BILL ANALYSIS                                                                                                                                                                                                    



          SENATE COMMITTEE ON APPROPRIATIONS
                             Senator Ricardo Lara, Chair
                            2015 - 2016  Regular  Session

          AB 848 (Mark Stone) - Alcoholism and drug abuse treatment  
          facilities
          
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          |Version: July 16, 2015          |Policy Vote: HEALTH 8 - 1       |
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          |Urgency: No                     |Mandate: No                     |
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          |Hearing Date: August 17, 2015   |Consultant: Brendan McCarthy    |
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          This bill meets the criteria for referral to the Suspense File.


          Bill  
          Summary:  AB 848 would allow alcoholism and drug abuse recovery  
          or treatment facilities licensed by the Department of Health  
          Care Services to provide incidental medical services.


          Fiscal  
          Impact:  
           One-time costs of about $550,000 to develop program  
            requirements and adopt regulations by the Department of Health  
            Care Services (General Fund).

           Ongoing costs of about $550,000 per year to perform ongoing  
            licensing, inspection, and enforcement activities relating to  
            facilities licensed to provide incidental medical services by  
            the Department of Health Care Services, offset by fee revenues  
            (Residential and Outpatient Program Licensing Fund).

           Unknown additional legal costs relating to future enforcement  
            actions that may result in appeals or litigation (Residential  







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            and Outpatient Program Licensing Fund). The Department has  
            indicated that there could be significant additional legal  
            costs due to enforcement activity and the complexities of  
            determining appropriate medical care for residents. Whether or  
            not such costs will occur is not known at this time.


          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 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 found that many licensed  
          facilities do provide medical care to patients, in violation of  
          current licensing requirements.


          Proposed Law:  
            AB 848 would allow alcoholism and drug abuse recovery or  
          treatment facilities licensed by the Department of Health Care  
          Services to provide incidental medical services.
          Specific provisions of the bill would:
           Require a licensed facility to obtain a form signed by a  
            health care provider from an applicant for services (i.e. a  
            resident) that lists the necessary medical services the  
            applicant needs;
           Require the Department of Health Care Services to define  
            incidental medical services in regulation;
           Authorize a licensed alcoholism or drug abuse recovery or  
            treatment facility to permit incidental medical services to be  
            provided to a resident of the facility, if specified  
            conditions are met;
           Require the Department to adopt implementing regulations by  
            July 1, 2017, but also allow the Department to implement the  
            requirements of the bill prior to adoption of those  
            regulations through provider bulletins or other means;
           Require a facility that intends to permit incidental medical  
            services to provide specified information to the Department;
           Require the Department to establish an additional license fee  








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            for those facilities that wish to permit incidental medical  
            services, in an amount sufficient to cover the Department's  
            licensing and regulatory costs.


          Related  
          Legislation:  
           AB 395 (Fox, 2013) would have expanded 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. That bill was  
            held on this committee's Suspense File.
           AB 972 (Butler and Beall, 2011) would have expanded the  
            category of residential treatment facilities to include  
            facilities that provide limited medical services. That bill  
            was held on this committee's Suspense File.
           AB 2221 (Beall, 2010) was similar to AB 972. that bill was  
            held on this 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.


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