BILL ANALYSIS                                                                                                                                                                                                    �



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          ASSEMBLY THIRD READING
          AB 972 (Butler and Beall)
          As Amended April 13, 2011
          Majority vote 

           HEALTH              17-1        APPROPRIATIONS      17-0        
           
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          |Ayes:|Monning, Logue, Ammiano,  |Ayes:|Fuentes, Harkey,          |
          |     |Atkins, Bonilla, Eng,     |     |Blumenfield, Bradford,    |
          |     |Garrick, Gordon, Hayashi, |     |Charles Calderon, Campos, |
          |     |Roger Hern�ndez,          |     |Davis, Donnelly, Gatto,   |
          |     |Bonnie Lowenthal,         |     |Hall, Hill, Lara,         |
          |     |Mitchell, Nestande, Pan,  |     |Mitchell, Nielsen, Norby, |
          |     |V. Manuel P�rez, Silva,   |     |Solorio, Wagner           |
          |     |Williams                  |     |                          |
          |     |                          |     |                          |
          |-----+--------------------------+-----+--------------------------|
          |Nays:|Smyth                     |     |                          |
          |     |                          |     |                          |
           ----------------------------------------------------------------- 
           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;









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             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. 

           FISCAL EFFECT  :  According to the Assembly Appropriations 
          Committee, on previous similar legislation, DADP estimated 
          General Fund costs of $125,000 in the first year and $250,000 in 
          the following year, and continuing.
           COMMENTS  :  The sponsors of this bill, the California Society of 
          Addiction Medicine and CRC Health Group, Inc., state that it is 
          intended to ensure that California's physicians maintain their 
          vital role in providing medical services to individuals 
          overcoming addiction.  The sponsors assert 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.  

          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; 








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          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.  
          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.

          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.  They write 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.  Lastly, supporters add that this bill 
          promotes more thorough care in California's substance abuse 
          treatment facilities while saving money by preventing 
          unnecessary hospital stays.  
           

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


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