BILL ANALYSIS                                                                                                                                                                                                    Ó



                                                                    AB 2403


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          Date of Hearing:  April 19, 2016


                            ASSEMBLY COMMITTEE ON HEALTH


                                   Jim Wood, Chair


          AB 2403  
          (Bloom) - As Amended April 5, 2016


          SUBJECT:  Alcoholism or drug abuse recovery or treatment  
          facilities.


          SUMMARY:  Requires the Department of Health Care Services (DHCS)  
          to deny an application for a new alcoholism or drug abuse  
          recovery or treatment facility license if the proposed location  
          is within 300 feet of an existing facility.  Establishes a  
          definition for integral facilities and permits integral  
          facilities to be subject to local regulations and ordinances as  
          specified.  Specifically, this bill:


          1)Defines "integral facilities" as any combination of two or  
            more facilities that collectively serve seven or more persons,  
            including, but not limited to, facilities that provide housing  
            in one facility and recovery programming, treatment, meals, or  
            any other service at another facility, or facilities that  
            assign staff or a consultant to provide services to or in more  
            than one facility.

          2)Excludes from the definition of integral facilities the  
            licensee or members of the licensee's family or persons  
            employed as facility staff, as specified.

          3)Defines "overconcentration" as two or more alcoholism or drug  








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            abuse recovery or treatment facilities established within 300  
            feet or less of each other as measured from the nearest  
            property line on which an existing facility is located to the  
            nearest property line of the proposed facility.  Specifies  
            that the siting of facilities that combine to form integral  
            facilities within 300 feet of one is not considered  
            overconcentration.

          4)Requires DHCS to deny an application for a new facility  
            license if the proposed location is in proximity to an  
            existing facility that would result in overconcentration.

          5)Permits DHCS to approve a separation distance of less than 300  
            feet if the proximity of facilities to one another would not  
            conflict with regulations of the city or county in which the  
            proposed facility will be located.

          6)Permits cities or counties to request denial of the license  
            applied for on the basis of an overconcentration of  
            facilities.

          7)Requires, at least 45 days prior to approving any application  
            for a new facility, DHCS or a county licensing agency to  
            notify the planning agency of the city or of the county of the  
            proposed location of the facility.

          8)Excludes integral facilities, from existing law requirements  
            that prohibit local ordinances from excluding alcoholism or  
            drug abuse facilities as specified.

          9)Gives standing to a city, county, or city and county whose  
            application of zoning ordinances to a licensed treatment to  
            pursue any available administrative appeals or otherwise seek  
            judicial review of the licensing decision of DHCS for a  
            facility that serves six or fewer persons.

          10)Requires that affected local agencies be reimbursed if the  
            Commission on State Mandates determines that this act contains  
            costs mandated by the state.








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          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  
            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.








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          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  
            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  








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            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  
            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  








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          committee.


          COMMENTS:  


          1)PURPOSE OF THIS BILL.  According to the author, residential  
            group home facilities provide valuable rehabilitation and  
            support services in a therapeutic environment, which can  
            benefit both individual patients and the greater community.  A  
            rehabilitation facility with six beds in a single-family home  
            is welcome in any neighborhood.  It is good for the community,  
            good for the neighbors, and more importantly, good for the  
            patient who is trying to recover. The author states that in  
            establishing residential group home facilities, it was not  
            anticipated that existing laws would be manipulated for the  
            advantage of business owners to garner maximum profits.   
            Business owners have found loopholes within the existing laws  
            and have exploited them for personal gain.  The single  
            rehabilitation facility nestled into the residential  
            neighborhood has been taken over by companies that have  
            created multi-structure, campus-style facilities within a  
            residentially zoned neighborhood.  The overconcentrated campus  
            style facilities are more profitable than standalone  
            facilities and they can drastically change the character of a  
            neighborhood, causing it to become more similar to a hospital  
            zone or busy commercial center.  Most importantly, the campus  
            style facilities eliminate a vital benefit to the patient,  
            which is to become part of the fabric of a community.  The  
            author states that with this bill, cities and counties would  
            be given notice of state license applications, and the  
            municipality could help recognize overconcentration, which is  
            defined as having two facilities separated by less than 300  
            feet.  The author concludes that this measure would simply  
            provide consistency with all other state licensed group homes  
            to protect existing neighborhoods and protect the therapeutic,  
            nurturing environment that benefits all categories of  
            protected residence recovering in state licensed group homes.









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          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  
            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)   ADA, Fair Housing and Equal Protection.  The FEHA makes  
               it illegal to engage in various discriminatory practices  








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               relating to the sale and rental of housing based on race,  
               color, religion, sex, marital status, national origin,  
               ancestry, familial status, or disability.  The definition  
               of a disability includes individuals recovering from  
               substance abuse.  The FEHA also prohibits land use  
               regulations, zoning ordinances, and restrictive covenants  
               from discriminating in housing on the basis of the  
               aforementioned categories.  

             Additionally, 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, the ADA applies  
               to those who have successfully completed a drug  
               rehabilitation program, or who are currently enrolled in  
               such programs.  A document published by the federal  
               Substance Abuse and Mental Health Services Administration  
               entitled, "Know your Rights" explains the Federal laws that  
               prohibit discrimination against individuals with  
               disabilities and how they protect people receiving  
               addiction detoxification or maintenance treatment.  The  
               document discusses discrimination as treating someone less  
               favorably than someone else because he or she has a  
               disability, once had a disability, or is regarded as having  
               a disability and states that because addiction is a chronic  
               disease, employers, landlords, government agencies, and  
               health care and treatment providers must comply with  
               anti-discrimination laws that protect people with  
               disabilities when working with individuals recovering from  
               addiction.











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             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  
               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)   Additional Legal Concerns.  The supporters provided the  
               Committee with a 1997 Legislative Counsel Opinion that  








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               states, "A state or local government entity may not  
               regulate 'sober living homes' through dispersal or distance  
               requirements, conditional use permits, or business  
               licenses, or zoning restrictions?unless the regulation  
               benefits the protected class, or responds to a legitimate  
               safety concern raised by the individuals affected rather  
               than being based on stereotypes."  It is unclear how the  
               provisions of this bill, that would effectively restrict  
               treatment availability for those needing alcohol or drug  
               treatment services, benefit the protected class.   
               Additionally the Ninth Circuit Court of Appeal's decision  
               in Pacific Shores would preempt this opinion. 



             d)   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  
               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.
               










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             e)   Recent substance use treatment reforms.  Medicaid is  
               playing an increasingly important role as a payor for  
               services provided to individuals with substance abuse  
               disorder (SUD) in the United States.  An estimated 12% of  
               adult Medicaid beneficiaries ages 18-64 have an SUD.  The  
               Patient Prot3ection and Affordable Care Act (ACA) included  
               one of the largest expansions of mental health and SUD  
               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  
               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  








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               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,  
                 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  








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               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.





          1)SUPPORT.  The League of Cities (League) states that with this  
            measure, cities and counties would be noticed of state license  
            applications, and the municipality could help recognize  
            overconcentration, which is defined as having two facilities  
            separated by less than 300 feet.  The League states that in  
            establishing residential group home facilities, it was not  
            anticipated that existing laws would be manipulated for the  
            advantage of business owners to garner maximum profits.   
            Business owners have found loopholes within the existing laws  
            and have exploited them for personal gain.  The single  
            rehabilitation facility nestled into the residential  
            neighborhood has been taken over by companies that have  
            created multi-structure, campus-style facilities within a  
            residentially zoned neighborhood.  The overconcentrated campus  
            style facilities are more profitable than standalone  
            facilities and they can drastically change the character of a  
            neighborhood, causing it to become more similar to a hospital  
            zone or busy commercial center.  Most importantly, the campus  
            style facilities eliminate a vital benefit to the patient,  
            which is to become part of the fabric of a community.  The  
            League argues that this with this bill, cities and counties  
            would be noticed of state license applications, and the  
            municipality could help recognize overconcentration, which is  
            defined as having two facilities separated by less than 300  








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            feet.  The League concludes that this measure would simply  
            provide consistency with all other state licensed group homes  
            to protect existing neighborhoods and protect the therapeutic,  
            nurturing environment that benefits all categories of  
            protected residence recovering in state-licensed group homes.
          2)OPPOSITION.  Promises Treatment Centers of California  
            (Promises) writes in opposition to the bill that the new  
            definition of an "integral facility" unravels long-standing  
            state law designed to promote effective treatment strategies  
            and removes anti-discrimination protections from integral  
            facilities.  Regulations outline the process by which DHCS may  
            issue a single license to a residential treatment facility in  
            which multiple sites are "integral" components to a single  
            treatment operation.  This treatment model has led to  
            significantly improved outcomes for patients.  Promises argues  
            that allowing licensed programs in adjacent homes to share  
            resources such as therapists improves the financial viability  
            of both operations, improves the clinical experience by  
            allowing for more specialized treatments for clients and  
            ensures that programs will be available to those in need.  The  
            population demands for drug and alcohol treatment cannot be  
            met by forcing providers to operate in an inefficient model  
            when there are no demonstrable benefits to the communities in  
            changing the current legislation.


            Promises states that the civil rights implications of this  
            measure are very troubling.  The ADA and federal Fair Housing  
            Act combine to protect people recovering from alcoholism or  
            other drug dependence from being discriminated against in  
            their access to housing.  The federal Fair Housing Act  
            specifically prohibits housing discrimination against members  
            of various protected classes of people based on factors  
            including national origin, race, and disability status.   
            Unlike other state and federal laws which conform to the  
            provisions of these landmark civil rights protections, this  
            measure directly conflicts with them.  Promises concludes that  
            if this measure were to become law, it would entitle local  
            governments to discriminate against a protected class of  








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            people by denying those people opportunities for housing in a  
            treatment program meeting the definition of an "integral  
            facility".  The plain language in the existing statute forbids  
            local governments from treating "6 and under" facilities  
            differently than any other single-family residence.  


          3)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 2255 (Melendez) would defines "drug and alcohol free  
               residences" and requires these residences to be certified  
               by a certifying organization approved by DHCS to register  
               drug and alcohol free residences.  AB 2255 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.








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          4)PREVIOUS LEGISLATION.  


             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  








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               by the same licensee and is located within 300 feet of the  
               existing facility.  AB 1284 died on the Assembly  
               Appropriations Committee Suspense File.

             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.  This bill 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  








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               requirements.  AB 724 failed passage in the Senate Health  
               Committee.

             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.


          5)POLICY COMMENTS


             a)   Potential Discriminatory Policy.  As noted above,  
               individuals recovering from alcohol or drug dependency  
               problems are deemed to be a protected class and have been  
               extended civil rights protections under the ADA, FEHA, and  
               other state anti-discriminatory laws.  The recent Ninth  
               Circuit decision in Pacific Shores further strengthened the  
               protections available to this class of individuals by the  
               Court's nullification of a city ordinance that imposed  
               zoning requirements on these types of treatment facilities.  
                As such, the Committee may wish to consider deleting the  
               provisions of this bill expanding the authority of cities  
               and counties to impose further limitations of the  
               establishments of new treatment facilities.   










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             b)   Certification requirements.  As discussed above, DHCS is  
               in the middle of overhauling the licensing process for  
               residential treatment facilities with the implementation of  
               the DMC-ODS Waiver.  This bill requires, at least 45 days  
               prior to approving any application for a new facility, DHCS  
               or a county licensing agency to notify the planning agency  
               of the city or of the county of the proposed location of  
               the facility.  It is unclear what, if any, impact the  
               requirements of this bill would have on the current  
               overhaul of the licensing process. The Committee may wish  
               to consider deleting the changes in the DHCS licensing  
               process for treatment facilities from this bill. 
             c)   Existing need for treatment options.  The bill currently  
               states that it shall be presumed, based solely on treatment  
               location proximity, that local need for treatment  
               facilities is satisfied.  However, this provision is  
               problematic. Whether or not a local need for treatment  
               facility is satisfied is more properly determined by the  
               number of potential beneficiaries in need of treatment.   
               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  
               that the state's need for treatment facilities has not been  
               met, and therefore local needs are most likely not met.   
               The Committee may wish to consider an amendment deleting  
               the provisions of this bill establishing overconcentration  
               requirements and prohibiting the establishment of new  
               treatment facilities solely based on location.


             d)   Grandfathering clause.  Current DHCS licensing  
               provisions allow a license to be valid for two years once  
               the license is approved.  The author wishes to amend this  
               bill to specify that current applications are valid, and  
               this bill applies to license applications submitted after  
               January 1, 2017. 










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          REGISTERED SUPPORT / OPPOSITION:




          Support


          City of Lakewood


          City of Malibu


          City of Norwalk


          City of Pico Rivera


          League of California Cities


          Los Angeles County Professional Peace Officers Association


          Los Angeles Deputy Sheriffs


          Multiple individuals




          Opposition


          Cliffside Malibu









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                                                                    Page  21






          County Behavioral Health Directors Association


          Promises Treatment Centers of California




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