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|Addiction Treatment Center Resources - California|
Frequently Asked Questions
1. What is the difference between medical and non-medical social model treatment programs?
Both medical and non-medical social model programs offer services designed to promote detoxification, treatment and maintenance of recovery from alcohol or drug problems. View More
2. What is the difference between medical and non-medical detoxification programs?
Medical detoxification is typically appropriate where clients manifest a more severe level of chemical dependency, withdrawal symptoms that are incapacitating, or other serious health issues requiring inpatient medical care. View More
3. Which addiction treatment facilities are required to be licensed?
Any facility which proposes to offer 24-hour non-medical residential alcohol or drug abuse-related recovery services to adults must be licensed by the Department of Health Care Services (DHCS) through its Substance Use Disorders Licensing and Certification Division. View More
4. What kinds of treatment options are available for clients with addiction problems?
A client with severe withdrawal signs and symptoms may need a medically-monitored inpatient detoxification program, with services delivered in an acute care hospital or chemical dependency recovery hospital by doctors with 24/7 monitoring by nurses. View More
5. What does it mean to be ‘licensed’, ‘certified’ or ‘accredited’ in this industry?
Licensing means that a particular type of facility or professional may only operate or a certain set of services may only be delivered with the advance and continuous authorization (“license”) of a designated government agency, to ensure protection of public health, safety, and welfare. Healthcare and residential facilities and healthcare professionals are typically licensed at the state level. It is illegal for an unlicensed facility or professional to provide a service requiring a license. View More
Non-Medical Rehabilitation Facilities (Inpatient and Outpatient) Services
6. What kinds of services can we offer within our program?
Drug and alcohol rehabilitation services are those which are designed to promote recovery from substance use disorder problems and include one or more of the following: detoxification, group sessions, individual sessions, educational sessions, and recovery or treatment planning. View More
7. What services are prohibited?
Historically, facilities are not permitted to provide medical care or contract with physicians directly to provide medical services, although they can contract with a physician in an administrative role to provide non-clinical directorship services, such as oversight or input into program development. View More
8. What information must be provided in an initial application for licensure?
In the initial application for licensure, the applicant will need to identify a site where it plans to offer drug and alcohol rehabilitation, detoxification and recovery services and provide the Department of Health Care Services with information about the building, land ownership, governance structure, occupancy, services, and staff qualifications. View More
9. How long does a licensing application usually take and when does it need to be renewed?
The Department of Health Care Services notifies licensing applicants if their application is complete or incomplete within 45 days of receipt. View More
10. How should a residential facility prepare for an on-site audit for licensure determination?
Inspectors from the Department of Health Care Services (DHCS) evaluate facilities according to a field evaluation criterion, which are based on licensing standards. View More
11. Does our facility have to be certified?
Certification for residential and outpatient programs is voluntary, but demonstrates that a higher level of quality has been attained than might be illustrated by licensing alone. View More
12. What are the practical benefits of certifying a facility?
Certification is a signal to potential clients, insurance companies, regulators and the public that a facility aims to offer a responsible and high quality service. View More
13. How does a facility apply for certification/what information should be included?
The initial application should contain...View More
14. How long does the Department of Health Care Services take to review my application?
DHCS confirms whether the application is complete or incomplete within 45 working days of receiving the application. View More
15. What should a facility do in preparation for the on-site compliance review?
The facility should be mindful of the survey criteria which are used by DHCS inspectors to determine whether a facility meets the standards for certification. View More
16. What happens if the inspector finds compliance deficiencies when conducting an on-site review?
Some deficiencies may be immediately correctable but if this is not possible, the compliance inspector will leave a certification report, or send one within 10 days of the visit. View More
17. How often must certification be renewed?
Certification expires within two years, and must be renewed. View More
18. Under what circumstances can the Department of Health Care Services conduct an unannounced on-site inspection?
Employees of DHCS are empowered to conduct a site visit at any time, and need not announce their site visits in advance. View More
19. Under what circumstances will a certification be terminated prior to its expiration date?
A program’s certification status will be affected where...View More
20. Under what circumstances will the Department of Health Care Services suspend certification?
Certification is suspended where a program fails to comply with any statutory requirement, regulation or standard of DHCS. View More
21. Under what circumstances will the Department of Health Care Services revoke certification?
Certification is revoked where...View More
22. What if a program relocates to another facility?
At least 30 days prior to a change of location, the following must be submitted to the Department of Health Care Services...View More
Zoning and Land use
23. What are the protections afforded to small group homes used for the purpose of residential drug rehabilitation?
Any facility with six or fewer residents is exempt from local zoning and land use regulations (based on federal and state law) and is therefore not required to seek municipal approval to operate. View More
24. Are there any proximity restrictions regulating how close treatment centers may be to each other? Can I open a facility right next to one that is already there?
At the present time, California law does not regulate or prevent multiple facilities from operating in close proximity. View More
25. How can a facility decide if a client is suitable for the services it offers within its program?
A potential client should be assessed to determine how severe his/her addiction is, the nature of the drugs he/she uses, his/her medical history and present health, his/her level of functioning, his/her support needs, his/her ability to pay, and his/her suitability for the program model. View More
26. What kind of health clearances are needed prior to admitting a client?
Both residential and non-residential programs should carefully complete a health questionnaire with any incoming client to determine the likelihood that the client needs medical attention. The form is available here, and it should be placed in the client’s file when completed...View More
27. How can a facility decide what level of detox would be appropriate for a potential client?
A client with severe withdrawal signs and symptoms may need medically-monitored inpatient detoxification program, which requires that services be delivered in an acute care hospital or chemical dependency recovery hospital by doctors and nurses. View More
28. What client information should be collected in an Intake Screening Form?
At a minimum, intake should include name, date of birth, sex, address, telephone number, next of kin/emergency contact and consent to contact; View More
29. What is required for an admissions agreement?
An admissions agreement should include, at a minimum, a breakdown of expected fees and services, activities expected of clients, program rules and regulations, client’s right to confidentiality, client’s grievance procedure and reasons for termination, as well as a payment schedule and a refund policy. View More
Care, Treatment and Services
30. What information must be collected about a client in developing a treatment plan?
It is helpful to complete a statement of problems experienced by the client, a statement of objectives to be reached to address those problems; View More
31. How much contact should program staff have with the client once admitted?
California has specific requirements for certified detoxification that include...View More
32. How should residential facilities manage clients’ medication?
Staff may not prescribe or control medications. All medications must be prescribed by the client’s physician. View More
33. What grounds are needed in order to dismiss a client from our program?
There are four types of discharge. Successful completion of program means that the client has met the goals of their recovery plan. View More
34. If a facility discharges a client who has relapsed, and that client proceeds to overdose in the following days, is the facility at risk and if so, how can it protect itself?
The discharge of a client must be handled carefully given the risks if a client suffers negative health consequences in the aftermath of discharge. View More
35. How should clients’ privacy be protected?
Any facility that submits billing electronically (whether directly or through an outside biller) is a covered entity within the meaning of the federal Health Insurance Portability and Accountability Act (HIPAA), which imposes specific health data privacy and security compliance requirements. View More
Governance and Staffing
36. May addiction treatment centers have medical directors?
It is permissible for a center to employ or contract a medical or clinical director who exercises non-clinical “directorship” services, such as program development, policies and procedures, and personnel oversight. View More
37. Are there limitations on hiring or contracting with physicians to provide medical care to treatment facility clients?
In general, clients are required to seek medical services that they need independently of the licensed facility. View More
38. What licensing or certification requirements are there for addiction treatment staff at a residential facility?
For a residential facility to be licensed and/or certified by the Department of Health Care Services, at least 30% of all staff providing counseling services need to be licensed or certified. View More
39. How should facilities respond to clients in need of treatment who are unable to pay the required deductibles and coinsurance?
Clients seeking drug and alcohol rehabilitative services often face financial difficulties, whether as a result of the consequences of their addiction or as a result of the expense of multiple, prior failed treatment programs. View More
40. What are the key issues insurers raise to demand recoupment of fees from substance abuse treatment programs?
Insurers may demand recoupment of fees based on any defect in the billing claim or supporting documentation and/or based on any noncompliance with federal or state laws. View More
41. What marketing practices are prohibited?
The most widespread prohibited marketing practices in addiction treatment appear to revolve around inappropriate inducements and inaccurate marketing claims. View More
42. What are the limits of gift giving to potential referral sources?
State and federal regulators prohibit the exchange of items of value to induce referrals so the exchange of any item of value, whether it is cash or in kind, must be carefully monitored. View More
43. What kind of benefits can be offered to new or existing clients?
Facilities should avoid giving gifts to clients or referral sources based on anti-kickback statutes. View More
Sober Living Residences Licensing
44. Does a sober living home need a license?
Shared or cooperative living arrangements which do not offer rehabilitative and recovery services, known as sober living, sober homes, transitional living, or extended care facilities, do not require a license from the Department of Health Care Services, because...View More
45. Are there any consequences to being ‘unlicensed’?
The absence of a license means that addiction recovery treatment services may not be provided at a sober living facility. View More
46. What kinds of services can be offered by a sober living home?
Alcohol and drug-free houses (sober-living environments) typically provide a living environment to enable residents to organize activities and participate in self-help initiatives which promote their goal to live without drugs or alcohol. View More
47. How can we demonstrate to our clients that we are offering a high quality living environment?
A Sober Living home can elect to demonstrate voluntarily that it meets minimum quality standards. Several states (including Florida and Massachusetts) have formally adopted an optional certification process for sober living residences. View More
48. Does a home have to obtain certification in order to operate?
No, but becoming certified may encourage residents to consider a particular facility for accommodation over other options, and other drug and alcohol service facilities may also be more interested in developing referral relationships with certified homes. View More
49. How does a home apply for certification/what information should be included?
The California Consortium of Addiction Programs and Professionals has devised standards for those wishing to improve the quality of their sober living residences. View More
An application form is available here...View More
50. What should a sober home do in preparation for the on-site compliance review?
The California Consortium of Addiction Programs and Professionals certification program evaluates home design and condition, space and capacity, fire safety, food and hygiene, management arrangements, staffing, record keeping, house rules and residency requirements. View More
51. How often must I renew certification?
Under the California Consortium of Addiction Programs Standards, homes are peer-reviewed on an annual basis, as a condition of receiving registration and a certificate. View More
Zoning and Land Use
52. What are the protections afforded by federal law to small group homes used for the purpose of residential drug rehabilitation?
A facility with six or fewer people is exempt from zoning and land use regulations based on federal and state law, and need not seek municipal approval to operate. View More
53. Can local governments put special restrictions on sober living residences?
Sober-living residences in some communities have found growing efforts to regulate them by local ordinance, including registration requirements, concentration (spacing) limits, and other requirements. View More
54. What other aspects should be considered before choosing a location for a sober living environment?
In siting a sober living, attention should be paid to potential hostility from neighbors. View More
Resident’s Rights and Responsibilities
55. What are the obligations to residents?
To enforce that the premises remain safe and free of intoxicant use; to maintain the premises in a habitable manner; to honor promises about condition, repairs and replacements; to respect the resident’s peaceable possession of property and to abide by all landlord and tenant laws. View More
56. What kind of agreement should a resident be asked to sign?
The agreement should include a pledge from the tenant to live by the house rules including to abstain from drug and alcohol use and (usually) to attend a weekly residents’ meeting and any other rules the landlord wishes to make (guests, pets); View More
57. Can a sober living home insist on drug tests and searches?
No, sober living residences do not have the right to impose testing or searches without consent. View More
58. Can a sober living facility bill insurance for required and/or random drug testing?
Sober living residences sometimes rely on the drug screening which takes place when the resident attends outpatient services, although they may make use of drug testing equipment which can be used onsite. View More
59. Can residents’ obligations be made contractually enforceable?
If the rules are contained in the tenancy agreement as conditions of residence, and the resident agrees to them upon accepting the tenancy, then they are enforceable. View More
Governance and Staffing
60. What kind of ownership and staffing structures are common with these types of residential arrangements?
A housing facility may be structured as a nonprofit corporation, a for-profit corporation, limited liability company, partnership, or a sole owner arrangement. View More
61. Are there any other organizations which could help?