§ 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.