BILL ANALYSIS                                                                                                                                                                                                    



                                                                     AB 848


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          Date of Hearing:  May 20, 2015


                        ASSEMBLY COMMITTEE ON APPROPRIATIONS


                                 Jimmy Gomez, Chair


          AB  
          848 (Mark Stone) - As Amended May 6, 2015


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          Urgency:  No  State Mandated Local Program:  NoReimbursable:  No


          SUMMARY:


          1)This bill authorizes alcoholism and drug treatment facilities  
            to allow a licensed physician, or other qualified health care  
            practitioner, to provide incidental medical services as  
            defined to a resident of the facility.  Requires DHCS to  








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            develop a standard certification form and, on or before  
            January 1, 2017, to adopt emergency regulations that are only  
            effective for 180 days or once final regulations are adopted,  
            whichever comes first.  Exempts emergency regulations adopted  
            by DHCS from review by the Office of Administrative Law.   
            Requires DHCS to adopt final regulations. 


          FISCAL EFFECT:





          1)Significant costs to adopt emergency and final regulations,  
            likely in the range of $400,000 over two years (licensing fees  
            and Substance Abuse Prevention and Treatment (SAPT) Block  
            Grant). 



          2)Unknown ongoing costs to oversee this new requirement as a  
            component of licensure, possibly in the range of $100,000  
            annually (licensing fees and Substance Abuse Prevention and  
            Treatment (SAPT) Block Grant).



          COMMENTS:





          1)Purpose. The author believes this bill will allow people to  
            get appropriate whole-person care that is unfortunately  
            unavailable at residential drug treatment facilities because  
            of current-law restrictions. Alcohol and drug rehabilitation  
            facilities cannot be licensed by DHCS if they use on-site  








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            doctors or other medical personnel to evaluate or provide  
            medical care to facility clients.  This prohibition precludes  
            facilities from meeting the medical needs of clients that  
            could easily and efficiently be provided on-site.  Instead, if  
            clients have medical needs during the course of their  
            residential treatment, facility staff must transport them to  
            doctors' offices, clinics, or hospital emergency rooms, which  
            can be inefficient and costly.



          2)Background. An alcoholism or drug abuse recovery or treatment  
            facility provides 24-hour residential non-medical services,  
            defined as recovery services, treatment services, and  
            detoxification services to adults who are recovering from  
            problems related to alcohol, drug, or alcohol and drug misuse  
            or abuse.  These facilities are licensed by DHCS, formerly the  
            Department of Drug and Alcohol Programs.  They are community  
            facilities, not medical facilities.  These facilities grew out  
            of a "social rehabilitation" model, which is somewhat in  
            conflict with the evolution of drug treatment, which often can  
            be medication-assisted.  



            A September 2012 investigative report by the Senate Office of  
            Oversight and Outcomes (SOOO) identified gaps in the  
            Department of Drug and Alcohol Program's (DADP's) regulation  
            of residential programs.  The report recommended, among other  
            things, the Legislature consider approving a bill allowing  
            medical care in residential treatment facilities, given that  
            many experts believe that medical care is an integral part of  
            successful treatment.  


          


          3)Previous Legislation. AB 395 (Fox) of 2013, AB 972 (Butler) of  








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            2011, AB 2221 (Beall) of 2010, and AB 1055 (Chesbro) of 2009,  
            took similar approaches to include as DADP licensees  
            residential programs that provided some medical services. AB  
            395, AB 972, and AB 2221 were held on the Senate  
            Appropriations Suspense File. AB 1055 was held on this  
            committee's Suspense File.






          Analysis Prepared by:Lisa Murawski / APPR. / (916)  
          319-2081