Bill to let cities help state with rogue rehabs dies despite wide support and making sense

Why do anything right, when you can do it yourself?

This cruelly accurate DIY home-repair observation seems to animate California’s elected officials as well — dooming an eminently logical bill by Sen. Tom Umberg that had stunningly bipartisan support.

The death of Senate Bill 913 is tragic, but not at all surprising. It would have simply empowered local governments to help overburdened state regulators handle complaints about state-licensed addiction treatment centers.

It’s a power 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.

Way to go!

SB 913 was championed by the League of California Cities and supported by local governments. It sailed through the Senate Health Committee, 10-0. It 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,” and it withers and dies.

“I’m very sad and very disappointed,” said Umberg, D-Santa Ana. “It’s fact that there’s inadequate enforcement. That’s not debatable.”

People are dying from drug overdoses in state-licensed rehabs. Patients with good insurance are being bought and sold (“body brokering“). Umberg has spoken with families failed by lax oversight and fraudulent operators and has had a front-row seat to the “Rehab Riviera’s” growth in Southern California over recent years. He fears the bill’s deep freeze will mean more vulnerable people are funneled into substandard treatment and recovery facilities, exacerbating the brokering that treats users like dollar signs rather than people with serious health-care issues.

“As we battle the state’s opioid and fentanyl crises, we cannot move people onto a path of recovery without the beds and facilities in which to place them,” he said in prepared remarks. “SB 913 has always been about more than just regulation. It is about respect, recovery and restoring trust in our systems designed to support an addict’s journey towards healing. I’m worried that (the suspense file) vote sends a very clear message to a struggling population that the state doesn’t really care about them in their darkest hours.”

Why do local governments need this power? Because local governments are the ones getting complaints about wayward facilities (which are usually six-bed operations in tract homes in residential neighborhoods, which is a weird place to provide life-or-death health care), yet can do precious little about it.

The California Department of Health Care Services — and only the California Department of Health Care Services — can investigate complaints, but, as we’ve determined, has trouble keeping up.

Supporters of the new approach included the cities of Fountain Valley, Cypress, Garden Grove, Mission Viejo, Laguna Beach and Placentia. (Orange County, incidentally, was declared the nation’s center of addiction treatment fraud by the federal government.)

While the bill is dead for this session, Umberg already has plans for its resurrection.

Opposition

Opposition was lodged by the California Association of Alcohol and Drug Program Executives, the California Consortium of Addiction Programs and Professionals, and the Steinberg Institute. (We’ll note that their objections didn’t sway a single legislator who recorded a vote on the bill.)

SB 913, they argued, would “create unsafe, hostile environments by green lighting ‘no knock’ warrants by city officials who have no expertise in the DHCS regulatory process,” according to written opposition. Expanding a city’s authority to enforce state licensing laws “would establish a truly perilous precedent; one that would not only jeopardize the integrity of the regulatory process, but also endanger the well-being of vulnerable individuals receiving SUD treatment. Entrusting such crucial oversight responsibilities to local entities lacking specialized expertise in substance use disorder treatment and recovery could result in inconsistent enforcement practices at best and completely erode the effectiveness of regulatory enforcement at worst.”

(Don’t cities enforce state-level laws all the time? Ever been pulled over by a city police officer for violating the state vehicle code?)

“This proposal not only undermines the established regulatory framework but also poses a significant threat to the efficiency and effectiveness of the complaint process,” the opposition continued. “DHCS has made substantial strides in enhancing its procedures to expedite the review and resolution of complaints. In the last two years alone, the average time to close a complaint has been nearly halved, plummeting from 245 days to just 114 days. Entrusting city attorneys with oversight of the complaint process would not only overlook these remarkable improvements but also disregard the specialized expertise and knowledge possessed by DHCS in regulating licensed SUD facilities.”

Substantial strides? Remarkable improvements?

In the bill’s next incarnation, Umberg plans to dive heavy into the data. That four-month average to close a complaint — how does that vary much from place to place? Is it true for Orange County? What does closing a complaint actually mean? That the problem has been solved, or that someone has answered the phone?

“There are many people in need of help who have substance use and often mental health issues, and expect to have some sort of standard of care,” Umberg said. “That is very often not happening. In addition to their health being jeopardized, they’re often also victimized in terms of their pocketbooks.”

SB 913 had faced withering skepticism from the chair of the Senate Health Committee, Richard Roth, D-Riverside. To the extent that sloshed over to Appropriations — well, Roth’s term ends in December.

Mission Viejo Councilmember Wendy Bucknum, who co-chairs the California Sober Living and Recovery Task Force, will be watching.

“Sacramento is failing those who are in need of legitimate health care and addiction support services, as well as our residential communities,” she said by email. “The longer the challenges associated with sober living and recovery homes go ignored, the more patients and neighborhoods will suffer. This is quite literally a matter of life and death, so we will continue to do everything possible to raise awareness and grow support for necessary reform and regulation.”

Stay tuned.