BILL ANALYSIS                                                                                                                                                                                                    Ó



                                                                    AB 2255


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          Date of Hearing:  April 19, 2016


                            ASSEMBLY COMMITTEE ON HEALTH


                                   Jim Wood, Chair


          AB 2255  
          (Melendez) - As Amended April 12, 2016


          SUBJECT:  Drug and alcohol free residences.


          SUMMARY:  Defines "drug and alcohol free residences" and  
          requires these residences to be certified by a certifying  
          organization approved by the Department of Health Care Services  
          (DHCS) to register drug and alcohol free residences.  
          Specifically, this bill:  


          1)Defines a "drug and alcohol free residence" (recovery  
            residence) as a residential property that has been certified  
            and is operated as a cooperative living arrangement to provide  
            an alcohol and drug free environment for persons recovering  
            from alcoholism or drug abuse, or both, who seek a living  
            environment in which to remain clean and sober.


          2)Requires residents, including live-in managers, operators, or  
            owners, to live a sober lifestyle. Requires residents to be  
            actively participating in legitimate programs of recovery from  
            substance use disorder, including, but not limited to,  
            Alcoholics Anonymous or Narcotics Anonymous programs. 


          3)Requires residents within the recovery residence, and  








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            residents who have been referred and have access to ongoing  
            outpatient treatment, aftercare, or other recovery maintenance  
            services to continue to use these services in accordance with  
            a clinically managed system of care if one exists for the  
            resident.


          4)Requires owners, managers, operators, and residents to observe  
            and promote a zero tolerance policy regarding the consumption  
            or possession of alcohol or controlled substances being used  
            in any manner not consistent with a documented prescription.


          5)Requires a residence that houses persons recovering from drug  
            and alcohol abuse to be presumed to be a recovery residence if  
            the residence has been certified by an approved certifying  
            organization.


          6)Requires, if a residence is certified as specified within 90  
            days of beginning its operations, the activities at that  
            residence to be deemed a residential use of property and a use  
            of property by a single family.


          7)Defines an approved certifying organization as an organization  
            approved by DHCS to register a residence as a drug and alcohol  
            free residence.


          8)Defines an approved national organization as a recognized  
            national organization, approved by DHCS, the primary function  
            of which is to improve access to, and the quality of, drug and  
            alcohol recovery residences through standards, education,  
            research, and advocacy. Requires an approved certifying  
            organization do all of the following:


             a)   Maintain an office in the state;








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             b)   Maintain nonprofit status in the state;


             c)   Be an affiliate of, and continuously maintain  
               affiliation with, an approved national organization;


             d)   Maintain the most current standards published by the  
               approved national organization;


             e)   Document that the organization actively develops and  
               confers professional, residential, or organizational  
               quality designations according to applicable nationally  
               recognized standards;


             f)   Establish drug and alcohol free residence certification  
               requirements;


             g)   Establish procedures to administer the application,  
               certification, renewal, and disciplinary processes for a  
               drug and alcohol free residence;


             h)   Inspect, at least annually, a drug and alcohol free  
               residence to ensure compliance with certification  
               requirements;


             i)   Submit to DHCS and the operator of the certifying  
               organization, a written code of conduct for a recovery  
               residence that incorporates national standards for legal  
               and ethical conduct for recovery residences;










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             j)   Submit to DHCS and the operator of a recovery residence  
               disciplinary guidelines that include sanctions for first  
               and subsequent violations of the organization's code of  
               conduct that allows the recovery residence notice and  
               opportunity to correct a violation and requires the  
               approved certifying organization to revoke the  
               certification of the residence if the required corrective  
               action is not completed within the specified time period;


             aa)  Respond to and investigate suspected violations of the  
               organization's code of conduct;


             bb)  Require an operator who seeks to have a residence  
               certified to submit all of the following documents with the  
               operator's completed application and fee:


                 i)       Procedures and requirements for verifying that a  
                   resident remains drug and alcohol free;


                 ii)      A prohibition on the premises against alcohol,  
                   illegal drugs, or the use of prescribed medications by  
                   an individual except as prescribed by a physician and  
                   used in accordance with the prescription;


                 iii)     Policies to support a resident's recovery  
                   efforts;


                 iv)      A good neighbor policy to address neighborhood  
                   concerns and complaints;


                 v)       A policy for informing local government  
                   officials and neighbors about the approved  








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                   certification organization's complaint procedures, the  
                   contact number of the operator of the residence, and a  
                   contact number of a minimum of one resident assigned  
                   with the responsibility of mitigating a complaint;


                 vi)      Rules for residents, copies of forms provided to  
                   a resident, relapse policy, fee and refund policies,  
                   and eviction procedures and policies;


                 vii)     Proof that the operator of the residence has  
                   completed a minimum of 10 hours of alcohol and drug  
                   free program management education approved by the  
                   approved certifying organization; and,


                 viii)    Proof that a minimum of one resident has  
                   received certification approved by the approved  
                   certifying organization. Certification must include, at  
                   a minimum, the following subjects: ethics, health and  
                   safety topics related to addiction recovery and  
                   maintenance, and emergency planning procedures.


             cc)  Review the registry posted on DHCS's Internet Website to  
               determine whether the residence that the operator has  
               applied to have certified has had a previous certification  
               revoked or the operator submitting the application for  
               certification has operated a residence for which a previous  
               certification has been revoked; and, 


             dd)  Deny an application for certification if the residence  
               address or operator name in the application is listed on  
               the registry and send the applicant a written notice of  
               denial of certification.










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          9)Requires DHCS to adopt application procedures and standards of  
            approval for an organization that seeks to be approved by DHCS  
            as an approved certifying organization or as an approved  
            national organization.


          10)Permits DHCS to conduct periodic reviews of an approved  
            certifying organization to determine whether the organization  
            is in compliance with all applicable laws.  Permits DHCS to  
            revoke approval of an approved certifying organization.


          11)Permits DHCS to investigate complaints it receives regarding  
            a recovery residence independently or in conjunction with the  
            approved certifying organization and permits DHCS to impose  
            sanctions and commence disciplinary actions, including  
            revoking the certification of a residence as a drug and  
            alcohol free residence.


          12)Permits a city, county, city and county, or local law  
            enforcement agency that suspects that a drug and alcohol  
            residence is not operating in compliance with the residence's  
            code of conduct to request DHCS to revoke the certification of  
            that residence. 


          13)Requires DHCS to maintain and post on its Internet Website a  
            registry containing all of the following information:


             a)   The street address and the name and contact telephone  
               number of the operator of each residence that has been  
               certified as a drug and alcohol free residence pursuant to  
               this section;


             b)   The street address of each residence that has had its  
               certification revoked; and, 








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             c)   The name of each operator of a residence that has had  
               its certification revoked.


          14)Requires, on and after January 1, 2018, a state agency,  
            state-contracted vendor, county agency, or county-contracted  
            vendor that directs substance abuse treatment, or a judge or  
            parole board that sets terms and conditions for the release,  
            parole, or discharge of a person from custody, if it requires  
            a person to reside in a sober living environment, to refer  
            that person only to a residence listed as a certified drug and  
            alcohol free residence on the registry posted on the DHCS's  
            Internet Website.


          EXISTING LAW:  


          1)Establishes DHCS as the sole licensing authority for adult  
            alcoholism or drug abuse recovery or treatment facilities.   
            Permits new licenses to be issued for a period of two years,  
            and requires DHCS to conduct onsite program visits for  
            compliance at least once during the two year licensing period.


          2)Defines "alcoholism or drug abuse recovery or treatment  
            facility" (treatment facility) as any premise, place, or  
            building that provides 24-hour residential nonmedical services  
            to adults who are recovering from problems related to alcohol,  
            drug, or alcohol and drug misuse or abuse, and who need  
            alcohol, drug, or alcohol and drug recovery treatment or  
            detoxification services.


          3)Establishes requirements for application to DHCS for licensure  
            of a facility, requires DHCS to terminate licensure if these  
            requirements are not met, and authorizes DHCS to deny  








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            applicants that do not demonstrate an ability to comply with  
            specified requirements.


          4)Requires, if an applicant intends to provide incidental  
            medical services, such as obtaining medical histories,  
            monitoring health status, testing associated with  
            detoxification from alcohol or drugs, and overseeing patient  
            self-administered medications, evidence of a valid license of  
            a physician and surgeon who will provide or oversee those  
            services, and any other information deemed appropriate by  
            DHCS, as specified.





          5)Permits DHCS to issue single licenses to residential  
            facilities and a facility where separate buildings or portions  
            of a residential facility are integral components of a single  
            treatment facility and all of the components of the facility  
            are managed by the same licensee.


          6)Authorizes DHCS to assess civil penalties on facilities that  
            provide alcoholism or drug abuse recovery, treatment, or  
            detoxification services without a license.



          7)Requires a treatment facility that serves six or fewer persons  
            to be considered a residential use of property whether or not  
            unrelated persons are living together. Requires the residents  
            and operators of the facility to be considered a family for  
            the purposes of any law or zoning ordinance that relates to  
            the residential use of property.


          8)Excludes, for the purposes of local ordinances, a treatment  








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            facility that serves six or fewer persons from the definition  
            of a boarding house, rooming house, institution or home for  
            the care of minors, the aged, or persons with mental health  
            disorders, foster care home, guest home, rest home, community  
            residence, or other similar term that implies that the  
            alcoholism or drug abuse recovery or treatment home is a  
            business run for profit or differs in any other way from a  
            single-family residence.

          9)Authorizes a city, county, or other local public entity from  
            placing restrictions on building heights, setback, lot  
            dimensions, or placement of signs of a treatment facility that  
            serves six or fewer persons as long as the restrictions are  
            identical to those applied to other single-family residences.


          10)Specifies that any local ordinance that deals with health and  
            safety, building standards, environmental impact standards, or  
            any other matter within the jurisdiction of a local public  
            entity also applies to a treatment facility, however, local  
            ordinances cannot distinguish treatment facilities that serve  
            six or fewer persons from other single-family dwellings or  
            distinguish residents of treatment facilities from persons who  
            reside in other single-family dwellings.


          11)Prohibits a conditional use permit, zoning variance, or other  
            zoning clearance from being required of an alcoholism or drug  
            abuse recovery or treatment facility that serves six or fewer  
            persons that is not required of a single-family residence in  
            the same zone.


          12)Prohibits, under the California Fair Employment and Housing  
            Act (FEHA), discrimination against any person in any housing  
            accommodation on the basis of race, color, religion, sex,  
            marital status, national origin, ancestry, familial status, or  
            disability.  Specifies that discriminatory land use  
            regulations, zoning laws, and restrictive covenants are  








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            unlawful acts.



          13)Prohibits under the federal Americans with Disabilities Act  
            of 1990 (ADA), prohibits discrimination by any public entity  
            by reason of an individual's disability.  Makes it unlawful,  
            under the federal Fair Housing Act, to make unavailable or  
            deny, a dwelling to any buyer or renter because of a  
            disability.



          FISCAL EFFECT:  This bill has not yet been analyzed by a fiscal  
          committee.


          COMMENTS: 


          1)PURPOSE OF THIS BILL.  According to the author, thousands of  
            facilities treat former alcoholics and drug abusers, who are  
            very susceptible to relapse, without possessing any formal  
            credentials.  Defining drug and alcohol free residences as a  
            type of treatment facility will not only protect former  
            abusers from relapsing, but will also increase the safety of  
            our communities statewide.


          2)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. The basic services  
            provided by facilities include group, individual and  
            educational sessions, alcoholism or drug abuse recovery and  








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            treatment planning.  Detoxification services are also provided  
            and are defined by the DHCS as services to support and assist  
            an individual in the alcohol and/or drug withdrawal process  
            and to explore plans for continued treatment. 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. 





            From 1976 to 2014, the National Institute on Drug Abuse  
            supported the Community Epidemiology Work Group (CEWG), a  
            network of local drug abuse experts who reported semiannually  
            on drug trends and emerging issues in sentinel sites including  
            major metropolitan areas and some states around the United  
            States.  CEWG monitoring included the cities of Los Angeles,  
            San Diego, and San Francisco. As of 2014, all of the  
            California cities monitored by the CEWG were experiencing an  
            increase in incidences of drug abuse including heroin,  
            prescription drugs and synthetic drug abuse. 


               


             a)   Recent substance use treatment reforms.  Medicaid is  
               playing an increasingly important role as a payor for  
               services provided to individuals with SUD in the United  
               States.  An estimated 12% of adult Medicaid beneficiaries  
               ages 18-64 have an SUD.  The Patient Protection and  
               Affordable Care Act (ACA) included one of the largest  
               expansions of mental health and substance use disorder  
               coverage in a generation by adding mental health and  
               substance use disorder services as an Essential Health  
               Benefit category.  In July of 2015, in response to this  
               growing need, the Centers for Medicare & Medicaid Services  
               (CMS) notified states of opportunities to design service  








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               delivery systems for individuals with SUD, including a new  
               opportunity for demonstration projects approved under  
               section 1115 of the Social Security Act to ensure that a  
               continuum of care is available to individuals with SUD.   
               Participating states are eligible to receive federal  
               financial participation (FFP) for costs not otherwise  
               matchable, such as services delivered to targeted  
               populations, in limited geographic areas, or in settings  
               that are not otherwise covered under the Medicaid program.   
               On August 13, 2015, DHCS announced that CMS approved  
               California's Drug Medi-Cal Organized Delivery System  
               (DMC-ODS) Waiver. Counties participating in the DMC-ODS  
               waiver program will administer, or arrange for, substance  
               use disorder treatment for Medi-Cal beneficiaries.  The  
               DMC-ODS demonstration will be elective for five years.
               


               The DMC-ODS provides a continuum of care modeled after the  
               American Society of Addiction Medicine (ASAM) Criteria for  
               SUD treatment services.  As part of their participation in  
               the DMC-ODS, CMS requires all residential providers to meet  
               the ASAM requirements and obtain a DHCS-issued ASAM  
               designation.  The ASAM criteria is a nationally accepted  
               set of treatment criteria for SUD care and is being adopted  
               beyond Medi-Cal beneficiaries as the SUD industry standard.  
                As of March 14, DHCS has designated 168 residential  
               alcohol and/or other drug treatment facilities with the  
               appropriate ASAM level of care. DHCS has initiated a  
               phased-in implementation of the DMC-ODS and established  
               five regions throughout the state.  DHCS determined the  
               order of implementation based on location, population, and  
               county and provider readiness. 





               i)     Phase One, Bay Area: Alameda, Contra Costa, Marin,  








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                 Monterey, Napa, San Benito, San Francisco, San Mateo,  
                 Santa Clara, Santa Cruz, Solano, Sonoma;
               ii)    Phase Two, Kern and Southern California: Kern,  
                 Imperial, Los Angeles, Orange, Riverside, San Bernardino,  
                 San Diego, San Luis Obispo, Santa Barbara, Ventura;


               iii)   Phase Three, Central and Northern California:  
                 Calaveras, Eldorado, Fresno Inyo, Kings, Madera, Merced,  
                 Mono, Placer, Sacramento, Stanislaus, Yolo, San Joaquin,  
                 Sutter, Tuolumne, Yuba;


               iv)    Phase Four, Northern California: Butte, Colusa, Del  
                 Norte, Glenn, Humboldt, Lake, Lassen, Mendocino, Modoc,  
                 Nevada, Plumas, Shasta, Siskiyou, Tehama, Trinity; and,


               v)     Phase Five: Tribal Partners





               DHCS has developed a designation program to certify that  
               all providers are certified based on the level of care they  
               are capable of delivering consistent with ASAM Criteria. As  
               part of this designation program, facilities must complete  
               the DHCS ASAM designation questionnaire and will be given a  
               provisional designation. The provisional status of the DHCS  
               ASAM designation will remain on the residential treatment  
               facility license until verification of the designation(s)  
               is completed during an on-site visit. Over the next several  
               months, DHCS will also be adding the ASAM designation  
               process to the initial licensing process; eventually all  
               residential providers will have an ASAM designation.











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             a)   ADA, Fair Housing and Equal Protection.  The FEHA makes  
               it illegal to engage in various discriminatory practices  
               relating to the sale and rental of housing based on race,  
               color, religion, sex, marital status, national origin,  
               ancestry, familial status, or disability.  It also  
               prohibits land use regulations, zoning ordinances, and  
               restrictive covenants from discriminating in housing on the  
               basis of the aforementioned categories.  FEHA also states  
               that groups of people with disabilities living together in  
               a single dwelling unit are considered a family.

             In addition, the ADA gives civil rights protection to  
                                           individuals with disabilities, similar to the protection  
               provided to individuals on the basis of race, sex, national  
               origin, and  religion.  Under these Federal laws, an  
               individual with a "disability" is someone who has a current  
               "physical or mental impairment" that "substantially limits"  
               one or more of that person's "major life activities," such  
               as caring for one's self, working, etc., or as a record of  
               such a substantially limiting impairment, or is regarded as  
               having such an impairment. Specifically, ADA applies to  
               those who have successfully completed a drug rehabilitation  
               program, or who are currently enrolled in such programs..



             b)   Pacific Shores Properties v. City of Newport Beach  
               (Pacific shores).  In the late 1990s, the number of  
               residential facilities for recovering drug and alcohol  
               abusers began to increase in the City of Newport Beach. By  
               April of 2007, 73 homes existed in the city, only 48 of  
               which were licensed.  Among these homes were Pacific Shores  
               Properties LLC, Newport Coast Recovery LLC (NCR), and  
               Yellowstone Women's First Step House, Inc. (collectively,  
               the "Group Homes").  Pacific Shores and Yellowstone were  
               unlicensed, while NCR provided services to more than seven  
               individuals at a time and was therefore a state-licensed  








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               facility.  As a result of the increasing number of group  
               homes, the City's residents began voicing hostile  
               complaints and concerns.  In 2008, responding to resident  
               discontent, the City of Newport Beach drafted an ordinance  
               that subjected "residential care facilities" to strict  
               zoning requirements and significantly limiting both the  
               continued existence of group homes and the creation of new  
               ones.  These new restrictions had an almost immediate  
               impact on residential treatment facilities, and by 2009,  
               the number of group housing opportunities was reduced by  
               40% and altogether shutting down about one-third of group  
               homes.  In 2010, the Group Homes filed suit against the  
               City alleging discrimination under the FHA, the ADA, the  
               California FEHA, and the Equal Protection Clause.  While  
               the district court ruled in favor of the City of Newport  
               Beach, the Group Homes appealed this decision to the United  
               States Court of Appeals for the Ninth Circuit.  In 2013,  
               the Ninth Circuit Court of Appeals reversed the district  
               court's decision and held that the ordinance enacted by the  
               City of Newport discriminated against residential treatment  
               facilities on the basis of disability, and that its  
               enactment and enforcement harmed a protected class and was  
               therefore in violation of federal law.



             c)   Siting Difficulties.  A technical assistance publication  
               published by the U.S. Department of Health and Human  
               Services (DHHS) entitled "Siting Drug and Alcohol Treatment  
               Programs:  Legal Challenges to the NIMBY Syndrome", states  
               that community opposition, 'not in my backyard (NIMBY),  
               prevents or delays the siting of treatment programs, even  
               when an already existing program tries to relocate.  NIMBY  
               is often targeted toward other types of health and social  
               service facilities, like shelters for the homeless, group  
               homes for the mentally ill, halfway houses for  
               ex-offenders, and health-related facilities for those with  
               AIDS.  According to DHHS, many discriminatory zoning  
               ordinances and practices may be unlawful under the FHA and  








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               the ADA.  It is also noted that communities often fear the  
               decline of property values and increased crime because of  
               residential treatment facilities in the neighborhood.   
               However, the DHHS document states that in almost every  
               instance a community's fears are unfounded, as residential  
               treatment facilities pose no danger to the health and  
               welfare of neighbors nor draw substance abusers or pushers  
               to the area. 



             d)   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.
               


               The total number of adult recovery maintenance facilities,  
               sober living homes, or similar entities in the state is not  
               known.  According to 2012 data that indicated the two  
               private entities that register sober living homes had  
               registered about 850 sober living homes in the state.   








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               However, these organizations indicated that they may be  
               registering as few as one-third of the total number of  
               sober living homes in the state.



          1)SUPPORT.  Multiple cities write in support of the bill that by  
            requiring that a residence housing individuals purporting to  
            be recovering from drug or alcohol abuse be presumed to be a  
            sober living home if it has been certified, registered or  
            approved by a state-recognized non-profit organization, the  
            state can ensure a sober living home is able to operate within  
            a defined set of guidelines to achieve its purpose and  
            mission, and in a manner that is suitable to its location  
            within a residential neighborhood.  The cities argue that the  
            bill assists those individuals with drug or alcohol abuse  
            issues to more readily identify sober living homes that can  
            provide the level and quality of services needed for  
            rehabilitation.  


            The California Consortium of Addiction Programs and  
            Professionals (CCAPP) write in support of the bill that this  
            measure is necessary in order to allow quality drug and  
            alcohol free residences to continue their important mission,  
            while ridding the system of "homes" that abuse residents and  
            ruin neighborhoods.  It will allow local governments to  
            identify quality homes by certification status; register  
            complaints with confidence they will be addressed; and, teach  
            owners, operators, and residents how to build relationships  
            with neighbors in positive ways.  CCAPP states that modeled  
            upon California's counselor certification law/regulations,  
            this bill would utilize private certifying organizations, with  
            qualified staff and long histories of quality assessment of  
            sober living, to approve drug and alcohol free residences for  
            certification and to respond to complaints from the public or  
            local government.  To give the bill "teeth," referrals and  
            reimbursement made from public sources would be tied to  
            certification status.  In addition, DHCS would be given  








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            authority to revoke certification of any drug and alcohol free  
            residence for which it has found to be not in conformance with  
            national quality standards.  CCAPP concludes that private  
            certification, backed by department oversight, with national  
            standards at the helm has the potential to foster quality and  
            reduce the number of "bad actors" doing business in  
            California.





          2)OPPOSITION.  Western Center on Law and Poverty (Western  
            Center) states in opposition to the bill that it is not in the  
            interest of the State of California to erect barriers to  
            housing for those with special needs.  The state has a serious  
            shortage of specialized housing that serves those with  
            barriers - many of whom are coming from state institutions of  
            care.  Successful re-integration into the community is crucial  
            to helping those with special needs make a transition to a  
            productive life and it is crucial for the state to have the  
            person succeed to reduce the burden on taxpayers.  Western  
            Center concludes that this measure will encourage local  
            governments to create additional barriers that may have the  
            effect of reducing the number of facilities within their  
            jurisdiction.  Once one community reduces the number of  
            facilities, there will be tremendous political pressure on  
            neighboring jurisdictions to enact similar bands to avoid  
            over-concentration of facilities in one community.  


            Cliffside Malibu writes in opposition to the bill that it  
            would have the effect of reducing access to treatment for the  
            state's residents and is contrary to the State's avowed  
            interest in alleviating problems related to addiction and  
            would grant local municipalities new power to force  
            residential treatment facilities from their communities.   
            Cliffside Malibu further states that California's approach to  
            the treatment of alcohol and drug abuse treatment relies, to a  








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            significant degree, on thousands of state-licensed six-bed  
            substance abuse treatment facilities in residential  
            communities throughout California.  Those programs are  
            supplemented with transitional sober living homes throughout  
            the state.  Sober living environments offer safe and  
            structured living situations to bridge the gap between  
            treatment and returning fulltime to independent living.  They  
            are necessary because it is detrimental for people in early  
            recovery to return to the people, places, and situations that  
            fueled their addiction.  It's also often difficult for people  
            in early recovery to go straight from residential treatment to  
            the potentially hectic atmosphere of their own homes. 


          3)COMMITTEE COMMENTS.  


             a)   Local regulation.  This bill requires, if a recovery  
               residence is certified within 90 days, the activities at  
               that residence to be deemed a residential use of property  
               and a use of property by a single family. This Committee  
               may wish to consider an amendment clarifying that as a  
               residential use of property, recovery residences should be  
               excluded from local city and county ordinances. 



             b)   Voluntary certification.  As discussed above,  
               individuals recovering from alcohol or drug dependency have  
               been deemed by the court system to be a protected class and  
               have been extended civil rights protections afforded under  
               the ADA and other state laws.  If the provisions of this  
               bill required recovery residences to be certified, the  
               measure would single out these individuals, and likely be  
               in violation of federal and state anti-discrimination laws.  
                The Committee may wish to consider an amendment clarifying  
               that certification of a recovery residence is optional  
               under the provisions of this bill, and does not prohibit  
               the operation of establishments which serve six or fewer  








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               persons and are deemed residential uses of property.



             c)   Existing need for treatment options.  Requires, after  
               January 1, 2018, a state agency, county agency, or a judge  
               or parole board that sets terms and conditions for the  
               release, parole, and other entities as specified, when  
               requiring a person to reside in a sober living environment,  
               to refer that person only to a residence listed as a  
               certified drug and alcohol free residence on the registry  
               posted on the DHCS's Internet Website.  Federal data on  
               drug abuse patterns and trends, expanded efforts in the  
               ACA, and a state overhaul of how alcohol and drug treatment  
               services are administered are all indicators of an  
               additional need for treatment facilities.  The conditions  
               imposed by this bill are too restrictive and may prevent  
               those persons legitimately seeking treatment for a drug or  
               alcohol problem from receiving such treatment when the  
               treatment is available from a facility that is not  
               certified.  The Committee may wish to consider an amendment  
               deleting the provisions of this bill requiring referral to  
               certified recovery residences in specified circumstances.



             d)   Sober lifestyle.  This bill requires residents,  
               including live-in managers, operators, or owners, to live a  
               "sober lifestyle."  It is unclear what that means or why  
               the language is necessary given that the measure already  
               explicitly prohibits alcohol or drug use that is  
               inconsistent with a prescription from a doctor.  The  
               Committee may wish to consider if it is appropriate to  
               legislate any kind of lifestyle. 



             e)   Authority to Revoke.  This bill authorizes DHCS to  
               approve the certifying agencies that would certify recovery  








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               residences but also gives authority for DHCS to revoke  
               certification.  However, it is unclear how DHCS can revoke  
               a certification it did not issue.
          4)RELATED LEGISLATION.  


             a)   AB 1915 (Santiago) would establish the Residential  
               Treatment Facility Expansion Fund for the purpose of making  
               grants or loans to residential treatment centers that are  
               expanding services or to substance use disorder treatment  
               service facilities that are expanding to provide  
               residential treatment services.  AB 1915 is pending in the  
               Assembly Health Committee.


             b)   AB 2403 (Bloom) would require DHCS to issue a single  
               license to a residential or integral alcoholism or drug  
               abuse recovery or treatment facility when specified  
               criteria are met and establishes a definition for integral  
               facilities.  AB 2403 is pending in the Assembly Health  
               Committee.


             c)   SB 1101 (Wieckowski) would establish new licensing  
               requirements for alcohol and drug counselors and would  
               transfer responsibilities pertaining to alcohol and drug  
               counselor certification and the approval and regulation of  
               certifying organizations from DHCS to the Department of  
               Public Health.  SB 1101 is pending in the Senate Health  
               Committee.


             d)   SB 1283 (Bates) would require DHCS to licensee and  
               regulate adult recovery maintenance facilities and would  
               establish licensure fees for that purpose.  SB 1283 is  
               pending in the Senate Health Committee.


          5)PREVIOUS LEGISLATION. 








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             a)   AB 848 (Stone), Chapter 744, Statutes of 2015,  
               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 DHCS to conduct an  
               evaluation of the program on or before July 1, 2018.



             b)   AB 2491 (Nestande) of 2014 would have exempted sober  
               living homes from licensure as an adult alcoholism or drug  
               abuse recovery or treatment facility and required sober  
               living homes to meet specified requirements, including the  
               active participation of residents in legitimate recovery  
               programs and the maintenance of records of meeting  
               attendance.  AB 2491 was held under submission in the  
               Senate Appropriations Committee.



             c)   AB 1983 (Mansoor) of 2012 would have defined integral  
               alcohol and drug abuse treatment facilities for purposes of  
               licensure by the Department of Alcohol and Drug Programs  
               (DADP) and excluded integral facilities from being  
               considered a residential use of property.  AB 1983 failed  
               passage in the Assembly Health Committee.



             d)   AB 1284 (Huffman) of 2009 would have required DADP to  
               notify the appropriate city or county planning agency of a  
               proposed facility's application for licensure as a  
               residential treatment facility if it operates as an  
               integral component of an existing licensed facility managed  
               by the same licensee and is located within 300 feet of the  
               existing facility.  AB 1284 died on the Assembly  
               Appropriations Committee Suspense File.








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             e)   SB 268 (Harman) of 2009, which was substantially similar  
               to SB 1000 (Harman) of 2008, failed passage in the Assembly  
               Health Committee and was subsequently amended to a  
               different topic.

             f)   AB 2903 (Huffman) of 2008 would have authorized DADP to  
               require any person or entity applying for licensure to  
               provide specified information to DADP before a license is  
               issued.  AB 2903 was held in the Senate Health Committee.

             g)   SB 1000 (Harman) of 2008 would have required applicants  
               seeking a treatment facility license from DADP to certify  
               that the facility is consistent with local zoning  
               ordinances and would have required DADP to verify the  
               certification.  SB 1000 failed passage in the Senate Health  
               Committee.





             h)   SB 992 (Wiggins) of 2007 would have required the  
               Department of Alcohol and Drug
               Programs to license adult recovery maintenance facilities  
               and applied existing alcohol and drug abuse recovery or  
               treatment facilities licensure requirements to adult  
               recovery maintenance facilities.  SB 992 was vetoed by  
               Governor Schwarzenegger.



             i)   AB 724 (Benoit) of 2007 would have defined a sober  
               living home as a residential property that is operated as a  
               cooperative living arrangement to provide an alcohol and  
               drug free environment for persons recovering from  
               alcoholism or drug abuse and meets other specified  
               requirements.  AB 724 failed passage in the Senate Health  
               Committee.








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             j)   SB 530 (Dutton) of 2007 would have prohibited DADP from  
               licensing a treatment facility if another treatment  
               facility was located within 300 feet.  SB 530 was held in  
               the Senate Health Committee.

             aa)  AB 370 (Adams) of 2007 would have permitted a local  
               government to include a residential care facility serving  
               six or fewer persons, including a sober living facility,  
               within the definition of single family residence.  AB 370  
               died on the Assembly Appropriations Committee Suspense  
               File.

             bb)  AB 3007 (Emmerson) of 2006 would have prohibited DADP  
               from licensing a treatment facility if another treatment  
               facility was located within 300 feet.  AB 3007 died on the  
               Assembly Appropriations Committee Suspense File.


          REGISTERED SUPPORT / OPPOSITION:




          Support


          Association of California Cities - Orange County


          California Consortium of Addiction Programs and Professionals


          California Police Chiefs Association


          City of Dana Point










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          City of Costa Mesa


          City of Hemet


          City of Laguna Niguel


          City of Menifee


          City of Rancho Mirage


          City of Riverside


          City of Whittier


          League of California Cities


          National Coalition Against Prescription Drug Abuse


          Dozens of individuals




          Opposition


          Cliffside Malibu


          Western Center on Law and Poverty








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          Analysis Prepared by:Paula Villescaz / HEALTH / (916) 319-2097