California auditor suggests new law to address drug, alcohol treatment centers in neighborhoods

SACRAMENTO, Calif. (CN) — The California auditor’s office in a Thursday report said the Legislature might want to examine changing the law for small drug and alcohol treatment facilities, as local zoning ordinances can’t restrict them.

The audit, requested by the Joint Legislative Audit Committee, examined the state Department of Health Care Services’ oversight of these residential treatment facilities. It found that the department was late in inspecting some facilities under its purview and failed to properly follow up with some unlicensed facilities.

However, the audit did find that the department properly suspended and revoked licenses when it discovered significant problems.

The auditor’s office issued a series of recommendations, which include giving management information about compliance inspections, having a trigger in its database that alerts staff to upcoming inspections and filling vacant positions.

“[The department] is committed to robust oversight of residential treatment facilities to ensure Californians receive safe and high-quality care,” said Michelle Baass, director of the Department of Health Care Services, in a response to the auditor. “In addition to proactively implementing initial operational changes to improve outcomes, the 2023-24 budget included additional resources to strengthen our compliance oversight, including additional positions for a statewide presence and increasing fees to strengthen [our] capacity to conduct oversight and enforcement to ensure patient safety and quality care.”

According to the auditor’s office, some people have complained about grouping several small treatment centers in the same area. In some cases, a handful of small facilities were adjacent to or across the street from each other in Orange and San Diego counties.

This isn’t a legal violation, as facilities serving up to six people are considered as residential use under zoning ordinances. However, the auditor’s office noted that operators could sidestep zoning rules by grouping these smaller facilities together instead of making a large center.

“The Legislature could potentially change state law if these facility concentrations are not consistent with the law’s intent, which we believe was to integrate residents of these facilities into the communities and to provide for sufficient numbers and types of treatment services to meet local needs,” wrote Mike Tilden, chief deputy state auditor, in the report.

As of June 2023, California had almost 1,000 residential treatment facilities. About 500 of them served under seven people.

Asked about the possibility of a bill addressing the issue next year, the state Senate president pro tempore’s office didn’t provide comment by publication time. The Assembly speaker’s office couldn’t be reached for comment.

Pivoting to the department’s actions, the auditor’s office said that it complied with essential requirements when approving the 26 treatment centers examined in the report. The auditor’s office called its compliance inspections thorough, but noted they weren’t timely for half of the facilities reviewed.

The department ensured that a facility fixed any issue when it was discovered during an inspection. The department also properly terminated or denied license applications when warranted.

“We found that although Health Care Services’ compliance inspections were generally thorough, they were not always on time,” Tilden wrote.

The auditor’s office noted that one late inspection revealed some facility employees didn’t have proof of the licenses they needed. Also, some employees lacked health screening documentation.

The department was quick to start investigating high-priority complaints, but regularly passed the 10-day limit for investigations that weren’t considered high priority. Also, according to the auditor, the department didn’t completely examine all accusations that unlicensed facilities were operating or following up with an on-site visit.

The auditor’s office recommended that the department perform site visits starting in December for all accusations about an unlicensed facility continuing to operate.

The department should update its policies and staff training about complaints and time requirements for investigations by April. It also should create follow-up procedures by the same date to ensure unlicensed treatment facilities cease operations.

Guidelines should be in place by October 2025 that detail how long analysts have to perform essential investigative steps.