BILL ANALYSIS Ó AB 848 Page 1 CONCURRENCE IN SENATE AMENDMENTS AB 848 (Mark Stone) As Amended August 31, 2015 Majority vote -------------------------------------------------------------------- |ASSEMBLY: |74-3 |(June 3, 2015) |SENATE: |29-9 |(September 1, | | | | | | |2015) | | | | | | | | | | | | | | | -------------------------------------------------------------------- Original Committee Reference: B. & P. SUMMARY: Authorizes alcoholism and drug treatment facilities to allow a licensed physician, or other health care practitioner, to provide incidental medical services to a resident of the facility and requires the Department of Health Care Services (DHCS) to conduct an evaluation of the program on or before July 1, 2018. Specifically, this bill: 1)Specifies that a health care practitioner should submit a signed certification form, within a reasonable period of time, as defined by the DHCS in regulations, to a facility licensed by the DHCS where they plan to provide alcoholism or drug abuse recovery or treatment services. 2)Defines "health care practitioner" as a healing arts AB 848 Page 2 professional, licensed under Business and Professions Code Section 500, and who is acting within the scope of practice of his or her license or certificate. 3)Specifies that the DHCS shall develop a standard certification form, for use by a health care practitioner, that includes, but is not limited to, a description of the alcoholism and drug abuse recovery or treatment services that an applicant needs. 4)Defines "incidental medical services" 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 defined by Section 1200 or 1250, respectively, to address medical issues associated with either detoxification from alcohol or drugs or the provisions of alcoholism or drug abuse recovery or treatment services, including all of the following categories of services that the DHCS shall further define by regulation: a) Obtaining medical histories. b) Monitoring health status to determine whether the health status warrants transfer of the patient in order to receive urgent or emergent care. c) Testing associated with detoxification from alcohol or drugs. d) Providing alcoholism or drug abuse recovery or treatment services. e) Overseeing patient self-administered medications. AB 848 Page 3 f) Treating substance abuse disorders, including detoxification. 5)Specifies that incidental medical services do not include the provision of general primary medical care. 6)Specifies that a facility may permit incidental medical services to be provided to a resident at the facility by, or under the supervision of, one or more physicians and surgeons licensed by the Medical Board of California or the Osteopathic Medical Board who are knowledgeable about addiction medicine, or one or more other health care practitioners acting within the scope of practice of his or her license and under the direction of a physician and surgeon, and are also knowledgeable about addiction medicine if all of the following conditions are met: a) The facility must comply with all other applicable laws and regulations to meet the needs of a resident receiving incidental medical services. b) Specifies that the physician and surgeon and any other health care practitioner has signed an acknowledgment on a form provided by the DHCS that he or she has been advised of and understands the statutory and regulatory limitations on the services that may legally be provided at the facility, and the statutory and regulatory requirements and limitations for the physician and surgeon or other health care professional and for the facility. 7)Indicates that a physician and surgeon or other health care practitioner shall assess a resident, prior to that resident receiving incidental medical services, to determine whether it is medically appropriate for the resident to receive these services at the premises of the licensed facility. A copy of the form provide by the DHCS shall be signed by the physician and surgeon and maintained in the resident's file at the AB 848 Page 4 facility. 8)Requires that before a facility resident receives incidental medical services, the resident has signed an admission agreement. The admission agreement, at a minimum, shall describe the incidental medical services that the facility may permit to be provided and shall state that the permitted incidental medical services will be provided by, or under the supervision of, a physician and surgeon. The department shall specify in regulations, at a minimum, the content and manner of providing the admission agreement, and any other information that the department deems appropriate. The facility shall maintain a copy of the signed admission agreement in the resident's file. 9)Specifies that once incidental medical services are initiated for a resident, the physician and surgeon, and the facility shall monitor the resident to ensure that the services remain appropriate for the resident. If the physician and surgeon determines that a change in the resident's medical condition requires other medical services or that a higher level of care is required, the facility shall immediately arrange for the other medical services or higher level of care, as appropriate. 10)Requires the facility to maintain in its files a copy of the relevant professional license or other written evidence of licensure to practice medicine or perform medical services in the state for the physician and surgeon and any other health care practitioner providing incidental medical services at the facility. 11)Indicates that the DHCS shall not evaluate or have any responsibility or liability with respect to evaluating incidental medical services provided by a physician and surgeon or other health care practitioner at a licensed facility. AB 848 Page 5 12)States that a facility licensed and approved by the DHCS to allow for the provision of incidental medical services shall not be deemed a clinic or health facility. 13)Specifies that, other than incidental medical services permitted to be provided or any urgent of emergent care required in the case of a life threatening emergency, provision of medical or health care services or services that require a higher level of care than the care that is permitted to be provided at a facility, is not permitted at a facility. 14)Specifies that this section does not require a residential treatment facility licensed by the DHCS to provide incidental medical services or any services not otherwise permitted by law. 15)Specifies that on or before July 1, 2018, the DHCS shall adopt regulations to implement this section I accordance with the Administrative Procedure Act, and notwithstanding the rulemaking provisions of the Administrative Procedure Act, the DHCS, if it deems appropriate, implement, interpret, or make specific this section by means of provider bulletins, written guidelines, or similar instructions from the DHCS until regulations are adopted. 16)Indicates that if an applicant for facility licensure intends to permit incidental medical services, the applicant shall submit evidence of a valid license of the physician and surgeon who will provide or oversee those services, and any other information the DHCS deems appropriate. 17)Allows the DHCS to establish and collect an additional licensure fee for an application that includes a request for a facility to provide services. AB 848 Page 6 18)Further specifies that the fee shall be set at an amount sufficient to cover the reasonable costs to the DHCS of the additional assessment and investigation necessary to license facilities to provide these services, including, but not limited to, processing applications, issuing licenses, and investigating reports of noncompliance with licensing regulations. 19)Permits the director of DHCS to temporarily suspend any license prior to any hearing when, in the opinion of the director, the action is necessary to protect residents of the facility from physical or mental abuse, abandonment, or any other substantial threat to health or safety. 20)Makes other findings and declarations. The Senate amendments delay the deadline for adopting regulations until July 1, 2018, further define incidental medical services and the categories of services that the DHCS shall define by regulation, and make a number of clarifying and technical changes. FISCAL EFFECT: According to the Senate Appropriations Committee, this bill will result in: 1)One-time costs of about $550,000 to develop program requirements and adopt regulations by the DHCS. 2)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 DHCS, offset by fee revenues. 3)Unknown additional legal costs relating to future enforcement actions that may result in appeals or litigation. The DHCS has AB 848 Page 7 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. COMMENTS: Purpose. This bill is co-sponsored by the California Society of Addiction Medicine, Elements Behavioral Health and JANUS of Santa Cruz. According to the author, "AB 848 protects the physical and mental health of people seeking alcohol and drug rehabilitation services in residential treatment facilities. Under AB 848, physicians and other appropriate medical personnel can be available on-site to provide 24-hour medical services related to clients' addictions. Clients of these facilities often have a variety of medical needs related to their addictions. Because clients' medical needs can affect and even interfere with their recovery, they may have better recovery outcomes when they have on-site access to medical care including vital sign monitoring, seizure risk assessment, medication management, and psychiatric therapy?The measure requires that facilities seeking licensure adhere to protocol that protect client privacy, notify clients of financial responsibility for medical care, and clearly define the level of medical care to be provided. The measure requires DHCS to promulgate final regulations by July 1, 2017, to implement the policy. Additionally, the measure requires that DHCS perform an evaluation of the law's effectiveness by 2019." Background. Alcoholism or drug abuse recovery or treatment facilities provide 24-hour non-medical care and specialize in providing services to chemically dependent adults who do not require treatment in an acute-care medical facility on an inpatient, intensive outpatient, outpatient, and partial hospitalization basis. These facilities range in size from six-bed facilities in residential neighborhoods to centers that accommodate more than 100 beds (California Senate Office of Oversight and Outcomes report, Rogue Rehabs: State failed to police drug and alcohol homes, with deadly results, September AB 848 Page 8 2012). The basic services provided by facilities include group, individual and educational sessions, alcoholism or drug abuse recovery and treatment planning. Detoxification services are also provided and are defined by the DHCS as, "? a service to support and to assist and individual in the alcohol and/or drug withdrawal process and to explore plans for continued service." These services can be provided by a variety of health care providers such as alcohol and drug counselors, mental health therapists, social workers, psychologists, nurses and physicians. Currently, the only medical care that facilities are allowed to provide to clients is first aid and emergency care. If a patient requires medical care, they must leave the facility to receive care from a medical professional and the patient must pay the medical professional directly for services. Facility Licensing and Oversight. Prior to July 1, 2013, the Department of Alcohol and Drug Programs (ADP) was responsible for oversight of alcoholism or drug abuse recovery or treatment facilities. 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 the DHCS. Now, the DHCS is responsible for oversight. The DHCS licenses the facilities and conducts reviews of their operations every two years. As part of the review process, the DHCS checks for compliance with a variety of requirements including, whether staff has passed tuberculosis tests, that residents have completed health questionnaires and if at least one staff member is certified in first aid and cardiopulmonary resuscitation (CPR). The DHCS's Substance Use Disorder (SUD) Compliance Division investigates complaints against facilities. The SUD Compliance Division also investigates violations of the code of conduct of registered or certified alcohol and drug counselors. AB 848 Page 9 Additionally, facilities licensed or certified by DHCS are required to report counselor misconduct to DHCS within 24 hours of the violation. Facilities that do not comply with existing requirements are subject to civil penalties and license suspension or revocation. Facility Accreditation. Two national organizations, the Joint Commission on Accreditation of Healthcare Organizations (JCAHO) and the Joint Commission on Accreditation of Rehabilitation Facilities (CARF), accredit facilities that provide behavioral health care services such as addiction treatment, opioid treatment and maintenance programs, crisis stabilization, case management and care coordination, employment services and vocational rehabilitation. JCAHO and CARF each require facilities to demonstrate that their programs meet the accrediting organizations' quality standards in order to obtain accreditation. These quality standards evaluate functions relating to client care and program management, including administrative requirements, financial management, personnel qualifications, client services, performance outcomes, client safety and information privacy and security. JCAHO requires accredited organizations to reapply for accreditation every three years while CARF accreditation ranges from one to five years, depending on the type of facility. Senate Office of Oversight and Outcomes Report. 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 the ADP's regulation of residential programs as well as a review of the state's ban on medical care at residential drug and alcohol programs. The SOOO advised that state law be changed to "better reflect current treatment practices?[there is a] mismatch between the department's regulation and the industry's prevalent practices. " The SOOO recommended, "?lifting the ban on medical care as long as it is accompanied with more extensive oversight." AB 848 Page 10 Other States. As part of the SOOO's aforementioned investigation in 2012, it contacted nine other highly populous states. The SOOO found, "California is unusual among populous states in prohibiting medical care." All but one of the nine states allowed physicians and other medical professionals to work in residential rehabilitation facilities. Implementation Issues. As indicated above, there have been a number of bills that have attempted to address the issue of removing the ban on provision of medical services at alcoholism or drug abuse recovery or treatment facilities. While there have been recent changes to these facilities, e.g. the licensing and oversight of these facilities was transferred to the DHCS in 2013, the Legislature may wish to consider requiring additional implementation safeguards should this bill pass. As noted in the SOOO report, it is recommended that the DHCS, the facility and/or the accrediting organization implement regulations requiring that the credentials and malpractice insurance for medical professionals providing medical treatment be checked before they contract with the facility. It may also be beneficial to set up a system to require a yearly review of the medical professional's credentials and insurance to assure ongoing compliance and patient protection. As is consistent with practices in other states, it may also be beneficial for programs that offer any type of medical detoxification to hire a medical director to oversee the administration of this treatment. To safeguard against the state's prohibition against the corporate practice of medicine, physicians should contract with the facilities instead of working directly for them. This would necessitate that the employment contract specify that the program cannot control or interfere with the physician's practice and that the physician retains the ability to make AB 848 Page 11 decisions. The contract should also clearly state that the physician is not paid for the types or amount of services provided. Analysis Prepared by: Le Ondra Clark Harvey / B. & P. / (916) 319-3301 FN: 0001923