BILL ANALYSIS �
SENATE COMMITTEE ON HEALTH
Senator Ed Hernandez, O.D., Chair
BILL NO: AB 2374
AUTHOR: Mansoor
AMENDED: May 6, 2014
HEARING DATE: June 25, 2014
CONSULTANT: Diaz
SUBJECT : Substance abuse: recovery and treatment services.
SUMMARY : Requires resident deaths at Department of Health Care
Services-licensed (DHCS) residential facilities, as specified,
to be reported by telephone and in writing, as specified, in a
timely manner. Requires counselors working in specified DHCS
programs to be registered or certified by DHCS-approved
organizations, as specified. Prohibits DHCS from approving
organizations that do not consult with the available electronic
databases of other DHCS-approved organizations to obtain
specified information.
Existing law:
1.Gives DHCS sole authority in state government to license adult
residential treatment facilities (RTFs) and determine the
qualifications of personnel working within RTFs or any
facility licensed or certified by DHCS. Defines an RTF as any
premises, 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, as specified.
2.Requires, through regulation, RTFs to report to DHCS by
telephone within one working day and in a written report
within seven working days: deaths of residents from any cause;
facility-related injuries of residents that require medical
treatment; reportable communicable diseases; poisonings;
catastrophes (natural disasters); and fires/explosions that
occur in or on the premises.
3.Requires, through regulation, a DHCS-approved certifying
organization (CO), prior to certifying any registrant, to
contact all other DHCS-approved COs to determine if a
registrant's certification was ever revoked.
4.Prohibits, through regulation, licensed professionals in good
standing with their licensing agency from being required to
Continued---
AB 2374 | Page 2
become certified by a CO in order to work at a facility
licensed or certified by DHCS. Defines "licensed professional"
as a physician licensed by the Medical Board of California; a
psychologist licensed by the California Board of Psychology
(CBP); a clinical social worker or marriage and family
therapist licensed by the California Board of Behavioral
Sciences (CBBS); or an intern registered with the CBP or the
CBBS. Defines "in good standing" as the professional's license
being valid and not revoked, suspended, or otherwise
terminated.
This bill:
1.Requires DHCS's death investigation policy for RTFs to ensure
that a resident's death is reported by the RTF and addressed
by DHCS in a timely manner.
2.Requires telephonic and written reports to DHCS of events or
incidents occurring in an RTF to include at a minimum:
a. A description of the event or incident,
including the time, location, and nature of the event
or incident;
b. A list of immediate actions taken, including
persons contacted; and,
c. A description of the follow-up action that is
planned, including steps taken to prevent a recurrence
of the event or incident.
3.Requires DHCS to require a counselor working within a
substance use disorder (SUD) program licensed or certified by
DHCS to be registered with or certified by a DHCS-approved CO.
4.Prohibits DHCS from approving a CO that does not consult with
the available electronic databases of the other DHCS-approved
COs prior to registering or certifying a person to determine
whether the person has ever had registration or certification
as a counselor revoked.
FISCAL EFFECT : According to the Assembly Appropriations
Committee, minor and absorbable costs to DHCS to adjust existing
processes to comply with this bill.
PRIOR VOTES :
Assembly Health: 18- 0
Assembly Appropriations:17- 0
AB 2374 | Page
3
Assembly Floor: 73- 0
COMMENTS :
1.Author's statement. According to the author, DHCS recently
took over the responsibilities formerly held by the Department
of Alcohol and Drug Programs (ADP) to license and enforce
regulations related to alcohol and drug substance abuse
rehabilitation in residential facilities. However, there have
been rising concerns that current regulations and enforcement
are inadequate. These have been brought to light by both a
recent state Senate report and various media coverage of
unfortunate deaths and accidents within these facilities.
2.Senate Office of Oversight and Outcomes (SOOO) reports.
a. Rogue Rehabs: State Failed to Police Drug and Alcohol
Homes, with Deadly Results. This September 2012 SOOO report
identified a pattern, over the past decade, of the ADP
(absorbed fully by DHCS in July 2013) failing to identify
potentially dangerous problems and, when it did, neglecting
to follow up and assure that the problems were corrected.
This report cited several incidents where ADP's enforcement
and investigation activities following resident deaths at
RTFs were inconsistent. At one facility where four patient
deaths occurred over a span of two and a half years, SOOO
reported that ADP was slow to respond. One death was only
investigated a year and a half after the fact, upon ADP
learning of another death in the same facility. By the time
ADP suspended the facility's license, the home had been
closed due to foreclosure. At other facilities, SOOO
reported that patients who needed medical care were
admitted to an RTF with the expectation that they would
receive medical care and ended up dying at the RTF. The
report states that ADP indicated it was being more
aggressive in halting practices that could lead to injury
or death, and was revoking and suspending licenses more
frequently. ADP also stated it had implemented new policies
intended to focus limited resources on cases that pose the
greatest risk to the public. The report recommended that
ADP's improved death investigation policy be used as a
template for statutory death investigation requirements, if
the policy were found to be effective.
b. Suspect Treatment: State's lack of scrutiny allows
unscreened sex offenders and unethical counselors to treat
addicts. This May 2013 SOOO report stated that for three
AB 2374 | Page 4
decades the state and the SUD treatment industry have been
unable to agree on a framework to give the state authority
to credential counselors. The report concluded that
California's public-private hybrid system precludes
criminal background checks and leaves gaps that can be
exploited by counselors who move between seven COs that
register and certify them. While the report acknowledged
that many counselors draw from their own struggles with SUD
to excel at jobs with not much pay, some come to the
profession with serious criminal backgrounds, which the
report states raises questions about their fitness to treat
clients, who are often at the most vulnerable time of their
lives.
3.Prior legislation. AB 40 (Mansoor) would have required RTFs to
report deaths and other unusual events to ADP and would have
required licensees that provide medical detoxification
services to provide those services under the supervision of a
medical doctor. AB 40 was held on the Assembly Appropriations
Committee suspense file.
4.Support. Supporters of this bill argue that it will ensure the
timely reporting by the licensee in the event of the death of
a resident of an RTF, thus adding accountability to RTFs and
protection to the public.
5.Amendments. The author may wish to consider the following
amendments suggested by committee staff (in bold, underline,
and italics):
a. Section 11830.01 is added to the Health and Safety
Code, to read:
(a) The death investigation policy of the department The
department's death investigation policy shall be designed
to ensure that a resident's death is reported by the
licensee and addressed and investigated by the department
in a timely manner.
(b) The telephonic and written reports of events or
incidents resident deaths occurring in a licensed
facility that are required to be reported to the
department shall include, but not be limited to, a
description of the event or incident, including the time,
location, and nature of the event or incident, a list of
immediate actions that were taken, including persons
AB 2374 | Page
5
contacted, and a description of the followup follow up
action that is planned, including, but not limited to,
steps taken to prevent a recurrence of the event or
incident future death .
b. Section 11833 of the Health and Safety Code is
amended to read:
(b) The Except for licensed professionals, as defined by
the department, the department shall require that a
counselor working within a program described in
subdivision (a) be registered with or certified by an a
certifying organization approved by the department to
register and certify counselors. Prior The department
shall not approve an a certifying organization that does
not, prior to registering or certifying a counselor an
individual , an approved organization shall consult with
the available electronic databases of the contact other
department-approved counselor registration and
certification certifying organizations to determine
whether the person individual has ever had his or her
registration or certification as a counselor revoked.
SUPPORT AND OPPOSITION :
Support: California Association of Addiction Recovery Resources
California Narcotic Officers' Association
League of California Cities
Los Angeles County Board of Supervisors
Oppose: None received.
-- END --