BILL ANALYSIS                                                                                                                                                                                                    Ó




                   Senate Appropriations Committee Fiscal Summary
                            Senator Kevin de León, Chair


          AB 395 (Fox) - Alcoholism and drug abuse treatment facilities.
          
          Amended: July 10, 2013          Policy Vote: Health 9-0
          Urgency: No                     Mandate: No
          Hearing Date: August 12, 2013                           
          Consultant: Brendan McCarthy    
          
          This bill meets the criteria for referral to the Suspense File.
          
          
          Bill Summary: AB 395 would expand the types of facilities  
          licensed by the Department of Health Care Services as alcoholism  
          or drug abuse recovery or treatment facilities to include  
          facilities that provide medical care.

          Fiscal Impact: 
              One-time costs between $150,000 and $300,000 for the  
              development of regulations by the Department of Health Care  
              Services (Residential and Outpatient Program Licensing  
              Fund).

              Ongoing costs likely in the hundreds of thousands per year  
              for licensing and enforcement of regulatory requirements on  
              treatment facilities that provide medical care (Residential  
              and Outpatient Program Licensing Fund).

          Background: Under current law, the Department of Health Care  
          Services licenses and regulates residential treatment facilities  
          that provide recovery and detoxification services to adults who  
          are addicted to alcohol and/or drugs. (These licensing functions  
          were recently transferred to the Department of Health Care  
          Services from the Department of Alcohol and Drug Programs, which  
          was eliminated.)

          Current law does not allow operators of those licensed  
          facilities to provide medical care to patients. However, the  
          Senate Office of Oversight and Outcomes has found that many  
          licensed facilities do provide medical care to patients, in  
          violation of current licensing requirements.

          Proposed Law: AB 395 would expand the types of facilities  
          licensed by the Department of Health Care Services as alcoholism  








          AB 395 (Fox)
          Page 1


          or drug abuse recovery or treatment facilities to include  
          facilities that provide recovery or detoxification services and  
          medical care.

          Specific provisions of the bill would
              Authorize licensed facilities to provide medical services;
              Require facilities to be accredited by a national  
              accrediting organization;
              Require facilities to include a licensed physician on the  
              treatment team;
              Specify what types of medical services may be provided;
              Require the Department of Health Care Services to report to  
              the Legislature by January 1, 2016 on implementation of the  
              bill;
              Require facility operators to report any resident deaths to  
              the Department within 24 hours.

          Related Legislation: 
              AB 972 (Butler, 2011) was substantially similar to this  
              bill. That bill was held on this committee's Suspense File  
              and subsequently amended to address a different subject.
              AB 2221 (Beall, 2011) was substantially similar to this  
              bill. That bill was held on this committee's Suspense File.
              AB 1055 (Chesbro, 2009) was substantially similar to this  
              bill. That bill was held on the Assembly Appropriations  
              Committee's Suspense File.

          Staff Comments: According to the Senate Office of Oversight and  
          Outcomes report, there has been a trend in the alcohol and drug  
          treatment industry in recent years away from a purely "social  
          model" of treatment (based on group counseling) towards a model  
          that incorporates more medical interventions into detoxification  
          and treatment. As noted above, the report indicates that there  
          are many treatment facilities in the state that are currently  
          providing medical services to residents.