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Date Published: 07/01/2019 09:00 PM
SB325:v94#DOCUMENT

Amended  IN  Assembly  July 01, 2019
Amended  IN  Assembly  June 13, 2019
Amended  IN  Senate  May 17, 2019
Amended  IN  Senate  April 11, 2019
Amended  IN  Senate  March 28, 2019

CALIFORNIA LEGISLATURE— 2019–2020 REGULAR SESSION

Senate Bill
No. 325


Introduced by Senator Hill
(Coauthor: Senator Bates)
(Coauthor: Assembly Member Petrie-Norris)

February 15, 2019


An act to add Chapter 9.7 (commencing with Section 4450) to Division 2 of the Business and Professions Code, and to amend Sections 11830, 11830.1, 11830.5, 11831, 11831.2, 11831.5, 11831.6, 11831.7, 11832, 11832.1, and 11833 of, to amend the heading of Chapter 7 (commencing with Section 11830) of Part 2 of Division 10.5 of, to amend and renumber Section 11830.01 of, and to add Section 11831.1 11831.51 to, the Health and Safety Code, relating to public health.


LEGISLATIVE COUNSEL'S DIGEST


SB 325, as amended, Hill. Substance abuse recovery or treatment providers.
Existing law grants the State Department of Health Care Services the sole authority in state government to determine the qualifications of personnel working within alcoholism or drug abuse recovery and treatment programs licensed, certified, or funded under state law. Existing law requires the department to require that a person providing counseling services within those programs be registered with or certified by a certifying organization approved by the department. Existing law also generally provides for the registration, certification, and licensure of various healing arts professionals by the Department of Consumer Affairs.
This bill would require the Department of Consumer Affairs, by January 1, 2021, July 1, 2020, to conduct a sunrise review for the licensing of alcohol or drug counselors and to submit a report to the Legislature proposing licensing standards for independent practitioners providing alcohol or drug abuse recovery or treatment services.
Existing law requires the State Department of Health Care Services to license and regulate alcoholism or drug abuse recovery or treatment facilities serving adults. Existing law authorizes the department to certify qualified alcoholism or drug abuse recovery or treatment programs, as prescribed. Under existing law, the department regulates the quality of these programs, taking into consideration the significance of community-based programs to alcohol and other drug abuse recovery and the need to encourage opportunities for low-income and special needs populations to receive alcohol and other drug abuse recovery or treatment services.
This bill would require an outpatient alcohol or other substance use disorder recovery or treatment services program that provides those services to the public and is not otherwise licensed under existing law, to be licensed by the department, beginning January 1, 2021, except as specified. 2021. The bill would require the department to develop regulations to establish program licensure standards and would integrate existing quality assurance provisions into the licensure requirements. The bill would identify certain substance use disorder treatment services that do not need to obtain a license pursuant to the bill, and would deem a Drug Medi-Cal certified treatment program operating under the Drug Medi-Cal Organized Delivery System Waiver to be in compliance with the bill’s licensure requirements under certain conditions. The bill would specify that the requirements of the bill would not constrict, limit, or affect the application of various health professional practice acts, as specified. The bill would require the department to charge a fee, not to exceed the reasonable regulatory costs of administering the licensing program and issuing a license under these provisions. The bill would prohibit the practice or operation of a qualified outpatient alcoholism or drug abuse recovery or treatment service, program, or provider without first obtaining a current valid license, and would impose specified penalties for violations of that prohibition.
Vote: MAJORITY   Appropriation: NO   Fiscal Committee: YES   Local Program: NO  

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


SECTION 1.

 The Legislature finds and declares as follows:
(a) It is the intent of the Legislature that by July 1, 2022, all outpatient services for addiction treatment shall be provided by programs licensed by the State Department of Health Care Services or by individuals appropriately licensed by the Department of Consumer Affairs.
(b) It is the further intent of the Legislature that after July 1, 2022, any offer or provision of addiction treatment services shall be provided in a licensed environment by qualified professionals.

SECTION 1.SEC. 2.

 Chapter 9.7 (commencing with Section 4450) is added to Division 2 of the Business and Professions Code, to read:
CHAPTER  9.7. Alcohol or Drug Counseling Professionals

4450.
 For purposes of this chapter, the “department” means the Department of Consumer Affairs.

4451.
 (a) The department shall, on or before January 1, 2021, July 1, 2020, do both of the following:
(1) Conduct a sunrise review for the licensing of alcohol or drug counselors. The department may contract with a public or private entity to conduct the review.
(2) Submit a report to the Legislature containing proposed licensing standards for independent practitioners providing alcohol or drug recovery or treatment services. In preparing the report, the department shall consider the data included in the review described in paragraph (1) and consult with the County Behavioral Health Directors Association of California, the California Society of Addiction Medicine, certifying organizations approved by the Department of Health Care Services to register and certify counselors pursuant to Section 11833 of the Health and Safety Code, and other interested organizations and individuals.
(b) (1) The requirement for submitting a report imposed under paragraph (2) of subdivision (a) is inoperative on January 1, 2024, pursuant to Section 10231.5 of the Government Code.
(2) A report to be submitted pursuant to paragraph (2) of subdivision (a) shall be submitted in compliance with Section 9795 of the Government Code.

SEC. 2.SEC. 3.

 The heading of Chapter 7 (commencing with Section 11830) of Part 2 of Division 10.5 of the Health and Safety Code is amended to read:
CHAPTER  7.  Licensing of Outpatient Substance Use Disorder Recovery or Treatment Services Programs and Providers

SEC. 3.SEC. 4.

 Section 11830 of the Health and Safety Code is amended to read:

11830.
 (a) Beginning January 1, 2021, an outpatient alcohol or other substance use disorder recovery or treatment services program that provides those services to the public and is not otherwise licensed pursuant to this part shall be licensed by the department pursuant to the program established under this chapter.
(b) The department shall take the following goals and objectives into consideration in the implementation of this chapter:
(1) The significance of county-operated or community-based programs to alcohol and other drug abuse recovery shall not be diminished.
(2) Opportunities for low-income and special needs populations to receive alcohol and other drug abuse recovery or treatment services shall be encouraged.

SEC. 4.SEC. 5.

 Section 11830.01 of the Health and Safety Code is amended and renumbered to read:

11834.19.
 (a) The department’s death investigation policy shall be designed to ensure that a resident’s resident or program client death is addressed and investigated by the department in a timely manner.
(b) The telephonic and written reports of resident or program client deaths occurring in a licensed facility that or to a program’s client are required to be reported to the department shall include, but not be department, including, but not limited to, all of the following:
(1) A description of the event or incident, including the time, location, and nature of the event or incident.
(2) A list of immediate actions that were taken, including persons contacted.
(3) A description of planned followup action, including, but not limited to, steps taken to prevent a future death.
(c) A telephonic report required under subdivision (b), which includes the event or incident and all information required under subdivision (b) that is known at the time of the report, shall be submitted to the department within one working day of the event or incident.
(d) A written report required under subdivision (b), which includes all information required under subdivision (b), shall be submitted to the department within seven calendar days of the event or incident.

SEC. 5.SEC. 6.

 Section 11830.1 of the Health and Safety Code is amended to read:

11830.1.
 In order to ensure quality assurance of outpatient alcohol and other drug programs and expand the availability of funding resources, the department shall implement a program licensing procedure for outpatient alcohol and other drug treatment or recovery services. The department, after consultation with the County Behavioral Health Directors Association of California, the California Society of Addiction Medicine, and other interested organizations and individuals, shall develop regulations for the alcohol and other drug treatment recovery services describing the minimal level of service quality required of the service providers to qualify for and obtain an outpatient state license. For the purposes of Section 2626.2 of the Unemployment Insurance Code, licensure shall be equivalent to program review.

SEC. 6.SEC. 7.

 Section 11830.5 of the Health and Safety Code is amended to read:

11830.5.
 (a) The department, in consultation with the county alcohol and drug program administrators administrators, the California Society of Addiction Medicine, and other interested organizations and individuals, shall develop program standards for inclusion in regulations specific to each type of residential and nonresidential program, to be used during its licensure process.
(b) The program licensure standards shall include, but not be limited to, all of the following:
(1) Recognition and characterization of different approaches and solutions to the alcohol and drug problems that the department determines have sufficient merit for a separate standard.
(2) Reference to the needs of youth up to 26 years of age, elderly individuals, women, pregnant women, mothers and their children, lesbian, gay, bisexual, transgender, and nonbinary individuals, the disabled, and special populations, with recognition of innovative solutions to the problems of those special populations.
(3) Evidence-based standards that are equivalent to the American Society of Addiction Medicine (ASAM) treatment criteria as those criteria existed on January 1, 2019, or the latest adopted version as the minimum standard of care for licensed programs.
(4) (A) A Drug Medi-Cal certified treatment program operating under the Section 1115 Bridge to Reform Demonstration Waiver’s Drug Medi-Cal Organized Delivery System (DMC-ODS) Waiver shall be deemed in compliance with the requirements of this section as long as the DMC-ODS Waiver is in place and the program remains Drug Medi-Cal certified. The program shall notify the department of its operation.

(B)A provider that is employed by or provides services pursuant to a contract with a county that does not have a DMC-ODS Waiver, and who would otherwise be subject to this chapter, is exempt from this chapter until January 1, 2023, or until the county obtains a DMC-ODS Waiver, whichever comes first.

(B) A county that does not have a DMC-ODS Waiver, and an entity that contracts with a non-DMC-ODS Waiver county and that provides services exclusively to clients of the non-DMC-ODS Waiver county and would otherwise be subject to this chapter, is exempt from this chapter until January 1, 2023, or until the county obtains a DMC-ODS Waiver, whichever comes first.
(5) A program licensed under this chapter shall not ban the use of medication-assisted treatment (MAT) to any client in its program if that client meets the ASAM criteria for MAT.
(6) A program shall be required to keep accurate records of admissions, withdrawals, transfers, and discharges and the reasons for each.
(7) Licensure standards shall be implemented in a way that provides for sufficient time for programs and individual providers to comply without significant displacement of clients.
(c) The program standards shall serve as educational documents to inform the public of the current state-of-the-art in effective and cost-efficient alcohol and drug problem programming.

SEC. 7.SEC. 8.

 Section 11831 of the Health and Safety Code is amended to read:

11831.
 A client shall be referred to other licensed programs, facilities, or services when a program or facility is unable to accept a client after initial assessment.

SEC. 8.Section 11831.1 is added to the Health and Safety Code, to read:
11831.1.

(a)This chapter does not constrict, limit, or affect the application of the Medical Practice Act (Chapter 5 (commencing with Section 2000)), the Nursing Practice Act (Chapter 6 (commencing with Section 2700)), the Psychology Licensing Law (Chapter 6.6 (commencing with Section 2900)), the Licensed Marriage and Family Therapist Act (Chapter 13 (commencing with Section 4980)), the Clinical Social Worker Practice Act (Chapter 14 (commencing with Section 4991)), or the Licensed Professional Clinical Counselor Act (Chapter 16 (commencing with Section 4999.10)), of Division 2 of the Business and Professions Code.

(b)Substance use disorder treatment services provided in a driving-under-the-influence program, in an educational environment, by a United States Department of Transportation (USDOT) Substance Abuse Professional evaluating an individual in public or private employment who is subject to USDOT regulation and who has violated a USDOT drug and alcohol program regulation, or in a licensed hospital or clinic do not need to obtain a license to provide these services.

SEC. 9.

 Section 11831.2 of the Health and Safety Code is amended to read:

11831.2.
 (a) The department shall charge a fee not to exceed the reasonable regulatory costs of administering this chapter and licensing a program or practitioner under this chapter, in accordance with Chapter 7.3 (commencing with Section 11833.01).
(b) In setting the fee described in subdivision (a), the department shall take into account the size of the program, based on projected caseload.

SEC. 10.

 Section 11831.5 of the Health and Safety Code is amended to read:

11831.5.
 (a) A license shall be granted by the department pursuant to this section to any qualified outpatient alcoholism or drug abuse recovery or treatment service, program, or provider, regardless of the source of the program’s funding, upon approval of a completed application and payment of the required fee. The license shall be valid for a period of not more than two years. The department may extend the licensure period upon receipt and approval of an application for renewal and payment of the required licensure fee prior to the expiration date of the license.
(b) The purposes of licensure under this section shall be all of the following:
(1) To identify and license programs that meet or exceed minimum levels of service quality, are in compliance with the department’s regulations, and merit the confidence of the public, third-party payers, and county alcohol and drug programs.
(2) To ensure that programs meet their stated goals and objectives.
(3) To ensure that programs provide high-quality, evidence-based treatment for Californians in need of substance use disorder treatment.
(4) To assist programs to identify their needs for technical assistance, training, and program improvements.
(c) The department and the State Department of Social Services shall enter into a memorandum of understanding to establish a process by which the State Department of Health Care Services can license residential facilities or programs serving primarily adolescents, as defined in paragraph (1) of subdivision (a) of Section 1502, that have programs that primarily serve adolescents and provide alcohol and other drug recovery or treatment services.

SEC. 11.

 Section 11831.51 is added to the Health and Safety Code, immediately following Section 11831.5, to read:

11831.51.
 (a) A person, firm, partnership, association, corporation, or local governmental entity shall not operate, establish, manage, conduct, maintain, or practice as a qualified outpatient alcoholism or drug abuse recovery or treatment service, program, or provider within this state without first obtaining a current valid license issued pursuant to Section 11831.5.
(b) If an outpatient alcoholism or drug abuse recovery or treatment service, program, or provider is alleged to be in violation of subdivision (a), the department shall conduct a site visit to investigate the allegation. If the department’s employee or agent finds evidence that the service, program, or provider is providing those services without a license, the employee or agent shall take the following actions:
(1) Submit the findings of the investigation to the department.
(2) Upon departmental authorization, issue a written notice to the service, program, or provider stating that the service, program, or provider is operating in violation of subdivision (a). The notice shall include all of the following:
(A) The date by which the service, program, or provider shall cease providing services.
(B) Notice that the department will assess against the service, program, or provider a civil penalty of two thousand dollars ($2,000) per day for every day the service, program, or provider continues to provide services beyond the date specified in the notice.
(C) Notice that the case will be referred for civil proceedings pursuant to subdivision (c) in the event the service, program, or provider continues to provide services beyond the date specified in the notice.
(3) Inform the service, program, or provider of the licensing requirements of paragraph (2).
(4) A person or entity found to be in violation of subdivision (a) shall be prohibited from applying for initial licensure for a period of five years from the date of the notice specified in paragraph (2).
(c) (1) The director may bring an action to enjoin the violation of subdivision (a) in the superior court in and for the county in which the violation occurred. A proceeding under this section shall conform to the requirements of Chapter 3 (commencing with Section 525) of Title 7 of Part 2 of the Code of Civil Procedure, except that the director shall not be required to allege facts necessary to show or tending to show lack of adequate remedy at law or irreparable damage or loss.
(2) With respect to any and all actions brought pursuant to this section alleging actual violation of subdivision (a), the court shall, if it finds the allegations to be true, issue its order enjoining the service, program, or provider from continuance of the violation.
(d) (1) In addition to the penalties of suspension or revocation of a license issued under this chapter, the department may also levy a civil penalty for violation of this chapter or the regulations adopted pursuant to this chapter.
(A) The amount of the civil penalty, as determined by the department, shall not be less than two hundred fifty dollars ($250) or more than five hundred dollars ($500) per day for each violation, except when the nature or seriousness of the violation or the frequency of the violation warrants a higher penalty or an immediate civil penalty assessment, or both, as determined by the department. In no event shall a civil penalty assessment exceed one thousand dollars ($1,000) per day.
(B) A licensee that is cited for repeating the same violation within 24 months of the first violation is subject to an immediate civil penalty of five hundred dollars ($500) and seven hundred fifty dollars ($750) for each day the violation continues, until the deficiency is corrected.
(C) A licensee that has been assessed a civil penalty pursuant to subparagraph (B) that repeats the same violation within 24 months of the violation subject to subparagraph (B) is subject to an immediate civil penalty of five hundred dollars ($500) and one thousand dollars ($1,000) for each day the violation continues, until the deficiency is corrected.

SEC. 11.SEC. 12.

 Section 11831.6 of the Health and Safety Code is amended to read:

11831.6.
 (a) The following persons, programs, or entities shall not give or receive remuneration or anything of value for the referral of a person who is seeking alcoholism or drug abuse recovery or treatment services:
(1) An alcoholism or drug abuse recovery or treatment facility, program, or provider licensed under this part.
(2) An owner, partner, officer, or director, or shareholder who holds an interest of at least 10 percent in an alcoholism or drug abuse recovery or treatment facility licensed under this part.
(3) A person employed by, or working for, an alcoholism or drug abuse recovery or treatment facility licensed under this part, including, but not limited to, registered and certified counselors and licensed professionals providing counseling services.
(b) Notwithstanding the rulemaking provisions of the Administrative Procedure Act (Chapter 3.5 (commencing with Section 11340) of Part 1 of Division 3 of Title 2 of the Government Code), 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. 12.SEC. 13.

 Section 11831.7 of the Health and Safety Code is amended to read:

11831.7.
 (a) The department may investigate allegations of violations of this chapter. The department, upon finding a violation of this chapter or a regulation adopted pursuant to this chapter, shall do any of the following:
(1) Assess a penalty upon an alcoholism or drug abuse recovery or treatment facility or program licensed under this part.
(2) Suspend or revoke the license of an outpatient alcoholism or drug abuse recovery or treatment service, program, or provider service or program licensed under this chapter, or an alcoholism or drug abuse recovery or treatment facility licensed under Chapter 7.5 (commencing with Section 11834.01), or deny an application for licensure, extension of the licensing period, or modification to a license. Article 4 (commencing with Section 11834.35) of Chapter 7.5 shall apply to any action taken pursuant to this paragraph.
(3) Suspend or revoke the registration or certification of a counselor for a violation of this chapter.
(b) The department may investigate allegations against a licensed professional providing counseling services at an alcoholism or drug abuse recovery or treatment program licensed or funded under this part, and recommend disciplinary actions, including, but not limited to, termination of employment at a program and suspension and revocation of licensure by the respective licensing board.
(c)  Notwithstanding the rulemaking provisions of the Administrative Procedure Act (Chapter 3.5 (commencing with Section 11340) of Part 1 of Division 3 of Title 2 of the Government Code), 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. 13.SEC. 14.

 Section 11832 of the Health and Safety Code is amended to read:

11832.
 The department may contract with public or private individuals or agencies to provide technical assistance and training to qualify programs for state licensure.

SEC. 14.SEC. 15.

 Section 11832.1 of the Health and Safety Code is amended to read:

11832.1.
 The department shall encourage the development of, and approve, educational courses that provide core knowledge concerning alcohol and drug abuse problems and programs to personnel working within alcohol and drug abuse programs.

SEC. 15.SEC. 16.

 Section 11833 of the Health and Safety Code is amended to read:

11833.
 (a) The department shall have the sole authority in state government to determine the qualifications, including the appropriate skills, education, training, and experience of personnel working within alcoholism or drug abuse recovery or treatment programs licensed or funded under this part.
(b) (1) Except for licensed professionals, as defined by the department, the department shall require that an individual providing counseling services working within a program described in subdivision (a) be registered with or certified by a certifying organization approved by the department to register and certify counselors.
(2) The department shall not approve a certifying organization that does not, prior to registering or certifying an individual, contact other department-approved certifying organizations to determine whether the individual has ever had a registration or certification revoked.
(c) If a counselor’s registration or certification has been previously revoked, the certifying organization shall deny the request for registration and shall send the counselor a written notice of denial. The notice shall specify the counselor’s right to appeal the denial in accordance with applicable statutes and regulations.
(d) The department shall have the authority to conduct periodic reviews of certifying organizations to determine compliance with all applicable laws and regulations, including subdivision (c), and to take actions for noncompliance, including revocation of the department’s approval.
(e) (1) Notwithstanding Chapter 3.5 (commencing with Section 11340) of Part 1 of Division 3 of Title 2 of the Government Code, the department, without taking any further regulatory action, shall implement, interpret, or make specific this section by means of all-county letters, plan letters, plan or provider bulletins, or similar instructions until the time that regulations are adopted.
(2) The department shall adopt regulations by December 31, 2021, in accordance with the requirements of Chapter 3.5 (commencing with Section 11340) of Part 1 of Division 3 of Title 2 of the Government Code.