BILL NUMBER: AB 1055AMENDED BILL TEXT AMENDED IN ASSEMBLY MAY 5, 2009 INTRODUCED BY Assembly Member Chesbro FEBRUARY 27, 2009 An act to amend Sections 11834.02, 11839.6, and 11876 of the Health and Safety Code, relating to alcoholism or drug abuse treatment. LEGISLATIVE COUNSEL'S DIGEST AB 1055, as amended, Chesbro. Substance abuse: treatment facilities. Existing law provides for the licensure, certification, and regulation of alcoholism or drug use recovery or treatment facilities serving adults, administered by the State Department of Alcohol and Drug Programs. These facilities are defined to mean any premises, 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. This bill would revise the above-described definition to also include any premises, place, or building that providesa program, accredited by a nationally recognized accrediting organization, that uses a multidisciplinary team to provide24-hourresidential medicalservices that do not require a health facility license 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 , and which may include, at the sole discretion of the facility, detoxification services assisted by licensed physicians . Existing law requires the department to establish a program for the operation and regulation of office-based narcotic treatment programs in which interested and knowledgeable physicians provide addiction treatment services, and in which community pharmacies supply necessary medication both to these physicians for distribution to patients and through direct administration and specified dispensing services. This bill would provide that the above-described program requirements are not intended to restrict the scope of practice of a physician that meets the criteria described in the federal Drug Addiction Treatment Act of 2000 to engage in office-based treatment of opioid dependence, provided that the physician is not affiliated or associated with a licensed narcotic treatment program. Vote: majority. Appropriation: no. Fiscal committee: yes. State-mandated local program: no. THE PEOPLE OF THE STATE OF CALIFORNIA DO ENACT AS FOLLOWS: SECTION 1. Section 11834.02 of the Health and Safety Code is amended to read: 11834.02. (a) As used in this chapter, "alcoholism or drug abuse recovery or treatment facility" or "facility" means any premises, 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. As used in this chapter, "alcoholism or drug abuse recovery or treatment facility" or "facility" also means any premises, place, or building that providesa program, accredited by a nationally recognized accrediting organization, that uses a multidisciplinary team to provide 24-hour residential medical24-hour services that do not require a health facility license 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 detoxificationservicesservices, and which may include, at the sole discretion of the facility, detoxification services assisted by licensed physicians . (b) As used in this chapter, "adults" include, but are not limited to, all of the following: (1) Mothers over 18 years of age and their children. (2) Emancipated minors, which may include, but is not limited to, mothers under 18 years of age and their children. (c) As used in this chapter, "emancipated minors" means persons under 18 years of age who have acquired emancipation status pursuant to Section 7002 of the Family Code. (d) Notwithstanding subdivision (a), an alcoholism or drug abuse recovery or treatment facility may serve adolescents upon the issuance of a waiver granted by the department pursuant to regulations adopted under subdivision (c) of Section 11834.50. SEC. 2. Section 11839.6 of the Health and Safety Code is amended to read: 11839.6. (a) The department shall establish a program for the operation and regulation of office-based narcotic treatment programs. An office-based narcotic treatment program established pursuant to this section shall meet either of the following conditions: (1) Hold a primary narcotic treatment program license. (2) Be affiliated and associated with a primary licensed narcotic treatment program. An office-based narcotic treatment program meeting the requirement of this paragraph shall not be required to have a license separate from the primary licensed narcotic treatment program with which it is affiliated and associated. (b) For purposes of this section, "office-based narcotic treatment program" means a program in which interested and knowledgeable physicians and surgeons provide addiction treatment services, and in which community pharmacies supply necessary medication both to these physicians and surgeons for distribution to patients and through direct administration and specified dispensing services. (c) Notwithstanding any other provision of law or regulation, including Section 10020 of Title 9 of the California Code of Regulations, an office-based narcotic treatment program in a remote site that is affiliated and associated with a licensed narcotic treatment program may be approved by the department, if all of the following conditions are met: (1) A physician may provide office-based addiction services only if each office-based patient is registered as a patient in the licensed narcotic treatment program and both the licensed narcotic treatment program and the office-based narcotic treatment program ensure that all services required under Chapter 4 (commencing with Section 10000) of Division 4 of Title 9 of the California Code of Regulations for the management of narcotic addiction are provided to all patients treated in the remote site. (2) A physician in an office-based narcotic treatment program may provide treatment for a maximum of 20 patients under the appropriate United States Drug Enforcement Administration registration. The primary licensed narcotic treatment program shall be limited to its total licensed capacity as established by the department, including the patients of physicians in the office-based narcotic treatment program. (3) The physicians in the office-based narcotic treatment program shall dispense or administer pharmacologic treatment for narcotic addiction that has been approved by the federal Food and Drug Administration such as levoalphacetylmethadol (LAAM) or methadone. (4) Office-based narcotic treatment programs, in conjunction with primary licensed narcotic treatment programs, shall develop protocols to prevent the diversion of methadone. The department may develop regulations to prevent the diversion of methadone. (d) For purposes of this section, "remote site" means a site that is geographically or physically isolated from any licensed narcotic treatment program. Therefore, the requirements in this subdivision regarding a remote site do not apply to an office-based narcotic treatment program that holds a primary narcotic treatment program license. (e) In considering an office-based narcotic treatment program application, the department shall independently weigh the treatment needs and concerns of the county, city, or areas to be served by the program. (f) Nothing in this section is intended to expand the scope of the practice of pharmacy. Nothing in this section is intended to restrict the scope of practice of a physician that meets the criteria described in the federal Drug Addiction Treatment Act of 2000 (P.L. 106-310) to engage in office-based treatment of opioid dependence provided that the physician is not affiliated or associated with a licensed narcotic treatment program. SEC. 3. Section 11876 of the Health and Safety Code is amended to read: 11876. The department shall inspect licensed narcotic treatment programs dispensing controlled substances described in subdivision (c) of Section 11875 to ensure that the programs are operating in compliance with applicable federal statutes and regulations, including Part 8 of Title 42 of the Code of Federal Regulations.