Section 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  the  mentally  retarded  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  the  mentally
  retarded  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.