§ 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.