AB 2214: Recovery residences.
- Session Year: 2017-2018
- House: Assembly
- Latest Version Date: 2018-04-11
Existing law provides for the licensure and regulation of community care facilities by the State Department of Social Services. Existing law also provides for the licensure and regulation by the State Department of Health Care Services of adult alcoholism and drug abuse recovery and treatment facilities for adults.
This bill would, among other things, define a recovery residence as a residential property that is operated as a cooperative living arrangement to provide an alcohol and drug free environment for persons recovering from alcoholism or drug abuse, or both, who seek a living environment that supports personal recovery. The bill would authorize a recovery residence to demonstrate its commitment to providing a supportive recovery environment by applying and becoming certified by a certifying organization that is approved by the State Department of Health Care Services. The bill would require an approved certifying organization to, among other things, maintain an affiliation with a national organization recognized by the department, establish and use procedures to administer the application, certification, renewal, and disciplinary processes for a recovery residence, and investigate and enforce violations by a residence of the organizations code of conduct, as provided. The bill would specify the information and documentation that an operator who seeks to have a residence certified is required to submit to an approved certifying organization.
This bill would require an approved certifying organization to maintain and post on its Internet Web site a registry containing specified information of a residence that has been certified pursuant to these provisions, and would require the department to maintain and post on its Internet Web site a registry that contains specified information regarding each residence and operator that has had its certification revoked.
This bill would require, on and after January 1, 2020, specified entities, including a state agency, state-contracted vendor, county agency, or county-contracted vendor, certified alcohol drug counselor, and person or entity licensed in the healing arts that directs substance use treatment, or a judge or parole board that sets terms and conditions for the release, parole, or discharge of a person from custody, if it requires that person to reside in a sober living environment, to first refer that person to a residence listed as a certified recovery residence on a registry posted by an approved certifying organization, if available. The bill would authorize those entities to refer persons to noncertified recovery residences, if they determine it is in the best interests of those persons, and, in that case, and would authorize those entities to notify the State Department of Health Care Services department of their decision. The bill would require the department to report to the Legislature on or before January 1, 2021, regarding the efficacy of its regulation of certifying organizations impact on complaint resolution, as specified. By imposing additional duties on local governments, this bill would create a state-mandated local program. The bill would provide for the repeal of all of these provisions on January 1, 2026.
The California Constitution requires the state to reimburse local agencies and school districts for certain costs mandated by the state. Statutory provisions establish procedures for making that reimbursement.
This bill would provide that, if the Commission on State Mandates determines that the bill contains costs mandated by the state, reimbursement for those costs shall be made pursuant to the statutory provisions noted above.
Existing law provides for the licensure and regulation of community care facilities by the State Department of Social Services. Existing law also provides for the licensure and regulation by the State Department of Health Care Services of adult alcoholism and drug abuse recovery and treatment facilities for adults.
This bill would, among other things, define a recovery residence as a residential property that is operated as a cooperative living arrangement to provide an alcohol and drug free environment for persons recovering from alcoholism or drug abuse, or both, who seek a living environment that supports personal recovery. The bill would authorize a recovery residence to demonstrate its commitment to providing a supportive recovery environment by applying and becoming certified by a certifying organization that is approved by the State Department of Health Care Services. The bill would require an approved certifying organization to, among other things, maintain an affiliation with a national organization recognized by the department, establish and use procedures to administer the application, certification, renewal, and disciplinary processes for a recovery residence, and investigate and enforce violations by a residence of the organizations code of conduct, as provided. The bill would specify the information and documentation that an operator who seeks to have a residence certified is required to submit to an approved certifying organization.
This bill would require an approved certifying organization to maintain and post on its Internet Web site a registry containing specified information of a residence that has been certified pursuant to these provisions, and would require the department to maintain and post on its Internet Web site a registry that contains specified information regarding each residence and operator that has had its certification revoked.
This bill would require, on and after January 1, 2020, specified entities, including a state agency, state-contracted vendor, county agency, or county-contracted vendor, certified alcohol drug counselor, and person or entity licensed in the healing arts that directs substance use treatment, or a judge or parole board that sets terms and conditions for the release, parole, or discharge of a person from custody, if it requires that person to reside in a sober living environment, to first refer that person to a residence listed as a certified recovery residence on a registry posted by an approved certifying organization, if available. The bill would authorize those entities to refer persons to noncertified recovery residences, if they determine it is in the best interests of those persons, and, in that case, to notify available certifying organizations the State Department of Health Care Services of their decision. The bill would require the department to report to the Legislature on or before January 1, 2021, regarding the efficacy of its regulation of certifying organizations impact on complaint resolution, as specified. By imposing additional duties on local governments, this bill would create a state-mandated local program. The bill would provide for the repeal of all of these provisions on January 1, 2026.
The California Constitution requires the state to reimburse local agencies and school districts for certain costs mandated by the state. Statutory provisions establish procedures for making that reimbursement.
This bill would provide that, if the Commission on State Mandates determines that the bill contains costs mandated by the state, reimbursement for those costs shall be made pursuant to the statutory provisions noted above.
Existing law provides for the licensure and regulation of community care facilities by the State Department of Social Services. Existing law also provides for the licensure and regulation by the State Department of Health Care Services of adult alcoholism and drug abuse recovery and treatment facilities for adults.
This bill would, among other things, define a drug and alcohol free recovery residence as a residential property that is operated as a cooperative living arrangement to provide an alcohol and drug free environment for persons recovering from alcoholism or drug abuse, or both, who seek a living environment that supports personal recovery. The bill would authorize a drug and alcohol free recovery residence to demonstrate its commitment to providing a supportive recovery environment by applying and becoming certified by a certifying organization that is approved by the State Department of Health Care Services. The bill would require an approved certifying organization to, among other things, maintain an affiliation with a national organization recognized by the department, establish and use procedures to administer the application, certification, renewal, and disciplinary processes for a drug and alcohol free recovery residence, and investigate and enforce violations by a residence of the organizations code of conduct, as provided. The bill would specify the information and documentation that an operator who seeks to have a residence certified is required to submit to an approved certifying organization.
This bill would require an approved certifying organization to maintain and post on its Internet Web site a registry containing specified information of a residence that has been certified pursuant to these provisions, and would require the department to maintain and post on its Internet Web site a registry that contains specified information regarding each residence and operator that has had its certification revoked.
This bill would require, on and after January 1, 2020, specified entities, including a state agency, state-contracted vendor, county agency, or county-contracted vendor, certified alcohol drug counselor, and person or entity licensed in the healing arts that directs substance use treatment, or a judge or parole board that sets terms and conditions for the release, parole, or discharge of a person from custody, if it requires that person to reside in a sober living environment, to first refer that person to a residence listed as a certified drug and alcohol free recovery residence on a registry posted by an approved certifying organization, if available. The bill would authorize those entities to refer persons to noncertified recovery residences, if they determine it is in the best interests of those persons, and, in that case, to notify available certifying organizations of their decision. By imposing additional duties on local governments, this bill would create a state-mandated local program.
The California Constitution requires the state to reimburse local agencies and school districts for certain costs mandated by the state. Statutory provisions establish procedures for making that reimbursement.
This bill would provide that, if the Commission on State Mandates determines that the bill contains costs mandated by the state, reimbursement for those costs shall be made pursuant to the statutory provisions noted above.
Existing law provides for the licensure and regulation of community care facilities by the State Department of Social Services. Existing law also provides for the licensure and regulation by the State Department of Health Care Services of adult alcoholism and drug abuse recovery and treatment facilities for adults.
This bill would, among other things, define a drug and alcohol free residence as a residential property that is operated as a cooperative living arrangement to provide an alcohol and drug free environment for persons recovering from alcoholism or drug abuse, or both, who seek a living environment that supports personal recovery. The bill would authorize a drug and alcohol free residence to demonstrate its commitment to providing a supportive recovery environment by applying and becoming certified by a certifying organization that is approved by the State Department of Health Care Services. The bill would require an approved certifying organization to, among other things, maintain an affiliation with a national organization recognized by the department, establish and use procedures to administer the application, certification, renewal, and disciplinary processes for a drug and alcohol free residence, and investigate and enforce violations by a residence of the organizations code of conduct, as provided. The bill would specify the information and documentation that an operator who seeks to have a residence certified is required to submit to an approved certifying organization.
This bill would require an approved certifying organization to maintain and post on its Internet Web site a registry containing specified information of a residence that has been certified pursuant to these provisions, and would require the department to maintain and post on its Internet Web site a registry that contains specified information regarding each residence and operator that has had its certification revoked.
This bill would require, on and after January 1, 2020, specified entities, including a state agency, state-contracted vendor, county agency, or county-contracted vendor, certified alcohol drug counselor, and person or entity licensed in the healing arts that directs substance use treatment, or a judge or parole board that sets terms and conditions for the release, parole, or discharge of a person from custody, if it requires that person to reside in a sober living environment, to first refer that person to a residence listed as a certified drug and alcohol free residence on a registry posted by an approved certifying organization, if available. The bill would authorize those entities to refer persons to noncertified recovery residences, if they determine it is in the best interests of those persons, and, in that case, to notify available certifying organizations of their decision. By imposing additional duties on local governments, this bill would create a state-mandated local program.
The California Constitution requires the state to reimburse local agencies and school districts for certain costs mandated by the state. Statutory provisions establish procedures for making that reimbursement.
This bill would provide that, if the Commission on State Mandates determines that the bill contains costs mandated by the state, reimbursement for those costs shall be made pursuant to the statutory provisions noted above.
The Legislature finds and declares all of the following:
(a)(1)Substance use disorder is ranked in the top five clinically preventable burdens on health care spending.
(2)The level of health care services used by substance use disorder patients before receiving treatment is more than double that of nonaddicts. It has been shown that after 12 months of treatment of substance use disorders, the levels of health care services used return to almost average.
(3)An estimated four to five years is necessary for persons experiencing the chronic disease of addiction to reach a full, sustained recovery and the first 30 to 90 days after initial treatment are the most critical for preventing relapse, making it imperative that recovery residences be expanded as a means of reducing costs associated with multiple treatment episodes.
(4)There are an estimated 3.5 million persons with diagnosable substance use disorders in California and a limited number of available recovery residences to effectively provide healthy living environments for long-term recovery.
(5)The need for quality recovery residence housing will continue to rise throughout the next decade.
(b)Therefore, it is the intent of the Legislature, in enacting this act, to establish a voluntary recovery residence certification program so that all of the following may occur:
(1)Access to recovery residence housing can be expanded.
(2)Those seeking recovery housing for substance use disorders in California will find a coordinated system of care in which no wrong door is found in response to accessing healthy environments to reside in where long-term recovery can be supported.
(3)Quality recovery residences can be recognized for their valuable contributions to the continuum of care in addiction treatment and recovery.
SEC. 2.Section 11834.19 is added to the Health and Safety Code, to read:11834.19.(a)(1)For purposes of this section, recovery residence means a residential property that is operated as a cooperative living arrangement to provide an alcohol and drug free environment for persons recovering from alcoholism or drug abuse, or both, who seek a living environment that supports personal recovery.
(2)A recovery residence may demonstrate its commitment to providing a supportive recovery environment by applying and becoming certified by an approved certifying organization pursuant to subdivision (c).
(3)To use the designation certified recovery residence the cooperative living arrangement shall satisfy all of the following requirements:
(A)Owners, managers, operators, and residents observe and promote a zero tolerance policy regarding the consumption or possession of alcohol or controlled substances or marijuana being used in any manner not consistent with a documented prescription.
(B)Residents actively participate in community or individual programs of recovery from substance use disorder, including, but not limited to, Alcoholics Anonymous or Narcotics Anonymous programs.
(C)Within the recovery residence, a resident who has been referred to, and has access to, ongoing outpatient treatment, aftercare, or other recovery maintenance services commits to continue to use these services in accordance with a clinically managed system of care, if one exists for the resident.
(4)A residence that houses persons who are committed to recovering from drug and alcohol addiction shall be presumed to be a recovery residence if the residence has been certified by an approved certifying organization.
(5)If a residence is certified pursuant to this section, the activities at that residence shall be deemed a residential use of property and a use of property by a single family, pursuant to Article 2 (commencing with Section 11834.20).(b)For purposes of this section, the following definitions apply:
(1)Approved certifying organization means an organization approved by the department to certify a residence as a recovery residence pursuant to this section.
(2)Approved national organization means a national organization, recognized by the department, the primary function of which is to improve access to, and the quality of, recovery residences through standards, education, research, and advocacy.
(3)Recovery specialist training means training in recognizing addiction, dependence, abuse of alcohol or other drugs, and other symptoms that relate to substance use, and supporting recovery to address that addiction, dependence, or use.
(c)An approved certifying organization shall do all of the following:
(1)Maintain an office in the state.
(2)Maintain nonprofit status in the state.
(3)Be an affiliate of, and continuously maintain affiliation with, the approved national organization recognized by the department.
(4)Maintain the most current standards published by the approved national organization.
(5)Document that the organization actively develops and confers professional, residential, or organizational quality designations according to applicable nationally recognized standards.
(6)Demonstrate that it has and uses established recovery residence certification requirements.
(7)Demonstrate that it has and uses procedures to administer the application, certification, renewal, and disciplinary processes for a recovery residence.
(8)(A)Inspect, at least annually, a recovery residence to ensure compliance with certification requirements.
(B)Conduct, at the discretion of the approved certifying organization, periodic reviews of a residence to determine whether the residence is in compliance with all applicable laws.
(C)Revoke the certification of a residence if the residence is not operating in compliance with certification requirements or applicable laws, and notify the department of the revocation.
(9)Submit to the department and the operator of a residence that the organization certifies a written code of conduct for a recovery residence that incorporates national standards for legal and ethical conduct for recovery residences.
(10)Submit to the department and the operator of a recovery residence disciplinary guidelines that include sanctions for first and subsequent violations of the organizations code of conduct, that allow the recovery residence notice and opportunity to correct a violation, and that require the approved certifying organization to revoke the certification of the residence if the required corrective action is not completed within the specified time period and to notify the department of the revocation.
(11)Respond to and investigate suspected violations of the organizations code of conduct.
(12)Require an operator who seeks to have a residence certified to submit all of the following documents with the operators completed application and fee:
(A)Procedures and requirements for verifying that a resident is not using alcohol or drugs in a manner not consistent with a prescription or product labeling.
(B)A prohibition on the premises against alcohol, illegal drugs, or the use of prescribed medications by an individual except as prescribed by a physician and used in accordance with the prescription.
(C)Policies to support a residents recovery efforts.
(D)A good neighbor policy to address neighborhood concerns and complaints.
(E)A policy for informing local government officials and neighbors about the approved certification organizations complaint procedures, the contact number of the operator of the residence, and a contact number of at least one resident assigned with the responsibility of mitigating a complaint.
(F)Rules for residents, copies of forms provided to residents, relapse policy, fee and refund policies, and eviction procedures and policies.
(G)Proof that the owner or operator of the residence has completed a minimum of 10 hours of alcohol and drug free program management education accepted by the approved certifying organization.
(H)Proof that at least one resident or an onsite staff member has completed or will complete a minimum of 10 hours of recovery specialist training accepted by the approved certifying organization. At least one resident or onsite staff member shall complete a minimum of 10 hours of this training each year. Training shall include, at a minimum, the subjects of ethics, health and safety topics related to addiction recovery and maintenance, and emergency planning procedures.
(13)Maintain and post on its Internet Web site a registry containing the street address and the name and contact telephone number of the operator of each residence that chooses to be listed as a certified recovery residence pursuant to this section.
(14)Make available to the department a nonpublic, confidential Internet Web site registry containing the street address and the name and contact telephone number of the operator of each residence it has certified as a recovery residence pursuant to this section.
(15)(A)Review the registry posted on the departments Internet Web site pursuant to subdivision (i) to determine whether the residence that the operator has applied to have certified has had a previous certification revoked or the operator submitting the application for certification has operated a residence for which a previous certification has been revoked.
(B)Deny an application for certification if the residence address or operator name in the application is listed on the registry and satisfies the conditions described in subparagraph (A), and send the applicant a written notice of denial of certification.
(C)Deny an application for certification if the residence owner or operator name in the application is listed on the Office of the Inspector General exclusions list under the authority of Sections 1128 and 1156 of the Social Security Act.
(16)Provide a public telephone number and email contact specifically dedicated to certified recovery residence complaint resolution whereby complaints shall be responded to within 24 hours, or the next business day for weekend complaints. Certifying organization complaint telephone and email contact information shall be provided to all cities, counties, or cities and counties in which a certified recovery residence is located within 30 days of approval of that residence.
(17)Publish certification fees and keep fees consistent with national standards for certification.
(d)The department shall adopt application procedures and standards of approval for an organization that seeks to become an approved certifying organization.
(e)The department shall adopt application procedures and standards of approval for an organization that seeks to become an approved national organization.
(f)(1)The department may conduct periodic reviews and inspect the records of an approved certifying organization, as necessary, to determine whether the organization is in compliance with all applicable laws.
(2)The department may revoke approval of an approved certifying organization if the organization does any of the following:
(A)Ceases to be affiliated with the approved national organization.
(B)Fails to perform any of the duties imposed by subdivision (c).
(C)Refuses to comply with sanctions imposed by the department.
(D)Discontinues certifying recovery residences.
(g)(1)The department may investigate complaints it receives regarding a recovery residence independently or in conjunction with the approved certifying organization.
(2)The department may require certifying organizations to impose sanctions and commence disciplinary actions, including revoking the certification of a residence as a recovery residence.
(3)The department may require revocation of certification if an applicant has previously applied for a license to operate a residential alcoholism or drug abuse recovery or treatment facility, or certified alcoholism or drug abuse recovery or treatment program, or previously held a license to operate a residential alcoholism or drug abuse recovery or treatment facility, and that application was denied or the previous license was revoked, suspended, terminated, surrendered, forfeited, or otherwise had disciplinary or administrative action taken against it by the department, including imposition of civil penalties, that the department determines would make its certification inconsistent with ethical and safety standards required for certification.
(h)A city, county, city and county, or local law enforcement agency that suspects that a recovery residence is not operating in compliance with the residences code of conduct may request the department to revoke the certification of that residence.
(i)The department shall maintain and post on its Internet Web site a registry containing the following information:
(1)The street address of each residence that has had its certification revoked.
(2)The name of each operator of a residence that has had its certification revoked.
(j)(1)Notwithstanding any other law, on and after January 1, 2020, a state agency, state contracted vendor, county agency, county contracted vendor, licensed or certified alcohol drug treatment program, certified alcohol drug counselor, or a person or entity licensed in the healing arts pursuant to Division 2 (commencing with Section 500) of the Business and Professions Code that directs substance use treatment, shall first, when referring a person to a recovery residence as part of its duties with regard to substance use treatment, refer that person to a residence listed as a certified recovery residence on a registry posted by an approved certifying organization, if available.
(2)A judge or parole board that sets terms and conditions for the release, parole, or discharge of a person from custody, if it requires a person to reside in a sober living environment, shall first, when referring a person to a recovery residence as part of its duties with regard to substance use treatment, refer that person to a residence listed as a certified recovery residence on a registry posted by an approved certifying organization, if available, to guarantee proper rehabilitation in accordance with the terms and conditions of the courts orders or terms of release as applicable, pursuant to subdivision (a) of Section 1170 of the Penal Code. This section does not prohibit a judge or parole board that sets terms and conditions for the release, parole, or discharge of a person from custody from referring a person to a noncertified recovery residence.
(k)An entity or person specified in subdivision (j) may refer an individual to a noncertified recovery residence, if the entity or person determines it is in the individuals best interest, and, upon making that referral, shall may notify the State Department of Health Care Services department of that decision. decision without divulging the name of the person being referred, or the residence to which the referral is made.
(l)This section does not prohibit any county contracting authority from requiring similar or additional quality and performance standards when contracting for recovery residence or sober living services and does not require any county to become a certifying organization in order to certify recovery residences for the purpose of meeting contractual obligations within a county.
(m)A recognized certifying organization may enter into a memorandum of understanding with a county for the purposes of determining if the countys requirements meet or exceed the minimum requirements of the certifying organization. A memorandum of understanding may include the granting of reciprocal certifications based upon the requirements of the county contract, listing county certified recovery residences on the certifying organizations Internet Web site, and coordination regarding complaint resolution.
(n)(1)The department shall report to the Legislature on or before January 1, 2021, regarding the efficacy of its regulation of certifying organizations impact on complaint resolution. The report shall include, but not be limited to, the number and types of complaints received by certifying organizations and the department, the status of complaints received, and the geographic concentration of reported complaints.
(2)The report submitted pursuant to paragraph (1) shall be submitted in compliance with Section 9795 of the Government Code.
(o)This section shall remain in effect only until January 1, 2026, and as of that date is repealed.
SEC. 3.If the Commission on State Mandates determines that this act contains costs mandated by the state, reimbursement to local agencies and school districts for those costs shall be made pursuant to Part 7 (commencing with Section 17500) of Division 4 of Title 2 of the Government Code.
The Legislature finds and declares all of the following:
(a)(1)Substance use disorder is ranked in the top five clinically preventable burdens on health care spending.
(2)The level of health care services used by substance use disorder patients before receiving treatment is more than double that of nonaddicts. It has been shown that after 12 months of treatment of substance use disorders, the levels of health care services used return to almost average.
(3)An estimated four to five years is necessary for persons experiencing the chronic disease of addiction to reach a full, sustained recovery and the first 30 to 90 days after initial treatment are the most critical for preventing relapse, making it imperative that recovery residences be expanded as a means of reducing costs associated with multiple treatment episodes.
(4)There are an estimated 3.5 million persons with diagnosable substance use disorders in California and a limited number of available recovery residences to effectively provide healthy living environments for long term long-term recovery.
(5)The need for quality recovery residence housing will continue to rise throughout the next decade.
(b)Therefore, it is the intent of the Legislature, in enacting this act, to establish a voluntary recovery residence certification program so that all of the following may occur:
(1)Access to recovery residence housing can be expanded.
(2)Those seeking recovery housing for substance use disorders in California will find a coordinated system of care in which no wrong door is found in response to accessing healthy environments to reside in where long term long-term recovery can be supported.
(3)Quality recovery residences can be recognized for their valuable contributions to the continuum of care in addiction treatment and recovery.
SEC. 2.Section 11834.19 is added to the Health and Safety Code, to read:11834.19.(a)(1)For purposes of this section, recovery residence means a residential property that is operated as a cooperative living arrangement to provide an alcohol and drug free environment for persons recovering from alcoholism or drug abuse, or both, who seek a living environment that supports personal recovery.
(2)A recovery residence may demonstrate its commitment to providing a supportive recovery environment by applying and becoming certified by an approved certifying organization pursuant to subdivision (c).
(3)To use the designation certified recovery residence the cooperative living arrangement shall satisfy all of the following requirements:
(A)Owners, managers, operators, and residents observe and promote a zero tolerance policy regarding the consumption or possession of alcohol or controlled substances or marijuana being used in any manner not consistent with a documented prescription.
(B)Residents actively participate in community or individual programs of recovery from substance use disorder, including, but not limited to, Alcoholics Anonymous or Narcotics Anonymous programs.
(C)Within the recovery residence, a resident who has been referred to, and has access to, ongoing outpatient treatment, aftercare, or other recovery maintenance services commits to continue to use these services in accordance with a clinically managed system of care, if one exists for the resident.
(4)A residence that houses persons who are committed to recovering from drug and alcohol addiction shall be presumed to be a recovery residence if the residence has been certified by an approved certifying organization.
(5)If a residence is certified pursuant to this section, the activities at that residence shall be deemed a residential use of property and a use of property by a single family, pursuant to Article 2 (commencing with Section 11834.20).
(b)For purposes of this section, the following definitions apply:
(1)Approved certifying organization means an organization approved by the department to certify a residence as a recovery residence pursuant to this section.
(2)Approved national organization means a national organization, recognized by the department, the primary function of which is to improve access to, and the quality of, recovery residences through standards, education, research, and advocacy.
(3)Recovery specialist training means training in recognizing addiction, dependence, abuse of alcohol or other drugs, and other symptoms that relate to substance use, and supporting recovery to address that addiction, dependence, or use.
(c)An approved certifying organization shall do all of the following:
(1)Maintain an office in the state.
(2)Maintain nonprofit status in the state.
(3)Be an affiliate of, and continuously maintain affiliation with, the approved national organization recognized by the department.
(4)Maintain the most current standards published by the approved national organization.
(5)Document that the organization actively develops and confers professional, residential, or organizational quality designations according to applicable nationally recognized standards.
(6)Demonstrate that it has and uses established recovery residence certification requirements.
(7)Demonstrate that it has and uses procedures to administer the application, certification, renewal, and disciplinary processes for a recovery residence.
(8)(A)Inspect, at least annually, a recovery residence to ensure compliance with certification requirements.
(B)Conduct, at the discretion of the approved certifying organization, periodic reviews of a residence to determine whether the residence is in compliance with all applicable laws.
(C)Revoke the certification of a residence if the residence is not operating in compliance with certification requirements or applicable laws, and notify the department of the revocation.
(9)Submit to the department and the operator of a residence that the organization certifies a written code of conduct for a recovery residence that incorporates national standards for legal and ethical conduct for recovery residences.
(10)Submit to the department and the operator of a recovery residence disciplinary guidelines that include sanctions for first and subsequent violations of the organizations code of conduct, that allow the recovery residence notice and opportunity to correct a violation, and that require the approved certifying organization to revoke the certification of the residence if the required corrective action is not completed within the specified time period and to notify the department of the revocation.
(11)Respond to and investigate suspected violations of the organizations code of conduct.
(12)Require an operator who seeks to have a residence certified to submit all of the following documents with the operators completed application and fee:
(A)Procedures and requirements for verifying that a resident is not using alcohol or drugs in a manner not consistent with a prescription or product labeling.
(B)A prohibition on the premises against alcohol, illegal drugs, or the use of prescribed medications by an individual except as prescribed by a physician and used in accordance with the prescription.
(C)Policies to support a residents recovery efforts.
(D)A good neighbor policy to address neighborhood concerns and complaints.
(E)A policy for informing local government officials and neighbors about the approved certification organizations complaint procedures, the contact number of the operator of the residence, and a contact number of at least one resident assigned with the responsibility of mitigating a complaint.
(F)Rules for residents, copies of forms provided to residents, relapse policy, fee and refund policies, and eviction procedures and policies.
(G)Proof that the owner or operator of the residence has completed a minimum of 10 hours of alcohol and drug free program management education accepted by the approved certifying organization.
(H)Proof that at least one resident or an onsite staff member has completed or will complete a minimum of 10 hours of recovery specialist training accepted by the approved certifying organization. At least one resident or onsite staff member shall complete a minimum of 10 hours of this training each year. Training shall include, at a minimum, the subjects of ethics, health and safety topics related to addiction recovery and maintenance, and emergency planning procedures.
(13)Maintain and post on its Internet Web site a registry containing the street address and the name and contact telephone number of the operator of each residence that chooses to be listed as a certified recovery residence pursuant to this section.
(14)Make available to the department a nonpublic, confidential Internet Web site registry containing the street address and the name and contact telephone number of the operator of each residence it has certified as a recovery residence pursuant to this section.
(15)(A)Review the registry posted on the departments Internet Web site pursuant to subdivision (i) to determine whether the residence that the operator has applied to have certified has had a previous certification revoked or the operator submitting the application for certification has operated a residence for which a previous certification has been revoked.
(B)Deny an application for certification if the residence address or operator name in the application is listed on the registry and satisfies the conditions described in subparagraph (A), and send the applicant a written notice of denial of certification.
(C)Deny an application for certification if the residence owner or operator name in the application is listed on the Office of the Inspector General exclusions list under the authority of Sections 1128 and 1156 of the Social Security Act.
(16)Provide a public telephone number and email contact specifically dedicated to certified recovery residence complaint resolution whereby complaints shall be responded to within 24 hours, or the next business day for weekend complaints. Certifying organization complaint telephone and email contact information shall be provided to all cities, counties, or cities and counties in which a certified recovery residence is located within 30 days of approval of that residence.
(d)The department shall adopt application procedures and standards of approval for an organization that seeks to become an approved certifying organization.
(e)The department shall adopt application procedures and standards of approval for an organization that seeks to become an approved national organization.
(f)(1)The department may conduct periodic reviews and inspect the records of an approved certifying organization, as necessary, to determine whether the organization is in compliance with all applicable laws.
(2)The department may revoke approval of an approved certifying organization if the organization does any of the following:
(A)Ceases to be affiliated with the approved national organization.
(B)Fails to perform any of the duties imposed by subdivision (c).
(C)Refuses to comply with sanctions imposed by the department.
(D)Discontinues certifying recovery residences.
(g)(1)The department may investigate complaints it receives regarding a recovery residence independently or in conjunction with the approved certifying organization.
(2)The department may require certifying organizations to impose sanctions and commence disciplinary actions, including revoking the certification of a residence as a recovery residence.
(3)The department may require revocation of certification if an applicant has previously applied for a license to operate a residential alcoholism or drug abuse recovery or treatment facility, or certified alcoholism or drug abuse recovery or treatment program, or previously held a license to operate a residential alcoholism or drug abuse recovery or treatment facility, and that application was denied or the previous license was revoked, suspended, terminated, surrendered, forfeited, or otherwise had disciplinary or administrative action taken against it by the department, including imposition of civil penalties, that the department determines would make its certification inconsistent with ethical and safety standards required for certification.
(h)A city, county, city and county, or local law enforcement agency that suspects that a recovery residence is not operating in compliance with the residences code of conduct may request the department to revoke the certification of that residence.
(i)The department shall maintain and post on its Internet Web site a registry containing the following information:
(1)The street address of each residence that has had its certification revoked.
(2)The name of each operator of a residence that has had its certification revoked.
(j)(1)Notwithstanding any other law, on and after January 1, 2020, a state agency, state contracted vendor, county agency, county contracted vendor, licensed or certified alcohol drug treatment program, certified alcohol drug counselor, or a person or entity licensed in the healing arts pursuant to Division 2 (commencing with Section 500) of the Business and Professions Code that directs substance use treatment, shall first, when referring a person to a recovery residence as part of its duties with regard to substance use treatment, refer that person to a residence listed as a certified recovery residence on a registry posted by an approved certifying organization, if available.
(2)A judge or parole board that sets terms and conditions for the release, parole, or discharge of a person from custody, if it requires a person to reside in a sober living environment, shall first, when referring a person to a recovery residence as part of its duties with regard to substance use treatment, refer that person to a residence listed as a certified recovery residence on a registry posted by an approved certifying organization, if available, to guarantee proper rehabilitation in accordance with the terms and conditions of the courts orders or terms of release as applicable, pursuant to subdivision (a) of Section 1170 of the Penal Code. This section does not prohibit a judge or parole board that sets terms and conditions for the release, parole, or discharge of a person from custody from referring a person to a noncertified recovery residence.
(k)An entity or person specified in subdivision (j) may refer an individual to a noncertified recovery residence, if the entity or person determines it is in the individuals best interest, and, upon making that referral, shall notify available certifying organizations the State Department of Health Care Services of that decision.
(l)This section does not prohibit any county contracting authority from requiring similar or additional quality and performance standards when contracting for recovery residence or sober living services and does not require any county to become a certifying organization in order to certify recovery residences for the purpose of meeting contractual obligations within a county.
(m)A recognized certifying organization may enter into a memorandum of understanding with a county for the purposes of determining if the countys requirements meet or exceed the minimum requirements of the certifying organization. A memorandum of understanding may include the granting of reciprocal certifications based upon the requirements of the county contract, listing county certified recovery residences on the certifying organizations Internet Web site, and coordination regarding complaint resolution.
(n)(1)The department shall report to the Legislature on or before January 1, 2025, 2021, regarding the efficacy of its regulation of certifying organizations impact on complaint resolution. The report shall include, but not be limited to, the number and types of complaints received by certifying organizations and the department, the status of complaints received, and the geographic concentration of reported complaints.
(2)The report submitted pursuant to paragraph (1) shall be submitted in compliance with Section 9795 of the Government Code.
(o)This section shall remain in effect only until January 1, 2026, and as of that date is repealed.
SEC. 3.If the Commission on State Mandates determines that this act contains costs mandated by the state, reimbursement to local agencies and school districts for those costs shall be made pursuant to Part 7 (commencing with Section 17500) of Division 4 of Title 2 of the Government Code.
The Legislature finds and declares all of the following:
(a)(1)Substance use disorder is ranked in the top five clinically preventable burdens on health care spending.
(2)The level of health care services used by addicts substance use disorder patients before receiving treatment is more than double that of nonaddicts. It has been shown that after 12 months of treatment of substance use disorders, the levels of health care services used return to almost average.
(3)An estimated four to five years is necessary for persons experiencing the chronic disease of addiction to reach a full, sustained recovery and the first 30 to 90 days after initial treatment are the most critical for preventing relapse, making it imperative that recovery residences be expanded as a means of reducing costs associated with multiple treatment episodes.
(3)(4)There are an estimated 3.5 million persons with diagnosable substance use disorders in California and a limited number of available drug and alcohol free recovery residences to effectively treat addiction in California. provide healthy living environments for long term recovery.
(4)Substance use disorder can be treated in a cost-effective manner in its earliest stages in a private practice environment.(5)The federal Patient Protection and Affordable Care Act (Public Law 111-148) mandates substance disorder treatment as an essential benefit.(6)(5)The need for competent substance disorder treatment quality recovery residence housing will continue to rise throughout the next decade.
(b)Therefore, it is the intent of the Legislature, in enacting this act, to establish specialty certifications for proper substance use treatment a voluntary recovery residence certification program so that all of the following may occur:
(1)Access to substance use treatment services recovery residence housing can be expanded.
(2)Those seeking treatment recovery housing for substance use disorders in California will find a coordinated system of care in which no wrong door is found in response to accessing this care. healthy environments to reside in where long term recovery can be supported.
(3)Professional services Quality recovery residences can be recognized for their valuable contributions to the continuum of care in addiction treatment and recovery.
SEC. 2.Section 11834.19 is added to the Health and Safety Code, to read:11834.19.(a)(1)For purposes of this section, drug and alcohol free recovery residence means a residential property that is operated as a cooperative living arrangement to provide an alcohol and drug free environment for persons recovering from alcoholism or drug abuse, or both, who seek a living environment that supports personal recovery.
(2)A drug and alcohol free recovery residence may demonstrate its commitment to providing a supportive recovery environment by applying and becoming certified by an approved certifying organization pursuant to subdivision (c).
(3)To use the designation certified drug and alcohol free recovery residence the cooperative living arrangement shall satisfy all of the following requirements:
(A)Owners, managers, operators, and residents observe and promote a zero tolerance policy regarding the consumption or possession of alcohol or controlled substances or marijuana being used in any manner not consistent with a documented prescription.
(B)Residents actively participate in community or individual programs of recovery from substance use disorder, including, but not limited to, Alcoholics Anonymous or Narcotics Anonymous programs.
(C)Within the drug and alcohol free recovery residence, a resident who has been referred to, and has access to, ongoing outpatient treatment, aftercare, or other recovery maintenance services commits to continue to use these services in accordance with a clinically managed system of care, if one exists for the resident.
(4)A residence that houses persons who are committed to recovering from drug and alcohol addiction shall be presumed to be a drug and alcohol free recovery residence if the residence has been certified by an approved certifying organization.
(5)If a residence is certified pursuant to this section, the activities at that residence shall be deemed a residential use of property and a use of property by a single family, pursuant to Article 2 (commencing with Section 11834.20).
(b)For purposes of this section, the following definitions apply:
(1)Approved certifying organization means an organization approved by the department to certify a residence as a drug and alcohol free recovery residence pursuant to this section.
(2)Approved national organization means a national organization, recognized by the department, the primary function of which is to improve access to, and the quality of, drug and alcohol recovery residences through standards, education, research, and advocacy.
(3)Recovery specialist training means training in recognizing addiction, dependence, abuse of alcohol or other drugs, and other symptoms that relate to substance use, and supporting recovery to address that addiction, dependence, or use.
(c)An approved certifying organization shall do all of the following:
(1)Maintain an office in the state.
(2)Maintain nonprofit status in the state.
(3)Be an affiliate of, and continuously maintain affiliation with, the approved national organization recognized by the department.
(4)Maintain the most current standards published by the approved national organization.
(5)Document that the organization actively develops and confers professional, residential, or organizational quality designations according to applicable nationally recognized standards.
(6)Demonstrate that it has and uses established drug and alcohol free recovery residence certification requirements.
(7)Demonstrate that it has and uses procedures to administer the application, certification, renewal, and disciplinary processes for a drug and alcohol free recovery residence.
(8)(A)Inspect, at least annually, a drug and alcohol free recovery residence to ensure compliance with certification requirements.
(B)Conduct, at the discretion of the approved certifying organization, periodic reviews of a residence to determine whether the residence is in compliance with all applicable laws.
(C)Revoke the certification of a residence if the residence is not operating in compliance with certification requirements or applicable laws, and notify the department of the revocation.
(9)Submit to the department and the operator of a residence that the organization certifies a written code of conduct for a drug and alcohol free recovery residence that incorporates national standards for legal and ethical conduct for recovery residences.
(10)Submit to the department and the operator of a drug and alcohol free recovery residence disciplinary guidelines that include sanctions for first and subsequent violations of the organizations code of conduct, that allow the drug and alcohol free recovery residence notice and opportunity to correct a violation, and that require the approved certifying organization to revoke the certification of the residence if the required corrective action is not completed within the specified time period and to notify the department of the revocation.
(11)Respond to and investigate suspected violations of the organizations code of conduct.
(12)Require an operator who seeks to have a residence certified to submit all of the following documents with the operators completed application and fee:
(A)Procedures and requirements for verifying that a resident is not using alcohol or drugs in a manner not consistent with a prescription or product labeling.
(B)A prohibition on the premises against alcohol, illegal drugs, or the use of prescribed medications by an individual except as prescribed by a physician and used in accordance with the prescription.
(C)Policies to support a residents recovery efforts.
(D)A good neighbor policy to address neighborhood concerns and complaints.
(E)A policy for informing local government officials and neighbors about the approved certification organizations complaint procedures, the contact number of the operator of the residence, and a contact number of at least one resident assigned with the responsibility of mitigating a complaint.
(F)Rules for residents, copies of forms provided to residents, relapse policy, fee and refund policies, and eviction procedures and policies.
(G)Proof that the owner or operator of the residence has completed a minimum of 10 hours of alcohol and drug free program management education accepted by the approved certifying organization.
(H)Proof that at least one resident or an onsite staff member has completed or will complete a minimum of 10 hours of recovery specialist training accepted by the approved certifying organization. At least one resident or onsite staff member shall complete a minimum of 10 hours of this training each year. Training shall include, at a minimum, the subjects of ethics, health and safety topics related to addiction recovery and maintenance, and emergency planning procedures.
(13)Maintain and post on its Internet Web site a registry containing the street address and the name and contact telephone number of the operator of each residence that chooses to be listed as a certified drug and alcohol free recovery residence pursuant to this section.
(14)Make available to the department a nonpublic, confidential Internet Web site registry containing the street address and the name and contact telephone number of the operator of each residence it has certified as a drug and alcohol free recovery residence pursuant to this section.
(15)(A)Review the registry posted on the departments Internet Web site pursuant to subdivision (i) to determine whether the residence that the operator has applied to have certified has had a previous certification revoked or the operator submitting the application for certification has operated a residence for which a previous certification has been revoked.
(B)Deny an application for certification if the residence address or operator name in the application is listed on the registry and satisfies the conditions described in subparagraph (A), and send the applicant a written notice of denial of certification.
(C)Deny an application for certification if the residence owner or operator name in the application is listed on the Office of the Inspector General exclusions list under the authority of Sections 1128 and 1156 of the Social Security Act.
(16)Provide a public telephone number and email contact specifically dedicated to certified recovery residence complaint resolution whereby complaints shall be responded to within 24 hours, or the next business day for weekend complaints. Certifying organization complaint telephone and email contact information shall be provided to all cities, counties, or cities and counties within five miles of in which a certified drug and alcohol free recovery residence is located within 30 days of approval of that residence.
(d)The department shall adopt application procedures and standards of approval for an organization that seeks to become an approved certifying organization.
(e)The department shall adopt application procedures and standards of approval for an organization that seeks to become an approved national organization.
(f)(1)The department may conduct periodic reviews and inspect the records of an approved certifying organization, as necessary, to determine whether the organization is in compliance with all applicable laws.
(2)The department may revoke approval of an approved certifying organization if the organization does any of the following:
(A)Ceases to be affiliated with the approved national organization.
(B)Fails to perform any of the duties imposed by subdivision (c).
(C)Refuses to comply with sanctions imposed by the department.
(D)Discontinues certifying drug and alcohol free recovery residences.
(g)(1)The department may investigate complaints it receives regarding a drug and alcohol free recovery residence independently or in conjunction with the approved certifying organization.
(2)The department may require certifying organizations to impose sanctions and commence disciplinary actions, including revoking the certification of a residence as a drug and alcohol free recovery residence.
(3)The department may require revocation of certification if an applicant has previously applied for a license to operate a residential alcoholism or drug abuse recovery or treatment facility, or certified alcoholism or drug abuse recovery or treatment program, or previously held a license to operate a residential alcoholism or drug abuse recovery or treatment facility, and that application was denied or the previous license was revoked, suspended, terminated, surrendered, forfeited, or otherwise had disciplinary or administrative action taken against it by the department, including imposition of civil penalties, that the department determines would make its certification inconsistent with ethical and safety standards required for certification.
(h)A city, county, city and county, or local law enforcement agency that suspects that a drug and alcohol recovery residence is not operating in compliance with the residences code of conduct may request the department to revoke the certification of that residence.
(i)The department shall maintain and post on its Internet Web site a registry containing the following information:
(1)The street address of each residence that has had its certification revoked.
(2)The name of each operator of a residence that has had its certification revoked.
(j)(1)Notwithstanding any other law, on and after January 1, 2020, a state agency, state contracted vendor, county agency, county contracted vendor, licensed or certified alcohol drug treatment program, certified alcohol drug counselor, or a person or entity licensed in the healing arts pursuant to Division 2 (commencing with Section 500) of the Business and Professions Code that directs substance use treatment, shall first, when referring a person to a drug and alcohol free recovery residence as part of its duties with regard to substance use treatment, refer that person to a residence listed as a certified drug and alcohol free recovery residence on a registry posted by an approved certifying organization, if available.
(2)A judge or parole board that sets terms and conditions for the release, parole, or discharge of a person from custody, if it requires a person to reside in a sober living environment, shall first, when referring a person to a drug and alcohol free recovery residence as part of its duties with regard to substance use treatment, refer that person to a residence listed as a certified drug and alcohol free recovery residence on a registry posted by an approved certifying organization, if available, to guarantee proper rehabilitation in accordance with the terms and conditions of the courts orders or terms of release as applicable, pursuant to subdivision (a) of Section 1170 of the Penal Code.
(k)An entity or person specified in subdivision (j) may refer an individual to a noncertified recovery residence, if the entity or person determines it is in the individuals best interest, and, upon making that referral, shall notify available certifying organizations of that decision.
(l)This section does not prohibit any county contracting authority from requiring similar or additional quality and performance standards when contracting for recovery residence or sober living services. services and does not require any county to become a certifying organization in order to certify recovery residences for the purpose of meeting contractual obligations within a county.
(m)A recognized certifying organization may enter into a memorandum of understanding with a county for the purposes of determining if the county has fulfilled the minimum requirements countys requirements meet or exceed the minimum requirements of the certifying organization. A memorandum of understanding may include the granting of certification reciprocal certifications based upon the requirements of the county contract, listing county certified recovery residences on the certifying organizations Internet Web site, and coordination regarding complaint resolution.
(n)(1)The department shall report to the Legislature on or before January 1, 2025, regarding the efficacy of its regulation of certifying organizations impact on complaint resolution. The report shall include, but not be limited to, the number and types of complaints received by certifying organizations and the department, the status of complaints received, and the geographic concentration of reported complaints.
(2)The report submitted pursuant to paragraph (1) shall be submitted in compliance with Section 9795 of the Government Code.
(o)This section shall remain in effect only until January 1, 2026, and as of that date is repealed.
SEC. 3.If the Commission on State Mandates determines that this act contains costs mandated by the state, reimbursement to local agencies and school districts for those costs shall be made pursuant to Part 7 (commencing with Section 17500) of Division 4 of Title 2 of the Government Code.
The Legislature finds and declares all of the following:
(a)(1)Substance use disorder is ranked in the top five clinically preventable burdens on health care spending.
(2)The level of health care services used by addicts before receiving treatment is more than double that of nonaddicts. It has been shown that after 12 months of treatment of substance use disorders, the levels of health care services used return to almost average.
(3)There are an estimated 3.5 million persons with diagnosable substance use disorders in California and a limited number of available drug and alcohol free residences to effectively treat addiction in California.
(4)Substance use disorder can be treated in a cost-effective manner in its earliest stages in a private practice environment.
(5)The federal Patient Protection and Affordable Care Act (Public Law 111-148) mandates substance disorder treatment as an essential benefit.
(6)The need for competent substance disorder treatment will continue to rise throughout the next decade.
(b)Therefore, it is the intent of the Legislature, in enacting this act, to establish specialty certifications for proper substance use treatment so that all of the following may occur:
(1)Access to substance use treatment services can be expanded.
(2)Those seeking treatment for substance use disorders in California will find a coordinated system of care in which no wrong door is found in response to accessing this care.
(3)Professional services can be recognized for their valuable contributions to the continuum of care in addiction treatment and recovery.
SEC. 2.Section 11834.19 is added to the Health and Safety Code, to read:11834.19.(a)(1)For purposes of this section, drug and alcohol free residence means a residential property that is operated as a cooperative living arrangement to provide an alcohol and drug free environment for persons recovering from alcoholism or drug abuse, or both, who seek a living environment that supports personal recovery.
(2)A drug and alcohol free residence may demonstrate its commitment to providing a supportive recovery environment by applying and becoming certified by an approved certifying organization pursuant to subdivision (c).
(3)To use the designation certified drug and alcohol free residence the cooperative living arrangement shall satisfy all of the following requirements:
(A)Owners, managers, operators, and residents observe and promote a zero tolerance policy regarding the consumption or possession of alcohol or controlled substances or marijuana being used in any manner not consistent with a documented prescription.
(B)Residents actively participate in community or individual programs of recovery from substance use disorder, including, but not limited to, Alcoholics Anonymous or Narcotics Anonymous programs.
(C)Within the drug and alcohol free residence, a resident who has been referred to, and has access to, ongoing outpatient treatment, aftercare, or other recovery maintenance services commits to continue to use these services in accordance with a clinically managed system of care, if one exists for the resident.
(4)A residence that houses persons who are committed to recovering from drug and alcohol addiction shall be presumed to be a drug and alcohol free residence if the residence has been certified by an approved certifying organization.
(5)If a residence is certified pursuant to this section, the activities at that residence shall be deemed a residential use of property and a use of property by a single family, pursuant to Article 2 (commencing with Section 11834.20).
(b)For purposes of this section, the following definitions apply:
(1)Approved certifying organization means an organization approved by the department to certify a residence as a drug and alcohol free residence pursuant to this section.
(2)Approved national organization means a national organization, recognized by the department, the primary function of which is to improve access to, and the quality of, drug and alcohol recovery residences through standards, education, research, and advocacy.
(3)Recovery specialist training means training in recognizing addiction, dependence, abuse of alcohol or other drugs, and other symptoms that relate to substance use, and supporting recovery to address that addiction, dependence, or use.
(c)An approved certifying organization shall do all of the following:
(1)Maintain an office in the state.
(2)Maintain nonprofit status in the state.
(3)Be an affiliate of, and continuously maintain affiliation with, the approved national organization recognized by the department.
(4)Maintain the most current standards published by the approved national organization.
(5)Document that the organization actively develops and confers professional, residential, or organizational quality designations according to applicable nationally recognized standards.
(6)Demonstrate that it has and uses established drug and alcohol free residence certification requirements.
(7)Demonstrate that it has and uses procedures to administer the application, certification, renewal, and disciplinary processes for a drug and alcohol free residence.
(8)(A)Inspect, at least annually, a drug and alcohol free residence to ensure compliance with certification requirements.
(B)Conduct, at the discretion of the approved certifying organization, periodic reviews of a residence to determine whether the residence is in compliance with all applicable laws.
(C)Revoke the certification of a residence if the residence is not operating in compliance with certification requirements or applicable laws, and notify the department of the revocation.
(9)Submit to the department and the operator of a residence that the organization certifies a written code of conduct for a drug and alcohol free residence that incorporates national standards for legal and ethical conduct for recovery residences.
(10)Submit to the department and the operator of a drug and alcohol free residence disciplinary guidelines that include sanctions for first and subsequent violations of the organizations code of conduct, that allow the drug and alcohol free residence notice and opportunity to correct a violation, and that require the approved certifying organization to revoke the certification of the residence if the required corrective action is not completed within the specified time period and to notify the department of the revocation.
(11)Respond to and investigate suspected violations of the organizations code of conduct.
(12)Require an operator who seeks to have a residence certified to submit all of the following documents with the operators completed application and fee:
(A)Procedures and requirements for verifying that a resident is not using alcohol or drugs in a manner not consistent with a prescription or product labeling.
(B)A prohibition on the premises against alcohol, illegal drugs, or the use of prescribed medications by an individual except as prescribed by a physician and used in accordance with the prescription.
(C)Policies to support a residents recovery efforts.
(D)A good neighbor policy to address neighborhood concerns and complaints.
(E)A policy for informing local government officials and neighbors about the approved certification organizations complaint procedures, the contact number of the operator of the residence, and a contact number of at least one resident assigned with the responsibility of mitigating a complaint.
(F)Rules for residents, copies of forms provided to residents, relapse policy, fee and refund policies, and eviction procedures and policies.
(G)Proof that the owner or operator of the residence has completed a minimum of 10 hours of alcohol and drug free program management education accepted by the approved certifying organization.
(H)Proof that at least one resident or an onsite staff member has completed or will complete a minimum of 10 hours of recovery specialist training accepted by the approved certifying organization. At least one resident or onsite staff member shall complete a minimum of 10 hours of this training each year. Training shall include, at a minimum, the subjects of ethics, health and safety topics related to addiction recovery and maintenance, and emergency planning procedures.
(13)Maintain and post on its Internet Web site a registry containing the street address and the name and contact telephone number of the operator of each residence that chooses to be listed as a certified drug and alcohol free residence pursuant to this section.
(14)Make available to the department a nonpublic, confidential Internet Web site registry containing the street address and the name and contact telephone number of the operator of each residence it has certified as a drug and alcohol free residence pursuant to this section.
(15)(A)Review the registry posted on the departments Internet Web site pursuant to subdivision (i) to determine whether the residence that the operator has applied to have certified has had a previous certification revoked or the operator submitting the application for certification has operated a residence for which a previous certification has been revoked.
(B)Deny an application for certification if the residence address or operator name in the application is listed on the registry and satisfies the conditions described in subparagraph (A), and send the applicant a written notice of denial of certification.
(C)Deny an application for certification if the residence owner or operator name in the application is listed on the Office of the Inspector General exclusions list under the authority of Sections 1128 and 1156 of the Social Security Act.
(16)Provide a public telephone number and email contact specifically dedicated to certified recovery residence complaint resolution whereby complaints shall be responded to within 24 hours, or the next business day for weekend complaints. Certifying organization complaint telephone and email contact information shall be provided to all cities, counties, or cities and counties within five miles of a certified drug and alcohol free residence within 30 days of approval of that residence.
(d)The department shall adopt application procedures and standards of approval for an organization that seeks to become an approved certifying organization.
(e)The department shall adopt application procedures and standards of approval for an organization that seeks to become an approved national organization.
(f)(1)The department may conduct periodic reviews and inspect the records of an approved certifying organization, as necessary, to determine whether the organization is in compliance with all applicable laws.
(2)The department may revoke approval of an approved certifying organization if the organization does any of the following:
(A)Ceases to be affiliated with the approved national organization.
(B)Fails to perform any of the duties imposed by subdivision (c).
(C)Refuses to comply with sanctions imposed by the department.
(D)Discontinues certifying drug and alcohol free residences.
(g)(1)The department may investigate complaints it receives regarding a drug and alcohol free residence independently or in conjunction with the approved certifying organization.
(2)The department may require certifying organizations to impose sanctions and commence disciplinary actions, including revoking the certification of a residence as a drug and alcohol free residence.
(3)The department may require revocation of certification if an applicant has previously applied for a license to operate a residential alcoholism or drug abuse recovery or treatment facility, or certified alcoholism or drug abuse recovery or treatment program, or previously held a license to operate a residential alcoholism or drug abuse recovery or treatment facility, and that application was denied or the previous license was revoked, suspended, terminated, surrendered, forfeited, or otherwise had disciplinary or administrative action taken against it by the department, including imposition of civil penalties, that the department determines would make its certification inconsistent with ethical and safety standards required for certification.
(h)A city, county, city and county, or local law enforcement agency that suspects that a drug and alcohol residence is not operating in compliance with the residences code of conduct may request the department to revoke the certification of that residence.
(i)The department shall maintain and post on its Internet Web site a registry containing the following information:
(1)The street address of each residence that has had its certification revoked.
(2)The name of each operator of a residence that has had its certification revoked.
(j)(1)Notwithstanding any other law, on and after January 1, 2020, a state agency, state contracted vendor, county agency, county contracted vendor, licensed or certified alcohol drug treatment program, certified alcohol drug counselor, or a person or entity licensed in the healing arts pursuant to Division 2 (commencing with Section 500) of the Business and Professions Code that directs substance use treatment, shall first, when referring a person to a drug and alcohol free residence as part of its duties with regard to substance use treatment, refer that person to a residence listed as a certified drug and alcohol free residence on a registry posted by an approved certifying organization, if available.
(2)A judge or parole board that sets terms and conditions for the release, parole, or discharge of a person from custody, if it requires a person to reside in a sober living environment, shall first, when referring a person to a drug and alcohol free residence as part of its duties with regard to substance use treatment, refer that person to a residence listed as a certified drug and alcohol free residence on a registry posted by an approved certifying organization, if available, to guarantee proper rehabilitation in accordance with the terms and conditions of the courts orders or terms of release as applicable, pursuant to subdivision (a) of Section 1170 of the Penal Code.
(k)An entity or person specified in subdivision (j) may refer an individual to a noncertified recovery residence, if the entity or person determines it is in the individuals best interest, and, upon making that referral, shall notify available certifying organizations of that decision.
(l)This section does not prohibit any county contracting authority from requiring similar or additional quality and performance standards when contracting for recovery residence or sober living services.
(m)A recognized certifying organization may enter into a memorandum of understanding with a county for the purposes of determining if the county has fulfilled the minimum requirements of the certifying organization. A memorandum of understanding may include the granting of certification based upon the requirements of the county contract, listing county certified recovery residences on the certifying organizations Internet Web site, and coordination regarding complaint resolution.
(n)(1)The department shall report to the Legislature on or before January 1, 2025, regarding the efficacy of its regulation of certifying organizations impact on complaint resolution. The report shall include, but not be limited to, the number and types of complaints received by certifying organizations and the department, the status of complaints received, and the geographic concentration of reported complaints.
(2)The report submitted pursuant to paragraph (1) shall be submitted in compliance with Section 9795 of the Government Code.
(o)This section shall remain in effect only until January 1, 2026, and as of that date is repealed.
SEC. 3.If the Commission on State Mandates determines that this act contains costs mandated by the state, reimbursement to local agencies and school districts for those costs shall be made pursuant to Part 7 (commencing with Section 17500) of Division 4 of Title 2 of the Government Code.
|
Date
|
Status
|
|---|---|
| May 25, 2018 | In committee: Held under submission. |
| Apr 18, 2018 | In committee: Set, first hearing. Referred to APPR. suspense file. |
| Apr 12, 2018 | Re-referred to Com. on APPR. |
| Apr 11, 2018 | From committee chair, with author's amendments: Amend, and re-refer to Com. on APPR. Read second time and amended. |
| Apr 3, 2018 | Re-referred to Com. on APPR. |
| Apr 2, 2018 | Read second time and amended. |
| Mar 22, 2018 | From committee: Amend, and do pass as amended and re-refer to Com. on APPR. (Ayes 13. Noes 0.) (March 20). |
| Mar 13, 2018 | Re-referred to Com. on HEALTH. |
| Mar 12, 2018 | From committee chair, with author's amendments: Amend, and re-refer to Com. on HEALTH. Read second time and amended. |
| Mar 1, 2018 | Referred to Com. on HEALTH. |
| Feb 13, 2018 | From printer. May be heard in committee March 15. |
| Feb 12, 2018 | Read first time. To print. |
|
Date
|
Description
|
Location
|
Votes
|
|
|---|---|---|---|---|
| Mar 20, 2018 | Do pass as amended and be re-referred to the Committee on [Appropriations] | Assembly Standing Committee on Health |
Passed |
This list shows positions taken on this bill by organizations on the date displayed, which is linked to the original source.
Positions by individuals are not included.
|
Organization
|
Position
|
Date
|
|---|---|---|
| Azure Acres | * Support | Mar 20, 2018 |
| California Behavioral Health Directors Association | ** Support | Mar 16, 2018 |
| California Consortium Of Addicted Programs And Professionals | ** Support | Mar 16, 2018 |
| California Consortium of Addiction Programs and Professionals | * Support | Mar 20, 2018 |
| California Disability Rights | * Against | Mar 20, 2018 |
| City of Murrieta | * Support | Mar 20, 2018 |
| Community Recovery Resources | ** Support | Mar 16, 2018 |
| County Behavioral Health Directors | * Indeterminate | Mar 20, 2018 |
| County Behavioral Health Directors Association | * Support | Mar 20, 2018 |
| Numerous individuals | ** Against | Mar 16, 2018 |
| Recovery Now | * Support | Mar 20, 2018 |
| Soroptomist House Of Hope, Inc. | ** Support | Mar 16, 2018 |
| The Western Center on Law and Poverty | * Against | Mar 20, 2018 |
Date of Hearing: April 18, 2018
ASSEMBLY COMMITTEE ON APPROPRIATIONS
Lorena Gonzalez Fletcher, Chair
ABPCA Bill Id:AB 2214
Author:(Rodriguez) – As Amended Ver:April 11, 2018
Policy Committee: | Health | Vote: | 13 - 0 |
Urgency: No State Mandated Local Program: Yes Reimbursable: No
SUMMARY:
This bill establishes state oversight of “recovery residences" or sober living homes, which can choose to be certified pursuant to this bill on a voluntary basis. Specifically, this bill:
- Requires the Department of Health Care Services (DHCS) to adopt procedures to approve third-party organizations (“certifying organizations”) that will certify compliance with enumerated standards. Also requires DHCS to maintain on its website a registry containing the name and street address of each residence that has had its certification revoked.
- Lists standards recovery residences must meet in order to be certified, as well as requirements for the certifying organizations that verify compliance with the listed standards.
- Authorizes DHCS to review and inspect approved certifying organizations, revoke approval of certifying organizations, require the organizations to impose sanctions and commence disciplinary actions, and investigate complaints about certified recovery residences.
- Requires any state and local agencies and their vendors that direct substance use treatment, as well as judges and parole boards that sets terms and conditions for release, parole, or discharge, to refer to a certified recovery residence, if available.
FISCAL EFFECT:
- Administrative costs to DHCS in the range of $1.5 million to $2.5 million GF in the first year of implementation. Ongoing annual costs would be slightly lower.
- Uncertain, potentially significant GF costs to the California Department of Corrections and Rehabilitation (CDCR) for oversight of parolees. Sober living homes that become certified pursuant to this bill are likely to incur costs to comply with the standards, as well as costs for certification itself, which will be reflected in higher rents. Assuming the state pays on behalf of approximately 36,000 months of sober living homes per year, if rents increase by $30/month on average as a result of this bill, state costs will increase by $1 million GF.
- $500,000 one-time GF costs to DHCS for information technology changes to meet business needs for the approval of certifying organizations and registry of residences with revocations.
- One-time, likely minor, GF costs to CDCR for revising procedures and training staff about the new requirements, as well as ongoing costs to verify space in a certified facility.
- Local public safety agencies could also incur local costs, similar in type to costs as noted in (2) and (4), due to the requirement to refer to certified sober living homes. This bill requires county agencies or county-contracted vendors that direct substance abuse treatment to first refer to a certified home. Although this bill requires a higher level of local government service through mandating local entities refer to certified sober living homes, it is unclear whether the Commission on State Mandates would determine these local costs to be reimbursable by the state.
COMMENTS:
- Purpose. According to the author, thousands of facilities treat people with substance use disorders, who are very susceptible to relapse, without possessing any formal credentials. The author states this bill will help people stay sober and improve community safety.
- Background. DHCS, formerly the Department of Drug and Alcohol Programs, is the state oversight body for drug and alcohol treatment facilities and personnel. DHCS licenses substance use treatment facilities, which provide 24-hour residential nonmedical services to eligible adults who are recovering from problems related to substance use. DHCS also offers a voluntary facility certification to both residential and nonresidential programs.
Sober living homes are alcohol and drug-free living environments for individuals attempting to maintain abstinence from alcohol and drugs. They are private residences, do not offer treatment services and, in contrast to alcoholism and drug abuse recovery or treatment programs, they are not regulated by the state. Private voluntary certifications do exist, however. This bill would offer a "state stamp of approval" to private certifying organizations that comply with its requirements and would allow the state to investigate complaints against residences.
- Prior Legislation. A litany of bills has addressed the issue of sober living homes and related issues over the past decade. Most recently:
AB 2255 (Melendez), of the 2015-16 Legislative Session, and AB 285 (Melendez), of the current session, were both similar to this bill and held on the Suspense File of this committee.
AB 2491 (Nestande), of the 2013-14 Legislative Session, also required sober living homes to meet specified requirements and was held on the Suspense File of the Senate Appropriations Committee.
- Support and Opposition. This bill is sponsored by the California Consortium of Addiction Programs and Professionals, an organization that certifies sober living homes. The California Behavioral Health Directors Association and other organizations support this bill. Disability Rights California (DRC), Western Center on Law and Poverty (WCLP), and numerous individuals have expressed opposition. DRC argues this bill creates a coercive structure for certification, violates state and federal rights, and eliminates housing opportunities. WCLP argues the bill discriminates against people living with disabilities and limits housing opportunities, while subjecting uncertified houses to harassment and legal challenges.
- Staff Comments. Most private entities seeking state licensure or approval are charged a fee to support state workload. This bill contains no such fee authority. Therefore, all administrative costs as a result of this bill accrue to the General Fund.
Analysis Prepared by: Lisa Murawski / APPR. / (916) 319-2081
Date of Hearing: March 20, 2018
ASSEMBLY COMMITTEE ON HEALTH
Jim Wood, Chair
ABPCA Bill Id:AB 2214
Author:(Rodriguez) – As Amended Ver:March 12, 2018
SUBJECT: Recovery residences.
SUMMARY: Establishes a voluntary certification process for recovery residences. Specifically, this bill:
- Defines a “recovery residence" as a residential property that is operated as a cooperative living arrangement to provide an alcohol and drug free environment for persons recovering from alcoholism or drug abuse, or both, who seek a living environment that supports personal recovery.
- Permits a recovery residence to demonstrate its commitment to providing a supportive recovery environment by applying and becoming certified by an approved certifying organization pursuant to 3) below.
- Establishes a certified recovery residence as a recovery residence that has been certified by an approved certifying organization and has satisfied all of the following requirements:
- Owners, managers, operators, and residents observe and promote a zero tolerance policy regarding the consumption or possession of alcohol or controlled substances or marijuana being used in any manner not consistent with a documented prescription;
- Residents actively participate in community or individual programs of recovery from substance use disorder, including, but not limited to, Alcoholics Anonymous or Narcotics Anonymous programs; and,
- Within the recovery residence, a resident who has been referred to, and has access to, ongoing outpatient treatment, aftercare, or other recovery maintenance services commits to continue to use these services in accordance with a clinically managed system of care, if one exists for the resident.
- Provides that a residence that is certified within 90 days of beginning its operations, and that the activities at that residence be deemed a residential use of property and a use of property by a single family.
- Defines an approved certifying organization as an organization approved by the Department of Health Care Services (DHCS) to certify a residence as a recovery residence.
- Defines "recovery specialist training" as training in recognizing addiction, dependence, abuse of alcohol or other drugs, and other symptoms that relate to substance use, and supporting recovery to address that addiction, dependence, or use.
- Defines an approved national organization as a national organization, recognized by DHCS, where the primary function of which is to improve access to, and the quality of, recovery residences through standards, education, research, and advocacy.
- Requires an approved certifying organization do all of the following:
- Maintain an office in the state;
- Maintain nonprofit status in the state;
- Be an affiliate of, and continuously maintain affiliation with, an approved national organization;
- Maintain the most current standards published by the approved national organization;
- Document that the organization actively develops and confers professional, residential, or organizational quality designations according to applicable nationally recognized standards;
- Demonstrate that it has and uses established recovery residence certification requirements;
- Demonstrate that it actively develops and confers professional, residential, or organizational quality designations according to the applicable nationally recognized standards;
- Demonstrate that it has and uses established procedures to administer the application, certification, renewal, and disciplinary processes for a recovery residence;
- Inspect, at least annually, a recovery residence to ensure compliance with certification requirements;
- Conduct, at the discretion of the approved certifying organization, periodic reviews of a residence to determine whether the residence is in compliance with all applicable laws;
- Revoke the certification of a residence if the residence is not operating in compliance with certification requirements or applicable laws, and notify DHCS of the revocation;
- Submit to DHCS and the operator of the certifying organization, a written code of conduct for a recovery residence that incorporates national standards for legal and ethical conduct for recovery residences;
- Submit to DHCS and the operator of a recovery residence disciplinary guidelines that include sanctions for first and subsequent violations of the organization’s code of conduct that allows the recovery residence notice and opportunity to correct a violation and requires the approved certifying organization to revoke the certification of the residence if the required corrective action is not completed within the specified time period;
- Respond to and investigate suspected violations of the organization’s code of conduct;
- Require an operator who seeks to have a residence certified to submit all of the following documents with the operator’s completed application and fee:
- Procedures and requirements for verifying that a resident remains drug and alcohol free;
- A prohibition on the premises against alcohol, illegal drugs, or the use of prescribed medications by an individual except as prescribed by a physician and used in accordance with the prescription;
- Policies to support a resident’s recovery efforts;
- A good neighbor policy to address neighborhood concerns and complaints;
- A policy for informing local government officials and neighbors about the approved certification organization’s complaint procedures, the contact number of the operator of the residence, and a contact number of a minimum of one resident assigned with the responsibility of mitigating a complaint;
- Rules for residents, copies of forms provided to a resident, relapse policy, fee and refund policies, and eviction procedures and policies;
- Proof that the owner or operator of the residence has completed a minimum of 10 hours of alcohol and drug free program management education approved by the approved certifying organization;
- Proof that at least one resident or an onsite staff member has completed or will complete a minimum of 10 hours of recovery specialist training accepted by the approved certifying organization; and,
- Proof that a minimum of one resident has received certification approved by the approved certifying organization. Certification must include, at a minimum, the following subjects: ethics; health and safety topics related to addiction recovery and maintenance; and, emergency planning procedures.
- Maintain and post on its Internet Website a registry containing the street address and the name and contact telephone number of the operator of each residence that has been certified as a recovery residence;
- Review the registry posted on DHCS’s Internet Website to determine whether the residence that the operator has applied to have certified has had a previous certification revoked or the operator submitting the application for certification has operated a residence for which a previous certification has been revoked;
- Deny an application for certification if the residence address or operator name in the application is listed on the registry and send the applicant a written notice of denial of certification;
- Provide a public telephone number and email contact specifically dedicated to certified recovery residence complaint resolutions and requires that complaints be responded to within 24 hours or the next business day for weekend complaints; and,
- Require that certifying organization complaint telephone and email contact information in s) above be provided to all cities, counties, or cities and counties in which a certified recovery residence s located within 30 days of approval of that residence.
- Requires DHCS to adopt application procedures and standards of approval for an organization that seeks to be approved by DHCS as an approved certifying organization or as an approved national organization.
- Permits DHCS to conduct periodic reviews of an approved certifying organization to determine whether the organization is in compliance with all applicable laws. Permits DHCS to revoke approval of an approved certifying organization if the organization does any of the following:
- Ceases to be affiliated with the approved national organization;
- Fails to perform any of the duties specified in 8) above;
- Refuses to comply with imposed sanctions; or,
- Discontinues certifying recovery residences.
- Permits DHCS to investigate complaints it receives regarding a recovery residence independently or in conjunction with the approved certifying organization and permits DHCS to impose sanctions and commence disciplinary actions, including revoking the certification of a residence as a recovery residence.
- Permits a city, county, city and county, or local law enforcement agency that suspects that a recovery residence is not operating in compliance with the residence’s code of conduct to request DHCS to revoke the certification of that residence.
- Requires DHCS to maintain and post on its Internet Website a registry containing all of the following information:
- The street address of each residence that has had its certification revoked; and,
- The name of each operator of a residence that has had its certification revoked.
- Requires, on and after January 1, 2020, a state agency, state-contracted vendor, county agency, or county-contracted vendor that directs substance abuse treatment, or a judge or parole board that sets terms and conditions for the release, parole, or discharge of a person from custody, if it requires a person to reside in a sober living environment, to refer that person only to a residence listed as a certified recovery residence on the registry posted on the DHCS’s Internet Website.
- Requires that, when a person is ordered to reside in a sober living environment for purposes of terms and conditions of release, parole, or discharge of a person from custody, a judge to first refer that person to a residence listed as a certified recovery residence on a registry posted by an approved certifying organization, if available, to guarantee proper rehabilitation in accordance with the terms and conditions of the court’s orders or terms of release as applicable. Permits an individual to be referred to a noncertified recovery residence if a judge determines that is in an individual's best interest, and requires that certified organizations be notified of that decision.
- Specifies that a county contracting authority is not prohibited from requiring similar or additional quality and performance standards when contracting for a recovery residence or sober living services and does not require any county to become a certifying organization in order to certify recovery residences for the purpose of meeting contractual obligations within a county.
- Permits a recognized certifying organization to enter into a memorandum of understanding with a county for the purposes of determining if the county’s requirements meet or exceed the minimum requirements of the certifying organization. Allows a MOU to include the granting of reciprocal certifications based upon the requirements of the county contract, listing county certified recovery residences on the certifying organization’s Internet Website, and coordination regarding complaint resolution.
- Requires DHCS to report to the Legislature on or before January 1, 2025, regarding the efficacy of its regulation of certifying organizations’ impact on complaint resolution and requires the report to include the number and types of complaints received by certifying organizations and DHCS, the status of complaints received, and the geographic concentration of reported complaints.
- Repeals the provisions of this bill on January 1, 2026 and establishes legislative findings and declarations.
EXISTING LAW:
- Establishes DHCS to license adult alcoholism or drug abuse recovery or treatment facilities. Permits new licenses to be issued for a period of two years, and requires DHCS to conduct onsite program visits for compliance at least once during the two year licensing period.
- Defines “alcoholism or drug abuse recovery or treatment facility” (treatment facility) as any premise, place, or building that provides 24-hour residential nonmedical 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.
- Establishes requirements for application for licensure of a facility, requires DHCS to terminate licensure if these requirements are not met, and authorizes DHCS to deny a license of applicants that do not demonstrate an ability to comply with specified requirements.
- Requires, if an applicant intends to provide incidental medical services, such as obtaining medical histories, monitoring health status, testing associated with detoxification from alcohol or drugs, and overseeing patient self-administered medications, evidence of a valid license of a physician and surgeon who will provide or oversee those services, and any other information deemed appropriate by DHCS, as specified.
- Permits DHCS to issue single licenses to residential facilities and a facility where separate buildings or portions of a residential facility are integral components of a single treatment facility and all of the components of the facility are managed by the same licensee.
- Authorizes DHCS to assess civil penalties on facilities that provide alcoholism or drug abuse recovery, treatment, or detoxification services without a license.
- Requires a treatment facility that serves six or fewer persons to be considered a residential use of property whether or not unrelated persons are living together. Requires the residents and operators of the facility to be considered a family for the purposes of any law or zoning ordinance that relates to the residential use of property.
- Excludes, for the purposes of local ordinances, a treatment facility that serves six or fewer persons from the definition of a boarding house, rooming house, institution or home for the care of minors, the aged, or persons with mental health disorders, foster care home, guest home, rest home, community residence, or other similar term that implies that the alcoholism or drug abuse recovery, or treatment home is a business run for profit or differs in any other way from a single-family residence.
- Authorizes a city, county, or other local public entity from placing restrictions on building heights, setback, lot dimensions, or placement of signs of a treatment facility that serves six or fewer persons as long as the restrictions are identical to those applied to other single-family residences.
- Specifies that any local ordinance that deals with health and safety, building standards, environmental impact standards, or any other matter within the jurisdiction of a local public entity also applies to a treatment facility, however, local ordinances cannot distinguish treatment facilities that serve six or fewer persons from other single-family dwellings or distinguish residents of treatment facilities from persons who reside in other single-family dwellings.
- Prohibits a conditional use permit, zoning variance, or other zoning clearance from being required of an alcoholism or drug abuse recovery or treatment facility that serves six or fewer persons that is not required of a single-family residence in the same zone.
- Prohibits, under the California Fair Employment and Housing Act (FEHA), discrimination against any person in any housing accommodation on the basis of race, color, religion, sex, marital status, national origin, ancestry, familial status, or disability. Specifies that discriminatory land use regulations, zoning laws, and restrictive covenants are unlawful acts.
- Prohibits under the federal Americans with Disabilities Act of 1990 (ADA), discrimination by any public entity by reason of an individual’s disability. Makes it unlawful, under the federal Fair Housing Act, to make unavailable or deny, a dwelling to any buyer or renter because of a disability.
FISCAL EFFECT: This bill has not yet been analyzed by a fiscal committee.
COMMENTS:
- PURPOSE OF THIS BILL. According to the author, under existing law, sober living homes with six residents or fewer do not require certification, a code of conduct, or even a drug and alcohol free policy in order to operate. Recoverees from drug and alcohol addiction are particularly vulnerable to relapse without appropriate programming and a supportive drug and alcohol free community. This bill will allow sober living homes to voluntarily apply for a state recognized certification through DHCS. Certification requires homes to undergo inspections at least annually and maintain a drug and alcohol free environment. Should standards not be met, DHCS will be able to revoke certification. This bill will improve transparency about sober living home standards and inform the public about the quality they can expect at a certified home. This bill will help ensure that those recovering from addiction can find the support they need.
- BACKGROUND. Alcoholism or drug abuse recovery or treatment facilities provide 24- hour non-medical care and specialize in providing services to chemically dependent adults who do not require treatment in an acute-care medical facility on an inpatient, intensive outpatient, outpatient, and partial hospitalization basis. These facilities range in size from six-bed facilities in residential neighborhoods to centers that accommodate more than 100 beds. The basic services provided by facilities include group, individual and educational sessions, alcoholism or drug abuse, recovery and treatment planning. Detoxification services are also provided and are defined by the DHCS as services to support and assist an individual in the alcohol and/or drug withdrawal process and to explore plans for continued treatment. These services can be provided by a variety of health care providers such as alcohol and drug counselors, mental health therapists, social workers, psychologists, nurses, and physicians.
- Recent substance use treatment reforms. On August 13, 2015, DHCS announced that the Centers for Medicare and Medicaid Services (CMS) approved California's Drug Medi-Cal Organized Delivery System (DMC-ODS) Waiver. Counties participating in the DMC-ODS waiver program will administer, or arrange for, substance use disorder (SUD) treatment for Medi-Cal beneficiaries. The DMC-ODS demonstration will be elective for five years.
The DMC-ODS waiver provides a continuum of care modeled after the American Society of Addiction Medicine (ASAM) Criteria for SUD treatment services. As part of their participation in the DMC-ODS, CMS requires all residential providers to meet the ASAM requirements and obtain a DHCS-issued ASAM designation. The ASAM criterion is a nationally accepted set of treatment criteria for SUD care and is being adopted beyond Medi-Cal beneficiaries as the SUD industry standard. As of March 14, 2017, DHCS has designated 168 residential alcohol and/or other drug treatment facilities with the appropriate ASAM level of care. DHCS has initiated a phased-in implementation of the DMC-ODS waiver and established five regions throughout the state. DHCS determined the order of implementation based on location, population, and county and provider readiness, in five phases.
- ADA, the Fair Housing Act (FHA), and the California Fair Housing and Equal Opportunity Act (FEHA). The FHA makes it illegal to engage in various discriminatory practices relating to the sale and rental of housing based on race, color, religion, sex, marital status, national origin, ancestry, familial status, or disability. FEHA also prohibits land use regulations, zoning ordinances, and restrictive covenants from discriminating in housing on the basis of the aforementioned categories. FEHA also states that groups of people with disabilities living together in a single dwelling unit are considered a family.
In addition, the ADA gives civil rights protection to individuals with disabilities, similar to the protections provided to individuals on the basis of race, sex, national origin, and religion. Under the ADA, an individual with a “disability” is someone who has a current “physical or mental impairment” that “substantially limits” one or more of that person’s “major life activities,” such as caring for one’s self, working, etc., or has a record of such a substantially limiting impairment, or is regarded as having such an impairment. The protections of the ADA apply to those who have successfully completed a drug rehabilitation program, or who are currently enrolled in such programs. - Pacific Shores Properties v. City of Newport Beach (Pacific Shores). In the late 1990s, the number of residential facilities for recovering drug and alcohol abusers began to increase in the City of Newport Beach. By April of 2007, 73 homes existed in the city, only 48 of which were licensed. Among these homes were Pacific Shores Properties LLC, Newport Coast Recovery LLC (NCR), and Yellowstone Women’s First Step House, Inc. (collectively, the “Group Homes”). Pacific Shores and Yellowstone were unlicensed, while NCR provided services to more than seven individuals at a time and was therefore a state-licensed facility. As a result of the increasing number of group homes, the City’s residents began voicing hostile complaints and concerns. In 2008, responding to resident discontent, the City of Newport Beach drafted an ordinance that subjected “residential care facilities” to strict zoning requirements and significantly limiting both the continued existence of group homes and the creation of new ones. These new restrictions had an almost immediate impact on residential treatment facilities, and by 2009, the number of group housing opportunities was reduced by 40% and altogether shutting down about one-third of group homes. In 2010, the Group Homes filed suit against the City alleging discrimination under the FHA, the ADA, the FEHA, and the Equal Protection Clause. While the district court ruled in favor of the City of Newport Beach, the Group Homes appealed this decision to the United States Court of Appeals for the Ninth Circuit. In 2013, the Ninth Circuit Court of Appeals reversed the district court’s decision and held that the ordinance enacted by the City of Newport discriminated against residential treatment facilities on the basis of disability, and that its enactment and enforcement harmed a protected class and was therefore in violation of federal law.
- Siting Difficulties. A report published by the U.S. Department of Health and Human Services (DHHS) entitled “Siting Drug and Alcohol Treatment Programs: Legal Challenges to the NIMBY Syndrome,” states that community opposition to alcohol and drug treatment programs also known as ‘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, and health-related facilities for those with AIDS. According to DHHS, many discriminatory zoning ordinances and practices may be unlawful under the FHA and the ADA. It is also noted that communities often fear the decline of property values and increased crime because of residential treatment facilities in the neighborhood. However, the DHHS document states that in almost every instance a community’s fears are unfounded, as residential treatment facilities pose no danger to the health and welfare of neighbors nor draw substance abusers or pushers to the area.
- Facility Accreditation. Two national organizations, the Joint Commission on Accreditation of Healthcare Organizations (JCAHO) and the Joint Commission on Accreditation of Rehabilitation Facilities (CARF), accredit facilities that provide behavioral health care services such as addiction treatment, opioid treatment and maintenance programs, crisis stabilization, case management and care coordination, employment services, and vocational rehabilitation. JCAHO and CARF each require facilities to demonstrate that their programs meet the accrediting organizations’ quality standards in order to obtain accreditation. These quality standards evaluate functions relating to client care and program management, including administrative requirements, financial management, personnel qualifications, client services, performance outcomes, client safety and information privacy, and security. JCAHO requires accredited organizations to reapply for accreditation every three years while CARF accreditation ranges from one to five years, depending on the type of facility.
The total number of adult recovery maintenance facilities, sober living homes, or similar entities in the state is not known. According to 2012 data that indicated the two private entities that register sober living homes had registered about 850 sober living homes in the state. However, these organizations indicated that they may be registering as few as one-third of the total number of sober living homes in the state.
- ADA, the Fair Housing Act (FHA), and the California Fair Housing and Equal Opportunity Act (FEHA). The FHA makes it illegal to engage in various discriminatory practices relating to the sale and rental of housing based on race, color, religion, sex, marital status, national origin, ancestry, familial status, or disability. FEHA also prohibits land use regulations, zoning ordinances, and restrictive covenants from discriminating in housing on the basis of the aforementioned categories. FEHA also states that groups of people with disabilities living together in a single dwelling unit are considered a family.
- SUPPORT. The County Behavioral Health Directors Association (CBHDA) states in support of this bill that there is a need for greater accountability for and oversight of recovery residences that provide a drug and alcohol free environment for individuals recovering from substance use disorders, in order to ensure that these clients are placed in a positive, healthy, and safe environment. CBHDA states that this bill will take a big step in the right direction by enabling DHCS to approve organizations that have a certification or registration process for recovery residences, and by requiring certified residences to meet specified standards. CBHDA states that recovery residences, also known as "sober living homes" support individuals recovering from substance use disorders in California by providing safe and healthy living environments. However, under-performing residences can negatively affect those clients by not enforcing a drug and alcohol free policy, or by neglecting to provide a support system conducive to recovery that leads to unfortunate consequences, including overdose deaths, which could have been avoided had clients been better informed of the residence's credibility.
The California Consortium of Addiction Programs and Professionals (CCAPP) state in support that recovery residences are an important element to California's continuum of care for addiction treatment and recovery. Recovery residences have been shown to improve outcomes, reduce recidivism, reunite families, and diminish homelessness. However, without quality sober living homes, in many cases, people vested in recovery from addiction would face uncertain futures and bleak prospects for continuing the road to productivity and abstinence. CCAPP states that this bill is necessary in order to allow quality recovery residences to continue their important missions; to allow local governments to identify quality homes by certification status; to register complaints and with confidence they will be addressed, and to teach owners, operators, and residents how to build relationships with neighbors in positive ways.
- OPPOSITION. Disability Rights California (DRC) states in opposition to the bill that it creates an intricate and coercive structure for the certification of "sober living residences" that, under state law and design, are intended to provide housing and supportive relationships for drug and alcohol addiction treatment. DRC argues that the bill violates both state and FHA, and the ADA, state and federal rights to privacy, eliminates housing opportunities for individuals seeking to live in supportive environments, and creates a massive and expansive state regulator scheme to oversee the process. DRC notes that the practical effect of this bill will be to eliminate housing opportunities for persons with disabilities in the midst of both a treatment and homelessness crisis in the state. DRC states that by requiring that state agencies, contracted vendors, county agencies and judge or parole boards to first refer a person to certified residence, residences that are not certified will be starved of referrals and disabled individuals who may choose to live in a non-certified residence will be forced out of housing and sober living relationships.
The Western Center on Law and Poverty (WCLP) states in opposition that the bill would discriminate against persons living with disabilities and limit badly needed housing opportunities. WCLP argues that the bill does nothing to expand the capacity of housing for persons with disabilities. It does not require local governments to make changes to land use policy, provide fiscal incentives or streamline approval processes and it will in fact reduce the availability of such housing by making any sober living facility a target for neighborhood harassment if they do not become certified. That is because certified homes will be found to be single family residence and those that do not will be under a legal cloud. They will be subject to legal challenges and harassment by local governments. While Fair Housing Law makes it clear that any group of individuals living in a single family residence cannot be discriminated against many providers will simply quit in frustration rather than pay to defend themselves against legal actions.
- RELATED LEGISLATION.
- AB 285 (Melendez) of 2017 was a substantially similar bill that was held in the Assembly Appropriations Committee.
- AB 572 (Quirk-Silva) requires DHCS to establish a pilot program to locate an investigator within a participating county to investigate complaints against licensed adult alcoholism or drug abuse recovery or treatment facilities within County of Orange if the Orange County Board of Supervisors elects to participate in the pilot program. AB 572 is pending in the Senate Health Committee.
- AB 1095 (Harper), introduced in 2017, defines drug abuse recovery or treatment "integral facilities" and exempt integral facilities that provide treatment and recovery services for seven or more persons from existing requirements that an alcoholism or drug abuse recovery or treatment facility that serves six or fewer persons to be considered a residential use of property, as specified. AB 1095 was never heard in the Assembly Health Committee.
- PREVIOUS LEGISLATION.
- AB 2255 (Waldron) of 2016 was a substantially similar bill that would have established state oversight of “drug and alcohol free residences” or sober living homes. AB 2255 was held in the Assembly Appropriations Committee.
- AB 2403 (Bloom) of 2016 would have established a new definition of "integral facility" for licensure purposes, and a prohibition on licensure approval for facilities whose siting would result in overconcentration, as defined. AB 2403 was held in the Assembly Appropriations Committee.
- SB 1283 (Bates) of 2016 would have allowed 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. SB 1283 failed passage in the Senate Health Committee.
- AB 2491 (Nestande) of 2014 would have exempted sober living homes from licensure as an adult alcoholism or drug abuse recovery or treatment facility and required sober living homes to meet specified requirements, including the active participation of residents in legitimate recovery programs and the maintenance of records of meeting attendance. AB 2491 was held under submission in the Senate Appropriations Committee.
- AB 1983 (Mansoor) of 2012 would have defined integral alcohol and drug abuse treatment facilities for purposes of licensure by the Department of Alcohol and Drug Programs (DADP) and excluded integral facilities from being considered a residential use of property. AB 1983 failed passage in the Assembly Health Committee.
- AB 1284 (Huffman) of 2009 would have required DADP to notify the appropriate city or county planning agency of a proposed facility's application for licensure as a residential treatment facility if it operates as an integral component of an existing licensed facility managed by the same licensee and is located within 300 feet of the existing facility. AB 1284 died on the Assembly Appropriations Committee Suspense File.
- SB 1000 (Harman) of 2008 would have required applicants seeking a treatment facility license from DADP to certify that the facility is consistent with local zoning ordinances and would have required DADP to verify the certification. SB 1000 failed passage in the Senate Health Committee.
- SUGGESTED AMENDMENTS.
- This bill currently requires a report to the legislature on or before January 1, 2025. Should this bill be enacted, that would delay a report on the status, implementation, and impact of its provisions unnecessarily for five years. The Committee recommends moving this date to January 1, 2021.
- This bill currently requires, in the event that an individual is referred by a local jurisdiction to a non-certified recovery residence, that the certifying organizations be notified of the referral to a non-certified recovery residence. The Committee recommends instead notifying DHCS of the referral to a non-certified recovery residence.
- This bill currently requires that, when a person is ordered to reside in a sober living environment for purposes of terms and conditions of release, parole, or discharge of a person from custody, a judge to first refer that person to a residence listed as a certified recovery residence. This Committee recommends clarifying that this bill does not prohibit referrals by local jurisdictions to non-certified recovery residences.
REGISTERED SUPPORT / OPPOSITION:
Support
California Behavioral Health Directors Association
California Consortium of Addicted Programs and Professionals
City of Murrieta
Community Recovery Resources
Soroptomist House of Hope, Inc.
Opposition
Disability Rights California
Western Center on Law and Poverty
Numerous individuals
Analysis Prepared by: Paula Villescaz / HEALTH / (916) 319-2097
Bill Co-Author(s):
