BILL ANALYSIS �
AB 972
Page 1
Date of Hearing: April 26, 2011
ASSEMBLY COMMITTEE ON HEALTH
William W. Monning, Chair
AB 972 (Butler and Beall) - As Amended: April 13, 2011
SUBJECT : Substance abuse: treatment facilities.
SUMMARY : Adds facilities that provide limited medical
services, as specified, to adults recovering from alcohol and
drug abuse to the definition of treatment facilities licensed by
the Department of Alcohol and Drug Programs (DADP).
Specifically, this bill :
1)Specifies that an alcoholism or drug abuse recovery or
treatment facility licensed by DADP includes a facility that
provides limited medical services, as defined, exclusively to
residents of the facility for the purpose of assisting in
detoxification and recovery and that is accredited by a
nationally recognized accrediting organization.
2)Limits the medical services provided in 1) above to the
following activities:
a) Medical evaluation, psychiatric counseling, and
prescription of medications for assistance with
detoxification;
b) Additional psychiatric evaluation and counseling, if
necessary;
c) Prescribing and monitoring medications, including public
health inoculations;
d) Obtaining medical histories and routine examinations for
general oversight of the medical condition of residents
within the facility; and,
e) Routine, noninvasive testing, including drawing blood
samples for laboratory examination and testing offsite.
3)Prohibits the provisions of this bill from being construed to
allow the state or a local governmental entity to require
medical services to be provided within a facility as a
condition of licensure, funding, or other regulatory
supervision.
4)Sunsets the provisions of this bill on January 1, 2017.
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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 : This bill has not yet been analyzed by a fiscal
committee.
COMMENTS :
1)PURPOSE OF THIS BILL . According to the sponsors, the
California Society of Addiction Medicine and CRC Health Group,
Inc., this bill is intended to ensure that California's
physicians maintain their vital role in providing medical
services to individuals overcoming addiction. The sponsors
state that modern addiction treatment involves medical care
and allowing physicians to provide onsite medical supervision
of the residents at a DADP licensed facility is far more cost
efficient than taking clients back and forth to a clinic or
hospital. They also assert that, in the rare case where a
higher level of care is required, the resident can be
transported to a health care facility if necessary. The
sponsors note that this bill is intended to enhance the
continuum of care provided to individuals seeking addiction
treatment by updating the existing definition of a residential
treatment facility to include those facilities that allow
physicians to provide a limited scope of medical services to
residents.
2)DADP LICENSURE AUTHORITY . 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,
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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 permit DADP
to extend its licensing authority to facilities with
physicians on site to provide a limited number of medical
services to assist residents in their detoxification and
recovery from substance abuse. DADP indicates that 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 the premises to provide medical assistance with
detoxification, psychiatric evaluation and counseling,
medication prescribing and monitoring, and general oversight
of the medical condition of clients residing in the facility.
3)NATIONAL ACCREDITING ORGANIZATIONS . According to DADP,
accreditation by two national organizations, the Joint
Commission and the Commission on Accreditation of
Rehabilitation Facilities (CARF) is currently available for
such behavioral health care services as addiction treatment,
opioid treatment and maintenance programs, crisis
stabilization, case management and care coordination,
employment services, and vocational rehabilitation. The Joint
Commission and CARF each require a facility to demonstrate
that its program meets their respective quality standards in
order to obtain accreditation. These quality standards
evaluate important functions relating to client care and
program management, including administrative requirements,
financial management, personnel qualifications, client
services, performance outcomes, client safety, and information
privacy and security. The Joint Commission requires
accredited organizations to reapply for accreditation every
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three years while CARF accreditation ranges from one to five
years, depending on the type of facility.
4)PRIOR LEGISLATION .
a) AB 2221 (Beall) of 2010, which was substantively similar
to this bill, died on the Senate Appropriations Committee
Suspense File.
b) AB 1055 (Chesbro) of 2009, which contained provisions
substantially similar to this bill, died on the Assembly
Appropriations Committee Suspense File.
5)SUPPORT . Supporters, representing treatment facility
operators, providers, and consumers, state that this bill
updates existing law to ensure that physicians retain their
ability to participate in the full range of treatment for
Californians with addictions. Promises Treatment Centers
writes that medical services are particularly important during
the early stages of detoxification and providing a limited
level of medical care conforms to scientific research about
recovery. Drug Policy Alliance supports this bill because, in
addition to promoting more thorough care in California's
substance abuse treatment facilities, it saves money by
preventing unnecessary hospital stays. Lastly, the California
Psychiatric Association adds in support that this bill
clarifies ambiguity in state law with regard to whether or not
physicians are authorized to provide services in residential
non-medical facilities and in doing so affords residents a
full range of treatment options in these settings.
REGISTERED SUPPORT / OPPOSITION :
Support
California Society of Addiction Medicine (sponsor)
CRC Health Group, Inc. (sponsor)
California Association of Addiction Recovery Resources
California Medical Association
California Psychiatric Association
County Alcohol and Drug Program Administrators Association of
California
Drug Policy Alliance
Promises Treatment Centers
Opposition
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None on file.
Analysis Prepared by : Cassie Royce / HEALTH / (916) 319-2097