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AB-920 Substance abuse recovery or treatment providers.(2019-2020)



Current Version: 09/20/19 - Enrolled

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AB920:v95#DOCUMENT

Enrolled  September 20, 2019
Passed  IN  Senate  September 13, 2019
Passed  IN  Assembly  September 13, 2019
Amended  IN  Senate  September 06, 2019
Amended  IN  Senate  June 25, 2019
Amended  IN  Assembly  March 25, 2019

CALIFORNIA LEGISLATURE— 2019–2020 REGULAR SESSION

Assembly Bill
No. 920

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

February 20, 2019

An act to amend Sections 11830, 11830.1, 11830.5, 11831, 11831.2, 11831.5, 11831.6, 11831.7, 11832, 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 11831.51 to, the Health and Safety Code, relating to public health.


LEGISLATIVE COUNSEL'S DIGEST


AB 920, Petrie-Norris. Substance abuse recovery or treatment providers.
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, beginning January 1, 2021, require an outpatient alcoholism or drug abuse recovery or treatment program that provides those services to the public and is not otherwise licensed under existing law to be licensed by the department, except as specified. 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 require the department to charge a fee that does not 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 an outpatient alcoholism or drug abuse recovery or treatment program without obtaining a current valid license and would impose specified penalties for violations of that prohibition.
Existing law requires the department to implement the Medi-Cal 2020 demonstration project, including the Drug Medi-Cal organized delivery system (DMC-ODS) that provides alcohol and drug use services to eligible persons and authorizes the department to enter into a Drug Medi-Cal Treatment Program contract with a county for the provision of those services within a county service area.
This bill would deem a county DMC-ODS to be in compliance with the bill’s licensure requirements and would exempt a Drug Medi-Cal Treatment Program contractor from those licensure requirements until January 1, 2023, or the date that the county becomes a DMC-ODS, whichever is earlier.
This bill would incorporate additional changes to Section 11831.7 of the Health and Safety Code proposed by AB 919 to be operative only if this bill and AB 919 are enacted and this bill is enacted last.
Vote: MAJORITY   Appropriation: NO   Fiscal Committee: YES   Local Program: NO  

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


SECTION 1.

 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 Programs

SEC. 2.

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

11830.
 (a) Beginning January 1, 2021, an outpatient alcoholism or drug abuse recovery or treatment program that provides those services to the public for compensation and is not otherwise licensed pursuant to this part shall be licensed by the department pursuant to the program established under this chapter. This chapter does not apply to peer-to-peer support groups such as Narcotics Anonymous, Alcoholics Anonymous, or other religious or nonreligious recovery groups that are peer-led and do not provide or bill for outpatient services.
(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. 3.

 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 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 or at a licensed program are required to be reported to the 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. 4.

 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 licensing procedure for outpatient alcohol and other drug treatment or recovery programs. 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 alcoholism or drug abuse treatment or recovery programs describing the minimal level of service quality required to qualify for and obtain an outpatient program state license. For the purposes of Section 2626.2 of the Unemployment Insurance Code, licensure shall be equivalent to program review.

SEC. 5.

 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, 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 county Drug Medi-Cal organized delivery system (DMC-ODS) authorized under the California Medi-Cal 2020 Demonstration, Number 11-W-00193/9, as approved by the federal Centers for Medicare and Medicaid Services and described in the Special Terms and Conditions, shall be deemed in compliance with the requirements of this chapter.
(B) A county that contracts with the department under the Drug Medi-Cal Treatment Program, as specified in Article 3.2 (commencing with Section 14124.20) of Chapter 7 of Part 3 of Division 9 of the Welfare and Institutions Code, and an entity that contracts with a county for purposes of this program, for the provision of alcohol and drug use services exclusively to clients within a county service area that is a non-DMC-ODS, shall be exempt from this chapter until January 1, 2023, or until the county operates a DMC-ODS, whichever is earlier.
(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 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. 6.

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

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

SEC. 7.

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

11831.2.
 (a) The department shall charge a fee that does not exceed the reasonable regulatory costs of administering this chapter and licensing a program 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. 8.

 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 program, 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. 9.

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

11831.51.
 (a) An entity shall not operate, establish, manage, conduct, or maintain an outpatient alcoholism or drug abuse recovery or treatment program 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 program 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 program 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 program stating that the program is operating in violation of subdivision (a). The notice shall include all of the following:
(A) The date by which the program shall cease providing services.
(B) Notice that the department will assess against the program a civil penalty of two thousand dollars ($2,000) per day for every day the program 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 program continues to provide services beyond the date specified in the notice.
(3) Inform the program of the licensing requirements of paragraph (2).
(4) An 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 program 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 an additional 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 an additional one thousand dollars ($1,000) for each day the violation continues, until the deficiency is corrected.

SEC. 10.

 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 or program 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 or program licensed under this part.
(3) A person employed by, or working for, an alcoholism or drug abuse recovery or treatment facility or program 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. 11.

 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 shall, upon finding a violation of this chapter or a regulation adopted pursuant to this chapter, 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 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. 11.5.

 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 shall, upon finding a violation of this chapter or a regulation adopted pursuant to this chapter, 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 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) The department shall establish an enforcement program focused on the oversight duties of this chapter. Staff of the enforcement program shall have responsibilities including, but not limited to, all of the following:
(1) Provide the department with analytical support for the development and administration of this chapter.
(2) Provide the department with general oversight and monitoring focused on investigations and enforcement of this chapter.
(3) Provide the department with legal guidance in the interpretation of this chapter.
(d) 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.

 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. 13.

 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.

SEC. 14.

 Section 11.5 of this bill incorporates amendments to Section 11831.7 of the Health and Safety Code proposed by both this bill and Assembly Bill 919. That section shall only become operative if (1) both bills are enacted and become effective on or before January 1, 2020, (2) each bill amends Section 11831.7 of the Health and Safety Code, and (3) this bill is enacted after Assembly Bill 919, in which case Section 11 of this bill shall not become operative.