Bill Text: CA AB848 | 2015-2016 | Regular Session | Chaptered
Bill Title: Alcoholism and drug abuse treatment facilities.
Spectrum: Partisan Bill (Democrat 1-0)
Status: (Passed) 2015-10-10 - Chaptered by Secretary of State - Chapter 744, Statutes of 2015. [AB848 Detail]
Download: California-2015-AB848-Chaptered.html
BILL NUMBER: AB 848 CHAPTERED
BILL TEXT
CHAPTER 744
FILED WITH SECRETARY OF STATE OCTOBER 10, 2015
APPROVED BY GOVERNOR OCTOBER 10, 2015
PASSED THE SENATE SEPTEMBER 1, 2015
PASSED THE ASSEMBLY SEPTEMBER 3, 2015
AMENDED IN SENATE AUGUST 31, 2015
AMENDED IN SENATE JULY 16, 2015
AMENDED IN SENATE JULY 2, 2015
AMENDED IN ASSEMBLY JUNE 1, 2015
AMENDED IN ASSEMBLY MAY 6, 2015
AMENDED IN ASSEMBLY APRIL 6, 2015
INTRODUCED BY Assembly Member Mark Stone
FEBRUARY 26, 2015
An act to amend Sections 11834.03 and 11834.36 of, and to add
Sections 11834.025 and 11834.026 to, the Health and Safety Code,
relating to alcohol and drug treatment programs.
LEGISLATIVE COUNSEL'S DIGEST
AB 848, Mark Stone. Alcoholism and drug abuse treatment
facilities.
Existing law requires the State Department of Health Care Services
to license adult alcoholism or drug abuse recovery or treatment
facilities, as defined. Existing law provides for the licensure and
regulation of health care practitioners by various boards and other
entities within the Department of Consumer Affairs, and prescribes
the scope of practice of those health care practitioners.
This bill would authorize an adult alcoholism or drug abuse
recovery or treatment facility that is licensed under those
provisions to allow a licensed physician and surgeon or other health
care practitioner, as defined, to provide incidental medical
services, as defined, to a resident of the facility at the facility
premises under specified limited circumstances, including, among
others, that the resident signs an admission agreement and a
physician and surgeon or other health care practitioner determines
that it is medically appropriate for the resident to receive these
services. The bill would require the department to establish and
collect an additional fee from those facilities, in an amount
sufficient to cover the department's reasonable costs of regulating
the provision of those services. The bill would require the
department, on or before July 1, 2018, to adopt regulations to
implement its provisions. The bill would also make related findings
and declarations.
THE PEOPLE OF THE STATE OF CALIFORNIA DO ENACT AS FOLLOWS:
SECTION 1. The Legislature hereby finds and declares all of the
following:
(a) Substance abuse is a medical condition requiring
interdisciplinary treatment including, when medically necessary,
treatment by a licensed physician and surgeon.
(b) Subsequent to the enactment of state law licensing and
regulating residential facilities providing alcohol and other drug
detoxification treatment, public knowledge of addiction and treatment
has advanced significantly.
(c) Lack of scientific understanding at the time of enactment of
those state laws prevents the State Department of Health Care
Services from licensing a residential treatment facility that uses a
California-licensed physician and surgeon to provide necessary
evaluation and treatment at the facility premises.
(d) This prohibition has been found to endanger persons in
treatment, can result in treatment below the recognized standard of
care, jeopardizes patient health, and delays patient recovery.
(e) To resolve this problem, it is the intent of the Legislature
to enact this act in order to modernize and update state law and
allow those in treatment to be protected and to receive modern
medical treatment for a medical condition.
SEC. 2. Section 11834.025 is added to the Health and Safety Code,
to read:
11834.025. (a) (1) As a condition of providing incidental medical
services, as defined in subdivision (a) of Section 11834.026, at a
facility licensed by the department, the facility, within a
reasonable period of time, as defined by the department in
regulations, shall obtain from each program participant, a signed
certification described in subdivision (b) from a health care
practitioner.
(2) For purposes of this chapter, "health care practitioner" means
a person duly licensed and regulated under Division 2 (commencing
with Section 500) of the Business and Professions Code, who is acting
within the scope of practice of his or her license or certificate.
(b) The department shall develop a standard certification form for
use by a health care practitioner. The form shall include, but not
be limited to, a description of the alcoholism and drug abuse
recovery or treatment services that an applicant needs.
(c) (1) The department shall adopt regulations, on or before July
1, 2018, to implement this section. The regulations shall be adopted
in accordance with the Administrative Procedure Act (Chapter 3.5
(commencing with Section 11340) of Part 1 of Division 3 of Title 2 of
the Government Code).
(2) Notwithstanding the rulemaking provisions of the
Administrative Procedure Act, the department may, if it deems
appropriate, implement, interpret, or make specific this section by
means of provider bulletins, written guidelines, or similar
instructions from the department only until the department adopts
regulations.
SEC. 3. Section 11834.026 is added to the Health and Safety Code,
to read:
11834.026. (a) As used in this section, "incidental medical
services" means services that are in compliance with the community
standard of practice and are not required to be performed in a
licensed clinic or licensed health facility, as defined by Section
1200 or 1250, respectively, to address medical issues associated with
either detoxification from alcohol or drugs or the provision of
alcoholism or drug abuse recovery or treatment services, including
all of the following categories of services that the department shall
further define by regulation:
(1) Obtaining medical histories.
(2) Monitoring health status to determine whether the health
status warrants transfer of the patient in order to receive urgent or
emergent care.
(3) Testing associated with detoxification from alcohol or drugs.
(4) Providing alcoholism or drug abuse recovery or treatment
services.
(5) Overseeing patient self-administered medications.
(6) Treating substance abuse disorders, including detoxification.
(b) Incidental medical services do not include the provision of
general primary medical care.
(c) Notwithstanding any other law, a licensed alcoholism or drug
abuse recovery or treatment facility may permit incidental medical
services to be provided to a resident at the facility premises by, or
under the supervision of, one or more physicians and surgeons
licensed by the Medical Board of California or the Osteopathic
Medical Board who are knowledgeable about addiction medicine, or one
or more other health care practitioners acting within the scope of
practice of his or her license and under the direction of a physician
and surgeon, and who are also knowledgeable about addiction
medicine, if all of the following conditions are met:
(1) The facility, in the judgment of the department, has the
ability to comply with the requirements of this chapter and all other
applicable laws and regulations to meet the needs of a resident
receiving incidental medical services pursuant to this chapter. The
department shall specify in regulations the minimum requirements that
a facility shall meet in order to be approved to permit the
provision of incidental medical services on its premises. The license
of a facility approved to permit the provision of incidental medical
services shall reflect that those services are permitted at the
facility premises.
(2) The physician and surgeon and any other health care
practitioner has signed an acknowledgment on a form provided by the
department that he or she has been advised of and understands the
statutory and regulatory limitations on the services that may legally
be provided at a licensed alcoholism or drug abuse recovery or
treatment facility and the statutory and regulatory requirements and
limitations for the physician and surgeon or other health care
practitioner and for the facility, related to providing incidental
medical services. The licensee shall maintain a copy of the signed
form at the facility for a physician and surgeon or other health care
practitioner providing incidental medical services at the facility
premises.
(3) A physician and surgeon or other health care practitioner
shall assess a resident, prior to that resident receiving incidental
medical services, to determine whether it is medically appropriate
for that resident to receive these services at the premises of the
licensed facility. A copy of the form provided by the department
shall be signed by the physician and surgeon and maintained in the
resident's file at the facility.
(4) The resident has signed an admission agreement. The admission
agreement, at a minimum, shall describe the incidental medical
services that the facility may permit to be provided and shall state
that the permitted incidental medical services will be provided by,
or under the supervision of, a physician and surgeon. The department
shall specify in regulations, at a minimum, the content and manner of
providing the admission agreement, and any other information that
the department deems appropriate. The facility shall maintain a copy
of the signed admission agreement in the resident's file.
(5) Once incidental medical services are initiated for a resident,
the physician and surgeon and facility shall monitor the resident to
ensure that the resident remains appropriate to receive those
services. If the physician and surgeon determines that a change in
the resident's medical condition requires other medical services or
that a higher level of care is required, the facility shall
immediately arrange for the other medical services or higher level of
care, as appropriate.
(6) The facility maintains in its files a copy of the relevant
professional license or other written evidence of licensure to
practice medicine or perform medical services in the state for the
physician and surgeon and any other health care practitioner
providing incidental medical services at the facility.
(d) The department is not required to evaluate or have any
responsibility or liability with respect to evaluating the incidental
medical services provided by a physician and surgeon or other health
care practitioner at a licensed facility. This section does not
limit the department's ability to report suspected misconduct by a
physician and surgeon or other health care practitioner to the
appropriate licensing entity or to law enforcement.
(e) A facility licensed and approved by the department to allow
provision of incidental medical services shall not by offering
approved incidental medical services be deemed a clinic or health
facility within the meaning of Section 1200 or 1250, respectively.
(f) Other than incidental medical services permitted to be
provided or any urgent or emergent care required in the case of a
life threatening emergency, this section does not authorize the
provision at the premises of the facility of any medical or health
care services or any other services that require a higher level of
care than the care that may be provided within a licensed alcoholism
or drug abuse recovery or treatment facility.
(g) This section does not require a residential treatment facility
licensed by the department to provide incidental medical services or
any services not otherwise permitted by law.
(h) (1) On or before July 1, 2018, the department shall adopt
regulations to implement this section in accordance with the
Administrative Procedure Act (Chapter 3.5 (commencing with Section
11340) of Part 1 of Division 3 of Title 2 of the Government Code).
(2) Notwithstanding the rulemaking provisions of the
Administrative Procedure Act, the department may, if it deems
appropriate, implement, interpret, or make specific this section by
means of provider bulletins, written guidelines, or similar
instructions from the department until regulations are adopted.
SEC. 4. Section 11834.03 of the Health and Safety Code is amended
to read:
11834.03. (a) A person or entity applying for licensure shall
file with the department, on forms provided by the department, all of
the following:
(1) A completed written application for licensure.
(2) A fire clearance approved by the State Fire Marshal or local
fire enforcement officer.
(3) A licensure fee, established in accordance with Chapter 7.3
(commencing with Section 11833.01).
(b) (1) If an applicant intends to permit services pursuant to
Section 11834.026, the applicant shall submit evidence of a valid
license of the physician and surgeon who will provide or oversee
those services, and any other information the department deems
appropriate.
(2) The department shall establish and collect an additional
licensure fee for an application that includes a request to provide
services pursuant to Section 11834.026. The fee shall be set at an
amount sufficient to cover the reasonable costs to the department of
the additional assessment and investigation necessary to license
facilities to provide these services, including, but not limited to,
processing applications, issuing licenses, and investigating reports
of noncompliance with licensing regulations.
SEC. 5. Section 11834.36 of the Health and Safety Code is amended
to read:
11834.36. (a) The director may suspend or revoke any license
issued under this chapter, or deny an application for licensure,
extension of the licensing period, or modification to a license, upon
any of the following grounds and in the manner provided in this
chapter:
(1) Violation by the licensee of any provision of this chapter or
regulations adopted pursuant to this chapter.
(2) Repeated violation by the licensee of any of the provisions of
this chapter or regulations adopted pursuant to this chapter.
(3) Aiding, abetting, or permitting the violation of, or any
repeated violation of, any of the provisions described in paragraph
(1) or (2).
(4) Conduct in the operation of an alcoholism or drug abuse
recovery or treatment facility that is inimical to the health,
morals, welfare, or safety of either an individual in, or receiving
services from, the facility or to the people of the State of
California.
(5) Misrepresentation of any material fact in obtaining the
alcoholism or drug abuse recovery or treatment facility license,
including, but not limited to, providing false information or
documentation to the department.
(6) The licensee's refusal to allow the department entry into the
facility to determine compliance with the requirements of this
chapter or regulations adopted pursuant to this chapter.
(7) Violation by the licensee of Section 11834.026 or the
regulations adopted pursuant to that section.
(8) Failure to pay any civil penalties assessed by the department.
(b) The director may temporarily suspend any license prior to any
hearing when, in the opinion of the director, the action is necessary
to protect residents of the alcoholism or drug abuse recovery or
treatment facility from physical or mental abuse, abandonment, or any
other substantial threat to health or safety. The director shall
notify the licensee of the temporary suspension and the effective
date of the temporary suspension and at the same time shall serve the
provider with an accusation. Upon receipt of a notice of defense to
the accusation by the licensee, the director shall, within 15 days,
set the matter for hearing, and the hearing shall be held as soon as
possible. The temporary suspension shall remain in effect until the
time the hearing is completed and the director has made a final
determination on the merits. However, the temporary suspension shall
be deemed vacated if the director fails to make a final determination
on the merits within 30 days after the department receives the
proposed decision from the Office of Administrative Hearings.
