Existing law provides for the licensure and regulation of alcoholism or drug abuse recovery or treatment facilities serving adults by the State Department of Health Care Services, as prescribed.

This bill would authorize a city, county, or city and county to enact an ordinance to register structured sober living homes, consistent with specified state and federal law, and with specified exclusions. The bill would define a structured sober living home as any premises, place, or building that provides groups of unrelated adults recovering from drug or alcohol addiction with alcoholfree and drugfree housing, promotes independent living and life skill development, and provides structured activities that are directed primarily toward recovery from substance use disorders in a supervised setting. The bill would specify registration and other requirements applicable to structured sober living homes. A structured sober living home, as defined by and registered pursuant to the bill, would not be subject to existing state licensure and regulation requirements for alcoholism or drug abuse recovery or treatment facilities. The bill would provide that it does not establish a new category of state-licensed facility, or otherwise authorize a structured sober living home registered pursuant to an ordinance adopted under the bill to provide any service for which a license is required by state law.

Existing law provides for the licensure and regulation of alcoholism or drug abuse recovery or treatment facilities serving adults by the State Department of Health Care Services, as prescribed.

This bill would also require the department to administer the licensure and regulation of adult recovery maintenance facilities, as defined, pursuant to those provisions. The bill would establish licensure fees for purposes of administering these provisions. The bill would make conforming changes. authorize a city, county, or city and county to enact an ordinance to register structured sober living homes, consistent with specified state and federal law, and with specified exclusions. The bill would define a structured sober living home as any premises, place, or building that provides groups of unrelated adults recovering from drug or alcohol addiction with alcoholfree and drugfree housing, promotes independent living and life skill development, and provides structured activities that are directed primarily toward recovery from substance use disorders in a supervised setting. The bill would specify registration and other requirements applicable to structured sober living homes. A structured sober living home, as defined by and registered pursuant to the bill, would not be subject to existing state licensure and regulation requirements for alcoholism or drug abuse recovery or treatment facilities.

Existing law provides for the licensure and regulation of alcoholism or drug abuse recovery or treatment facilities serving adults by the State Department of Health Care Services, as prescribed.

This bill would also require the department to administer the licensure and regulation of adult recovery maintenance facilities, as defined, pursuant to those provisions. The bill would establish licensure fees for purposes of administering these provisions. The bill would make conforming changes.

SENATE COMMITTEE ON HEALTH

Senator Ed Hernandez, O.D., Chair

BILL NO: SB 1283

SUBJECT: Substance abuse: structured sober living homes

SUMMARY:

Allows a city, county, or city and county to adopt, by ordinance, health and safety standards and enforcement mechanisms for structured sober living homes, as defined. Specifies that a structured sober living home registered pursuant to an ordinance authorized by this bill is not subject to state licensure and regulation, as specified.

Existing law:

1. Requires the Department of Health Care Services (DHCS) to license alcoholism or drug abuse recovery or treatment facilities (or RTFs) that provide 24-hour residential non-medical services to adults who are recovering from problems related to alcohol, drug, or alcohol and drug misuse or abuse, and who need alcohol, drug, or alcohol and drug recovery treatment or detoxification services.
2. Requires RTF licensees to provide at least one of the following: recovery, treatment, or detoxification services. Requires DHCS to adopt regulations requiring records and procedures appropriate for the type of service provided. Provides that the records and procedures can include all of the following: admission criteria; intake process; assessments; recovery, treatment, or detoxification planning; referral; documentation of provision of recovery, treatment, or detoxification services; discharge and continuing care planning; or indicators of recovery, treatment, or detoxification outcomes.

This bill:

1. Allows a city, county, or city and county to adopt, by ordinance, health and safety standards and enforcement mechanisms for structured sober living homes (SLHs) that comply with state and federal housing laws and the federal Americans with Disabilities Act of 1990 and amendments thereto.
2. Requires the ordinance in 1) above to include, but not be limited to, all of the following:
   1. Mandatory registration requirements for all structured SLHs to ensure that residents are living in a safe environment. Requires registration requirements to include, at a minimum:
      1. The name and address of the structured SLH.
      2. Information regarding the property, such as the property owner’s name, address, and contact telephone number, or if the property is leased, a copy of the lease with a statement that the property will be used as a structured SLH.
   2. In-home supervision requirements for the residents of the structured SLH during all hours of operation; and,
   3. The establishment and maintenance of an operation plan that facilitates the rehabilitative process, including discharge planning, and that addresses maintenance of the property and noise abatement consistent with local ordinances.
3. Allows a city, county, or city and county that adopts health and safety standards and enforcement mechanisms for structured SLHs required in 1) above to exclude from regulation any structured SLH that is subject to adequate oversight by another governmental entity or contractor that meets or exceeds the requirements in this bill.
4. Defines a “structured SLH” as any premises, place, or building that provides alcohol-free or drug-free housing, promotes independent living and life skill development, and provides structured activities that are directed primarily toward recovery from substance use disorders (SUDs) in a supervised setting to a group of unrelated adults who are recovering from drug and alcohol addiction, and who are receiving outpatient behavioral health services for substance abuse or addiction treatment while living in the home. Specifies that within this definition is not included a private residence in which a related family member is required to receive outpatient behavioral health services as a condition of continuing to reside in the family dwelling.
5. Specifies that a structured SLH registered pursuant to an ordinance authorized by this bill is not subject to state licensure and regulation as an RTF. Specifies that the provisions in this bill do not establish a new category of state-licensed facility or authorize a structured SLH to provide any service for which a license is required by state law.
6. Prohibits the provisions in this bill from being interpreted to require the adoption of a structured SLH ordinance.

FISCAL EFFECT:

This bill has not been analyzed by a fiscal committee.

COMMENTS:

1. Author’s statement. According to the author, various types of group homes, including RTFs, are licensed by the state, but SLHs that do not provide the same services that licensed facilities do are not required to be licensed by the state. Some cities have adopted ordinances for SLHs. Lengthy and expensive litigation has left uncertainty, and the experiences of these cities may discourage others from adopting adequate and appropriate ordinances. This measure seeks to provide clarity over what is expressly authorized by state law for city and county ordinances that establish health and safety standards for structured SLHs. As defined in this measure, a structured SLH provides alcohol-free or drug-free housing, promotes independent living and life skill development, and provides structured activities that are directed primarily toward recovery from SUDs in a supervised setting. The clarity that the measure provides is intended to facilitate the adoption of appropriate and adequate local health and safety standards for structured SLHs. This measure does not authorize any ordinance that does not comply with state and federal housing laws and the federal Americans with Disabilities Act.
2. SLHs. A 2010 report on the National Institutes of Health (NIH) Web site, Sober Living Houses for Alcohol and Drug Dependence: 18-month Outcomes, states that SLHs are not formal treatment programs and are not obligated to comply with state or local regulations applicable to treatment. However, NIH does not provide a formal definition of an SLH. The report also mentions that it is difficult to determine how many SLHs there are in California because they are outside of the purview of state licensing authorities (so no one is tracking SLHs). The NIH report cites the protection that the federal Fair Housing Act affords SLHs to be located in residentially zoned areas, personal privacy under the Fourth Amendment, and the right of people with disabilities to live together for a shared purpose, such as mutually assisted recovery and maintenance of an abstinent lifestyle.

According to DHCS’s Web site, some types of RTFs do not provide alcohol and other drug services and do not require licensure by DHCS, including cooperative living arrangements with a commitment or requirement to be free from alcohol and other drugs, sometimes referred to as SLHs, transitional housing, or alcohol- and drug-free housing. DHCS states that while SLHs or alcohol- and drug-free housing are not required to be licensed by DHCS, they may be subject to other types of permits, clearances, business taxes, or local fees, which may be required by the cities or counties in which they are located. DHCS also does not certify or investigate complaints against SLHs. If an SLH is providing licensable services to adults then it must obtain a valid RTF license from DHCS. Licensable services can include, but are not limited to, detoxification services, group sessions, individual sessions, one-on-one counseling, educational sessions, or recovery, treatment, or discharge planning. If an SLH is providing just one of the mentioned services, then it should be classified as an RTF and must obtain a valid license from DHCS.

1. Difficulty siting RTFs. A document published by the U.S. Department of Health and Human Services (DHHS), “Siting Drug and Alcohol Treatment Programs: Legal Challenges to the NIMBY Syndrome,” states that community opposition, “not in my backyard” (NIMBY), prevents or delays the siting of treatment programs, even when an already existing program tries to relocate. NIMBY is often targeted toward other types of health and social service facilities, like shelters for the homeless, group homes for the mentally ill, halfway houses for ex-offenders, SLHs, and other health-related facilities. According to DHHS, many discriminatory zoning ordinances and practices may be unlawful under the Fair Housing Act, the Rehabilitation Act, and the Americans with Disabilities Act. It is also noted that communities often fear the decline of property values and increased crime because of RTFs in the neighborhood. However, the DHHS document states that in almost every instance a community’s fears are unfounded, as RTFs pose no danger to the health and welfare of neighbors nor draw substance abusers or pushers to the area.
2. Newport Beach Ordinance. According to the Web site for the City of Newport Beach, in 2008 the Newport Beach City Council adopted an ordinance that changed how the city regulates group residential uses, defined as a “non-traditional single housekeeping unit,” including a boarding house, dorm, reunion rental, state-licensed recovery home, SLHs, and elder care homes. The ordinance required many home operators at the time to obtain a use permit to stay in place. The ordinance requires city approval for new unlicensed homes for recovering addicts in certain neighborhoods.

A September 20, 2013, Los Angeles Times article, “Appeals court backs sober-living homes in suit against Newport Beach,” states that the U.S. 9^th Circuit Court of Appeals unanimously ruled that the Newport Beach ordinance may have illegally discriminated against those with a disability. The article states the ordinance forced many group homes to close and prevented new ones from opening. A March 26, 2014, article in the Orange County Register, “Newport Beach takes sober home law to Supreme Court,” reported that the Newport Beach City Council petitioned the U.S. Supreme Court about the ruling by the 9^th Circuit Court of Appeals, and that the city would know by the end of September 2014 if the court would review the case. The U.S. Supreme Court ultimately declined to review it.

1. Discriminating against the disabled? A July 15, 2015, article in the Orange County Register, “Newport Beach settles legal battle over sober-living homes,” states that Newport Beach ended its seven-year battle over SLHs by reaching an agreement with three entities that operate SLHs. The article quotes the attorney representing the SLHs as saying that because a trial could have taken several years his clients were more interested in ending the proceedings rather than battling in court. Also noted in the article is the fact that in 2007, before Newport Beach implemented its ordinance, there were an estimated 86 facilities (both RTFs and SLHs) in the city. As of February 2016, that number is now 25: 15 RTFs licensed by DHCS and 10 SLHs. The article further notes that the 9^th Circuit Court of Appeals sided with the SLHs because there was enough evidence to argue discrimination. As alcohol and drug treatment and recovery experts argue, most RTFs and SLHs would rather give in to discrimination and shutter their doors than spend years battling it out in courts, which can be very costly. The DHHS document noted that in one instance in New Jersey a campaign of harassment against a treatment facility caused each of the home’s residents to relapse. While SLHs do not provide formal treatment, they often serve as part of the continuum of treatment, providing a drug-free and alcohol-free environment for individuals recently discharged from an RTF who often do not have a home or who are not ready to return to the environment they were in before they entered treatment. What effect does enforcing a possibly discriminatory ordinance have on communities when treatment and recovery options are hampered?
2. Related legislation. AB 2255 (Melendez), would provide that a residence housing those purporting to be recovering from drug or alcohol abuse would be presumed to be a SLH if it has been certified, registered, or approved by a state-recognized nonprofit organization, which would be required to establish minimum standards for SLHs, including protocols to address suspected drug and alcohol abuse or to report the death of a resident. AB 2255 is pending in the Assembly Health Committee.
3. Prior legislation. AB 2491 (Nestande, of 2014), would have required DHCS to administer the licensure and regulation of adult recovery maintenance facilities (SLHs), as defined, and to adopt emergency regulations, applicable only to adult recovery maintenance facilities, to implement the fee process for initial licensure, and the provisions for the extension of licensure, follow-up compliance visits, and civil penalties. AB 2491 was held on suspense in the Senate Appropriations Committee.

AB 2335 (Mansoor, of 2014) would have defined SLHs with certain criteria and exempted an SLH or supportive housing from licensure as an RTF. AB 2335 failed passage in the Assembly Health Committee on April 22, 2014, on a 6-12 vote.

SB 214 (Benoit, of 2009), and AB 724 (Benoit, of 2007), were both substantially similar to AB 2255 (Melendez). SB 214 failed in the Senate Health Committee without being heard. AB 724 failed passage in the Senate Health Committee on a 5-4 vote. Reconsideration was granted, but the bill was not heard again in the committee.

SB 992 (Wiggins, of 2008), would have required the Department of Alcohol and Drug Programs to license SLHs, or “adult recovery maintenance facilities.” SB 992 was vetoed by Governor Schwarzenegger who stated that while licensure and regulation of SLHs are important to ensure SLHs respect and participate in their local community; for communities to provide support to these facilities; and for individuals seeking recovery from alcohol and drug addiction to live in safe environments that help them in their recovery, this bill did not accomplish these policy goals.

AB 370 (Adams, of 2007), would have permitted a local government to include an RTF serving six or fewer persons, including a SLH, within the definition of single family residence. AB 370 was held on suspense in the Assembly Appropriations Committee.

AB 36 (Strickland, of 2006), was similar to SB 992. AB 36 was held on suspense in the Senate Appropriations Committee.

SB 340 (Florez, of 2003), was similar to SB 992 and AB 36. SB 340 failed in the Senate Health and Human Services Committee without being heard.

AB 2317 (Chu, of 2002), was similar to SB 992, AB 36, and SB 340. AB 2317 was held on suspense in the Senate Appropriations Committee.

1. Support. The City of Laguna Niguel states that this bill allows cities and patients to focus on the best treatment options for their communities by providing them with the resources they need to work with compliant RTFs. Laguna Niguel argues that this bill would address many of the concerns surrounding RTFs by creating consistency in the licensing requirements for licensing SLHs and RTFs. The League of California Cities states that this bill allows local governments to adopt ordinances that protect the health and safety of SLH residents and surrounding neighborhoods from facilities that are poorly managed or have no state oversight. The League also states that this bill spares cities from costly litigation spawned by a climate of uncertainty. The League supports permitting cities to exercise review and land use regulation of group homes and RTFs, including the application of zoning, building, and safety standards. The City of Encinitas states that this bill provides common sense measures to ensure the function of an SLH is to serve clients and impacted neighbors, and that in-house supervision is a reasonable requirement since SLHs are for adult sober living and recidivism is a reality.
2. Opposition. Opponents, consisting of facility owners and health advocates, argue that provisions in this bill are contrary to the state’s avowed interest in alleviating problems related to SUDs because it would limit the availability of options for those with SUDs. Opponents state that while California’s approach to treatment relies significantly on state-licensed facilities, those programs are supplemented with SLHs in residential neighborhoods, which do not provide treatment and provide living situations in a peer-supported community critical to bridging the gap between treatment and returning full-time to independent living. Opponents further argue that this bill would allow local governments to contravene the intent of the state to increase the availability of treatment and recovery options for those with SUDs. Cliffside states that this bill allows local governments to unfairly discriminate against disabled persons, and that rather than litigate the ordinances SLHs will be forced financially to close. The Western Center on Law and Poverty states that while this bill provides that local governments cannot enact provisions in violation of federal and state housing and anti-discrimination laws, there are more than 500 local governments and there is no ability by the state or advocates to ensure that violations do not happen. 1 Method Center, LLC, states that ordinances would have a crippling effect on the operation and maintenance of SLHs, and that this bill would allow local governments who desire to keep SLHs out of their communities to adopt ordinances that will accomplish their NIMBY goals.
3. Policy comments.
4. Should the Legislature interfere? While the U.S. Supreme Court declined to review the case between the City of Newport Beach and a group of SLHs, the most recent court decision was that of the 9^th Circuit Court of Appeals, which ruled there was sufficient evidence that the Newport Beach ordinance may have illegally discriminated against those with a disability. This bill would give a city, county, or city and county the authority to adopt and enforce an ordinance for SLHs, allowing for Newport Beach’s ordinance to stand. Should the Legislature empower local governments when courts have ruled there is evidence to support they are being discriminatory?
5. Do requirements of structured SLHs constitute licensable services? This bill requires structured SLHs to provide, among other things, structured activities that are directed primarily toward recovery from SUDs in a supervised setting and to establish and maintain an operation plan that facilitates the rehabilitative process, including discharge planning. While this bill provides that structured SLHs do not require state licensure and cannot provide services that would require state licensure, the listed required services appear to be licensable services. Therefore, the effect of this bill is unclear.
6. Does this bill solve the current SLH problem? Because there is no state authority that oversees SLHs and no universal definition in statute of a SLH, the author contends that many cities have had to enter costly litigation and that other cities are discouraged from adopting adequate and appropriate ordinances. This bill adds a definition for structured SLHs to current statute that sets forth DHCS’s powers and duties for licensing RTFs for those with SUDs but does not require DHCS to license and/or oversee SLHs. It is unclear if DHCS would be responsible for oversight of SLHs.

SUPPORT AND OPPOSITION:

Support: City of Encinitas

City of Laguna Niguel

League of California Cities

Oppose: Cliffside Malibu

1 Method Center, LLC

Promises Treatment Centers

Western Center on Law and Poverty

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