Strung out from drugs or alcohol? Good luck.
A bed in a licensed residential detox in California can set you (or your insurance company) back as much as $3,500 a day. You may still have an annoying roommate and lumpy oatmeal, but that bed will, most likely, be in some non-descript tract home in a residential neighborhood, with maybe a pool and a chef and a licensed vocational nurse on duty. There may be an M.D. who weighs in occasionally, and doses of Narcan in a locked cabinet. Some boast ocean views and horse-petting sessions and Alcoholics Anonymous/Narcotics Anonymous meetings, but there won’t be a comprehensive, licensed medical staff at your fingertips if things go awry.
And in detox, which can be medically fraught, things often and tragically go awry, in ways staffers are just not equipped to handle. People die.
Enter now the newest law aiming to make things better: Sen. Tom Umberg’s SB 349, signed by the governor in April, requires every treatment provider in California to provide a “client bill of rights” to folks seeking addiction treatment, notifying them that they have the right to safe, ethical, evidence-based services (can you imagine needing this at your doctor’s office?).
This will be an actual piece of paper that clients must sign off on, “ensuring that those seeking substance use disorder treatment are afforded basic rights and protections.” Like other laws before it, it prohibits false or misleading advertising. Unlike other laws before it, it packs penalties of up to $20,000 per pop for violations, and expressly allows clients, families and the California Attorney General to take treatment providers who violate its provisions to court.
“This is particularly important in Orange County — we’ve been a magnet for fraudulent providers,” said Umberg. “We have people hanging out signs — ‘Dr. Feelgood’s Treatment Program’ — advertising something like 30 days at a spa. It’s not 30 days at a spa. It’s critically important that families know they have a right to evidence-based treatment, to a treatment plan, to services that are actually designed to help people recover.”
Bill Of Rights
So, specifically, this “bill of rights” will alert folks that they must be informed of all aspects of recommended treatment, including the option of no treatment at all, treatment risks and expected results; are to be treated by licensed and certified providers with qualified staff; receive an individualized, outcome-driven treatment plan; receive support, education and treatment for their families and loved ones; are free from mental and physical abuse, exploitation, coercion and physical restraint; and get information on how to file official complaints with state regulators.
Marketing materials must be accurate and in plain language. Programs affiliated with sober living homes must clearly provide that information to prospective clients, abide by state disclosure requirements that are already on the books, and keep records of referrals made to or from sober homes.
“People seeking treatment have a right to know that they are receiving appropriate and safe care,” said Gov. Gavin Newsom in a statement after he signed the bill. “There is no place in California for treatment providers who take advantage of those struggling with addiction — and with this legislation, we are taking steps to provide additional protections for patients, family members and loved ones of those who are seeking treatment.”
The current (overburdened, understaffed) regulator, the California Department of Health Care Services, can investigate complaints, but the Attorney General, county-level district attorneys, other governmental agencies (cities), and anyone who has been harmed (patients, families) can haul providers who violate the law’s provisions to court.
“It’s designed to weed out bad actors and provide a deterrent element,” said Michele Worobiec, president of the National Alliance for Model State Drug Laws, which helped craft it. “We convened a workgroup and people felt very strongly that, if you do set up shop in our state and we catch you, there will be real consequences.”
The goal is not to ensnare good providers on technicalities, she said, but to discourage predators whose goal is to make money off people who are suffering.
‘Abhorrent Practice’
Among the bill’s supporters is the California Consortium of Addiction Programs and Professionals, which said it “continues the effort of previously enacted legislation to end the abhorrent practice of selling vulnerable patients seeking addiction treatment services to the highest bidder.”
In opposition was the California Association of Alcohol and Drug Program Executives, which argued that the bill duplicates functions already vested in the DHCS, and that the fine is too large and it’s unclear precisely what violations would trigger it.
“Abuses within the treatment industry have become so prevalent and common that they have been given a name: The Florida Shuffle, a cycle in which clients are wooed aggressively by rehabs and freelance ‘patient brokers’ in an effort to fill beds and collect insurance money,” says Umberg’s author’s statement on the bill.
“Southern California’s ‘Rehab Riviera’ is well known as an area in which a network of rehab facilities exist in a quasi-medical realm where evidence-based care is rare, licensed medical staffers are optional, conflicts of interest are rampant and regulation is stunningly lax. The result is preventable harm to some of California’s most vulnerable residents and unnecessary pain for their loved ones.
“This bill seeks to end these predatory behaviors by establishing uniform ethical standards for treatment programs and mechanisms for enforcing those standards.”
Wishing everyone the best of luck.
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