Senate Bill No. 973

Introduced by Senator Hernandez

February 10, 2014

An act to amend Section 11839.3 of the Health and Safety Code, relating to narcotic treatment.

LEGISLATIVE COUNSEL’S DIGEST

SB 973, as introduced, Hernandez. Narcotic treatment programs.

Existing law requires the State Department of Health Care Services to administer prevention, treatment, and recovery services for alcohol and drug abuse. Existing law requires the department to license the establishment of narcotic treatment programs in this state to use narcotic replacement therapy in the treatment of addicted persons whose addiction was acquired or supported by the use of a narcotic drug or drugs, not in compliance with a physician and surgeon’s legal prescription. Existing law authorizes a program to admit a patient to narcotic maintenance or narcotic detoxification treatment 7 days after completion of a prior withdrawal treatment episode.

This bill, instead, would authorize a program to admit a patient to narcotic maintenance or narcotic detoxification treatment at the discretion of the medical director.

Vote: majority. Appropriation: no. Fiscal committee: yes. State-mandated local program: no.

The people of the State of California do enact as follows:

SECTION 1.  

Section 11839.3 of the Health and Safety Code
is amended to read:

11839.3.  

(a) In addition to the duties authorized by other
statutes, the department shall perform all of the following:

(1) License the establishment of narcotic treatment programs
in this state to use narcotic replacement therapy in the treatment
of addicted persons whose addiction was acquired or supported
by the use of a narcotic drug or drugs, not in compliance with a
physician and surgeon’s legal prescription, except that the Research
Advisory Panel shall have authority to approve methadone or
LAAM research programs. The department shall establish and
enforce the criteria for the eligibility of patients to be included in
the programs, program operation guidelines, begin delete such as end delete begin insert including end insert
dosage levels, recordkeeping and reporting, urinalysis
requirements, take-home doses of controlled substances authorized
for use pursuant to Section 11839.2, security against redistribution
of the narcotic replacement drugs, and any other regulations that
are necessary to protect the safety and well-being of the patient,
the local community, and the public, and to carry out this chapter.
A program may admit a patient to narcotic maintenance or narcotic
detoxification treatment begin delete seven days after completion of a prior
withdrawal treatment episode end delete begin insert at the discretion of the medical
director end insert . The arrest and conviction records and the records of
pending charges against begin delete any end delete begin insert a end insert person seeking admission to a
narcotic treatment program shall be furnished to narcotic treatment
program directors upon written request of the narcotic treatment
program director provided the request is accompanied by a signed
release from the person whose records are being requested.

(2) Inspect narcotic treatment programs in this state and ensure
that programs are operating in accordance with the law and
regulations. The department shall have sole responsibility for
compliance inspections of all programs in each county. Annual
compliance inspections shall consist of an evaluation by onsite
review of the operations and records of licensed narcotic treatment
programs’ compliance with applicable state and federal laws and
regulations and the evaluation of input from local law enforcement
and local governments, regarding concerns about the narcotic
treatment program. At the conclusion of each inspection visit, the
department shall conduct an exit conference to explain the cited
deficiencies to the program staff and to provide recommendations
to ensure compliance with applicable laws and regulations. The
department shall provide an inspection report to the licensee within
30 days of the completed onsite review describing the program
deficiencies. A corrective action plan shall be required from the
program within 30 days of receipt of the inspection report. All
corrective actions contained in the plan shall be implemented
within 30 days of receipt of approval by the department of the
corrective action plan submitted by the narcotic treatment program.
For programs found not to be in compliance, a subsequent
inspection of the program shall be conducted within 30 days after
the receipt of the corrective action plan in order to ensure that
corrective action has been implemented satisfactorily. Subsequent
inspections of the program shall be conducted to determine and
ensure that the corrective action has been implemented
satisfactorily. For purposes of this requirement, “compliance” shall
mean to have not committed any of the grounds for suspension or
revocation of a license provided for under subdivision (a) of
Section 11839.9 or paragraph (2) of subdivision (b) of Section
11839.9. Inspection of narcotic treatment programs shall be based
on objective criteria including, but not limited to, an evaluation of
the programs’ adherence to all applicable laws and regulations and
input from local law enforcement and local governments. Nothing
in this section shall preclude counties from monitoring their
contract providers for compliance with contract requirements.

(3) Charge and collect licensure fees. In calculating the licensure
fees, the department shall include staff salaries and benefits, related
travel costs, and state operational and administrative costs. Fees
shall be used to offset licensure and inspection costs not to exceed
actual costs.

(4) Study and evaluate, on an ongoing basis, narcotic treatment
programs including, but not limited to, the adherence of the
programs to all applicable laws and regulations and the impact of
the programs on the communities in which they are located.

(5) Provide advice, consultation, and technical assistance to
narcotic treatment programs to ensure that the programs comply
with all applicable laws and regulations and to minimize any
negative impact that the programs may have on the communities
in which they are located.

(6) In its discretion, to approve local agencies or bodies to assist
it in carrying out this chapter provided that the department may
not delegate responsibility for inspection or any other licensure
activity without prior and specific statutory approval. However,
the department shall evaluate recommendations made by county
alcohol and drug program administrators regarding licensing
activity in their respective counties.

(7) The director may grant exceptions to the regulations adopted
under this chapter if he or she determines that this action would
improve treatment services or achieve greater protection to the
health and safety of patients, the local community, or the general
public. No exception may be granted if it is contrary to, or less
stringent than, the federal laws and regulations begin delete which end delete begin insert that end insert govern
narcotic treatment programs.

(b) It is the intent of the Legislature in enacting this section in
order to protect the general public and local communities, that
self-administered dosage shall only be provided when the patient
is clearly adhering to the requirements of the program, and where
daily attendance at a clinic would be incompatible with gainful
employment, education, and responsible homemaking. The
department shall define “satisfactory adherence” and shall ensure
that patients not satisfactorily adhering to their programs shall not
be provided take-home dosage.

(c) There is established in the State Treasury the Narcotic
Treatment Program Licensing Trust Fund. All licensure fees
collected from the providers of narcotic treatment service shall be
deposited in this fund. Except as otherwise provided in this section,
if funds remain in this fund after appropriation by the Legislature
and allocation for the costs associated with narcotic treatment
licensure actions and inspection of narcotic treatment programs,
a percentage of the excess funds shall be annually rebated to the
licensees based on the percentage their licensing fee is of the total
amount of fees collected by the department. A reserve equal to 10
percent of the total licensure fees collected during the preceding
fiscal year may be held in each trust account to reimburse the
department if the actual cost for the licensure and inspection exceed
fees collected during a fiscal year.

(d) Notwithstanding any provision of this code or regulations
to the contrary, the department shall have sole responsibility and
authority for determining if a state narcotic treatment program
license shall be granted and for administratively establishing the
maximum treatment capacity of begin delete any end delete begin insert a end insert license. However, the
department shall not increase the capacity of a program unless it
determines that the licensee is operating in full compliance with
applicable laws and regulations.