SB 526: Mental Health; the licensing and regulation of recovery residences; provide

Senate Bill 526

By: Senators Robertson of the 29th, Dixon of the 45th, Brass of the 6th, Strickland of the 42nd, Hickman of the 4th and others

A BILL TO BE ENTITLED

AN ACT

To amend Title 37 of the Official Code of Georgia Annotated, relating to mental health, so as to provide for the licensing and regulation of recovery residences; to provide for minimum standards; to provide for rules and regulations; to provide for applications for licensing; to provide for provisional licensing; to provide for compliance; to provide for the denial, suspension, or revocation of licenses; to provide for enforcement actions; to provide for confidentiality; to provide for inspections; to provide for procedures and penalties relating to unlicensed recovery residences; to provide for definitions; to provide for conforming changes; to provide legislative findings; to provide a short title; to provide for related matters; to repeal conflicting laws; and for other purposes.

BE IT ENACTED BY THE GENERAL ASSEMBLY OF GEORGIA:

SECTION 1.

Title 37 of the Official Code of Georgia Annotated, relating to mental health, is amended in Code Section 37-2-70, relating to definitions relative to adult residential mental health programs, by adding a new paragraph to read as follows:

"(8) 'Recovery residence' means a program licensed by the department under Chapter 14 of this title."

SECTION 2.

Said title is further amended by revising Code Section 37-2-71, relating to fee schedule for licensure relative to adult residential mental health programs, as follows:

"37-2-71.

The department shall establish by rule adopted pursuant to Chapter 13 of Title 50, the 'Georgia Administrative Procedure Act,' a schedule of fees for licensure activities for adult residential mental health programs, community living arrangements, drug abuse treatment and education programs, recovery residences, and narcotic treatment programs required to be licensed by the department. Such schedules shall be determined in a manner so as to help defray the costs incurred by the department, but in no event to exceed such costs, both direct and indirect, in providing such licensure activities. Such fees may be annually adjusted by the department but shall not be increased by more than the annual rate of inflation as measured by the Consumer Price Index as reported by the Bureau of Labor Statistics of the United States Department of Labor. All fees paid thereunder shall be paid into the general fund of the State of Georgia. It is the intent of the General Assembly that the proceeds from all fees imposed pursuant to this Code section be used to support and improve the quality of licensing services provided by the department."

SECTION 3.

Said title is further amended by adding a new chapter to read as follows: "CHAPTER 14

37-14-1.

This chapter shall be known and may be cited as the 'Recovery Residences Licensing Act.'

37-14-2.

The General Assembly finds that:

(1) Recovery residences provide vital peer based housing support for individuals in recovery from substance use disorders; and

(2) A regulatory framework for recovery residences would improve the safety of residents and increase accountability for facilities that receive court mandated or publicly supported referrals.

37-14-3.

As used in this chapter, the term:

(1) 'Applicant' means any individual affiliated with a partnership, corporation, association, or individuals or groups of individuals submitting an application to operate a recovery residence under this chapter.

(2) 'Department' means the Department of Behavioral Health and Developmental Disabilities.

(3) 'Governing body' means the partnership, corporation, limited liability company, association, or person or group of persons that maintains and controls the recovery residence and that is legally responsible for its operation.

(4) 'License' means the official permit issued by the department which authorizes the holder to operate a recovery residence.

(5) 'Licensee' means any person holding a license issued by the department under this chapter.

(6) 'Recovery residence' means a residential living arrangement for unrelated individuals that provides a safe and substance-free living environment that supports individuals in recovery from substance use disorders and which provides support for such individuals by:

(A) Providing a supportive peer community to which residents are accountable or other supervision or monitoring; and

(B) Ensuring access to mutual aid groups, recovery support services, and other needed services and supports.

(7) 'Resident' means an individual residing in a recovery residence for the purpose of recovery from a substance use disorder.

(8) 'Substance use disorder' means a cluster of cognitive, behavioral, and physiological symptoms indicating that an individual continues using a substance despite significant substance related problems such as impaired control, social impairment, risky use, and pharmacological tolerance and withdrawal; provided, however, that such term shall not include an individual's use of tobacco or caffeine.

37-14-4.

The department shall create and promulgate minimum standards of quality and services for recovery residences, and shall, at a minimum include in the rules and regulations:

(1) Admission criteria;

(2) Adequate and safe buildings or housing facilities where programs are offered and standards for emergency conditions relating to such buildings or facilities;

(4) Standards for sufficiently trained staff or staff with prior experience who are competent in the duties they are to perform;

(5) The content and quality of services to be provided;

(6) Requirements for intake, discharge, and aftercare of residents;

(7) Referral arrangements to other appropriate agencies or facilities, including a process and adequate staff to facilitate the transfer of a resident to a licensed general or specialty hospital authorized to provide inpatient medical or psychiatric services;

(8) Maintenance of adequate records on each resident;

(9) Standards for the storage, administration, and dispensing of prescribed medications to residents in programs licensed under this chapter, in accordance with guidelines established by the United States Drug Enforcement Administration and the Georgia Board of Pharmacy;

(10) Permission and standards for the regulation or control and provision of food and other nutrition;

(11) Standards for protection of resident rights while participating in a program and for internal grievance procedures;

(12) Standards for the ethics and integrity of the staff, owners, and governing body of the program;

(13) Standards to ensure protection of the resident and the community at large in the event a resident poses a risk of potential harm to self or others; and

(14) Standards and procedures for incident reports to the department in the event of the occurrence of major incidents and for the provision for appropriate departmental actions and appeal thereof.

37-14-5.

(a) No later than January 1, 2028, the department shall create and promulgate all rules and regulations necessary for the implementation of this chapter.

(b) The department is authorized to issue, deny, suspend, or revoke a license or take other enforcement actions against a licensee or applicant as provided in Article 3 of Chapter 2 of this title.

(c) All rules and regulations and any enforcement actions initiated by the department shall comply with the requirements of Chapter 13 of Title 50, the 'Georgia Administrative Procedure Act.'

37-14-6.

(a) On and after January 1, 2029, no governing body shall operate a recovery residence without having a valid license or provisional license issued pursuant to this chapter.

(b) No recovery residence shall advertise or hold itself out as offering any service or program which it is not authorized to offer.

37-14-7.

(a) Application for a license to operate a recovery residence shall be submitted by the governing body to the department in the manner prescribed in the department's rules and regulations and shall contain a comprehensive outline of the program to be offered by the applicant.

(b) Proof of compliance with all applicable federal and state laws for the handling and dispensing of medications, and all state and local health, safety, sanitation, building, and zoning codes shall be attached to any application submitted to the department.

37-14-8.

(a) The department may issue a provisional license effective for a period not to exceed 90 days to each applicant that has substantially complied with all requirements for a regular license. Provisional licenses shall be renewed in the discretion of the department only in cases of extreme hardship and in no case for longer than 90 days.

(b) The obligations and conditions of a provisional license shall be the same as those of a regular license except as otherwise provided for in this chapter.

37-14-9.

As evidence of compliance with one or more departmental requirements for issuance or renewal of a license or provisional license, the department may accept proof of certification by an organization in this state which provides certification for recovery residences in accordance with national standards for recovery residences established by a national organization with expertise in recovery residences.

37-14-10.

(a) The department shall issue a license to a governing body for a recovery residence which meets all the rules and regulations for such license. The license shall be nontransferable for a change of location or governing body.

(b) The department shall make available on its website a registry of all licensed recovery residences.

37-14-11.

(a) The department is authorized to deny, suspend, or revoke a license issued under this chapter for a violation of this chapter or a rule or regulation adopted under this chapter or to take other enforcement action against a licensee as provided in Article 3 of Chapter 2 of this title.

(b) The denial, suspension, or revocation of a license by the department shall be a contested case for purposes of Chapter 13 of Title 50, the 'Georgia Administrative Procedure Act.'

37-14-12.

For the purpose of providing more effective treatment and rehabilitation, the records and name of any individual who seeks or obtains treatment, therapeutic advice, or counsel from any recovery residence licensed under this chapter and any communication by such individual to an authorized employee of a licensee shall be confidential except to the extent authorized in writing by the individual affected or his or her guardian or custodian; provided, however, that, except for matters privileged under other laws of this state, the records of such individual and information about the individual shall be produced in response to a valid court order of any court of competent jurisdiction after a full and fair show-cause hearing and in response to a departmental request for access for licensing purposes when such request is accompanied by a written statement that no record of patient-identifying information will be made. The protections provided in this Code section and other provisions of state or federal law of an individual's identity or communications to the clinical staff of any recovery residence licensed under this chapter shall not prohibit the use of de-identified data relating to such individual for clinical or programmatic research or education or in presentations about the programs offered by a licensee under this chapter. Subject to and in compliance with the limitations of any state or federal privacy laws, the department may require at reasonable intervals, and each licensee shall furnish, copies of summary records of each individual treated or advised pursuant to a recovery residence.

37-14-13.

The department shall conduct periodic on-site inspection of each recovery residence licensed in this state. Such inspection shall include, but shall not be limited to, the premises, staff, residents, and documents pertinent to the continued licensing of such recovery residence so that the department may determine whether a provider is operating in compliance with licensing requirements. Each licensee shall permit authorized department representatives to enter upon and inspect any and all premises upon or in which a program is to be conducted, for which a license has been applied, or for which a license has been issued so that verification of compliance with all relevant laws or regulations can be made.

37-14-14.

(a) On and after January 1, 2029, a program shall be deemed to be an unlicensed recovery residence if it is unlicensed and not exempt from licensure under this chapter and:

(1) The program is providing services and is operating as a recovery residence;

(2) The program is held out as or represented as providing services and operating as a recovery residence; or

(3) The program represents itself as a licensed recovery residence.

(b) Any unlicensed recovery residence may be assessed by the department, after opportunity for hearing in accordance with the provisions of Chapter 13 of Title 50, the 'Georgia Administrative Procedure Act,' a civil penalty in the amount of $100.00 per bed per day for each day of violation. The department shall send a notice by certified mail or statutory overnight delivery stating that licensure is required and the department's intent to impose a civil penalty. Such notice shall be deemed to be constructively received on the date of the first attempt to deliver the notice by the United States Postal Service. The department shall take no action to collect such civil penalty until after opportunity for a hearing.

(c) In addition to other remedies available to the department, the civil penalty authorized by subsection (b) of this Code section shall be doubled if the program owner or operator continues to operate the unlicensed recovery residence after receipt of notice pursuant to subsection (b) of this Code section.

(d) The program owner or operator of an unlicensed recovery residence that is assessed a civil penalty in accordance with this Code section may appeal such civil penalty to the superior court in the county in which the action arose or to the Superior Court of Fulton County."

SECTION 4.

All laws and parts of laws in conflict with this Act are repealed.