BILL ANALYSIS                                                                                                                                                                                                    �




                   Senate Appropriations Committee Fiscal Summary
                           Senator Christine Kehoe, Chair

                                          AB 972 (Butler and Beall)
          
          Hearing Date: 8/15/2011         Amended: 8/15/2011
          Consultant: Katie Johnson       Policy Vote: Health 7-1
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          ____
          BILL SUMMARY:  AB 972 would permit 24-hour residential treatment 
          facilities that provide services to adults recovering from 
          alcohol and drug abuse that are licensed by the Department of 
          Alcohol and Drug Programs (DADP) to provide medical services and 
          would provide that such a facility would not require a health 
          facility license.
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          ____
                            Fiscal Impact (in thousands)

           Major Provisions         2011-12     2012-13       2013-14     Fund
           DADP adoption of                       at least $100   at least 
          $100          $0                General
          emergency regulations 
                                          
          DADP ongoing oversight   up to $150 up to $300         up to 
          $300          Special*

          *Residential and Outpatient Program Licensing Fund
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          ____

          STAFF COMMENTS: This bill meets the criteria for referral to the 
          Suspense File.
          
          Until January 1, 2017, this bill would permit 24-hour 
          residential treatment facilities that provide services to adults 
          recovering from alcohol and drug abuse that are licensed by the 
          Department of Alcohol and Drug Programs (DADP) to provide 
          specified medical services and would provide that such a 
          facility would not require a health facility license. 

          The addition of medical services to the services provided by 
          residential treatment facilities would increase the time DADP 
          could expect to spend conducting its biennial facility site 
          reviews. DADP would need up to two and a half permanent staff at 
          an annual cost of up to $300,000 to accommodate the increased 








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          site inspection time. Currently, site reviews are conducted 
          biennially. Actual staffing costs would depend on the number of 
          licensed facilities that would choose to offer medical services. 
          There are 824 facilities licensed. For example, if only 10 
          percent of licensed facilities chose to offer medical services, 
          DADP would need to augment its site reviews for 41 facilities 
          commencing in FY 2011-2012.

          The August 15 amendments would delete provisions in this bill 
          that would have provided for a per bed fee based on, and not to 
          exceed, the patient slot fee for a narcotic treatment program 
          ($31) and would instead:

             1)   Require the department to impose a licensure and 
               certification fee on a facility that chooses to provide 
               limited medical services and that, for the first year of 
               implementation, would prohibit the fee from being set at 
               more than $50 per client based on the number of clients the 
               facility served that year.
             2)   Permit DADP to implement these provisions by 
               all-facility letters or similar instructions, but would 
               require DADP to adopt emergency regulations implementing 
               this bill on or before December 31, 2012. 
             3)   Require that, in promulgating emergency regulations, the 
               department would adopt the specific accreditation standards 
               established by the Joint Commission on Accreditation of 
               Healthcare Organizations (JCAHO) and the Commission on 
               Accreditation of Rehabilitation Facilities (CARF), and any 
               additional accrediting organizations that DADP may choose 
               to rely upon. DADP would be permitted to readopt the 
               emergency regulations once.

          DADP would likely need at least $100,000 in FY 2011-12 and in FY 
          2012-13 in General Fund in order to develop the all-facility 
          letters and to adopt the emergency regulations. It is unknown 
          whether or not DADP would choose to promulgate permanent 
          regulations. It is unclear after the readoption of the emergency 
          regulations expires under what authority DADP would have to 
          license, certify, and inspect the facilities providing medical 
          services through this bill's January 1, 2017, sunset date, if 
          the department were to choose to not adopt permanent 
          regulations.

          To the extent that the $50 per client fee does not cover the 








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          costs of DADP's inspections in the first year of implementation, 
          there would be General Fund cost pressure to fund the remainder. 
          Additionally, staff recommends that this bill be amended to 
          require DADP to set a licensure fee that would be sufficient to 
          cover the costs of administering the program.