September 19, 2017
California Department of Health Care Services (DHCS) issued updated guidelines in its Alcohol and/or Other Drug Program Certification Standards. These guidelines reflect a change in California law that permits the provision of incidental medical services at residential substance use disorder treatment facilities, among other important updates to its certification standards that certified programs must comply with no later than November 1, 2017.
"Treatment facilities should be aware that pursuant to the new certification standards DHCS will no longer send out a notice to facilities that their certification is expiring," said Kathryn Edgerton, Associate at Nelson Hardiman. "Facilities must be diligent in ensuring that their renewal applications and fees are received by DHCS at least 120 days prior to expiration of their current certification."
Prior to October 2015, the provision of healthcare services by physicians to residents of treatment facilities could only legally be provided pursuant to a direct relationship between the resident and the physician, separate and apart from the services provided by the residential treatment facility. In October 2015, California law was amended to allow licensed healthcare practitioners at residential treatment facilities to provide “incidental medical services,” which were defined as (i) obtaining medical histories; (ii) monitoring resident health status to determine the need for emergency or urgent care; (iii) detoxification testing; (iv) providing alcoholism/drug abuse recovery/treatment services; (v) overseeing patient self-administered medication; and (vi) treating substance use disorders, including detoxification. Residential facilities interested in providing incidental medical services must apply to DHCS before providing any such services. Even if approved to provide incidental medical services, residential treatment centers still cannot contract with physicians to provide broader primary care or psychiatric care to their clients, which remain exclusively subject to a direct patient-health professional relationship, distinct from the treatment facility’s services.
In addition to the updates related to incidental medical services, the revised certification standards contain other important changes relevant to licensed and certified programs. DHCS has set forth additional reasons that an initial certification request can be denied, added additional authority for DHCS to suspend or revoke a certification, and specified new timelines related to applications for certification renewals, among other changes to DHCS internal policies and procedures. DHCS has also specified additional requirements related to treatment and recovery planning and to residential detoxification services.
On September 19, 2017, AATA issued an update to the Frequently Asked Questions webpages for California members, incorporating relevant changes from the updated certification standards. At the DHCS Substance Use Disorders Statewide Conference on August 23, 2017, DHCS officials gave a presentation outlining the revised certification standards and incidental medical services policy guidelines. DHCS’ presentation slides are available HERE.