BILL ANALYSIS Ó ----------------------------------------------------------------- |SENATE RULES COMMITTEE | AB 848| |Office of Senate Floor Analyses | | |(916) 651-1520 Fax: (916) | | |327-4478 | | ----------------------------------------------------------------- THIRD READING Bill No: AB 848 Author: Mark Stone (D) Amended: 8/31/15 in Senate Vote: 21 SENATE HEALTH COMMITTEE: 8-1, 7/15/15 AYES: Hernandez, Hall, Mitchell, Monning, Nielsen, Pan, Roth, Wolk NOES: Nguyen SENATE APPROPRIATIONS COMMITTEE: 6-1, 8/27/15 AYES: Lara, Beall, Hill, Leyva, Mendoza, Nielsen NOES: Bates ASSEMBLY FLOOR: 74-3, 6/3/15 - See last page for vote SUBJECT: Alcoholism and drug abuse treatment facilities SOURCE: California Society of Addiction Medicine Elements of Behavioral Health/Promises Treatment Centers Janus of Santa Cruz DIGEST: This bill allows alcoholism or drug abuse recovery or treatment facilities licensed by the Department of Health Care Services to provide incidental medical services, as specified, upon receiving a license to provide those services. This bill requires incidental medical services to be provided by a physician and surgeon or other health care practitioner who are knowledgeable about addiction medicine, as specified. ANALYSIS: AB 848 Page 2 Existing law: 1) Requires the Department of Health Care Services (DHCS) to license nonmedical adult alcoholism or drug abuse recovery or treatment facilities (RTFs), and specifies that a license is valid for two years. 2) Defines an RTF as a facility that provides 24-hour residential, nonmedical 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. 3) Prohibits a licensee from operating an RTF beyond the conditions of the license, and if it does, the RTF is subject to civil penalties, suspension, or revocation of the license. 4) Allows DHCS's director to suspend or revoke any license, or deny an application for licensure, for extension of the licensing period, or to modify the terms and conditions of a license for specified reasons, including repeated violations of licensing laws or misrepresentation of any material fact in obtaining a license. 5) Provides for the licensure of physicians and surgeons, and the enforcement of the disciplinary and criminal provisions of the Medical Practice Act, by the Medical Board of California (MBC) within the Department of Consumer Affairs. This bill: 1) Allows RTFs to apply to DHCS to obtain a license to provide "incidental medical services (IMS)." Defines IMS as services that are in compliance with the community standard of practice and are not required to be performed in a licensed clinic or licensed health facility, as specified. Specifies that IMS includes obtaining medical histories, monitoring health status, overseeing patient self-administration of medications, and other services to be further defined by DHCS by regulation. 2) Requires, as a condition of providing IMS, an RTF to obtain AB 848 Page 3 from an applicant (a prospective resident) a signed certification from a health care practitioner that includes, but is not limited to, a description of the recovery or treatment services that the applicant needs. 3) Allows RTFs to permit IMS to a resident of the RTF on the premises by one or more physicians licensed by MBC or the Osteopathic Medical Board of California (OMBC) who are knowledgeable about addiction medicine, or one or more other health care practitioners acting within the scope of their license and under the direction or supervision of a physician, who are also knowledgeable about addiction medicine, when all of the following conditions are met: a) The RTF, in the judgment of DHCS, has the ability to comply with the licensing requirements; b) The physician and any other health care practitioner has signed and acknowledged on a form provided by DHCS that he or she has been advised of and understands the statutory and regulatory limitations on the IMS services allowed at the RTF; c) The RTF resident is authorized by a physician as medically appropriate to received IMS on the premises of the RTF; d) Before a resident received IMS, the resident signs an admission agreement to receive IMS. Requires the admission agreement, at a minimum, to describe the IMS that the RTF may permit to be provided and states that the permitted IMS will be provided by, or under the supervision of, a physician or other health care practitioner working under the direction of a physician; e) Once IMS are initiated for a resident, the physician monitors the resident to ensure that the resident remains appropriate to receive IMS. Requires, if the physician determines a change in the resident's medical condition requires other medical services or a higher level of care than what an RTF may provide, the physician to immediately notify the RTF and to assist the RTF in initiating emergency care, urgent care, or other higher level of care, as appropriate; and AB 848 Page 4 f) The RTF maintains in its files the physician's license or other written evidence of licensure to practice medicine in the state. 1) Specifies that DHCS is not responsible for evaluating and does not have liability with respect to evaluating IMS. 2) Specifies that an RTF providing IMS is not deemed a clinic or health facility, as specified. 3) Specifies that a license to provide IMS does not authorize an RTF to provide on the premises any medical or health care services or any other services that require a higher level of care than what the RTF can provide. 4) Requires an RTF that intends to apply to provide IMS to submit evidence of a physician's license who will provide the services, and any other information DHCS deems appropriate. 5) Requires DHCS to establish and collect an additional licensure fee for an RTF that includes a request to provide IMS. Requires the fee to be in an amount sufficient to cover DHCS's reasonable costs related to IMS, including processing applications, issuing licenses, and investigating reports of noncompliance with licensing regulations. 6) Broadens DHCS's director's authority to suspend or revoke a license, or deny an application for licensure, extension of licensure period, or modify a license to include, but not limited to, the following: a) An RTF providing false information or documentation to DHCS; b) An RTF's refusal to allow DHCS to enter an RTF to determine compliance with licensing laws; and c) Violation by the RTF of any IMS regulations adopted by DHCS. 7) Requires DHCS to adopt regulations to implement the provisions of this bill on or before July 1, 2018, and allows DHCS to implement, interpret, or make specific these AB 848 Page 5 provisions by means of provider bulletins, written guidelines, or similar instructions until regulations are adopted. Background RTFs licensed by DHCS, based on what is commonly referred to as the social model, are currently allowed to provide recovery, treatment, and detoxification services. (The Department of Public Health licenses medical model RTFs known as chemical dependency recovery hospitals.) Social model RTFs range in size from six-bed facilities in residential neighborhoods to centers that accommodate hundreds of beds. According to DHCS, there are 298 licensed social model RTFs that serve six or fewer people, and the largest RTF that DHCS licenses has a capacity of 309 beds. The services provided by these RTFs include group and individual counseling, educational sessions, and alcoholism or drug abuse recovery and treatment planning. Social model RTFs are allowed to provide clients first aid and emergency care. However, if a resident needs medical care (defined by DHCS as a service provided by a professional required to hold a professional license from the MBC, the OMBC, the Board of Registered Nursing, etc.), the resident must be referred to the proper facility to receive care from a medical professional, and the resident must pay the medical professional directly for services. According to the MBC and DHCS, nothing in current law prohibits a medical professional from conducting a house call at an RTF for a resident. MBC also states that social model RTFs can contract with a physician or a physician group to provide medical services, as long as the RTF contracts with, not employs, the medical professional. The contract also should contain language that makes it clear that the RTF cannot interfere with, control, or otherwise direct the medical professional and that the medical professional has decision-making authority. The contract should also specify that the medical professional is paid a flat or hourly fee, not fees based on the kinds or amounts of services provided. Comments 1)Author's statement. According to the author, many patients seeking treatment at RTFs have physical and mental health AB 848 Page 6 needs related to their addictions when they arrive at these facilities, yet the state has barred RTFs from having medical personnel onsite to provide medical treatment related to addiction. Facility staff may provide basic first aid or emergency care, but these are the only exceptions to medical care. Instead, patients who have medical needs related to their addictions must be transported to a doctor's office or health care facility to receive care. This requirement to transport patients who could receive care in their RTFs is burdensome to patients, facilities, and physicians alike. RTFs should be able to provide the best possible care for vulnerable people struggling to overcome addictions. Sometimes, the best possible care can include medical treatment related to addiction and recovery if that care has been determined in the view of a physician to be able to be provided onsite rather than in a health care facility. By allowing such care to be provided onsite, AB 848 allows thousands of vulnerable people to recover from addiction safely. 2)Facility licensing and oversight. Prior to July 1, 2013, the Department of Alcohol and Drug Programs (ADP) was responsible for oversight of RTFs. Effective with the passage of the 2013-2014 Budget Act and associated legislation, all ADP programs and staff, except the Office of Problem Gambling, transferred to DHCS. As part of their licensing function, DHCS conducts reviews of social model RTF operations every two years, or as necessary. As part of the review process, DHCS checks for compliance with a variety of requirements, including whether staff has passed tuberculosis tests, that residents have completed health questionnaires prior to admission at an RTF, and if at least one staff member is certified in first aid and CPR. DHCS's Substance Use Disorder (SUD) Compliance Division investigates all complaints related to social model RTFs, including deaths, complaints against staff, and allegations of operating without a license. The SUD Compliance Division also investigates violations of the code of conduct of registered or certified alcohol and drug counselors. Additionally, RTFs licensed by DHCS are required to report counselor misconduct to DHCS within 24 hours of the violation. RTFs that do not comply with existing requirements are subject to civil penalties and license suspension or revocation. AB 848 Page 7 3)Reports about RTFs. In 2012, the Senate Office of Oversight and Outcomes (SOOO) published a report, Rogue Rehabs: State failed to police drug and alcohol homes, with deadly results. The report focused on gaps in ADP's regulation of residential programs, as well as a review of the state's ban on medical care at RTFs. SOOO advised that state law be changed to better reflect current treatment practices and stated that there is a mismatch between ADP's regulation and the industry's prevalent practices. SOOO recommended lifting the ban on medical care as long as it is accompanied with more extensive oversight. An article published in Mother Jones in the May/June 2015 issue, "The Rehab Racket: The Way We Treat Addiction is a Costly, Dangerous Mess," written by the same author of the SOOO report, notes that deaths sometimes occur at RTFs not just because of the effects caused by a person's addiction but also from the treatment they receive at the RTF. The article cites a case at one RTF in California where a physician, who had been repeatedly investigated by and had several actions taken against his license over several years by the MBC, excessively prescribed medications to residents of the RTF with no regard for their health or safety, and despite the physician's history, he was allowed to continue to treat residents of the RTF. The article points out that the vast majority of people in need of treatment do not receive anything that approximates evidence-based care. The article further notes that while 18.7 million Americans needed alcohol treatment in 2010 only 1.7 million (or 8.8%) received it in specialized facilities. Issues that compound the problem include: a) out of 14,148 addiction treatment facilities in the U.S., only 26% are RTFs; b) only 15% of costs of addiction treatment are covered by private insurance (treatment can range from $1,800 a month at a government-subsidized RTF to $60,000 a month at an RTF that treats celebrities and other high-profile clients); and c) for every federal and state government dollar spent, 95.6 cents went to pay for consequences of substance abuse while only 1.9 cents were spent on any type of prevention or treatment. 4)Other states. As part of its investigation, SOOO contacted nine other highly populous states and found that California is unusual in prohibiting medical care at social model RTFs. AB 848 Page 8 Eight of the nine states (IL, IN, NY, NC, OH, PA, TX, and WA) allowed physicians and other medical professionals to work in social model RTFs. One state, MA, refers RTF clients to local doctors, but nurses are available at the RTFs. FISCAL EFFECT: Appropriation: No Fiscal Com.:YesLocal: No According to the Senate Appropriations Committee: One-time costs of about $550,000 to develop program requirements and adopt regulations by DHCS (General Fund). Ongoing costs of about $550,000 per year to perform ongoing licensing, inspection, and enforcement activities relating to facilities licensed to provide IMS by DHCS, 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 and Outpatient Program Licensing Fund). DHCS 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. SUPPORT: (Verified8/28/15) California Society of Addiction Medicine (co-source) Elements of Behavioral Health/Promises Treatment Centers (co-source) Janus of Santa Cruz (co-source) Alkermes, Inc. California Narcotic Officers' Association California Naturopathic Doctors Association CalNet County Behavioral Health Directors Association of California San Francisco Department of Public Health OPPOSITION: (Verified8/28/15) AB 848 Page 9 City of Long Beach ARGUMENTS IN SUPPORT: The cosponsors and other supporters, comprised of RTFs and behavioral health advocates, argue that for too long the RTF licensing authority has prohibited RTFs from having onsite medical personnel to evaluate or provide medical care to residents, which precludes RTFs from meeting residents' medical needs that could easily and efficiently be provided onsite. Supporters further argue that, currently, residents who need medical care have to be transported to a doctor's office or emergency room, which is inefficient, costly, and sometimes dangerous, and also disrupts a resident's recovery efforts. ARGUMENTS IN OPPOSITION: The City of Long Beach writes to oppose allowing medical treatment in residential neighborhoods on a routine basis. The City argues that medical treatment should be performed in areas of the city that are zoned and permitted for medical facilities-not in local neighborhoods. ASSEMBLY FLOOR: 74-3, 6/3/15 AYES: Achadjian, Alejo, Travis Allen, Baker, Bigelow, Bloom, Bonilla, Bonta, Brough, Brown, Burke, Calderon, Campos, Chang, Chau, Chávez, Chiu, Chu, Cooley, Cooper, Dababneh, Dahle, Daly, Dodd, Eggman, Frazier, Beth Gaines, Cristina Garcia, Eduardo Garcia, Gipson, Gomez, Gonzalez, Gordon, Gray, Grove, Hadley, Roger Hernández, Holden, Irwin, Jones, Jones-Sawyer, Kim, Lackey, Levine, Linder, Lopez, Low, Maienschein, Mathis, McCarty, Medina, Melendez, Mullin, Nazarian, Obernolte, O'Donnell, Olsen, Patterson, Perea, Quirk, Rendon, Ridley-Thomas, Rodriguez, Salas, Santiago, Steinorth, Mark Stone, Ting, Wagner, Waldron, Weber, Williams, Wood, Atkins NOES: Gallagher, Gatto, Wilk NO VOTE RECORDED: Harper, Mayes, Thurmond Prepared by:Reyes Diaz / HEALTH / 8/31/15 11:43:35 **** END **** AB 848 Page 10