Lawmakers vow to push stiffer regulations on addiction treatment in California
After disturbing reports of death, sexual assault, drug abuse and paying for patients inside California’s loosely regulated addiction treatment industry, an across-the-aisle team of lawmakers has banded together to fundamentally change the rules of the game.
The new Bi-Partisan Legislative Substance Abuse Treatment Working Group seeks to significantly expand state oversight, improve patient protections and ensure taxpayer dollars are spent on programs that work.
“The scope and scale of the opioid crisis really is staggering,” said the group’s organizer, Assemblywoman Cottie Petrie-Norris, D-Laguna Beach, at a Sacramento news conference Tuesday June 4. “In California alone in 2017, there were over 2,000 deaths because of opioid abuse. It’s heartbreaking.
“And what’s particularly heartbreaking is that, at every step, we’ve seen unscrupulous actors profiteering from this crisis. Pharmaceutical companies that have engaged in deceptive marketing practices. Doctors who have knowingly overprescribed these medicines. And rogue rehab and sober living home operators who are exploiting patients for profit.”
The new group was formed in the wake of the Southern California News Group’s probe of the treatment industry. It found that dozens of people have died for want of proper medical care in California’s non-medical treatment centers — facilities that would not be allowed to open in many other states.
Young drug users continue to be lured here with free plane tickets, rehab “scholarships” and cash payments. They are signed up for PPO health insurance on the Covered California exchange, with rehabs paying premiums until benefits max out. And then some addicts are given drugs — often heroin — so they test “dirty” and the whole insurance billing cycle can begin anew.
“It’s a cycle that far too often ends in patient death,” Petrie-Norris said. “And it’s a cycle that’s only possible because of the virtual lack of any regulation or oversight here in California. For years — for years — attempts to address this atrocity have failed. And, in the meantime, far too many people are dying.”
The new team tasked with trying to repair the system includes lawmakers who have been working on the issue for years: state Sens. Pat Bates, R-Laguna Niguel, Jerry Hill, D-San Mateo, and Henry Stern, D-Calabasas; as well as Assembly members Petrie-Norris, Richard Bloom, D-Santa Monica, Tasha Boerner Horvath, D-Encinitas, Bill Brough, R-Dana Point, Tom Daly, D-Anaheim, Kevin McCarty, D-Sacramento, and Marie Waldron, R-Escondido.
Some progress so far
There has been some progress. Last year, Hill’s Senate Bill 823 was signed into law, and will require state-licensed residential rehabs to adopt the American Society of Addiction Medicine’s treatment criteria as the minimum standard of care. But outpatient centers — where the vast majority of treatment occurs in California — don’t have to meet that standard, or any standard at all, Hill said with incredulity.
“Anyone can hang that shingle and open an outpatient treatment center today. No license, no training or prior experience necessary at all. Nothing,” he said. “We don’t know how many outpatient facilities are operating in the state, or how many people are returning to outpatient treatment after they relapse. If you wanted to know how many people died at outpatient facilities, we couldn’t tell you today.”
Bills target rehab industry
Hill’s new bill, SB 325, would require outpatient centers to be licensed and meet evidence-based treatment standards, as well as prohibit providers from engaging in patient-selling and recruiting.
Other bills moving forward this year include Bates’ SB 589, which would end deceptive marketing in the rehab industry; Petrie-Norris’ AB 919, which would require the state to establish an enforcement program to tackle body-brokering fraud; and Petrie-Norris’ AB 920, which would clarify that sober homes and treatment facilities serving six or fewer people aren’t “families” under the law if they have economic relationships with treatment providers.
“The tragedy is when we reach out for help, and for hope, to be met with exploitation, to be met with a profit motive,” Stern said. “To reach out that hand and have someone grab it who has ill-intent is something that government really should come in and rectify.”
Mom ‘horrified’
Among those appearing with lawmakers at the news conference was Wendy McEntyre of Sky Forest, who lost her son, Jarrod, to an overdose in a sober living home in the San Fernando Valley in 2004. Twenty-four men were living in the three-bedroom, two-bath house at the time, and one brought in speedballs to share.
McEntyre founded the nonprofit Jarrod’s Law in memory of her 23-year-old son and began fighting to change California’s laws, hoping to spare other parents the same agony. AB 920 is named in his honor.
“I’m horrified at what I’ve discovered,” said McEntyre, reading a long list of names of those who died trying to recover. “A week doesn’t go by where I don’t get a phone call from a broken mom or dad. I can’t keep coming to the state with this list of dead boys.”
Nearly 2,200 opioid deaths in 2017
Opioid-related overdoses claimed 2,196 lives in California in 2017, according to the California Department of Public Health. Doctors wrote 21.8 million opioid prescriptions that year; the state’s population was 39.4 million.
But opioids are just part of the problem. All drug overdose deaths totaled 4,868 in California that year, with 40% of them reported in Los Angeles, Orange, Riverside and San Bernardino counties.
Addiction treatment is projected to be a $42 billion industry by 2020, according to federal data. Petrie-Norris said California represents about 10 percent of that figure.
“There’s no other $4-$5 billion industry in this state with such lax regulation and oversight,” she said.
Stern said they needed help from their colleagues in both Sacramento and Washington, D.C. He didn’t want to overpromise, but said he was ready to work.
“Let’s get something done,” Stern said.