Remember those stuffy doctors who, a couple hundred years ago, tried to cure disease with leeches and dismissed women as weak and hysterical?
This is sort of like that, except the doctors are legislators in Sacramento and the hysterical women are folks of all genders in Orange County (and everywhere else) who say that California’s addiction treatment and sober living systems are dysfunctional and dangerous.
The perception in the state Capitol is that Orange County is exaggerating. Hysterical, if you will.
Of the half-dozen or so bills aiming to tackle these issues, all but two have met tragic deaths in the state Legislature this year.
Even as the feds arrest and sentence rehab operators. Even as insurers sue them for fraud, asserting they’re little more than drug dens. Even as states 3,000 miles away issue “Scam Alerts” on them.
“It’s clear that a wall went up,” said Nick Anas, chief of staff for Orange County Supervisor Katrina Foley. “We all kind of got grouped together, called ‘too aggressive.’ “
ATTENTION, folks: Orange County is asking for more governmental regulation! This runs counter to every stereotype ever conjured about our community.
“There’s just a real a lack of understanding that this truly is a patients’ rights issue,” said Kris Murray, executive director of the Association of California Cities – Orange County. “The crux of it is, people are being abused in these facilities.”
Hysterical, indeed. But folks at the June meeting of the Southern California Sober Living and Recovery Task Force refused to be gloomy: Reform won’t be easy or quick, co-chair Wendy Bucknum, Mission Viejo councilmember, reminded everyone.
So we’ll focus first on the legislative survivors before we mourn those that have fallen.
Survivors
In what would be a partial victory for consumers and transparency, a bill by Assemblymember Laurie Davies, R-Laguna Niguel, would require licensed rehabs to tell people where to look to discover their shortcomings.
That would have been a big step toward getting useful information into consumers’ hands. But why would we want to do that?
After processing by Sacramento’s legislative sausage grinder, the bill now calls for operators to tell folks where to look on the state’s web site “to confirm whether the facility’s license or program’s certification has been placed in probationary status, been subject to a temporary suspension order, been revoked, or (if) the operator has been given a notice of operation in violation of law.”
Better than nothing, perhaps, but not enough. Back when we started writing about fraud and death in California’s private-pay addiction treatment industry we had to wait months to see licensing, inspection and violation reports from state regulators. Today, seven years later, we still have to wait months for those records. California has been promising to put this vital information online for years. We’re still waiting.
The cynical amongst us might conclude that the state is more concerned about protecting rehab operators and related businesses than it is about protecting consumers and patients. It’s a critique you may have heard about the state boards overseeing doctors, nurses, lawyers, etc.
Anyway, the other survivor is a bill by Assemblymember Avelino Valencia, D-Anaheim. It would acknowledge the reality that many sober homes aren’t organic collections of like-minded folks just trying to stay sober but are, instead, branch offices for lucrative treatment businesses.
People hoping for sobriety often go to these sober homes after finishing a provider’s intensive (and expensive) residential in-patient treatment, then report to the provider’s central location for (less-expensive but still insurance-billable) outpatient treatment. This bill would require clear disclosures of any financial relationships between treatment providers and sober homes.
(Word to the wise, gleaned from the experts we’ve talked to over the years: When seeking addiction treatment, see an addiction medicine specialist first, then look for public programs that accept MediCal. Those must hit quality metrics and are more closely monitored.)
Dead
The bill we mourn most really, truly, deeply, is one proposed by Sen. Tom Umberg, D-Santa Ana.
This one would have simply empowered local governments to help overburdened state regulators handle complaints about state-licensed addiction treatment centers. The power currently is exclusively reserved for the state — but clearly beyond the state’s ability to handle in anything close to real-time. (Officials recently crowed about shrinking the average complaint response time from eight months to four months.)
The bill had stunningly bipartisan support from lawmakers. It was championed by the League of California Cities. It was supported by local governments.
Opponents predicted horror show scenarios — cowboy local officials raiding state-licensed treatment facilities willy nilly — but they weren’t convincing: Umberg’s bill sailed through the Senate Health Committee, 10-0, and flew through the Senate Judiciary Committee, 11-0.
So, of course, it was placed in the “suspense file” by the Senate Appropriations Committee — where a bill’s cost goes to be “studied,” where it withers and dies.
We wait, with baited breath, for its resurrection.
Also off the table is the bill by Sen. Josh Newman, D-Fullerton, which would have clarified exactly what sober living homes/recovery residences are, and would have allowed local governments to require permits for operations that house seven or more people.
Newman’s bill would have allowed local governments to require a 1,000 feet separation between sober living homes and state-licensed addiction treatment facilities, to help prevent the “institutionalization” of neighborhoods.
Local laws like this have come into the cross hairs of the state housing department, which calls them discriminatory — asserting that there’s essentially no consumer angle, or patient protection angle, or quality bar, that state and local governments have an interest in promoting. Which is sad.
Another stalled bill was pitched by Assemblymember Diane Dixon, R-Newport Beach. It would have made some technical changes to the laws governing rehab licensing and regulation.
SoCal lawmakers know this is a serious issue — but lawmakers from other parts of California aren’t convinced. The mission at hand is to move beyond anecdote and gather enough dispassionate evidence to make the case.
A state audit of how well the California Department of Health Care Services does its job regulating the addiction treatment industry — requested last year by Assemblymember Diane Dixon, R-Newport Beach — might do exactly that. Local cities groaning under the weight of complaints about unruly facilities hope it will provide the hard, cold, evidence that so many legislators in Sacramento currently dismiss as NIMBY-ism. It’s slated to wrap up by fall.
The Task Force is gathering data locally as well to make its case. Perhaps, then, O.C.’s concerns will be taken seriously.
