BILL NUMBER: SB 973	INTRODUCED
	BILL TEXT


INTRODUCED BY   Senator Hernandez

                        FEBRUARY 10, 2014

   An act to amend Section 11839.3 of the Health and Safety Code,
relating to narcotic treatment.


	LEGISLATIVE COUNSEL'S DIGEST


   SB 973, as introduced, Hernandez. Narcotic treatment programs.
   Existing law requires the State Department of Health Care Services
to administer prevention, treatment, and recovery services for
alcohol and drug abuse. Existing law requires the department to
license the establishment of narcotic treatment programs in this
state to use narcotic replacement therapy in the treatment of
addicted persons whose addiction was acquired or supported by the use
of a narcotic drug or drugs, not in compliance with a physician and
surgeon's legal prescription. Existing law authorizes a program to
admit a patient to narcotic maintenance or narcotic detoxification
treatment 7 days after completion of a prior withdrawal treatment
episode.
   This bill, instead, would authorize a program to admit a patient
to narcotic maintenance or narcotic detoxification treatment at the
discretion of the medical director.
   Vote: majority. Appropriation: no. Fiscal committee: yes.
State-mandated local program: no.


THE PEOPLE OF THE STATE OF CALIFORNIA DO ENACT AS FOLLOWS:

  SECTION 1.  Section 11839.3 of the Health and Safety Code is
amended to read:
   11839.3.  (a) In addition to the duties authorized by other
statutes, the department shall perform all of the following:
   (1) License the establishment of narcotic treatment programs in
this state to use narcotic replacement therapy in the treatment of
addicted persons whose addiction was acquired or supported by the use
of a narcotic drug or drugs, not in compliance with a physician and
surgeon's legal prescription, except that the Research Advisory Panel
shall have authority to approve methadone or LAAM research programs.
The department shall establish and enforce the criteria for the
eligibility of patients to be included in the programs, program
operation guidelines,  such as   including 
dosage levels, recordkeeping and reporting, urinalysis requirements,
take-home doses of controlled substances authorized for use pursuant
to Section 11839.2, security against redistribution of the narcotic
replacement drugs, and any other regulations that are necessary to
protect the safety and well-being of the patient, the local
community, and the public, and to carry out this chapter. A program
may admit a patient to narcotic maintenance or narcotic
detoxification treatment  seven days after completion of a
prior withdrawal treatment episode   at the discretion
of the medical director  . The arrest and conviction records and
the records of pending charges against  any   a
 person seeking admission to a narcotic treatment program shall
be furnished to narcotic treatment program directors upon written
request of the narcotic treatment program director provided the
request is accompanied by a signed release from the person whose
records are being requested.
   (2) Inspect narcotic treatment programs in this state and ensure
that programs are operating in accordance with the law and
regulations. The department shall have sole responsibility for
compliance inspections of all programs in each county. Annual
compliance inspections shall consist of an evaluation by onsite
review of the operations and records of licensed narcotic treatment
programs' compliance with applicable state and federal laws and
regulations and the evaluation of input from local law enforcement
and local governments, regarding concerns about the narcotic
treatment program. At the conclusion of each inspection visit, the
department shall conduct an exit conference to explain the cited
deficiencies to the program staff and to provide recommendations to
ensure compliance with applicable laws and regulations. The
department shall provide an inspection report to the licensee within
30 days of the completed onsite review describing the program
deficiencies. A corrective action plan shall be required from the
program within 30 days of receipt of the inspection report. All
corrective actions contained in the plan shall be implemented within
30 days of receipt of approval by the department of the corrective
action plan submitted by the narcotic treatment program. For programs
found not to be in compliance, a subsequent inspection of the
program shall be conducted within 30 days after the receipt of the
corrective action plan in order to ensure that corrective action has
been implemented satisfactorily. Subsequent inspections of the
program shall be conducted to determine and ensure that the
corrective action has been implemented satisfactorily. For purposes
of this requirement, "compliance" shall mean to have not committed
any of the grounds for suspension or revocation of a license provided
for under subdivision (a) of Section 11839.9 or paragraph (2) of
subdivision (b) of Section 11839.9. Inspection of narcotic treatment
programs shall be based on objective criteria including, but not
limited to, an evaluation of the programs' adherence to all
applicable laws and regulations and input from local law enforcement
and local governments. Nothing in this section shall preclude
counties from monitoring their contract providers for compliance with
contract requirements.
   (3) Charge and collect licensure fees. In calculating the
licensure fees, the department shall include staff salaries and
benefits, related travel costs, and state operational and
administrative costs. Fees shall be used to offset licensure and
inspection costs not to exceed actual costs.
   (4) Study and evaluate, on an ongoing basis, narcotic treatment
programs including, but not limited to, the adherence of the programs
to all applicable laws and regulations and the impact of the
programs on the communities in which they are located.
   (5) Provide advice, consultation, and technical assistance to
narcotic treatment programs to ensure that the programs comply with
all applicable laws and regulations and to minimize any negative
impact that the programs may have on the communities in which they
are located.
   (6) In its discretion, to approve local agencies or bodies to
assist it in carrying out this chapter provided that the department
may not delegate responsibility for inspection or any other licensure
activity without prior and specific statutory approval. However, the
department shall evaluate recommendations made by county alcohol and
drug program administrators regarding licensing activity in their
respective counties.
   (7) The director may grant exceptions to the regulations adopted
under this chapter if he or she determines that this action would
improve treatment services or achieve greater protection to the
health and safety of patients, the local community, or the general
public. No exception may be granted if it is contrary to, or less
stringent than, the federal laws and regulations  which
  that  govern narcotic treatment programs.
   (b) It is the intent of the Legislature in enacting this section
in order to protect the general public and local communities, that
self-administered dosage shall only be provided when the patient is
clearly adhering to the requirements of the program, and where daily
attendance at a clinic would be incompatible with gainful employment,
education, and responsible homemaking. The department shall define
"satisfactory adherence" and shall ensure that patients not
satisfactorily adhering to their programs shall not be provided
take-home dosage.
   (c) There is established in the State Treasury the Narcotic
Treatment Program Licensing Trust Fund. All licensure fees collected
from the providers of narcotic treatment service shall be deposited
in this fund. Except as otherwise provided in this section, if funds
remain in this fund after appropriation by the Legislature and
allocation for the costs associated with narcotic treatment licensure
actions and inspection of narcotic treatment programs, a percentage
of the excess funds shall be annually rebated to the licensees based
on the percentage their licensing fee is of the total amount of fees
collected by the department. A reserve equal to 10 percent of the
total licensure fees collected during the preceding fiscal year may
be held in each trust account to reimburse the department if the
actual cost for the licensure and inspection exceed fees collected
during a fiscal year.
   (d) Notwithstanding any provision of this code or regulations to
the contrary, the department shall have sole responsibility and
authority for determining if a state narcotic treatment program
license shall be granted and for administratively establishing the
maximum treatment capacity of  any   a 
license. However, the department shall not increase the capacity of a
program unless it determines that the licensee is operating in full
compliance with applicable laws and regulations.