BILL ANALYSIS                                                                                                                                                                                                    



                                                                  SB 268
                                                                  Page  1

          Date of Hearing:   July 7, 2009

                            ASSEMBLY COMMITTEE ON HEALTH
                                  Dave Jones, Chair
                     SB 268 (Harman) - As Amended:  July 1, 2009

           SENATE VOTE  :   23-15
           
          SUBJECT  :   Alcoholism or drug abuse recovery or treatment  
          facilities: licensing.

           SUMMARY  :   Requires applicants seeking licensure as a  
          residential alcoholism or drug abuse recovery treatment facility  
          (treatment facility) to include in the application to the  
          Department of Alcohol and Drug Programs (DADP) a certification  
          that the proposed facility complies with local zoning, or is a  
          legal non-conforming use, and to submit an approved fire  
          clearance, as specified.   Specifically,  this bill  :  

          1)Requires applicants seeking a license for a treatment facility  
            to file with DADP, on forms provided by DADP, a completed  
            written application that includes a certification by the  
            applicant that the proposed facility is in compliance with  
            local zoning or is a legal nonconforming use.

          2)Directs DADP to ensure that the license application in 1)  
            above contains a clear reference to existing law requiring  
            treatment facilities serving six or fewer persons to be  
            considered residential uses of property not subject to  
            conditional use permits, zoning ordinances, or other  
            clearances.

          3)Requires applicants to also include in the completed written  
            application in 1) above a fire clearance approved by the State  
            Fire Marshall (SFM) or local fire prevention officer.

          4)Makes the approved fire clearance valid for the two-year  
            duration of the license.  

          5)Requires any license renewal by a treatment facility serving  
            seven or more persons to include a fire clearance approved by  
            the SFM or local fire prevention officer based on building  
            codes in place at the time that the facility was initially  
            licensed.  









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           EXISTING LAW  :

          1)Establishes DADP to develop and implement a statewide plan to  
            alleviate problems related to alcohol abuse and license  
            treatment facilities that provide a broad range of services in  
            a supportive environment for adults who are addicted to  
            alcohol or drugs.

          2)Defines a 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)Requires the Department of Social Services (DSS) to deny an  
            application for a new residential care facility license if the  
            director determines that the location is in proximity to an  
            existing residential care facility that would result in  
            overconcentration.  Defines "overconcentration" to mean that  
            if a new license is issued, there will be residential care  
            facilities that are separated by a distance of 300 feet or  
            less.

          4)Requires an applicant, when applying to DADP for a treatment  
            facility license, to file an application, obtain a fire  
            clearance approved by the SFM or local fire enforcement  
            officer, and pay a license fee.  

          5)Requires, in regulations, the documentation to be submitted  
            with the application to include a valid and appropriate fire  
            clearance issued from the fire authority having jurisdiction  
            for the area in which the facility is located.  Requires the  
            fire clearance to include a determination of the number of  
            beds for ambulatory and nonambulatory residents and any  
            restrictions regarding nonambulatory clearances.

          6)Requires, in regulations, the buildings and grounds of  
            treatment facilities to be clean, safe, sanitary, and in good  
            repair at all times for the safety and well-being of  
            residents, employees, and visitors. 

          7)Makes the license in 4) above valid for two years from the  
            date of issuance and permits DADP to extend the license for  
            subsequent two-year periods if the licensee submits a  








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            completed written application for extension and pays the  
            licensing fee prior to the expiration date on the license.

          8)Requires, in regulations, DADP to conduct a licensing  
            compliance review of each treatment facility at least once  
            during every two-year licensure period.

          9)Requires a treatment facility with six or fewer persons to be  
            considered a residential use of property and not subject to  
            conditional use permits, zoning ordinances, or other  
            clearances.

          10)Prohibits, for the purpose of all local ordinances, a  
            treatment facility serving six or fewer residents from being  
            included within the definition of a boarding home, rooming  
            house, institution or home for the care of minors, the aged,  
            or mentally infirm, foster care home, guest home, rest home,  
            sanitarium, mental hygiene home, or other similar term which  
            implies that the treatment facility is a business run for  
            profit or differs in any other way from a single family  
            residence.

          11)Makes a legislative declaration that it is the policy of this  
            state that each county and city shall permit and encourage the  
            development of sufficient numbers and types of treatment  
            facilities as are commensurate with local need.

          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.

           FISCAL EFFECT  :   According to the Senate Appropriations  
          Committee, pursuant to Senate Rule 28.8, negligible state costs.

           
          COMMENTS  :   

           1)PURPOSE OF THIS BILL  .  The author asserts that there is a lack  
            of adherence to local zoning, fire, or any reasonable  
            regulations for recovery and treatment facilities.  The  
            sponsor of this bill, the City of Newport Beach, contends that  








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            applicants for a proposed facility should be required to  
            actually certify with their license application that the  
            facility meets local zoning or is a legal nonconforming use,  
            rather than merely being required to sign a statement on the  
            current application acknowledging that they understand that  
            they are obligated to comply with other state and local codes  
            and regulations.  Furthermore, the sponsor states that clients  
            in these facilities deserve to be in places that reflect  
            proper health and safety protections and requiring an updated  
            fire clearance based on the building codes in effect at the  
            time a facility was initially licensed accomplishes this goal.  
             According to the author, this bill is intended to assist the  
            Legislature, DADP, and local jurisdictions in preserving the  
            spirit of residential recovery by fully integrating genuine  
            treatment homes in neighborhoods while enabling localities to  
            apply local zoning and updated building safety standards to  
            these facilities.   

           2)RESIDENTIAL TREATMENT FACILITIES  .  According to DADP,  
            residential treatment facilities provide nonmedical services  
            to individuals who are working to overcome their addiction to  
            alcohol or other drugs.  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.  

          According to a survey by the federal Substance Abuse and Mental  
            Health Services Administration, more than 141,000 clients in  
            California received substance abuse treatment services from  
            1,751 treatment facilities in 2007.  Of these facilities,  
            1,117 were private-non-profit; 406 were private for-profit;  
            177 were owned or operated by local governments; and, 12 were  
            owned or operated by the state.  Over 90% served clients with  
            both alcohol and drug abuse problems.  The 2007 survey  
            reported that the specific populations served in these  
            settings include clients with co-occurring mental health and  
            substance abuse disorders; adult men only; adult women only;  
            pregnant women and children; persons with HIV or AIDS; and,  
            criminal justice clients.  For pregnant women and those with  
            young children, in particular, the small number of facilities  
            in California that allow women to bring their children with  








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            them to a residential facility while they receive treatment  
            provide a residential option that ensures that these women are  
            not required to turn their children over to the foster care  
            system.     

          3)DADP LICENSING REQUIREMENTS  .  DADP requires prospective  
            applicants for licensure as a residential treatment facility  
            to first identify a location where they plan to provide  
            non-medical alcoholism or drug abuse recovery, treatment, or  
            detoxification services.  Applicants are required to complete  
            an initial application, submit an approved fire clearance from  
            the local fire authority, and pay an applicable license fee.   
            DADP reports that an update of the required fire clearance  
            depends on how frequently the local fire authority inspects a  
            facility for fire safety.  Generally, DADP indicates that the  
            licensing process primarily focuses on health and safety  
            concerns, such as appropriate fire clearances, food service  
            standards, personnel requirements, physical environment  
            requirements, and residents' personal rights.  Applicants are  
            required to pass a treatment facility on-site inspection  
            conducted by DADP to determine compliance with all applicable  
            laws and regulations.  According to DADP, a review of the  
            entire facility is necessary to determine that it is a safe  
            and healthy environment.  Regardless of the type of review,  
            whether it is for initial licensure or licensure renewal, a  
            DADP field inspector is required to complete a facility  
            walk-through form.  The form includes a checklist of items  
            that the inspector evaluates during the walk-through  
            including, with regard to client safety, the presence of a  
            fire escape or escape ladder, if appropriate; posted exit  
            signs; posted emergency telephone numbers; and, the presence  
            of working smoke detectors and fire extinguishers.  An  
            applicant that passes the initial inspection is issued a  
            license valid for two years.  When a facility is due to renew  
            its license, DADP sends a courtesy notice to the facility 120  
            days prior to the expiration date on the license and conducts  
            an inspection of renewed licensees once every two year period.  
             Licensed facilities are mandated to display their license,  
            which indicates the treatment capacity and the population they  
            are allowed to serve, in a public location.   

           4)DSS FACILITIES  .  DSS reports that it does not contact local  
            government agencies regarding entities under its jurisdiction,  
            including adult residential facilities, adult residential  
            facilities for persons with special health care needs, group  








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            homes, and social rehabilitation facilities that are applying  
            for licensure for purposes other than requesting fire  
            clearances and providing overconcentration notification  
            required under current law.  DSS indicates that it advises  
            applicants during the application process that they may be  
            subject to local ordinances regarding zoning or use permits  
            and recommends that they contact the local city or county  
            planning office to ensure that they comply with all local  
            requirements.  However, DSS does not require proof that this  
            has been done as a condition of licensure. 

          Additionally, DSS notes that it issues licenses to facilities in  
            perpetuity; there is no requirement to "renew" a license.   
            However, a facility is required to submit a new application  
            and obtain a new fire clearance when there is an increase in  
            capacity, a change of ownership, or a change in location.  If  
            a facility remodels or alters the structure of an existing  
            facility, the facility must obtain a building permit and may  
            be required to obtain a new fire clearance.  DSS facilities  
            are required to obtain a fire clearance that is appropriate  
            for the clients served by the facility.  

           5)FAIR HOUSING PROTECTIONS  .  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.

           6)PENDING STATE FIRE MARSHAL REPORT  .  In response to non-uniform  
            code enforcement between treatment facilities and local  
            governments, the SFM has convened a Drug and Alcohol Recovery  
            Treatment (DART) Work Group comprised of representatives from  
            the SFM's Office, the local Fire Marshal of Newport Beach, a  
            representative from Sacramento Metropolitan Fire Department,  
            representatives from DADP, and treatment facility providers.   
            The SFM's Office reports that the DART committee's draft  
            report containing recommendations with respect to the fire  
            clearance process for treatment facilities has been prepared  
            and is awaiting comment from the SFM before it is finalized.   
            According to the SFM's Office, it cannot provide a date  
            certain for publication of the final report but it expects to  








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            incorporate some of the DART committee's recommendations in  
            future code interpretations issued by the SFM.  

           7)SUPPORT  .  Various city fire departments write in support that  
            this bill will ensure that operators of group care facilities  
            have current fire clearances and their clients are treated in  
            facilities that reflect current standards for personal safety  
            protections.  The Marin County Council of Mayors and  
            Councilmembers (MCCMC) claims that, in many instances,  
            facilities are placed in high concentration, creating  
            campus-like compounds, in and among single family  
            neighborhoods and, as a result, MCCMC believes a modicum of  
            oversight with respect to fire safety is appropriate.  MCCMC  
            adds that requiring a facility to assert that it knows what  
            the approved local land uses are and that they are compatible  
            is also a simple and reasonable approach to working with the  
            community.  Supporters note that, by helping to assure fire  
            code adherence in group homes serving as licensed treatment  
            facilities, this bill will benefit the residents of these  
            facilities and the communities in which they are located.

           8)OPPOSITION  .  Providers and consumers of residential treatment  
            services object to this bill, contending that it is  
            unnecessary, disruptive, burdensome, and discriminatory.   
            Opponents argue that there is no showing of problems to  
            challenge the adequacy or effectiveness of the existing  
            licensing authority of DADP to regulate these facilities and  
            no demonstrable evidence to justify mandating fire clearances  
            every two years when the same requirement is not imposed on  
            other types of facilities that are not licensed by DADP.  The  
            County Alcohol and Drug Program Administrators Association of  
            California (CADPAAC) points out that, by singling out  
            residential treatment programs for additional regulation that  
            is not required of all group home facilities, this bill  
            discriminates against individuals in recovery, who are  
            protected under FEHA and the federal Americans with  
            Disabilities Act.  CADPAAC also contends that the requirement  
            for these facilities to obtain new fire clearances every two  
            years is problematic because, in many counties, fire  
            departments are too short-staffed to respond in a timely  
            manner to requests for fire inspections and this bill could  
            render a facility, through no fault of its own, non-compliant  
            because the local fire department failed to respond quickly  
            enough to the facility's request for an inspection.  Lastly,  
            Narconon Southern California opposes the certification  








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            requirement in this bill because it would place an onerous  
            burden on operators of proposed facilities to learn every  
            nuance of the zoning code in the jurisdiction in which they  
            wish to locate and even a minor mistake could expose operators  
            to serious risk of having a license denied on the grounds of  
            misrepresentation.   

           9)RELATED LEGISLATION  .  AB 1284 (Huffman) 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 the facility operates as an  
            integral component of an existing licensed treatment facility  
            managed by the same licensee and is located within 300 feet of  
            the existing facility, as specified.  AB 1284 was held on the  
            Assembly Appropriations Committee suspense file.

           10)PRIOR LEGISLATION  .

             a)   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.

             b)   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, or both, who seek a living  
               environment in which to remain clean and sober, and that  
               meets other specified requirements.  AB 724 failed passage  
               in the Senate Health Committee.

             c)   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.

             d)   AB 370 (Adams) of 2007 would have allowed a local  
               government to prohibit a registered sex offender released  
               on parole from residing with any other person on parole in  
               a residential treatment facility serving six or fewer  
               residents, unless the other resident is related by blood,  
               marriage, or adoption.  This bill also would have permitted  
               a local government to include a residential care facility  
               serving six or fewer persons, including a sober living  








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               facility, within the definition of single family residence.  
                AB 370 was held in the Assembly Appropriations Committee.

             e)   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 was held in  
               the Assembly Appropriations Committee.

           11)POLICY CONCERNS  .

              a)   The certification requirement in this bill is vague  .   
               This bill requires the operator of a proposed facility to  
               certify in its licensure application that the facility  
               complies with local zoning or is a legal nonconforming use.  
                The term "legal nonconforming use" is not defined and this  
               bill does not describe what the certification would consist  
               of in order to enable an applicant to comply with this  
               requirement.  In addition, this bill does not specify what  
               DADP would do with this certification information when  
               processing the application.  Lastly, this requirement does  
               not clearly specify that the certification takes place only  
               at the time of initial licensure, and, therefore, could  
               create a barrier to licensure for these facilities and  
               reduce the availability of services, as compliance may be  
               difficult to achieve because zoning laws are subject to  
               change without an operator's knowledge.  The author may  
               wish to clarify the intent of this provision and address  
               the potential for licensure denials that could result from  
               this bill.

              b)   Is this bill premature  ?  In light of the pending report  
               from the SFM, it may be appropriate to review the final  
               recommendations, since they may address some of the same  
               fire safety issues that this bill seeks to address, before  
               making any changes to existing requirements.    
              
              c)   Discrimination based on disability  .  Federal and state  
               law prohibits discrimination against persons with  
               disabilities in housing.  Individuals recovering from  
               substance abuse are included in these protections.  By  
               applying new requirements only to residential alcohol and  
               drug treatment facilities but not to other types of  
               housing, is an unintended consequence of this bill to  
               discriminate against people with substance abuse  
               disabilities? 








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          REGISTERED SUPPORT / OPPOSITION  :

           Support 
           
          City of Newport Beach (sponsor)
                     Belmont-San Carlos Fire Department
          City of Dana Point (prior version)
          City of Lodi Fire Department
          City of Pasadena Fire Department
          City of Paso Robles Department of Emergency Services
          City of Westminster (prior version)
          City of Whittier (prior version)
          Foster City Fire Department
          Hayward Fire Department
          Lake Forest City Council (prior version)
          League of California Cities (prior version)
          Marin County Council of Mayors and Councilmembers
          South Lake Tahoe Fire Department
          Templeton Fire Department
           
            Opposition 
           
          California Association of Addiction Recovery Resources (prior  
          version)
          California Association of Alcohol and Drug Program Executives,  
          Inc. (prior version)
          California Therapeutic Communities (prior version)
          CLARE Foundation (prior version)
          Cliffside Malibu
          County Alcohol and Drug Program Administrators Association of  
          California
          CRC Health Group, Inc.
          Narconon Southern California
          Elements Behavioral Health (prior version)
          Western Center on Law and Poverty (prior version)


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