Letter to California Department of Health Care Services
Department of Health Care Services
To Whom It May Concern,
I am writing from San Juan Capistrano to let you know that DHCS’ response to the crisis in Residential Recovery Facilities is unconscionable. In 2012, the state legislature commissioned two reports, Rogue Rehabs and Suspect Treatment, and in the four years since, DHCS has done little to nothing to rectify a combination of loopholes that are directly resulting in harm to a very vulnerable population. It is time that DHCS accelerated its rulemaking. Mid-2018 is much too late. Day by day people are dying in California due to our lax regulation.
Here is how California’s rules MUST change.
1) The state must clearly define the difference between Residential Recovery Facilities -- in which people temporarily reside while receiving active, for-fee treatment--and “Sober Living Homes” -- in which sober people wish to live communally while working and becoming part of a community. Any house where an adult resides in which that adult is doing more than three hours per week of paid-therapy to treat addiction must be declared a Residential Recovery Facility. Detox facilities must be declared to be a sub-category of RRF — the state may continue to license and inspect RRF that offer treatment at a residential site as it has in the past.
—> The state has made these definitions unclear, greatly exacerbating the difficulty of regulating these facilities.
2) The state must clarify that RRF ARE businesses and, while serving the disabled, are not entitled to rights greater than those of other businesses or even greater than those of other Congregate Care facilities.
—> The state has commingled the rights of the disabled with the rights of businesses that serve the disabled, and the two are not the same.
3) Each RRF in the state of California must be required to take out a city business license which accurately reflects costs incurred by the city for that facility, and cities must report their licensees to the state. The state will thereby be able to accurately count and locate all legally operated RRFs. Cities must be granted the authority to inspect RRF up to twice a year in unannounced visits to ensure RRF do not violate municipal codes by housing an excessive number of people.
—> This will ensure that the State can count and locate all RRF in the state, that all RRF are inspected more regularly than they are today, and that the vulnerable are not abused by being forced to reside under horrific conditions, which the state never inspects.
4) Cities must have the right to limit weekly or monthly-rental RFFs to zones where other healthy people reside under the same form of rental agreement. The state must clarify that cities have the right to regulate rentals of the disabled so long as the disabled are treated fairly.
—> The State MUST clear up the ambiguity it has created between the rights of cities and the disabled.
5) All RRFs must be brought up to ADA code.
—> The State allows RRFs to operate without accommodations for the full spectrum of disabilities and without support for many disabled.
6) All RRFs must, before accepting first month’s rent, acquire an escrowed “Departure Transport” sum. With this money, the business or person who receives rent must, upon departure of the tenant, arrange transportation services and ensure the former tenant is placed in that transport to return to his/her original residence.
—> This would prevent recurring “dumping” that takes place today, in which an RRF “kicks out” a relapsing client who then has nowhere to go.
7) All recovering patients entering into contracts for either treatment or lodging must be required to declare an “External Advocate” to both their Treatment Provider and their Lodging Provider. DHCS must ensure that the External Advocate has the following rights:
a) The right to inspect the property at which the vulnerable party resides one morning each week when the tenants are not present
b) The right to communicate daily with the recovering patient, if the recovering patient so desires
c) The right to be informed immediately if the recovering patient is moved, is transported under emergent conditions, or departs.
—> This would prevent many abuses of the disabled who are often promised one type of service in advance and are then mistreated subsequently.
8) All board members, owners, employees and consultants must be fingerprinted and have background checks performed, as the state requires in other Congregate Care facilities. No probationer, parolees or felons whose crimes took place in the last five years should be employed or have an ownership position in this industry. No doctors with revoked medical licenses should be employed or own a portion of these businesses. No probationer, parolee or felons with a history of drug distribution, domestic violence, violence, sexual harassment or sexual assault should be employed in this industry.
—> If the State would not allow these people to be foster parents, they should not be in this industry.
9) All RFFs must employ, at a minimum of healthcare certification, certified EMTs and rotate through such staff so that someone with certification is present 24 x 7.
—> The state has indicated that recovering addicts are disabled and yet has done nothing to protect their health from medical crises.
10) All forms of false advertising of these businesses should carry fines of over $1000 per day. Examples of currently occurring false advertising include:
• advertising a success rate that cannot be proven
• "guaranteeing" success
• showing photographs that are not indicative of the actual location (one shows a photo of Santorini) or facilities
• claiming employees have “years of experience in the industry,” when a significant percentage of those years were spent as an addict
• references to the ocean, sea or beach, such as “by the sea,” “shore,” “beachside,” “sea cliff,” “oceanside,” “coast,” “waterfront,” when the properties are not located proximate to the ocean.
• advertising in videos or photographs people as recovered who have since relapsed
• posting of fake reviews
• claiming someone is a “doctor,” when they have a PhD—inappropriate because of the context of medical treatment.
We recommend that the fine be split 50/50 with the person who reports the false advertising.
In short, we ask that the State make these important changes to protect the vulnerable and restore the faith of citizens in the quality of our Department of Health Care Services.
Sincerely,
To Whom It May Concern,
I am writing from San Juan Capistrano to let you know that DHCS’ response to the crisis in Residential Recovery Facilities is unconscionable. In 2012, the state legislature commissioned two reports, Rogue Rehabs and Suspect Treatment, and in the four years since, DHCS has done little to nothing to rectify a combination of loopholes that are directly resulting in harm to a very vulnerable population. It is time that DHCS accelerated its rulemaking. Mid-2018 is much too late. Day by day people are dying in California due to our lax regulation.
Here is how California’s rules MUST change.
1) The state must clearly define the difference between Residential Recovery Facilities -- in which people temporarily reside while receiving active, for-fee treatment--and “Sober Living Homes” -- in which sober people wish to live communally while working and becoming part of a community. Any house where an adult resides in which that adult is doing more than three hours per week of paid-therapy to treat addiction must be declared a Residential Recovery Facility. Detox facilities must be declared to be a sub-category of RRF — the state may continue to license and inspect RRF that offer treatment at a residential site as it has in the past.
—> The state has made these definitions unclear, greatly exacerbating the difficulty of regulating these facilities.
2) The state must clarify that RRF ARE businesses and, while serving the disabled, are not entitled to rights greater than those of other businesses or even greater than those of other Congregate Care facilities.
—> The state has commingled the rights of the disabled with the rights of businesses that serve the disabled, and the two are not the same.
3) Each RRF in the state of California must be required to take out a city business license which accurately reflects costs incurred by the city for that facility, and cities must report their licensees to the state. The state will thereby be able to accurately count and locate all legally operated RRFs. Cities must be granted the authority to inspect RRF up to twice a year in unannounced visits to ensure RRF do not violate municipal codes by housing an excessive number of people.
—> This will ensure that the State can count and locate all RRF in the state, that all RRF are inspected more regularly than they are today, and that the vulnerable are not abused by being forced to reside under horrific conditions, which the state never inspects.
4) Cities must have the right to limit weekly or monthly-rental RFFs to zones where other healthy people reside under the same form of rental agreement. The state must clarify that cities have the right to regulate rentals of the disabled so long as the disabled are treated fairly.
—> The State MUST clear up the ambiguity it has created between the rights of cities and the disabled.
5) All RRFs must be brought up to ADA code.
—> The State allows RRFs to operate without accommodations for the full spectrum of disabilities and without support for many disabled.
6) All RRFs must, before accepting first month’s rent, acquire an escrowed “Departure Transport” sum. With this money, the business or person who receives rent must, upon departure of the tenant, arrange transportation services and ensure the former tenant is placed in that transport to return to his/her original residence.
—> This would prevent recurring “dumping” that takes place today, in which an RRF “kicks out” a relapsing client who then has nowhere to go.
7) All recovering patients entering into contracts for either treatment or lodging must be required to declare an “External Advocate” to both their Treatment Provider and their Lodging Provider. DHCS must ensure that the External Advocate has the following rights:
a) The right to inspect the property at which the vulnerable party resides one morning each week when the tenants are not present
b) The right to communicate daily with the recovering patient, if the recovering patient so desires
c) The right to be informed immediately if the recovering patient is moved, is transported under emergent conditions, or departs.
—> This would prevent many abuses of the disabled who are often promised one type of service in advance and are then mistreated subsequently.
8) All board members, owners, employees and consultants must be fingerprinted and have background checks performed, as the state requires in other Congregate Care facilities. No probationer, parolees or felons whose crimes took place in the last five years should be employed or have an ownership position in this industry. No doctors with revoked medical licenses should be employed or own a portion of these businesses. No probationer, parolee or felons with a history of drug distribution, domestic violence, violence, sexual harassment or sexual assault should be employed in this industry.
—> If the State would not allow these people to be foster parents, they should not be in this industry.
9) All RFFs must employ, at a minimum of healthcare certification, certified EMTs and rotate through such staff so that someone with certification is present 24 x 7.
—> The state has indicated that recovering addicts are disabled and yet has done nothing to protect their health from medical crises.
10) All forms of false advertising of these businesses should carry fines of over $1000 per day. Examples of currently occurring false advertising include:
• advertising a success rate that cannot be proven
• "guaranteeing" success
• showing photographs that are not indicative of the actual location (one shows a photo of Santorini) or facilities
• claiming employees have “years of experience in the industry,” when a significant percentage of those years were spent as an addict
• references to the ocean, sea or beach, such as “by the sea,” “shore,” “beachside,” “sea cliff,” “oceanside,” “coast,” “waterfront,” when the properties are not located proximate to the ocean.
• advertising in videos or photographs people as recovered who have since relapsed
• posting of fake reviews
• claiming someone is a “doctor,” when they have a PhD—inappropriate because of the context of medical treatment.
We recommend that the fine be split 50/50 with the person who reports the false advertising.
In short, we ask that the State make these important changes to protect the vulnerable and restore the faith of citizens in the quality of our Department of Health Care Services.
Sincerely,