BILL ANALYSIS Ó
SENATE COMMITTEE ON HEALTH
Senator Ed Hernandez, O.D., Chair
BILL NO: SB 1283
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|AUTHOR: |Bates |
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|VERSION: |April 7, 2016 |
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|HEARING DATE: |April 20, 2016 | | |
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|CONSULTANT: |Reyes Diaz |
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SUBJECT : Substance abuse: structured sober living homes
SUMMARY : Allows a city, county, or city and county to adopt, by
ordinance, health and safety standards and enforcement
mechanisms for structured sober living homes, as defined.
Specifies that a structured sober living home registered
pursuant to an ordinance authorized by this bill is not subject
to state licensure and regulation, as specified.
Existing law:
1)Requires the Department of Health Care Services (DHCS) to
license alcoholism or drug abuse recovery or treatment
facilities (or RTFs) that provide 24-hour residential
non-medical 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.
2)Requires RTF licensees to provide at least one of the
following: recovery, treatment, or detoxification services.
Requires DHCS to adopt regulations requiring records and
procedures appropriate for the type of service provided.
Provides that the records and procedures can include all of
the following: admission criteria; intake process;
assessments; recovery, treatment, or detoxification planning;
referral; documentation of provision of recovery, treatment,
or detoxification services; discharge and continuing care
planning; or indicators of recovery, treatment, or
detoxification outcomes.
This bill:
1)Allows a city, county, or city and county to adopt, by
ordinance, health and safety standards and enforcement
SB 1283 (Bates) Page 2 of ?
mechanisms for structured sober living homes (SLHs) that
comply with state and federal housing laws and the federal
Americans with Disabilities Act of 1990 and amendments
thereto.
2)Requires the ordinance in 1) above to include, but not be
limited to, all of the following:
a) Mandatory registration requirements for all
structured SLHs to ensure that residents are living in
a safe environment. Requires registration requirements
to include, at a minimum:
i. The name and address of the
structured SLH.
ii. Information regarding the property,
such as the property owner's name, address, and
contact telephone number, or if the property is
leased, a copy of the lease with a statement that
the property will be used as a structured SLH.
b) In-home supervision requirements for the
residents of the structured SLH during all hours of
operation; and,
c) The establishment and maintenance of an
operation plan that facilitates the rehabilitative
process, including discharge planning, and that
addresses maintenance of the property and noise
abatement consistent with local ordinances.
3)Allows a city, county, or city and county that adopts health
and safety standards and enforcement mechanisms for structured
SLHs required in 1) above to exclude from regulation any
structured SLH that is subject to adequate oversight by
another governmental entity or contractor that meets or
exceeds the requirements in this bill.
4)Defines a "structured SLH" as any premises, place, or building
that provides alcohol-free or drug-free housing, promotes
independent living and life skill development, and provides
structured activities that are directed primarily toward
recovery from substance use disorders (SUDs) in a supervised
setting to a group of unrelated adults who are recovering from
drug and alcohol addiction, and who are receiving outpatient
behavioral health services for substance abuse or addiction
SB 1283 (Bates) Page 3 of ?
treatment while living in the home. Specifies that within this
definition is not included a private residence in which a
related family member is required to receive outpatient
behavioral health services as a condition of continuing to
reside in the family dwelling.
5)Specifies that a structured SLH registered pursuant to an
ordinance authorized by this bill is not subject to state
licensure and regulation as an RTF. Specifies that the
provisions in this bill do not establish a new category of
state-licensed facility or authorize a structured SLH to
provide any service for which a license is required by state
law.
6)Prohibits the provisions in this bill from being interpreted
to require the adoption of a structured SLH ordinance.
FISCAL
EFFECT : This bill has not been analyzed by a fiscal committee.
COMMENTS :
1)Author's statement. According to the author, various types of
group homes, including RTFs, are licensed by the state, but
SLHs that do not provide the same services that licensed
facilities do are not required to be licensed by the state.
Some cities have adopted ordinances for SLHs. Lengthy and
expensive litigation has left uncertainty, and the experiences
of these cities may discourage others from adopting adequate
and appropriate ordinances. This measure seeks to provide
clarity over what is expressly authorized by state law for
city and county ordinances that establish health and safety
standards for structured SLHs. As defined in this measure, a
structured SLH provides alcohol-free or drug-free housing,
promotes independent living and life skill development, and
provides structured activities that are directed primarily
toward recovery from SUDs in a supervised setting. The clarity
that the measure provides is intended to facilitate the
adoption of appropriate and adequate local health and safety
standards for structured SLHs. This measure does not authorize
any ordinance that does not comply with state and federal
housing laws and the federal Americans with Disabilities Act.
2)SLHs. A 2010 report on the National Institutes of Health (NIH)
Web site, Sober Living Houses for Alcohol and Drug Dependence:
18-month Outcomes, states that SLHs are not formal treatment
SB 1283 (Bates) Page 4 of ?
programs and are not obligated to comply with state or local
regulations applicable to treatment. However, NIH does not
provide a formal definition of an SLH. The report also
mentions that it is difficult to determine how many SLHs there
are in California because they are outside of the purview of
state licensing authorities (so no one is tracking SLHs). The
NIH report cites the protection that the federal Fair Housing
Act affords SLHs to be located in residentially zoned areas,
personal privacy under the Fourth Amendment, and the right of
people with disabilities to live together for a shared
purpose, such as mutually assisted recovery and maintenance of
an abstinent lifestyle.
According to DHCS's Web site, some types of RTFs do not
provide alcohol and other drug services and do not require
licensure by DHCS, including cooperative living arrangements
with a commitment or requirement to be free from alcohol and
other drugs, sometimes referred to as SLHs, transitional
housing, or alcohol- and drug-free housing. DHCS states that
while SLHs or alcohol- and drug-free housing are not required
to be licensed by DHCS, they may be subject to other types of
permits, clearances, business taxes, or local fees, which may
be required by the cities or counties in which they are
located. DHCS also does not certify or investigate complaints
against SLHs. If an SLH is providing licensable services to
adults then it must obtain a valid RTF license from DHCS.
Licensable services can include, but are not limited to,
detoxification services, group sessions, individual sessions,
one-on-one counseling, educational sessions, or recovery,
treatment, or discharge planning. If an SLH is providing just
one of the mentioned services, then it should be classified as
an RTF and must obtain a valid license from DHCS.
3)Difficulty siting RTFs. A document published by the U.S.
Department of Health and Human Services (DHHS), "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, SLHs, and other health-related facilities.
According to DHHS, many discriminatory zoning ordinances and
practices may be unlawful under the Fair Housing Act, the
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Rehabilitation Act, and the Americans with Disabilities Act.
It is also noted that communities often fear the decline of
property values and increased crime because of RTFs in the
neighborhood. However, the DHHS document states that in almost
every instance a community's fears are unfounded, as RTFs pose
no danger to the health and welfare of neighbors nor draw
substance abusers or pushers to the area.
4)Newport Beach Ordinance. According to the Web site for the
City of Newport Beach, in 2008 the Newport Beach City Council
adopted an ordinance that changed how the city regulates group
residential uses, defined as a "non-traditional single
housekeeping unit," including a boarding house, dorm, reunion
rental, state-licensed recovery home, SLHs, and elder care
homes. The ordinance required many home operators at the time
to obtain a use permit to stay in place. The ordinance
requires city approval for new unlicensed homes for recovering
addicts in certain neighborhoods.
A September 20, 2013, Los Angeles Times article, "Appeals
court backs sober-living homes in suit against Newport Beach,"
states that the U.S. 9th Circuit Court of Appeals unanimously
ruled that the Newport Beach ordinance may have illegally
discriminated against those with a disability. The article
states the ordinance forced many group homes to close and
prevented new ones from opening. A March 26, 2014, article in
the Orange County Register, "Newport Beach takes sober home
law to Supreme Court," reported that the Newport Beach City
Council petitioned the U.S. Supreme Court about the ruling by
the 9th Circuit Court of Appeals, and that the city would know
by the end of September 2014 if the court would review the
case. The U.S. Supreme Court ultimately declined to review it.
5)Discriminating against the disabled? A July 15, 2015, article
in the Orange County Register, "Newport Beach settles legal
battle over sober-living homes," states that Newport Beach
ended its seven-year battle over SLHs by reaching an agreement
with three entities that operate SLHs. The article quotes the
attorney representing the SLHs as saying that because a trial
could have taken several years his clients were more
interested in ending the proceedings rather than battling in
court. Also noted in the article is the fact that in 2007,
before Newport Beach implemented its ordinance, there were an
estimated 86 facilities (both RTFs and SLHs) in the city. As
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of February 2016, that number is now 25: 15 RTFs licensed by
DHCS and 10 SLHs. The article further notes that the 9th
Circuit Court of Appeals sided with the SLHs because there was
enough evidence to argue discrimination. As alcohol and drug
treatment and recovery experts argue, most RTFs and SLHs would
rather give in to discrimination and shutter their doors than
spend years battling it out in courts, which can be very
costly. The DHHS document noted that in one instance in New
Jersey a campaign of harassment against a treatment facility
caused each of the home's residents to relapse. While SLHs do
not provide formal treatment, they often serve as part of the
continuum of treatment, providing a drug-free and alcohol-free
environment for individuals recently discharged from an RTF
who often do not have a home or who are not ready to return to
the environment they were in before they entered treatment.
What effect does enforcing a possibly discriminatory ordinance
have on communities when treatment and recovery options are
hampered?
6)Related legislation. AB 2255 (Melendez), would provide that a
residence housing those purporting to be recovering from drug
or alcohol abuse would be presumed to be a SLH if it has been
certified, registered, or approved by a state-recognized
nonprofit organization, which would be required to establish
minimum standards for SLHs, including protocols to address
suspected drug and alcohol abuse or to report the death of a
resident. AB 2255 is pending in the Assembly Health Committee.
7)Prior legislation. AB 2491 (Nestande, of 2014), would have
required DHCS to administer the licensure and regulation of
adult recovery maintenance facilities (SLHs), as defined, and
to adopt emergency regulations, applicable only to adult
recovery maintenance facilities, to implement the fee process
for initial licensure, and the provisions for the extension of
licensure, follow-up compliance visits, and civil penalties.
AB 2491 was held on suspense in the Senate Appropriations
Committee.
AB 2335 (Mansoor, of 2014) would have defined SLHs with
certain criteria and exempted an SLH or supportive housing
from licensure as an RTF. AB 2335 failed passage in the
Assembly Health Committee on April 22, 2014, on a 6-12 vote.
SB 214 (Benoit, of 2009), and AB 724 (Benoit, of 2007), were
both substantially similar to AB 2255 (Melendez). SB 214
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failed in the Senate Health Committee without being heard. AB
724 failed passage in the Senate Health Committee on a 5-4
vote. Reconsideration was granted, but the bill was not heard
again in the committee.
SB 992 (Wiggins, of 2008), would have required the Department
of Alcohol and Drug Programs to license SLHs, or "adult
recovery maintenance facilities." SB 992 was vetoed by
Governor Schwarzenegger who stated that while licensure and
regulation of SLHs are important to ensure SLHs respect and
participate in their local community; for communities to
provide support to these facilities; and for individuals
seeking recovery from alcohol and drug addiction to live in
safe environments that help them in their recovery, this bill
did not accomplish these policy goals.
AB 370 (Adams, of 2007), would have permitted a local
government to include an RTF serving six or fewer persons,
including a SLH, within the definition of single family
residence. AB 370 was held on suspense in the Assembly
Appropriations Committee.
AB 36 (Strickland, of 2006), was similar to SB 992. AB 36 was
held on suspense in the Senate Appropriations Committee.
SB 340 (Florez, of 2003), was similar to SB 992 and AB 36. SB
340 failed in the Senate Health and Human Services Committee
without being heard.
AB 2317 (Chu, of 2002), was similar to SB 992, AB 36, and SB
340. AB 2317 was held on suspense in the Senate Appropriations
Committee.
8)Support. The City of Laguna Niguel states that this bill
allows cities and patients to focus on the best treatment
options for their communities by providing them with the
resources they need to work with compliant RTFs. Laguna Niguel
argues that this bill would address many of the concerns
surrounding RTFs by creating consistency in the licensing
requirements for licensing SLHs and RTFs. The League of
California Cities states that this bill allows local
governments to adopt ordinances that protect the health and
safety of SLH residents and surrounding neighborhoods from
facilities that are poorly managed or have no state oversight.
The League also states that this bill spares cities from
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costly litigation spawned by a climate of uncertainty. The
League supports permitting cities to exercise review and land
use regulation of group homes and RTFs, including the
application of zoning, building, and safety standards. The
City of Encinitas states that this bill provides common sense
measures to ensure the function of an SLH is to serve clients
and impacted neighbors, and that in-house supervision is a
reasonable requirement since SLHs are for adult sober living
and recidivism is a reality.
9)Opposition. Opponents, consisting of facility owners and
health advocates, argue that provisions in this bill are
contrary to the state's avowed interest in alleviating
problems related to SUDs because it would limit the
availability of options for those with SUDs. Opponents state
that while California's approach to treatment relies
significantly on state-licensed facilities, those programs are
supplemented with SLHs in residential neighborhoods, which do
not provide treatment and provide living situations in a
peer-supported community critical to bridging the gap between
treatment and returning full-time to independent living.
Opponents further argue that this bill would allow local
governments to contravene the intent of the state to increase
the availability of treatment and recovery options for those
with SUDs. Cliffside states that this bill allows local
governments to unfairly discriminate against disabled persons,
and that rather than litigate the ordinances SLHs will be
forced financially to close. The Western Center on Law and
Poverty states that while this bill provides that local
governments cannot enact provisions in violation of federal
and state housing and anti-discrimination laws, there are more
than 500 local governments and there is no ability by the
state or advocates to ensure that violations do not happen. 1
Method Center, LLC, states that ordinances would have a
crippling effect on the operation and maintenance of SLHs, and
that this bill would allow local governments who desire to
keep SLHs out of their communities to adopt ordinances that
will accomplish their NIMBY goals.
10)Policy comments.
a) Should the Legislature interfere? While the
U.S. Supreme Court declined to review the case between
the City of Newport Beach and a group of SLHs, the
most recent court decision was that of the 9th Circuit
SB 1283 (Bates) Page 9 of ?
Court of Appeals, which ruled there was sufficient
evidence that the Newport Beach ordinance may have
illegally discriminated against those with a
disability. This bill would give a city, county, or
city and county the authority to adopt and enforce an
ordinance for SLHs, allowing for Newport Beach's
ordinance to stand. Should the Legislature empower
local governments when courts have ruled there is
evidence to support they are being discriminatory?
b) Do requirements of structured SLHs constitute
licensable services? This bill requires structured
SLHs to provide, among other things, structured
activities that are directed primarily toward recovery
from SUDs in a supervised setting and to establish and
maintain an operation plan that facilitates the
rehabilitative process, including discharge planning.
While this bill provides that structured SLHs do not
require state licensure and cannot provide services
that would require state licensure, the listed
required services appear to be licensable services.
Therefore, the effect of this bill is unclear.
c) Does this bill solve the current SLH problem?
Because there is no state authority that oversees SLHs
and no universal definition in statute of a SLH, the
author contends that many cities have had to enter
costly litigation and that other cities are
discouraged from adopting adequate and appropriate
ordinances. This bill adds a definition for structured
SLHs to current statute that sets forth DHCS's powers
and duties for licensing RTFs for those with SUDs but
does not require DHCS to license and/or oversee SLHs.
It is unclear if DHCS would be responsible for
oversight of SLHs.
SUPPORT AND OPPOSITION :
Support: City of Encinitas
City of Laguna Niguel
League of California Cities
Oppose: Cliffside Malibu
1 Method Center, LLC
Promises Treatment Centers
Western Center on Law and Poverty
SB 1283 (Bates) Page 10 of ?
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