter or other law\nnotwithstanding, the department shall be responsible for furnishing\nmedical assistance to eligible veterans and their dependents (a) in that\npart of the New York state home for veterans and their dependents at\nOxford that has been approved pursuant to law as a nursing home, and (b)\nin a hospital while on release from that home for the purpose of\nreceiving care in such hospital. The department may at its option\ndischarge such responsibility, in whole or in part, through social\nservices districts designated to act as agents of the department. While\nso designated, a social services district shall act as agent of the\ndepartment and shall be entitled to reimbursement as provided in section\nthree hundred sixty-eight-a of this title.\n 4. Any inconsistent provision of this chapter or other law\nnotwithstanding, the department shall be responsible for furnishing\nmedical assistance to eligible individuals: (a) who are patients in that\npart of a public institution operated for the care of individuals with\ndevelopmental disabilities that has been approved pursuant to law as an\nintermediate care facility or who are participating in a program\noperated by the department of mental hygiene or by a voluntary agency\nunder an agreement with such department, in that part of such a facility\nthat has been approved as a day treatment program in accordance with the\nregulations of the state commissioner of mental hygiene; (b) who are\nveterans and their dependents in that part of the New York state home\nfor veterans and their dependents at Oxford that has been approved\npursuant to law as an intermediate care facility; (c) such persons under\ncare in a hospital while they are on release from such home for the\npurpose of receiving care in such hospital; and (d) who are included in\neither one of the model waivers or the general waiver described in\nsubdivisions seven and nine of section three hundred sixty-six of this\nchapter. The department may, at its option, discharge such\nresponsibility, in whole or in part, through social services districts\ndesignated to act as agents of the department. While so designated, a\nsocial services district shall act as agent of the department and shall\nbe entitled to reimbursements as provided in section three hundred\nsixty-eight-a of this chapter.\n 5. Any inconsistent provision of this chapter or other law\nnotwithstanding the department shall be responsible for determining\neligibility of and furnishing medical assistance to eligible persons\nwhen such person is in need of such medical assistance at the time he is\ndischarged or released or conditionally released from a state department\nof mental hygiene facility pursuant to the mental hygiene law and when\nsuch person was admitted to such facility and has been a patient therein\nfor a continuous period of five or more years prior to his discharge or\nrelease. For purposes of determining whether a person has been a patient\nin such a facility for a continuous period of five years or more, if a\nperson who has been discharged or released from such a facility is\nthereafter returned to such a facility within ninety days of the\ndischarge or release, the period of time between such discharge or\nrelease and such return shall not constitute an interruption of, and\nshall be counted as part of, the continuous period. The department may,\nat its option, discharge its responsibility for eligibility\ndeterminations or for providing medical assistance or both, in whole or\nin part, through designated social services districts. While so\ndesignated, a social services district shall act as agent of the\ndepartment and shall be entitled to reimbursement of the full amount\nexpended on behalf of the department as provided in section three\nhundred sixty-eight-a of this article.\n 6. Any inconsistent provisions of this chapter or other law\nnotwithstanding, the department shall be responsible for determining\neligibility for medical assistance for a person for whom the full cost\nof such assistance is reimbursable by the state and who is in need of\nsuch assistance at the time he is discharged or released or\nconditionally released from a state hospital operated by the office of\nmental health or a facility operated by the division of alcoholism and\nalcohol abuse located on the grounds of such hospital. The department\nmay at its option discharge such responsibility, in whole or in part,\nthrough social services districts designated to act as agents of the\ndepartment. While so designated, a social services district shall act as\nagent of the department and shall be entitled to reimbursement as\nprovided in section three hundred sixty-eight-a of this title.\n 7. Any inconsistent provision of this chapter or other law\nnotwithstanding, the department may, with the consent of the\ncommissioner of mental health, designate the office of mental health as\nits agent to discharge its responsibility, or so much of its\nresponsibility as is permitted by federal law, for determining\neligibility for medical assistance pursuant to subdivisions two, five,\nsix and eight of this section.\n 8. Any inconsistent provision of this chapter or other law\nnotwithstanding, the department shall be responsible for determining\neligibility of and furnishing medical assistance to eligible persons who\nreside in residential care centers for adults or community residences\noperated by the office of mental health. The department may, at its\noption, discharge its responsibility for eligibility determinations or\nfor providing medical assistance or both, in whole or in part, through\ndesignated social services districts. While so designated, a social\nservices district shall act as agent of the department and shall be\nentitled to reimbursement as provided in section three hundred\nsixty-eight-a of this article.\n 9. Any inconsistent provision of this chapter or other law\nnotwithstanding, the social services district in which an eligible major\npublic general hospital is physically located shall be responsible for\nthe supplementary bad debt and charity care adjustment component of the\nrate of payment for such major public general hospital (as determined in\naccordance with subdivision fourteen-a of section twenty-eight hundred\nseven-c of the public health law) for all inpatient hospital services\nprovided by such major public general hospital in accordance with\nsection three hundred sixty-five-a of this article, regardless of\nwhether another social services district or the department may otherwise\nbe responsible for furnishing medical assistance to the eligible persons\nreceiving such inpatient services.\n 10. Any inconsistent provision of this chapter or other law\nnotwithstanding, the social services district in which an eligible\npublic general hospital is physically located shall be responsible for\nthe supplementary low income patient adjustment component of the rate of\npayment for such public general hospital (as determined in accordance\nwith subdivision fourteen-d of section twenty-eight hundred seven-c of\nthe public health law) for all inpatient hospital services provided by\nsuch public general hospital in accordance with section three hundred\nsixty-five-a of this article, regardless of whether another social\nservices district or the department may otherwise be responsible for\nfurnishing medical assistance to the eligible persons receiving such\ninpatient services.\n 11. Any inconsistent provision of this chapter or other law\nnotwithstanding, the social services district in which an eligible\npublic residential health care facility is physically located shall be\nresponsible for the adjustment component of the payments for such public\nresidential health care facility as determined in accordance with\nsubdivision twelve of section twenty-eight hundred eight of the public\nhealth law for all residential health care facility services provided by\nsuch public residential health care facility in accordance with section\nthree hundred sixty-five-a of this article, regardless of whether\nanother social services district or the department may otherwise be\nresponsible for furnishing medical assistance to the eligible persons\nreceiving such services.\n 12. Any inconsistent provision of this chapter or other law\nnotwithstanding, the social services district in which an eligible\npublic general hospital is physically located shall be responsible for\nthe public general hospital indigent care adjustment component of the\npayments to such public general hospital (as determined in accordance\nwith subdivision fourteen-f of section twenty-eight hundred seven-c of\nthe public health law) for all inpatient hospital services provided by\nsuch public general hospital in accordance with section three hundred\nsixty-five-a of this article, regardless of whether another social\nservices district or the department may otherwise be responsible for\nfurnishing medical assistance to the eligible persons receiving such\ninpatient services.\n