Existing law requires the State Department of Health Care Services to license and regulate facilities that provide 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. Existing law requires a licensed facility to disclose specified information to the department, including ownership or control of, or financial interest in, a recovery residence, defined as a residential dwelling that provides primary housing for individuals who seek a cooperative living arrangement that supports personal recovery from a substance use disorder and that does not require licensure by the department or does not provide licensable services, and requires the department to conduct a site visit of a disclosed recovery residence if it is alleged to be providing recovery, treatment, or detoxification services.

This bill would define a recovery residence, for purposes of licensing alcoholism or drug abuse recovery or treatment facilities, as a residential dwelling that provides primary housing for individuals who seek a cooperative living arrangement that supports personal recovery from a substance use disorder, does not require licensure by the department, and does not provide licensable services, and would clarify that an unlicensed recovery residence may provide services to its residents, including, but not limited to, dining, housekeeping, security, transportation, and recreation. The bill would exempt recovery residences from being required to be licensed as an alcoholism or drug abuse recovery or treatment facility if the facility does not offer recovery services, as defined, and would allow residents of a recovery residence to actively participate in recovery services outside of the home. The bill would require a recovery residence to be operated as a separate business from a licensed facility and require the recovery residence to maintain separate agreements with each resident for the housing and services it provides.

Existing law declares that it is the policy of the state that each county and city shall permit and encourage the development of sufficient numbers and types of alcoholism or drug abuse recovery or treatment facilities as are commensurate with local need. Existing law requires an alcoholism or drug abuse recovery or treatment facility that serves 6 or fewer persons to be considered a residential use of property for the purposes of local regulation, regardless of whether or not unrelated persons are living together.

This bill would additionally consider recovery residences that serve 6 or fewer people to be considered a residential use of property for the purposes of local regulation. The bill would authorize local jurisdictions to require a use permit or conditional use permit for an alcoholism or drug abuse recovery or treatment facility or a recovery residence that serves 7 or more residents, and allow local jurisdictions to require those facilities to be at least 1,000 feet from another state-licensed alcoholism or drug abuse recovery or treatment facility or recovery residence as part of the use permit.

SENATE COMMITTEE ON HEALTH

Senator Richard Roth, Chair

BILL NO: SB 1334

SUBJECT: Substance use disorder treatment: licensing

SUMMARY:

Prohibits a recovery residence (RR) from being required to be licensed if it does not offer recovery services, as specified. Adds RRs that serve six or fewer residents to provisions of existing law related to licensed facilities, such as being deemed a residential use of property and a family residence for purposes of any law or zoning ordinance, except as specified. Permits local jurisdictions to require RTFs and RRs to be at least 1,000 feet from another licensed RTF or RR.

Existing federal law: Prohibits, pursuant to the federal Fair Housing Act (FHA), housing discrimination based on race, color, religion, sex, handicap, familial status, and national origin. Defines “handicap” (disability) as a physical or mental impairment that substantially limits one or more major life activities, including having a drug addiction (other than addiction caused by current illegal use of a controlled substance) and alcoholism. [42 USC §3601, et seq.]

Existing state law:

1. Requires the Department of Health Care Services (DHCS) to license and regulate residential alcoholism or drug abuse (or substance use disorder [SUD]) recovery or treatment facilities (RTFs). [HSC §11834.02, et seq.]
2. Requires RTFs to provide at least one of the following nonmedical services: recovery, treatment, or detoxification services. Requires DHCS to adopt regulations requiring records and procedures that are appropriate for each of the services that may include all of the following:
3. Admission criteria;
4. Intake process;
5. Assessments;
6. Recovery, treatment, or detoxification planning;
7. Referral;
8. Documentation of provision of recovery, treatment, or detoxification services;
9. Discharge and continuing care planning; and,
10. Indicators of recovery, treatment, or detoxification outcomes. [HSC §11834.26]
11. Prohibits a person, firm, partnership, association, corporation, or local governmental entity from operating, establishing, managing, conducting, or maintaining a RTF to provide recovery, treatment, or detoxification services within this state without first obtaining a current valid license from DHCS. [HSC §11834.30]
12. Requires a RTF, whether or not unrelated persons are living together, that serves six or fewer persons to be considered a residential use of property. Requires the residents and operators of the RTF to be considered a family for the purposes of any law or zoning ordinance that relates to the residential use of property. [HSC §11834.23]
13. Prohibits 4) above from being construed to forbid a city, county, or other local public entity from placing restrictions on building heights, setback, lot dimensions, or placement of signs of an alcoholism or drug abuse recovery or treatment facility that serves six or fewer persons as long as the restrictions are identical to those applied to other single-family residences. Prohibits 4) above from being construed to forbid the application to RTF of 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. Prohibits the ordinance from distinguishing a RTF that serve six or fewer persons from other single-family dwellings or distinguishing residents of RTFs from persons who reside in other single-family dwellings. [HSC §11834.23]
14. Defines “recovery residence (RR)” as a residential dwelling that provides primary housing for individuals who seek a cooperative living arrangement that supports personal recovery from a SUD and that does not require licensure by DHCS or does not provide licensable services, as specified. Defines “RRs” as including, but not limited to, residential dwellings commonly referred to as “sober living homes (SLHs),” “sober living environments,” or “unlicensed alcohol and drug free residences.” [HSC §111833.05]
15. Requires the California Department of Social Services (CDSS) to license community care facilities (CCFs), including any facility, place, or building that is maintained and operated to provide nonmedical residential care, day treatment, adult day care, or foster family agency services for children, adults, or children and adults, including, but not limited to, the physically handicapped, mentally impaired, incompetent persons, and abused or neglected children, and may include crisis residential services. [HSC §1501, et seq.]
16. Declares it to be the policy of the state to prevent overconcentration of CCFs that impair the integrity of residential neighborhoods. Requires CDSS to deny an application for a new residential facility license if it determines that the location is in a proximity to an existing residential facility that would result in “overconcentration,” defined as separated by a distance of 300 feet or less, as measured from any point upon the outside walls of the structures housing those facilities. [HSC §1250.5]
17. Prohibits CDSS from applying the overconcentration rule to foster family homes, residential care facilities for the elderly, transitional shelter care facilities, and temporary shelter care facilities. [HSC §1250.5(f) and (g)]
18. Deems it unlawful, pursuant to the Fair Housing and Employment Act (FEHA), to discriminate through public or private land use practices, decisions, and authorizations because of race, color, religion, sex, gender, gender identity, gender expression, sexual orientation, familial status, marital status, disability, genetic information, national origin, source of income, veteran or military status, or ancestry. Specifies that discrimination includes, but is not limited to, restrictive covenants, zoning laws, denials of use permits, and other actions authorized under the Planning and Zoning Law, as specified, that make housing opportunities unavailable. [GOV §12955(l)]
19. Prohibits law from being construed to afford to protected classes, as specified, fewer rights or remedies than the FHA and its implementing regulations, or FEHA, as specified. Requires any state law that purports to require or permit any action that would be an unlawful practice to that extent be invalid. [GOV §12955.6]

This bill:

1. Prohibits a RR from being required to be licensed as a RTF if the RR does not offer “recovery services.” Defines “recovery services” as a service that is designed to promote treatment and maintain recovery from alcohol or drug problems, including detoxification, group sessions, individual sessions, educational sessions, and alcoholism or drug abuse recovery or treatment planning.
2. Permits a RR to provide services to its residents that are not recovery services, including, but not limited to, dining, housekeeping, security, transportation, and recreation.
3. Permits residents of a recovery residence to actively participate in recovery services outside of the home.
4. Requires a RR to be operated as a separate business from a licensed RTF, and to maintain separate agreements with each resident for the housing and services it provides.
5. Adds RRs to the provisions as outlined in 4) and 5) above of existing law, regarding such things as residential use of property, zoning laws, and local ordinances.
6. Permits local jurisdictions to require a use permit or conditional use permit for licensed RTFs or RRs that serve seven or more residents. Permits local jurisdictions, as part of the conditional use permit or use permit, to require that licensed RTFs and RRs be at least 1,000 feet from another licensed RTF or RR.

FISCAL EFFECT:

This bill has not been analyzed by a fiscal committee.

COMMENTS:

1. Author’s statement. According to the author, due to the current lack of use permits, the overconcentration of RTFs and RRs in residential neighborhoods has led to de facto institutionalized settings in some neighborhoods, counter to the prevailing emphasis on integrating disabled populations into existing and developing neighborhoods. Under the provisions of this bill, a RR would be explicitly defined as primary housing for individuals seeking cooperative living arrangements that support personal recovery from SUDs. This bill would also authorize local jurisdictions to require a use permit or conditional use permit for any RR that serves seven or more residents. By statutorily defining RRs and by allowing local governments to issue use permits, this bill represents an essential step forward as part of California’s overall commitment to protecting vulnerable populations from exploitation and harm within the addiction treatment industry.
2. Licensed and certified programs. RTFs licensed by DHCS, based on what is commonly referred to as the “social model,” provide recovery, treatment, or detoxification services. (The Department of Public Health licenses medical model RTFs, known as chemical dependency recovery hospitals.) The services provided by social model RTFs include group and individual counseling, educational sessions, and alcoholism or drug abuse recovery and treatment planning. Social model RTFs are allowed to provide clients first aid and emergency care, and since the passage of AB 848 (Stone, Chapter 744, Statutes of 2015) RTFs can apply to DHCS for an additional license to provide incidental medical services by a licensed physician or other health care practitioner. SB 823 (Hill, Chapter 781, Statutes of 2018) requires DHCS to adopt American Society of Addiction Medicine treatment criteria as the minimum standard of care for licensed RTFs. DHCS also is responsible for certification of a business entity with a physical location in the state that provides one or more of the following services to clients: treatment, recovery, or detoxification services, or medications for addiction treatment. DHCS also provides program certification for facilities that are licensed by CDSS that serve adolescents. As part of their licensing and certification functions, DHCS conducts reviews of licensed and certified programs every two years, or as necessary; checks for compliance with statute, regulations, and certification standards to ensure the health and safety of clients; investigates all complaints; and, has the authority to suspend or revoke a program’s license or certification for a violation of statute, regulations, and certification standards.
3. RRs/SLHs. A 2010 report on the National Institutes of Health (NIH) website, “Sober Living Houses for Alcohol and Drug Dependence: 18-month Outcomes,” states that SLHs are not formal treatment programs and are not obligated to comply with state or local regulations applicable to treatment. However, NIH does not provide a formal definition of an SLH. The report also mentions that it is difficult to determine how many SLHs there are in California because they are outside of the purview of state licensing authorities. The NIH report cites the protection that the federal FHA affords SLHs to be located in residentially zoned areas, personal privacy under the Fourth Amendment, and the right of people with disabilities to live together for a shared purpose, such as mutually assisted recovery and maintenance of an abstinent lifestyle.

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

DHCS’s Drug Medi-Cal Organized Delivery System waiver allows counties to use RR/SLHs in their continuum of services if they adhere to the following guidelines: do not provide SUD services that would require licensure by DHCS; all residents of an RR are actively engaged in medically necessary recovery support services to be provided off-site; and, each county develops guidelines for contracted RR providers and provide monitoring and oversight.

1. Housing for the disabled. A joint statement issued in November 2016 by the federal Department of Justice (DOJ) and Department of Housing and Urban Development (HUD), which together are responsible for enforcing the FHA, declared that the term “group home” does not have a specific legal meaning, though land use and zoning officials and the courts have referred to some residences for persons with disabilities as group homes, including homes occupied by persons in recovery from alcohol or substance abuse that are commonly called SLHs. DOJ and HUD contend that persons with disabilities have the same FHA protections whether or not their housing is considered a group home, and that a household where two or more persons with disabilities choose to live together, as a matter of association, may not be subject to requirements or conditions that are not imposed on households consisting of persons without disabilities. DOJ and HUD further state that the provision of services (medical, supervisory, supportive, etc.) is not required for a group home to be protected under the FHA. Group homes can also be opened by individuals or organizations, both for-profit (“commercially operated”) and not-for-profit, and still be protected by the FHA. Further, the FHA does not require a person who resides in an SLH to have participated in or be currently participating in a substance abuse treatment program to be considered a person with a disability. The fact that a resident of a SLH may currently be illegally using a controlled substance does not deprive the other residents of the SLH of the protection of the FHA. The DOJ and HUD statement contends that localities and states must ensure that actions to enforce criminal and other laws against SLHs are not taken to target SLHs and are applied equally, regardless of whether the residents of housing are persons with disabilities.
2. Group Home Technical Advisory (GHTA). The California Department of Housing and Community Development (CHCD) Division of Housing Policy Development issued the GHTA in December 2022 and states that group homes are an especially important type of housing for persons with disabilities. By supporting their residents’ individualized needs while providing flexible and affordable housing options, group homes help persons with disabilities live in deinstitutionalized settings that facilitate their integration into local communities. CHCD further states in recent years, some local governments have amended their zoning ordinances to add new regulations for group homes, particularly for SLH/RRs. These amendments have raised concerns that local governments are not complying with their affirmative obligations under state planning and zoning laws to promote more inclusive communities and affirmatively further fair housing (AFFH). These amendments have also generated disputes and confusion over whether local governments are violating fair housing laws by discriminating against persons with disabilities or other protected characteristics. Among other concerns, local land use policies and practices can block new group homes from opening, force existing ones to close, and impose costs, legal fees, and administrative burdens that make it difficult for group homes to operate. These concerns arise in the context of a shortage of adequate housing for persons with disabilities, which is a particularly acute problem within California’s broader housing crisis. CHCD states that with concerns, disputes, and confusion continuing to grow, the GHTA provides guidance on how state planning, zoning, and fair housing laws apply when local governments attempt to regulate group homes through land use policies and practices. It is designed to help local governments comply with their obligations under these state laws, including, for example, the Planning and Zoning Law; Housing Element Law; AFFH provisions; Anti-Discrimination in Land Use Law; and the Fair Employment and Housing Act, collectively “state housing laws.” Taken from the GHTA, local governments can comply with state housing laws regarding group homes, including the following:
3. Discriminatory Purpose or Effect. Ensure that the policy or practice does not discriminate on the basis of disability or other characteristics protected by state law. Apply the GHTA’s analysis on how to determine if a policy or practice has a discriminatory purpose or effect and how to implement flexible reasonable accommodation procedures that promptly and efficiently resolve accommodation requests in compliance with state housing laws and regulations. (pp. 12-20);
4. Supportive and Transitional Housing. Comply with the specific protections for group homes that fall within the definitions of supportive or transitional housing (pp. 20-22);
5. State and Federal Law Distinctions. Confirm that a policy or practice complies with state housing laws even if it complies with federal law, because California law provides broader and different protections than federal law (pp. 22-23);
6. Definition of Single-Family Residence. Avoid restrictive definitions of single housekeeping units or single-family homes that impermissibly constrain group homes from locating in single-family zones. This includes, for example, avoiding definitions that equate group homes with boardinghouses, require all residents to share a common deed or lease, overly scrutinize residents’ living arrangements, or automatically exclude group homes that are owned by for-profit businesses or pay staff to help manage a home’s operations (pp. 24-25);
7. Group Homes that Do Not Provide Licensable Services. Allow group homes that operate as single-family residences and that do not provide licensable services to locate in single-family neighborhoods, subject only to the generally applicable, nondiscriminatory health, safety, and zoning laws that apply to all single-family residences (pp. 25-26) (emphasis added); and,
8. Other Requirements for Group Home Operators and Residents. Avoid the other examples of special requirements for operators and residents discussed that can overly constrain group homes, conflict with the duty to affirmatively support this housing, and discriminate on the basis of disability and other protected characteristics. Examples discussed include, among other things, parking requirements, restrictions on residents or staff, neighborhood notice requirements, and local law enforcement registration requirements (pp. 30-33).
9. Spacing requirements. CHCD’s advisory also states that spacing requirements restrict group homes from locating within a specific distance of other group homes, and that local governments should be very wary about imposing spacing requirements that extend beyond the limited requirements the Legislature has deemed necessary to prevent the overconcentration of certain licensed facilities to ensure their residents are integrated into their communities. The Legislature has found spacing requirements justified only for specific types of licensed facilities. CCFs, intermediate care facilities serving persons with developmental disabilities who require intermittent but recurring skilled nursing care, and pediatric day health and respite care facilities that provide services to children with particularly acute or chronic health care needs and their parents or guardians must be separated by at least 300 feet. Congregate living health facilities serving persons with terminal or life-threatening illnesses or with catastrophic or severe disabilities acquired through trauma or nondegenerative neurologic illness must be separated by at least 1,000 feet. Further limiting these spacing requirements, the Legislature has specified that they:
10. Apply to some types of licensed facilities, but not to others. For example, the spacing requirements apply only to some types of intermediate care facilities but not to SUD facilities or to residential care facilities for the elderly;
11. Apply to proposed, new facilities, not existing ones;
12. Only require separation of facilities with similar licenses; and,
13. Allow closer spacing based on local needs and conditions.

CHCD’s advisory states that contrary to these carefully crafted limitations on spacing requirements, some local governments have imposed spacing requirements on RRs, including those already in operation. These spacing requirements are very unlikely to withstand scrutiny under state housing laws. Among other things (emphasis added by CHCD):

1. They are at odds with the Legislature’s narrowly crafted spacing requirements in other sections of law;
2. They can conflict with local governments’ obligations to, for example, remove constraints on housing for persons with disabilities, affirmatively support such housing, avoid policies that displace persons with protected characteristics, and affirmatively support their right to live where they choose;
3. They are very hard to justify based on the narrow exceptions that state fair housing laws allow for facial discrimination. Justifications based on the goal of avoiding overconcentration are difficult to establish and require substantial and detailed statistical evidence establishing that an overconcentration of RRs has reached the point where it is, for example, creating an institutionalized living environment or perpetuating segregation within specific neighborhoods or communities. Merely comparing the number of RRs in one city with the number in others generally will not suffice.
4. They can lack the flexibility required to reasonably accommodate RRs and their occupants’ disability-related needs.
5. The Legislature has repeatedly rejected attempts to impose spacing requirements on RRs. As recently as 2018, for instance, the Legislature declined to adopt SB 786 (Mendoza), a bill that would have imposed a 300-foot spacing requirement on RRs. The legislative history shows that the Legislature considered the lack of clear data showing that this spacing requirement would benefit persons recovering from alcohol and drug addiction. The Legislature also considered concerns that this spacing requirement would discriminate on the basis of disability, impede opening new recovery residences, reduce access to much needed recovery and treatment services, and stigmatize RRs and their occupants.

The DOJ and HUD joint statement, likewise, discusses instances in which local governments may require spacing requirements of all group homes as long as they are applied equally and the local governments do not enact such requirements based on discriminatory intent and can prove such. However, some courts have found that spacing requirements violate the FHA because they deny persons with disabilities an equal opportunity to choose where they live. Because an across-the-board spacing requirement may discriminate against persons with disabilities in some areas, DOJ/HUD recommend any standards that state or local governments adopt should evaluate the location of group homes for persons with disabilities on a case-by-case basis.

1. Discriminating against the disabled? Some alcohol and drug treatment and recovery experts argue most RTFs and SLHs would rather give in to discrimination and shutter their doors than spend years battling it out in courts, which can be very costly. A July 15, 2015 article in the Orange County Register, “Newport Beach settles legal battle over sober-living homes,” states that Newport Beach ended its seven-year battle over SLHs by reaching an agreement with three entities that operate SLHs. The article quotes the attorney representing the SLHs as saying that because a trial could have taken several years, his clients were more interested in ending the proceedings rather than battling in court. Also noted in the article is the fact that in 2007, before Newport Beach implemented its ordinance, there were an estimated 86 facilities (both RTFs and SLHs) in the city. (As of February 2016, that number was down to 25: 15 RTFs licensed by DHCS and 10 SLHs.) The article further notes that the 9^th Circuit Court of Appeals sided with the SLHs because there was enough evidence to argue discrimination. In another case, Horizon House Developmental Services, Inc. v. Township of Upper Southampton, township officials first enacted and then revised an ordinance governing group homes for the disabled four times, starting the distance requirement at 3,000 feet between group homes and then revising it to 2,500 feet, and then 1,000 feet, to address what the township thought was clustering/overconcentration of facilities. Horizon House complied with the ordinance but then later sued based on discrimination against the disabled. The court ruled in favor of Horizon House because the ordinance discriminated against the disabled and restricted their housing choices and capped the number of people who could live in the township based on disability. The court also found that the opposition to clustering/overconcentration was based largely on the community’s fears of disabled individuals living in its neighborhoods.

1. DSS-licensed facilities. Over the years, proponents of spacing requirements have argued that adding one to RTFs would provide consistency with most other state-licensed group homes. Under current law, DSS-licensed CCFs include the same provisions as RTF licensing law that prohibit facilities serving six or fewer residents from being included within the definition of any term that implies the facility is a business run for profit or differs in any other way from a single-family residence. In previous conversations with Committee staff on similar bills, CDSS stated the overconcentration rule in their current law is not applied to facilities that serve six or fewer persons, as they are considered to be like any other single-family dwelling, and state law prohibits any restrictions from being applied to them if the same restrictions are not applied to other single-family residences in the same area.
2. Legislative Counsel Bureau (LBC) letters. While the state’s LCB has not issued a formal opinion on the provisions contained in this bill, authors of other bills that have been substantially similar to this one have received cover letters from LCB stating that the FHA generally prohibits housing discrimination on the basis of various characteristics, including handicap or familial status, and that those with SUDs fall within the scope of the FHA. The letters have further stated that provisions in the bills may violate the FHA if they are enacted with discriminatory intent and do not benefit the protected class or respond to legitimate safety concerns raised by the individuals affected.
3. Related legislation. SB 913 (Umberg) permits a city attorney of a city in which housing units are located or a district attorney, if the units are located in the unincorporated area of the county, to enforce parts of DHCS licensing laws, as specified. Requires DHCS to adopt a process that permits a city or county to conduct announced and/or unannounced site visits to DHCS-licensed facilities and to SLH/RRs that do not require DHCS licensure. SB 913 is set for hearing on April 23, 2024 in the Senate Judiciary Committee.

SB 1017 (Eggman) requires DHCS, in consultation with the California Department of Public Health and CDSS, to develop a solution to collect, aggregate, and display information about beds in specified facilities to identify the availability of inpatient and residential mental health or substance use disorder treatment. SB 1017 is pending in the Senate Appropriations Committee.

1. Prior legislation. AB 1696 (Sanchez of 2023) would have required any government entity that enters into, renews, or amends a contract, beginning January 1, 2024, with a privately owned RR to require the contracting RR to submit specified information. AB 1696 was vetoed by Governor Newsom who stated that privately owned RRs are not subject to state licensure or certification, and AB 1696 would conflate requirements in existing law for licensed and certified programs providing SUD recovery services with new requirements for privately owned RRs, which DHCS does not oversee or enforce. This may create confusion among people seeking recovery services from licensed or certified programs or treatment facilities.

SB 786 (Mendoza of 2018) would have required DHCS to deny an application for a new RTF if the proposed location of the RTF is in proximity to an existing facility in an area zoned residential that would result in “overconcentration,” defined as, if a new RTF license is issued, two or more RTFs would be separated by a distance of 300 feet or less, as specified. SB 786 was not heard in this Committee.

SB 34 (Bates of 2017) would have required DHCS to report to the Legislature regarding the effect of the concentration of RTFs in a community, as specified. SB 34 was held on the Senate Appropriations suspense file.

AB 2403 (Bloom of 2016) and AB 1284 (Huffman of 2009) contained similar provisions as SB 786 and also would have established a definition for integral facilities and permitted integral facilities to be subject to local regulations and ordinances, as specified. AB 2403 was held under submission in the Assembly Appropriations Committee. AB 1284 was held under submission in the Assembly Appropriations Committee.

SB 268 (Harman of 2009) and SB 1000 (Harman of 2008) would have required applicants seeking a RTF license from the Department of Alcohol and Drug Programs (ADP, now DHCS) to certify that the RTF is consistent with local zoning ordinances and would have required ADP to verify the certification. SB 268 failed passage in the Assembly Health Committee and was subsequently amended to a different topic. SB 1000 failed passage in the Senate Health Committee.

AB 2903 (Huffman of 2008) would have authorized ADP to require any person or entity applying for licensure for an RTF to provide specified information to ADP before a license is issued. AB 2903 was not heard in this Committee.

1. Support. The sponsor of this bill Orange County Board of Supervisors (OCBOS), states that current law allows cities and counties to require residential care facilities, CCFs, RTFs, and congregate living health facilities serving seven or more residents to obtain a use permit. In some instances, recovery residences skirt that law by self-asserting that licensable services are not being provided. OCBOS argues unless local jurisdictions can require minimal zoning regulation in the form of a use permit, there is no way to verify compliance. Under this bill, a RR would be clearly defined, and local jurisdictions would be authorized to require a use permit or conditional use permit for any RR that services seven or more residents. The bill also allows local jurisdictions to require RRs to be located at least 1,000 feet from another DHCS-licensed RTF or a RR. OCBOS states this bill will clarify definitions around RRs used for alcohol or drug abuse recovery, ensuring a safe living environment conducive to recovery. The Association of California Cities – Orange County states that as the implementation of Proposition 1 (2024) gets underway, they support clarity and maximum flexibility for local agencies to implement programs covered under this measure, particularly related to homelessness, behavioral health, and RR/SLHs. Unscrupulous operators of RR/SLHs create public health and safety risks in our local communities.
2. Opposition. The Steinberg Institute (SI) states that this bill risks imposing significant restrictions on the availability and accessibility of recovery services, restrictions that have little to do with the needs of individuals in recovery. RRs play a critical role in the continuum of care by providing safe, supportive living environments crucial for sustained recovery. The requirement for use permits, particularly with a threshold of seven residents, appears arbitrary and would create administrative barriers when the state desperately needs more treatment options. This bill also allows local jurisdictions significant leeway in regulating these residences, including stipulating that such facilities be located at least 1,000 feet from any other state-licensed recovery facility. SI argues these restrictions may push RRs away from other supportive community resources, counteracting efforts to integrate recovering individuals into the broader community. It may also exacerbate stigma and misunderstanding of SUD treatment. Moreover, the focus on use permits and spatial requirements does not directly address the quality of care or the operational standards of RRs. Effective regulation should prioritize residents’ health, safety, and rights, ensuring that RRs are well-integrated into communities and adhere to high standards of care and support. The emphasis should be on enhancing oversight of the services provided within these residences rather than imposing potentially restrictive zoning and permitting requirements that could potentially reduce the number of legitimate facilities and resources in any given community.
3. Oppose unless amended. The California Consortium of Addiction Programs and Professionals (CCAPP) argues that the sponsors of this bill claim that it intends to protect people living in RR/SLHs, but the provisions of the bill aim to close down RRs by requiring them to obtain permits in order to operate. This is not only bad policy, but it is unconstitutional, discriminatory, and violates federal Americans with Disabilities Act and FEHA provisions. According to the CHCD, RRs are to enjoy the same rights and freedoms that any other household is entitled to. CCAPP further argues that spacing requirements are very unlikely to withstand scrutiny under state housing laws because, among other things, they are very hard to justify based on the narrow exceptions that state fair housing laws allow for facial discrimination. Justifications based on the goal of avoiding overconcentration are difficult to establish and require substantial and detailed statistical evidence establishing that an overconcentration of RRs has reached the point where it is, for example, creating an institutionalized living environment or perpetuating segregation within specific neighborhoods or communities. CCAPP states that because the bill proposes to both require permits from a protected class of citizens where there is no licensable activity occurring and proposes to set limits to restrict where this group of people may live, it would be deemed discriminatory without question. Santa Barabara v. Adamson established the right under the Constitution of California for any group of unrelated groups of people to live as a family, thus enshrining the right of people in recovery to live together as a unit. CCAPP argues that CHCD produced its technical assistance to fully reference statutory and constitutional sections, both at the state and federal levels, that prohibit requiring permits (or any other requirement not applied to other households) for people who choose to live with one another in recovery. This bill proposes that the state ignore its own guidance on the illegality of the policy mandated by the bill. CCAPP suggests amendments that delete SEC. 3 of this bill and more aptly define recovery services.
4. Policy concerns.
5. As noted by CHCD, the Legislature generally has approved spacing requirements for specific CCFs that appear to treat very physically ill individuals who may also be non-ambulatory, given the nature of those facilities being more clinical. However, statute explicitly prohibits the overconcentration spacing rule from being applied to certain entities that seem more in line with DHCS-licensed RTFs, which are nonmedical, social model facilities that would not be appropriate to treat very physically ill, non-ambulatory individuals. Further, absent any data that closely located facilities are creating a health and safety concern for the protected-class residents, implementing such rules for these facilities that are not going to be applied equally to other single-family dwellings in the same area could potentially have a discriminatory effect, according to CHCD, DOJ, and HUD. The Committee may wish to consider whether authorizing locals to implement a rule when CHCD is actively working to get local governments to comply with state housing laws would only exacerbate the difficulty in providing housing options to this protected class when such options continue to be scarce.
6. While both RTFs and RRs are protected by fair housing laws, only RTFs are required to be licensed by DHCS because they provide at least one of the licensable services. RRs do not provide services, so they are not required to be licensed and, therefore, do not require oversight by any entity. Various bills that have been considered by this Committee tend to conflate the two types of facilities. Adding RRs to DHCS’s licensing law and requiring them to adhere to it, such as zoning requirements and local ordinances, not only is contrary to its FHA and state housing law protections, which CHCD has been actively notifying local governments about, but it also carries the potential of giving consumers false hope that DHCS would regulate RRs when they have no authority. The Committee may wish to consider whether adding RRs to DHCS licensing law sends consumers the right message.
7. Adding a definition to DHCS’s licensing statute for the services RRs provide carries the potential for limiting what they could provide if any given service is not delineated in statute. Any desire to further add non-treatment services may require legislative action. The Committee may wish to consider whether potentially constraining RRs in this way is consistent with the protections they are afforded.

In order to address the policy concerns outlined above, the author may wish to consider the following amendments:

1. Delete SEC. 3 of this bill, which adds a spacing requirement and adds RRs to DHCS’s licensing laws for RTFs;
2. Move SEC. 1 and 2 of this bill to the existing licensing law; and,
3. Delete the definition of “recovery services” and instead reference licensing statute in the provision prohibiting RRs from providing those services.

SUPPORT AND OPPOSITION:

Support: County of Orange, Board of Supervisors (sponsor)

Association of California Cities – Orange County

Oppose: California Consortium of Addiction Programs and Professionals (unless amended)

Steinberg Institute

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