BILL ANALYSIS                                                                                                                                                                                                    



                                                                  AB 2221
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          ASSEMBLY THIRD READING
          AB 2221 (Beall)
          As Amended April 27, 2010
          Majority vote 

           HEALTH              18-0        APPROPRIATIONS      16-0        
           
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          |Ayes:|Monning, Fletcher,        |Ayes:|Fuentes, Conway, Ammiano, |
          |     |Ammiano, Carter, Conway,  |     |Bradford, Coto, Davis,    |
          |     |Caballero, Emmerson, Eng, |     |Hill, Hall, Harkey,       |
          |     |Gaines, Hayashi,          |     |Miller, Nielsen, Norby,   |
          |     |Hernandez, Jones, Bonnie  |     |Skinner, Solorio,         |
          |     |Lowenthal, Nava,          |     |Torlakson, Torrico        |
          |     |V. Manuel Perez, Salas,   |     |                          |
          |     |Smyth, Audra Strickland   |     |                          |
          |     |                          |     |                          |
           ----------------------------------------------------------------- 
           SUMMARY  :  Expands the category of residential treatment  
          facilities licensed by the Department of Alcohol and Drug  
          Programs (DADP) to include facilities that provide limited  
          residential medical services to adults recovering from alcohol  
          and drug abuse that are not required to have a separate health  
          facility license.

           EXISTING LAW  :

          1)Establishes DADP to license treatment facilities that provide  
            a broad range of services in a supportive environment to  
            adults who are addicted to alcohol or drugs.

          2)Defines a "treatment facility" as any premise, place, or  
            building that provides 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.

          3)Defines residential nonmedical services provided by a licensed  
            treatment facility to mean recovery services, treatment  
            services, and detoxification services. 

           FISCAL EFFECT  :  According to the Assembly Appropriations  
          Committee, costs should be minor and absorbable within existing  








                                                                  AB 2221
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          resources.

           COMMENTS :  According to the sponsor, the California Society of  
          Addiction Medicine (CSAM), this bill is intended to ensure that  
          California's physicians maintain their vital role in providing  
          medical services to individuals withdrawing from alcohol and  
          other drugs.  CSAM notes that this bill updates the existing  
          definition of a residential treatment facility to allow DADP to  
          license and regulate treatment facilities that provide medical  
          services, limited to routine services within the scope of  
          practice of an addiction medicine specialist.

          DADP licenses residential treatment facilities to provide  
          nonmedical services to individuals who are working to overcome  
          their addiction to alcohol or other drugs.  According to DADP,  
          these services include education, group, or individual sessions;  
          recovery or treatment planning; and, detoxification services.   
          In addition, a licensed treatment facility may offer  
          individualized services, such as vocational and employment  
          search training, community volunteer opportunities, new skills  
          training, peer support, social and recreational activities, and  
          information about and referral to appropriate community  
          services.  This bill would require DADP to extend its licensing  
          authority to facilities that use a multidisciplinary team,  
          including an available physician, to provide residential medical  
          services that do not require it to obtain a separate health  
          facility license.  

          According to DADP, since current law only authorizes it to  
          license nonmedical services, many larger licensed facilities  
          enter into contracting arrangements with physicians to provide  
          medical services on-site, such as treatment of medical symptoms  
          associated with addiction, including post withdrawal  
          hypertension, seizure prevention, and impaired liver function.   
          Residents of smaller facilities (six beds or less) that provide  
          detoxification services are currently required to obtain medical  
          clearance from a physician off-site before participating in a  
          detoxification program.  This bill would enable DADP to license  
          treatment facilities with programs that include physicians on  
          site to provide medical clearance and assist with other limited  
          medical services, such as routine physicals, communicable  
          disease screening, vital sign assessment, and the prescribing,  
          administering, and dispensing of medications for withdrawal  
          symptoms.       








                                                                  AB 2221
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          Analysis Prepared by  :    Cassie Rafanan / HEALTH / (916)  
          319-2097 

                                                                FN: 0004327