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SB-34 Residential treatment facilities.(2017-2018)

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Date Published: 03/17/2017 04:00 AM
SB34:v98#DOCUMENT

Amended  IN  Senate  March 16, 2017

CALIFORNIA LEGISLATURE— 2017–2018 REGULAR SESSION

Senate Bill No. 34


Introduced by Senator Bates

December 05, 2016


An act to amend Sections 1543, 11834.026, and 11834.26 of, and to add Sections 11834.028 and 11834.33 to, the Health and Safety Code, relating to substance abuse. residential facilities.


LEGISLATIVE COUNSEL'S DIGEST


SB 34, as amended, Bates. Substance abuse. Residential treatment facilities.
Existing law, the California Community Care Facilities Act (the act), provides for the licensing and regulation of community care facilities, as defined, by the State Department of Social Services. A violation of the act is a misdemeanor.
Existing law requires the district attorney of every county, and city attorneys in those cities which have city attorneys who have jurisdiction to prosecute misdemeanors pursuant to a specified law, to, upon their own initiative or upon application by the state department or its authorized representative, institute and conduct the prosecution of any action for a violation that occurs within his or her county of the act.
This bill would make that requirement applicable to city attorneys in every city. By imposing additional duties on local employees, the bill would impose a state-mandated local program.
Existing law regulates alcoholism or drug abuse recovery or treatment facilities to provide recovery, treatment, or detoxification services within this state and makes the State Department of Health Care Services the sole authority in state government to license those facilities. Existing law authorizes these facilities to permit to be provided, under certain conditions, to a resident at the facility, incidental medical services, as defined, and requires a licensee to provide at least one of specified nonmedical services, such as recovery services or treatment services.
This bill would make a person who violates the laws governing the licensing of these facilities guilty of a misdemeanor and subject to punishment by a fine not to exceed $1,000, or by imprisonment in the county jail for a period not to exceed 180 days, or by both that fine and imprisonment. The bill would also require the district attorney of every county and the city attorney of every city, upon their own initiative or upon application by the state department or its authorized representative, to institute and conduct the prosecution of an action for a violation that occurs within their county or city. By creating new crimes, and by imposing additional duties on local employees, the bill would impose a state-mandated local program.
The bill would describe recovery and treatment services, for purposes of the requirement that a licensee provide at least one of specified nonmedical services, to include providing group or individual counseling to a resident or controlling or managing a resident’s schedule, among other services. The bill would expand the definition of incidental medical services to include testing or collecting for testing a resident’s blood, urine, or saliva and controlling, administering, or monitoring a resident’s medications.
The bill would authorize a city or county to request denial of a license applied for on the basis of overconcentration of residential facilities. The bill would require the department to notify, in writing, at least 45 days prior to approving an application for a new facility, the planning agency of the city, if the facility is to be located in the city, or the planning agency of the county, if the facility is to be located in an unincorporated area, of the proposed location of the facility.
The California Constitution requires the state to reimburse local agencies and school districts for certain costs mandated by the state. Statutory provisions establish procedures for making that reimbursement.
This bill would provide that with regard to certain mandates no reimbursement is required by this act for a specified reason.
With regard to any other mandates, this bill would provide that, if the Commission on State Mandates determines that the bill contains costs so mandated by the state, reimbursement for those costs shall be made pursuant to the statutory provisions noted above.

Existing law provides for the licensure and regulation of alcoholism or drug abuse recovery or treatment facilities serving adults as prescribed.

This bill would state the intent of the Legislature to enact legislation that would address residential environments for persons in recovery from alcohol and drug addiction.

Vote: MAJORITY   Appropriation: NO   Fiscal Committee: NOYES   Local Program: NOYES  

The people of the State of California do enact as follows:


SECTION 1.

 Section 1543 of the Health and Safety Code is amended to read:

1543.
 Notwithstanding any other provision of this chapter, the district attorney of every county, and the city attorneys in those cities which have city attorneys who have jurisdiction to prosecute misdemeanors pursuant to Section 72193 of the Government Code, attorney in every city, shall, upon their own initiative or upon application by the state department or its authorized representative, institute and conduct the prosecution of any action for violation within his or her county of any provisions of this chapter. an action for a violation of this chapter that occurs within their county or city.

SEC. 2.

 Section 11834.026 of the Health and Safety Code is amended to read:

11834.026.
 (a) As used in this section, “incidental medical services” means services that are in compliance with the community standard of practice and are not required to be performed in a licensed clinic or licensed health facility, as defined by Section 1200 or 1250, respectively, to address medical issues associated with either detoxification from alcohol or drugs or the provision of alcoholism or drug abuse recovery or treatment services, including all of the following categories of services that the department shall further define by regulation:
(1) Obtaining medical histories.
(2) Monitoring health status to determine whether the health status warrants transfer of the patient in order to receive urgent or emergent care.
(3) Testing associated with detoxification from alcohol or drugs.
(4) Providing alcoholism or drug abuse recovery or treatment services.
(5) Overseeing patient self-administered medications. medications or otherwise controlling, administering, or monitoring a resident’s medications.
(6) Treating substance abuse disorders, including detoxification.
(7) Testing a resident’s blood, urine, or saliva.
(8) Collecting a resident’s blood, urine, or saliva sample for testing.
(b) Incidental medical services do not include the provision of general primary medical care.
(c) Notwithstanding any other law, a licensed alcoholism or drug abuse recovery or treatment facility may permit incidental medical services to be provided to a resident at the facility premises by, or under the supervision of, one or more physicians and surgeons licensed by the Medical Board of California or the Osteopathic Medical Board who are knowledgeable about addiction medicine, or one or more other health care practitioners acting within the scope of practice of his or her license and under the direction of a physician and surgeon, and who are also knowledgeable about addiction medicine, if all of the following conditions are met:
(1) The facility, in the judgment of the department, has the ability to comply with the requirements of this chapter and all other applicable laws and regulations to meet the needs of a resident receiving incidental medical services pursuant to this chapter. The department shall specify in regulations the minimum requirements that a facility shall meet in order to be approved to permit the provision of incidental medical services on its premises. The license of a facility approved to permit the provision of incidental medical services shall reflect that those services are permitted at the facility premises.
(2) The physician and surgeon and any other health care practitioner has signed an acknowledgment on a form provided by the department that he or she has been advised of and understands the statutory and regulatory limitations on the services that may legally be provided at a licensed alcoholism or drug abuse recovery or treatment facility and the statutory and regulatory requirements and limitations for the physician and surgeon or other health care practitioner and for the facility, related to providing incidental medical services. The licensee shall maintain a copy of the signed form at the facility for a physician and surgeon or other health care practitioner providing incidental medical services at the facility premises.
(3) A physician and surgeon or other health care practitioner shall assess a resident, prior to that resident receiving incidental medical services, to determine whether it is medically appropriate for that resident to receive these services at the premises of the licensed facility. A copy of the form provided by the department shall be signed by the physician and surgeon and maintained in the resident’s file at the facility.
(4) The resident has signed an admission agreement. The admission agreement, at a minimum, shall describe the incidental medical services that the facility may permit to be provided and shall state that the permitted incidental medical services will be provided by, or under the supervision of, a physician and surgeon. The department shall specify in regulations, at a minimum, the content and manner of providing the admission agreement, and any other information that the department deems appropriate. The facility shall maintain a copy of the signed admission agreement in the resident’s file.
(5) Once incidental medical services are initiated for a resident, the physician and surgeon and facility shall monitor the resident to ensure that the resident remains appropriate to receive those services. If the physician and surgeon determines that a change in the resident’s medical condition requires other medical services or that a higher level of care is required, the facility shall immediately arrange for the other medical services or higher level of care, as appropriate.
(6) The facility maintains in its files a copy of the relevant professional license or other written evidence of licensure to practice medicine or perform medical services in the state for the physician and surgeon and any other health care practitioner providing incidental medical services at the facility.
(d) The department is not required to evaluate or have any responsibility or liability with respect to evaluating the incidental medical services provided by a physician and surgeon or other health care practitioner at a licensed facility. This section does not limit the department’s ability to report suspected misconduct by a physician and surgeon or other health care practitioner to the appropriate licensing entity or to law enforcement.
(e) A facility licensed and approved by the department to allow provision of incidental medical services shall not by offering approved incidental medical services be deemed a clinic or health facility within the meaning of Section 1200 or 1250, respectively.
(f) Other than incidental medical services permitted to be provided or any urgent or emergent care required in the case of a life threatening emergency, this section does not authorize the provision at the premises of the facility of any medical or health care services or any other services that require a higher level of care than the care that may be provided within a licensed alcoholism or drug abuse recovery or treatment facility.
(g) This section does not require a residential treatment facility licensed by the department to provide incidental medical services or any services not otherwise permitted by law.
(h) (1) On or before July 1, 2018, the department shall adopt regulations to implement this section in accordance with the Administrative Procedure Act (Chapter 3.5 (commencing with Section 11340) of Part 1 of Division 3 of Title 2 of the Government Code).
(2) Notwithstanding the rulemaking provisions of the Administrative Procedure Act, the department may, if it deems appropriate, implement, interpret, or make specific this section by means of provider bulletins, written guidelines, or similar instructions from the department until regulations are adopted.

SEC. 3.

 Section 11834.028 is added to the Health and Safety Code, to read:

11834.028.
 (a) The Legislature hereby declares it to be the policy of the state to prevent overconcentrations of facilities that impair the integrity of residential neighborhoods. Therefore, the department shall deny an application for a new facility license if the department determines that the location is in a proximity to an existing facility that would result in overconcentration.
(b) As used in this section, “overconcentration” means that if a new license is issued, there will be facilities that are separated by a distance of 300 feet or less, as measured from any point upon the outside walls of the structures housing those facilities. Based on special local needs and conditions, the department may approve a separation distance of less than 300 feet with the approval of the city or county in which the proposed facility will be located.
(c) At least 45 days prior to approving an application for a new facility, the department shall notify, in writing, the planning agency of the city, if the facility is to be located in the city, or the planning agency of the county, if the facility is to be located in an unincorporated area, of the proposed location of the facility.
(d) Any city or county may request denial of the license applied for on the basis of overconcentration of residential facilities.
(e) This section does not authorize the department, on the basis of overconcentration, to refuse to grant a license upon a change of ownership of an existing facility when the location of the facility does not change.

SEC. 4.

 Section 11834.26 of the Health and Safety Code is amended to read:

11834.26.
 (a)  The licensee shall provide at least one of the following nonmedical services:
(1)  Recovery services.
(2)  Treatment services.
(3)  Detoxification services.
(b)  The department shall adopt regulations requiring records and procedures that are appropriate for each of the services specified in subdivision (a). The records and procedures may include all of the following:
(1)  Admission criteria.
(2)  Intake process.
(3)  Assessments.
(4)  Recovery, treatment, or detoxification planning.
(5)  Referral.
(6)  Documentation of provision of recovery, treatment or detoxification services.
(7)  Discharge and continuing care planning.
(8)  Indicators of recovery, treatment, or detoxification outcomes.
(c)  In the development of regulations implementing this section, the written record requirements shall be modified or adapted for social model programs.
(d) Examples of recovery and treatment services, for purposes of subdivision (a), include, but are not limited to, the following:
(1) Providing group or individual counseling or physical, psychological, psychiatric, occupational, recreational, or mental-health therapy or treatment of any kind to a resident.
(2) Organizing or otherwise providing therapeutic activities for residents.
(3) Providing recovery-education sessions to residents.
(4) Controlling a resident’s physical access to food or drink.
(5) Providing meal or nutrition planning to a resident.
(6) Dictating or otherwise controlling a resident’s dietary intake.
(7) Preparing or providing food to a resident as part of a nutrition plan.
(8) Controlling or managing a resident’s schedule.
(9) Organizing and providing transportation for a resident.
(10) Arranging for a resident’s medical, dental, counseling, or therapy appointment.
(11) Referring a resident to outside therapy or other recovery-service provider.
(12) Making recovery or treatment plans with or for a resident.
(13) Monitoring a resident’s recovery or treatment.
(14) Establishing goals for a resident’s recovery or treatment.

SEC. 5.

 Section 11834.33 is added to the Health and Safety Code, to read:

11834.33.
 (a) A person who violates this chapter, or who willfully or repeatedly violates any rule or regulation promulgated under this chapter, is guilty of a misdemeanor and upon conviction thereof shall be punished by a fine not to exceed one thousand dollars ($1,000), or by imprisonment in the county jail for a period not to exceed 180 days, or by both that fine and imprisonment.
(b) Notwithstanding any other provision of this chapter, the district attorney of every county and the city attorney of every city shall, upon their own initiative or upon application by the state department or its authorized representative, institute and conduct the prosecution of an action for a violation of this chapter that occurs within their county or city.

SEC. 6.

 No reimbursement is required by this act pursuant to Section 6 of Article XIII B of the California Constitution for certain costs that may be incurred by a local agency or school district because, in that regard, this act creates a new crime or infraction, eliminates a crime or infraction, or changes the penalty for a crime or infraction, within the meaning of Section 17556 of the Government Code, or changes the definition of a crime within the meaning of Section 6 of Article XIII B of the California Constitution.
However, if the Commission on State Mandates determines that this act contains other costs mandated by the state, reimbursement to local agencies and school districts for those costs shall be made pursuant to Part 7 (commencing with Section 17500) of Division 4 of Title 2 of the Government Code.
SECTION 1.

It is the intent of the Legislature to enact legislation that would address residential environments for persons in recovery from alcohol and drug addiction.