Today's Law As Amended


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AB-1477 Alcohol and drug treatment programs: licensing and certification fee.(2023-2024)



As Amends the Law Today


SECTION 1.
 The Legislature finds and declares the following:
(a) Data from the federal Centers for Disease Control and Prevention’s (CDC) National Center for Health Statistics shows that nationally there were more than 100,000 Americans who died by overdose from May 2020 to April 2021, inclusive, with more than 64,000 of these deaths being a result of synthetic opioids and fentanyl.
(b) California experienced a 45-percent increase as more than 10,800 Californians died during this time.
(c) The number of amphetamine-related emergency department visits increased by nearly 50 percent between 2018 and 2020 and the number of non-heroin-related opioid emergency room visits more than doubled in the same period.
(d) Data from the California Health Care Foundation shows that around 8.5 percent of California’s population lives with a substance use disorder, with 6.4 percent meeting criteria for an alcohol use disorder and 3.3 percent meeting criteria for a substance use disorder involving illegal drugs.
(e) Fifty-six of 58 counties in California are not meeting network adequacy requirements for the provision of substance use disorder services.
(f) Only 40 percent of commercial HMO and PPO health plan members with an alcohol or other drug dependence diagnosis received care that met the national quality standard of an initial treatment visit within 14 days of diagnosis.
(g) About 2.7 million Californians had a diagnosable substance use disorder in the past year, and only 1 in 10 of these individuals received treatment.
(h) The State Department of Health Care Services (DHCS) instituted licensure and certification fee reduction waivers throughout the first year of the COVID-19 Pandemic Emergency to assist facilities licensed and certified by DHCS to keep their doors open and to provide critical services, thus depleting the Residential and Outpatient Program Licensing Fund reserve.
(i) Section 11833.02 of the Health and Safety Code requires the fund to be supported by fees and federal funds, unless there is a specific appropriation from the General Fund.
(j) The Legislature declares that California faces a substance use disorder emergency and resolves to temporarily freeze licensing and certification fees for treatment programs to remove disincentives to building the state’s treatment capacity.

SEC. 2.

 Section 11833.02 of the Health and Safety Code is amended to read:

11833.02.
 (a) The department shall charge a fee to all programs for licensure or certification by the department, regardless of the form of organization or ownership of the program.
(b) The department may establish fee scales using different capacity levels, categories based on measures other than program capacity, or any other category or classification that the department deems necessary or convenient to maintain an effective and equitable fee structure.
(c) Licensing and certification fees shall be evaluated annually, taking into consideration the overall cost of the residential and outpatient licensing and certification activities of the department, including initial issuance, renewals, complaints, enforcement activity, related litigation, and any other program activity relating to licensure and certification, plus a reasonable reserve. Any excess fees remaining in the Residential and Outpatient Program Licensing Fund pursuant to Section 11833.03 at the end of each fiscal year shall be carried forward and taken into consideration in setting the amount of fees imposed in the immediately subsequent fiscal year. 
(d) No sooner than July 1, 2027, the department is authorized to approve a fee increase, up to and including 5 percent on an annual basis, as needed to address the costs of  Beginning January 1, 2024, all fees for licensing of residential treatment facilities and certification of treatment programs that provide addiction treatment services shall be designated at the rate last published in 2022. This rate shall remain in effect until January 1, 2031, or until deaths related to any opioid overdose reported by the California Overdose Surveillance Dashboard have declined by 50 percent compared to the deaths on January 1, 2024, whichever is first. Upon a 50-percent reduction in overdose deaths, or after January 1, 2031, fees may be increased. These increases shall occur over a number of years and at a percentage to be determined based upon the estimated annual operating deficit for the  licensing and certification activities identified in subdivision (c). programs. These fee increases shall continue until the licensing and certification programs funded through the Residential and Outpatient Program Licensing Fund are self-sufficient. A single-year increase prior to fund self-sufficiency shall not be more than 15 percent. 
(e) If the department proposes new fees or an increase in fees in excess of 5 percent, the department shall submit those  The department shall submit any proposed  new fees or fee increases changes  to the Legislature for approval no later than April 1 of each year as part of the spring finance letter process. New fees or fee increases in excess of 5 percent  changes  shall not be implemented without legislative approval.
(f) The department shall issue a provider bulletin pursuant to subdivision (a) of  Section 11833.04 setting forth the approved  fee structure. The department shall, on an annual basis, publish the current fee structure on the department’s internet website.
(g) To provide access to quality substance use disorder services, the department shall develop a process for programs and facilities to apply for a hardship fee waiver. The department shall issue a provider bulletin pursuant to Section 11833.04 detailing the process to apply for a hardship fee waiver that includes eligibility requirements for demonstrated need by July 1, 2024.
(h) (g)  Unless funds are specifically appropriated from the General Fund in the annual Budget Act or other legislation to support the division, the Licensing and Certification Division, no later than the beginning of the 2010–11 fiscal year, shall be supported entirely by federal funds and special funds.