GOOD MORNING EVERYONE AND
DIAL WELCOME TO TODAY'S
OVERSIGHT HEARING ON SUBSTANCE
ABUSE TREATMENT FACILITIES
POSTED BY THE ASSEMBLY'S
COMMITTEE ON ACCOUNTABILITY AND
ADMINISTRATIVE REVIEW I AM
COUNTY PETRIE-NORRIS I REPRESENT
CALIFORNIA SEVENTY FOURTH
ASSEMBLY DISTRICT AND I ALSO
SERVED AS CHAIR OF THE
ASSEMBLY'S ACCOUNTABILITY AND
ADMINISTRATIVE REVIEW COMMITTEE
BEFORE WE BEGIN TODAY'S HEARING
LET ME FIRST COVER A COUPLE OF
HOUSEKEEPING ITEMS AT FIRST WE
ARE REQUIRING THAT MASKS BE WORN
BY ALL MEMBERS OF THE PUBLIC WHO
ARE JOINING US TODAY IN THIS
ROOM. IF YOU DO NOT HAVE A MASK
WE CAN PROVIDE ONE FOR YOU ARE
WE WILL BE HEARING PUBLIC
COMMENT AT THE CLOSE OF TODAY'S
HEARING AND WE ARE GOING TO HAVE
A COUPLE OF DIFFERENT OPTIONS
AVAILABLE FOR WITNESS TESTIMONY
IF ANY MEMBER OF THE PUBLIC WHO
IS HERE IN THE ROOM TODAY WOULD
LIKE TO TESTIFY DURING PUBLIC
COMMENT PLEASE RAISE YOUR HAND
AT THE APPROPRIATE TIME AND I
WILL THEN ASK YOU TO APPROACH
THE MICROPHONE. FOR ANY DIAL IN
WITNESSES WE WILL BE USING A
MODERATED TELEPHONE SERVICE
THROUGH WHICH ANY MEMBER OF THE
PUBLIC CAN CALL IN TO PROVIDE A
COMMENT I'LL PROVIDE THE KALINDA
TELLS NOW AND THEN WE'LL DO THAT
WHEN WE OPENED PUBLIC COMMENT AS
WELL BUT AT THE CALL IN NUMBER
FOR THIS HEARING IS.
877-692-8957 AND THE ACCESS CODE
IS. ONE THREE ONE FIVE FOUR TWO
ZERO TWO. YOU CAN ALSO FIND THIS
NUMBER ON THE ASSEMBLY
ACCOUNTABILITY AND
ADMINISTRATIVE REVIEW
COMMITTEE'S WEBSITE AS WELL AS
ON YOUR TV SCREEN AND I DO ALSO
WANT TO NOTE THAT WE ARE
ACCEPTING WRITTEN TESTIMONY
THROUGH THE POSITION LETTER
PORTAL ON THE COMMITTEE'S
WEBSITE OUT WITH THAT I BELIEVE
THAT WE ARE READY TO JUMP INTO
THE SUBSTANCE OF. TODAY'S
HEARING. I AND THE FOR WE OPEN
UP OUR OUR PANEL AND OUR FIRST
PANEL DISCUSSION AND WELCOME OUR
FIRST PANELISTS. I WENT TO JUST
TO SHARE A COUPLE OF COMMENTS TO
FRAME THE CONVERSATION. ON
AUGUST TWENTY SIX TWENTY TWENTY
ONE A TROUBLED YOUNG MAN LOST
HIS LIFE TRAGICALLY. IN MY
DISTRICT AROUND FOUR AM ON THE
MORNING OF AUGUST TWENTY SIXTH.
RICHARD R. HENRY RICHARD BLAIR
AGE TWENTY THREE LEFT HIS STATE
LICENSED ALCOHOL AND DRUG
TREATMENT FACILITY. THE
GRATITUDE LATCH. AND FORCED HIS
WAY INTO A NEIGHBORHOOD HOME ON
A NEARBY STREET. HI MR LEHRER
WAS SHOT AND KILLED BY THE
HOMEOWNER WHO IS FOUND TO BE
ACTING IN SELF DEFENSE BY THE
ORANGE COUNTY DISTRICT ATTORNEY
. TWO FAMILIES AND OUR ENTIRE
COMMUNITY WORK HI. MISTER LEHRER
FATHER HI COMMENTED. RIGHT RIGHT
THANK YOU BELIEVE THIS I WAS
EXPERIENCING A SYMPTOM OF
WITHDRAWAL A PSYCHOTIC EPISODE
AND I SHARE THIS STORY- ONLY
BECAUSE I THINK IT REALLY.
SHINES A LIGHT ON THE- FAILINGS
IN SUBSTANCE ABUSE TREATMENT AND
IN THE INDUSTRY HERE IN
CALIFORNIA AND INDEED ON THE
FAILINGS OF CALIFORNIA'S
REGULATORY AGENCIES TO PROVIDE
EFFECTIVE OVERSIGHT AND
APPROPRIATE ACCOUNTABILITY FOR
THESE FACILITIES- THIS TRAGEDIES
I SAID REALLY SPOTLIGHTS THE
LIFE THREATENING ISSUES THAT ARE
PLAGUING THE SUBSTANCE ABUSE
TREATMENT INDUSTRY HERE IN
CALIFORNIA. AS SUBSTANCE ABUSE
HAS SKYROCKETED ALL ACROSS THE
COUNTRY AND AS THE NEED FOR
TREATMENT HAS EXPLODED THIS
INDUSTRY UNFORTUNATELY HAS BEEN
PLAGUED BY BAD ACTORS WHO ARE
EXPLOITING PATIENTS FOR PROFIT
WITH VULNERABLE PATIENTS AND
THEIR FAMILIES BEING LOWERED
FROM ALL CORNERS OF THE COUNTRY
TO ROGUE REHAB CENTERS AND SHAM.
SERVER LEVINE HOMES.
UNFORTUNATELY BECAUSE OF
CALIFORNIA'S LACK OF REGULATION
AND OVERSIGHT IN THIS SPACE
FRAUD AND ABUSE HAVE BEEN
RAMPANT IN MY DISTRICT I'VE BEEN
WORKING WITH LOCAL OFFICIALS AND
COMMUNITY MEMBERS TO TRY TO
ADDRESS THIS CRISIS. I SAT WITH
LOCAL MOMS IS THE SHARED
HEARTBREAKING STORIES OF
BRINGING THEIR CHILDREN HOME
FROM THESE FACILITIES IN BODY
BAGS. AND THEY'VE ASKED ME TO
HELP THEM STOP THIS MADNESS THE
BOTTOM LINE IS THAT THE
UNSCRUPULOUS OPERATORS IN THIS
INDUSTRY ARE HAVING A HORRIFIC
IMPACT ON PATIENTS WHO ARE
DESPERATE FOR HELP. ON THEIR
FAMILIES AND ON OUR ENTIRE
COMMUNITY WITH SUBSTANCE ABUSE
SKYROCKETING AS A RESULT OF THE
CONVICT NINE TEEN PANDEMIC THE
SUBJECT IS MORE CRITICAL NOW
THAN EVER AND SO I AM LOOKING
FORWARD TO TODAY'S HEARING. AND
HEARING FROM OUR WITNESSES AS
THAT AS PART OF THIS DISCUSSION.
OUT WITH THAT I WOULD LIKE TO
NOW WELCOME OUR FIRST PANEL I
BELIEVE OUR WITNESSES ARE BOTH
JOINING U- BY OUR REMOTE
TESTIMONY FACILITY. ARE WE ARE
GOING TO WELCOME AT DOCTOR. BART
PTOLEMY WITH THE CALIFORNIA
SOCIETY OF ADDICTION MEDICINE AS
WELL AS DIRECTOR MICHELLE BASS
WITH THE DEPARTMENT OF HEALTH
CARE SERVICES I DOCTOR BAR
PTOLEMY WILL PROVIDE AN OVERVIEW
OF SUBSTANCE ABUSE TREATMENT IN
CALIFORNIA. AND THE ROLE THAT
THE CALIFORNIA SOCIETY OF
ADDICTION MEDICINE HAS IN
ENSURING THE PROVISION OF
QUALITY CARE FOR SUBSTANCE ABUSE
DISORDERS AND DIRECTOR BOSS WILL
PROVIDE AN OVERVIEW OF THE
LICENSING. RENEWAL AND FORTON
ENFORCEMENT AND OVERSIGHT
PROCESSES FOR ALCOHOL AND DRUG
ABUSE RECOVERY TREATMENT
FACILITIES IN THE STATE ARE WITH
THAT WE'LL GO AHEAD AND- TURN IT
OVER I BELIEVE WE'RE GOING TO
FIRST HEAR FROM DOCTOR BOUGHT BY. PTOLEMY THANK YOU FOR JOINING
US. THANK YOU CAN YOU HEAR ME OK
YES WE CAN WONDERFUL WELL THANK
YOU FOR THE OPPORTUNITY TO
ADDRESS THIS COMMITTEE HI MY
NAME IS DR MARIO SOME ARTILLERY.
AND I'M A CLINICALLY ACTIVE
BOARD CERTIFIED ADDICTION
MEDICINE SPECIALIST AND ALSO
BOARD CERTIFIED IN FAMILY
MEDICINE. BESIDES HAVING THE
PRIVILEGE OF SERVING PATIENTS
AND FAMILIES IMPACTED BY
SUBSTANCE USE HOWEVER VARIOUS
OTHER HATS INVOLVING- EYES FOR
EXAMPLE THE VICE CHAIR OF THE
PRACTICE MANAGEMENT AND
REGULATORY AFFAIRS COMMITTEE FOR
THE AMERICAN SOCIETY OF
ADDICTION MEDICINE THAT'S THE
NATIONAL. SOCIETY FOR
PHYSICIANS- PRIMARILY- ADD THAT
IN THEIR INVOLVED IN ADDICTION
MEDICINE AND I ALSO SERVE ON THE
PUBLIC POLICY COMMITTEE FOR C.
SAM THE CALIFORNIA SOCIETY OF
ADDICTION MEDICINE. AS WELL AS
ON THE BOARD OF DIRECTORS I
SERVICE THE MEDICAL DIRECTOR FOR
THE ORANGE COUNTY COALITION OF
COMMUNITY CLINICS MATT CONNECT
PROGRAM. I IT'S A GRANT FUNDED
EFFORT AIMED AT EXPANSION OF
MEDICATION ASSISTED TREATMENT
FOR ADDICTIONS AND HAVE SERVED
AS THE MEDICAL DIRECTOR OF THE
ORANGE COUNTY YOUTH OPIOID
RESPONSE. TO THE AUSPICES OF THE
COALITION IN THE CAR AND THE
COLLABORATIVE- ORGANIZATIONS-
THAT AT THEIR ALSO INVOLVED-
SUCH AS MINE DOES SEE I LEAD
THE- COUNTY S. U. DEVIATION
COMMITTEE AND PROVIDE
CONSULTATION FOR THE COUNTY
JUSTICE SYSTEM AND SOCIAL
SERVICES. CONTINUE TO TEACH
RESIDENT PHYSICIANS AND OTHERS
ON THE TOPICS INVOLVED INVOLVING
SUBSTANCE USE AND ALSO SERVED AS
AN EXPERT WITNESS ON MANY OF THE
VERY CASES THAT YOU ALL ARE
TALKING ABOUT- THAT HAVE
RESULTED IN BAD OUTCOMES AT
TREATMENT FACILITIES. SO I'M
VERY VERY AWARE OF MANY OF THE
ISSUES I'VE ALSO SERVED AS A
MEDICAL DIRECTOR AT PRETTY MUCH
EVERY LEVEL OF A SAM CRITERIA OR
A SAM LEVELS OF CARE I SHOULD
SAY- WHICH WHICH MEANS
OUTPATIENT ALL THE WAY. TO A
HOSPITAL BASED DETOX. AS A
NATION COULD TO GROW. WITH THE
CON. OF STUFF SUBSTANCE USE
DISORDERS LIKE OPIOID USE. THE
STATISTICS DO CONTINUE TO BECOME
MORE ALARMING AS ALREADY
MENTIONED. RECENTLY THE CDC
ANNOUNCE THAT WE EXCEEDED A
HUNDRED THOUSAND DRUG OVERDOSE
DEATHS. NATIONALLY AND
CALIFORNIA BETWEEN APRIL TWO
THOUSAND TWENTY IN TWO THOUSAND
TWENTY ONE. I HAVE EXCEEDED TEN
THOUSAND OVERDOSE DEATHS THAT
WERE REPORTED. THAT REPRESENTED
A FORTY THREE POINT 8% INCREASE
OR AT 840% APA PERCENT CHANGE
OVER THE CURRENT THE PRIOR
PERIOD. FROM A SUBSTANCE
PERSPECTIVE THE DRIVER APPEARS
TO BE RELATED TO SYNTHETIC
OPIOIDS LIKE FENTANYL. AND
WORKED SWIFTLY MOVING INTO THE
FOURTH WAVE OF THE OPIOID
EPIDEMIC THAT INVOLVES BOTH
FENTANYL AND CYCLE STIMULANTS
LIKE METHAMPHETAMINE. SO WERE
RUSHING TO ADAPT TO WHAT IS
EVOLVING. BEFORE OUR VERY EYES.
THE PATIENTS AND THE FAMILIES
THAT I SERVE ALONE ARE NO MATCH
FOR THE COMPLEXITIES OF
ACCESSING SUBSTANCE USE DISORDER
TREATMENT IN OUR COUNTRY AND THE
SAME HOLDS FOR OUR STATE. IT'S
DIFFICULT TO MANEUVER THE MAZE
THAT IS ADDICTION TREATMENT
MATCHING APPROPRIATE SERVICES
WITH NEED ARE DIFFICULT ENOUGH
OUR TREATMENT SYSTEM LEAVES MUCH
TO BE DESIRED FOR PROVIDING
TRANSPARENCY AND FOCUS ON
QUALITY OF CARE. AND ALSO JUST
BEING ABLE TO SORT OUT WHAT IS
TREATMENT VERSUS WHAT IS
RECOVERY SERVICES THOSE LINES
CAN OFTEN BE BLURRED AND THEY
WHEN THEY DO GET BLURRED THEY
OFTEN RESULT IN SOMEBODY
ACCESSING. INADEQUATE SERVICES.
FRANKLY IT'S DIFFICULT TO KNOW
WHAT YOU'RE GETTING JUST TRY TO
GOOGLE IT YOURSELF IT'S OFTEN
THE FIRST WAY THAT MANY OF THE
FAMILIES THAT THAT I DEAL WITH
FIRST ENGAGE WITH THE SYSTEM
ONCE THEY FIND OUT WHAT A LOVED
ONE FOR EXAMPLE THAT HAS. THE
DISEASE OF ADDICTION. AND WE
KNOW ADDICTION IS A BRAIN
DISEASE WE NOW UNDERSTAND THAT.
IT'S COUCHED IN AN AMALGAMATION
OF VARIOUS OTHER FACTORS LIKE
SOCIETAL FACTORS WE STILL HAVE
STIGMA STIGMA STILL KILLS. AND
WE HAVE A LOT OF OTHER BARRIERS
AROUND SOCIAL DETERMINANTS OF
HEALTH. WE HAVE ISSUES AROUND
THE MEDICAL HEALTH SYSTEM THAT
HAS YET TO FULLY EMBRACE
ADDICTION MEDICINE THE MENTAL
HEALTH SYSTEM THE JUSTICE SYSTEM
AND ALSO SOCIAL SERVICES TO
NAME. BUT A FEW. AND WHERE THE
SUBSTANCE USE DISORDER TREATMENT
SYSTEM SETS OFTEN DEPENDS ON
WHAT IS EMPHASIZED AT A TIME.
AND A MOMENT OF CRISIS. WHICH IS
THE WORST TIME. TENTH WE STILL
REMAIN SILO TO. AND OFTEN IT'S
DIFFICULT TO NAVIGATE NOT TO
MENTION THE PAYER SIDE- WHERE WE
ARE CARVE OUT IN CERTAIN IT
DEPENDING ON WHAT WHAT WHAT
PAYER YOU HAVE ALSO THE
CONTINUITY OF CARE AND
INTEGRATION INTO PRIMARY CARE.
IT ALSO HAS SOME ISSUES NOW KOBE
NINETEEN IS AMPLIFIED THE NEEDS
THE DISPARITIES THE DESPERATION
AND THE GAPS ADDICTION TREATMENT
IS IN A CONSTANT STATE OF
EVOLUTION THE AMERICAN SOCIETY
OF ADDICTION MEDICINE A SAM AND
THE CALIFORNIA SOCIETY OF
ADDICTION MEDICINE AND MANY
OTHER COLLABORATORS HAVE BEEN
HOPING AND PUSHING FOR LAWS MANY
OF WHICH WERE WRITTEN AS FAR
BACK AS IN THE EARLY SEVENTIES
WHEN WE KNEW MUCH LESS ABOUT
ADDICTION TREATMENT TO CATCH UP.
WITH EVIDENCE BASED TREATMENTS
AND A SHIFT FROM A FOCUS OF A
LICENSURE FLOOR MEETING MINIMUM
FACILITY STANDARDS FOR EXAMPLE
TO ONE OF THE FOCUS ON QUALITY.
ACCOUNTABILITY TRANSPARENCY AND
UP TO DATE ON TREATMENT
MODALITIES SUCH AS MEDICATIONS
FOR ADDICTION TREATMENT
INCLUDING BUPRENORPHINE AND
NALTREXONE IN CONJUNCTION IN
CONJUNCTION WITH A THERAPEUTIC
MODALITIES USED TO USE OF
THERAPY SUCH AS CONTINGENCY
MANAGEMENT COGNITIVE BEHAVIORAL
THERAPY AS EVIDENCE BASED TOOLS
TO WORK ON BUILDING RESILIENCY
IN RECOVERY. AND FOR CARE TO BE
COMPREHENSIVE ADDICTION AMONG
ALL DISEASES IS MULTIFACTORIAL
AND IT REQUIRES A SKILLED AND
QUALIFIED MULTI DISCIPLINARY
TEAM AND NOT. JUST A FOCUS ON
SUBSTANCES. HM THE BILL THE INTO
STANDARD CRITERIA FOR USE IN THE
TREATMENT INDUSTRY WE CALL IT
BASED ON CRITERIA. CURRENTLY IS
ON ITS THIRD EDITION AND IS
CURRENTLY BEING REWRITTEN TO THE
FOURTH ADDITION AS WE SPEAK IN
FACT I SERVE. AS ONE OF THE
INDIVIDUALS HELPING RIGHT THE
SECTION ON UTILIZATION
MANAGEMENT FOR THE FOURTH. MD
SHOULD STILL CONTINUE TO BE THE
STANDARD TOOL THAT INFORM ON
APPROPRIATENESS OF LEVEL OF
CARE. AND WHAT DEFINES THE LEVEL
OF CARE. I DEDICATE MUCH OF MY
TIME TO HELPING TRAIN COLLEAGUES
IN PRACTICE TO EXPAND THE WORK
FORCE AT THE C. SAM. WE WANT TO
PROVIDE HELP TO A HIGH QUALITY
EVIDENCE BASED CARE AND
UNFORTUNATELY WE DO HAVE A
WORKFORCE PROBLEM. IT'S NOT
GOING TO BE THE ADDICTION
MEDICINE SPECIALISTS THAT SOLVE
THIS WE HAVE TO CONTINUE TO
EXPAND THE WORK FORCE TO INCLUDE
PRIMARY CARE PHYSICIANS AND
OTHERS INTERESTED TO PROVIDE
SOME SOME OF THE SERVICES. AND
THAT YOU KNOW THOSE THOSE
CHALLENGES THE COMPANY THE
CURRENT OVERSIGHT AND REGULATORY
AT CHALLENGES AS WELL LASTLY
I'LL SAY THAT IT'S IMPERATIVE.
THAT THOSE PROVIDING THE
REGULATORY OVERSIGHT POP UP TO
DATE. AND MEANINGFUL TOOLS AT
THEIR DISPOSAL. THE LAWS. TO
CARRY OUT MORE EFFECTIVE
OVERSIGHT. BEYOND THE MECHANICS
OF BEING AN EFFECTIVE
ADMINISTRATIVE PROCESS WHICH IS
REALLY A BASELINE NEED. THERE
NEEDS TO BE AN EFFORT. AGAIN TO
ENSURE A QUALITY ACCOUNTABILITY
AND TRANSPARENCY. I REMAIN
OPTIMISTIC THAT THESE ISSUES
WILL BE IN THE FOREFRONT OF
MATCHING LAW WITH SCIENCE. AND
WE MUST CONTINUE TO IMPROVE MY
PATIENTS. AND THEIR LOVED ONES.
CERTAINLY DESERVE IT I THANK YOU
VERY MUCH FOR YOUR TIME THIS
MORNING. WELL AND THANK YOU AT
DR TONY FOR YOUR COMMENTS AND AT
. WHAT WE'LL DO IS GO AHEAD AND
HEAR FROM DOCTOR BOSS AND THEN
WILL OPEN UP FOR QUESTIONS OFFER
FOR BOTH OF YOU HAVE- BUT YOU'VE
CERTAINLY GIVEN US A LOT A LOT
ADD TO RIDE TO THINK ABOUT- AND
DO APPRECIATE YOU BEING HERE IS
PART OF THE HEARING. UP WITH
THAT I WILL GO AHEAD AND WELCOME
MICHELLE BOSS WHO IS THE
DIRECTOR OF THE DEPARTMENT OF
HEALTH CARE SERVICES. FORTY
MADAM CHAIR BEFORE I BEGIN I
WOULD LIKE TO INTRODUCE DR KELLY
PFEIFER. WHO IS OUR DEPUTY
DIRECTOR OVER BEHAVIORAL HEALTH.
AND IS JANELLE ITO OR L. CHIEF
OF OUR LICENSING AND
CERTIFICATION DIVISION ARE ALSO
PARTICIPATING. WE'VE BEEN ASKED
TO PROVIDE AN OVERVIEW OF THE
LICENSING RENEWAL ENFORCEMENT
AND OVERSIGHT PROCESSES FOR
ALCOHOL AND DRUG RECOVERY
TREATMENT FACILITIES. ARE
AUTHORITY AT DCS IS LICENSED
AUTHORITY WE HAVE THE SOLE
AUTHORITY TO LICENSE RESIDENTIAL
ADULT SUBSTANCE USE TREATMENT
FACILITIES AND WE HAVE TIS YEAH
HEALTH AND SAFETY CODE STATUTE
AND- CALIFORNIA REGULATIONS.
LICENSE IS MANDATORY FOR
RESIDENTIAL FACILITIES PROVIDING
CLINICAL SERVICES LIKE
DETOXIFICATION GROUP AND
INDIVIDUAL COUNSELING OR
EDUCATION AND OTHER RECOVERY OR
TREATMENT SERVICES. I LICENSE IS
VALID FOR TWO YEARS AND IN ORDER
TO BE RENEWED THE PROGRAM MUST
SUBMIT A RENEWAL APPLICATION AND
FEE PRIOR TO EXPIRATION. DH YES
DOES NOT LICENSE OR CERTIFY
RECOVERY RESIDENCES WHICH ARE
REMAIN ARRANGEMENTS WITH A
LANDMARK WERE NO SUBSTANCE USE
DISORDER CLINICAL SERVICES ARE
PROVIDED. WE ENGAGED YES I
UNDERSTAND THE FRUSTRATION
REGARDING THE BEHAVIOR OF SOME
PEOPLE LIVING IN RECOVERY
RESIDENTS IS ALSO KNOWN AS SOBER
LIVING HOMES IN TERMS OF THE
IMPACT ON THEIR NEIGHBORHOOD.
RECOVERY RESIDENTS ARE NOT
REGULATED BY ANY GOVERNMENT
AUTHORITY INSTEAD THESE HOMES
ARE VIEWED AS MORE OF A LANDLORD
TENANT. ARRANGEMENTS AND NO LIFE
SIMPLE LICENSABLE TREATMENT
SERVICES ARE BEING PERFORMED IN
THEM. WE AGGRESSIVELY
INVESTIGATE WHEN WE LEARNED OF
RECOVERY RESIDENTS THAT ARE
PROVIDING LICENSABLE TREATMENT
SERVICES. WE ALSO POST ON OUR
WEBSITE A LIST OF ALL FACILITIES
THAT WE HAVE DETERMINED TO BE
PROVIDED LICENSES FULL TREATMENT
SERVICES AND HAVE BEEN SENT A
NOTIFICATION TO CEASE THE
ACTIVITY. G. H. YES THEN FOLLOWS
UP TO ENSURE THE ACTIVITIES HAVE
CEASED THROUGH MONITORING WEB
ADVERTISEMENTS AND DOING
UNANNOUNCED SITE VISITS WHEN
NEEDED. LICENSURE REGULATIONS
INSTEAD OF THE HEALTH AND SAFETY
ACT OF CLIENTS AND REQUIRE THAT
A CLIENT MEDICAL NEEDS ARE
APPROPRIATELY ADDRESSED. THESE
REQUIREMENTS CAN INCLUDE
ENSURING SAFE MEDICATION
ADMINISTRATION AND DISPOSAL
REFERRING TO A HIGHER LEVEL OF
CARE IS NEEDED. AND PROVIDING
SAFE WITHDRAWAL MANAGEMENT.
CERTIFICATION THE FCS OFFERS A
VOLUNTARY FACILITATE
CERTIFICATION PROPOSED
RESIDENTIAL AND OUTPATIENT
SUBSTANCE USE TREATMENT PROGRAMS
A BILL SO HE MUST BE CERTIFIED
IN ORDER TO BILL MEDICARE L. DH
CS DOES NOT TRACK UNCERTIFIED
FACILITIES THAT SERVE COMMERCIAL
OR PRIVATE PAY CLIENTS.
CERTIFICATION DEMONSTRATES THAT
THE PROGRAM IS IN COMPLIANCE
WITH DH CS QUALITY STANDARDS
WHICH CAN INCLUDE REQUIREMENTS
SUCH AS MINIMUM COUNSELING
SERVICES PROVIDED TO CLIENTS AND
ENSURING TREATMENT AND RECOVERY
PLANS ARE IN PLACE. RESIDENTIAL
TREATMENT PROGRAMS MUST BE
LICENSED AND MEDICAL CERTIFIED
IN ORDER TO RECEIVE MEDICARE
REIMBURSEMENT FOR SERVICE. TO
DISTINGUISH CLEARLY LICENSURE
PRIMARILY ADDRESSES THE HEALTH
AND SAFETY OF CLIENTS INCLUDING
THE PHYSICAL STRUCTURAL
REQUIREMENTS AT THE FACILITY
CERTIFICATION PRIMARILY
ADDRESSES THE QUALITY OF CARE
REQUIREMENTS. PROGRAM FUNDING AN
OUTPATIENT OR RESIDENTIAL
SUBSTANCE USE TREATMENT PROGRAM
CAN BE FUNDED BY ANY OF THE
FOLLOWING PRIVATE INSURANCE
MEDICARE THROUGH THE DRUG MEDI
CAL OR DRUG MEDI CAL ORGANIZED
DELIVERY SYSTEM. AND PRIVATE PAY
. MEDICALS FUNDED THROUGH A
COMBINATION OF COUNTY STATE AND
FEDERAL FUNDS AND COUNTY FUNDING
CAN COME FROM REALIGNMENT OR
OTHER SOURCES SUCH AS LOCAL TAX
TWENTY TWENTY ONE DST HAS HAS
FIVE HUNDRED AND FORTY SIX
LICENSED AND CERTIFIED
RESIDENTIAL FACILITIES. FOUR
HUNDRED AND THIRTY FIVE LICENSE
RESIDENTIAL FACILITIES WITHOUT
CERTIFICATION. AND NINE HUNDRED
AND THIRTY FOUR CERTIFIED
OUTPATIENT TREATMENT FACILITIES
. I WANT TO TALK A LITTLE BIT
ABOUT THE CATEGORIES OR TYPES OF
COMPLAINTS WE RECEIVE A WEEK
CATEGORIZE COMPLAINTS IN ORDER
OF PRIORITY WHERE WE HAVE HIGH
PRIORITY INVESTIGATIONS OCCUR
WITH THE CLIENT THAT. VARIATION
ON MONITORING CLIENTS DURING
DETOXIFICATION ALLEGATIONS
REGARDING MEDICATION ERRORS
CLIENT GROSGRAIN OR SEXUAL
MISCONDUCT. MEDIUM PRIORITY
INCLUDE COMPLAINTS RELATED TO
MEDICAL SERVICES HYGIENE ISSUES
SUCH AS INVESTIGATIONS OR
CLEANLINESS OR STAFF
QUALIFICATIONS. HELLO PRIORITY
INCLUDE REQUEST FOR INFORMATION
REFUNDS HEATING AND AIR ISSUES.
DTS CATEGORIES COMPS HOW TO
CRISIS COMPLAINTS FOUR
CATEGORIES. UNLICENSED
COMPLAINED ARE ALLEGATIONS THAT
A FACILITY IS PROVIDING CLINICAL
SERVICES IN A RESIDENTIAL
SETTING WITHOUT A VALID LICENSE
FROM THE DEPARTMENT. TCS IS
REQUIRED TO FORMALLY INVESTIGATE
ALL ALLEGATIONS THAT THE
FACILITY IS ADVERTISING FOR OUR
PROVIDING LICENSABLE SERVICES
AND AN UNLICENSED CITING.
COUNCILLOR COMPLAINTS OR
ALLEGATIONS AGAINST A REGISTERED
OR CERTIFIED COUNSELOR WHAT
LEGEND THE VIOLATED THEIR
CERTIFIED ORGANIZATIONS CODE OF
CONDUCT. YES YES IS REQUIRED TO
TAKE ACTION WITHIN NINETY DAYS
OF RECEIPT OF THESE ALLEGATIONS
. DEATH INVESTIGATIONS ARE
CONDUCTED WHATEVER CLIENT DIES
WILL RECEIVING SERVICES IN A
RESIDENTIAL OR OUTPATIENT
TREATMENT FACILITY. DCS
INVESTIGATES TO ENSURE WE WERE
IMMEDIATELY NEVER ALERTED OF THE
DEATH TO DISCOVER WHERE THE
FACILITY OR STAFF WERE SIXTY
INTO WITH ANY ACTION OR IN
ACTION THAT RESULTED IN THE
DEATH. PHYSICAL HARM OR IMMINENT
DANGER TO A CLIENT AND ENSURE
THAT THERE ARE NO IMMEDIATE RISK
TO THE HEALTH AND SAFETY OF
REMAINING ARE FUTURE RESIDENCE
OUR CLIENTS. AND GENERAL
COMPLAINTS OR ALLEGATIONS
AGAINST A FACILITY OR STAFF
REGARDING GENERAL OPERATION
CONCERNS. THE COMPLAINT.
COMPLAINTS MAY BE FILED BY ANY
MEMBER OF THE PUBLIC THROUGH
ONLINE SUBMISSION AT OUR
LICENSING AND CERTIFICATION
COMPELLING COMPLAINTS PAGE MAIL
FAX EMAIL OR PHONE COMPLAINTS
REMAIN ANONYMOUS WHEN SUBMITTING
A COMPLAINT A COMPLAINT
COMPLAINT AND WE REQUEST THE
OUTCOME UPON CLOSURE OF
INVESTIGATION AND THE PUBLIC
RECORDS ACT REQUEST WILL BE
INITIATEDUPON THE COMPLAINT
IT'S BEHALF. CURRENTLY THIS MUST
BE STATED ARE NOTED WHEN
INITIATING THE COMPLAINT AGAINST
YEAH ARE IN THE PROCESS OF
UPDATING THE FORMS TO ASK
COMPLAINTS ABOUT THEIR
PREFERENCE TO HAVE A PUREE
INITIATED FOR THEM. WE HAVE ALSO
UPDATED THE DH YES WEBSITE ADD
THE PUREED REQUESTING TO THE
COMPLAINTS PAGE. EACH COMPLAINT
IS UNIQUE AND REQUIRES A
SPECIFIC RESPONSE AND
INVESTIGATION. OVER THE PAST
THREE YEARS DO YOU SEE AS
IMPROVE PROCESSES TO STREAMLINE
THE REVIEW AND COMPLETION OF
COMPLAINTS.THE AVERAGE TIME TO
CLOSE THE COMPLAINT HAS DROPPED
SIGNIFICANTLY IN THE LAST TWO
YEARS AND HAS BEEN RATE REDUCED
BY OVER 60% SOME COMPLAINTS
REQUIRE MORE IN DEPTH
INVESTIGATION MULTIPLE SITE
VISITS AND DISCUSSIONS WITH
PROVIDERS AND STAFF WHICH CAN
PROLONG THE LENGTH OF TIME TO
COMPLETE AN INVESTIGATION. WHEN
DH CS RECEIVED SUFFICIENT
INFORMATION TO INDICATE THAT THE
FACILITY IS IN DANGER TO
CLIENTS. AND OR SIGNIFICANT
QUALITY ISSUES ARE NOT RESOLVED
LICENSES ARE SUSPENDED OR
REVOKED. DHS'S INTENDED OR VOTE
FOR LICENSES AND AT TWO THOUSAND
NINETEEN TWENTY SEVEN AND TWENTY
TWENTY ONE AND TWO AND TWENTY
TWENTY TWO YEAR TO DATE. PSCS IS
RECEIVING INCREASING PERCENTAGE
OF COMPLAINTS IN RECENT YEARS
THAT ARE NON JURISDICTIONAL
MEANING OUTSIDE OF DH CS FORTY.
EXAMPLE OF NON JURISDICTIONAL
COMPLAINTS INCLUDE NOISE LITTER
PARKING AND SMOKING ISSUES. 10%
OF ENQUIRIES WERE NON
JURISDICTIONAL IN TWO THOUSAND
NINETEEN TWENTY. 21% OF
ENQUIRIES WERE NON
JURISDICTIONAL IN TWENTY TWENTY
ONE AND 26% INCREASE IN THE
CURRENT FISCAL YEAR HAVE BEEN
NON JURISDICTIONAL. IN REGARD TO
UNLICENSED TREATMENT UNLICENSED
TREATMENTACTIVITY AND NOTICED
OPERATION IN VIOLATION OF LAW.
IN FISCAL YEAR TWENTY NINETEEN
TWENTY THE DEPARTMENT
INVESTIGATED A TOTAL OF SIXTY
ONE CASES OF UNLICENSED
TREATMENT ACTIVITY AND ISSUED
TWO NOTICES OF VIOLATION. IN
TWENTY TWENTY ONE THE DEPARTMENT
INVESTIGATED FORTY THREE CASES
AND ISSUED FIVE NOTICES OF
VIOLATION. AND IN THE CURRENT
FISCAL YEAR TWENTY ONE TWENTY
TWO THE DEPARTMENT HAS OPENED
AND INVESTIGATED AND IS
INVESTIGATING A TOTAL OF TWELVE
CASES UNLICENSED TREATMENT
ACTIVITY AND IS ISSUED ONE
NOTICE OF VIOLATION TODAY.
FINALLY AT THE GOOD NEIGHBOR
POLICY REQUIREMENTS DIETSCH YES
CERTIFICATION STANDARDS REQUIRE
PROGRAMS TO HAVE A COMMUNITY
RELATIONS POLICY. THE COMMUNITY
RELATIONS POLICIES REQUIREMENTS
IN AN EFFORT TO ASSIST TREATMENT
PROGRAMS AND ESTABLISHING AND
MAINTAINING POSITIVE
RELATIONSHIPS WITH NEIGHBORS AND
THEIR SURROUNDING COMMUNITIES.
THANK YOU. AND AT THANK YOU
DIRECTOR BASS RETURNING US TODAY
I'M- TRACTOR I AT THE BEGINNING
AS AS THE HEARING AID AND IF YOU
WERE LISTENING I. SHARED THE
STORY OF A FACILITY THAT I
BELIEVE YOU ARE FAMILIAR WITH AT
GRATITUDE LODGE I ALSO WANT. TO
SHARE ANOTHER STATEMENT WITH YOU
AB FROM. ATLAN MANY ACE. WHO'S
AT SIGNED MATTHEW MANY ACE
TRAGICALLY LOST HIS LIFE IN A
ADDICTION TREATMENT FACILITY AND
THIS IS FROM MRS MANY ICE MY
TWENTY YEAR OLD SON FALSELY
ASSURED OF AROUND THE CLOCK
MEDICAL SUPERVISION TRAVELED
CROSS COUNTRY SEEKING A MEDICAL
DETOX WITH HIS ADDICTION FOR
ABOVE IT ALL TREATMENT CENTER IN
LAKE ARROWHEAD WHEN HE ARRIVED
MATHEW'S DRUG TEST WAS CLEAN
THREE DAYS LATER ON FEBRUARY
SIXTH TWENTY SEVENTEEN HE WAS
DEAD. I WILL NEVER SEE HIM AGAIN
I LATER FOUND OUT THAT SIX
PEOPLE HAD DIED AT A AYE A
BEFORE MATTHEW. THE DEPARTMENT
OF HEALTH CARE SERVICES
INVESTIGATED AND ISSUED A DEATH
INVESTIGATION REPORT DATED
DECEMBER FOURTH TWENTY
SEVENTEEN. FINDING AMONGST OTHER
THINGS FALSIFICATION OF
DOCUMENTS AND AN ACCURATE RECORD
RESIDENT RECORDS WAS
SUBSEQUENTLY DISCOVERED THAT IN
A NURSE FORGED A PRESCRIPTION
AND GAVE MY SON CLINT AS A PAN
AND- SUBOXONE. POTENTIALLY
DANGEROUS AND COUNTRY INDICATED
MEDICATIONS DISCOVERING THE
FORGE PRESCRIPTION I FACE AN
UPHILL BATTLE TO HAVE DH CS RE
OPEN THE INVESTIGATION INTO MY
SON'S DEATH ONLY TO BE
DISAPPOINTED AGAIN. DH CS
INVESTIGATED AND DID NOTHING
WHICH RESULTED AND STILL MORE
NEGLIGENT DEATHS. AND SO I GUESS
MY FIRST QUESTION IS. WHEN YOU.
HERE THAT STORY WHAT IS YOUR
RESPONSE TO THAT MOM WHEN YOU
HEAR THE STORY OF HENRY LAYER
WHAT IS YOUR RESPONSE TO HIS
PARENTS. THAT THIS IS A TRAGIC
LOSS OF LIFE PARTICULARLY FOR
SOMEONE WHO IS SEEKING SERVICES
TGL TO RECOVER TO GET BETTER WE
TAKE THESE VERY SERIOUSLY- AND I
I'M SORRY I FEEL BAD FOR THE
MOTHER AND I THINK IT'S- IT'S A
TRAGIC LOSS OF LIFE. AND AT. I
GUESS THEY'RE TAKING A STEP BACK
BIG PICTURE AND A DOCTOR ARE
TONY TALKED ABOUT SOME
OPPORTUNITIES- DO YOU THINK
CALIFORNIA IS DOING A GOOD JOB
OF MANAGING AND REGULATING THE
SUBSTANCE ABUSE TREATMENT
FACILITIES. CLEARLY EVERY
REGULATORY AGENCY CAN DO A
BETTER JOB AT OVERSIGHT H- YOU
KNOW I THINK ONE OF THE STATE
THAT TOPICS THAT WE'VE HAD
CONVERSATIONS WITH YOUR OFFICE
ON IS REALLY GOT THE
CERTIFICATION OF PROGRAMS AND
HOW WE- NEED MORE THERE AND MAKE
THAT A MORE MANDATORY
REQUIREMENTS ARE PROGRAMS TO
ENSURE THAT THE QUALITY OF CARE
IS PROVIDED. FOLLOWING UP ON
SOME OF THE COMMENTS THE DOCTOR
SEND BURKE TOLD ME MAKE THIS
WALL LOOK WHAT IT WHAT IS
QUALITY CARE HOW DO WE DEFINE
THAT ENSURE THAT OUR PROGRAMS
ARE HELD ACCOUNTABLE. AND I GET
SPECIFICALLY WHAT DO YOU THINK
NEEDS TO BE CHANGED AND IMPROVED. AS WE AS I MENTIONED AT THE
BEGINNING ONE OF IDEAS THAT I
KNOW THAT WE'VE. CURRENTLY IT'S
A VOLUNTARY REQUIREMENT PER
STATUTE AND I KNOW WE'VE BEEN IN
COMMUNICATIONS ON MAKING THAT A
MANDATORY REQUIREMENT FOR
OUTPATIENT PROGRAMS TO ENSURE
THAT QUALITY CARE IS PROVIDED
AND STANDARDS ARE CLEAR IN
STATUTE CLEARS ENFORCEMENT
REQUIREMENTS- AND THAT WE CAN
APPLY THOSE STATEWIDE. AND I'M
I'M CERTAINLY GRATEFUL THAT I
YOU AND YOUR YOUR DEPUTIES
AGREED THAT. AS SOME SORT OF
MANDATORY LICENSURE OR
CERTIFICATION IS NEEDED I KNOW
IT'S A CONVERSATION THAT. HAS
BEEN ONGOING SINCE I WAS WAS
FIRST ELECTED THREE YEARS AGO
AND- I THINK THAT. IT SAYS IT'S
PRETTY SHOCKING I THINK TO MOST
CALIFORNIANS WHEN THEY LEARNED
THAT FIVE YOU KNOW YOU NEED A
LICENSE TO FISH YOU NEED A
LICENSE TO CUT SOMEBODY'S HAIR.
BUT RIGHT NOW ANYONE ANYONE CAN
OPEN A DRUG TREATMENT FACILITY
AND OPERATED WITHOUT ANY SORT OF
CERTIFICATION OR LICENSE I WHICH
I THINK IS. IS SHOCKING AND- AT
ISSUE THAT THAT WE URGENTLY NEED
TO WORK TOGETHER TO ADDRESS. AB
AND ACTUALLY DOCTOR MARK
BARTOLOMMEO AT YOU IT OUTLINES
SOME OF THE AREAS WHERE YOU
THINK THERE'S OPPORTUNITY FOR.
AS CALIFORNIA TO IMPROVE
OVERSIGHT I'M ANY OTHER
SPECIFICS THAT YOU YOU WOULD
SHARE THAT YOU WOULD
HIGHLIGHTED. AT THE FACT THAT WE
NEED. TO FIVE. AT ADOPT EVIDENCE
BASED MEASURES AND- INJURED
QUALITY TRANSPARENCY AND
ACCOUNTABILITY HE SAID SHIFT
FROM THIS LICENSE FOR FLORIDA Q.
FIVE MEASURES OF QUALITY IS ARE
THERE ANY OTHER DETAILS THAT
THAT YOU'D LIKE TO SHARE EITHER
WITH ME OR I WITH DIRECTOR BASS.
SHE'S ON THE LINE SHE GESTIONES
FOR HOW WE CAN IMPROVE. OUR
OVERSIGHT IN THIS AREA.
ABSOLUTELY I THINK ONE OF THE
ONE OF THE MAIN AREAS WOULD BE-
YOU KNOW WE HAVE THIS SYSTEM
RIGHT RIGHT NOW THAT IF IT'S A
MEDIC CAL RELATED TYPE OF THING
WHERE. THEN THE REQUIRED TO
ENGAGE IN THE SYSTEM BUT IF IT'S
NOT AND THEN THEY'RE NOT AS WE
HAVE NO WAY TO REALLY GET A
SENSE THAT AND IF YOU'RE A
PARENT OR A LOVED ONE IN YOUR-
YOU KNOW LOOKING FOR A TREATMENT
CENTER AND THEY SAY THAT THEY
PROVIDE SOME SORT OF SERVICES.
THERE'S NO STANDARDIZATION TO
KNOW EXACTLY WHAT'S GOING ON IN
IN PARTICULARLY FOR EXAMPLE IN
THE USE OF MEDICATIONS- THAT'S
IT THAT'S IT THAT'S A BIG ONE SO
THERE ARE STILL FACILITIES OUT
THERE THAT- THEY MAY HAVE THEIR
OWN PHILOSOPHICAL APPROACH TO
STEW AT THE CHARACTER OF FOLKS
WITH. SUBSTANCE USE DISORDERS
AND- AND BECAUSE THEY'RE NOT
NECESSARILY IN THE MEDICAL
SYSTEM THEN THEY WOULDN'T HAVE
TO GO TO THE SIR THE
CERTIFICATION HOWEVER. THEY'RE
STILL TAKING CARE OF THE SAME
PEOPLE IN TERMS OF HUMAN BEINGS
THAT DOESN'T CHANGE I MEAN THE
PAYER IS JUST PAYER SYSTEM- AND
SO IT DOESN'T MAKE SENSE TO ME
THAT THAT THAT THAT WOULD BE A
DIFFERENCE THERE AND THEY YOU
KNOW. IT IT'S HOW WE ALSO KNOW
WHETHER SOMEBODY'S COMING IN
AND- THEY'RE USING MEDICATIONS
ARE NOT USING MEDICATIONS WHAT
YOU CAN IMAGINE GOING THROUGH
WITHDRAWAL AND IN ONE PROGRAM
YOU WOULD JUST BE YOU KNOW MAYBE
HANDED A BOOK AND ASKED TO JUST
KIND OF GO THROUGH IT. WITH
MEANT WITHOUT NECESSARILY HAVING
THE TYPE OF ASSESSMENTS THAT
WOULD NECESSITATE ARE LOOKING
INTO YOUR MEDICAL HISTORY TO
KNOW WHETHER YOU'RE EVEN
APPROPRIATE TO BE THERE IF YOU
HAVE CO MORBID CONDITIONS- AND
THEN AND THEN ANOTHER GROUP WOOD
BUT- RIGHT NOW ONLY BECAUSE OF A
PAIR. SO THOSE KIND OF THINGS
NEED TO BE ALIGNED FOR SURE- AND
THERE NEEDS TO BE NOT JUST AN
OPTION TO BE. TO BE. SOMEBODY
THAT DOES PROVIDE CARE THAT'S IT
THAT THAT IS EVIDENCE BASED- SO
I WOULD SAY THAT THAT THAT IS
ONE MAIN ONE AND THEN THE OTHER
ASPECT IS THE TRANSPARENCY SO
THAT. THE FOLKS THAT ARE
ENGAGING IN SERVICES AT ANY ONE
OFTHESE IT SHOULD BE SIMPLER.
TO UNDERSTAND. WHAT YOU'RE
GETTING. SO THE IF EUROPE.
YOU'RE SENDING YOUR CHILD. YOU
THINK MIGHT HAVE A MEDICAL ISSUE
MAYBE THEY HAD A SEIZURE IN THE
PAST. AND YOU DON'T RUN THE RISK
OF THEM GOING TO A PLACE. TO
DETOX OR- EVEN JUST BEING THERE
WITHOUT A DETOX. WITHOUT
APPROPRIATE. APPROPRIATELY
TRAINED INDIVIDUALS. AND ARE
PEOPLE THAT CAN HANDLE SUCH
THINGS. NOW BECAUSE THAT'S WHERE
WE RUN INTO SOME OF THE PROBLEMS
A LOT OF THE MOM AND DAD THAT
ARE GOING TO TELL YOU ABOUT HOW
THAT. THEIR CHILD IS NO LONGER.
IS OFTENTIMES BECAUSE OF THAT AS
WELL AS EXPECTATIONS AROUND
STOPPING WHEN PEOPLE WANT TO
LEAVE AGAINST MEDICAL ADVICE OR
AGAINST. CLINICAL ADVICE WHICH
HAPPENS AS WELL. IF PEOPLE.
DON'T HAVE THEIR SYMPTOMS- IT
TREATED IF THEY DON'T HAVE THEIR
WITHDRAWAL AMELIORATED WELL THEN
THEY GET UP AND GO. AND THAT AND
THEN AND SO WITH THE EXPECTATION
AROUND THAT WELL RIGHT NOW WE
DON'T HAVE. WE GET WE HAVEN'T.
GATHERED THAT UP AND SAID YOU
KNOW WHAT IT IS AN EXPECTATION
THAT IF EVEN IF SOMEBODY WANTS
TO LEAVE AGAINST MEDICAL ADVICE
IT IS STILL YOUR DUTY. TO TRY TO
PROTECT AND THE SAFETY OF THAT
INDIVIDUAL AND THE AND THEN
THERE SHOULD BE SOME STEPS.
OTHER OTHERWISE WHAT HAPPENS IS
PEOPLE LEAVE AND THEN THEY DIE.
BECAUSE THEY'RE GOING OUT INTO
AN ENVIRONMENT THAT IS NOT A
QUICK FOR THE PROBABLY UNSTABLE
. THOSE CAMPAIGN- SACRAMENTO
HAPPY TO SEE DOCTORS AND BUT HOW
MAY BRING UP THIS ISSUE
TRANSPARENCY BECAUSE WHEN YOU
HAVE A- PARENTS ARE YOU AS A
CLIENT OF TRYING TO GET HELP A
YEAR IF YOU GOOGLE THERE'S NO
WAY TO FIND- GOOD QUALITY
FACILITIES SO WE'RE GOING TO BE
A LAUNCHING IN RESPONSE TO THAT
CONCERN. THAT SHATTER PROOF THAT
LIST PLATFORM WHICH HAS BEEN
LAUNCHED IN FEDERAL STATE. AND
THE PLATFORM WILL ALLOW YOU TO
TAKE IN A ST VALIDATED SURVEY.
SHOULD DETERMINE YOU NEED
RESIDENTIAL CARE COMMITTEE
SERVED AS AN OUTPATIENT AND YOU
NEED. MEDICATIONS ADDICTION.
AFFECT THE STANDARD OF CARE
APPROPRIATE THIS ORDER. AND THEN
ONLY ON THAT I'M NOT DISABILITY
WOULD YOU FIND FACILITIES THAT
HAVE BEEN CERTIFIED BY THE STATE
OF CALIFORNIA. LICENSED AT THEIR
RESIDENTIAL AND WITH QUALITY
METRICS THAT ARE ON HAVE BEEN
VALIDATED NATIONALLY SO WE'RE
REALLY EXCITED THAT IN THE FALL
OF NEXT YEAR WILL BE LAUNCHING
THIS PROGRAM TO SOLVE EXACTLY
THIS PROBLEM OF TRANSPARENCY.
AND QUALITY STANDARDS WE ALSO
WANTED TO BRING THAT BAD- WE
HAVE IMPLEMENTED. AT EIGHT
TWENTY THREE WHICH REQUIRES.
FACILITIES TO ATTAIN A
DESIGNATION BASED ON THE-
SANTANDER'S CARE THE AYE LEVEL
CARE DESIGNATION THAT DOCTORS
HAD BEEN CALLING THE INVENTION
SO WE SEE THAT. AND MANDATORY
CERTIFICATION AS HER THREE-
STRATEGIES TO ADDRESS. THEIR
CONCERNS OF THEM BROUGHT UP
TODAY ALONG WITH AGGRESSIVE
INVESTIGATION WHEN WE SEE THEIR. ANSWERS FROM OUR OUR STANDARDS
. AND THANK YOU FOR THOSE COME.
I'M AND I DO HAVE I HAVE A FEW
FOLLOW UP QUESTIONS RELATED TO.
THE GRATITUDE LARGE
INVESTIGATION BUT I'M GOING TO
SAVE THOSE FOR OUR SECOND PANEL
WHICH IS ABOUT RESPONDING TO
PATIENT SAFETY INCIDENTS. I DO
WANT TO ASK A FEW QUESTIONS
RELATED TO. OUR SPENDING IN THIS
AREA SO- I EITHER FOR YOU OR FOR
DIRECT BOSS. HOW MUCH DOES THE
STATE OF CALIFORNIA SPEND ON
SUBSTANCE ABUSE TREATMENT
SERVICES TODAY. ONE SECOND
PLEASE I HAVE THE NUMBER. THE
DRUG MEDIC HELP PROGRAMS THAT
THIS IS JUST IN AND THE MEDICAL
PROGRAM BUT IT IS ABOUT FOUR
HUNDRED AND SIXTY MILLION
DOLLARS. EXCUSE ME ABOUT. ABOUT
BY ABOUT SIX HUNDRED MILLION
DOLLARS IN THE IN THE DRUG
MEDICAL PROGRAM SO UP FOR
MEDICARE RECIPIENTS. TWO SIX AND
A MILLION DOLLARS THAT'S FOR
MEDICARE RECIPIENTS ONLY AND-
HOW DOES DH CS TRACK THE
EFFICACY OF THIS SPENDING. WE
TRACK UTILIZATION WE TRACK-
METRICS FOR OUTCOMES I WOULD
TURN IT OVER TO IT DR PFEIFFER
OR AND- YOU KNOW AROUND D. YEMEN
ABOUT 95% OF MEDICARE
BENEFICIARIES ARE IN COUNTY THAT
ARE INVOLVED- WE CALL THE DRUG
MEDI CAL ORGANIZED DELIVERY
SYSTEM. WE WERE THE FIRST STATE
IN THE NATION TO ROLL THIS
PROGRAM OUT TO ALLOW THE FULL
CONTINUUM OF CARE FOR SUBSTANCE
USE DISORDER TREATMENT- WITH ALL
THE REQUIREMENTS THAT WE HAVE
FOR MANAGED CARE PLANS RUN
NETWORK ADEQUACY AND QUALITY AND
WEHAVE REQUIRED METRICS THAT
ARE- FOLLOWED IN THE OUR DRUG
MEDI CAL ORGANIZED DELIVERY
SYSTEM EVALUATION WHICH IS
REPORTED TO CMS EVERY. YEAR AND
IT'S ON OUR WEBSITE. SO WE DO
YOU TRACK AND OUTCOMES AND
UNDERSTAND. WHAT PERCENTAGE OF
PATIENTS RECEIVE TREATMENT THAT
IS EFFECTIVE VERSES. NOT
EFFECTIVE. WE DO I WILL ADMIT
THAT THE- DATA THAT WE COLLECTED
THEM PERFECT SAYS YOU GO ON TO
OUR VALUATION- WEBSITE THE DATA
IS NOT AS ROBUST AS I THINK ANY
OF US IN THIS ROOM WOULD LIKE TO
SEE AND THAT'S SOMETHING THAT
WE'RE CONTINUALLY WORKING TO
IMPROVE BECAUSE UTILIZATION
MEANS WHO'S GETTING SERVICES AND
THAT'S JUST THE STARTING POINT
WE WANT TO SEE THAT PEOPLE ARE
GETTING BETTER AND WE WANT TO
SEE THAT THAT WE ARE AVOIDING
OVERDOSE DEATHS AND WE WANT TO
SEE IF WE'RE TREATING PEOPLE OF
EVIDENCE BASED TREATMENTS AND-
AND THAT IN ALL OF THAT THE
APRIL HEALTH FIELD IS. NOT WHERE
WE WANT TO BE AND WE'RE
CONTINUING TO WORK AND IMPROVE
SO THAT WE CAN HAVE ROBUST
QUALITY METRICS THAT ARE
TRANSPARENT FOR ALL. AND THAT'S
SOMETHING WE'RE ACTIVELY WORKING
ON. CAN YOU AT. BUT WHEN YOU SAY
ACTIVELY WORKING ON CAN YOU.
GIVE ME A LITTLE MORE DETAIL IN
TERMS OF WHAT WHAT WE CAN EXPECT
RELATED TO THAT IN THAT THE
COMING YEAR. THANK YOU WE
BELIEVE THAT WE SHOULD BE
PUBLISHING EASY T READ
DASHBOARD SO THAT WE HAVE
STANDARDIZED METRICS FOR MENTAL
HEALTH AND ISSUE THE AND THAT
THEY'RE AVAILABLE TO THE PUBLIC
AND SO WE- HAVE METRICS
PUBLISHED FROM MENTAL HEALTH AND
WE'RE WORKING ON THAT FOR
SUBSTANCE USE DISORDERS WELL AND
RAINING TO PUBLISH THAT IN THE
NEW YEAR. OKAY BUT WE WILL AT
LEAST FOUR TRIBUNE NOT WHEN THAT
IS. AVAILABLE AND AT AGAIN
BEFORE WE WRAP UP THIS PANEL I
DO HAVE A COUPLE OF QUESTIONS AT
DIRECTOR BUS. RELATED TO IF YOU
POINTS THAT YOU. MADE I'M SO
SEVERAL TIMES YOU NOTED THAT. I
THAT THESE. WHAT ARE THESE READ
THESE RESIDENTIAL RECOVERY
FACILITIES THESE LESS THAN SIX
BY FIVE RECOVERY RESIDENCES ARE
NOT SUPPOSED TO BE PROVIDING
TREATMENT SERVICES BOB WE HAVE
NUMEROUS EXAMPLES BOTH IN MY
DISTRICT AS WELL AS OTHER
COMMUNITIES WHERE THESE RECOVERY
RESIDENCES ARE PROVIDING
TREATMENT SERVICES SO FOR
EXAMPLE THE CITY OF DANA POINT
HAS SINCE SUED MANY RECOVERY
RESIDENTS OPERATORS AND
DETERMINED THAT THEY ARE
OPERATING WITHOUT A LICENSE.
WHAT DO YOU DO WHEN THIS HAPPENS. BAKER CHARLIE JUST DISTRICT
START BY SAYING WHEN WE HEAR OF
THIS WE GO IN AND WE DO AN
INVESTIGATION TO SEE IF INDEED
THAT. LICENSE OF ALL SERVICES
ARE BEING PROVIDED- AND IF THEY
ARE THEN WE- ASSEMBLY. THIS
EFFORT ON OUR- I TALK IF I
FORGET MARCH OUT ON THAT.
COMPLAIN WITHIN OUR AUTHORITY
ENSURE THE NOT PRO SO THAT
SHOULD BE LICENSED WE
INVESTIGATE WHEN THEY DO AND
WHEN THEY- AND WE CONTINUE TO
MONITOR THEM TO MAKE SURE THAT
THEY COMPLY. AND I THINK THAT
THE ISSUE FROM. MY VANTAGE POINT
SEEMS TO BE THAT THERE'S NO
TEETH ASSOCIATED WITH THAT SO.
THAT'S ALL WELL AND GOOD IF YOU
SEND SOMEONE A LETTER SAYING
PLEASECEASE AND DESIST BUT IF
THE VERY NEXT WEEK. THAT THEY'RE
STILL DOING THE SAME THING IT
FEELS LIKE THERE'S ABSOLUTELY NO
CONSEQUENCES. WHICH IS WHY THIS
IS JUST CYCLE OF DYSFUNCTION IS
NOT STOPPED. WHEN AT WHAT POINT
YOU ACTUALLY GO IN. AND SAY
ALRIGHT WE'RE GOING TO DO MORE
THAN SEND YOU A LETTER. WE ARE
GOING TO SHUT YOU DOWN. HELLO
THIS IS JANELLE AND I AM- WITH
THE LICENSING AND CERTIFICATION
DIVISION SO WE DO HAVE THE
AUTHORITY WITHIN OUR STATUTES
REGULATIONS TO ISSUE DOUBLE DOSE
OF OPERATIONAL VIOLATION OF LAW
LETTER THEY ARE- REQUIRED TO
SEIZE THE SERVICES WITHIN
FIFTEEN DAYS AND THAT THEY DO
NOT CONCLUDE THEIR SERVICES ARE
STOP WRITING SERVICE AND-
BEGINNING ON THE SIXTEENTH DAY I
TWO THOUSAND DOLLAR DAY CIVIL
PENALTY DOES BEGIN PROGRAM. AND
SO THAT IS ISSUED AGAINST THE-
THE FACILITY SO WE WORK WITH
THEM TO ENSURE THEY HAVE STOCKED
AND IF THEY HAVE NOT BEEN ABLE
TO PROVE TO US THAT THEY STOP
AND WE DO HAVE THE- AUTHORITY
THEN TO GO IN AND SEES- OR SEEK
AN INJUNCTION AGAINST THE
FACILITY WE WORK WITH OUR
PARTNERS AT THE DEPARTMENT OF
JUSTICE. TO GET FOR ORDERS AND-
IF NEEDED- INSPECTION WARRANTS-
EXETER SO ANYTHING ALONG THOSE
LINES THAT IF IT AGAIN IS
DETERMINED THAT THEY ARE NOT
CEASING THE SERVICES THAT WE CAN
GO IN AND I'M. SEEK INJUNCTIONS
AGAINST THE FACILITY. AND HOW
OFF IS THAT. LIKE THIS PAST YEAR
HOW OFTEN DID YOU ACTUALLY. ONE
OF THESE ROGUE WHAT I WOULD CALL
ROGUE REHAB FACILITIES OUT OF
BUSINESS. SO WE HAVE NOT HAD TO
SEEK- AN INJUNCTION AGAINST A
FACILITY IN THIS PAST YEAR. YOU
HAVE NOT HAD TO ARE YOU CHOSE
NOT TO. WE HAVE NOT HAD TO WE
HAVE NOT FOUND ANY EVIDENCE
THAT- AND FACILITY THAT WE HAVE.
ISSUED A CEASE AND DESIST
CONTINUE TO OPERATE BEYOND- THAT
FIFTEEN DAYS. AGAIN IF THERE IS
OTHER EVIDENCE OUT THERE AND
WE'RE ABSOLUTELY HAPPY TO
CONTINUE TO INVESTIGATE OKAY LET
ME FOLLOW UP WITH YOU ON. ON
THAT. ABSOLUTELY ANY M.
INFORMATION HOW WE'RE HAPPY TO
TAKE. AND AT DRUCKER BUS AGAIN
BEFORE WE MOVE ON FROM THIS AT A
COUPLE OF QUESTIONS TO. DO YOU
THINK THE DH CS THIS IS I GUESS
TAKING A BIG STEP BACK. DO YOU
THINK THE DH CS IS THE
APPROPRIATE ENTITY AND STATE
GOVERNMENT. TO ISSUE LICENSES
AND TO MONITOR THESE FACILITIES
OR IS THIS FUNCTION BETTER
SITUATED WITH THE CALIFORNIA
DEPARTMENT PUBLIC HEALTH SINCE
THIS IS A PUBLIC HEALTH ISSUE
FOR. WHAT WE MADE AT THE
DEPARTMENT HEALTHCARE SERVICES
MAINTAINS OVERSIGHT OF BEHAVIOR
HEALTH PROGRAMS AND SO WE HAVE
OUR SUBJECT MATTER EXPERTISE IN
TERMS OF. A MENTAL HEALTH AND
SUBSTANCE USE TREATMENT AND
SERVICES IN RECOVERING KIND OF
UNDERSTANDING THE CONTINUUM OF
THE SERVICES AVAILABLE AND OUR
MEDICAL DELIVERY SYSTEM. SO WE
MAINTAIN EACH YES IS THE
APPROPRIATE ENTITY TO- EMBARK ON
THESE DUTIES. AND AT LAST WE
BEFORE WE TURN TO THAT THE
SECOND PANEL WHICH WILL FOCUS
ON. A PATIENT SAFETY INCIDENTS
AND RESPONSES I DO WANT. TO ASK
A COUPLE OF QUESTIONS RELATED
TO. THE LOCATION OF THESE
FACILITIES AT. THESE MANY OF
THESE FACILITIES INCLUDING
LICENSED. DETOX FACILITIES ARE
HOUSED IN RESIDENTIAL
NEIGHBORHOODS NOW IF I WANT TO
OPEN A DIALYSIS CLINIC IN
CALIFORNIA CAN I DO THAT TO
PROVIDE THE SERVICES CAN I DO
THAT IN MY HOME. I CAN'T SPEAK
TO THE REQUIREMENTS OF A
DIALYSIS CLINIC AND WHAT WHAT IS
NECESSARY TO KNOW WHERE THE
LOCATION OF A DIALYSIS CLINIC
MAY BE LOCATED BUT A CORNER I
KEEP AWARE OF OUR KIND OF OUR
RECOVERY MODEL IS THAT
INDIVIDUALS ARE ABLE TO A LIVE
IN THE COMMUNITY GREAT SUPPORTS
IN THE COMMUNITY WE KNOW THAT
THIS IS THIS IS A BETTER PATH
TOWARDS RECOVERY AND SO. I'M
WITH THAT IN MIND THIS IS HOW
ARE OUR LICENSING STRUCTURE IS-
IS- OUTLINED. SO YOU SAID IT'S A
KEY PILLAR OF YOUR RECOVERY
MODEL AND WE KNOW THIS IS. THE
BETTER MODEL HOW DO YOU KNOW
THIS IS THE BETTER MODEL. AT ALL
TO MY UNDERSTANDING FOR MY PART
PRE PREVIOUS QUESTIONS. I DON'T
THINK YOU'RE ACTUALLY TRACKING
OUTCOMES. THE JUST THE GENERAL
PREMISE OF THE MEDICAID PROGRAM
IN HOME AND COMMUNITY BASED
SERVICES IS THAT THIS IS A
CONTINUE- I'VE SERVICES AN
INDIVIDUAL SHOULD BE TREATED
AND- I CARED FOR AND THE LOWEST
LEVEL OF CARE NEEDED AND WE
RECOGNIZE THAT INDIVIDUALS. IN
ORDER FOR THEM TO SUCCEED AND
THRIVE NEED TO BE PART OF THEIR
COMMUNITY- AND SO THIS IS KIND
OF PART OF THE CONTINUUM AS WE
THINK THROUGH THE DIFFERENT
SERVICES AVAILABLE- I'M- ON THE
PATH TO RECOVERY. AND I
CERTAINLY CAN UNDERSTAND THAT
WHEN IT'S- SIMPLY RECOVERY
RESIDENTS IN SUPPORT BATES. A
LICENSED TO DETOX FACILITY
FACILITY IS PROVIDING MEDICAL
SERVICES. IS THAT SOMETHING THAT
YOU THINK IS APPROPRIATE FOR ME
TO BE DOING OUT OF MY HOME. WE
HAVE MANY PROGRAMS IN THE
MEDICAL SPACE WERE AT MEDICAL
SERVICES ARE PROVIDED IN THE
COMMUNITY AND SO THIS IS SIMILAR
IN THE IN A SIMILAR VEIN WHERE
MEDICAL AND HEALTH SERVICES ARE
PROVIDED IN THE COMMUNITY TO
ENSURE THAT INDIVIDUALS CAN
RECEIVE- SERVICES AND SUPPORTS
IN THE LOWEST LEVEL OF.
INTERVENTION THAT IS NECESSARY.
RIGHT YEAH. I'M LET'S SEE AND
THEN LASTLY. LET ME JUST ASK YOU
ABOUT THE IMPLEMENTATION OF A
COUPLE OF. PIECES OF LEGISLATION
THAT HAVE BEEN PASSED IN RECENT
YEARS SO. ON SEPTEMBER TWENTY
SIX TWENTY EIGHTEEN THE GOVERNOR
SIGNED SB NINE NINETY TWO INTO
LAW AND THIS REQUIRES THE
PROGRAMS THAT ARE CERTIFIED BY
DH CS DISCLOSURE MENTORSHIP OR
CONTROL OF ANY FINANCIAL
INTEREST IN A RECOVERY AT
RESIDENTS- THAT WAS TO BE
IMPLEMENTED BY JANUARY FIRST
TWENTY TWENTY ONE HAS THIS
PROVISION BEEN IMPLEMENTED. SB
NINE NINETY WAS IMPLEMENTED VIA
AN INFORMATION NOTICE ON JANUARY
TWENTY NINTH TWENTY NINETEEN-
AND THIS IS INSURANCE WITH ALL
THESE DISCLOSE OWNERSHIP
RELATIONSHIPS AND- INSURED
CLIENTS ARE NOT DISCRIMINATED
AGAINST FOR TAKING MEDICATIONS
OR KICKED IN ADDICTION OUR-
TREATMENT. SO THIS HAS BEEN
IMPLEMENTED. YES OKAY AND I.
ANOTHER PROVISION ENABLES AT DH
CS TO DENY LICENSURE TO ENTITIES
UNDER A NUMBER OF CONDITIONS IN
WHICH THE LICENSEE HAS ENGAGED
AVERAGE DEVOTEES AS DH CS
IMPLEMENTED THIS PROVISION AND
HAVE ANY LICENSES BEEN DNIED OR
SUSPENDED AS A RESULT OF THIS
PROVISION OF S. B. NINE NINETY
TWO. HOW WOULD YOU RESPOND ON
OUR BEHALF. SO LIKE DIRECTOR
BUST HAS MENTIONED THAT WE HAVE
IMPLEMENTED THAT BILL AND TO
DATE WE DON'T HAVE ANY THAT ARE
RELATED TO THAT IT DOESN'T MEAN
THAT WE HAVE AND CONTINUE TO
TAKE ACTION I'M AGAINST ANY
FACILITIES BUT IN RELATION TO
THIS BILL SPECIFICALLY THERE HAS
BEEN- I THINK THAT WE'VE HAD-
RELATED TO IT. BUT WHEN THEY
AUTHORITY IS THERE AND- ANYTIME
THERE IS ANY ACTION THAT COMES
UP WE DEFINITELY WILL RELY UPON
OUR AUTHORITY WITHIN THAT BILL
TO USE IT IF NEEDED. AN EIGHTY
NINE NINETEEN WHICH I AUTHORED I
WAS STRUCTURED ON OCTOBER
TWELFTH TWENTY NINETEEN. I SAID
JUST OVER TWO YEARS AGO. SO CHIU
QUESTIONS RELATED TO THIS BILLS
IMPLEMENTATION SAID THIS BILL
REQUIRED THE DEVELOPMENT OF AN
ENFORCEMENT PROGRAM. PLEASE CAN
YOU DESCRIBE THAT ENFORCEMENT
PROGRAM AND HOW IT'S BEEN
STAFFED. AND SECONDLY CAN YOU.
PLEASE REPLY TO HOW MANY OF THE
LICENSE FACILITIES HAVE PRODUCED
THE CONTRACTS THAT WAS REQUIRED
BY THIS LEGISLATION. BE SURE SO
WE- HAS STEPPED UP AND ADDED
SOME ANALYSTS TO SUPPORT THIS
PROGRAM AND WE ARE NOW CURRENTLY
IN OUR REVIEWS WHEN WORKING-
WITH OUR LICENSED FACILITIES
REQUIRING THAT THEY SUBMIT ALL
THE REQUIRED INFORMATION IN
ALIGNMENT WITH THE BILL- WE WILL
HAVE TO GET BACK TO YOU ON THE
DATA- I DON'T HAVE THAT. AT MY
FINGERTIPS TO DATE- BUT WE HAVE
IMPLEMENTED THIS BILL WE ARE
ENFORCING IT AND WE HAVE ADDED
ANALYSTS TO- OVERSEE THE SPARK
PLUG. AND ACTUALLY AT RELATED.
TO YOUR- ENFORCEMENT. PERSONNEL
BOTH. THE ADDITIONAL INDIVIDUALS
THAT WERE HIRED AS A RESULT OF
AB NINE NINETEEN AND ALSO MORE
BROADLY. OUT WHERE ARE YOUR
INSPECTORS LOCATED. OVERSTOCKED
WAREHOUSES- AT IN SACRAMENTO. I
HAVE AND WHERE WHERE ARE THE
MAJORITY OF THE SUBSTANCE ABUSE
TREATMENT FACILITIES LOCATED. WE
DO HAVE MAJORITY OF OUR
FACILITIES- LICENSED AND
CERTIFIED- WITHIN THE SOUTHERN
CALIFORNIA REGION BUT WE DO
COVER AGAINST STATEWIDE- WE HAVE
FACILITIES THAT GO ALL THE WAY
UP TO THE NORTHERN BORDERS OF
CALIFORNIA INCLUDING UP TO THE
EASTERN BORDERS SO WE DO-
MONITOR AND OVERSEE FACILITIES
STATEWIDE. AND BUT GIVEN THAT
THE FIVE HIGHEST CONCENTRATION
OF THESE FACILITIES IS IN
SOUTHERN CALIFORNIA- WHY DO WE
HAVE ENFORCEMENT STAFF ONLY
BASED IN SACRAMENTO. IT IS
CURRENTLY WHERE OUR- BEHAVIORAL
HEALTH AND C. D.'S- DIVISION IS
LOCATED AND OUR STAFF ARE READY
TO GO AND- ARE ABLE TO TRAVEL-
WHEN NEEDED SO WE DO SEND OUT
STAFF REGULARLY AND THEY TRAVEL
TO ANY FACILITY- REGARDLESS OF
THE LOCATION SO WE CAN SEND
FOLKS. OUT IN CALIFORNIA THE
GRANT VALUABLE WITHIN AN HOUR
PLANE FLIGHT SO WE DEPLOYED ALL
OF OUR STAFF- THROUGHOUT THE
STATE. AND I'M NOT FAMILIAR IS
NOT AT. SACRAMENTO CENTRIC MODEL
CONSISTENT WITH THE
INVESTIGATORS AND THE WAY THAT
YOU STAFF OTHER FUNCTIONS OF DH
CS DO YOU HAVE ANY REGIONAL
PRESENCE FOR OTHER DH CS
DEPARTMENTS OR UNITS. YES I
BELIEVE SO I'M SHE WENT INTO
THIS ROLE BUT I BELIEVE WE DO
HAVE OTHER REGIONAL OFFICES- FOR
DIFFERENT OTHER FUNCTIONS IN IN
THE DEPARTMENT. SUIT AT IT
STRIKES ME THAT THIS IS AN AREA
THAT WOULD BENEFIT FROM A
REGIONAL PRESENCE AND FROM SOME
RESOURCES BEING HOUSED IN THE
REGION WHERE THAT THEY'RE
ACTUALLY TASKED WITH MONITORING
AND INSPECTING I'M WHAT DO YOU
THINK ABOUT THAT. PROPOSAL. I
MEAN IT'S SOMETHING THAT WE
WOULD WANT TO DISCUSS AND
UNDERSTAND THAT THE SCOPE AND
THE BREADTH OF HOW THAT WOULD
WORK- IN PART OF THIS IS ALL IN
TERMS OF HOW DO WE IMPROVE THE
PROCESS AND SO I WOULD BE
INTERESTED IN CONTINUING
CONVERSATIONS ABOUT. APPLE I'LL
CERTAINLY PUT THAT ON OUR PART
LIST TO FOLLOW UP THAT YOU KNOW
AS YOU SAID YOU RECENTLY JOINED
THE DEPARTMENT AND YOU'VE BEEN
VERY ENGAGED IN THIS TOPIC AND I
APPRECIATE THAT. AS I HAVE
SHARED WITH YOU. THERE WAS A
LEGISLATIVE PROPOSAL THAT IN
FACT ACTUALLY PUT EVEN PROCEEDED
MY TIME IN THE LEGISLATURE WHICH
WOULD HAVE LOCATED INVESTIGATORS
COST TO THE DEPARTMENT OF HEALTH
CARE SERVICES AND- I'M ONE THAT
PROPOSAL ENJOYED BROAD. REGIONAL
SUPPORT AND FORTUNATELY THAT
PROPOSAL WAS BLOCKED BY ONE OF
YOUR PREDECESSORS SO I WOULD
HOPE THAT WE CAN AB PURSUE THAT-%
IN A MORE COLLABORATIVE FASHION
AS WE MOVE FORWARD. I DO HAVE A
NUMBER OF OTHER QUESTIONS BUT I
REALIZE THE WORD IN OUR AND SO
WHAT I'M GOING TO GO AHEAD AND
DO IS. OPEN IT UP FOR IS CLOSE
THIS PORTION OF THE HEARING- I
WANT TO THANK YOU AGAIN DR
BARTONE A FOR JOINING US I THINK
YOU I'M DIRECTOR BASS AND I KNEW
THAT YOU'RE GOING TO ALSO BE
PART OF OUR OUR DISCUSSION IN
OUR SECOND PANEL. WITH THAT
LET'S GO AHEAD AND AB WELL TIMED
OUR SECOND PANEL YOU SEE WE'VE
GOT AT WE ARE. AT B. JOINED ON
OUR SECOND PANEL BY ORANGE
COUNTY SUPERVISOR KATRINA FOLEY.
AND BY TODD FRANSON WHO IS AN
INVESTIGATOR WITH THE ORANGE
COUNTY DISTRICT ATTORNEY'S
OFFICE. MISTER FRANSON AND
SUPERVISOR FULLY WILL DISCUSS
THEIR EXPERIENCES RESPONDING TO
PATIENT SAFETY INCIDENTS.
RELATED TO RECOVERY TREATMENT
FACILITIES AND THEN WE WILL. AS
I SAID BE ASKING DOCTOR BASS TO
RE JOIN US TO DISCUSS HOW THAT
IT DEPARTMENT RESPONSE TO THESE
INCIDENTS- WITH THAT GO AHEAD
AND- WE WILL WELCOME AND- ORANGE
COUNTY SUPERVISOR KATRINA FOLEY
THANK YOU SUPERVISOR FULLY FOR
JOINING US. THANK YOU SIR ONE
AND TEACHING. CAN YOU HEAR ME
YES CAN. OKAY EXCELLENT WE HAD A
FEW TECHNICAL DIFFICULTIES THAT
ARE AMAZING STAFF TO CARE THANK
YOU FOR YOUR STAFF THE DISTANCE-
THANK YOU FOR CALLING THIS
HEARING TODAY AND FOR YOUR
LEADERSHIP ON GOING ON THIS
IMPORTANT ISSUE I DON'T THINK
DIRECTOR MATTHEW- IS NEW TO THE
JOB AND TO EVERYONE OUT TO
TESTIFYING HERE TODAY. THESE ARE
VERY CRITICAL ISSUES THAT WE
HEAR AN ORANGE COUNTY HAVE BEEN-
CACKLING FOR MANY MANY YEARS. AS
YOU HEARD MY NAME IS KATRINA
FOLEY I'M YOUR ORANGE COUNTY
SUPERVISOR AND FOR MORE THAN A
DECADE AT THE COSTA MESA CITY
COUNCIL MEMBER AND MAYOR I'VE
ADVOCATED FOR REGULATORY REFORMS
TO PROTECT PATIENTS FROM ABUSIVE
PROFIT MAIL STYLE DETOX AND
SOBER LIVING HOME OPERATORS.
THANK YOU MORE HARM TO PATIENTS
THAN THEY HELP. THE TYPES OF
REGULATORY REFORMS THAT WE HAVE
ADVOCATED FOR SIX TO PREVENT
TRAGEDIES LIKE THE DEATH OF A
TWENTY THREE YEAR OLD. MR LEHRER
FROM HAPPENING. ALL OF US I
THINK IT'S VERY IN. BECAUSE
WE'VE DONE WANT BE HEADING OUT
BURKE AT THE- ALL OF THAT. HAVE
HAD FAMILY MEMBERS WHO STRUGGLE
WITH ADDICTION IT'S SO COMMON IN
AMERICA AND IN ORANGE COUNTY
THAT IT'S HARD TO KNOW SOMEONE
WHO HASN'T HAD A FAMILY MEMBER.
WHO HAS BEEN ENGAGED IN THAT
SYSTEM. THIS IS AN ISSUE WE TAKE
VERY SERIOUSLY AND WE WANT TO
ENSURE THAT FAMILIES HAVE ACCESS
TO STATE SPACE. AND MEDICALLY
APPROPRIATE TREATMENT I THINK
THAT'S THE KEY MEDICALLY
APPROPRIATE ESPECIALLY GIVEN
SOME OF THE QUESTIONS AND-
RESPONSES THAT WE HEARD HERE
ALREADY. I BELIEVE THAT CONTRARY
TO STATEMENTS BY DIRECTOR BACK
SOBER LIVING HOMES ARE REGULATED
IN SOME CITY. THE CITY OF CUSTOM
MADE AS AN EXAM AND THE COUNTY
ORANGE. AB REGULATORY ORDINANCES
THAT REGULATE- SOBER LIVING HOME
. AND THEY HAVE BEEN DETERMINED
TO BE LEGAL IN SEPTEMBER THE
NINTH CIRCUIT UPHELD A JURY
VERDICT THAT THE ORDINANCE FOR
COSTA MESA WAS NON
DISCRIMINATORY LATER THE COUNTY
OF ORANGE I THOUGHT DID A
SIMILAR ORDINANCE. THE
PROVISIONS OF THE ORDINANCE
REQUIRE COMMONSENSE PRACTICES
INCLUDING DISPENSING
REQUIREMENTS BETWEEN FACILITIES
TWENTY FOUR HOUR SUPERVISION AND
THE REQUIREMENT THAT OPERATORS
TRANSPORT PATIENTS TO A SHELTER
OR BACK HOME AMONG OTHER
PROVISIONS TO PROTECT THE HEALTH
AND SAFETY OF THOSE IN RECOVERY
. ONE OF THE REASONS JUST TO
REQUIRE A TRANSPORT AND
NOTIFICATION IF PEOPLE ARE TO
LEAVE IS TO PREVENT PEOPLE FROM
WANDERING AROUND AND POSSIBLY
GOING INTO OTHER PEOPLE'S
PRIVATE RESIDENTS IT. IT'S ALSO
TO PROTECT THEM FROM BECOMING
HOMELESS. ONE I'M LICENSED
FAILED TO COMPLY WITH THESE
REGULATIONS THE CITY HAS FILED
NUISANCE ABATEMENT CLAIMS TO
SHUT DOWN UNSCRUPULOUS OPERATORS
ENFORCEMENT AS IS KEEN AND IT'S
WORKING. SO MY QUESTION IS WHY
CAN'T THE H. P. S. SUPPORT
SIMILAR STATEWIDE REGULATIONS.
MOSTLY HOME HAVE BEEN CONVERTED
HOSPITAL STYLE- NURSING STATION
AND CAUGHT FOR DETOX SERVICES
THEY'RE NOT LIKE REGULAR
RESIDENTS AND THEY DON'T
INTERACT WITH THE RESIDENTIAL
NEIGHBORHOOD AS YOU ARE I MIGHT
. HE TALKS LOCATED IN
RESIDENTIAL NEIGHBORHOODS THE
RESIDENTS DON'T FOR EXAMPLE
PARTICIPATING NEIGHBORHOOD GET
TOGETHER HOLIDAY PARTIES PICNIC
AT THAT TRACK THEY'RE REALLY
THERE FOR MEDICAL TREATMENT AND
THERE'S BEEN ONGOING ROTATION IN
AND OUT RARELY LEAVING THE SITE
EXCEPT TO GO TO ORGANIZED
ACTIVITIES. AFTER THE TRAGIC
DEATH OF MR LEHRER I SENT A
LETTER TO DIRECTOR BACK RAISING
CONCERNS ABOUT GRATITUDE LARGEST
STRICT COMPLIANCE WITH ALL
REGULATIONS TO ENSURE HEALTH AND
SAFETY OF THOSE IN THE TOP. I
APPRECIATED HER RESPONSE TO MY
LETTER BUT IT FAILED TO ADDRESS
THE IMPORTANT ISSUES AND
CONCERNS THAT IRATE MOREOVER THE
PUBLIC RECORD REQUESTS THAT WE
RECEIVED INCLUDING THE BIENNIAL
LICENSE REPORT AND A DEATH
INVESTIGATION REPORT RAISED MORE
DOUBTS ABOUT THE OPERATION LIKE
TO GRATITUDE LARGE DETOX AND
THEIR ABILITY TO COMPLY WITH
REGULATIONS AND TO ENSURE THE
HEALTH AND SAFETY OF PATIENTS.
IN DETOX AND RECOVERY YOU SHOULD
THE SUBSTANTIAL NEGLIGENT
DEMONSTRATED BY THIS FACILITY
THE LACK OF MEANINGFUL
ENFORCEMENT OF STATE REGULATION
IS UNACCEPTABLE. I THE FACT
RECORDS REQUESTS WILL REVEAL
SIMILAR LACK ENFORCEMENT IN
OTHER STATE LICENSED FACILITY.
AND THOSE FACILITIES ARE
PREDOMINANTLY LOCATED IN ORANGE
COUNTY. AS AN EXAMPLE ACCORDING
TO THE BIENNIAL LICENSE REPORT
GRATITUDE LARGE WAS CITED FOR
EIGHT DEFICIENCY. WELL THE DATE
OF THE REVIEW IS REDACTED THE
REPORT APPEARS TO HAVE BEEN
PUBLISHED ON AUGUST NINETEENTH
TWENTY TWENTY ONE THAT'S SEVEN
DAYS PRIOR TO THE DEATH OF MR
LEHRER. VIOLATIONS INDICATE THE
NEGLIGENT CONDUCT PRACTICE BY
THIS PROGRAMS INCLUDING THE
FAILURE TO MAINTAIN APPROPRIATE
PERSONNEL FILES ADMISSION
AGREEMENT AND RESIDENTS HELP
GREENING. THE FACILITY WAS ALSO
DEFICIENT IN COMPLYING WITH THE
REQUIREMENTS OF THE LICENSE FEES
SO DEVELOP MAINTAIN AND
IMPLEMENT AN ONGOINGTRAINING
PROGRAM FOR ALL STAFF. ADEQUATE
TRAINING IS FUNDAMENTAL TO END
UP TO ENSURE THE HEALTH AND
SAFETY OF THOSE IN DETOX. SURE
PROVISION OF PATIENTS AND DETOX
ALSO IS FUNDAMENTAL STAFF SHOULD
HAVE THE COMPETENCY TO DEAL WITH
DIFFICULT SITUATIONS INCLUDING
NEGATIVE PSYCHOLOGICAL EFFECTS.
AND EFFECT OF MEDICAL DRUGS THAT
PATIENTS EXPERIENCE WHILE IN
DETOX. THIS IS WHY IN ORANGE
COUNTY WE ARE OPENING TO BE WELL
FACILITIES THAT HAVE RESIDENTIAL
TREATMENT DETOX ASSOCIATED WITH
THEM AND ARE IN A MEDICALLY-
SUPERVISE ENVIRONMENT NOT
NEIGHBORHOODS. IF THE STAFF
MEMBER RESPONSIBLE FOR
MONITORING THE SURVEYOR HAD THE
PROPER TRAINING IT'S POSSIBLE
THAT THEY COULD BETTER THAN
BETTER EQUIPPED TO RESPOND TO
HIS REPORTED HALLUCINATION AND
ACTION ON THIS TRAGIC NIGHT.
ONGOING TRAINING AND ONGOING
TRAINING PROGRAM AND STAFF THAT
HAVE PARTICIPATED IN THAT
NECESSARY TRAINING ARE CRITICAL
TO BE ABLE TO SUPERVISE PATIENTS
IN DETOX PROPERLY. WE REQUEST
THAT THE DEPARTMENT ENFORCE THE
EXISTING RULES THAT RELATE TO
TRAINING AT THE VERY. WHY
DOESN'T THE DEPARTMENT REQUIRE
PROFESSIONAL LICENSING AND
CERTIFICATION OF TRAINING FOR
STAFF STANDARDIZATION IS NEEDED
. THE FAILURE OF THE FACILITY TO
COMPLY WITH EVEN THE MOST BASIC
REQUIREMENT RAISES QUESTIONS
ABOUT THE LEVEL OF MEANINGFUL
ENFORCEMENT. BY THE DEPARTMENT.
I'M ASKING THAT THE AGENCY HAD
PROVIDE OUR OFFICE WITH WRITTEN
EVIDENCE AND ALSO TO THE
CHAIRWOMAN OF THE CORRECTIVE
ACTIONS THAT HAVE BEEN TAKEN.
THE OTHER ISSUE THAT WE ARE
CONCERNED ABOUT IS THE DEATH
INVESTIGATION REPORT IS
PREDOMINANTLY REDACTED IT MAKES
IT DIFFICULT TO UNDERSTAND WHAT
STEPS WERE TAKEN IN RESPONSE TO
THIS INCIDENT. WE'VE REQUESTED
THAT WE DID PROVIDED WITH AN
UNREDACTED VERSION OF THIS FULL
REPORT IMMEDIATELY. THIS WEEK I
ALSO BECAME AWARE OF A MARCH
TWENTY TWENTY INVESTIGATIVE
REPORT CONCERNING ALLEGATIONS
ABOUT TWO OTHER LICENSED
FACILITIES ON DAHLIA STREET IN
NEWPORT BEACH. THIS IS SENSITIVE
ALLEGATIONS RAISED BY AN
INVESTIGATOR INDIANS YEAH ARE
TROUBLING ESPECIALLY CONSIDERING
THAT MANY OF THESE DEFICIENCIES
WERE IDENTIFIED IN PREVIOUS. BI
ANNUAL REVIEW. BUT TWENTY TWENTY
RECORD RAISE QUESTIONS ABOUT THE
HEALTH AND SAFETY OF PATIENTS IN
BOTH FACILITY. IN ADDITION I'M
CONCERNED THAT THESE TWO
FACILITIES HAVE REPEATEDLY
FAILED TO MAKE TIMELY CORRECTIVE
ACTIONS IN RESPONSE TO THE
DEFICIENCIES AND NOTHING REALLY
GETS DONE. I SIGNIFICANT
QUESTIONS ABOUT THE ABILITY TO
ENFORCE REGULATIONS CONCERNING
LICENSE ALCOHOL AND DRUG
TREATMENT FACILITY. I'M
CONCERNED THAT THERE'S A PATTERN
IN WHICH IDENTIFIED DEFICIENCIES
ARE NOT BEING MEANINGFULLY
ADDRESS. THE CURRENT REGULATORY
APPROACH IS NOT WORKING I HOPE
THAT YOU H. C. S. WHAT DENNIS BY
IMPROVEMENTS TO INTERNAL DH CS
PROCEDURE THAT WILL PROVIDE
FEATHER REGULATORY OVERSIGHT OF
WHITES AND DRUG AND ALCOHOL
FACILITY. I HOPE YOU CAN EXPLAIN
TO US WHAT THOSE INTERNAL
PROCEDURAL CHANGES WILL BE. IT
SHOULD NOT TAKE A TRAGEDY AND A
DEATH OF A YOUNG MAN. A TRAGEDY
INVOLVING ANOTHER FAMILY THAT
LIVES IN THE NEIGHBORHOOD TO
HAVE INVESTIGATORS FROM THE HDS
INSPECTED SILVA DATE. MORE THAN
ONCE EVERY TWO YEARS. I KNOW
THAT THE CHAIRWOMAN MENTIONED
DEPRIVE YOUR BILL WELL THAT BILL
WAS SOMETHING THAT I HELPED
ASSEMBLYWOMAN SHARON QUIRK SILVA
TRIED TO PURSUE AT THE STATE
LEVEL MANY YEARS AGO. WHERE WE
WOULD HAVE TO LEAVE THE CITY OF
COSTA MESA AT THAT TIME HAD
AGREED TO PAY FOR INSPECTORS TO
THE HOUSE IN ORANGE COUNTY SO
THAT THEY COULD ADDRESS THE MANY
INSPECTIONS NEEDED HERE LOCALLY
. BUT THE DEPARTMENT AT THE TIME
AND INDUSTRIES. OPPOSED THAT
BILL AND IT DID NOT PASS. IT'S
TIME FOR THIS COMMONSENSE
PROPOSAL TO BE RECONSIDERED AND
THIS TIME IS FUNDED BY THE STATE
. THE DEPARTMENT OF HEALTH CARE
SERVICES NEEDS A PARADIGM SHIFT
THAT PROVIDE BETTER ENFORCEMENT
COULD PROTECT THE HEALTH AND
SAFETY OF PATIENTS AND RECOVERY
THE STAFF PUT AN ACCEPTABLE PUTS
PATIENTS IN DETOX THAT RAN. THAT
NEGATIVELY IMPACTS NEIGHBORHOODS
I APPRECIATE YOU TAKING THE TIME
TO HEAR TESTIMONY AND TO ASK
QUESTIONS AND FOR CARING ABOUT
THAT'S REALLY IMPORTANT ISSUE
THANK YOU SO MUCH AND THANK YOU
A SUPERVISOR FULLY. AND ACTUALLY
BEFORE WE TURN TO- HERE FROM
INSPECTOR FRIENDS AND- I WANT
DIRECTOR BOSS I'D HAVE AN
OPPORTUNITY TO RESPOND TO. A
NUMBER OF THE QUESTIONS THAT YOU
RAISED IN YOUR OPENING COMMENTS.
AT AND I THINK. LET'S LET'S
START FIVE DIRECTOR ABBAS WITH
THE INVESTIGATION INTO GRATITUDE
. AT THE CURRENT STATUS AND AT
YOUR RESPONSE TO THE QUESTIONS
AND CONCERNS THAT SUPERVISOR
FULLY RAISED IN HER COMMENTS. I
WILL START AND THEN I WILL ASK
MY TEAM TO ADD ANY ADDITIONAL
DETAILS AND SOME OF THE
SPECIFICS ON THE- ON THE
INVESTIGATIONS- SO TO BEGIN WITH. WE M. IN REGARD TO THE
GRATITUDE BOTCH- INVESTIGATION
IN THE EVENT THAT OCCURRED ON
AUGUST TWENTY SIX TWENTY TWENTY
ONE I AGAIN WE WANT TO
ACKNOWLEDGE THE TRAGIC LOSS OF A
YOUNG LIFE AND HOW MANY PEOPLE
WERE AFFECTED BY THE EVENTS OF
THE DAY I'M WE ALSO WANT TO
ACKNOWLEDGE THAT PEOPLE
OBTAINING TREATMENT SERVICES AND
RECOVERY RESIDENCES AND LICENSED
TREATMENT FACILITIES ARE OUR
FAMILY MEMBERS OUR COMMUNITY
FAMILY MEMBERS AND THAT CHRONIC
DISEASE OF ADDICTION AFFECTS
PEOPLE FROM ALL WALKS OF LIFE-
NEED SAFE LIVING SPACES THAT
THEY- PURSUE PATH TO RECOVERY
AND WE SUPPORT AND BELIEVE THAT
PEOPLE WITH ADDICTION DESERVE TO
LIVE IN RESIDENTIAL COMMUNITIES.
AS THEY PURSUE THEIR PATH TO
RECOVERY. AT THE SAME TIME WE
HOLD OURSELVES RESPONSIBLE FOR
INVESTIGATING EVERY DEATH EARLY
AND HOLDING FACILITIES
ACCOUNTABLE FOR SAFE PRACTICES.
GRATITUDE LODGE CURRENTLY HAS
THREE SEPARATE LICENSE
RESIDENTIAL FACILITIES CHIU AND
NEWPORT BEACH AND ONE IN LONG
BEACH. UP SO WE HAVE THAT.
REDLANDS DR LOCATION- IN NEWPORT
BEACH IN THIS WAS HAD ITS
INITIAL LICENSE ON MAY FIRST
TWENTY TWENTY ONE GET A LICENSE
ONLY NO CERTIFICATION- AND IT'S
LICENSE FOR RESIDENTIAL CARE FOR
ALL GENDERS AND DETOXIFICATION.
THERE IS ANOTHER LOCATION ON
CLIENT DRIVE IN NEWPORT BEACH IN
THE INITIAL LICENSE WAS FEBRUARY
FIRST TWENTY TWENTY AGAINST
LICENSE ONLY AND NO
CERTIFICATION. A LICENSE FOR
RESIDENTIAL CARE FOR ALL GENDERS
AND DETOXIFICATION AND THEN THE
THIRD LOCATION IN LONG BEACH
ADDITIONAL LICENSE IN NOVEMBER
OF TWENTY EIGHTEEN. AGAIN
LICENSE ONLY AND NO
CERTIFICATION AND OUT LICENSE
FOR RESIDENTIAL CARE. FOR ALL
TRACTORS AND DETOXIFICATION. IN
THIS CASE IMAGE CREDIT TO WATCH
DH CS THE DEATH VERIZON ON.
AUGUST TWENTY SIX TWENTY TWENTY
ONE AND A PHONE CALL WAS PLACED
AT THE FACILITY ON AUGUST
THIRTIETH TWENTY TWENTY ONE TO
OBTAIN MORE DETAILS REGARDING
THE INCIDENT. THIS WAS PROPERLY
INVESTIGATED AND AN UNANNOUNCED
SITE VISIT OCCURRED ON SEPTEMBER
EIGHTH TWENTY TWENTY ONE. THE
INVESTIGATION CONSISTED OF THE
ACS STAFF REVIEWING CLIENT
INTERVIEWING CLIENTS AND STAFF
REVIEWING CLIENT FILES AND
DOCUMENTATION REVIEWING CAMERA
FOOTAGE REVIEWING POLICIES AND
PROCEDURES AND REQUESTING THE
POLICE AND CORONER'S REPORT.
PRIOR TO CONDUCTING AN ONSITE
DEATH INVESTIGATION GENERALLY
DCF STAFF CONDUCT INTERNAL
MEETINGS WITH MANAGEMENT TO
DISCUSS THE PLAN FOR HOW THE
INVESTIGATION WILL. BE
CONDUCTED. THE PREPLANNING OF
INVESTIGATION ASSISTING H. YES
STAFF AND OBTAINING ALL
NECESSARY INFORMATION AND
INTERVIEWS. DEFICIENCIES WERE
CITED AS A RESULT OF THE
INVESTIGATION. FIRST
DEFICIENCIES THE PROGRAM FAILED
TO REFER THE CLIENT TO A HIGHER
LEVEL OF CARE IN A TIMELY
MANNER. THE REMEDIAL ACTION WAS
PROGRAM HAS RETRAINED ALL STAFF
AND UPDATED THEIR POLICIES AND
PROCEDURES TO INCLUDE IMMEDIATE
TRANSFER OR NINE ONE ONE WHEN A
CLIENT IS IDENTIFIED AS HAVING
SEVERE MEDICAL OR PSYCHIATRIC
ISSUES. THIS DIVISIONS THAT THE
PROGRAM DID NOT FOLLOW THEIR OWN
POLICY PROCEDURE REGARDING
DOCUMENTATION OF RESIDENT
REFERRALS AND THE REMEDIAL
ACTION WAS IDENTIFIED THAT THE
RESPONSIBLE CLINICIAN FAILED TO
DOCUMENT THE REFERRAL CURRENT
THE PROCEDURE. THE CLINICAL
PROGRAM DIRECTOR COMPLETED IT M.
PERSON TRAINING ON IT NOVEMBER
ELEVEN TWENTY TWENTY ONE ON THE
PROTOCOL FOR DOCUMENTING. A
CLIENT REFERRALS THE FACILITY
RESPONDED TO THESE DEFICIENCIES
AND THE CORRECTIVE ACTIONS HAVE
BEEN X. ACCEPTED. IN ADDITION A
ROUTINE BY ANIL LICENSING
COMPLIANCE VISIT WAS CONDUCTED
AT THAT LINE DRIVE LOCATION ON
AUGUST TWENTY SEVEN TWENTY
TWENTY ONE. DEFICIENCIES WERE
CITED IN THAT SENSE BEEN CLEARED
BY DH YES WE WILL ALSO BE
CONDUCTING CONDUCTING ADDITIONAL
COMPLIANCE REVIEWS AT BOTH
LOCATIONS IN THE NEAR FUTURE.
THIS IS A VERY TRAGIC AND
UNFORTUNATE INCIDENT. AND DCS
DID NOT FIND THAT THE PROGRAM
WAS NEGLIGENT IN CARE OF THE
CLIENT IMMEDIATELY PRIOR TO THE
INCIDENT. D. H. U. S. LICENSE
PROGRAMS ARE RESPONSIBLE FOR
REVIEWING MEDICAL CLEARANCES TO
DETERMINE IF THE REPLACEMENT IS
APPROPRIATE AND RELY ON A
MEDICAL ASSESSMENT A CLEARANCE.
BASED ON DOCUMENTATION REPUTED
HITCH YES DID NOT FIND THAT THE
PROGRAM WAS ACTING BEYOND THE
AUTHORITY THAT WOULD WARRANT
ASSIST SUSPENSION OR REVOCATION
OF THEIR LICENSE. DGS WILL
REVOKE OR SUSPEND THE LICENSE OF
A PROGRAM WHEN IT'S BEEN
DETERMINED TO LEGALLY JUSTIFY
SUCH AN ACTION. DCS ISSUE THE
FACILITY A CLASS A DEFICIENCY
ABOUT THERE IS DEFICIENCY LEVEL
AND CORRECTIVE ACTIONS WERE
APPROVED AND THE COMPLAINT WAS
CLOSE. NO SUSPENSIONS ARE
REVOCATIONS HAVE BEEN ISSUED
AGAINST THE PROGRAM WE
UNDERSTAND THE FRUSTRATION WITH
THE REDACTED REPORT HOWEVER
FEDERAL HIPPA PRIVACY LAWS AND
FEDERAL REGULAR REGULATIONS
PREVENT THE RELEASE AS MANY
DETAILS. AND I WILL SAY THAT WE
SHARE- SOME OF THE SUPERVISOR'S
COMMENTS IN TERMS OF REALLY
CREATING A STANDARDIZATION AND
THE NEED FOR MANDATORY
CERTIFICATION OF THESE PROGRAMS
THAT WE ALL HAVE A COMPREHENSIVE
A CLEAR UNDERSTANDING OF THE
STANDARDS OF THESE PROGRAMS. I
THINK I'LL TURN IT OVER TO THE
TEAM FOR ANY SPECIFICS THAT I
MISSED IN REGARD TO THESE
INVESTIGATIONS. WELL AND
ACTUALLY I GUESS BEFORE YOUR
YOUR TEAM COMMENTS. THAT PERHAPS
THEY CAN DO. SO IN THE CONTEXT
OF I THINK MY FEEDBACK ON THIS
ISSUE. SO BASED ON THE
INFORMATION YOU HAVE SHARED WITH
US THIS FACILITY WAS CITED FOR
EIGHT DEFICIENCIES. MERE DAYS
EIGHT DAYS PRIOR TO THE DEATH OF
MISTER LATER. I UNDERSTAND WHAT
YOU SAID THEN YOU DID A AT
SURPRISE VISIT ONE DAY AFTER THE
DEATH OF THIS GENTLEMAN AND
ADDITIONAL DEFICIENCIES WHERE
SITE IT. YET EACH AND EVERY TIME
YOU. APPEAR TO NOT EVEN BE
GIVING THIS FACILITY A SLAP ON
THE WRIST. AND NOTHING IS
CHANGING NOTHING IS IMPROVING I
THINK WE ALL EARNED AT A VERY
EARLY AGE THAT CONSEQUENCES
MATTER. CONSEQUENCES MATTER AND
WHEN YOU ARE INTERACTING WITH
THIS INDUSTRY WHERE THERE'S
ABSOLUTELY NO CONSEQUENCES. FOR
THEM NOT. LIVING UP TO STATE
REGULATIONS THEM NOT LIVING UP
TO THEIR RESPONSIBILITIES. THEY
THIS INDUSTRY IS LEARNING THAT
THEY CAN DO WHATEVER THE HELL
THEY WANT. AND YOU'LL SEE RIGHT
THE MINUTE AS CITATION AND IT'S
LIKE A FIX IT TICKET. AND GUESS
WHAT AT SOME POINT. THE BLOOD OF
THESE KIDS ARE DYING IN THESE
FACILITIES IS NOT JUST ON THE
HANDED THESE HORRIBLE OPERATORS
IT'S ON YOUR HANDS AS WELL. AND
SO I WOULD SUBMIT TO YOU THAT WE
NEED A SYSTEM THAT GOES BEYOND
ISSUANCE OF A LIST A LONG LIST
OF DEFICIENCIES. THAT DOESN'T
CHANGE A THING ABOUT THE QUALITY
F CARE THAT PATIENTS ARE
RECEIVING. AND I WOULD ALSO I
WOULD ALSO ARGUE. THAT YOUR
EMPHASIS ON ASIANS DESERVING TO
LIVE IN A RESIDENTIAL COMMUNITY
IN MY VIEW IS COMPLETELY MISSING
THE FOREST FOR THE TREES I LIKE
SO MANY OF THE INDIVIDUALS WHO
ARE PART OF THIS HEARING LIKE SO
MANY INDIVIDUALS ACROSS
CALIFORNIA HAVE FAMILY MEMBERS
WHO HAVE BATTLED THE DEMONS OF
ADDICTION AND GUESS WHAT I THINK
THEY DESERVE I THINK THEY
DESERVE. HIGH QUALITY TREATMENT
. I THINK THEY DESERVE TO GET
THEIR LIFE ON TRACK I DON'T CARE
WHERE THAT HAPPENS I WANTED TO
HAPPEN. AND I WOULD ALSO SUBMIT
TO YOU THAT MR LAYERS PARENTS
FEEL THE SAME WAY. I WOULD
SUBMIT TO YOU. THAT WENDY
MCINTYRE THE MOTHER OF A BOY
NAMED JARED SHE FEELS THE SAME
WAY. SHE WANTS YOU TO PROTECT
PATIENTS IN RECOVERY. NOT HIDE
BEHIND SOME WEIRD SMOKESCREEN
WHERE IT'S SOMEHOW THE MOST
IMPORTANT THING IS THAT THEY CAN
LIVE IN A RESIDENTIAL HOME. SO
IF YOU CAN PLEASE. AT EIGHT YOUR
OF YOUR DEPUTIES CAN PLEASE
RESPOND TO MY CONCERNS ABOUT
THIS CONSTANT HAMSTER WHEEL OF
DEFICIENCIES. RESPONSE AND
ACCEPTANCE AND AT WHAT POINT
DOES IT END LIKE WHAT TO
SOMEBODY ACTUALLY HAVE TO DO. TO
GET THEIR LICENSE REVOKED. BACK
TO BACK I THINK YOU'RE ON MUTE.
AND I'M SURE I WOULD LOVE TO
RESPOND AND THEN I'LL HAND IT
OFF TO CHEN ALLIED PURSE GRANT
THREE YOUNG PEOPLE NOT IN MY
LIFE BECAUSE OF- DEATH OF
OVERDOSE I TAKE THAT VERY VERY
SERIOUSLY I READ EVERY DESK
RECORDED WORKS WITH THE TEAM TO
HOLD THEM. AND OURSELVES
ACCOUNTABLE TO MAKE SURE THAT WE
DO THE RIGHT THING BY THE
FACILITIES RESPECTFULLY IN THIS
CASE STATE DEFICIENCIES THAT
YOUR REFERENCE OR NOT
ESTRATEGIAS LARGE THEY'RE IN A
DIFFERENT SITE. OWNED BY THE
SAME ORGANIZATION THEY WERE
MOSTLY- PERSONNEL FILE ISSUES
THAT THEY THAT WE ISSUED THE
DEFICIENCIES AND ENSURE THAT THE
FACILITY RENEGADE THEM AND THEN
THEY WERE PROMPTLY. SEX SO- AND
- WHICH THIS OF LIFE VERY VERY
SERIOUSLY RESPONSIBILITY
SERIOUSLY HELLO DON'T SEE THESE
. AND THINGS. LINKED TO THE SHOW
- THIS TRAGIC AND UNDER WHICH IS
WANT TO ADD ANYTHING TO PREVENT
. AGAIN THAT AND WE ALSO JUST
SHARING THE CONCERN IT IS THAT
IT IS A VERY HIGH PRIORITY
ANYTIME WE HEAR OF ANY TYPE OF
LOSS OF LIFE THE DEPARTMENT
TAKES A VERY SERIOUS AND- VERY
POSSIBLY IF THERE'S ANY. I AM
INTERNET LEGENDS THAT WE FIND
WITH THEM OUR LICENSEE WE- WORK
VERY CLOSELY WITH OUR LEGAL
TEAMS TO TAKE ACTION. I'M
AGAINST ANY OF THOSE PROVIDERS
SO AGAIN WE I THINK WE ALL
SHARE. THE SAME CONCERN. I'M TO
MAKE SURE THAT WE- ACT SWIFTLY.
AGAINST ANY PROVIDER THAT WE
FEEL HAS- YOU KNOW ANY
RESPONSIBILITY HERE AND SO AGAIN
BUT I THINK WE ALL SHARE THE
SAME CONCERN. AND I WOULD.
MENTION SOMETHING THAT BEGAN
WITH THAT BUT AGAIN WHY WERE SO-
HAPPY ABOUT YOUR LEADERSHIP ON
THE ISSUE OF MANDATING STANDARDS
STATEWIDE STANDARDS AND WOULD
LIKE TO CONTINUE TO WORK WITH
EUROPE AND BECAUSE WE DO BELIEVE
THAT OUR- CERTIFICATION
STANDARDS ARE EXPLAINED FOR
EXAMPLE THEY- ARE VERY STRICT.
ON THE REQUIREMENTS FOR TREATING
OPIOID USE DISORDER WHICH
MEDICATIONS WHICH IS THE
STANDARD CARE AND THE PRINCIPAL
CAUSE OF MANY OVERDOSE DEATHS AT
THE LACK OF THESE MEDICATIONS
SO. WE DO THINK THAT MANDATORY
CERTIFICATION HOW. MUCH PROMISE
IN TREATING THE KIND OF
STATEWIDE STANDARDS FOR QUALITY
AND. SAFETY THAT WE ARE THANK
YOU. THANK YOU FOR THAT AND
BEFORE I WELCOME- MR FRANCE AND
- I DO WANT TO JUST ASK THAT FOR
YOUR SPECIFIC RESPONSE IN A
COUPLE OF THE OTHER POINTS THAT
SUPERVISOR FULLY RAISED IN HER
OPENING STATEMENT. AND BOTH A
REQUEST TO ENFORCE TRAINING
REQUIREMENTS. AND AS- A BRIEF
REQUIRED BY STATE LAW. AT AND
THE SECOND FOR I WRITTEN
EVIDENCE OF CORRECTIVE ACTION TO
BE SENT TO HER OFFICE AS WELL AS
TO THIS COMMITTEE. SO FIRST WE
ABSOLUTELY AGREE THAT THAT
TRAINING STANDARDS MUST ENFORCE
AN UNIDENTIFIED DEFICIENCY WE
WORK WITH THAT FACILITY TO
REMEDY THAT QUICKLY- REGARDING
THE OTHER ISSUE IN TERMS OF THE
RECORD I DISCARDED YOU KNOW IN
TERMS OF WHAT WERE ALLOWED TO DO
IT AND I'M PROUD TO STANDARDS
BUT I BELIEVE THAT THAT SPEAK OF
ALL. RIGHT SO. THE REPORTS- WE
DO PROVIDE HELP PUBLIC B. THAT
YOU HAVE TO BE IN ACCORDANCE
WITH ALL OF OUR HIT THE AND
FORTY TWO CFR PART TO
CONFIDENTIALITY LINES- PRIOR TO
A REPORT BEING RELEASED IT DOES
GO HROUGH OUR PRIVACY OFFICE
AND LEGAL TEAMS. I'M TO MAKE
SURE IT'S IN ACCORDANCE WITH
THAT SO THE DEPARTMENT IS
BEHOLDEN TO BOTH AND NOT ONLY
THE HIT THE CONFIDENTIALITY LAWS
BUT THE FORTY TWO CFR. AND I
WILL SAY THAT THE FORTY TWO CFR
PARTS YOUR REQUIREMENTS ARE VERY
STRICT WHICH IS WHY YOU WILL SEE
A HIGH LEVEL OF REDUCTION IN OUR
REPORT SO AGAIN- IT'S- THAT'S
THE WAY WE HAVE TO RELEASE THEM
AND- IT IS DONE. THROUGH OUR
PRIVACY OFFICES. AND THEN LASTLY
IN HER OPENING REMARKS IS
REVISOR FULLY ASKED- WOOD D.
DOES DH CS SUPPORT THE KINDS OF
REFORMS THAT HAVE BEEN ADOPTED
IN THE CITY OF COSTA MESA. AS A
MODEL A STATE A MODEL FOR AT.
RAISING STANDARDS STATEWIDE. I
IN TERMS OF- OVERSEEN-
RESIDENTIAL US IT BUT LET ME
HOMES THAT I THINK THAT IS
BEYOND THE SCOPE OF LIKE DCS-
EMBARKED ON IS IT HEY IT'S
UNRELATEDTO MEDICAL OR HEALTH
THE PROVISION OF MEDICAL HEALTH
SERVICES SO WITH THAT I DON'T
KNOW IF THERE'S ANOTHER STATE
ENTITY THAT. ESSENTIALLY
REGULATES BROMATE TYPE
RELATIONSHIPS I DON'T KNOW THAT
THERE IS I DON'T BELIEVE THERE
IS BUT I- IT WE COULD BE HAPPY
TO DISCUSS MORE WHAT THAT
PARTICULAR CITY ORDINANCES ARE
BUT MAKING GENERALLY SPEAKING
THAT. IS OUR PERSPECTIVE OKAY
AND PERHAPS WE SHOULD DO THAT
ARE FINE BUT- IF I UNDERSTAND
WHAT YOU'RE SAYING. IT'S OUTSIDE
OF YOUR- SCOPE SO FIVE VALUE.
MAY NOT SUPPORT IT IT IS NOT
SOMETHING THAT YOU OPPOSE. I'M
NOT EXACTLY SURE WHAT THE
ORDINANCE IS DUE IT IN THEIR
SPECIFICS WHERE WE REGULATE AND
OVERSEE HEALTH PROGRAMS AND
HEALTH STANDARDS AND TREATMENT
SERVICES AND SO- IF THAT THAT
ORDINANCES ARE BEYOND THAT I
GUESS IT'S JUST ON OUR AREA OF
EXPERTISE OKAY ALL RIGHT AND WE
CAN FOLLOW UP OFFLINE. AT AND
IT. WITH A LITTLE MORE
SPECIFICITY AROUND THESE
ORDINANCES DIVISOR FULLY DID
SHARE SOME OF THAT IN HER
OPENING REMARKS BUT- IT'S
PROBABLYA BLANK HERE DISCUSSION
THAT WE HAVE TIME FOR THAT
RIGHT. RIGHT NOW. BOB SO WITH
THAT LET'S GO AHEAD AND WELCOME
HI TODD FRANSON WHO IS. AN
INVESTIGATOR WITH THE ORANGE
COUNTY DISTRICT ATTORNEY'S
OFFICE THANK YOU FOR JOINING US
MISTER FRANCIS. THANK YOU I
DON'T HAVE A PREPARED STATEMENTS
WE HAVE A COUPLE WILL CONSIDER
JOTTED DOWN AS WE WERE GOING
THROUGH THIS. INTRODUCTION OF
MYSELF- I STARTED WITH THAT
ANOTHER AGENCY WITH ORANGE
COUNTY- I WORKED AS A- PATROL
OFFICER AND DETECTIVE FOR A FEW
YEARS AND JOIN THE ORANGE COUNTY
IS OFFICE IN TWENTY EIGHTEEN. I
WAS LUCKY ENOUGH TO LAND AND OUR
MEDICAL INSURANCE FRAUD UNIT. IN
A FEW MONTHS LATER WELL AS A
SIGN CHIU- WILL BECOME KNOWN AS
THE SOBER LIVING INVESTIGATION
PROSECUTION TEAM- FROM TWENTY
EIGHTEEN THROUGH BEGINNING OF
THIS YEAR- I'VE HAD THE
OPPORTUNITY TO GO BACK THAT
HUNDREDS OF INTERVIEWS. WITH
THEIR PATIENTS AND PEOPLE
INVOLVED IN THE ADDICTION
TREATMENT- UNDER THE UMBRELLA OF
THE ADDICTION TREATMENT CENTER
WORLD- THE BULK OF TOSE BEING
PATIENCE- NEXT CLASSIFICATION OF
HIS BODY BROKERS- WHICH IS-
EIGHTY. SUBSET WHICH IS BIG ON
THIS WHICH IS WHAT'S FUELING THE
BULK OF THE FRAUD IN THE
INDUSTRY- I TALKED TO DISABILITY
OWNERS I SPOKE WITH
PSYCHIATRISTS COUNSELORS AND
OTHER STAFF AT THESE FACILITIES.
I SPOKE WITH DOCTORS AND
SURGEONS- I'VE ALSO HAD- BOTH
UNFORTUNATE AND FORTUNATE-
CONVERSATIONS WITH- WHAT I WOULD
CLASSIFY AS DOZENS OF PARENTS
SIBLINGS AND FAMILY MEMBERS OF
PEOPLE WHO LOST THEIR THEIR
CHILDREN THEIR LOVED ONES- TO
ADDICTION TREATMENT- AND
ESPECIALLY PEOPLE THAT WERE HAVE
BEEN STUCK IN A CYCLE- YEAH
DIFFERENT TO ARENAS THAT. OUR IN
THIS OUR ORDERS OVER LIVING
HOMES WE JUST THAT WE HAVE
DISCUSSED- ADDICTION TREATMENT
FACILITIES LABS SURGERY CENTERS
AND THERE ARE SPECIALLY IT'S
MONEY INSURANCE I'M GOOD FUELS
ETCETERA. BUT CYCLE ABOUT
INJECTION TREATMENT. IN MY
OBSERVATIONS OVER THE LAST FEW
YEARS- IT'S BEEN LACK OF
RESOURCES THE INVESTIGATIONS WE
DO OUR SITE. FISSION SEE OF LAWS
THAT WE HAVE HERE IN THE STATE
OF CALIFORNIA AS WELL AS A LACK
OF A PUNISHMENT CONSEQUENCES FOR
THE PEOPLE THAT ARE INVOLVED.
WITHOUT THAT TED- ENFORCEMENT
ARM IT'S DIFFICULT FOR PEOPLE TO
TAKE A SERIOUS AND GET OUT OF.
THE INDUSTRY. ONE OF THE
DIFFICULTIES THAT WE HAVE- SINCE
I'VE BEEN WAS INTERESTED IN
TALKING ABOUT. ADDICTION
TREATMENT FACILITIES. AND
CUSTOMER LIVINGHOMES I WOULD I
WOULD SAY IS THE DIFFICULTY-
FROM MY PERSPECTIVE AS AN
INVESTIGATOR- IN CONDUCTING
INTERVIEWS THE PEOPLE THEY'RE
ALL. YES SOME OF THE PATIENTS.
AND THE PEOPLE THAT ARE IN THESE
RESIDENTIAL TREATMENT
FACILITIES- PROTECTION- SORRY AT
SOBER LIVING HOMES ARE YOUNGER
IMMATURE THERE FROM OUT OF
STATE. WELCOME NUMBER A DECADE
OPIATES. THEY DON'T HAVE THE
RESOURCES OR FAMILY STRUCTURE
WHEN PEOPLE COME IN FROM OUT OF
STATE TO FALL BACK ON- MOST OF
THESE PEOPLE ARE. HAVE BEEN
CONVICTED OF PRIOR CRIMES DON'T
TRUST LAW ENFORCEMENT. AND
THEY'RE GETTING PAID TO GO
THROUGH THIS AND ARE GETTING
PAID TO RESET OF ICE TO RELAPSE
AND STATE DEPARTMENT UNNECESSARY. STAND CYCLE. THANK YOU. AT THE
END AT RETURNED LET ME JUST ASK
YOU A COUPLE OF QUESTIONS SO AS
YOU HIGHLIGHTED A FRAUD AND
ABUSE IN THIS INDUSTRY IS
RAMPANT- I ACTUALLY WORKED ON A
PIECE OF LEGISLATION THIS YEAR
WITH OUR INSURANCE COMMISSIONER
LARA I AND- THE RECOVERY FRAUD
IS THE FASTEST GROWING FORM OF
INSURANCE FRAUD IN. THE STATE OF
CALIFORNIA. YOU TALKED ABOUT
SOME AS THE AT THE CHALLENGES-
AND AT LACK OF RESOURCES AND
INEFFICIENCIES IN STATE LAWS
LACK OF PUNISHMENT AND
CONSEQUENCES. IN YOUR VIEW I
WHAT ARE SOME SPECIFIC. I STEPS
THAT THE STATE OF CALIFORNIA CAN
AND SHOULD TAKE IN ORDER TO
ADDRESS WHAT WHAT I THINK IS A
REAL CRISIS. I WHEN THAT I
THINK. THIS IS NOT AN EASY
SOLUTION WOULD BE A MORE
SPECIFIC WALK- I CAN NAME BY TWO
DIFFERENT LAWS- THAT WE DON'T
HAVE HERE WITHIN OUR STATE
RESOURCES IN THE STATE OF
CALIFORNIA- AND I WOULD JUST BE
THE STATUTES BUT THAT THE
FEDERAL GOVERNMENT. HAS AN
ORDINANCE- IT IS THE ELIMINATING
KICKBACKS IN RECOVERY ACT. ACCRA
EIGHTEEN USC TWO TWO ZERO- AND
ALSO SPECIFIC AT THE STATE OF
FLORIDA ALSO HAS A PATIENT
BROKERING LAW- BEARER THEIR
STATUE NUMBER IS EIGHT ONE SEVEN
POINT FIVE ZERO FIVE.
ESSENTIALLY. EACH ONE OF THOSE
DO IS. MAKE THE LONG SPECIFIC
TO- FILING CHARGES. AGAINST
DISABILITIES THERE KICKED AND
ARE ALL MAPPED BOTH DIRECT WILL
PAYING EVERY. EACH ONE OF THOSE
ARE THE WAY THEY'RE WRITTEN ARE
STREAMLINE- EIGHT THE PROBLEM-
OF- AS OPPOSED TO THE STATE
ORDINANCES WE HAVE HERE IN THE
STATE OF CALIFORNIA WHICH WORKS
WERE BROAD BASED- AND DEAD
DIFFICULT TO BOTH PROSECUTE AND-
I GATHER EVIDENCE ON. SO THAT'S
THAT'S VERY HELPFUL SERVE I IT.
JUST MAKE SURE I UNDERSTAND
BECAUSE THERE'S BEEN A COUPLE
PIECES OF LEGISLATION ONE
AUTHORED BY FIVE. THEN ASSEMBLY
MEMBER AT THAT- THEN SENATOR NOW
IT AT COMMISSIONER LARA I
BELIEVE IN TWENTY EIGHTEEN AND
THEN I DID A FOLLOW UP PIECE OF
LEGISLATION AS WILD RELATED TO
TRYING TO CRACK DOWN ON
KICKBACKS IN THIS INDUSTRY. IS
WHAT YOU'RE SAYING THAT WE
EITHER HAVE NOT GONE FAR ENOUGH
OR- THERE'S ADDITIONAL
SPECIFICITY NEEDED SO THAT YOU
AND- OTHER INVESTIGATORSOTHER
DISTRICT ATTORNEYS HAVE BETTER
TOOLS IN YOUR TOOLBOX FOR
ENFORCEMENT. IS THAT YOUR SAY WE
HAVEN'T GONE FAR ENOUGH HAVEN'T
GOTTEN SPECIFIC ENOUGH CAN YOU
TO SPEAK TO WHAT'S MISSING. BUT
I WOULD SAY IS NOT SPECIFICITY-
BECAUSE THAT IS TO STATUTES THAT
I MENTIONED ARE DIRECTLY RELATED
TO PATIENT- KICKBACKS AND
FACILITY KICK- IT'S SPECIFIC TO
BODY BROKERING- WHICH IS IT
SPECIFIC TERM IT DESCRIBES A
SPECIFIC GROUP OF PEOPLE THAT
ARE. I'M IN MY EYES- ARE DRIVING
FORCE BEHIND THE WELCOME TO
FRAUD AND THE DEATHS IN THIS
INDUSTRY. YES AND I WOULD AGREE
I WOULD AGREE WITH THAT
ASSESSMENT I THINK. I AS WE HAVE
SEEN AT EVERY PHASE AND
CERTAINLY APPEARED CRISIS SADLY
WE HAVE SEEN. PREDATORY ACTORS
WHO HAVE- EXPLOITED THIS IS THE
CRISIS WHETHER IT WAS. THE DRUG
MANUFACTURERS TO BEGIN WITH THE
AT YOUR DOCTORS TO OVER
PRESCRIBE THIRD FOR NOW. BODY
BROKERS AND THESE REAL GREAT HAD
CENTER OPERATORS WHO I SEE AN
OPPORTUNITY TO MAKE A QUICK BUCK
OFF THE BACK OF PEOPLE WHO ARE
REALLY REALLY DESPERATE
CIRCUMSTANCES- IT IS. HER AFFECT
. ANY OTHER AT ANY OTHER STEPS
THAT COULD BE TAKEN AT THE STATE
LEVEL THAT WOULD GIVE YOU AND
FOLKS DOING SIMILAR WORK MORE
TOOLS FOR CRACKING DOWN ON POT
THAT THEIR FRAUDULENT AND BAD
ACTORS IN THIS SPACE. I WAS A
JUST A REPUTATIONAL RESOURCES
AND THAT INVESTIGATORS. THAT
COULD APPLY THEIR TIME-
SPECIFICALLY- AS I MENTIONED I
WORK FOR THE DISTRICT ATTORNEY'S
OFFICE. FOR THE ORANGE COUNTY-
THERE ARE ADDITIONAL CITIES
WITHIN ORANGE COUNTY THAT OFTEN
CASTIGATE HERS- AND IF WE COULD
ALL WORK TOGETHER SHARE THE SAME
INFORMATION. AND STREAMLINE SOME
OF THE INVESTIGATIONS THAT MAKE
UP A BIGGER TENT AND- THIS
PROBLEM. AND I THINK YOUR YOUR
COMMENTS. REALLY HIGHLIGHTING
WHY THIS HAS BEEN SUCH A
DIFFICULT PROBLEM TO WRAP OUR
HANDS AROUND THAT THE CHALLENGE
OF EFFECTIVE SUBSTANCE ABUSE
TREATMENT IS ENORMOUS. JUST IN
AND OF ITSELF AND BECAUSE YOU
HAVE AT INDIVIDUALS WHO ARE IT
IN FACT INCENTIVIZING BAD
BEHAVIORS AND SABOTAGING
RECOVERY. AND I THINK EXPLOITING
LOOPHOLES IN THE LAW TO AT.
REALLY JUST BROKE PATIENTS OPT
FOR MILLIONS OF MILLIONS OF
DOLLARS IT'S MADE IT EVEN IT'S
MADE IT EVEN MORE DIFFICULT FOR
US TO ACTUALLY MAKE PROGRESS
HERE AND ACTUALLY ENSURE THAT
WE'RE PROTECTING PATIENTS. AND
HELPING PEOPLE GET TACK AT THEIR
LIVES ON TRACK. AT ANY OTHER
PARTY PARTING WORDS OR ANY
QUESTIONS THAT YOU HAVE FOR AT.
DIRECTOR BOSS FROM DEPARTMENT OF
HEALTH CARE SERVICES. NO NOT AT
THIS TIME OKAY. AND AB I BELIEVE
FIVE AGAIN BEFORE WE CLOSE HIS
PANEL I WON IS JUST CYCLE BACK
ACT. TO SUPERVISOR FULLY. I KNOW
SUPERVISOR YOU HAD A COUPLE OF
QUESTIONS FOR. AS DIRECTOR BOSS
BEFORE WE CLOSE THIS PORTION OF
THE HEARING. THANK YOU THANK
YOU- ASSEMBLY WOMAN- SO WE'VE
TALKED ABOUT THE ISSUE OF DETOX
FACILITIES BEING LOCATED IN
RESIDENTIAL NEIGHBORHOODS AND I
THINK ONE OF THE MAIN CONCERNS
THAT- THAT THE COMMUNITY HAS IS
OVER CONCENTRATION SO. GIVEN THE
COMMENTS BY DIRECTOR BOUGHT DO
YOU AGREE THAT- OVER
CONCENTRATION OR CLUSTERING OF
DETOX FACILITIES ALL IN ONE
NEIGHBORHOOD OR ON A BLOCK
ACTUALLY CREATE
INSTITUTIONALIZATION OF THAT
NEIGHBORHOOD. NO I DON'T I DON'T
SEE HOW- IT HAVING SO THESE ARE
BY THAT ERROR HOMES LOCATED NEAR
ONE ANOTHER CREATES AN
INSTITUTION I THINK OF
INSTITUTION AS OUR STATE
HOSPITALS I THINK ABOUT SKILLED
NURSING FACILITIES ARE SKILLED
NURSING FACILITIES HOSPITALS
ETCETERA- AND SO IT JUST MAYBE
JUST TRY TO UNDERSTAND YOUR
COMMENT A LITTLE BIT MORE. THANK
YOU SO I WANT TO GIVE YOU AN
EXAMPLE BECAUSE THE IN OUR CITY
HERE COSTA MESA. THERE WAS ONE
BLOCK AND IT WAS A COLD THE FACT
STREET AND IT'S MUCH LIKE THE
STREET THAT- THE DETOX FACILITY
THAT- MISTER LEHRER LIVED IN-
WHAT SITUATED. THERE WERE. FOUR
DETOX OF THE LIVING HOMES- DRUG
REHAB TREATMENT FACILITIES THAT
HAD BOUGHT RESIDENTIAL HOMES
THREE BUSINESSES ON ONE SMALL
LITTLE CUL DE SAC LOT. AND WHAT
HAPPENED TO THAT LITTLE COLDER
BACK NEIGHBORHOOD WAS IT
TRANSFORMED INTO AN
INSTITUTIONAL DOWN. AS THE OWNER
FOR TREATMENT AND RECOVERY AND
DETOX INSTEAD OF BEING A
NEIGHBORHOOD. AND SO I WOULD. I
REQUEST THAT AS YOUR APPROVING
THESE LICENSES THAT YOU TAKE
INTO CONSIDERATION DISTANCING
REQUIREMENTS SO THAT YOU DON'T
CONCENTRATE. DETOX FACILITIES
ALL NEXT DOOR TO EACH OTHER. AND
SHOT TRANSFORM WHAT ARE
TRADITIONAL NEIGHBORHOODS INTO
LITERALLY INSTITUTIONS FOR
RECOVERY YEAH I HAVE BEEN. ONE
THAT SEVERAL LIVING HOW LONG A
DETOX FACILITY DRUG AND ALCOHOL
TREATMENT FACILITY ALL NEXT TO
EACH OTHER OR MAYBE A HOUSE IN
BETWEEN THAT'S WHAT I THINK IS
HAPPENING BECAUSE THERE ARE NO
DISTANCING REQUIREMENTS SO THAT
ORDINANCE THAT I WAS REFERRING
TO EARLIER FOR THE CITY OF COSTA
MESA AND THE COUNTY ORDINANCE AS
WELL. REQUIRE THAT- SEVERAL
LIVING HOMES NOT COLE LOCATED
RIGHT NEXT TO EACH OTHER THERE'S
DISPENSING REQUIREMENTS THE
STATE CURRENTLY DOES NOT AG
ACKNOWLEDGE ANY KIND OF
DISTANCING REQUIREMENTS AND SO
THE DEPARTMENT IS ESSENTIALLY-
LICENSING. HELLO OF- DETOX THIS
. AND ITS TRANSFER NAY. AND IT
REALLY JUST COUNTERED THIS IDEA
THAT YOU NEED TO LIVE IN A
RESIDENTIAL NEIGHBORHOOD IN
ORDER TO GET TREATMENT I
APPRECIATE THAT CHAIRWOMAN'S-
COMMENTS ABOUT THAT AS THE
FAMILY MEMBER I JUST WANT MY
LOVED ONE TO BE ABLE TO BE
HELPED. MEDICALLY BECAUSE DETOX
IS ACTUALLY QUITE RISKY FOR MANY
HEALTH CONDITIONS SO WOULD YOU
BE SUPPORTIVE OF THE DEFENSE
TEAM REQUIREMENTS AT THE STATE
LEVEL. I MEAN WE CAN DEFINITELY
TAKE THAT INTO CONSIDERATION AND
I THINK OUR OUR GOAL IS THAT WE
WANT TO ENSURE THAT THERE'S
ACCESS- FORTY SERVICES
THROUGHOUT THE STATE- AND SO
WITH THAT IN MIND I THINK WE CAN
CONTINUE JUST TO TALK THROUGH
THESE TYPES OF IDEAS AND
CONSIDERATIONS BUT YOU KNOW WE
ARE. WE WANT TO MAKE SURE
INDIVIDUALS HAVE ACCESS TO THESE
TYPES OF TREATMENT AND RECOVERY
SERVICES AND IN THE COMMUNITY AS
WELL SO I THINK IT'S AT A POINT
THAT WE CAN FURTHER DISCUSS. DO
YOU HAVE ANY DATA THAT SHOWS
THAT THERE'S A LACK OF ACCESS. I
MEAN IN TERMS OF THE MEDICAL
PROGRAM IS SOMETHING THAT WE
HAVE TO CONTINUE TO THINK
THROUGH BECAUSE WE MUST CERTIFY
TO THE FEDERAL GOVERNMENT THAT
WE HAVE ENOUGH CAPACITY
THROUGHOUT THE STATE TO PROVIDE
SERVICES TO OUR MEDICARE
BENEFICIARIES AND SO IT IS
SOMETHING THAT IS TOP OF MIND
FOR US FOR ALL OF OUR SERVICES
THAT WE DELIVER TO THE MEDICAL
PROGRAM. OKAY I KNOW YOU FOCUS
ON THE MEDICARE PROGRAM- A LOT
DURING GAIT CONVERSATION TODAY.
BUT MANY OF THESE. DETOX
FACILITY ARE. BEING PAID THROUGH
PRIVATE INSURANCE AND SO I THINK
THAT'S SOMETHING THAT YOU SHOULD
LOOK INTO AND WOULD YOU BE
WILLING TO LOOK INTO THAT HOW
THE PRIVATE INSURANCE INDUSTRY
IS ACTUALLY- THEY'RE THE ONES
THAT ARE BUYING UP PROPERTIES
AND OPENING UP DETOX FACILITIES.
MORE SO THAN MEDIC CAL-
HAITIANS- TREATMENT SERVICES.
AGAIN I THINK IT'S SOMETHING WE
CAN THINK THEY'RE IN THIS KIND
OF SPEAKS TO THE POINT OF THE
MANDATORY CERTIFICATION PROGRAM
TO ENSURE THAT ALL PROGRAMS
REGARDLESS OF THE CARE SOURCE.
ARE KIND OF MEET CERTAIN QUALITY
STANDARDS. THANK YOU FOR A
COUPLE MORE QUESTIONS AS IT
RELATES TO THE TWENTY FOUR HOUR
CARE AND SUPERVISION ONE OF
THAT- CRITICAL COMPONENTS THAT
THE COUNTY AND THE- CITY
ORDINANCE HERE. IS THAT THERE BE
TWENTY FOUR HOUR SUPERVISION
WOULD YOU BE SUPPORTIVE OF A
REQUIREMENT OF TWENTY FOUR HOUR
SUPERVISION. I DON'T KNOW WHAT
IT LOOKS THANK YOU I DON'T KNOW
ENOUGH ABOUT THIS ONE. TURN OVER
TO DOCTOR. THE FOURTEENTH AT THE
TONE IS LICENSE TO DO DETOX. WE
ALREADY HAVE STRICT REQUIREMENTS
ABOUT- I OBSERVING CLIENTS TO
MAKE SURE THAT THEY'RE SAFE
DURING THE DETOX PROCESS AND YOU
KNOW IF YOU DO YOU TO SAY A FEW
WORDS ABOUT THOSE REQUIREMENTS.
WHICH WE DID I HEAR IS TO
PROVISION TWENTY FOUR HELPERS IN
AND STUFF IN THE MAIL. IN LAKE
IN. IS THAT EVERYBODY NEEDS A TO
BE H. IT'S ERIC RENDON MONEY.
PLAIN SIMPLE. INDIVIDUAL
POLICIES WE'RE SORRY AND ARE IN
WE'RE HAVING AT LEAST ON MY
SENATE REALLY HERE THANK THE
PROBABLY UP AND IT KINDA WHEN I
WAITED YEARS ARE READ THE CASE
ON MY TO THE PENSIONS OF UP AND
TO. WHEN WE ARE NOT SEEING EVERY
THIRTY NOT CHOI WHEN SOMEONE'S
GOING TO IT YEAH BEAUTY TAX WE
HAVE TO QUICKLY- TOWARDS
FACILITIES THAT ARE MY TO
PROVIDE ID DID YOU TRY FOUR HOUR
MON. AND WE ALSO WORK THEM TO
DETERMINE WHAT THEIR LEVEL OF IS
HAVE BELIEVED HIM TO FURTHER AT
EARLIER NAY HAS THAT THE LEVEL
OF CARE FOR- MORE MEDICAL AND-
WITH STRONG. VERSUS LAST NIGHT
OF CLAIMS TRONG UNDERSTAND
BECAUSE WITH THE OTHER LEVEL THE
CARE. THANK YOU I'M NOT SURE WHY
HAVE PANEL THANK CREATE THE- AND
I HOPE THAT YOU WILL CAN- MAYBE
STRICTER SPORTS AND MORE. AS
INDIVIDUAL THANK YOU. THANK YOU
I SUPERVISOR FULL AVERAGE US AND
ON. I IS FRANCIS FOR PART OF
TODAY'S COMMERCE AND I'M
CERTAINLY WILL CAN. TO PARTNER
WITH YOU AS THAT LOOKED RAISE
TWO IN THIS INTO. WE THAT I'M WE
ARE GOING TO TRAINS TO OUR FINAL
PANEL BEFORE WE OPEN IT UP FOR.
PUBLIC COMMENTS AND AT FOR OUR
FINAL PANEL REALLY PLEASED TO.
WELCOME HI JENNIFER LOS WHO IS
JOINING US FROM THE HAZELDEN
BETTY FORD FOUNDATION. MISS
LEWIS WILL DISCUSS BEST PATIENT
CARE PRACTICES HOW TO MAKE
TREATMENT MORE EFFECTIVE. AND
ANY SUCCESSES OR CHALLENGES THAT
AT THE FOUNDATION HAS
ENCOUNTERED WITH OUR CURRENT
STATE LICENSING AND OVERSIGHT
PRACTICES. WITH THAT I THANK YOU
SO MUCH FOR AT FOR BEING HERE
WITH US THIS AFTERNOON. IF SO
MUCH AND GOOD AFTERNOON CHAIR
AND MEMBERS THANK YOU FOR HAVING
ME HERE TODAY TO DISCUSS SUCH AN
IMPORTANT TOPIC. MY NAME IS
JENNIFER LAWRENCE THE AND THE
GENERAL COUNSEL FOR HITLER AND
BETTY FORD FOUNDATION. AND I
JUST WANNA START OUT BY THINKING
THIS COMMITTEE AND CHAIR
PETRIE-NORRIS FOR HER TIRELESS
WORK ON THE REGULATORY REFORM
INUSTRY AND FOCUS ON QUALITY
STANDARDS INSTEAD IS. TO
STRUCTURE TREATMENT. TABLE THEN
BETTY FOR. IS THE LAW. NONPROFIT
THAT IS TREATMENT PROVIDER IN
THE COUNTRY. IT WAS FOUNDED IN
NINETEEN FORTY NINE AND TODAY
HAS SEVENTEEN. FIVE AND NINE
EIGHT. INCLUDING THE BETTY FORD
CENTER IN RANCHO MIRAGE. AND TWO
OTHER OUTPATIENT SITES IN
SOUTHERN CALIFORNIA. THROUGHOUT
THE COUNTRY WE TREAT MORE THAN
TWENTY THOUSAND PEOPLE ANNUALLY
INCLUDING THOUSANDS IN
CALIFORNIA BOTH IN PERSON AT OUR
CLINIC AND DIRECTIONAL SERVICES
. I NONPROFIT ALSO INCLUDES AN
ACCREDITED GRADUATE SCHOOL OF
ADDICTION STUDIES. A PUBLISHING
HOUSE RESEARCH CENTER AN
EDUCATION ARM FOR MEDICAL
PROFESSIONALS PREVENTION
SERVICES AND A PROGRAM FOR YOUNG
CHILDREN AFFECTED BY ADDICTION
IN THE FAMILY. WE STRONGLY
SUPPORT MANDATORY LICENSURE AND
CERTIFICATION OFALL OF THAT IT
IS REGISTERED IN CALIFORNIA. IN
ADDITION TO THE SAFETY AND
QUALITY CONCERNS MANY OF THE
REFORMS THAT HAVE BEEN SIGNED
INTO LAW OVER THE LAST SEVERAL
YEARS. SUCH AS EIGHT ANTI
PATIENT BROKERING AND MARKETING
REFORMS ONLY APPLY TO CERTAIN
LICENSED FACILITIES WHICH ALLOW
THOSE THAT OPERATE UNDER THE
RADAR AND TO CONTINUE TO ENGAGE
IN BEHAVIOR THAT IS HARMFUL TO
PATIENTS. CALIFORNIA AND ACROSS
THE COUNTRY HAVE THAN BETTY FORD
HAS AVAILED ITSELF EVERY
OPTIONAL AND MANDATORY
ACCREDITATION AND LYFT AND- THAT
IS PART NETWORK. ALL OF OUR
FACILITIES ACCREDITED BY THE
JOINT COMMISSION. ARE HIRING
STANDARDS FOR COUNSELING TEAM
REQUIRE A MINIMUM OF A
BACHELOR'S DEGREE LIFE OF
EDUCATION. WITH STRONG
PREFERENCE AND HIRING AT LEAST
MASTER'S LEVEL CLINICIAN. THE
BETTY FORD CENTER I LARGEST
PROGRAMMING CALIFORNIA MAINTAINS
LICENSE AND CERTIFICATION
ALIGNED WITH THE DELIVERING A
FULL CONTINUUM OF CARE. WE HAVE
LONG SUPPORTED QUALITY BASED
CARE AND STANDARD AND WE BELIEVE
THAT THE NUMBER OF HOURS THAT IF
ALONE IT'S NOT AN EFFECTIVE
INDICATOR TO DETERMINE THE
QUALITY OF TREATMENT PATIENTS
ARE RECEIVING. OTHER WHAT
HAPPENED DURING THOSE TREATMENTS
OUR IS MORE IMPORTANT. POLITIES
START WITH SAFE MEDICAL DETOX
SERVICES WHICH REQUIRE WELL
TRAINED DOCTORS NURSES AND STATE
MEDICAL FACILITIES. IT INCLUDES
QUALIFIED WELL TRAINED ADDICTION
COUNSELORS. HI INTERESTED
PSYCHOLOGISTS WHO CAN PROVIDE
EXCELLENT CLINICAL CARE FOR BOTH
ADDICTION AND CO OCCURRING
MENTAL HEALTH CONDITIONS. PILOTY
TREATMENT EVIDENCE BASED IF
PATIENT CENTERED AND IT HONORED
PATIENT DIGNITY IT HERE FOUND AN
ARTICLE BUSINESS PRACTICES. IF
COMPREHENSIVE ADJUSTING THE
BIOLOGICAL PSYCHOLOGICAL AND
SOCIAL ASPECTS OF ADDICTION.
POLITY CARE CONNECT PATIENTS ON
GOING RECOVERY SUPPORT OF
PROFESSIONAL AND COMMUNITY BASED
CARE SUPPORT. IT ALSO UTILIZES
CLINICAL TECHNOLOGY AND DATA
SYSTEMS THAT CAN BE USED TO
MEASURE PATIENT OUTCOMES AND
OTHER ASPECTS OF ORGANIZATIONAL
PERFORMANCE. WE ARE GRATEFUL FOR
YOUR LEADERSHIP AND DEVELOPING
FRAMEWORK THAT INCENT QUALITY IN
OUR FIELD. AND MORE NEEDS TO BE
DONE. ALTHOUGH MOST DO GREAT
WORK IN ORDER TO ENSURE ETHICAL
QUALITY CARE FOR THOSE WHO SEEK
HELP PROTECTION WE SUPPORT
EFFORTS TO ESTABLISH QUALITY
STANDARD. AND A MANDATORY
CONSISTENT ENFORCEABLE
REGULATORY FRAMEWORK FOR THE
ADDICTION TREATMENT INDUSTRY IN
CALIFORNIA. AT THE CALIFORNIA
ASSEMBLY CONTINUES TO PURSUE
CHANGES TO REGULATION WE HOPE
THAT THESE CHANGES INCLUDE
MANDATORY STANDARD FOR SUBSTANCE
USE TREATMENT PROVIDERS. IS A
LIBERTY FOR DANCE READY TO HELP
HOWEVER IT CAN TO HELP ADVANCE
THE SUBJECT AT. IN CLOSING I
WOULD LIKE TO SHARE THAT MY
BACKGROUND PRIOR TO COMING TO
HIS LIPS AND BETTY FORD WITH AN
ACUTE CARE. SINCE JOINING HIS
IRWIN BETTY FORD. I REMAIN
SHOCKED AT THE LACK OF
COMPREHENSIVE APPROACH IS
FOCUSED ON PATIENT CARE. NOT
JUST FOR TREATMENT PROVIDER. BUT
FOR THOSE INVOLVED IN THE ENTIRE
CONTINUUM. OVER HOME OPERATOR
RECOVERY PROFESSIONALS AND MORE
. IN MY ESTIMATION THIS IS DUE
IN PART TO THE FACT THAT THIS
SPECIALTY ADDICTION TREATMENT
THE L. HAD LONG BEEN
MARGINALIZED. AND IF STEP
REMOVED FROM MAINSTREAM
HEALTHCARE. NOT INTEGRATED NOT
TAUGHT IN MEDICAL SCHOOL AND NOT
EVEN RECOGNIZE THAT THE
SPECIALTY APPROPRIATELY. SIGMAR
HAVE KEPT IT SEPARATED WHICH IS
ONE REASON THAT IS BEEN ABLE TO
ACCESS UNDER THIS THEIR
OVERSIGHT. I HOPE TO BE PART OF
CHANGING THAT AND I THINK YOU
FOR HAVING ME HERE TODAY TO TALK
ABOUT QUALITY AND FOR YOUR
LEADERSHIP. THANK YOU SO MUCH
FOR BEING HERE AT FOR YOUR
REMARKS AND ALSO FOR YOUR IN
YOUR LEADERSHIP IN THIS SPACE.
HI MY OFFICE AND THAT AND I WE
HAVE BEEN SO GRATEFUL FOR. HIS
OPEN BETTY FORD'S ENGAGEMENT ON
THE SUBJECT WITH US WE'VE BEEN
WORKING REALLY CLOSELY WITH WITH
YOU AND YOUR COLLEAGUES. ON
DEVELOPING A ROBUST FRAMEWORK
FOR. AT MANDATORY CERTIFICATION
AND LICENSURE TO ENSURE THAT WE
DO YOU RAISE STANDARDS FOR
PATIENT CARE AND NOT REALLY IS.
WHAT IS AT THE HEART OF THIS
EFFORT I THINK LIKE YOU- I'VE
BEEN REALLY SHOCKED- AS I HAVE
DUG INTO THIS ISSUE BY JUST HOW
LAX. THE OVERSIGHT IS AND AT I
THINK THAT. GIVEN THAT IT SHOULD
BE NO SURPRISE THAT THIS SPACE
CONTINUES TO BE THE WILD WILD
WEST- BUT AS YOU SAID. JUST
BECAUSE THIS EVERY NIGHT AT THE
BEHAVIORAL HEALTH CARE MORE
BROADLY BUT PARTICULAR SUBSTANCE
USE TREATMENT. HAS BEEN- KIND OF
MARGINALIZED AND STIGMATIZED. WE
CANNOT ALLOW THAT TO CONTINUE
AND WE NEED TO UPDATE AND
UPGRADE OUR STANDARDS FOR
BEHAVIORAL HEALTH CARE ALL
ACROSS THE STATE I'M IN ORDER TO
TACKLE WHAT I THINK IS ONE OF
ADDED THE MOST PROFOUND
CHALLENGES. FACING FACING US
TODAY- AND- I DON'T BELIEVE THAT
I HAVE. WELL THEY DO HAVE ONE I
HAVE ONE SPECIFIC QUESTION
BECAUSE IT SAID AND ISSUE THAT
CAME UP- IN IN OUR PREVIOUS
CONVERSATION. RELATED TO. THE
LOCATION I'VE IN PURCHASE OF
SETTING SPECIFICALLY THESE THESE
DETOX FACILITIES SO I'M A- FIRST
QUESTION IS HOW LONG TYPICALLY
AS SOMEONE. DOING IN THE MIDDLE
OF A DETOX TREATMENT HOW LONG
DOES THAT LAST THAT'S KIND OF
DETOXIFICATION PHASE MAYBE IF
YOU CAN JUST MAYBE DESCRIBE KIND
OF THAT THE CONTINUE CONTINUE M.
OF RECOVERY CARE WHICH YOU KNOW
WOULD BEGIN WITH DETOX AND HOW
LONG TYPICALLY DO THESE THINGS
TAKE. YEAH ABSOLUTELY I'M HAPPY
TO COMMENT AND- YEAH ONE OF THE
OTHER PANEL MEMBERS AS A
CLINICIAN MIGHT CLEAN ME UP ON
ON ANY- TECHNICAL- THINGS
BECAUSE I'M NOT A CLINICIAN.
HOWEVER YOU KNOW WHEN. WE LOOK
AT DETOX YOU KNOW WE HAVE A YOU
KNOW ANY QUEUE AREA AS- AND WE
TRY TO INTEGRATE- EVEN AT THE
DETOX PLAN- THAT THAT-
COUNSELING SERVICES AND OTHER
SUPPORT THE NECESSARY TO SUPPORT
THAT INDIVIDUAL EVEN WHILE
THEY'RE IN DETOX THIRTY TAX
MIGHT LOOK A LITTLE BIT
DIFFERENT OUR FACILITIES THAN IT
DOES IN SOME OF. THE DETOX ONLY
FOR THIRTY EIGHT BECAUSE WE DO
START TO INTEGRATE OF COUNSELING
SERVICES GROUP DYNAMICS AND EVEN
WILD FOLKS ARE. DETECTING AND IT
ALSO DEPENDS ON A LITTLE BIT
ONLINE- YOU KNOW WHETHER THERE
ARE. USED DISORDER PATIENT
MEANING THAT THEY HAVE- MULTIPLE
THAT IS THAT THE IRAQI TAXING IN
AND OUT- SO WE'RE. THE LIKE-
AFTER PASSED ACT- IF BLINK COME
IN ON THAT WELL A. B. L. DEFECT
HAN ON. THAT THE ATTACKS PROCESS
. SURE SO KNOW GENERALLY IT'S-
WAS SO INITIAL THERE IS A
COMPREHENSIVE. AND THAT IF I-
USUALLY EMPLOYS A SAM CRITERIA
TO LOOK AT THE APPROPRIATENESS
OF THE INDIVIDUAL BEING ADMITTED
SO THINGS LIKE PAST MEDICAL
HISTORY ACUTE PSYCHIATRIC
PROBLEMS- THE SPECIFICS OF THE-
TYPES OF SUBSTANCES THAT THEY
WERE USING AND THE
APPROPRIATENESS OF. KENYA CAN
THE FACILITY HANDLE THAT SO TO
GIVE YOU A SPECIFIC EXAMPLE IF
YOU HAVE SOMEBODY WITH AN
ALCOHOL USE DISORDER WHO HAS HAD
MULTIPLE ADMISSIONS AND HAS
EXPERIENCED DELIRIUM TREMENS
WHICH IS A VERY TRAGIC- SIDE.
YOU KNOW BUT COMPLICATION. OF A
SEVERE ALCOHOL USE WITHDRAWAL.
THAT PERSON WOULD NOT BE
APPROPRIATE FOR YOUR AVERAGE
LEVEL THREE- YOU KNOW DETOX
CENTER- EVEN YOU KNOW THAT
PERSON WOULD NEED TO BE IN A
MORE OF A- MEDICALLY MANAGED
POSSIBLY HOSPITAL BASED TYPE OF
FACILITY THAT HAS THE TYPES OF
THINGS LIKE. AYE VISA AND- OTHER
TYPES OF THINGS THAT I SEE YOU
ACCESS UP SO THAT THE
TERMINATION NEEDS TO HAPPEN IN
THE BEGINNING AND IF DONE IN THE
INAPPROPRIATELY WHICH IS.
ACTUALLY ONE OF THE THINGS THAT
SAY- IS ONE OF THE THINGS THAT I
WOULD CRITICIZE A LOT OF
TREATMENT CENTERS IS THAT. BUT
THE MEDICAL STAFF BECAUSE
THERE'S BEEN THIS- YOU KNOW IF
YOU LOOK AT THE EVOLUTION IN THE
HISTORICAL CONTEXT OF HOW
TREATMENT CENTERS HAVE EVOLVED.
IT BACK IN THE DAY THEY WERE
JUST THEY WERE STRIPPED OF
MEDICAL ALMOST COMPLETELY I MEAN
UNTIL RECENTLY IN CALIFORNIA
RIGHT WITH IMS COULD YOU A
PHYSICIAN EVEN GO INTO A
FACILITY LIKE THAT TO DO WHAT
THEY'RE SUPPOSED TO DO. TO
ENSURE SAFETY- AND SO THERE'S
BEEN THIS. KIND OF SUPPORT IN
THE ROAD IN OF A CLINICAL
APPROACH VERSUS A MEDICAL
APPROACH WHICH IS UNFORTUNATE
BECAUSE HMAN BEING. REGARDLESS
THAT YOU KNOW YOU NEED ALL THAT
IS COMPREHENSIVE AND SO- BUT BUT
IF THAT DETERMINATION GETS DONE
INAPPROPRIATELY THAN A PERSON
GETS ADMITTED INAPPROPRIATELY
AND ALL SORTS OF BAD THINGS
HAPPEN AND THEN. ISSUES AROUND
STAFFING AND- WHAT WAS ALREADY
MENTIONED YOU KNOW LIKE FOR
EXAMPLE THE EVERY THIRTY MINUTES
CHECKS FOR VITAL SIGNS IN A
YEAR. THIS IS WHERE YOU BEGIN TO
SEIZE IT WHEN IT WHEN THERE'S
BREAK DOWNS- YOU KNOW THAT THAT
THAT'S AN ISSUE BUT IT TYPICALLY
IN AN UNCOMPLICATED SITUATION
FOR ALCOHOL MAYBE THREE TO FIVE
DAYS. BUT TYPICALLY FOR OPIOIDS
YOU MIGHT BE FIVE TO SEVEN DAYS
IF THEY'RE USING- AT A TAPER.
WITH THAT MEDICATION LIKE
BUPRENORPHINE. BENDED AS- WHICH
IS SEDATIVE. ARE TRIANGLE. CAN
SOMETIMES TAKE A BIT. AND CASES
. AS YOU PUMP IMAGINE A LOT OF
TIMES WHAT ISN'T INSERTED INTO
THE ISSUE IS. COVERAGE SO IS IT
A COVERED DAY FOR THEM TO IS THE
INSURANCE COMPANY- SAYING NO
IT'S NOT APPROPRIATE AND THERE'S
JUST BACK AND FORTH THAT. THE
FACILITY IS ALWAYS ASKING FOR
MORE BAD DAYS. AND THEN THE
INSURANCE COMPANIES ARE ARE
TRYING TO COMPARE TO THEIR
UTILIZATION MANAGEMENT TO SEE IF
IT'S APPROPRIATE. SO THERE'S
THIS DANCE THAT HAPPENS BACK AND
FORTH MANY VARIABLES AND THEN
THERE'S THE EVOLUTION OF WHAT'S
HAPPENING. THAT YOU KNOW WITH
WITH THE PATIENTS SO WE HAD THIS
WEIRD SYSTEM WITH EVEN WITH IMS.
THAT YOU CAN YOU COULD DO
MEDICAL THINGS THAT ARE RELATED
TO DETOX. BUT YOU'RE NOT REALLY
SUPPOSED TO BE DOING MEDICAL
THINGS THAT ARE OUTSIDE OF THE
SCOPE OF THAT YOU'RE SUPPOSED TO
SEND THEM OUT. TO A PROVIDER
OUTSIDE OF THAT FACILITY TO GET
THAT TAKEN CARE OF AN EXAMPLE
WOULD BE. LET'S SAY SOMEBODY
COMES IN WITH THE INSULIN PUMP.
AND AND THEN MAYBE AN INFECTION
THAT NEEDS AN INCISION AND
DRAINAGE. BECAUSE A LOT OF
PEOPLE INJECT INTO THEIR ARM FOR
EXAMPLE OR OTHER THINGS-
PNEUMONIA. TECHNICALLY THAT'S
NOT DETOX SO I'M NOT SUPPOSED TO
BE ABLE TO GIVE A MEDICATION TO
DO AN INTERVENTION. THIS IS A
SEND THEM OUT TO AN URGENT CARE
FACILITY TO AT THEIR PRIVATE
DOCTOR OR ANOTHER WAY TO SET IT
UP. WHICH IS UNFORTUNATE BECAUSE
THAT IF YOU CAN IMAGINE IF
YOU'RE IN THE MIDST OF
WITHDRAWAL MANAGEMENT- THAT
SOMEBODY. PUT YOU IN A VAN AND
SEND YOU OUT SOMEWHERE AND WE
JUST WOULDN'T DO THESE THINGS
FOR OTHER CONDITIONS- YOU KNOW
LAY ABOUT THE PRESSURES. SO BUT
BUT THAT'S KIND OF THE GENERAL
GIST THAT EVALUATION. THEN
THERE'S THE- CARRYING OUT OF
MEDICATION MANAGEMENT USUALLY-
THE LICENSE- AT PRESCRIBER WILL
BE ABLE TO GIVE SOME OF THE
MEDICATIONS DIFFERENT FACILITIES
WOULD DO IT DIFFERENTLY WHERE
SOMETIMES IT JUST. PATIENT COMES
IN WIT THEIR- PRESCRIPTION. AND
OTHER FACILITIES THEY HAVE THE
WAY THAT THEY CAN GET ORDERED IF
THEY HAVE AN IRON MASK IN ORDER
TO THEIR THE TRONIC MEDICAL
RECORD THEN IT GETS THERE. THE
MUSIC. OF PROBLEMS ABOUT GETTING
MEDICINES- DON'T EVEN. GET ME
STARTED THERE THANK THE- IS
FILLING MEDICINES LIKE CUBAN. IN
ORANGE COUNTY. THIS IS A PLAGUE
WE- GET. PHARMACY TO. IT AND
THEN PATIENTS GOING AROUND FIVE
SIX SEVEN PLACES. AND AND YOU
KNOW LOOKING FOR. WHERE JUST
WHERE TO GET SOURCE THEIR
MEDICATIONS AND THAT BECOMES A
PROBLEM FOR TREATMENT CENTERS
THAT ARE IN HOMES THAT YOU
MENTIONED WHERE THEY'RE JUST
SENDING SOMEBODY ATTACK OUT IN
YOU KNOW TO GO PICK UP PICK UP
THE METS. THIS IS NOT A PLACE
WITH A PHARMACY THAT DISPENSES
THE MEDICATIONS AND YOU HAVE
ACCESS TO THE MEDICATION THERE
COULD BE A WHOLE DAY. THAT
PASSES BEFORE YOU EVEN HAVE
ACCESS TO YOUR MEDICATIONS THAT
THE DOCTOR ORDERED A DAY AGO- IN
WHICH IT HAD BEEN A YOU KNOW
ISSUES OF WHY WE GET BAD
OUTCOMES FOR THAT AS WELL. SO
LIKE I SAID DON'T GET ME STARTED
BUT THERE ARE A LOT OF AREAS
THAT'S THE GENERAL GIST OF HOW
THAT DID THE DETOX PROCESS
HAPPENS IN THE NUMBER OF DAYS TO
EXPECT. I THINK YOU GET THANK
YOU FOR JUMPING IN ON THAT
QUESTION AND PROVIDING THAT
CONTEXT AND- I'M- I THINK WHEN.
ONE QUESTION I'D HAVE OPPOSED TO
BOTH OF YOU. IS THE QUESTION OF
WHETHER IT'S ACTUALLY MEDICLLY
APPROPRIATE FOR THESE INTENSE HE
SAID IT'S WE'RE TALKING THREE TO
FIVE DAYS OR FIVE TO SEVEN DAYS
ON AVERAGE. IS IT MEDICALLY
APPROPRIATE FOR THESE DETOX
FACILITIES TO BE IN SOMEBODY'S
GARAGE. WELL SO PROBABLY NOT A
GARAGE RIGHT SO THERE'S THAT
THERE THAT YOU CAN YOU CAN
ALMOST LIKE AND IF IT'S IF IT'S
A VERY MILD WITHDRAWAL AND THIS
IS WHY YOU NEED YOU NEED THE
SKILL OF SOMEBODY THAT
UNDERSTANDS HOW TO EVEN APPEAR
APPROPRIATELY- GAUGE WHAT THAT
WHAT THAT IS AND THAT'S WHY WHEN
WE TALK ABOUT THE SAME CRITERIA
FOR EXAMPLE A LEVEL FOUR WOULD
BE THE PERSON THAT I MENTIONED
THAT HAD STATE HISTORY OF
DELIRIUM TREMENS OR HISTORY OF
SEIZURES. THEY DON'T LOOK GOOD
BUT LET'S SAY SOMEBODY THAT- YOU
KNOW THEY'VE BEEN DRINKING FOR.
THREE OR FOUR WEEKS- AND THEY
SHOW UP AND IT NEVER HAD ANY
SORT OF OTHER MEDICAL ISSUES OR
ANYTHING ALONG THAT LINE. THAT
PERSON OFTENTIMES WE JUST. YOU
KNOW ARE NOT NECESSARILY NEED A
NEED MEDICATIONS- SO. THERE'S
DEFINITELY A LOT OF SPECIFICS TO
THE FACILITY KIND OF LIKE YOU
WOULD HAVE A FEW SOME PEOPLE GET
HOME HEALTH. WE DO DO WE DO DO-
MEDICAL TREATMENTS AND MEDICAL
THERAPIES IN PEOPLE'S HOMES-
JUST IN GENERAL IN OTHER AREAS
OF MEDICINE. BUT YOU'RE RIGHT IN
THAT IF IT'S NOT APPROPRIATELY
ASSESSED. WHICH IS KIND OF A THE
WAY I THINK YOU MAY BE GETTING
AT IS THAT THERE COULD BE PEOPLE
THAT NEED MORE. THAN A HOME
CERTAINLY WOULD NOT BE AND
THAT'S NOT ENDORSED EVEN BY THE
SAME CRITERIA. SO WHEN THAT GOES
WRONG BAD THINGS HAPPEN. YES YES
THEY DO. I WILL WITH THAT AT THE
STATE THANK YOU AGAIN DR BROUGHT
BARTOLOMMEO THANK YOU AND- ADD
TO JENNIFER LACEY. JOINING US
FROM HAZELDEN BETTY FORD I WILL
GO AHEAD AND CONCLUDE. OUR
WITNESS TESTIMONY AND I TURN TO
PUBLIC COMMENT. BOB SO AS WE
TURN TO PUBLIC COMMENT I JUST.
WANT TO REMIND EVERYONE PLEASE
LIMIT YOUR TESTIMONY TO ISSUE.
THREE MINUTES SO THAT WE WILL
HAVE AN OPPORTUNITY FOR ALL AT
WITNESSES TO HAVE AN OPPORTUNITY
TO SPEAK. FOR DIAL IN TESTIMONY
WE WILL BE USING A MODERATE A
TELEPHONE SERVICE THROUGH WHICH
ANY MEMBER OF THE PUBLIC CAN
CALL IN TO PROVIDE A COMMENT.
AGAIN THE CALL IN NUMBER FOR
THIS HEARING IS EIGHT. SEVEN
SEVEN. SIX NINE TWO EIGHT NINE
FIVE SEVEN. THE ACCESS CODE IS
ONE THREE ONE. FIVE FOUR TWO
ZERO TWO. IF YOU ARE CALLING IN
A REMINDER TO PLEASE ELIMINATE
ALL BACKGROUND NOISE THIS
INCLUDES MUTING YOUR LIVESTREAM
BROADCAST. AND ALLY ANY SMART
DEVICES TO REDUCE ON DISTORTION
IF YOU'RE HAVING ANY PROBLEMS
WITH THE MODERATED PHONE
SERVICE. YOU CAN CALL THE
COMMITTEE AT. NINE ONE SIX THREE
ONE NINE THREE SIX ZERO ZERO AND
MY STAFF WILL BE AVAILABLE TO
ASSIST. BUT LET'S FIRST BEGIN
WITH ANY IN PERSON TESTIMONY. F.
ANY MEMBER OF THE PUBLIC HERE IN
THE ROOM WOULD LIKE TO SPEAK
PLEASE RAISE YOUR HAND AND I
WILL ASK YOU TO APPROACH THE
MICROPHONE. THANK SEEN. NO ONE I
LOOKING TO PROVIDE IN PERSON
TESTIMONY LET'S GO AHEAD AND
TURN IT OVER TO THE PHONE LINES
MODERATOR CAN YOU PLEASE OPEN UP
THE FIRST LINE. THANK YOU VERY
MUCH LAYS DOWN ON THE PHONE
LINES IF YOU WOULD LIKE TO- MAKE
PUBLIC COMMENT TODAY PLEASE
PRESS ONE FOLLOWED BY ZERO AN A.
T. T. OPERATOR WILL ACCESS YOUR
LINE QUICKLY AND GIVE YOUR LINE
NUMBER SO YOU CAN ASK YOUR
QUESTION. AGAIN FOR A PUBLIC
COMMENT PLEASE PRESS ONE ZERO AT
THIS TIME. AND ONE MOMENT AS
PARTICIPANTS QUEUE UP. OKAY WE
DO HAVE A NUMBER OF PARTICIPANTS
QUEUING UP JUST GIVE US ONE
MOMENT HERE AS WE GET THE- FIRST
COUPLE. AND ARE. FIRST
PARTICIPANT. WE'LL BE LINE FORTY
FOUR PLEASE GO AHEAD. OKAY HI MY
NAME IS SHELLY FONTAINE AND I
LIVE IN OPEN FOREST ANY ECHO I
JUST WANTED TO GO ON RECORD
THAT- AND ARE EXPERIENCING IN
OUR COMMUNITY THE H. WE ASK DOES
NOT THEY'LL SURPRISE INSPECTIONS
AND THERE WAS. NO FOLLOW UP OR
AT LACK OF APPROPRIATE
CORRECTIVE ACTION ON VIOLATION
FINISHES WE HAD A- I AM A
LICENSED DETOX IN OUR COMMUNITY
AND OUR NEIGHBORHOOD WITNESSED
FIRE TRUCKS AMBULANCES COMING
AND GOING BODY BAGS BEING
REMOVED FROM THE PROPERTY. ON
STRETCHERS. I AT DON'T KNOW IF
ANYBODY DOES- THAT WE- YOU KNOW
YOU DON'T POLICE RIGHT. I WANT
WORK HAD THEIR GUNS OUT GET DOWN
ON THE WHILE NAY CHILL WITH IN.
CATION OUR OFTEN NOT AND TO
FIGURE IN THE OF THE HIGH FIRE
THEM AREA. WHERE WE HAVE AND I
THINK IT'S ALREADY AND MARCO
RIGHT NOW DOOR. THE RANGES OTHER
DRUG TRASH ON THE- I EVEN HAVING
CORE STRENGTH WERE STOLEN. AND
EVEN AFTER NOW THE HOUSE SOLD
AND- LATER. I THANK BUT B. B. TA
ABOUT HOW BEFORE AND THEN THE
NEW SO THE THAT THEY HAD TO
REPLACE ALL THE- IN THE KITCHEN
DETOXIFY THAT WAS NEVER DISCLOSE
. IT A MATTER OF TIME BEFORE THE
HOW HAD A CAT SCAN DISASTER
COMMUNITY. AND I JUST WANT TO GO
ON THAT THAT SHOULD. EVER HAVE
AND NEVER APPROVED. THANK YOU
MA'AM. AND WILL UP FORTY YOUR
OPEN. HI MY NAME IS GALE AND I
BEEN LISTENING ELEVEN AM AND I
JUST WANNA TO PUT FOR MY- OPIN
THAT DHEA IS DETOXING THAT
THEY'RE ACTUALLY SUPPOSED TO BE
PROTECTING- MY HUSBAND AND I-
LIVED NEXT DOOR TO A LICENSE
DETOX HOME IN A VERY VERY
UPSCALE NEIGHBORHOOD. MULTI
MILLION DOLLAR HOMES- IT'S FOUR
THIRTY AM SOMEBODY COMPLETELY
DRUNK WHICH WE DIDN'T REALIZE AT
THE TIME TOOK A LARGE ROCK AND
STARTED SMASHING OUR DOOR ALL OF
OUR BLAST DOUBLE GLASS WINDOWS
IN COST CONSIDERABLE DAMAGE MY
DOGS ARE BARKING I CALLED THE
POLICE THEY CAME OUT THEY DID
REMOVE THEM HE WAS COMPLETELY
INCOHERENT. BUT THANK GOD I
DIDN'T REACH FOR MY HAND GUN
BECAUSE THAT WOULD HAVE PROBABLY
BEEN COME BACK AND BITE ME BUT I
REALLY FEEL LIKE YOU KNOW THERE
NEEDS TO BE MORE DONE- I BELIEVE
THE DEATH AND NEWPORT RECENTLY
WAS COMPLETELY PREVENTABLE
BECAUSE IT WASN'T THE FIRST TIME
HE'S DETOXING ADDICTS TRYING TO
BREAK INTO SOMEONE'S HOME IT
COSTS. AND- YOU KNOW AND THAT'S
VERY SCARY MULTIPLE TIME I WALK
BY THEIR- THEY WERE NEEDLE ON
THE GROUND IN THE GUTTER
MEDIATION. KIDS AND- AGAIN LIKE
THE PREVIOUS POLICE CAME POLICE
WENT- CURRENTLY THAT HOME HAS
BEEN CLOSED DOWN AND RE SOLD BY
THE OWNER. AND BUT AGAIN I THINK
WHEN SOMETHING NEEDS TO BE DONE
MORE DEONDRE OF THAT PROPERTY
RUNNING IT HAD NO EXPERIENCE
WHATSOEVER AND SOMEHOW HE GOT A
STATE LICENSE TO HAVE A DETOX
CENTER. AND SO NOT FOUND WHAT I
WANTED TO PUT FORTH AND I REALLY
HOPE THAT YOU ALL COME UP WITH A
MUCH STRONGER- YOU KNOW
LICENSING AND FOLLOW. THROUGH
THANK YOU VERY MUCH. THANK YOU
MA'AM. M. LINE TWELVE PLEASE GO
AHEAD. HI MY NAME'S RESENT ALL
COLOR THANK YOU HEALTHCARE FRAUD
INVESTIGATOR FOR HEALTHCARE
HEALTH PLAN I HAVE PERSONALLY
WITNESSED THE H. FAILURE ON A
DUPLICATE APPLICATIONS YOU HAVE
BODY BROKERS OPENING UP
CONSULTING FIRMS IN USING
DUPLICATING APPLICATIONS
BASICALLY JUST COPIED ON A PIECE
OF PAPER CHANGING THE NAME AND
ADDRESS. TRINITY YEAR AND IT
GETS APPROVED YOU ALSO HAVE
LICENSES- THAT WERE RESCINDED BY
THAT OPERATORS WE CAN TURN IT DE
YES JUST GIVE THEM ANOTHER
LICENSE UNDER A NEW BUSINESS
NAME HUNDRED ADDRESS. AT WHAT
POINT ARE WE CHECKING
APPLICATIONS FOR DUPLICATION YOU
HAVE A NUMBER OF I AM AT
LICENSES AND APPLICATIONS
TENSION WITH THE SAME DOCTOR THE
SAME DOCTORS ARE THE MULTIPLE
DOCTORS ON ALL MAJORITY OF THE
APPLICATION THERE'S NO HUMANLY
WAY POSSIBLE THAT THESE DOCTORS
CAN GET. GREAT PATIENT CARE AND
GOOD HAIR TO THE NUMBER OF
PATIENTS SEEN ON THESE
APPLICATIONS I'VE ALSO WITNESSED
THE AMOUNT OF FRAUD COMING FROM
THIS SO ONCE YOU GET HERE MIND
YOU THIS IS A SMALL COMMUNITY OF
THAT OPERATORS THEY ALL SHARE
INFORMATION. I KNOW PEOPLE OUT
OF PRISON. EIGHT MINUTES AT THAT
THEY'RE GOING TO GET A LICENSE
PC. YOU HAVE PEOPLE CRIMINAL
BACKGROUND YOU KNOW WHAT YOU'RE
- GETTING THE EXACT OF MAKING
MILLIONS AND NINE OF THE- D. FOR
AND COMPANY. I WORK FOR OF THE
LAW MANY CAL PLANTS IN SOUTHERN
. AND I KNOW YOU GATE IT KEEPS
MEDICARE. EITHER TELL YOU THESE
GUYS THE GET MEDIC CAL
APPLICATION THERE NOT PROVIDER.
THEY DON'T PAY SO WHY WOULD THEY
DO THERE AND IT THE MONEY THIS
IS MANY MAKE SCHEME. HELLO AT
POINT YOU REALLY NEED TO LOOK AT
THE RIGHT NOW. AND ISSUE GATES
DOES IT THEY NOTIFY DR ONE
THEY'RE GOING TO BY THE PROPERTY
. I HAVE NO PERSONALLY WILL.
ILLEGAL OPERATORS MOVE OUT
ADDICT MODOC THE FURNITURE. THE
DAY BEFORE GATES THE RIGHT. THEN
DETECT THEN APPROVE THE THEY FOR
THE HEALTH APPROVAL. THE NEXT
DATE THESE ARE MOVE EVERYBODY IN
. SO WHY ARE WE TELLING THEM.
WHERE WE SHOWING. THERE NO
REGULATION ON IT LIKE THIS IS AN
THIS IS WHY HAS OUR- AND IS WHY
THERE'S SO MANY GAS. AND SO MUCH
MONEY WILL. ON NINETY SIDE
BECAUSE THESE ARE FAILED THAT
THAT THE SHOULD NAY BEEN AT.
THANK YOU FOR. I'M GOING YOU FOR
JOINING US. WHY FORTY YOU ARE
PLEASE GO AHEAD. YES THANK YOU
AND I DIæN OF BEACH THE
COUNCIL MEMBER I WANT TO THANK
CHAIR NOR PROPOSED THIS OF ME.
LONG OVER AND I KNOW YOU BEEN
WORKING FOR YEARS NOW WE ARE ARE
GRATEFUL OTHER BECAUSE FROM WILL
BE ON WILL ADDRESS AN ISSUE THAT
HAS COME UP- SUPERVISE FULLY AS
WELL AS THE- REQUIREMENTS WE
KNOW THAT WHEN GROUP HOMES ARE
WELL REGULATED THEY CAN AND DO
TREAT ADDICTION EFFECTIVELY.
THEY ALSO BLEND INTO THE
COMMUNITIES THAT PROVIDE THE
VERY TYPE OF ENVIRONMENT FOR
THEIR CLIENTS THAT THIS TYPE OF
FACILITY WAS SPECIFICALLY
INTENDED TO PRODUCE HOWEVER AS
WE'VE ALREADY HEARD THE STATE
DOES NOT CONSIDER THE PROJECT
MANY OF ONE LICENSED HOME TO
ANOTHER AND THIS HAS LED TO OVER
CONCENTRATION. IN SOME OF
NEWPORT BEACH IS NEIGHBORHOODS
AS THOSE IN OTHER COMMUNITIES
NEARBY SUCH AS COSTA MESA AND
YOU HEARD MARK. THIS COULD
COMPLETELY UNDERMINES THE
PURPOSE OF PROVIDING TREATMENT
IN A RESIDENTIAL SETTING AND IT
IS DAMAGING THE CHARACTER OF
QUALITY OF LIFE OF RESIDENTIAL
NEIGHBORHOODS THESE ARE
BUSINESSES AFTER ALL WITHIN
POINTS COMING GOING DELIVERY
TRUCKS AND OTHER IMPACTS THAT DO
MAKE THE HOME DIFFERENT THAN
OTHERS IN THE COMMUNITY. IT IS
IMPERATIVE THAT THE STATE COULD
DISTANCING AN OVER CONCENTRATION
CONSIDERATIONS. INTO ITS
LICENSING PROCESS. AS YOU IN THE
LAST MINUTES INADA LIE. AND FOR
IS A MAJOR FACTOR IN THE PRICE.
THANK ARE TODAY AND THE PATIENTS
ARE NOT RECOVERING. THAT IS THE
BOTTOM LINE ARE WE NEED TO
UNDERSTAND. THE OUTCOMES AND HOW
ARE PATIENTS BEING SUCCESSFULLY
TREATED AND I KNOW YOU'LL HEAR
MORE ABOUT THIS FROM OTHER
CALLERS. NEWPORT BEACH STANDS
READY TO WORK WITH THE STATE TO
ACHIEVE OUR COMMON GOAL OF
SUCCESSFUL EFFECTIVE TREATMENT
FOR ADDICTION WE KNOW WE
REGULATED. THE SAUDIS THAT ARE
SUBJECT TO CITY PERMITS WE
REGULATE EFFECTIVELY YOU'LL BE
HEARING MORE ABOUT THAT AND THE
SUBSEQUENT CALLS BUT AGAIN THANK
YOU FOR HOSTING TODAY'S MEETING.
YEAH WE WORK WANT TO WORK WITH
YOU TO SEE THAT LAWS ARE MADE
AND CHANGE THE LANGUAGE
NECESSARY IMPROVEMENTS IN OUR
COMMUNITY AND THE C. RECOVERY.
BUT THE PEOPLE WHO NEED IT MOST
THANK YOU VERY MUCH. THANK YOU
COUNCIL MEMBER. WHY FORTY SIX
YOU ARE OPEN. HI MY NAME IS BETH
DALY ALUM AND I'M A RESIDENT OF
ORANGE COUNTY AND SAN JUAN
CAPISTRANO- I'D LIKE TO SHARE MY
EXPERIENCE HAVING AN UNLICENSED
RECOVERY RESIDENTS. THAT WAS
LEFT WAS WAS NEXT DOOR TO MEFOR
A YEAR AND A HALF AND I AM
ASKING THAT YOU ALL CONSIDER
THAT THESE UNLICENSED RECOVERY
RESIDENCES SHOULD ALSO BE
LICENSE NOT JUST THE DETOX
FACILITIES BECAUSE THESE ARE ALL
SATELLITE BUSINESSES OF THE
CORE- BACK CARE BUSINESSES. THEY
ARE NOT WANTED ALL INTO OUR
COMMUNITY THEY HAD TWELVE MEN
THAT SOMETIMES COED- LIVING NEXT
DOOR TO US WITH TWO PEOPLE
ROTATING CHECKING IN ON THEM
ADMINISTERING MEDICINES AND
PROVIDING FOOD THEY DON'T ANSWER
THE DOOR IF THERE'S A NOISE
COMPLAINT OR A CONCERN WE
CONSTANTLY HAD. NOISE NUISANCE
LANGUAGE NEWSSTANDS MOPING WE
HAD METHADONE THROWN INTO OUR
YARD WE GET STUDENTS THAT WILL
BEING USED CLEARLY AS DRUG
PARAPHERNALIA AND NEEDLE BEING
THROWN INTO OUR YARD AND YOUNG
MEN IN THEIR IN THEIR RECOVERY
EXPERIENCED ROTATING IN AND OUT-
EVERY TWO WEEKS IT WAS A NEW
CROP OF PEOPLE EVERY TWO WEEKS
WHICH IS NOT. TYPICAL OF THE
NORMAL FAMILY NEIGHBORHOOD WHERE
YOU HAVE CONSISTENT NEIGHBORS
THAT YOU GET. TO KNOW- EITHER
THIS WAS PART OF A BUSINESS
OPERATION OF A LARGE- PROVIDER
THAT HAD D. TAX THAT. AND RENTED
ON LIFE RECOVER RATHER- WHEN
IT'S HARD A NEIGHBOR BECAUSE
THERE'S NOWHERE TO GO TO
COMPLAIN TO WHEN YOU HAVE
CONCERNS ABOUT THESE DRUGS THAT
ARE BEING THROWN OVER IN YOUR
YARD AND YOUR DOG HAS A BOTTLE
OF SOMEONE'S METHADONE NOW. IT'S
NOT FAIR TO US IN COMMUNITIES
THE CRIME WENT FROM NO NOTHING
IN OUR NEIGHBORHOOD WHICH IS A
PRETTY SLEEPY NEIGHBORHOOD JUST
THROUGH THE ROOF WE HAVE
FOURTEEN BREAK INS AND FOR
MONTHS. AND THIS YOU KNOW I
DEEPLY VALUES THAT PEOPLE NEED
GOOD. RECOVERY CARE BUT THIS IS
NOT THE RIGHT WAY TO DO IT IN
UNLICENSED RESIDENTIAL
COMMUNITIES WHERE THERE'S NO
OVERSIGHT AND NO WAY FOR US TO
VOICE CONCERNS OR FOR THE
PATIENT TO VOICE CONCERNS- IT
DRAMATICALLY CHANGE THE- FIELD
COMMUNITY OF OUR NEIGHBORHOOD-
AND I DON'T THINK WAS PROVIDING
THEM GOOD CARE IT WAS JUST AN
INSURANCE FRAUD SCHEME. SO I
WOULD ASK THAT YOU CONSIDER
CREATING A STATUTE WERE ALL
FACILITIES DETOX AND RECOVERY
RESIDENCES THAT ARE BUSINESSES
IN RESIDENTIAL NEIGHBORHOODS THE
LICENSE ESPECIALLY IF THOSE
BUSINESSES ARE SATELLITE OF
ACTIVE RECOVERY BUSINESSES.
THANK YOU SO MUCH REPRESENT
PETRIE-NORRIS FOR LEADING THE
DISCUSSION HERE AND FOR BRINGING
SO MANY GREAT RESOURCES TO
CONSIDERATION BUT PLEASE I. P.
H. C. S- NEEDS TO. WORK IN A
GRAY THE WHOLE. IN THE RECOVERY
PROCESS NOT JUST THE DETOX BUT
ALSO THE INTEGRATION OF THE-
UNLICENSED RECOVERY RESIDENCES.
BUSINESS SATELLITE. AND THANK
YOU THANK FOR TO US THANK YOU.
WIND EIGHTH PLEASE CALL. HOUSE
THANK YOU FOR HAVING THAT
FOREIGN THREATS TO DISCUSS MY
NAME IS LISA PHOTO I LIVE IN
MISSION VIEJO- I WANT TO TALK
ABOUT NO TRANSPARENCY- ARE
OBSERVATION. WITH THAT. DETOX
FOR DRUG AND ALCOHOL I BELIEVE
THEY HAVE A EXTENDED LICENSE FOR
MENTAL ILLNESS YOU. IS ACROSS
THE STREET FROM ME IT'S FOUR SIX
THAT SIX BETTER LAST- I KIND OF
HAD TO CHUCKLE A LITTLE BIT WHEN
YOU TALK ABOUT A CARING PARENT
DRIVING. THEIR CHILD TO DROP
THEM OFF I'VE NEVER SEEN A
PARENT. LEVINE MAY DROP OFF OF
THAT CHILD I SEE YOU WERE
DRIVERS DROP A MOP AND YOU WERE
DRIVERS PICK THEM OUT THERE'S NO
CARING. ABOUT THESE PEOPLE AT
ALL- THE TRANSFER LACKING IS IN
THE FINANCIAL BACKGROUND OF THE
PEOPLE THAT ARE OPERATING THESE
PLACES- THE L. L. C. ON OUR
STREETS ARE THE SAME INDIVIDUALS
THAT OPERATED UNDER A DIFFERENT
LLC IN NEVADA. IN NEVADA BUT
THEIR LICENSE WAS REVOKED
THEY'RE ASKING AND NUMBER WAS
REVOKED AND BANKRUPTCY FILED
ONLY TO OPEN UP IN OUR
NEIGHBORHOOD NOW. YOU HAVE THE
NAME ONLY TO BE KNOWN BY THEIR
L. L. C. NAMES WITHOUT TRUE
TRANSPARENCY ON WHO THE BUSINESSPARTNERS ARE OR THAT THE
BUSINESS PARTNERS COULD BE
LINKED TO SHOW THEY HAVE BEEN
SHUT DOWN BEFORE IN ANOTHER AREA
OR STATE EVEN. ARE THERE
CRIMINAL BACKGROUND CHECK THEIR
FINANCIAL CHECK DONE ON THE
PEOPLE IT DOESN'T APPEAR THAT
THERE ARE OR THIS WOULD BE KNOWN
PRIOR TO A LIFE AND BEING
APPROVED. WE ARE MET WITH
HOSTILITY WHEN ENQUIRING WHAT'S
ACTUALLY HAPPENING WITH THEIR
PROGRAM. IT IS THE- I AM UNDER
THE UNDERSTANDING THAT THEIR
MANUAL FOR OPERATION IS SUPPOSED
TO BE DISCLOSED TO THE PUBLIC
AND WE HAD TO MAKE UP FOR YEAH I
REQUEST. TO GET A COPY OF THEIR
MANUAL. AND WE'RE COMING UP ON A
YEAR AND WE STILL DON'T EVEN
HAVE THE MANUAL THAT THEY'RE
SUPPOSED TO BE PROVIDING TO THE
PUBLIC. SO THAT WE ACTUALLY CAN
HAVE ACOMFORT LEVEL OF WHAT'S
GOING ON OVER THERE. THERE IS NO
OVERSIGHT IN NINETEEN ZERO
OVERSIGHT THIS THIS HOUSE OPENED
WITH NO PRIOR INSPECTION AND
CODE RED WAS USED AS AN EXCUSE
AS TO WHY NO ONE CAN COME AND
CHECK BEFORE THE PLACE OPENED ON
OUR STREETS. IT'S DANGEROUS. TO
ALL PEOPLE INVOLVED. IT'S GOT TO
BE- I KNOW THEY OWN MORE THAN
THIS YES HOW I'M THE IMPRESSION
THAT GEN. ON YOUR MARK PLAY.
THERE'S A HANDY MAN THE HERE FIX
THE AND- DO CONSTRUCT- EVIDENTLY
HE OWNS A- AND. I HOW TIME
BELIEVING THE PEOPLE KNOW WHAT
DOING WE SEE FIRE TRUCKS AND-
THE STAFF ARRIVED DON'T EVEN
HAVE AN ADDRESS OF WHERE THEY'RE
SUPPOSED TO GO- LOOKING MY GAPS
OF MINE. IS GOING TO GET OUT OF
THEIR CAR AND MAY I ASK YOU FOR
JOINING US AND IF YOU COULD JUST
WRAP UP YOUR COMMENTS SO WE CAN
MOVE ON TO THE NEXT CALLER. I
THINK THAT'S SAID THAT JUSTIFY
CONGRESS GRAYSON AND THERE'S THE
TRANSPARENCY IS. OR LACKING IN
THANK YOU FOR LISTENING AND FOR
CALLING IN. AND FOR YOUR
COMMENTS. THANK YOU STE. SIX WE
WILL LINE FIFTY THREE PLEASE GO
AHEAD. HELLO MY NAME IS JENNIFER
TURNER I WOULD LIKE TO POINT OUT
THAT THE H. HERE DOESN'T HAVE
THE SAME TRANSPARENCY LIKE THE
COMMUNITY CARE LICENSING WEBSITE
IN REGARDS TO COMPLAINTS ONLINE.
AS IN GROUP HOMES AND ADULT
RESIDENTIAL FACILITY I CAN
EASILY TAKE THE NAMES AND AT THE
FACILITY- THREE ALL THE VISITS
COMPLY ISSUES AND AUDIT. THEM I
NEED TO SEND PRH THROUGH HOOPS
AND HAD MY TOES IS THAT BEFORE I
CAN GET A LETTER CAN MY REQUIRED
. IN THE STATE IT WILL TAKES
MONTHS TO PROCESS. NUMBER TWO
BILL COLE Q. WHERE THE LIGHT
VISIBILITY ON THE- LIVING COVER
LETTER AT THE KEY TALKING. I
KNOW P. I. OUTSIDE GIRL. THE
CLIENT PLAN GO DURING THE FILM
LIVING NOW EVER A- FROM THE H.
HERE YEAH. SIR NO LONG BE A TO
HIDE BEHIND OUT OF OUR. ALL ON
AT THE GOAL WE HAVE AFTER THEIR
WAY YOUR BILLING ENSURE LAB IN
THE- OF THE COMP INSURANCE. DOES
NOT PAY FOR RENT. YOU NEED AN-
ALL OF THOSE THREE. THAT THEY'RE
GOING REALLY CAN TIED TO THE
LIFE. THE LADY PERIOD. EVERY
WELFARE BENEFITS SPENDING IN THE
COULD RELAX. A BIRD WITHIN. THE
EIGHT YES DOING THE BARE MINIMUM
TO PROTECT THESE YOUNG I THINK
IT'S A GREAT OF ROCK THE VOTE
WITH THEIR STAKEHOLDERS. DE
REHAB. ON WE DID CHANGE OUR
CHILDREN MAY. MY CHILDREN MY
CHILD CAME FOR HELP BUT WAS
EXPLOITED FOR BENEFIT IN
HOMEWORK AND HURT. MY NOW
HUSBAND LATE WIFE. AND DAUGHTER
WERE AT BOB RUN HEALTH WORKS
FINE HE GAVE THEM A FIFTY DOLLAR
CANAL FRIEDMAN EARLIER WHAT YOU
. UNINSURABLE I DEMAND. THANK
YOU FOR SHARING YOUR STORY. NINE
FORTY NINE PLEASE GO AHEAD. GOOD
AFTERNOON MY NAME IS BRYCE
BUNKERS IN CITY OF COSTA MESA
THANK YOU SOMEBODY WOMAN
PETRIE-NORRIS FOR YOUR EFFORTS
IN PUTTING THIS COMMITTEE
TOGETHER THE CONVERSATION THIS
AFTERNOON- JUST A QUICK SHOUT
OUT TO MY FORMER MAYOR SLOWLY I
THANK YOU FOR ALSO PARTICIPATING
AND NOT KEEPING NOT I UNDERSTAND
YOUR COSTA MESA. I'M CALLING
BECAUSE- WE'VE INFORMED THERE'S
A FEW. OPENING UP A CUP HOUSES
FROM. I HAVE THREE SMALL.
INTERFERE WHAT COULD HAPPEN IN
SIMILAR TO WHAT HAPPENED IN
NEWPORT BEACH JUST A COUPLE
MONTHS AGO. AND I WOULD LIKE TO
AVOID THAT AT ALL COSTS BOTH
FOR. THE VICTIM'S FAMILY AND FOR
ALL THE NEIGHBORING FAMILIES. I
WANT TO PROVIDE SORT OF A
PARALLEL PERSPECTIVE ON
REGULATION I WANTED I'M FAMILIAR
WITH WHICH IS. VACATION RENTALS
NOW THERE WAS A BOOM IN VACATION
RENTALS. THERE WERE NOISE
NUISANCE COMPLAINTS AND QUICKLY.
A NUMBER OF CITIES JUMPED INTO
ACTION. TO PULL PERMITS FROM FOR
SIMPLY- YOU KNOW BEING TOO LOUD
AFTER TEN PM. IT SEEMED TO GO
PRETTY WELL. AND THE CITIES HAVE
BEEN ABLE TO GET- THE RENTALS
UNDER CONTROL. IT SEEMS LIKE-
PULLING DIFFERENT PARTS FROM.
THAT EXPERIENCE COULD WORK HERE-
THEY'VE BEEN ABLE TO STOP. BY
FEEDING AND PERMITTING IN THIS
CASE PRETTY IMMEDIATELY- AND I
HOPE THAT FOR ALL THESE-
POTENTIAL BUSINESSES THAT ARE
OFFERING AND TRYING TO PULL
LICENSES- MAYBE THERE'S A HALT.
UNTIL WE GET THIS UNDER CONTROL-
AND THAT WE DON'T HAVE MANY OF
THESE. ARE SORT OF ABSENT USERS
AND BUSINESSES CONTINUING TO
APPLY FOR A LICENSE. AND OPENING
UP FACILITIES-MIXED AMONG OUR
NEIGHBORS. THE ONE IN
PARTICULAR- SIMILAR. TO WHAT
WE'VE HEARD ON THE PHONE THIS
AFTERNOON. ARE WE- THEY COME
FROM A DISSOLVED A PRIOR TO L.
BASED ON A LAW- SO THEY JUST TO
OPEN UP UNDER NEW NAME WHICH CAN
US AGAIN ABOUT HOW THIS FACILITY
WILL BE RUN OUT AGAIN ABOUT YOU
ALSO EXPAND ON THE PROXIMITY TO
SCHOOLS- THERE ARE CERTAIN
BUSINESSES ALREADY AND ARE AND
ARE NOT ALLOWED IT SEEMS LIKE
THIS TYPE OF USE FITS WELL-
COULD NOT BE ALLOWED WITHIN. A
SHORT DISTANCE TO SCHOOLS
CHURCHES AND SO FORTH. I HOPE
THE CONVERSATION CONTINUES I
HOPE IT CONTINUES TO MOVE
FORWARD QUICKLY AND SHE'S SO
STRONG REGULATIONS- AGAINST
THESE TYPES OF USES THAT WE
DON'T TO SERVE OUR NEIGHBORS.
SAW THANK YOU VERY MUCH. AND
THANK YOU SIR FOR JOINING US.
WHY NINE EUROPE PLEASE GO AHEAD. HELLO AND I WANT TO THANK YOU
FOR HEARING MY CRIES FOR HELP
TODAY- MY NAME IS DEBBIE DANCING
AND I LIVE ANOTHER WAY DRIVE IN
HUNTINGTON BEACH. WE HAVE THREE
UNLICENSED RECOVERY AND
TREATMENT TREATMENT HOMES ALL
WITHIN SIX HUNDRED FEET OF EACH
OTHER I LIVE DIRECTLY ACROSS THE
STREET FROM AN UNLICENSED SOBER
HOME. WHICH IS OWNED BY AN
ORANGE COUNTY DEPUTY SHERIFFS.
THERE IS ZERO OVERSIGHT AT THIS
HOME. I WITNESSED DRUG OVERDOSES
ATTICS DANCING ON THE ROAD IN
THEIR UNDERWEAR. LOITERING ALL
HOURS OF THE NIGHT AND DAY. I
HEAR THAN CURSING YELLING
EXPOSING THEMSELVES IN THE
WORST. I'VE SEEN DEATH. MY
CHILDREN CANNOT GO OUTSIDE AND
PLAY. I DO NOT SLEEP AT NIGHT
BECAUSE I'M AFRAID ADDICTS WILL
BREAK INTO MY HOME. MY CHILDREN
DO NOT VERY WELL IF THEY ARE
ALSO FEARFUL. YEAH I GOT A HAD
BROKEN IN THE CAR. GIVEN
RECKLESSLY DOWN THE STREET AND
ALMOST HIT MY CHILD AND MY
GRANDMOTHER OKAY THE STREET. I
HAVE MAKES HIGHER FONG CALLS TO
THE POLICE. THE SHERIFF'S. AND
H. YEAH. NONE OF MY COMPLAINTS
HAVE FOLLOW UP ON I EVEN HELLO
PART VAN WHO PICKED UP EIGHT
FROM THE HOME THROUGHOUT
HUNTINGTON BEACH LANDON TO DROP
OFF ALL OF THE PASSENGERS OF THE
LOCAL TREATMENT CENTER. I ASK.
HOW CAN A DEPUTY AND ONE BE
ALLOWED TO OPERATE AN UNLICENSED
SOBER LIVING HOME WITH ZERO.
ZERO SUPERVISION. SOMETHING TO
BE DONE- RUINING FAMILIES
COMMUNITY PLAY YARDS FOR KIDS MY
HUSBAND I HAVE WORKED VERY HARD
TO LIVE IN A RESIDENTIAL
COMMUNITY AND I'M ASKING FOR
HELP DIRECTLY TODAY. ANYONE
WHO'S WILLING TO LISTEN TO HELP
MY FAMILY. I THANK YOU FOR YOUR
CURRENT MEDICAL. THANK YOU MA'AM
FOR SHARING YOUR STORY. NINE
FIFTY ONE PLEASE GO AHEAD. HELLO
MY NAME IS JOY BRENNER- THANK
YOU MADAM CHAIR AND COMMITTEE
MEMBERS FOR CONVENING THIS
HEARING TODAY ON THIS CRITICAL
ISSUE I KNOW YOU COULD BEACH
CITY COUNCIL MEMBER AND A MAJOR
SOURCE OF FRUSTRATION FOR ME AND
MY CONSTITUENTS IS OUR INABILITY
TO ADDRESS CONCERNS WITH STATE
LICENSE GROUP HOME A LOCAL
LEVEL. IN NEWPORT BEACH WE HAVE
SOBER LIVING FACILITIES THAT ARE
UNLICENSED WITH SIX UNDER
RESIDENTS THAT ARE SUBJECT TO
LOCAL COMMUNITY AND THE CITY
REGULATIONS THAT HAVE BEEN IN
PLACE SINCE TWO THOUSAND EIGHT
R. ORDINANCE ANTHONY OVERSIGHT
HELP INSURE THE HOME BLEND INTO
OUR NEIGHBORHOODS AS THEY ARE
SUPPOSED TO FOR THE GOOD OF THE
RESIDENTS. OF THE HOME AND THE
SURROUNDING COMMUNITY WHEN
THERE'S A COMPLAINT WE WORK
DIRECTLY WITH THE OPERATOR TO
RESOLVE THAT I CAN GIVE YOU MORE
THAN A DECADE OF EXAMPLES OF HOW
OUR PROCESS TO FACILITATE THIS
LITTLE LIST OF OPERATORS THAT
WORK WITH US ON A RESPONSIVE TO
SURROUNDING RESIDENTS. HOWEVER
WE HAVEN'T COMMITTED A NEW
FACILITY SINCE TWO THOUSAND NINE
WHY MANY OPERATORS SEEM TO KNOW
IT EASIER TO APPLY FOR AN
OPERATOR GROUP HOME WITH SIX OR
FEWER RESIDENTS LICENSED AND
REGULATED BY THE. STATE D. H.
YEAH. THERE'S LESS OVERSIGHT
WHEN MANAGER BY AGE LOW MORE
FOUR MILES AWAY IT'S A- TO US
AND A RED. FOR THE RULES ARE AND
HOW YOU ENFORCE THEM HOW DO THE
STATE GAME COMPLY. AND ITS
LICENSE INFO AT UP. IN THE
MANNER OF THE STATE. THEM TO WE
DON'T THINK THEY ARE THE CITY
COOPER. OF THE FACILITIES THEY
LAW THE VERY LIMITS WHAT WE CAN
DO TO RESOLVE THEM WE NEED
STRONGER STATE OVER SO AND- AT
THE LOCAL LEVEL. IT TO HAPPEN IN
ORANGE NOT SACRAMENTO AND IF YOU
CANNOT PROVIDE ANYTHING COUNTY
SHOULD BE GRANTED OVERSIGHT
MECHANISMS TO ENABLE US TO STEP
IN WHEN THERE ARE ISSUES OF
LOCAL CONCERN. WE NEED TO GIVE
US BACK THE ABILITY TO LICENSE
THE FAILITY SO THAT WE CAN
REGULATE THEM AND ENFORCE
AGAINST THEM. THANK YOU SO MUCH
FOR YOUR ATTENTION TO THIS
MATTER AND I HOPE THAT WE CAN
BETTER WORK TOGETHER TO PROTECT
ALL OF OUR RESIDENTS BOTH THOSE
IN AND AROUND. THE GROUP HOMES
THANK YOU. THANK YOU CAN MEMBER
. ONE FIFTY TO PLAY GO AHEAD. HI
THERE THIS IS WENDY MAK. AND- I
WANT TO THINK ASSEMBLY COUNTY
PETRIE-NORRIS FOR DOING SAID
ABOUT- MY PREPARED STATEMENT IS
THIS EVERY ELEVEN MINUTES
SOMEBODY IS DYING OF A DRUG
OVERDOSE BY THE END OF THIS
HEARING SIXTEEN US CITIZENS WILL
HAVE DIED OF A DRUG OVERDOSE
THIS CURRENT MODEL OF THE
TREATMENT IS NOT WORKING AND WE
NEED TO FIX IT NOW. NO MORE FOR
PROFIT TREATMENT NO MORE
TREATMENT IN RESIDENTIAL
NEIGHBORHOODS OUR COUNTRY PAYS
FOR DIALYSIS TREATMENT FOR
PEOPLE AFFLICTED WITH DIABETES
IN MEDICAL SETTINGS WITH
OVERSIGHT AND IT'S TRYING TO
MAKE A DICTION TREATMENT AND
MENTAL HEALTH THREE THE PEOPLE
AFFLICTED BY ADDICTION. THEY
NEED A COMMERCIAL AREA WITH THE
ENTIRE MODEL IS OF TREATMENT IS
REDESIGNED NO MORE NINETY DAYS
STAYS TIMES TWENTY IN DANGEROUS
HOMES WITH UNTRAINED STAFF WHERE
THE OWNERS MAKE BILLIONS YOU
NEED TO LOOK LIKE A ONE YEAR
MINIMUM SOBER HOUSING WHICH
SHALL ADDRESS OUR HOMELESS
PROBLEM MEDICAL PROFESSIONALS ON
SITE FOR MENTAL HEALTH PHYSICAL
HEALTH DENTAL AND VISION. FREE
MEDICATION JOB TRAINING G.
EDIE'S WE WANT TO GIVE OUR KIDS
A FIGHTING CHANCE AS IT IS WE
ARE USING A SCRIPT. ON TO PUT
OUT A FOREST FIRE. ALRP CAN
NEEDS TO BE A PART FOR THE PRO.
OR IN SIXTY MONTHS WHICH IS JUST
FIVE YEARS THE DEATH TOLL IS
GOING TO BE IMPORTANT FIFTY
SEVEN THOUSAND MORE DEATHS. AND
THOUSANDS MORE INEFFICIENT AND
DANGEROUS HOUSES. THAT HOLD
THEMSELVES OUT AND BILL OUT AS
PARTIAL HOSPITALIZATION AND NON
MEDICAL FACILITY. NEEDS TO STOP
NOW THERE'S ANOTHER DISASTER ON
THE HORIZON AND A HUGE POTENTIAL
FOR ANOTHER MONEY GRAB BECAUSE
IT IS WAY TOO EASY TO SET UP
SHOP. SB NINE WOULD ENABLE THE
CREATION OF AN ESTIMATED SEVEN
HUNDRED THOUSAND MORE UNITS IN
THE STATE'S EXISTING
NEIGHBORHOODS THAT MEANS
EVERYONE IN CALIFORNIA CAN TEAR
DOWN THEIR HOUSE AND BUILD
DUPLEXES. UNLESS THEY'RE IN A
PLANNED UNIT DEVELOPMENT WE MUST
HAVE FORESEEABILITY AND WE NEED
TO TAKE A BOLD STEP NOW OR IT
WILL BE A DISASTER OR EVERYONE
WILL GET INTO THE BUSINESS OF
RECOVERY. AS A REHAB OR SOBER
LIVING WITH INEPT OVERSIGHT
AGENCY THAT IS MORE CONCERNED
WITH MONEY REVENUES WITH A LONG
STANDING RECORD OF USELESS
OVERSIGHT. THIS IS THE HEALTH
AND HUMAN SERVICE PROBLEM AND
THE P. H. C. S. IS THE WRONG
AGENCY TO OVERSEE THIS INDUSTRY
AS IT HAS PROVED TIME AND TIME
AGAIN. TO BE AN INEFFECTIVE
OVERSIGHT BODY AND I LOOK
FORWARD TO BRINGING SOLUTIONS
I'M GOING TO GO OVER MY TIME
BECAUSE I HAVE. AN EFFECT BUT AN
IMPORTANT THING TO SAY PEOPLE
NEED TO UNDERSTAND THAT HE
DEPARTMENT OF HEALTH CARE
SERVICES TO SPLIT DOWN THE
MIDDLE ON ONE SIDE YOU'VE GOT.
MEDICARE ALL MONEY AND THEN THE
OTHER SIDE YOU HAVE PRIVATE
INSURANCE IT. ON THE MEDICAL
SIDE THEIR INVESTIGATORS WITH
TEETH ON THE AS YOU DECIDE THEIR
ANALYST WITH CORRECTIVE ACTION
PLANS AND AS MICHELLE ABOUT
STATED IN THE ONE- EXAMPLE YOU
HAVE THREE DETOX HOUSES FOR
SOMEBODY STATE FOR THREE DAYS
THAT NUMBER TO GO. TO THE TWENTY
OTHER HOUSES AT THIS BUSINESS
PHONES AND YOU SAY THEY DON'T
PROVIDE LICENSABLE SERVICES I
SAY THEY DO BECAUSE ONE PERSON
COMES ON ONE MEDICATION. IS PUT
ON SIXTEEN OTHERS. HEY DON WHAT
HAPPENS. AND AFTER THREE DAYS
AGO INTO THE SOBRE HOW REGION
TOLD ME AGO THAT SHE DOES WORK
SLEEP AT NIGHT AND NOW YOU
REFERRING THEM AS A ROOMMATE. NO
THERE MEDICAID IN THE MORE AND
MET. THAT NIGHT AND THE WEIGHT
ARE GETTING AROUND A LOT.
SERVICES ARE HAN. THE ATTIC
THEIR MEDICATION. DANNY HOW MANY
. SHOULD BE A LICENSABLE
SERVICES AND EVERYBODY SHOULD
HAVE A LICENSE MS MCINTYRE I'M
GONNA NEED TO I'M TO MOVE ON TO
HER NEXT COLOR AND THINK YOUR
ENGAGEMENT AND RATCHET AND-
CONTINUING TO WORK WITH OUR
OFFICE ON THIS ON THIS IMPORTANT
ISSUE. THANK YOU. THANK YOU.
LINE FORTY THREE PLEASE GO AHEAD. NINE FORTY THREE YOUR OPEN.
FORTY THREE ONE MORE TRY CAN YOU
CAN YOU HEAR US. I CAN HEAR YOU
I CAN'T GIVE AND WHAT'S THE CODE
NUMBER YEAH. BUT WE CAN HEAR YOU
YOUR YOUR LIFE LOOKS GREAT.
GREAT THANKS MY NAME IS LAURIE
DURANT AND MY NATION ADVOCATES
FOR RESPONSIBLE TREATMENT
WE WORKED ON THIS ISSUE FOR OVER
SIX YEARS WE SUBMITTED DOZENS OF
COMPLAINTS WE UNDERSTAND THE
EFFECTIVE YEAH A GOOD NEIGHBOR
POLICY DOES NOT EXIST IN
CALIFORNIA. IT'S OBVIOUS THE DH
YES DOES NOT UNDERSTAND OR
REFUSES TO ACKNOWLEDGE THE
RECOVERY RESIDENCES OUR
COMMERCIAL OPERATIONS OFFERING
SERVICES NOT MOVEMENT LAMBERTI
TUITION THESE ARE NOT HOME.
THEY'RE INSECURE CLIENTS DO NOT
COME AND GO FREELY THE COMPANY
ADDED SHOULD BE IN RESIDENTIAL
NAY. WHEN THEIR LIVING LIKE
ROOMMATES LAMB. ALIKE WHICH-
THANK. DHS'S LEGAL REQUIRE TO
HAVE A LOOK OF ALL THE RECOVERY
. IN CALIFORNIA ALREADY IF THE
HAVE ONE WE SUBMITTED A RECORDS
REQUEST UNDERSTAND DH WITH THAT
. TO LAWS WE SEE NOTHINGA YEAR
AND A HALF. DECEMBER TWO
THOUSAND THE YES COMPLAINTS WAS
FROM WEEKS NO ONE. I WE COULD
NOT COMPLAIN AFTER START PRICE
AND- SERVICES THE DH THE ACTIVE
THEM HOW HIDE THEIR TRANSFER.
HOW MUST MAKING TRAP OF COVERING
FROM OUT OF STATE. THE NUMBER OF
WHICH STATE DOES COUNT WHO
BECOME OUR HOME. ADDICTION IS A
HOT HEALTH PROBLEM THE STATE IS
THE COPY HAS GUIDE REGULAR WHO
OVER. BY FOR THE FIRST THREE OF
THE FOR. THANK YOU MEMBER
TEACHING. AND THE REVISED THE
FULLY YOU AFTER AND TREAT HELPS. THANK YOU MISTER. WHY TWENTY
TWO PLEASE GO AHEAD. YES HI MY
NAME IS AND I LIVE IN THE BE A
OFF. DOWN I WANT TO SAVE A
COUPLE OF THINGS NUMBER ONE IS
THAT EITHER THE STATE IS IN
CONFERENCE BY WHAT I'M HERE
TODAY AND OR THEY ARE A- TO A
THIS OF ALL THESE CONCERN THAT
PEOPLE HAVE HAD ON THIS CALL
THIS IS AN ABSOLUTELY TRAVESTY
TO THE RESIDENTS OF THE
NEIGHBORHOOD AND I'M SICK WHEN I
CALLED THE STATE. HERE THAT WE
CANNOT DISCRIMINATE AGAINST
ANYONE WE YOU KNOW WHO YOU'RE
DISCRIMINATING AGAINST ARE THE
RESIDENTS OF THE STREET THAT WE
HAVE TO IN DOOR. THE POLICE
CALLED THE FIRE DEPARTMENT AND
GUESS WHAT'S HAPPENING IN OUR
NEIGHBORHOOD WE'VE HAD THREE
INCIDENCES WHERE PEOPLE ARE
DROPPED OFF. THE CATCHER READ.
OR OFF THEY KNOCK ON NEIGHBORS
DOORS THEY DON'T EVEN KNOW THE
ADDRESS OF WHERE THEY'RE
SUPPOSED TO GO. AND JUST THE
OTHER DAY THEY KNOCKED ON THE
DOOR DID RESIDENTS OPENED HIS
DOOR AND THE GIRLS WALK IN HIS
HOUSE. YEAH WHAT COULD HAVE
HAPPENED IN THAT SITUATION.
SOMETHING LIKE WHAT HAPPENED IN
NEWPORT BEACH THIS IS NOT NEEDS
HAS STOCK AND WHEN THESE HOUSES
ARE WE LET I LIVE RIGHT ACROSS
THE STREET. THE STAFF HAVE NO
AYE DATE THEIR BABYSITTERS WHERE
IS THE OVERSIGHT IN DO THEY EVEN
LOOK AT THE APPLICATION OF THESE
OF THESE PEOPLE THAT ARE WORKING
THERE. AND I CAN TELL YOU I GET
A PUBLIC RECORDS REQUEST SIX
MONTHS AGO. FOR THE PROGRAM OF
THIS HOUSE AND HAVE NOT RECEIVED
IT YET AND YOU KNOW WHAT THEY
TELL ME AT THE STATE. WE HAVE WE
HAVE ONLY ARE TEN TO TWENTY
PEOPLE WORKING ON THAT ON- ON
THESE THINGS BUT YOU KNOW WHAT
THAT IS NOT MY PROBLEM. IT IS
THE STATE'S PROBLEMS WHICH
BECOME MY PROBLEM BECAUSE YOU
ARE NOT DOING YOUR JOB. AND I AM
APPALLED AT SOME OF THE STORIES
I AM HEARING TODAY. AND WHERE
ARE ARE RIGHT. WHERE ARE THE
RESIDENTS RIGHT BECAUSE IT
SOUNDS TO ME WHAT WE HAVE NO
RIGHT. AND WHERE IS LOCAL
CONTROL I AGREE WITH THE THIRD
PATH CALLER WE NEED LOCAL
CONTROL ART CITY TOLD US WE CAN
DO NOTHING. AND PLAYING. GOT THE
STOCK THANK YOU MA'AM FOR YOUR
COMMENTS I CERTAINLY AGREE. AND
MODERATOR HOW MANY COLORS DO WE
HAVE AT REMAINING IN THE QUEUE.
WE HAVE THREE LEFT QUEUED READ
AND SHARE. ONE SIXTY ONE PLEASE
GO AHEAD. FIVE POINT SIXTY ONE
YOU ARE OPEN. NINE SIXTY ONE.
THREE NINE SIXTY ONE MARCH RIGHT
SIX NINE SIXTY ONE I DON'T KNOW
IF YOU CAN HEAR US WE'RE HAVING
TROUBLE HEARING YOU. RIGHT YEAH
SHE'S **** A COUPLE TIMES IF SHE
WAS GOING TO BE ABLE TO BE
CALLED TO MY SIXTY ONE PLEASE GO
AHEAD. WELL PLEASE RE QUEUE IF
YOU WOULD LIKE TO MAKE PUBLIC
COMMENT OVER LINE SIXTY TWO. HI
IN MY LINE SIXTY TWO YES CORRECT
. WELL ACTUALLY YOU CAN HEAR ME
THERE'S BEEN SOME TECHNICAL
PROBLEMS- BUT I AM PLEASED TO
SEE THAT YOU'RE ACTUALLY TAKING
PUBLIC COMMENTS TODAY BECAUSE
THERE'S ALSO A PRECEDENT IN THE
LEGISLATURE LIKE WITH THE COURTS
HEARING AND LORENA GONZALEZ'S
WATCHING INEQUITIES COMMITTEE
HEARING- LAST WEEK THERE WAS A%
HOMELESS HEARING MORE PUBLIC
COMMENT WAS NOT TAKEN. JUST FOR
THE RECORD. WITH THAT BEING
SAID- I DON'T HAVE A LOT OF
EXPERIENCE WITH THIS ISSUE- THIS
WAS AN INSIGHTFUL HEARING TODAY-
BUT WHAT I CAN SAY IS I DID
LIVE- WHEN MY FAMILY OF- THREE
YOUNG CHILDREN AND I LIVED- IN
THE BAY AREA ABOUT FIFTEEN.
MILES FROM THE GOLDEN GATE
BRIDGE WE LIVED IN NEAR I.
TWENTY TWO BED FACILITY. THAT
OFFERS- TREATMENT- TO PEOPLE-
WITH CONVICTIONS. AND SO- I'M
MORE COMMENTING TODAY FROM
EXPERIENCE WHOLE STANDPOINT- I
COULD NOT LET MY CHILDREN OUT OF
THE APARTMENT. BASED ON- THE
KINDS OF ACTIVITIES THAT WENT
ON. AND SOMEONE CONNECTED TO
THAT- FACILITY BROKE INTO OUR-
APARTMENT ONE NIGHT- LOOKING FOR
DRUGS AND SO THAT WAS A
TERRIFYING EXPERIENCE FOR MY
FAMILY AND I AND THE ROLE OF WAS
WE WERE LIVING IN AN AREA WHERE
IT'S A TWO BEDROOM EIGHT HUNDRED
SQUARE FOOT- MOLD AND LEAD
INFESTED APARTMENT FOR FOUR
THOUSAND DOLLARS A MONTH FOR
LITERALLY THE ONLY HOUSING THAT
WE COULD FIND- AND SO WE
EVENTUALLY- WERE- PROPELLED TO
LEAVE THAT AREA- LONG STORY
SHORT TOO LATE MOVED TO SONOMA
COUNTY IT BURNED DOWN. NOW HERE
IN SACRAMENTO- AND I'VE HAD MY
SERVICE FINGERS AND FEELERS A
LITTLE BIT MORE ON WHAT'S GOING
ON IN THE LEGISLATURE AND I JUST
HAVE TO SAY- I AM PLEASED YOU'RE
TAKING PUBLIC COMMENT BUT THE
KIND OF THING THAT I'M HEARING
FROM THE CALLERS TODAY I THINK
SPEAKS TO NOT ONLY THE ISSUES
WITH THIS- TOPIC IN CALIFORNIA
BUT I THINK IT SPEAKS TO THE-
GREATER INCOMPETENCE AND
INEPTITUDE OF THE LEGISLATURE
AND JUST THE LEVELS AND WAY AND-
THE JUST OVERWHELMING CONSENSUS
ON HEARING PARTICULARLY FROM
THESE. COMMENTS OF HOW OLD YOU
ARE TOTALLY FAILING YOU THE
SUPERMAJORITY LEGISLATURE IN
WHAT YOU'RE DOING NOT ONLY WITH
THIS ISSUE BUT YOU KNOW I'M I'M
SITTING HERE TALKING TO YOU
CHARGED IN SUPPLY OF KNOW CELL
PHONE IN THE CAR BECAUSE MY
POWERS DOWN I MEAN YOU NAME IT
CALIFORNIA LEGISLATORS ARE
FAILING ITS CITIZENS AND THIS IS
JUST ONE OF THE MANY MANY PLACES
AND ISSUES. WHERE THE
SUPERMAJORITY. SAME TO BE COME.
IN AND THIS. YOU MAY LEARN WILL
THE PEOPLE SO THAT YOUR MINUTES
ARE UP BUT WE ARE GREAT FOR YOUR
INPUT AND WE'LL GO AHEAD AND
MOVE ON TO THE NEXT CALLER. ONE
SIXTY FOUR PLEASE GO AHEAD. A
GOOD AFTERNOON MY NAME IS DENISE
OVER MOUNT AND I WOULD LIKE TO I
WOULD LIKE TO FOCUS ON THE ISSUE
OF INTEGRAL FACILITY- AS AN AREA
THAT REQUIRES. SOME IMPROVE
PROCESS IMPROBABILITIES JUST
VERY QUICKLY DEFINED AS MULTIPLE
STATE LICENSES AND OR UNLICENSED
RESIDENTIAL CARE TREATMENT. AND
SO CALLED SOBER LIVING
FACILITIES- ARE THOSE WHICH
OPERATE UNDER COMMON MANAGEMENT
INFRASTRUCTURE OR SERVICE
FRAMEWORK- BUSINESSES OPERATING
INTENT OF GROW FACILITIES HAVE
DRIVEN THE PREPONDERANCE OF THE
OVER CONCENTRATION THAT EXCELS-
IN NEIGHBORHOODS AND DOOR
LOCATION INCOMPATIBLE TO THE
SURROUNDING USES LIKE THE
SCHOOLS AND DAY CARE. FOR
SUPERVISION AND ULTIMATELY THE
DIRE CONSEQUENCES- THAT WE'VE
HEARD DESCRIBED TODAY ASSOCIATED
WITH- INEFFECTIVE- PLANNING ON
THE FRONT END. AND OPERATING
SUPERVISION- MENIKAH BUSINESSES
HAVE TAKEN ADVANTAGE OF THE
STATE LICENSURE- KNOWN AS THE
SIX UNDER. STANDALONE FACILITY
TO PRESENT THIS AS A PLATFORM.
FOR OPENING WITHOUT ANY COUNTRY
ON WITHOUT ANY ADDITIONAL
CONTROL THE UNLICENSED
FACILITIES AND OR RELATED
FACILITIES SO THAT THEY ARE
EXPLOITING- THE PERMISSION TO
OPERATE AND THE DESIGNATION OF
THE SUPERVISOR ACROSS A MUCH
BROADER PLATFORM OF CLIENTS OR
PATIENTS AND LOCATIONS. SO UNDER
THIS TYPE OF MODEL IT WOULDN'T
BE UNCOMMON. FOR AN OPERATOR TO
HAVE REALLY A SINGLE MANAGER
GOING ACROSS MULTIPLE FACILITIES
IN MULTIPLE LOCATIONS. UNABLE TO
SAY THAT DOESN'T THAT DOES NOT
SATISFY THE TWENTY FOUR HOUR
CONSTANCY PROVISION. THAT IS
REQUIRED TO EFFECTIVELY HELP TO
TREAT AND PROVIDE OVERSIGHT TO
PEOPLE THAT ARE ATTEMPTING TO
ACHIEVE RECOVERY. THE OTHER
EXAMPLE IS THE UNLICENSED
FACILITIES STORE ALSO. EITHER IN
COMBINATION WITH SOME STATE
LICENSED FACILITY OR OTHER THEY
HAVE CREATED A CLUSTER INTEGRAL
FACILITY AND AGAIN NOT
LEVERAGING WHAT'S A GROSSLY
DEFICIENT AMOUNT OF- SUPERVISION
AND IN CARE- A CROSS SMALL
LOCATIONS AND MULTIPLE PATIENTS.
SO YOU KNOW SOME OF THE RESULTS
OF THAT HAVE BEEN THAT
MEDICATIONS- HAVE BEEN
ADMINISTERED BY PEOPLE THAT ARE
NOT QUALIFIED TO CONTROL THOSE.
YOU KNOW THEY THEY'RE DODGING
REQUIREMENTS WE NEED. IN IN
NEWPORT WE HAVE BEEN ABLE TO
ASCERTAIN THAT THERE IS ONLY ONE
FACILITY IN THE CITY THAT IS
ACTUALLY TRULY A STANDALONE SIX
AND UNDER MA'AM TELL MIKE MA'AM
THANK YOU SO MUCH FOR YOUR
COMMENTS- I'M GOING TO ASK YOU
TO WRAP UP- BUT WE WILL
CERTAINLY CONTINUE. THE SAD THIS
DIALOGUE ON ON THAT TOPIC THANK
YOU FOR JOINING US OKAY. THANK
YOU TO. AND THERE NEEDS TO BE
CONTROL. THERE NEEDS TO BE
CONTROLLED THE FRONT END TO
IDENTIFY ALL FACILITIES THAT ARE
GOING INTO THE NEIGHBORHOOD.
THANK YOU VERY MUCH. ONE SIXTY
FIVE PLEASE GO AHEAD. FIVE ARE
YOU MUTED PLEASE ON MUTE. NINE
SIXTY FIVE PLEASE GO AHEAD. WE I
THINK YOU'RE MUTED SIXTY FIVE
PLEASE GO AHEAD. THEY ARE NOT
RESPONDING- WE HAVE EXHAUSTED
THE QUEUE ALL RIGHT OUT OF JAIL
THANK YOU AB MODERATOR AND- WITH
THAT WE WILL CLOSE PUBLIC
COMMENT AND- GO AHEAD AND CLOSE
THIS HEARING I DO WANT TO THANK
ALL OF OUR PANELISTS. WHO JOINED
US TODAY AND ALSO EVERYONE WHO
JOINED US ON THE PHONE TO
PROVIDE TESTIMONY AND PUBLIC
COMMENT. INCLUDING ALL ALL
SIMPLY AT SAY THAT AS WE'VE SAID
THROUGHOUT THE HEARING WE ALL
KNOW SOMEONE WHO HAS BATTLED THE
DEMONS OF ADDICTION. A FRIEND
AND NEIGHBOR FAMILY MEMBER
PERHAPS PERHAPS EVEN OURSELVES
AND IN CALIFORNIA ALONE
APPROXIMATELY TWO POINT SEVEN
MILLION PEOPLE ARE WRESTLING
WITH SUBSTANCE ABUSE. TRAGICALLY
ONLY 10% OF THESE CALIFORNIANS
WILL RECEIVE ANY TYPE OF
ASSISTANCE ON THE ROAD TO
RECOVERY. AND AS WE'VE HEARD
TODAY EVEN FEWER WILL RECEIVE
HIGH QUALITY TREATMENT. THE
BOTTOM LINE IS THAT WHILE THERE
ARE GOOD ACTORS THEY'RE DOING
GOOD WORK TO HELP THOSE IN
RECOVERY FAR TOO MANY BAD ACTORS
ARE EXPLOITING PATIENTS FOR
PROFITS AND- WE NEED TO
DRAMATICALLY RAISE STANDARDS IN
THIS INDUSTRY WE NEED TO ENSURE
QUALITY. TRANSPARENCY AND
ACCOUNTABILITY ARE WE NEED TO
ESTABLISH STANDARDS FOR
TREATMENT PROGRAMS AND
PROVIDERS. WE NEED TO ENSURE
THAT OUR TAXPAYER DOLLARS ARE
BEING DIRECTED TO PROVEN
PROGRAMS THAT REALLY WORK. I
LOOK FORWARD TO CONTINUING THIS
WORK WITH OUR LOCAL. STATE AND
FEDERAL OFFICIALS AND LOOK
FORWARD TO ENSURING THAT WE ARE
MAKING PROGRESS ON THIS CRITICAL
ISSUE FOR ALL CALIFORNIANS. WITH
THAT THIS HEARING IS ADJOURNED.