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There are five types of adult care facilities and up until 1997 all were under the jurisdiction of the Department of Social Services until we moved to the Department of Health. New York State, through the NYS Department of Health, licenses and supervises three types of adult care facilities; adult homes, enriched housing and residences. The other two types are Family Type homes which are under the jurisdiction of The Office of Children and Family Services and shelters which are under the jurisdiction of The Office of Temporary and Disability Assistance. At this time there are no residences and there are 378 adult homes and 102 enriched housing statewide.

On October 26, 2004 Governor Pataki signed The Assisted Living Reform Act as Chapter 2 of the Laws of 2004. The Assisted Living Reform Act created several new certification categories and allowed facilities to call themselves “Assisted Living”. Once a facility is an adult care facility they can apply to be an Assisted Living Residence (ALR). The ALR level is viewed as a basic level of care with operator responsibilities and services must like those in adult homes or enriched housing program with the same admission/retention standards with some variations, higher case management staffing, an Individualized Service Plan (ISP) coordinating all service providers, new residency agreements and additional resident rights.

If a facility is an adult home/enriched housing program and an Assisted Living Residence, they can opt for two additional licenses:

Special Needs Assisted Living Residence (SNALR) This level was developed from the concept to serve individuals with special needs, including but not limited to dementia or cognitive impairments. The only model seen to date are those developed for dementia.

Enhanced Assisted Living Residence. This level was developed from the concept of “aging in place”. Each facility will decide to what extent they will retain residents, i.e., what their own retention standards will be. Some facilities have indicated that they will only keep residents for 1 or 2 person transfer while other facilities have indicated they will provide more skilled services.

Requirements were promulgated in March 2008, however, two lawsuits were filed in July 2008 and decisions rendered in September 2009 nullified certain sections of these regulations, i.e. nursing requirements, architectural requirements and other sections. Next steps are not decided as yet.

Under State Law, no person or organization may operate an adult care facility without an operating certificate from the New York State Department of Health. Operating certificates are issued only to operators who satisfactorily demonstrate good character, competency and the ability to operate facilities in compliance with law and regulations. Facilities are subject to periodic inspection by state staff, except family-type homes which are inspected by staff of local social services districts, to determine if the facility is being operated in a manner that protects the health, safety and well-being of residents. Failure of an operator to comply with regulations may result in fines or action to revoke or suspend the operating certificate.

The regulations for straight adult homes and enriched housing programs are found under Social Services Law and Regulation 18 NYCRR 487 and 488 while the assisted living residences are found under Public Health Law and Regulation 10 NYCRR 1001.


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