BILL ANALYSIS Ó
SENATE COMMITTEE ON HEALTH
Senator Ed Hernandez, O.D., Chair
BILL NO: AB 2491
AUTHOR: Nestande
AMENDED: April 22, 2014
HEARING DATE: June 18, 2014
CONSULTANT: Diaz
SUBJECT : Alcohol and drug abuse treatment facilities: sober
living homes.
SUMMARY : Exempts sober living homes (SLHs), as defined, from
licensure by the Department of Health Care Services as a
residential treatment facility as defined. Requires SLHs to
meet specified requirements, including the active participation
of residents in legitimate recovery programs and the maintenance
of records of meeting attendance. Requires that a residence
housing individuals who purport to be recovering from alcohol
and drug abuse be presumed to be an SLH if the residence has
been certified, registered, or approved by a recognized
non-profit organization that provides credible quality assurance
service, as specified.
Existing law:
1.Requires the Department of Health Care Services (DHCS) to
license alcoholism or drug abuse recovery or treatment
facilities (or RTFs) that provide 24-hour residential
non-medical services to adults who are recovering from
problems related to alcohol, drug, or alcohol and drug misuse
or abuse, and who need alcohol, drug, or alcohol and drug
recovery treatment or detoxification services.
2.Requires RTF licensees to provide at least one of the
following: recovery, treatment, or detoxification services.
Requires DHCS to adopt regulations requiring records and
procedures appropriate for the type of service provided.
Provides that the records and procedures can include all of
the following: admission criteria; intake process;
assessments; recovery, treatment, or detoxification planning;
referral; documentation of provision of recovery, treatment,
or detoxification services; discharge and continuing care
planning; or indicators of recovery, treatment, or
detoxification outcomes.
This bill:
Continued---
AB 2491 | Page 2
1. Exempts SLHs from licensure as RTFs. Defines SLH as a
residential property operated as a cooperative living
arrangement to provide an alcohol- and drug-free
environment for those recovering from alcoholism or drug
abuse, or both, who seek a living environment to remain
clean and sober. Requires SLHs to meet all of the
following:
a. Residents, including live-in managers, operators, or
owners, live a sober lifestyle;
b. Residents actively participate in legitimate
recovery programs, including, but not limited to,
outpatient treatment, 12-step recovery, and other
recognized programs of recovery, and maintain current
records of meeting attendance;
c. Owners, managers, operators, and residents observe
and promote a zero-tolerance policy regarding consumption
or possession of alcohol or controlled substances, except
for prescription medications;
d. Owners, managers, operators, and residents do not
provide onsite services, as defined in RTF regulations to
include: detoxification, educational counseling,
individual or group counseling sessions, or treatment or
recovery planning;
e. The number of residents subject to sex offender
registration requirements does not exceed specified
statutory limits, related to how many can live in a
residence, and does not violate statutory distance
provisions;
f. Residents do not require non-medical care or
supervision provided in community care facilities
licensed by the Department of Social Services; and,
g. Owners, managers, operators, and residents ensure
that the property and its use comply with applicable
state and local laws.
2. Requires that a residence housing individuals who
purport to be recovering from alcohol and drug abuse be
presumed to be an SLH if the residence has been certified,
registered, or approved by a recognized non-profit
organization that provides credible quality assurance
service for applicants and members. Specifies that the
non-profit organization should establish minimum standards
for protocols to address suspected alcohol and drug abuse,
to report a resident's death, and to address basic first
aid and cardiopulmonary resuscitation training.
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3
3. Prohibits this bill from being construed to prohibit
minor children who are dependents of a resident of an SLH
from also residing in the SLH.
FISCAL EFFECT : According to the Assembly Appropriations
Committee, this bill has negligible state fiscal effect.
PRIOR VOTES :
Assembly Health: 19 - 0
Assembly Appropriations:17 - 0
Assembly Floor: 73 - 0
COMMENTS :
1.Author's statement. According to the author, SLHs are
typically a cooperative living environment where individuals
can begin the next step of their sobriety in a safe and clean
environment. However, because there is not regulatory
authority that oversees these homes and no universal
definition in statute, there is no way to ensure these homes
are operating as they purport to. Therefore, there is a risk
for those in the delicate recovery phase to be in an
environment that does not support their sobriety goals.
2.SLHs. A 2010 report on the National Institutes of Health (NIH)
Web site, Sober Living Houses for Alcohol and Drug Dependence:
18-month Outcomes, states that SLHs are not formal treatment
programs and are not obligated to comply with state or local
regulations applicable to treatment. However, NIH does not
provide a formal definition of an SLH. The report also
mentions that it is difficult to determine how many SLHs there
are in California because they are outside of the purview of
state licensing authorities (so no one is tracking SLHs). The
NIH report cites the protection that the federal Fair Housing
Act affords SLHs to be located in residentially zoned areas,
personal privacy under the Fourth Amendment, and the right of
people with disabilities to live together for a shared
purpose, such as mutually assisted recovery and maintenance of
an abstinent lifestyle.
According to DHCS's Web site, some types of RTFs do not
provide alcohol and other drug services and do not require
licensure by DHCS, including cooperative living arrangements
with a commitment or requirement to be free from alcohol and
other drugs, sometimes referred to as SLHs, transitional
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housing, or alcohol- and drug-free housing. DHCS states that
while SLHs or alcohol- and drug-free housing are not required
to be licensed by DHCS, they may be subject to other types of
permits, clearances, business taxes, or local fees, which may
be required by the cities or counties in which they are
located. DHCS does not license, certify, or investigate
complaints against SLHs. If an SLH is providing licensable
services to adults then it must obtain a valid RTF license
from DHCS. Licensable services can include detoxification
services, group sessions, individual sessions, one-on-one
counseling, educational sessions, or recovery or treatment
planning. If an SLH is providing just one of the mentioned
services, then it should be classified as an RTF and must
obtain a valid license from DHCS.
3.Difficulty siting RTFs. A document published the U.S.
Department of Health and Human Services (DHHS), Siting Drug
and Alcohol Treatment Programs: Legal Challenges to the NIMBY
Syndrome, states that community opposition, "not in my
backyard" (NIMBY), prevents or delays the siting of treatment
programs, even when an already existing program tries to
relocate. NIMBY is often targeted toward other types of health
and social service facilities, like shelters for the homeless,
group homes for the mentally ill, halfway houses for
ex-offenders, and health-related facilities for those with
AIDS. According to DHHS, many discriminatory zoning ordinances
and practices may be unlawful under the Fair Housing Act, the
Rehabilitation Act, and the Americans with Disabilities Act.
It is also noted that communities often fear the decline of
property values and increased crime because of RTFs in the
neighborhood. However, the DHHS document states that in almost
every instance a community's fears are unfounded, as RTFs pose
no danger to the health and welfare of neighbors nor draw
substance abusers or pushers to the area.
4.Newport Beach Ordinance. According to the Web site for the
City of Newport Beach, in 2008 the Newport Beach City Council
adopted an ordinance that changed how the city regulates group
residential uses, defined as a "non-traditional single
housekeeping unit," including a boarding house, dorm, reunion
rental, state-licensed recovery home, SLHs, and elder care
homes. The ordinance required many home operators at the time
to obtain a use permit to stay in place.
A September 20, 2013, Los Angeles Times article, "Appeals
court backs sober-living homes in suit against Newport Beach,"
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states that the U.S. 9th Circuit Court of Appeals unanimously
ruled that the Newport Beach ordinance may have illegally
discriminated against those with a disability. The article
states the ordinance forced many group homes to close and
prevented new ones from opening. A March 26, 2014, article in
the Orange County Register, "Newport Beach takes sober home
law to Supreme Court," reported that the Newport Beach City
Council petitioned the U.S. Supreme Court about the ruling by
the 9th Circuit Court of Appeal, and that the city will know
by the end of September 2014 if the court will review the
case.
5.Related legislation. AB 2335 (Mansoor) would have defined SLHs
with certain criteria and exempted an SLH or supportive
housing from licensure as an RTF. This bill failed passage in
the Assembly Health Committee on April 22, 2014, on a 6-12
vote.
6.Prior legislation. SB 214 (Benoit), of 2009, and AB 724
(Benoit), of 2007, were both substantially similar to this
bill. SB 214 failed in the Senate Health Committee without
being heard. AB 724 failed passage in the Senate Health
Committee on a 5-4 vote. Reconsideration was granted, but the
bill was not heard again in the committee.
SB 992 (Wiggins), of 2008, would have required the Department
of Alcohol and Drug Programs to license SLHs, or "adult
recovery maintenance facilities." SB 992 was vetoed by
Governor Schwarzenegger who stated that while licensure and
regulation of SLHs are important to ensure SLHs respect and
participate in their local community; for communities to
provide support to these facilities; and for individuals
seeking recovery from alcohol and drug addiction to live in
safe environments that help them in their recovery, this bill
did not accomplish these policy goals.
AB 370 (Adams), of 2007, would have permitted a local
government to include an RTF serving six or fewer persons,
including a sober living facility, within the definition of
single family residence. AB 370 was held on suspense in the
Assembly Appropriations Committee.
AB 36 (Strickland), of 2006, was similar to SB 992. AB 36 was
held on suspense in the Senate Appropriations Committee.
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SB 340 (Florez), of 2003, was similar to SB 992 and AB 36. SB
340 failed in the Senate Health and Human Services Committee
without being heard.
AB 2317 (Chu), of 2002, was similar to SB 992, AB 36, and SB
340. AB 2317 was held on suspense in the Senate Appropriations
Committee.
7.Policy comments.
a. Does this bill solve the current SLH problem?
Because there is no state authority that oversees SLHs
and no universal definition in statute, the author
believes there is no way to ensure SLHs are operating as
they purport to operate. This bill adds a definition for
SLHs to DHCS's licensing statute but exempts them from
licensure. It is unclear if DHCS would be responsible for
oversight of SLHs.
b. Should residents be required to take on
responsibilities? This bill places a number of
requirements on residents of SLHs, including the
assurance that the SLH complies with applicable state and
local laws. The author states in support of this
provision that, without this requirement, there is a risk
for those in the delicate recovery phase to be in an
environment that does not support their sobriety goals.
Is ensuring that an SLH complies with applicable state
and local laws a function that should be required of a
person who is in the middle of treatment?
c. What are the recognized non-profit organizations
that certify, register, or approve SLHs? This bill
requires residences housing those who purport to be
recovering from alcohol and drug abuse to be presumed to
be SLHs if the residence is certified, registered, or
approved by a "recognized" non-profit organization.
However, it is unclear who the non-profit organizations
are and by whom they need to be recognized.
d. Do requirements of SLHs constitute licensable
services? This bill requires SLH residents to actively
participate in legitimate recovery programs and maintain
records of meeting attendance. It is unclear what a
"legitimate" recovery program is, as well as what the
purpose of maintaining records of meeting attendance is
or who will have access to those records.
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SUPPORT AND OPPOSITION :
Support: One individual
Oppose: None received.
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