California governor signs some addiction treatment reform measures, rejects others – Orange County Register


Four bills aiming to clean up California’s notoriously under-regulated habit remedy business landed on the governor’s desk final month — a meatier batch than had ever made it via the Sacramento sausage grinder earlier than.

Suspense rose to a fever pitch over the weekend because the final sands slipped via the legislative hourglass — after which Gov. Gavin Newsom vetoed two of the payments and signed two others, triggering a mix of elation and disappointment in reformers.

The profitable new legal guidelines will put some enamel right into a ban on “physique brokering” — the unsavory apply of paying for sufferers — and restrict the flexibility of financially third events to purchase medical insurance insurance policies for sufferers.

One of many vetoed payments would have taken main steps to reform outpatient facilities —  the place the overwhelming majority of habit remedy occurs in California — by requiring them to be licensed and meet minimal requirements. The opposite would have prohibited rehabs and sober houses from false or deceptive promoting, like telling folks they’ll be “cured” in simply 30 days.

Batting 500 on the remedy reform entrance was Assemblywoman Cottie Petrie-Norris, D-Laguna Seashore, who authored the profitable Meeting Invoice 919 in addition to the vetoed AB 920.

“I’m more than happy that we’re taking significant steps ahead, and I’m disenchanted, however not despondent, concerning the veto,” she mentioned. “The governor famous in his veto message that he does help our intent — to license all substance use dysfunction remedy providers — and we’re attending to work proper now to deal with the considerations the administration raised.”

Newsom’s vetoes don’t quibble with the large concepts behind the payments, however somewhat with the devilish particulars.

“There’s a transparent pathway ahead on mine,” mentioned Sen. Pat Bates, R-Laguna Niguel, who wrote Senate Invoice 589, which focused false promoting. “We’re not giving up — we simply have to string the needle. There’s some good path on that.”

On the books

Newsom signed AB 290, by Assemblyman Jim Wooden, D-Santa Rosa, which reduces the monetary incentive for remedy suppliers to lure folks to California by promising “free” insurance coverage protection.

Primarily directed at kidney dialysis schemes, the proposal additionally reins in habit remedy facilities that lure sufferers from different states, signal them up for personal medical insurance insurance policies and pay these premiums. That allowed the facilities to invoice insurers what was typically a whole lot of 1000’s of {dollars}, whereas paying a fraction of that in premiums.

“Per our crucial to deal with rising well being care prices, I’m signing Meeting Invoice 290,” Newsom mentioned in a signing letter. “This invoice removes monetary incentives for suppliers to steer sufferers into particular well being care protection by offering that sure well being suppliers, together with dialysis clinics and substance use dysfunction remedy facilities, be reimbursed at Medicare charges for providers rendered to sufferers who obtain premium help.”

Actual charities will proceed to assist individuals who need assistance, Newsom wrote.

Petrie-Norris’s AB 919 guarantees to crack down on monetary conflicts-of-interest amongst rehab operators by limiting how they provide housing and transportation as inducements to remedy. It can require that laboratories that check blood or urine for medicine, or outpatient remedy applications that provide housing to shoppers, have separate housing contracts particularly stating that cost for housing is the affected person’s duty and lease shouldn’t be not directly billed to medical insurance. The apply has develop into widespread within the business.

It additionally empowers the Division of Well being Care Providers to offer enforcement with seven new positions, costing $1.2 million the primary yr and $1.1 million after that.

Paths ahead for vetoes

In his veto message on Bates’ SB 589, Newsom mentioned, “Whereas it is very important defend susceptible sufferers and their households from unethical advertising and marketing practices, I’m involved that as crafted, this measure creates a false promise.

“The Division of Well being Care Providers has no jurisdiction or licensing oversight over restoration residences or third events. As such, it can not take enforcement towards these entities for violations of commercial necessities.”

Restoration residences is one other time period for sober dwelling houses — simply teams of recovering customers who dwell collectively as households to help each other in sobriety. They aren’t licensed or regulated in any manner, and are thought of by many to be past the attain of presidency regulation due to protections afforded by the federal People with Disabilities Act. Dependancy is taken into account a incapacity below the regulation.

In that distinction, Bates sees the best way ahead.

“They’re particularly staying away from the sober dwelling houses,” she mentioned. “They’re principally retreating from touching that exact space as a result of they anticipate litigation. We have now, and proceed to have, litigation when something regarding overseeing the sober dwelling houses comes up.

“There’s a pathway on mine, dropping the particular reference to restoration houses,” she mentioned.

Assembly Bill 920, by Petrie-Norris and Sen. Jerry Hill, D-San Mateo, would have ushered within the greatest change — requiring outpatient facilities, which are actually fully unsupervised by the state, to be licensed and controlled by the Division of Well being Care Providers. It was named to honor Wendy McEntyre ‘s son Jarrod, who died of an overdose in a sober dwelling house within the San Fernando Valley in 2004.

Outpatient facilities would have been required to undertake the American Society of Dependancy Medication’s remedy standards because the minimal normal of care, steering the business towards a extra medical method, somewhat than the 12-step social mannequin that at the moment dominates and infrequently succeeds. The invoice was modeled after Hill’s SB 823, requiring the identical guidelines of live-in remedy facilities, which was signed into law by Gov. Jerry Brown last year.

In his veto message, Newsom mentioned that “creating a brand new licensing schema is a major endeavor, and would require a major departure from the invoice as enrolled.”

“We’re working to have one thing that’s complete and addresses all the main points required to implement this,” Petrie-Norris mentioned. “I really feel like we’ve been caught in a little bit of a Catch 22. As a result of this has been an space with no regulation and no oversight in any respect, it’s a yawning chasm. We’re not attempting to tweak one thing on the margins — we’re attempting to create one thing the place nothing exists.”

This yr’s crop of legislation was the most far-reaching to make it to the governor’s desk to date.The motion comes within the wake of the Southern California News Group’s ongoing probe of death, sexual assault, drug abuse and paying for patients inside California’s habit remedy business.


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