N.Y. Comp. Codes R. & Regs. tit. 14, § 681.1 – Background and intent.

(a) Upon the effective date of this section [March 15, 1989], OPWDD (see glossary, section 681.13 of this Part) will utilize the requirements contained in 42 CFR 483, 42 CFR 456 and Parts 624 and 633 of this Title as the primary basis for issuing an operating certificate pursuant to article 16 of the Mental Hygiene Law in the class of facility known as intermediate care facility for individuals with intellectual disabilities. Where CFR 483 is more restrictive than Part 624 or 633, it shall be controlling.
(b) The Federal requirements referenced in subdivision (a) of this section are section 42 CFR 483 as published in the June 3 edition of the Federal Register (vol. 53, pages 20494-20505) and section 42 CFR 456, Utilization Control for Intermediate Care Facilities; 46 CFR (page 48561) published October 1, 1981 and as amended at 50 CFR (page 33034) published August 16, 1985. They are available from the United States Government Printing Office, Superintendent of Documents, Washington, DC 20402.
(c) The Federal requirements referenced in subdivision (a) of this section are also available and may be reviewed in person during regular business hours at the:
1. (1) New York State Department of State, 99 Washington Avenue, Albany, NY 12231; or by appointment at the:
2. (2) New York State Office for People with Developmental Disabilities, Public Information Office, 44 Holland Avenue, Albany, NY 12229.
(d) Additional requirements deemed to be necessary by OPWDD for this class of facility are contained in this Part and/or in other general regulations of the commissioner which are applicable to all classes of facility.
(e) Conformance with the Federal and State standards referenced herein shall be verified through periodic surveys by OPWDD in accordance with 42 CFR 442.30 and the Mental Hygiene Law. The Federal requirement referenced previously as section 42 CFR 442.30 as amended, is published in the June 3, 1988 edition of the Federal Register (vol. 53, page 20495). It is available from the United States Government Printing Office, Superintendent of Documents, Washington, DC 20402.
(f) Intermediate care facilities for individuals with intellectual disabilities may include Small Residential Units (SRU) constructed on State-owned land. Such SRU's while remaining institutional placements for census-counting purposes, shall be required to meet all standards mandated by this Part and shall hold a site-specific operating certificate in accordance therewith. Additional standards applicable to SRU's are found in section 681.10(b) of this Part.
(g) SRU's are limited capacity, (see glossary, section 681.13 of this Part) discrete living units designed for the purpose of providing small residential group settings. They are being considered for location on the grounds of:
1. (1) J.N. Adam Developmental Center;
2. (2) Long Island Developmental Center;
3. (3) Rome Developmental Center; and
4. (4) Sunmount Developmental Center.
  Nothing here shall preclude SRU development at other State-owned property pending the appropriate approvals, nor shall anything here preclude the operation of an SRU by a voluntary agency provider.
(h) Small residential unit facilities shall be designed to provide a more normalized and less restrictive living alternative for people with developmental disabilities. Such SRU placements shall be for persons for whom a community residential placement cannot be made available in a timely manner and for whom the SRU placement provides an experience in small group living which could facilitate placement into the community at large.
(i) For SRU's not beyond the preliminary design stage as of the effective date of these amendments, OPWDD will ensure that local officials and other interested parties are formally consulted.
(j) The intent shall be to incorporate those features into the design and operation of small residential units to facilitate integration into the community at large. Thus, there shall be an effectively functioning neighborhood advisory committee.
(k) Intermediate care facilities for individuals with intellectual disabilities may include extended treatment units (ETUs), operated by OPWDD. ETUs, while remaining institutional placements for census-counting purposes, shall be required to meet all standards mandated by this Part and shall hold a site-specific operating certificate in accordance therewith.
1. (1) ETUs are limited capacity (see glossary, section 681.99 of this Part) residential programs that may include discrete living units.
2. (2) ETUs shall have the following characteristics:
  1. (i) provide specialized residential services to individuals who:
    1. (a) meet criteria for admission to intermediate care facilities for individuals with intellectual disabilities;
    2. (b) have co-occurring psychiatric or behavioral health disorders;
    3. (c) are age 21 or older;
  2. (ii) promote behavioral and psychiatric stabilization;
  3. (iii) serve as a transitional living arrangement; and
  4. (iv) facilitate community reintegration.
3. (3) All admissions to an ETU shall require the prior approval of the commissioner, or designee, and necessitate that all criteria for admission to an ETU, as specified by OPWDD, have been met.
4. (4) The length of stay at an ETU shall be in increments of 30 days up to a maximum of six months, absent approval by the commissioner for an extension of stay. Such extensions shall only be granted upon a finding by the commissioner, or designee, that there exist compelling circumstances which warrant an extension. Extensions shall only be approved in increments of 30 days.