Bill Text: CA SB1339 | 2023-2024 | Regular Session | Amended
Bill Title: Step-down care.
Spectrum: Partisan Bill (Democrat 1-0)
Status: (Engrossed) 2024-06-26 - June 26 hearing postponed by committee. [SB1339 Detail]
Download: California-2023-SB1339-Amended.html
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Amended
IN
Assembly
June 17, 2024 |
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Amended
IN
Senate
May 16, 2024 |
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Amended
IN
Senate
April 29, 2024 |
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Amended
IN
Senate
April 15, 2024 |
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Amended
IN
Senate
March 20, 2024 |
CALIFORNIA LEGISLATURE—
2023–2024 REGULAR SESSION
Senate Bill
No. 1339
| Introduced by Senator Allen |
February 16, 2024 |
An act to add Section 1374.198 to, and to add Chapter 7.6 (commencing with Section 11834.75) and Chapter 7.8 (commencing with Section 11834.90) to Part 2 of Division 10.5 of of, the Health and Safety Code, and to add Section 10144.58 to the Insurance Code, relating to supportive community residences.
health and care facilities.
LEGISLATIVE COUNSEL'S DIGEST
SB 1339, as amended, Allen.
Supportive community residences. Step-down care.
Existing law generally requires the State Department of Public Health to license, inspect, and regulate health facilities, defined to include, among other types of health facilities, an acute psychiatric hospital. Existing law requires the State Department of Health Care Services to license and establish regulations for psychiatric residential treatment facilities.
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 also requires the department to implement a voluntary certification program for alcohol and other drug treatment recovery
services.
Existing law, the California Community Care Facilities Act, generally provides for the licensing and regulation of community care facilities by the State Department of Social Services, to provide 24-hour nonmedical care of persons in need of personal services, supervision, or assistance. Existing regulation includes an adult residential facility as a community care facility for those purposes.
This bill would require the State Department of Health Care Services (department), by January 1, 2027, and in consultation with relevant public agencies and stakeholders, to establish, and provide for the administration of, a voluntary certification program for supportive community residences. The bill would define a “supportive community residence” as specified residential dwellings providing housing for adults with a substance use disorder, mental health diagnosis, or dual diagnosis seeking a cooperative living arrangement that does not provide medical care or a level of support for activities of daily living that require state licensing.
as a transitional or long-term residence during the process of recovery. The bill would require the certification program to include standards and procedures for operation, such as types of certifications needed and services navigation, and procedures and penalties for enforcing laws and regulations governing supportive community residences. The bill also would require the department to create and maintain a searchable online database of certified facilities, which would include specified contact and complaint information for those residences. residences, and would require the database to be updated on a monthly basis.
The bill would require the department to adopt or amend regulations to require referring entities to provide information relating to the license or certification status of community care facilities and supportive community residences to individuals with a substance use disorder, mental health diagnosis, or dual diagnosis, and to report any suspected fraudulent license or
certification identified during verification to the department. The bill would define “referring entity” to include a state or local entity, or a state-regulated entity that provides adults with substance use disorders or mental health diagnoses with referrals to, or that authorizes health care coverage for, services provided by supportive community residences or licensed community care residential facilities. The bill also would require the regulations to include enforcement methods for willful and repeated violations of those requirements by referring entities.
The bill would prohibit a supportive community residence from providing any licensed services onsite, including, but not limited to, incidental medical services. The bill would authorize the department to charge a fee for certification of supportive community residences in an amount not to exceed the reasonable cost of administering the program, not to exceed $2,000, and would establish
the Supportive Community Residence Program Fund for collection of the fee. Under the bill, a certification would be valid for a period of 2 years and the bill would authorize the department to charge a recertification fee not to exceed $500.
The bill would require a referring entity, as defined, to provide information relating to the license or certification status of a step-down care facility when informing an individual with a substance use disorder, mental health diagnosis, or dual diagnosis of options for step-down care covered by the individual’s health insurance. The bill would require a referring entity to verify the license or certification of a step-down care facility if a particular step-down care facility is not covered by an individual’s insurance. The bill would define a “step-down care facility” to include a supportive community residence, a community care facility, or
other residential treatment or detox facility. The bill would require a referring entity to report any suspected fraudulent license or certification to the appropriate state agency.
By placing new requirements on local agencies acting as referring entities, the bill would impose 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, the Knox-Keene Health Care Service Plan Act of 1975, provides for the licensure and regulation of health care service plans by the Department of Managed Health Care, and makes a willful violation of the act a crime. Existing law also provides for the regulation of disability insurers by the Department of Insurance. Existing law requires a health care service plan contract or disability insurance policy issued, amended, or renewed on or after January 1, 2023, that provides coverage for medically necessary treatment of mental health and substance use disorders that credentials health care providers of those services for the health care service plan’s or disability insurer’s networks to assess and verify the qualifications of a health care provider, as specified.
For facility contracts issued, amended, or renewed on and after January 1, 2025, this bill would require a health care service plan or disability insurer that provides coverage for mental health and substance use disorders and credentials step-down care facilities for the health care service plan’s or disability insurer’s networks, to assess and verify the qualifications of a step-down care facility within 60 days after receiving a completed provider credentialing application. Because a violation of the bill’s requirements by a health care service plan would be a crime, the bill would impose 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 with regard
to certain mandates no reimbursement is required by this act for a specified reason.
With regard to any other mandates, this bill would provide that, if the Commission on State Mandates determines that the bill contains costs so mandated by the state, reimbursement for those costs shall be made pursuant to the statutory provisions noted above.
Digest Key
Vote: MAJORITY Appropriation: NO Fiscal Committee: YES Local Program: YESBill Text
The people of the State of California do enact as follows:
SECTION 1.
The Legislature finds and declares all of the following:(a) The prevalence of substance use disorders and mental health diagnoses have been increasing, exacerbated by the COVID-19 pandemic.
(b) There is a shortage of beds within facilities providing inpatient or residential mental health and substance use disorder treatment.
(c) Residential homes serving people with substance use disorders or mental health diagnoses at a level below that which requires licensing lack state standards and oversight.
(d) Many consumers with substance use disorders or mental health diagnoses have disabling conditions. These consumers and their families are vulnerable, and at risk of not receiving the care they need and deserve and being victims of fraud.
(e) Empowering people to have autonomy over their mental health care instills personal dignity, value, and respect, and results in better health outcomes.
(f) There is a need to improve access to quality community-based and noninstitutional settings for people with substance use disorders or mental health diagnoses.
SEC. 2.
Section 1374.198 is added to the Health and Safety Code, to read:1374.198.
(a) For facility contracts issued, amended, or renewed on and after January 1, 2025, a health care service plan that provides coverage for mental health and substance use disorders and that credentials step-down care facilities that provide those services for its networks shall assess and verify the qualifications of a step-down care facility within 60 days after receiving a completed facility credentialing application. Upon receipt of the application by the credentialing department, the health care service plan shall notify the applicant within seven business days to verify receipt and inform the applicant whether the application is complete. The 60-day timeline shall apply only to the credentialing process and does not include contracting completion. Nothing in this section requires a health care service plan to provide coverage for a type of step-down care facility for which a health care service plan is not otherwise required to provide coverage.(b) For the purposes of this section, the following definitions shall apply:
(1) “Mental health and substance use disorder” has the same meaning as defined in Section 1374.72.
(2) “Step-down care facility” has the same meaning as defined in Section 11834.90.
SEC. 2.SEC. 3.
Chapter 7.6 (commencing with Section 11834.75) is added to Part 2 of Division 10.5 of the Health and Safety Code, to read:CHAPTER 7.6. Supportive Community Residences
11834.75.
The following definitions apply for purposes of this chapter:(a) “Department” means the State Department of Health Care Services.
(b)“Referring entity” means a state or local entity, or a state-regulated entity that does either of the following:
(1)Discharges, directs, or provides a list of one or more supportive community residences or community care-licensed facilities for adults with a substance use disorder or mental health diagnosis.
(2)Preauthorizes or authorizes the health care coverage of services provided by supportive community residences or licensed community care residential facilities.
(c)(1)“Supportive community residence” means any of the following residential dwellings providing housing for adults with a substance use disorder, mental health diagnosis, or dual diagnosis seeking a cooperative living arrangement that does not provide medical care or a level of support for activities of daily living that require state licensing:
(A)Recovery residences, as defined in subdivision (f) of Section 11833.05, that serve people in recovery for a substance use disorder.
(B)Mental health recovery residences that serve people in recovery for a mental health diagnosis.
(C)Mixed recovery residences that serve people in recovery for a dual diagnosis of both a substance use disorder and a mental health diagnosis.
(2)Supportive community residences may be categorized as any of the following:
(A)“Abstinence-based” residences that serve people who desire a cooperative housing setting that prioritizes and requires abstinence from alcohol and other substances.
(B)“Non-abstinence-based” residences that serve people who desire a cooperative housing setting that does not require abstinence from alcohol and other substances.
(C)“Housing First compliant” residences that satisfy the core components of Housing First pursuant to Section 8255 of the Welfare and Institutions Code.
(D)“Non-Housing First compliant” residences that have requirements for abstinence or medication compliance or other restrictions as a condition of housing.
(b) “Harm reduction model” means services are informed by recognition of drug and alcohol use and addiction as a part of tenants’ lives, where tenants are engaged in nonjudgmental communication regarding drug and alcohol use, and where tenants are offered education regarding how to avoid risky behaviors and engage in safer practices, as well as connected to evidence-based treatment if the tenant so chooses.
(c) (1) “Supportive community residence” means a residence providing community-based, nonclinical housing for an adult with a substance use disorder, mental health diagnosis, or dual diagnoses seeking a cooperative living arrangement as a transitional or long-term residence during the process of recovery.
(2) Supportive community residences include, but are not limited to, “recovery residences,” as defined in subdivision (f) of Section 11833.05, that serve people in recovery for a substance use disorder in an alcohol and drug-free environment.
(3) Supportive community residences provide peer supports, services navigation, and physical design features that support an individual in the process of recovery from a substance use disorder, mental health diagnosis, or dual diagnoses.
(d) “Trauma informed” means an approach to care guided by the principles of safety, trustworthiness and transparency, peer support, collaboration and mutuality, empowerment and choice, and cultural, historical, and gender issues.
11834.76.
By January 1, 2027, the department, in consultation with relevant state and county agencies, and other stakeholders, shall do all of the following:(a) Establish and provide for the administration of a voluntary certification program for supportive community residences. Certification shall be for each supportive community residence location. The certification program shall include all of the following:
(1) Standards and procedures for operation of the certification program that consider, at a minimum, all of the following:
(A) Types of certifications needed for the various types of supportive community residences outlined in subdivision (c) of Section 11834.75.
(B) Nationally recognized standards of operation.
(C) Target populations and diversity of communities served.
(D) Evidence-based, trauma-informed, and culturally sensitive environments.
(E) Tenant rights and protections.
(F) Access to, and security of, residents’ medication.
(G) Services navigation.
(H) Peer support services. supports.
(I) Cleanliness, privacy, physical design, and safety.
(J) Relocation assistance.
(K) Data reporting requirements.
(L) Harm reduction and abstinence models.
(M) Screening and intake assessments and procedures.
(2) Methods for filing and investigating
complaints within a reasonable timeframe.
(3)Procedures and penalties for enforcing laws and regulations governing supportive community residences that do not remediate deficiencies within the designated timeframe, conditions under which a supportive community residence may be decertified, and the means by which a supportive community residence may regain certification.
(3) Procedures for periodic monitoring, onsite inspections, demonstration of successful outcomes, and enforcement of compliance with laws and regulations governing supportive community residences.
(4) Penalties for supportive community residences that do not remediate deficiencies within a designated timeframe, conditions under which a supportive community residence may be decertified, and the means by which a supportive community residence may regain certification.
(4)
(5) Technical assistance to assist owners, operators, house managers, and other supportive community residence staff with respect to the following:
(A) Developing an understanding of the applicable regulations and
statutes.
(B) Completing the application process for certification.
(C) Answering questions regarding day-to-day operation.
(D) Implementation of harm reduction principles, accommodation of medication-assisted treatment, and outcome data tracking and reporting.
(b) Create and maintain a searchable online database of certified facilities that meets the following requirements:
(1) To preserve privacy, the database shall not provide the address or specific location of a supportive community residence other than the city, ZIP Code,
or both.
(2) Provides telephone and email contact information.
(3) Provides a record of any substantive and validated complaints filed against a supportive community residence, findings after investigation of those complaints, and the time it took from the date of filing until the complaint is resolved.
(4) Updated monthly in order to reflect all new certifications or updated certification status for supportive community residences.
(c)Adopt or amend relevant regulations relating to referring entity practices, including:
(1)Requiring referring entities to provide the following information to individuals with a substance use disorder, mental health diagnosis, or dual diagnosis, as applicable:
(A)The verified community care or supportive community residence’s license or certification number.
(B)Contact information for the licensing or certifying agency. For purposes of this chapter, “verified” means that the license or certification that the entity holds is current and active, and is aligned with the services the entity is offering to provide.
(2)Report to the department any suspected fraudulent license or certification identified during verification.
(3)Establish when, and how frequently, a referring entity is required to verify licenses and certifications.
(4)Establish enforcement methods for willful and repeated violations of paragraphs (1) and (2) by referring entities, including imposition of administrative penalties, as appropriate.
11834.77.
A supportive community residence shall not provide any licensed services onsite, including, but not limited to, incidental medical services as defined in Section 11834.026.11834.78.
(a) The department may charge a fee for certification of supportive community residences in an amount not to exceed the reasonable cost of administering the program, not to exceed two thousand dollars ($2,000). A certification shall be valid for two years.(b) The department may charge a fee for recertification of supportive community residences in an amount not to exceed the reasonable cost of administering the program, not to exceed five hundred dollars ($500).
(c) The Supportive Community Residence Program Fund is hereby established in the State Treasury. All fees collected in accordance with
this division shall be deposited into the fund. The moneys in the fund shall be available upon appropriation by the Legislature for the purposes of supporting the certification activities of the department.
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.
SEC. 4.
Chapter 7.8 (commencing with Section 11834.90) is added to Part 2 of Division 10.5 of the Health and Safety Code, to read:CHAPTER 7.8. Step-Down Care Referrals
11834.90.
The following definitions apply for purposes of this chapter:(a) “Referring entity” means a state or local entity, or a state-licensed or state-certified entity that discharges, directs, or provides a list of one or more residential or inpatient step-down care options for adults with a substance use disorder or mental health diagnosis. A referring entity may include, but is not limited to, an adult treatment facility described in Section 910501 of Title 9 of the California Code of Regulations, a general acute care hospital or acute psychiatric hospital as defined in Section 1250, psychiatric health facilities as defined in Section 1250.2, a chemical dependency recovery hospital as defined in Section 1250.3, a licensed community care facility as defined in
Section 1502, certified supportive community residences as defined in Section 11834.75, mental health rehabilitation centers described in Section 5675 of the Welfare and Institutions Code, crisis stabilization units, short-term residential therapeutic programs, skilled nursing facilities with special treatment programs described in Section 5676 of the Welfare and Institutions Code, and county behavioral health agencies.
(b) “Step-down care facility” means a supportive community residence, as defined in Section 11834.75, any residential or inpatient licensed alcoholism or drug abuse recovery or treatment facility, as defined in Section 11834.02, or any residential or inpatient licensed community care facility as defined in Section 1502, serving adults with mental health or substance use disorders.
(c) “Verify” means a referring agency checks that the license or certification that
the entity holds is current and active, and is aligned with the services the entity is offering to provide.
11834.91.
(a) When informing an individual with a substance use disorder, mental health diagnosis, or dual diagnosis of one or more options for a step-down care facility that is covered by the individual’s health insurance, a referring entity shall provide the following information:(1) The license or certification number of the step-down care facility.
(2) The contact information for the licensing or certifying agency.
(b) When informing an individual with a substance use disorder, mental health diagnosis, or dual diagnosis of one or more options for a step-down care facility that is not covered by the individual’s
health insurance, a referring entity shall first verify any license or certification the step-down care facility claims to hold.
(c) A referring entity shall report to the appropriate state agency any suspected fraudulent license or certification identified during verification.
11834.92.
Nothing in this chapter shall alter, change, or otherwise affect, a coordinated entry system, as defined in Section 50230.SEC. 5.
Section 10144.58 is added to the Insurance Code, to read:10144.58.
(a) For facility contracts issued, amended, or renewed on and after January 1, 2025, a disability insurer that provides coverage for mental health and substance use disorders and that credentials step-down care facilities that provide those services for its networks shall assess and verify the qualifications of a step-down care facility within 60 days after receiving a completed facility credentialing application. Upon receipt of the application by the credentialing department, the disability insurer shall notify the applicant within seven business days, to verify receipt and inform the applicant whether the application is complete. The 60-day timeline shall apply only to the credentialing process and does not include contracting completion. Nothing in this section requires a disability insurer to provide coverage for a type of step-down care facility for which a disability insurer is not otherwise required to provide coverage.(b) For the purposes of this section, the following definitions shall apply:
(1) “Mental health and substance use disorder” has the same meaning as defined in Section 10144.5.
(2) “Step-down care facility” has the same meaning as defined in Section 11824.90 of the Health and Safety Code.
SEC. 6.
No reimbursement is required by this act pursuant to Section 6 of Article XIII B of the California Constitution for certain costs that may be incurred by a local agency or school district because, in that regard, this act creates a new crime or infraction, eliminates a crime or infraction, or changes the penalty for a crime or infraction, within the meaning of Section 17556 of the Government Code, or changes the definition of a crime within the meaning of Section 6 of Article XIII B of the California Constitution.However, if the Commission on State Mandates determines that this act contains other 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.
