SB526: SB526 Mental Health; the licensing and regulation of recovery residences; provide

26 LC 61 0409 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, so1 as to provide for the licensing and regulation of recovery residences; to provide for minimum2 standards; to provide for rules and regulations; to provide for applications for licensing; to3 provide for provisional licensing; to provide for compliance; t o provide for the denial,4 suspension, or revocation of licenses; to provide for enforceme nt actions; to provide for5 confidentiality; to provide for inspections; to provide for procedures and penalties relating6 to unlicensed recovery residen ces; to provide for definitions; to provide for conforming7 changes; to provide legislative findings; to provide a short ti tle; to provide for related8 matters; to repeal conflicting laws; and for other purposes.9 BE IT ENACTED BY THE GENERAL ASSEMBLY OF GEORGIA:10 SECTION 1.11 Title 37 of the Official Code of Georgia Annotated, relating to mental health, is amended in12 Code Section 37-2-70, relating to definitions relative to adult residential mental health13 programs, by adding a new paragraph to read as follows:14 S. B. 526 - 1 - 26 LC 61 0409 "(8) 'Recovery residence' means a program licensed by the department under Chapter 1415 of this title."16 SECTION 2.17 Said title is further amended by revising Code Section 37-2-71, relating to fee schedule for18 licensure relative to adult residential mental health programs, as follows:19 "37-2-71.20 The department shall establish by rule adopted pursuant to Chap ter 13 of Title 50, the21 'Georgia Administrative Procedure Act,' a schedule of fees for licensure activities for adult22 residential mental health programs, community living arrangements, drug abuse treatment23 and education programs, recovery residences, and narcotic treatment programs required to24 be licensed by the department. Such schedules shall be determi ned in a manner so as to25 help defray the costs incurred by the department, but in no event to exceed such costs, both26 direct and indirect, in providing such licensure activities. S uch fees may be annually27 adjusted by the department but shall not be increased by more t han the annual rate of28 inflation as measured by the Consumer Price Index as reported b y the Bureau of Labor29 Statistics of the United States Department of Labor. All fees paid thereunder shall be paid30 into the general fund of the State of Georgia. It is the intent of the General Assembly that31 the proceeds from all fees imposed pursuant to this Code sectio n be used to support and32 improve the quality of licensing services provided by the department."33 SECTION 3.34 Said title is further amended by adding a new chapter to read as follows:35 S. B. 526 - 2 - 26 LC 61 0409 "CHAPTER 1436 37-14-1.37 This chapter shall be known and may be cited as the 'Recovery Residences Licensing Act.'38 37-14-2.39 The General Assembly finds that:40 (1) Recovery residences provide vital peer based housing suppo rt for individuals in41 recovery from substance use disorders; and42 (2) A regulatory framework for recovery residences would impro ve the safety of43 residents and increase accountability for facilities that receive court mandated or publicly44 supported referrals.45 37-14-3.46 As used in this chapter, the term:47 (1) 'Applicant' m eans any individua l affiliated with a partner ship, corporation,48 association, or individuals or groups of individuals submitting an application to operate49 a recovery residence under this chapter.50 (2) 'Department' means the Department of Behavioral Health and Developmental51 Disabilities.52 (3) 'Governing body' means the partnership, corporation, limit ed liability company,53 association, or person or group of persons that maintains and c ontrols the recovery54 residence and that is legally responsible for its operation.55 (4) 'License' means the official permit issued by the departme nt which authorizes the56 holder to operate a recovery residence.57 (5) 'Licensee' means any person holding a license issued by th e department under this58 chapter.59 S. B. 526 - 3 - 26 LC 61 0409 (6) 'Recovery residence' means a residential living arrangement for unrelated individuals60 that provides a safe and substance-free living environment that supports individuals in61 recovery from substance use disorders and which provides support for such individuals62 by:63 (A) Providing a supportive peer community to which residents are accountable or other64 supervision or monitoring; and65 (B) Ensuring access to mutual aid groups, recovery support services, and other needed66 services and supports.67 (7) 'Resident' means an individual residing in a recovery resi dence for the purpose of68 recovery from a substance use disorder.69 (8) 'Substance use disorder' means a cluster of cognitive, behavioral, and physiological70 symptoms indicating that an individual continues using a substa nce despite significant71 substance related problems such as impaired control, social impairment, risky use, and72 pharmacological tolerance and withdrawal; provided, however, that such term shall not73 include an individual's use of tobacco or caffeine.74 37-14-4.75 The department shall create and promulgate minimum standards of quality and services for76 recovery residences, and shall, at a minimum include in the rules and regulations:77 (1) Admission criteria;78 (2) Adequate and safe buildings or housing facilities where pr ograms are offered and79 standards for emergency conditions relating to such buildings or facilities;80 (4) Standards for sufficiently trained staff or staff with pri or experience who are81 competent in the duties they are to perform;82 (5) The content and quality of services to be provided;83 (6) Requirements for intake, discharge, and aftercare of residents;84 S. B. 526 - 4 - 26 LC 61 0409 (7) Referral arrangements to other appropriate agencies or facilities, including a process85 and adequate staff to facilitate the transfer of a resident to a licensed general or specialty86 hospital authorized to provide inpatient medical or psychiatric services;87 (8) Maintenance of adequate records on each resident;88 (9) Standards for the storage, administration, and dispensing of prescribed medications89 to residents in programs licensed under this chapter, in accord ance with guidelines90 established by the United States Drug Enforcement Administratio n and the Georgia91 Board of Pharmacy;92 (10) Permission and standards for the regulation or control an d provision of food and93 other nutrition;94 (11) Standards for protection of resident rights while participating in a program and for95 internal grievance procedures;96 (12) Standards for the ethics and integrity of the staff, owners, and governing body of the97 program;98 (13) Standards to ensure protection of the resident and the co mmunity at large in the99 event a resident poses a risk of potential harm to self or others; and100 (14) Standards and procedures for incident reports to the department in the event of the101 occurrence of major incidents and for the provision for appropriate departmental actions102 and appeal thereof.103 37-14-5.104 (a) No later than January 1, 2028, the department shall create and promulgate all rules and105 regulations necessary for the implementation of this chapter.106 (b) The department is authorized to issue, deny, suspend, or revoke a license or take other107 enforcement actions against a licensee or applicant as provided in Article 3 of Chapter 2108 of this title.109 S. B. 526 - 5 - 26 LC 61 0409 (c) All rules and regulations and any enforcement actions initiated by the department shall110 comply with the requirements of Chapter 13 of Title 50, the 'Ge orgia Administrative111 Procedure Act.'112 37-14-6.113 (a) On and after January 1, 2029, no governing body shall oper ate a recovery residence114 without having a valid license or provisional license issued pursuant to this chapter.115 (b) No recovery residence shall advertise or hold itself out a s offering any service or116 program which it is not authorized to offer.117 37-14-7.118 (a) Application for a license to operate a recovery residence shall be submitted by the119 governing body to the department in the manner prescribed in the department's rules and120 regulations and shall contain a comprehensive outline of the program to be offered by the121 applicant.122 (b) Proof of compliance with all applicable federal and state laws for the handling and123 dispensing of medications, and all state and local health, safety, sanitation, building, and124 zoning codes shall be attached to any application submitted to the department.125 37-14-8.126 (a) The department may issue a provisional license effective for a period not to exceed 90127 days to each applicant that has substantially complied with all requirements for a regular128 license. Provisional licenses shall be renewed in the discretion of the department only in129 cases of extreme hardship and in no case for longer than 90 days.130 (b) The obligations and conditions of a provisional license shall be the same as those of131 a regular license except as otherwise provided for in this chapter.132 S. B. 526 - 6 - 26 LC 61 0409 37-14-9.133 As evidence of compliance with one or more departmental require ments for issuance or134 renewal of a license or provisional license, the department may accept proof of certification135 by an organization in this state which provides certification f or recovery residences in136 accordance with national standards for recovery residences esta blished by a national137 organization with expertise in recovery residences.138 37-14-10.139 (a) The department shall issue a license to a governing body f or a recovery residence140 which meets all the rules and regulations for such license. Th e license shall be141 nontransferable for a change of location or governing body.142 (b) The department shall make available on its website a registry of all licensed recovery143 residences.144 37-14-11.145 (a) The department is authorized to deny, suspend, or revoke a license issued under this146 chapter for a violation of this chapter or a rule or regulation adopted under this chapter or147 to take other enforcement action against a licensee as provided in Article 3 of Chapter 2 of148 this title.149 (b) The denial, suspension, or revocation of a license by the department shall be a150 contested case for purposes of Chapter 13 of Title 50, the 'Geo rgia Administrative151 Procedure Act.'152 37-14-12.153 For the purpose of providing more effective treatment and rehabilitation, the records and154 name of any individual who seeks or obtains treatment, therapeutic advice, or counsel from155 any recovery residence licensed under this chapter and any comm unication by such156 S. B. 526 - 7 - 26 LC 61 0409 individual to an authorized employee of a licensee shall be confidential except to the extent157 authorized in writing by the individual affected or his or her guardian or custodian;158 provided, however, that, except for matters privileged under ot her laws of this state, the159 records of such individual and information about the individual shall be produced in160 response to a valid court order of any court of competent jurisdiction after a full and fair161 show-cause hearing and in response to a departmental request fo r access for licensing162 purposes when such request is accompanied by a written statemen t that no record of163 patient-identifying information will be made. The protections provided in this Code164 section and other provisions of state or federal law of an indi vidual's identity or165 communications to the clinical staff of any recovery residence licensed under this chapter166 shall not prohibit the use of de-identified data relating to su ch individual for clinical or167 programmatic research or education or in presentations about th e programs offered by a168 licensee under this chapter. Subject to and in compliance with the limitations of any state169 or federal privacy laws, the department may require at reasonab le intervals, and each170 licensee shall furnish, copies of summary records of each indiv idual treated or advised171 pursuant to a recovery residence.172 37-14-13.173 The department shall conduct periodic on-site inspection of eac h recovery residence174 licensed in this state. Such inspection shall include, but sha ll not be limited to, the175 premises, staff, residents, and documents pertinent to the cont inued licensing of such176 recovery residence so that the department may determine whether a provider is operating177 in compliance with licensing requirements. Each licensee shall permit authorized178 department representatives to enter upon and inspect any and all premises upon or in which179 a program is to be conducted, for which a license has been applied, or for which a license180 has been issued so that verification of compliance with all relevant laws or regulations can181 be made.182 S. B. 526 - 8 - 26 LC 61 0409 37-14-14.183 (a) On and after January 1, 2029, a program shall be deemed to be an unlicensed recovery184 residence if it is unlicensed and not exempt from licensure under this chapter and:185 (1) The program is providing services and is operating as a recovery residence;186 (2) The program is held out as or represented as providing ser vices and operating as a187 recovery residence; or188 (3) The program represents itself as a licensed recovery residence.189 (b) Any unlicensed recovery residence may be assessed by the d epartment, after190 opportunity for hearing in accordance with the provisions of Ch apter 13 of Title 50, the191 'Georgia Administrative Procedure Act,' a civil penalty in the amount of $100.00 per bed192 per day for each day of violation. The department shall send a notice by certified mail or193 statutory overnight delivery stating that licensure is required and the department's intent194 to impose a civil penalty. Such notice shall be deemed to be constructively received on the195 date of the first attempt to deliver the notice by the United S tates Postal Service. The196 department shall take no action to collect such civil penalty u ntil after opportunity for a197 hearing.198 (c) In addition to other remedies available to the department, the civil penalty authorized199 by subsection (b) of this Code section shall be doubled if the program owner or operator200 continues to operate the unlicensed recovery residence after receipt of notice pursuant to201 subsection (b) of this Code section.202 (d) The program owner or operator of an unlicensed recovery re sidence that is assessed203 a civil penalty in accordance with this Code section may appeal such civil penalty to the204 superior court in the county in which the action arose or to th e Superior Court of Fulton205 County."206 SECTION 4.207 All laws and parts of laws in conflict with this Act are repealed.208 S. B. 526 - 9 -