BILL ANALYSIS Ó SENATE COMMITTEE ON APPROPRIATIONS Senator Ricardo Lara, Chair 2015 - 2016 Regular Session AB 848 (Mark Stone) - Alcoholism and drug abuse treatment facilities ----------------------------------------------------------------- | | | | | | ----------------------------------------------------------------- |--------------------------------+--------------------------------| | | | |Version: July 16, 2015 |Policy Vote: HEALTH 8 - 1 | | | | |--------------------------------+--------------------------------| | | | |Urgency: No |Mandate: No | | | | |--------------------------------+--------------------------------| | | | |Hearing Date: August 17, 2015 |Consultant: Brendan McCarthy | | | | ----------------------------------------------------------------- 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 AB 848 (Mark Stone) Page 1 of ? 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 AB 848 (Mark Stone) Page 2 of ? 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. -- END --