(a)
As used in this section, “incidental medical services” means services that are in compliance with the community standard of practice and are not required to be performed in a licensed clinic or licensed health facility, as defined by Section 1200 or 1250, respectively, to address medical issues associated with either detoxification from alcohol or other drugs or the provision of alcohol or other drug recovery or treatment services, including all of the following categories of services that the department shall further define by regulation:
(1)
Obtaining medical histories.
(2)
Monitoring health status to determine
whether the health status warrants transfer of the patient in order to receive urgent or emergent care.
(3)
Testing associated with detoxification from alcohol or other drugs.
(4)
Providing alcohol or other drug recovery or treatment services.
(5)
Overseeing patient self-administered medications.
(6)
Treating substance use disorders, including detoxification.
(b)
Incidental medical services do not include the provision of general primary medical care.
(c)
Notwithstanding any other law, a licensed alcohol or other drug recovery or
treatment facility may permit incidental medical services to be provided to a resident at the facility premises by, or under the supervision of, one or more physicians and surgeons licensed by the Medical Board of California or the Osteopathic Medical Board who are knowledgeable about addiction medicine, or one or more other health care practitioners acting within the scope of practice of their license and under the direction of a physician and surgeon, and who are also knowledgeable about addiction medicine, if all of the following conditions are met:
(1)
The facility, in the judgment of the department, has the ability to comply with the requirements of this chapter and all other applicable laws and regulations to meet the needs of a resident receiving incidental medical services pursuant to this chapter. The department shall specify in
regulations the minimum requirements that a facility shall meet in order to be approved to permit the provision of incidental medical services on its premises. The license of a facility approved to permit the provision of incidental medical services shall reflect that those services are permitted at the facility premises.
(2)
The physician and surgeon and any other health care practitioner has signed an acknowledgment on a form provided by the department that they have been advised of and understand the statutory and regulatory limitations on the services that may legally be provided at a licensed alcohol or other drug recovery or treatment facility and the statutory and regulatory requirements and limitations for the physician and surgeon or other health care practitioner and for the facility, related to providing incidental medical
services. The licensee shall maintain a copy of the signed form at the facility for a physician and surgeon or other health care practitioner providing incidental medical services at the facility premises.
(3)
A physician and surgeon or other health care practitioner shall assess a resident, prior to that resident receiving incidental medical services, to determine whether it is medically appropriate for that resident to receive these services at the premises of the licensed facility. A copy of the form provided by the department shall be signed by the physician and surgeon and maintained in the resident’s file at the facility.
(4)
The resident has signed an admission agreement.
(A)
The admission agreement, at a minimum, shall
describe the incidental medical services that the facility may permit to be provided and shall state that the permitted incidental medical services will be provided by, or under the supervision of, a physician and surgeon.
(B)
The department shall not require an admission agreement to require a person to have been abstinent, to not be intoxicated, or to otherwise not be under the influence in order to be
admitted into care,
be considered for treatment, or continue treatment.
(C)
The department shall specify in regulations, at a minimum, the content and manner of providing the admission agreement, and any other information that the department deems appropriate. The facility shall maintain a copy of the signed admission agreement in the resident’s file.
(5)
Once incidental medical services are initiated for a resident, the physician and surgeon and facility shall monitor the resident to ensure that the resident remains appropriate to receive those services. If the physician and surgeon determines that a change in the resident’s medical condition requires other medical services or that a higher level of care is required, the facility shall immediately arrange for the other medical
services or higher level of care, as appropriate.
(6)
The facility maintains in its files a copy of the relevant professional license or other written evidence of licensure to practice medicine or perform medical services in the state for the physician and surgeon and any other health care practitioner providing incidental medical services at the facility.
(d)
The department is not required to evaluate or have any responsibility or liability with respect to evaluating the incidental medical services provided by a physician and surgeon or other health care practitioner at a licensed facility. This section does not limit the department’s ability to report suspected misconduct by a physician and surgeon or other health care practitioner to the appropriate licensing entity or to law
enforcement.
(e)
A facility licensed and approved by the department to allow provision of incidental medical services shall not by offering approved incidental medical services be deemed a clinic or health facility within the meaning of Section 1200 or 1250, respectively.
(f)
Other than incidental medical services permitted to be provided or any urgent or emergent care required in the case of a life-threatening emergency, including the administration of naloxone hydrochloride, or any other opioid antagonist that is approved by the United States Food and Drug Administration for treatment of an opioid overdose, this section does not authorize the provision at the premises of the facility of any medical or health care services or any other services that require a higher level of care
than the care that may be provided within a licensed alcohol or other drug recovery or treatment facility.
(g)
This section does not require a residential treatment facility licensed by the department to provide incidental medical services or any services not otherwise permitted by law.
(h)
(1)
On or before July 1, 2024, the department shall adopt regulations to implement this section in accordance with the Administrative Procedure Act (Chapter 3.5 (commencing with Section 11340) of Part 1 of Division 3 of Title 2 of the Government Code).
(2)
Notwithstanding the rulemaking provisions of the Administrative Procedure Act, the department may, if it deems appropriate, implement, interpret, or make
specific this section by means of provider bulletins, written guidelines, or similar instructions from the department until regulations are adopted.
