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    More regulation of addiction treatment and sober living proposed for 2025
    • February 23, 2025

    Three deaths connected to rehab facilities in 2024 have something in common: The addicts who died all were seeking help in the vast, shape-shifting rehab empire overseen by Nathan Young, aka "Pablo Lopez," and associates. From left, Margaret Dickerson, Benjamin Barragan and Emmanuel Mitchell. (Illustration by Jeff Goertzen, Orange County Register/SCNG)
    From left, Margaret Dickerson, Benjamin Barragan and Emmanuel Mitchell died seeking treatment in California. (Illustration by Jeff Goertzen, Orange County Register/SCNG)

    My hard cold heart has been ripped, yet again, by another mother whose hope for her son’s recovery in California turned into the agony of planning his funeral. He overdosed while in treatment. There were doves, and promises, and the consuming conviction to make things better, as there are all too often.

    A slew of new bills in Sacramento aims to nudge that conviction along.

    Local officials are mounting a charm offensive to convince legislators of the need for closer regulation of the world of addiction recovery. And, after a state audit of the Department of Health Care Services (which licenses and regulates treatment centers) found “serious problems,” Assemblymember Diane Dixon, R-Newport Beach, seeks a new audit of yet another agency that licenses programs that treat addiction: the Department of Social Services.

    That department licenses, among other things, “social rehabilitation facilities.” Addiction treatment providers have started opening such homes to escape toothier new requirements enacted to reign in addiction programs licensed by Health Care Services. Billions of Proposition 1 mental health dollars could be available to these programs.

    State Auditor
    State Auditor

    Are these the best places to treat people with life-threatening conditions?

    The “serious problems” uncovered in the audit included the practice of clustering so-called treatment “campuses” in residential neighborhoods. This arguably results in the “re-institutionalization” of patients that community-based mental health care was supposed to end.

    The audit also found that it took Health Care Services more than a year to investigate many complaints, and that the department didn’t always follow up on facilities that were in violation.

    “The state’s own auditor has confirmed what cities have been saying for years: There is a lack of transparency, accountability, and information available to our communities when concerns over recovery housing facilities arise,” said League of California Cities Executive Director and CEO Carolyn Coleman in a prepared statement.

    Many of the new bills in Sacramento aim to remedy the flaws exposed in the audit. The League of California Cities has thrown its weight behind three of them: Senate Bill 329, Assembly Bill 424 and Assembly Bill 492, which we’ll tell you about in a minute.

    “Are people getting well?” asked Dixon. “We genuinely want people to get well….It really is heartbreaking, if you get a chance to talk to people who were in these facilities.”

    Wendy Bucknum, mayor pro tem of Mission Viejo and co-chair of the California Sober Living and Recovery Task Force, is hopeful. “We’re on the verge of breaking through the dam,” she said.

    State Auditor
    State Auditor

    Legislative Rx

    Let’s start with the three League-sponsored bills.

    There’s SB 329, by Sen. Catherine Blakespear, D-Encinitas, and co-authored by Sen. Tom Umberg, D-Santa Ana. That it takes the state more than a year to investigate some complaints about addiction treatment facilities is simply unacceptable, she said. This bill would require more timely investigations: Health Care Services would have to assign complaints to staff within 10 days of receipt, and complete investigations within 60 days. “If an alcohol or drug treatment facility is not following state regulations and jeopardizing the health or safety of its residents or neighbors, the state should act promptly,” Blakespear said in a statement.

    Assemblymember Laurie Davies, R-Laguna Niguel, gives us AB 424, which also aims to address the crazy lag on complaints. It would require Health Care Services to better communicate with people who lodge complaints, acknowledging their receipt within 30 days and then informing those folks when the investigation is done — and tell them if any violations were discovered.

    State Auditor
    State Auditor

    Facilities open and close with some regularity, but local governments are often in the dark about precisely where they are and who owns them. AB 492, by Assemblymember Avelino Valencia, D-Anaheim, with coauthor Umberg, would require the state to notify the city or county that a license has been issued in its boundaries. It would have to include the name and mailing address of the person holding the license, as well as the facility’s location.

    Several other bills also are aimed at raising the bar.

    Right now, licensed residential (i.e., live-in) programs must embrace the American Society of Addiction Medicine treatment criteria (or something very similar) as a minimum standard of care (which was a huge upgrade from the almost nothing they were required to do before). But outpatient programs — where most treatment happens and where, in an extremely bizarre move, the state decided don’t need licensing — could still pretty much do whatever they liked. AB 425, by Davies, would change that, requiring outpatient treatment to adopt ASAM-esque standards of care as well. “Patients should be getting evidence-based treatment, rather than who-knows-what in some of these places,” Davies said.

    Another Davies bill, AB 423, aims to keep rehab dropouts off the streets. It would require facilities to create discharge and continuing care plans for each patient, ensuring they can get back home after they finish treatment or are kicked out. Facilities would also have to schedule a follow-up meeting with a mental health professional for the patient no more than 7 days after discharge.

    And on the “battling re-institutionalization” front, Dixon’s AB 3 would require physical distance between recovery or treatment homes. Such businesses wouldn’t be considered “residential use of property” if they’re within 300 feet of another such facility; the facilities share the same owner, director, programs or amenities; and the total number of residents in both facilities is greater than six.

    “I hope, when I present my bill, it will make people understand they’ve been reinstutitionalized,” Dixon said. “Forty, 50 years ago, (in the institutions), they got medical care. They’re not getting medical care now.”

    More legislation is in the works, including a bill that would require disclosing to health insurers that these addiction programs do not provide medical care; one that would use state mental health bond money to boost oversight of facilities; and AB 448 by Assemblymember Darshana Patel, D-San Diego, which would require that the parent or guardian of an underage kid in a California treatment program is physically in the state for the duration of the youth’s treatment.

    Charm offensive

    The California Sober Living and Recovery Task Force, started several years ago by the city of Mission Viejo, has grown to include other SoCal cities grappling with these issues. The task force wants to build more momentum behind change, and it is partnering with the League of California Cities and the Association of California Cities-Orange County on a “call to action” to elected officials, asking them to support bipartisan legislative reform.

    The task force “was born out of your strong leadership and desire to create a coalition of cities and counties impacted by the lack of oversight in business-operated residential drug and alcohol rehabilitation homes,” one letter says. “The purpose of this task force is to speak as one voice with a united message. We are incredibly grateful for all your ongoing efforts to increase awareness of the rampant issues in this unregulated lucrative industry, as are the patients and their families who have experienced tragedies at the hands of operators who act irresponsibly.”

    Cities have the law on their side now, the letters point out.

    Trailblazer Costa Mesa, which enacted rules for sober living homes a decade ago and has been defending them in court ever since, had a major win in December. The city’s laws do not discriminate against recovering addicts, but may actually benefit them, the U.S. Court of Appeals for the Ninth Circuit said in a precedent-setting decision.

    That case isn’t over, but that victory could have far-reaching implications in Southern California and throughout the nation, as communities struggle with proliferating sober homes that have turned some neighborhoods into veritable treatment campuses and put recovering residents at risk.

    “Rather than focusing on enforcement and neighborhood impacts, we are asking that our state representatives consider supporting bills that protect individuals seeking care, increase standards for safety and fraud, and prioritize treatment beds for California residents,” the task force letter says. “These changes have the potential to transform a broken system that victimizes this vulnerable population, which also benefits our communities.”

    The request is signed by Mission Viejo’s Bucknum; Lauren Kleiman, mayor pro tem of Newport Beach; and Stephanie Klopfenstein, mayor of Garden Grove.

    Is there any cogent argument one can make against better regulation of addiction treatment and sober homes? Many programs in California are in tract homes or apartment complexes, overseen by recovering addicts without long histories of sobriety themselves. And overdoses are tragically common: There was Frankie Taylor. And Dean Rea. And Benjamin Barragan. And Emmanuel Mitchell. And so many more.

    “This is about our kids,” said a tearful Susan Rea, whose son Dean survived an overdose at a celebrity sober home in Palm Springs, was booted out with no care plan, and later died behind a gas station.

    “This is about our community, and this is about making a difference,” she said. “None of this should be happening. This has got to stop.”

    The feds are doing way more than the state on this front. Last week, Juan Carlos Gutierrez, 34, a.k.a. “Johnny G,” of Montebello, was sentenced to 20 years in federal prison for distributing fentanyl that killed a client in a Long Beach drug treatment facility.

    Dylan lyrics spring to mind. “….(H)ow many times must a man look up before he can see the sky? …. how many ears must one man have before he can hear people cry?… how many deaths will it take till he knows that too many people have died?”

    The answer, my friends, may be as close as Sacramento.

    ​ Orange County Register 

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