11839. The department, with the approval of the Secretary of the
Health and Human Services Agency, may contract with any public or
private agency for the performance of any of the functions vested in
the department by this chapter. Any department of the state is
authorized to enter into such a contract.
11839.1. The Legislature finds and declares that it is in the best
interests of the health and welfare of the people of this state to
coordinate narcotic treatment programs to use replacement narcotic
therapy in the treatment of addicted persons whose addiction was
acquired or supported by the use of a narcotic drug or drugs, not in
compliance with a physician and surgeon's legal prescription, and to
establish and enforce minimum requirements for the operation of all
narcotic treatment programs in this state.
11839.2. The following controlled substances are authorized for use
in replacement narcotic therapy by licensed narcotic treatment
programs:
(a) Methadone.
(b) Levoalphacetylmethadol (LAAM) as specified in paragraph (10)
of subdivision (c) of Section 11055.
11839.3. (a) In addition to the duties authorized by other
statutes, the department shall perform all of the following:
(1) License the establishment of narcotic treatment programs in
this state to use replacement narcotic therapy in the treatment of
addicted persons whose addiction was acquired or supported by the use
of a narcotic drug or drugs, not in compliance with a physician and
surgeon's legal prescription, except that the Research Advisory Panel
shall have authority to approve methadone or LAAM research programs.
The department shall establish and enforce the criteria for the
eligibility of patients to be included in the programs, program
operation guidelines, such as dosage levels, recordkeeping and
reporting, urinalysis requirements, take-home doses of methadone,
security against redistribution of the replacement narcotic drugs,
and any other regulations that are necessary to protect the safety
and well-being of the patient, the local community, and the public,
and to carry out this chapter. A program may admit a patient to
narcotic maintenance or narcotic detoxification treatment seven days
after completion of a prior withdrawal treatment episode. The arrest
and conviction records and the records of pending charges against any
person seeking admission to a narcotic treatment program shall be
furnished to narcotic treatment program directors upon written
request of the narcotic treatment program director provided the
request is accompanied by a signed release from the person whose
records are being requested.
(2) Inspect narcotic treatment programs in this state and ensure
that programs are operating in accordance with the law and
regulations. The department shall have sole responsibility for
compliance inspections of all programs in each county. Annual
compliance inspections shall consist of an evaluation by onsite
review of the operations and records of licensed narcotic treatment
programs' compliance with applicable state and federal laws and
regulations and the evaluation of input from local law enforcement
and local governments, regarding concerns about the narcotic
treatment program. At the conclusion of each inspection visit, the
department shall conduct an exit conference to explain the cited
deficiencies to the program staff and to provide recommendations to
ensure compliance with applicable laws and regulations. The
department shall provide an inspection report to the licensee within
30 days of the completed onsite review describing the program
deficiencies. A corrective action plan shall be required from the
program within 30 days of receipt of the inspection report. All
corrective actions contained in the plan shall be implemented within
30 days of receipt of approval by the department of the corrective
action plan submitted by the narcotic treatment program. For programs
found not to be in compliance, a subsequent inspection of the
program shall be conducted within 30 days after the receipt of the
corrective action plan in order to ensure that corrective action has
been implemented satisfactorily. Subsequent inspections of the
program shall be conducted to determine and ensure that the
corrective action has been implemented satisfactorily. For purposes
of this requirement, "compliance" shall mean to have not committed
any of the grounds for suspension or revocation of a license provided
for under subdivision (a) of Section 11839.9 or paragraph (2) of
subdivision (b) of Section 11839.9. Inspection of narcotic treatment
programs shall be based on objective criteria including, but not
limited to, an evaluation of the programs' adherence to all
applicable laws and regulations and input from local law enforcement
and local governments. Nothing in this section shall preclude
counties from monitoring their contract providers for compliance with
contract requirements.
(3) Charge and collect licensure fees. In calculating the
licensure fees, the department shall include staff salaries and
benefits, related travel costs, and state operational and
administrative costs. Fees shall be used to offset licensure and
inspection costs not to exceed actual costs.
(4) Study and evaluate, on an ongoing basis, narcotic treatment
programs including, but not limited to, the adherence of the programs
to all applicable laws and regulations and the impact of the
programs on the communities in which they are located.
(5) Provide advice, consultation, and technical assistance to
narcotic treatment programs to ensure that the programs comply with
all applicable laws and regulations and to minimize any negative
impact that the programs may have on the communities in which they
are located.
(6) In its discretion, to approve local agencies or bodies to
assist it in carrying out this chapter provided that the department
may not delegate responsibility for inspection or any other licensure
activity without prior and specific statutory approval. However, the
department shall evaluate recommendations made by county alcohol and
drug program administrators regarding licensing activity in their
respective counties.
(7) The director may grant exceptions to the regulations adopted
under this chapter if he or she determines that this action would
improve treatment services or achieve greater protection to the
health and safety of patients, the local community, or the general
public. No exception may be granted if it is contrary to, or less
stringent than, the federal laws and regulations which govern
narcotic treatment programs.
(b) It is the intent of the Legislature in enacting this section
in order to protect the general public and local communities, that
self-administered dosage shall only be provided when the patient is
clearly adhering to the requirements of the program, and where daily
attendance at a clinic would be incompatible with gainful employment,
education, and responsible homemaking. The department shall define
"satisfactory adherence" and shall ensure that patients not
satisfactorily adhering to their programs shall not be provided
take-home dosage.
(c) There is established in the State Treasury the Narcotic
Treatment Program Licensing Trust Fund. All licensure fees collected
from the providers of narcotic treatment service shall be deposited
in this fund. Except as otherwise provided in this section, if funds
remain in this fund after appropriation by the Legislature and
allocation for the costs associated with narcotic treatment licensure
actions and inspection of narcotic treatment programs, a percentage
of the excess funds shall be annually rebated to the licensees based
on the percentage their licensing fee is of the total amount of fees
collected by the department. A reserve equal to 10 percent of the
total licensure fees collected during the preceding fiscal year may
be held in each trust account to reimburse the department if the
actual cost for the licensure and inspection exceed fees collected
during a fiscal year.
(d) Notwithstanding any provision of this code or regulations to
the contrary, the department shall have sole responsibility and
authority for determining if a state narcotic treatment program
license shall be granted and for administratively establishing the
maximum treatment capacity of any license. However, the department
shall not increase the capacity of a program unless it determines
that the licensee is operating in full compliance with applicable
laws and regulations.
11839.4. The department shall impose a civil penalty of one hundred
dollars ($100) per day for a program that fails to timely submit a
corrective action plan, or to timely implement any corrective action
when it has been found to not be in compliance with applicable laws
and regulations as required in Section 11839.3.
11839.5. In addition to the duties authorized by other provisions,
the department shall be responsible for licensing narcotic treatment
programs to use replacement narcotic therapy in the treatment of
addicted persons whose addiction was acquired or supported by the use
of a narcotic drug or drugs, not in compliance with a physician and
surgeon's legal prescription. No narcotic treatment program shall be
authorized to use replacement narcotic therapy without first
obtaining a license therefor as provided in this chapter. The
department may license narcotic treatment programs on an inpatient or
outpatient basis, or both. The department may also grant a state
narcotic treatment license.
11839.6. (a) The department shall establish a program for the
operation and regulation of office-based narcotic treatment programs.
An office-based narcotic treatment program established pursuant to
this section shall meet either of the following conditions:
(1) Hold a primary narcotic treatment program license.
(2) Be affiliated and associated with a primary licensed narcotic
treatment program. An office-based narcotic treatment program meeting
the requirement of this paragraph shall not be required to have a
license separate from the primary licensed narcotic treatment program
with which it is affiliated and associated.
(b) For purposes of this section, "office-based narcotic treatment
program" means a program in which interested and knowledgeable
physicians and surgeons provide addiction treatment services, and in
which community pharmacies supply necessary medication both to these
physicians and surgeons for distribution to patients and through
direct administration and specified dispensing services.
(c) Notwithstanding any other provision of law or regulation,
including Section 10020 of Title 9 of the California Code of
Regulations, an office-based narcotic treatment program in a remote
site that is affiliated and associated with a licensed narcotic
treatment program may be approved by the department, if all of the
following conditions are met:
(1) A physician may provide office-based addiction services only
if each office-based patient is registered as a patient in the
licensed narcotic treatment program and both the licensed narcotic
treatment program and the office-based narcotic treatment program
ensure that all services required under Chapter 4 (commencing with
Section 10000) of Division 4 of Title 9 of the California Code of
Regulations for the management of narcotic addiction are provided to
all patients treated in the remote site.
(2) A physician in an office-based narcotic treatment program may
provide treatment for a maximum of 20 patients under the appropriate
United States Drug Enforcement Administration registration. The
primary licensed narcotic treatment program shall be limited to its
total licensed capacity as established by the department, including
the patients of physicians in the office-based narcotic treatment
program.
(3) The physicians in the office-based narcotic treatment program
shall dispense or administer pharmacologic treatment for narcotic
addiction that has been approved by the federal Food and Drug
Administration such as levoalphacetylmethadol (LAAM) or methadone.
(4) Office-based narcotic treatment programs, in conjunction with
primary licensed narcotic treatment programs, shall develop protocols
to prevent the diversion of methadone. The department may develop
regulations to prevent the diversion of methadone.
(d) For purposes of this section, "remote site" means a site that
is geographically or physically isolated from any licensed narcotic
treatment program. Therefore, the requirements in this subdivision
regarding a remote site do not apply to an office-based narcotic
treatment program that holds a primary narcotic treatment program
license.
(e) In considering an office-based narcotic treatment program
application, the department shall independently weigh the treatment
needs and concerns of the county, city, or areas to be served by the
program.
(f) Nothing in this section is intended to expand the scope of the
practice of pharmacy.
11839.7. (a) (1) Each narcotic treatment program authorized to use
replacement narcotic therapy in this state, except narcotic treatment
research programs approved by the Research Advisory Panel, shall be
licensed by the department.
(2) Each narcotic treatment program, other than a program owned
and operated by the state, county, city, or city and county, shall,
upon application for licensure and for renewal of a license, pay an
annual license fee to the department. July 1 shall be the annual
license renewal date.
(3) The department shall set the licensing fee at a level
sufficient to cover all departmental costs associated with licensing
incurred by the department, but the fee shall not, except as
specified in this section, increase at a rate greater than the
Consumer Price Index. The fees shall include the department's share
of pro rata charges for the expenses of state government. The fee may
be paid quarterly in arrears as determined by the department. Fees
paid quarterly in arrears shall be due and payable on the last day of
each quarter except for the fourth quarter for which payment shall
be due and payable no later than May 31. A failure of a program to
pay renewal license fees by the due date shall give rise to a civil
penalty of one hundred dollars ($100) a day for each day after the
due date. Second and subsequent inspection visits to narcotic
treatment programs that are operating in noncompliance with the
applicable laws and regulations shall be charged a rate of one-half
the program's annual license fee or one thousand dollars ($1,000),
whichever is less, for each visit.
(4) Licensing shall be contingent upon determination by the
department that the program is in compliance with applicable laws and
regulations and upon payment of the licensing fee. A license shall
not be transferable.
(5) (A) As used in this chapter, "quarter" means July, August, and
September; October, November, and December; January, February, and
March; and April, May, and June.
(B) As used in this chapter, "license" means a basic permit to
operate a narcotic treatment program. The license shall be issued
exclusively by the department and operated in accordance with a
patient capacity that shall be specified, approved, and monitored
solely by the department.
(b) Each narcotic treatment program, other than a program owned
and operated by the state, county, city, or city and county, shall be
charged an application fee that shall be at a level sufficient to
cover all departmental costs incurred by the department in processing
either an application for a new program license, or an application
for an existing program that has moved to a new location.
(c) Any licensee that increases fees to the patient, in response
to increases in licensure fees required by the department, shall
first provide written disclosure to the patient of that amount of the
patient fee increase that is attributable to the increase in the
licensure fee. This provision shall not be construed to limit patient
fee increases imposed by the licensee upon any other basis.
11839.8. The director may deny the application for initial issuance
of a license if the applicant or any partner, officer, director, 10
percent or greater shareholder, or person proposed to be employed by
the applicant under the authority of subdivision (c) of Section 2401
of the Business and Professions Code:
(a) Fails to meet the qualifications for licensure established by
the department pursuant to this article. However, the director may
waive any established qualification for licensure of a narcotic
treatment program if he or she determines that it is reasonably
necessary in the interests of the public health and welfare.
(b) Was previously the holder of a license issued under this
article, and the license was revoked and never reissued or was
suspended and not reinstated, or the holder failed to adhere to
applicable laws and regulations regarding narcotic treatment programs
while the license was in effect.
(c) Misrepresented any material fact in the application.
(d) Committed any act involving fraud, dishonesty, or deceit, with
the intent to substantially benefit himself or herself or another or
substantially injure another, and the act is substantially related
to the qualification, functions, or duties of, or relating to, a
narcotic treatment program license.
(e) Was convicted of any crime substantially related to the
qualifications, functions, or duties of, or relating to, a narcotic
treatment program license.
(f) The director, in considering whether to deny licensure under
subdivision (d) or (e), shall determine whether the applicant is
rehabilitated after considering all of the following criteria:
(1) The nature and severity of the act or crime.
(2) The time that has elapsed since the commission of the act or
crime.
(3) The commission by the applicant of other acts or crimes
constituting grounds for denial of the license under this section.
(4) The extent to which the applicant has complied with terms of
restitution, probation, parole, or any other sanction or order
lawfully imposed against the applicant.
(5) Other evidence of rehabilitation submitted by the applicant.
(g) With respect to any other license issued to an applicant to
provide narcotic treatment services, violated any provision of this
article or regulations adopted under this article that relate to the
health and safety of patients, the local community, or the general
public. Violations include, but are not limited to, violations of
laws and regulations applicable to take-home doses of methadone,
urinalysis requirements, and security against redistribution of
replacement narcotic drugs. In these cases, the department shall deny
the application for an initial license unless the department
determines that all other licensed narcotic treatment programs
maintained by the applicant have corrected all deficiencies and
maintained compliance for a minimum of six months.
11839.9. (a) The director shall suspend or revoke any license
issued under this article, or deny an application to renew a license
or to modify the terms and conditions of a license, upon any
violation by the licensee of this article or regulations adopted
under this article that presents an imminent danger of death or
severe harm to any participant of the program or a member of the
general public.
(b) The director may suspend or revoke any license issued under
this article, or deny an application to renew a license or to modify
the terms and conditions of a license, upon any of the following
grounds and in the manner provided in this article:
(1) Violation by the licensee of any laws or regulations of the
Substance Abuse and Mental Health Services Administration or the
United States Department of Justice, Drug Enforcement Administration,
that are applicable to narcotic treatment programs.
(2) Any violation that relates to the operation or maintenance of
the program that has an immediate relationship to the physical
health, mental health, or safety of the program participants or
general public.
(3) Aiding, abetting, or permitting the violation of, or any
repeated violation of, any of the provisions set forth in subdivision
(a) or in paragraph (1) or (2).
(4) Conduct in the operation of a narcotic treatment program that
is inimical to the health, welfare, or safety of an individual in, or
receiving services from, the program, the local community, or the
people of the State of California.
(5) The conviction of the licensee or any partner, officer,
director, 10 percent or greater shareholder, or person employed under
the authority of subdivision (c) of Section 2401 of the Business and
Professions Code at any time during licensure, of a crime
substantially related to the qualifications, functions, or duties of,
or relating to, a narcotic treatment program licensee.
(6) The commission by the licensee or any partner, officer,
director, 10 percent or greater shareholder, or person employed under
the authority of subdivision (c) of Section 2401 of the Business and
Professions Code at any time during licensure, of any act involving
fraud, dishonesty, or deceit, with the intent to substantially
benefit himself or herself or another, or substantially to injure
another, and that act is substantially related to the qualifications,
functions, or duties of, or relating to, a narcotic treatment
program licensee.
(7) Diversion of narcotic drugs. A program's failure to maintain a
narcotic drug reconciliation system that accounts for all incoming
and outgoing narcotic drugs, as required by departmental or federal
regulations, shall create a rebuttable presumption that narcotic
drugs are being diverted.
(8) Misrepresentation of any material fact in obtaining the
narcotic treatment program license.
(9) Failure to comply with a department order to cease admitting
patients or to cease providing patients with take-home dosages of
replacement narcotic drugs.
(10) Failure to pay any civil penalty assessed pursuant to
paragraph (3) of subdivision (a) of Section 11839.16 where the
penalty has become final, unless payment arrangements acceptable to
the department have been made.
(11) The suspension or exclusion of the licensee or any partner,
officer, director, 10 percent or greater shareholder, or person
employed under the authority of subdivision (c) of Section 2401 of
the Business and Professions Code from the Medicare, medicaid, or
Medi-Cal programs.
(c) Prior to issuing an order pursuant to this section, the
director shall ensure continuity of patient care by the program's
guarantor or through the transfer of patients to other licensed
programs. The director may issue any needed license or amend any
other license in an effort to ensure that patient care is not
impacted adversely by an order issued pursuant to this section.
11839.10. (a) The department shall cease review of an application
for a license if either of the following occur:
(1) An application for a license indicates, or the department
determines during the application inspection process, that the
applicant was issued a license under this article and the prior
license was revoked within the preceding two years. The department
shall cease any further review of the application until two years
have elapsed from the date of the revocation.
(2) An application for a license indicates, or the department
determines during the application inspection process, that the
applicant was denied a license or had a license suspended under this
article within the preceding year. The department shall cease any
further review of the application until one year has elapsed from the
date of the denial or suspension.
(b) The department may cease review of an application for license
renewal if either of the following occur:
(1) The applicant has not paid the required license fee.
(2) The county in which the licensee is located certifies to the
department's satisfaction that there is no need for the narcotic
treatment program because of a substantial decline in medically
qualified narcotic treatment patients in the licensee's catchment
area, or clearly demonstrates that other applicants for licensure can
provide more efficient, cost-effective, and sufficient narcotic
treatment services in the catchment area, or that the license should
not be renewed due to one of the grounds that are enumerated in
Section 11839.9.
(c) Upon cessation of review, the license shall be permitted to
expire by its own terms. However, if the licensee subsequently
submits the items, the absence of which led to the cessation of
review, the department may reinstate the license.
(d) Cessation of review shall not constitute a denial of the
application for purposes of Sections 11839.8 and 11839.9.
11839.11. A narcotic treatment program license shall automatically
terminate if the Substance Abuse and Mental Health Services
Administration withdraws or revokes its approval of the program, or
if the United States Department of Justice, Drug Enforcement
Administration, revokes the program's registration.
11839.12. Except as provided in Section 11839.16, proceedings for
the suspension, revocation, or denial of a license or cessation of
review of a renewal license under this article, except where there
has been a failure to pay required fees, under this article shall be
conducted in accordance with Chapter 5 (commencing with Section
11500) of Part 1 of Division 3 of Title 2 of the Government Code and
the department shall have all the powers granted thereby. In the
event of conflict between this article and the Administrative
Procedure Act, the Administrative Procedure Act shall prevail.
11839.13. (a) The withdrawal of an application for a license after
it has been filed with the department shall not, unless the
department consents in writing to the withdrawal, deprive the
department of its authority to institute or continue a proceeding
against the applicant for the denial of the license upon any ground
provided by law or to enter an order denying the license upon any
ground provided by law.
(b) The suspension, expiration, or forfeiture by operation of law
of a license issued by the department, or its suspension, forfeiture,
or cancellation by order of the department or by order of a court of
law, or its surrender without the written consent of the department,
shall not deprive the department of its authority to institute or
continue a disciplinary proceeding against the licensee upon any
ground provided by law or to enter an order suspending or revoking
the license or otherwise taking disciplinary action against the
licensee upon any ground provided by law.
11839.14. For purposes of this article, a conviction means a plea
or verdict of guilty or a conviction following a plea of nolo
contendere. Any action that the department is permitted to take
following the establishment of a conviction may be taken when the
time for appeal has elapsed, or the judgment of conviction has been
affirmed on appeal or when an order granting probation is made
suspending the imposition of sentence, notwithstanding a subsequent
order pursuant to Section 1203.4 or 1203.4a of the Penal Code
permitting the person to withdraw his or her plea of guilty and to
enter a plea of not guilty, or setting aside the verdict of guilty,
or dismissing the accusation, information, or indictment. For
purposes of this article, the record of conviction, or a certified
copy thereof, shall be conclusive evidence of the conviction.
11839.15. The director may bring an action to enjoin the violation
of Section 11839.7, or the violation of a departmental order issued
pursuant to Section 11839.16, in the superior court in and for the
county in which the violation occurred. Any proceeding under this
section shall conform to the requirements of Chapter 3 (commencing
with Section 525) of Title 7 of Part 2 of the Code of Civil
Procedure. The rebuttable presumption set forth in paragraph (7) of
subdivision (b) of Section 11839.9 shall be applicable. If the court
finds the allegations to be true, it shall issue its order enjoining
the narcotic treatment program from continuance of the violation.
11839.16. (a) (1) The director shall, in addition to any other
remedy, issue an order that prohibits a narcotic treatment program
from admitting new patients or from providing patients with take-home
dosages of a narcotic drug if the director determines, pursuant to
the compliance inspection procedures set out in paragraph (2) of
subdivision (a) of Section 11839.3, that a program has done any of
the following:
(A) Failed to provide adequate security measures over its narcotic
drug supply as agreed in the program's approved protocol.
(B) Failed to maintain a narcotic drug reconciliation system that
accounts for all incoming and outgoing narcotic drugs.
(C) Diverted narcotic drugs.
(D) Repeatedly violated one or more departmental or federal
regulations governing narcotic treatment programs, which violations
may subject, or may have subjected, a patient to a health or
life-endangering situation.
(E) Repeatedly violated one or more departmental or federal
regulations governing the provisions of take-home medication.
(F) Operated above combined licensed capacity for maintenance and
detoxification programs at a single location.
(2) (A) The order becomes effective when the department serves the
program with a copy of the order. The order shall state the
deficiencies forming the basis for the order and shall state the
corrective action required for the department to vacate the order.
The order, as it pertains to subparagraph (F) only, shall
automatically be vacated when the department receives the program's
written notification that licensed capacity has been achieved. If the
order is issued pursuant to subparagraph (A), (B), (C), (D), or (E),
the department shall vacate the order when the program submits a
corrective action plan that reasonably addresses the deficiency or
substantially conforms to the required action set out in the order.
(B) The department shall notify the program that the corrective
action plan is accepted or rejected within 10 working days after
receipt of the plan. If the department rejects the corrective action
plan, it shall detail its reason in writing. The department order is
vacated when the department either accepts a corrective action plan
and ensures substantial conformity with the required action set out
in the order or fails to reject a plan within 10 working days after
receipt of the plan.
(3) In addition to any other remedies, a failure of the program to
comply with the order of the department under this subdivision shall
give rise to a civil penalty of five hundred dollars ($500) a day
for each day that the order is violated.
(4) All civil penalties collected by the department under
paragraph (3) shall be deposited in the Narcotic Treatment Program
Licensing Trust Fund, and shall be used to offset the department's
costs associated with collecting the civil penalties, or associated
with any civil, administrative, or criminal action against the
program when appropriated for this purpose.
(b) (1) The director may, in addition to any other remedy, issue
an order temporarily suspending a narcotic treatment program license
prior to any administrative hearing for the reasons stated in
subparagraphs (A) to (E), inclusive, of paragraph (1) of subdivision
(a) when the department determines pursuant to the compliance
inspection procedures set out in paragraph (2) of subdivision (a) of
Section 11839.3, that the action is necessary to protect patients of
the program from any substantial threat to their health or safety, or
to protect the health or safety of the local community or the people
of the State of California. Prior to issuing the order, the director
shall ensure continuity of patient care by the program's guarantor
or through the transfer of patients to other licensed programs. The
director may issue any needed license or amend any other license in
his or her effort to assure that patient care is not impacted
adversely by the suspension order.
(2) The director shall notify the licensee of the temporary
suspension and the effective date thereof and at the same time shall
serve the licensee with an accusation. Upon receipt of a notice of
defense to the accusation by the licensee, the director shall, within
15 days, set the matter for hearing, and the hearing shall be held
as soon as possible, but not later than 20 days, exclusive of
weekends, after receipt of the notice. The temporary suspension shall
remain in effect until the hearing is completed and the director has
made a final determination on the merits. However, the temporary
suspension shall be deemed vacated if the director fails to make a
final determination on the merits within 20 days after the original
hearing has been completed. Failure to cease operating after the
department issues an order temporarily suspending the license shall
constitute an additional ground for license revocation and shall
constitute a violation of Section 11839.8. The department shall
suspend the program's license if the hearing outcome is adverse to
the license. The department shall notify the program of the license
suspension within five days of the director's final decision.
(c) A program may, at any time after it is served with an order,
petition the superior court to review the department's issuance of an
order or rejection of a corrective action plan.
11839.17. (a) In cases where a program is closing and the licensed
entity that has agreed to assume temporary operation of the closing
program is unable to do so, the department may assume temporary
operation of the closing program or designate another licensed entity
willing to do so. In cases where the licensed entity that has agreed
to assume temporary operation is the subject of a pending licensing
action or order issued pursuant to Section 11839.16, the department
may issue an order prohibiting the entity from assuming temporary
operation and may assume temporary operation of the closing program
or designate another licensed entity willing to do so. This section
shall not be construed to require the department or any other
licensed entity to assume any of the closing programs' financial
obligations.
(b) For purposes of this section, "temporary" means no more than
90 days.
11839.18. Any licensee may petition the director for waiver of
licensure fees or late payment penalties for the current fiscal year
based upon financial hardship. Prior to the granting of relief, the
licensee shall demonstrate hardship by production of appropriate
financial records. The director may, in his or her discretion, grant
all or part of the relief sought, but shall consider the
reasonableness of the relief in light of the other expenditures
undertaken by the licensee, giving particular scrutiny to the
licensee's own profits, earnings, or other compensation, and expenses
such as interest, mortgage, or loan payments, as well as noncash
expenses such as accruals and depreciation.
11839.19. (a) The department shall not license the establishment of
a narcotic treatment program without a written application by the
treatment facility that meets evaluative criteria required by the
department.
(b) The department shall not require disclosure of the identity of
patients or former patients or of any records containing identifying
information except as provided in Section 11845.5.
11839.20. (a) It is the intent of the Legislature in licensing
narcotic treatment programs to provide a means whereby the patient
may be rehabilitated and will no longer need to support a dependency
on opiates.
(b) It is the intent of the Legislature that each narcotic
treatment program shall have a strong rehabilitative element,
including, but not limited to, individual and group therapy,
counseling, vocational guidance, and job and education counseling.
(c) The Legislature declares the ultimate goal of all narcotic
treatment programs shall be to aid the patient in altering his or her
lifestyle and eventually to eliminate the improper use of legal
drugs and the use of illicit drugs.
(d) The department shall adopt any regulations necessary to ensure
that every program is making a sustained effort to end the drug
dependency of the patients.
11839.21. The State Department of Health Services shall establish
criteria for acceptable performance from those laboratories
performing urinalysis or other body fluid analysis and shall not
permit utilization of laboratories unable to meet an acceptable level
of performance. The results of any performance evaluation of any
laboratory shall immediately be made available to the local programs
upon request. Nothing in this section shall prohibit body fluid
analysis to be performed by a licensed narcotic treatment program
upon approval of the State Department of Health Services.
11839.22. The state department shall require a system to detect
multiple registration by narcotic clients.
11839. The department, with the approval of the Secretary of the
Health and Human Services Agency, may contract with any public or
private agency for the performance of any of the functions vested in
the department by this chapter. Any department of the state is
authorized to enter into such a contract.
11839.1. The Legislature finds and declares that it is in the best
interests of the health and welfare of the people of this state to
coordinate narcotic treatment programs to use replacement narcotic
therapy in the treatment of addicted persons whose addiction was
acquired or supported by the use of a narcotic drug or drugs, not in
compliance with a physician and surgeon's legal prescription, and to
establish and enforce minimum requirements for the operation of all
narcotic treatment programs in this state.
11839.2. The following controlled substances are authorized for use
in replacement narcotic therapy by licensed narcotic treatment
programs:
(a) Methadone.
(b) Levoalphacetylmethadol (LAAM) as specified in paragraph (10)
of subdivision (c) of Section 11055.
11839.3. (a) In addition to the duties authorized by other
statutes, the department shall perform all of the following:
(1) License the establishment of narcotic treatment programs in
this state to use replacement narcotic therapy in the treatment of
addicted persons whose addiction was acquired or supported by the use
of a narcotic drug or drugs, not in compliance with a physician and
surgeon's legal prescription, except that the Research Advisory Panel
shall have authority to approve methadone or LAAM research programs.
The department shall establish and enforce the criteria for the
eligibility of patients to be included in the programs, program
operation guidelines, such as dosage levels, recordkeeping and
reporting, urinalysis requirements, take-home doses of methadone,
security against redistribution of the replacement narcotic drugs,
and any other regulations that are necessary to protect the safety
and well-being of the patient, the local community, and the public,
and to carry out this chapter. A program may admit a patient to
narcotic maintenance or narcotic detoxification treatment seven days
after completion of a prior withdrawal treatment episode. The arrest
and conviction records and the records of pending charges against any
person seeking admission to a narcotic treatment program shall be
furnished to narcotic treatment program directors upon written
request of the narcotic treatment program director provided the
request is accompanied by a signed release from the person whose
records are being requested.
(2) Inspect narcotic treatment programs in this state and ensure
that programs are operating in accordance with the law and
regulations. The department shall have sole responsibility for
compliance inspections of all programs in each county. Annual
compliance inspections shall consist of an evaluation by onsite
review of the operations and records of licensed narcotic treatment
programs' compliance with applicable state and federal laws and
regulations and the evaluation of input from local law enforcement
and local governments, regarding concerns about the narcotic
treatment program. At the conclusion of each inspection visit, the
department shall conduct an exit conference to explain the cited
deficiencies to the program staff and to provide recommendations to
ensure compliance with applicable laws and regulations. The
department shall provide an inspection report to the licensee within
30 days of the completed onsite review describing the program
deficiencies. A corrective action plan shall be required from the
program within 30 days of receipt of the inspection report. All
corrective actions contained in the plan shall be implemented within
30 days of receipt of approval by the department of the corrective
action plan submitted by the narcotic treatment program. For programs
found not to be in compliance, a subsequent inspection of the
program shall be conducted within 30 days after the receipt of the
corrective action plan in order to ensure that corrective action has
been implemented satisfactorily. Subsequent inspections of the
program shall be conducted to determine and ensure that the
corrective action has been implemented satisfactorily. For purposes
of this requirement, "compliance" shall mean to have not committed
any of the grounds for suspension or revocation of a license provided
for under subdivision (a) of Section 11839.9 or paragraph (2) of
subdivision (b) of Section 11839.9. Inspection of narcotic treatment
programs shall be based on objective criteria including, but not
limited to, an evaluation of the programs' adherence to all
applicable laws and regulations and input from local law enforcement
and local governments. Nothing in this section shall preclude
counties from monitoring their contract providers for compliance with
contract requirements.
(3) Charge and collect licensure fees. In calculating the
licensure fees, the department shall include staff salaries and
benefits, related travel costs, and state operational and
administrative costs. Fees shall be used to offset licensure and
inspection costs not to exceed actual costs.
(4) Study and evaluate, on an ongoing basis, narcotic treatment
programs including, but not limited to, the adherence of the programs
to all applicable laws and regulations and the impact of the
programs on the communities in which they are located.
(5) Provide advice, consultation, and technical assistance to
narcotic treatment programs to ensure that the programs comply with
all applicable laws and regulations and to minimize any negative
impact that the programs may have on the communities in which they
are located.
(6) In its discretion, to approve local agencies or bodies to
assist it in carrying out this chapter provided that the department
may not delegate responsibility for inspection or any other licensure
activity without prior and specific statutory approval. However, the
department shall evaluate recommendations made by county alcohol and
drug program administrators regarding licensing activity in their
respective counties.
(7) The director may grant exceptions to the regulations adopted
under this chapter if he or she determines that this action would
improve treatment services or achieve greater protection to the
health and safety of patients, the local community, or the general
public. No exception may be granted if it is contrary to, or less
stringent than, the federal laws and regulations which govern
narcotic treatment programs.
(b) It is the intent of the Legislature in enacting this section
in order to protect the general public and local communities, that
self-administered dosage shall only be provided when the patient is
clearly adhering to the requirements of the program, and where daily
attendance at a clinic would be incompatible with gainful employment,
education, and responsible homemaking. The department shall define
"satisfactory adherence" and shall ensure that patients not
satisfactorily adhering to their programs shall not be provided
take-home dosage.
(c) There is established in the State Treasury the Narcotic
Treatment Program Licensing Trust Fund. All licensure fees collected
from the providers of narcotic treatment service shall be deposited
in this fund. Except as otherwise provided in this section, if funds
remain in this fund after appropriation by the Legislature and
allocation for the costs associated with narcotic treatment licensure
actions and inspection of narcotic treatment programs, a percentage
of the excess funds shall be annually rebated to the licensees based
on the percentage their licensing fee is of the total amount of fees
collected by the department. A reserve equal to 10 percent of the
total licensure fees collected during the preceding fiscal year may
be held in each trust account to reimburse the department if the
actual cost for the licensure and inspection exceed fees collected
during a fiscal year.
(d) Notwithstanding any provision of this code or regulations to
the contrary, the department shall have sole responsibility and
authority for determining if a state narcotic treatment program
license shall be granted and for administratively establishing the
maximum treatment capacity of any license. However, the department
shall not increase the capacity of a program unless it determines
that the licensee is operating in full compliance with applicable
laws and regulations.
11839.4. The department shall impose a civil penalty of one hundred
dollars ($100) per day for a program that fails to timely submit a
corrective action plan, or to timely implement any corrective action
when it has been found to not be in compliance with applicable laws
and regulations as required in Section 11839.3.
11839.5. In addition to the duties authorized by other provisions,
the department shall be responsible for licensing narcotic treatment
programs to use replacement narcotic therapy in the treatment of
addicted persons whose addiction was acquired or supported by the use
of a narcotic drug or drugs, not in compliance with a physician and
surgeon's legal prescription. No narcotic treatment program shall be
authorized to use replacement narcotic therapy without first
obtaining a license therefor as provided in this chapter. The
department may license narcotic treatment programs on an inpatient or
outpatient basis, or both. The department may also grant a state
narcotic treatment license.
11839.6. (a) The department shall establish a program for the
operation and regulation of office-based narcotic treatment programs.
An office-based narcotic treatment program established pursuant to
this section shall meet either of the following conditions:
(1) Hold a primary narcotic treatment program license.
(2) Be affiliated and associated with a primary licensed narcotic
treatment program. An office-based narcotic treatment program meeting
the requirement of this paragraph shall not be required to have a
license separate from the primary licensed narcotic treatment program
with which it is affiliated and associated.
(b) For purposes of this section, "office-based narcotic treatment
program" means a program in which interested and knowledgeable
physicians and surgeons provide addiction treatment services, and in
which community pharmacies supply necessary medication both to these
physicians and surgeons for distribution to patients and through
direct administration and specified dispensing services.
(c) Notwithstanding any other provision of law or regulation,
including Section 10020 of Title 9 of the California Code of
Regulations, an office-based narcotic treatment program in a remote
site that is affiliated and associated with a licensed narcotic
treatment program may be approved by the department, if all of the
following conditions are met:
(1) A physician may provide office-based addiction services only
if each office-based patient is registered as a patient in the
licensed narcotic treatment program and both the licensed narcotic
treatment program and the office-based narcotic treatment program
ensure that all services required under Chapter 4 (commencing with
Section 10000) of Division 4 of Title 9 of the California Code of
Regulations for the management of narcotic addiction are provided to
all patients treated in the remote site.
(2) A physician in an office-based narcotic treatment program may
provide treatment for a maximum of 20 patients under the appropriate
United States Drug Enforcement Administration registration. The
primary licensed narcotic treatment program shall be limited to its
total licensed capacity as established by the department, including
the patients of physicians in the office-based narcotic treatment
program.
(3) The physicians in the office-based narcotic treatment program
shall dispense or administer pharmacologic treatment for narcotic
addiction that has been approved by the federal Food and Drug
Administration such as levoalphacetylmethadol (LAAM) or methadone.
(4) Office-based narcotic treatment programs, in conjunction with
primary licensed narcotic treatment programs, shall develop protocols
to prevent the diversion of methadone. The department may develop
regulations to prevent the diversion of methadone.
(d) For purposes of this section, "remote site" means a site that
is geographically or physically isolated from any licensed narcotic
treatment program. Therefore, the requirements in this subdivision
regarding a remote site do not apply to an office-based narcotic
treatment program that holds a primary narcotic treatment program
license.
(e) In considering an office-based narcotic treatment program
application, the department shall independently weigh the treatment
needs and concerns of the county, city, or areas to be served by the
program.
(f) Nothing in this section is intended to expand the scope of the
practice of pharmacy.
11839.7. (a) (1) Each narcotic treatment program authorized to use
replacement narcotic therapy in this state, except narcotic treatment
research programs approved by the Research Advisory Panel, shall be
licensed by the department.
(2) Each narcotic treatment program, other than a program owned
and operated by the state, county, city, or city and county, shall,
upon application for licensure and for renewal of a license, pay an
annual license fee to the department. July 1 shall be the annual
license renewal date.
(3) The department shall set the licensing fee at a level
sufficient to cover all departmental costs associated with licensing
incurred by the department, but the fee shall not, except as
specified in this section, increase at a rate greater than the
Consumer Price Index. The fees shall include the department's share
of pro rata charges for the expenses of state government. The fee may
be paid quarterly in arrears as determined by the department. Fees
paid quarterly in arrears shall be due and payable on the last day of
each quarter except for the fourth quarter for which payment shall
be due and payable no later than May 31. A failure of a program to
pay renewal license fees by the due date shall give rise to a civil
penalty of one hundred dollars ($100) a day for each day after the
due date. Second and subsequent inspection visits to narcotic
treatment programs that are operating in noncompliance with the
applicable laws and regulations shall be charged a rate of one-half
the program's annual license fee or one thousand dollars ($1,000),
whichever is less, for each visit.
(4) Licensing shall be contingent upon determination by the
department that the program is in compliance with applicable laws and
regulations and upon payment of the licensing fee. A license shall
not be transferable.
(5) (A) As used in this chapter, "quarter" means July, August, and
September; October, November, and December; January, February, and
March; and April, May, and June.
(B) As used in this chapter, "license" means a basic permit to
operate a narcotic treatment program. The license shall be issued
exclusively by the department and operated in accordance with a
patient capacity that shall be specified, approved, and monitored
solely by the department.
(b) Each narcotic treatment program, other than a program owned
and operated by the state, county, city, or city and county, shall be
charged an application fee that shall be at a level sufficient to
cover all departmental costs incurred by the department in processing
either an application for a new program license, or an application
for an existing program that has moved to a new location.
(c) Any licensee that increases fees to the patient, in response
to increases in licensure fees required by the department, shall
first provide written disclosure to the patient of that amount of the
patient fee increase that is attributable to the increase in the
licensure fee. This provision shall not be construed to limit patient
fee increases imposed by the licensee upon any other basis.
11839.8. The director may deny the application for initial issuance
of a license if the applicant or any partner, officer, director, 10
percent or greater shareholder, or person proposed to be employed by
the applicant under the authority of subdivision (c) of Section 2401
of the Business and Professions Code:
(a) Fails to meet the qualifications for licensure established by
the department pursuant to this article. However, the director may
waive any established qualification for licensure of a narcotic
treatment program if he or she determines that it is reasonably
necessary in the interests of the public health and welfare.
(b) Was previously the holder of a license issued under this
article, and the license was revoked and never reissued or was
suspended and not reinstated, or the holder failed to adhere to
applicable laws and regulations regarding narcotic treatment programs
while the license was in effect.
(c) Misrepresented any material fact in the application.
(d) Committed any act involving fraud, dishonesty, or deceit, with
the intent to substantially benefit himself or herself or another or
substantially injure another, and the act is substantially related
to the qualification, functions, or duties of, or relating to, a
narcotic treatment program license.
(e) Was convicted of any crime substantially related to the
qualifications, functions, or duties of, or relating to, a narcotic
treatment program license.
(f) The director, in considering whether to deny licensure under
subdivision (d) or (e), shall determine whether the applicant is
rehabilitated after considering all of the following criteria:
(1) The nature and severity of the act or crime.
(2) The time that has elapsed since the commission of the act or
crime.
(3) The commission by the applicant of other acts or crimes
constituting grounds for denial of the license under this section.
(4) The extent to which the applicant has complied with terms of
restitution, probation, parole, or any other sanction or order
lawfully imposed against the applicant.
(5) Other evidence of rehabilitation submitted by the applicant.
(g) With respect to any other license issued to an applicant to
provide narcotic treatment services, violated any provision of this
article or regulations adopted under this article that relate to the
health and safety of patients, the local community, or the general
public. Violations include, but are not limited to, violations of
laws and regulations applicable to take-home doses of methadone,
urinalysis requirements, and security against redistribution of
replacement narcotic drugs. In these cases, the department shall deny
the application for an initial license unless the department
determines that all other licensed narcotic treatment programs
maintained by the applicant have corrected all deficiencies and
maintained compliance for a minimum of six months.
11839.9. (a) The director shall suspend or revoke any license
issued under this article, or deny an application to renew a license
or to modify the terms and conditions of a license, upon any
violation by the licensee of this article or regulations adopted
under this article that presents an imminent danger of death or
severe harm to any participant of the program or a member of the
general public.
(b) The director may suspend or revoke any license issued under
this article, or deny an application to renew a license or to modify
the terms and conditions of a license, upon any of the following
grounds and in the manner provided in this article:
(1) Violation by the licensee of any laws or regulations of the
Substance Abuse and Mental Health Services Administration or the
United States Department of Justice, Drug Enforcement Administration,
that are applicable to narcotic treatment programs.
(2) Any violation that relates to the operation or maintenance of
the program that has an immediate relationship to the physical
health, mental health, or safety of the program participants or
general public.
(3) Aiding, abetting, or permitting the violation of, or any
repeated violation of, any of the provisions set forth in subdivision
(a) or in paragraph (1) or (2).
(4) Conduct in the operation of a narcotic treatment program that
is inimical to the health, welfare, or safety of an individual in, or
receiving services from, the program, the local community, or the
people of the State of California.
(5) The conviction of the licensee or any partner, officer,
director, 10 percent or greater shareholder, or person employed under
the authority of subdivision (c) of Section 2401 of the Business and
Professions Code at any time during licensure, of a crime
substantially related to the qualifications, functions, or duties of,
or relating to, a narcotic treatment program licensee.
(6) The commission by the licensee or any partner, officer,
director, 10 percent or greater shareholder, or person employed under
the authority of subdivision (c) of Section 2401 of the Business and
Professions Code at any time during licensure, of any act involving
fraud, dishonesty, or deceit, with the intent to substantially
benefit himself or herself or another, or substantially to injure
another, and that act is substantially related to the qualifications,
functions, or duties of, or relating to, a narcotic treatment
program licensee.
(7) Diversion of narcotic drugs. A program's failure to maintain a
narcotic drug reconciliation system that accounts for all incoming
and outgoing narcotic drugs, as required by departmental or federal
regulations, shall create a rebuttable presumption that narcotic
drugs are being diverted.
(8) Misrepresentation of any material fact in obtaining the
narcotic treatment program license.
(9) Failure to comply with a department order to cease admitting
patients or to cease providing patients with take-home dosages of
replacement narcotic drugs.
(10) Failure to pay any civil penalty assessed pursuant to
paragraph (3) of subdivision (a) of Section 11839.16 where the
penalty has become final, unless payment arrangements acceptable to
the department have been made.
(11) The suspension or exclusion of the licensee or any partner,
officer, director, 10 percent or greater shareholder, or person
employed under the authority of subdivision (c) of Section 2401 of
the Business and Professions Code from the Medicare, medicaid, or
Medi-Cal programs.
(c) Prior to issuing an order pursuant to this section, the
director shall ensure continuity of patient care by the program's
guarantor or through the transfer of patients to other licensed
programs. The director may issue any needed license or amend any
other license in an effort to ensure that patient care is not
impacted adversely by an order issued pursuant to this section.
11839.10. (a) The department shall cease review of an application
for a license if either of the following occur:
(1) An application for a license indicates, or the department
determines during the application inspection process, that the
applicant was issued a license under this article and the prior
license was revoked within the preceding two years. The department
shall cease any further review of the application until two years
have elapsed from the date of the revocation.
(2) An application for a license indicates, or the department
determines during the application inspection process, that the
applicant was denied a license or had a license suspended under this
article within the preceding year. The department shall cease any
further review of the application until one year has elapsed from the
date of the denial or suspension.
(b) The department may cease review of an application for license
renewal if either of the following occur:
(1) The applicant has not paid the required license fee.
(2) The county in which the licensee is located certifies to the
department's satisfaction that there is no need for the narcotic
treatment program because of a substantial decline in medically
qualified narcotic treatment patients in the licensee's catchment
area, or clearly demonstrates that other applicants for licensure can
provide more efficient, cost-effective, and sufficient narcotic
treatment services in the catchment area, or that the license should
not be renewed due to one of the grounds that are enumerated in
Section 11839.9.
(c) Upon cessation of review, the license shall be permitted to
expire by its own terms. However, if the licensee subsequently
submits the items, the absence of which led to the cessation of
review, the department may reinstate the license.
(d) Cessation of review shall not constitute a denial of the
application for purposes of Sections 11839.8 and 11839.9.
11839.11. A narcotic treatment program license shall automatically
terminate if the Substance Abuse and Mental Health Services
Administration withdraws or revokes its approval of the program, or
if the United States Department of Justice, Drug Enforcement
Administration, revokes the program's registration.
11839.12. Except as provided in Section 11839.16, proceedings for
the suspension, revocation, or denial of a license or cessation of
review of a renewal license under this article, except where there
has been a failure to pay required fees, under this article shall be
conducted in accordance with Chapter 5 (commencing with Section
11500) of Part 1 of Division 3 of Title 2 of the Government Code and
the department shall have all the powers granted thereby. In the
event of conflict between this article and the Administrative
Procedure Act, the Administrative Procedure Act shall prevail.
11839.13. (a) The withdrawal of an application for a license after
it has been filed with the department shall not, unless the
department consents in writing to the withdrawal, deprive the
department of its authority to institute or continue a proceeding
against the applicant for the denial of the license upon any ground
provided by law or to enter an order denying the license upon any
ground provided by law.
(b) The suspension, expiration, or forfeiture by operation of law
of a license issued by the department, or its suspension, forfeiture,
or cancellation by order of the department or by order of a court of
law, or its surrender without the written consent of the department,
shall not deprive the department of its authority to institute or
continue a disciplinary proceeding against the licensee upon any
ground provided by law or to enter an order suspending or revoking
the license or otherwise taking disciplinary action against the
licensee upon any ground provided by law.
11839.14. For purposes of this article, a conviction means a plea
or verdict of guilty or a conviction following a plea of nolo
contendere. Any action that the department is permitted to take
following the establishment of a conviction may be taken when the
time for appeal has elapsed, or the judgment of conviction has been
affirmed on appeal or when an order granting probation is made
suspending the imposition of sentence, notwithstanding a subsequent
order pursuant to Section 1203.4 or 1203.4a of the Penal Code
permitting the person to withdraw his or her plea of guilty and to
enter a plea of not guilty, or setting aside the verdict of guilty,
or dismissing the accusation, information, or indictment. For
purposes of this article, the record of conviction, or a certified
copy thereof, shall be conclusive evidence of the conviction.
11839.15. The director may bring an action to enjoin the violation
of Section 11839.7, or the violation of a departmental order issued
pursuant to Section 11839.16, in the superior court in and for the
county in which the violation occurred. Any proceeding under this
section shall conform to the requirements of Chapter 3 (commencing
with Section 525) of Title 7 of Part 2 of the Code of Civil
Procedure. The rebuttable presumption set forth in paragraph (7) of
subdivision (b) of Section 11839.9 shall be applicable. If the court
finds the allegations to be true, it shall issue its order enjoining
the narcotic treatment program from continuance of the violation.
11839.16. (a) (1) The director shall, in addition to any other
remedy, issue an order that prohibits a narcotic treatment program
from admitting new patients or from providing patients with take-home
dosages of a narcotic drug if the director determines, pursuant to
the compliance inspection procedures set out in paragraph (2) of
subdivision (a) of Section 11839.3, that a program has done any of
the following:
(A) Failed to provide adequate security measures over its narcotic
drug supply as agreed in the program's approved protocol.
(B) Failed to maintain a narcotic drug reconciliation system that
accounts for all incoming and outgoing narcotic drugs.
(C) Diverted narcotic drugs.
(D) Repeatedly violated one or more departmental or federal
regulations governing narcotic treatment programs, which violations
may subject, or may have subjected, a patient to a health or
life-endangering situation.
(E) Repeatedly violated one or more departmental or federal
regulations governing the provisions of take-home medication.
(F) Operated above combined licensed capacity for maintenance and
detoxification programs at a single location.
(2) (A) The order becomes effective when the department serves the
program with a copy of the order. The order shall state the
deficiencies forming the basis for the order and shall state the
corrective action required for the department to vacate the order.
The order, as it pertains to subparagraph (F) only, shall
automatically be vacated when the department receives the program's
written notification that licensed capacity has been achieved. If the
order is issued pursuant to subparagraph (A), (B), (C), (D), or (E),
the department shall vacate the order when the program submits a
corrective action plan that reasonably addresses the deficiency or
substantially conforms to the required action set out in the order.
(B) The department shall notify the program that the corrective
action plan is accepted or rejected within 10 working days after
receipt of the plan. If the department rejects the corrective action
plan, it shall detail its reason in writing. The department order is
vacated when the department either accepts a corrective action plan
and ensures substantial conformity with the required action set out
in the order or fails to reject a plan within 10 working days after
receipt of the plan.
(3) In addition to any other remedies, a failure of the program to
comply with the order of the department under this subdivision shall
give rise to a civil penalty of five hundred dollars ($500) a day
for each day that the order is violated.
(4) All civil penalties collected by the department under
paragraph (3) shall be deposited in the Narcotic Treatment Program
Licensing Trust Fund, and shall be used to offset the department's
costs associated with collecting the civil penalties, or associated
with any civil, administrative, or criminal action against the
program when appropriated for this purpose.
(b) (1) The director may, in addition to any other remedy, issue
an order temporarily suspending a narcotic treatment program license
prior to any administrative hearing for the reasons stated in
subparagraphs (A) to (E), inclusive, of paragraph (1) of subdivision
(a) when the department determines pursuant to the compliance
inspection procedures set out in paragraph (2) of subdivision (a) of
Section 11839.3, that the action is necessary to protect patients of
the program from any substantial threat to their health or safety, or
to protect the health or safety of the local community or the people
of the State of California. Prior to issuing the order, the director
shall ensure continuity of patient care by the program's guarantor
or through the transfer of patients to other licensed programs. The
director may issue any needed license or amend any other license in
his or her effort to assure that patient care is not impacted
adversely by the suspension order.
(2) The director shall notify the licensee of the temporary
suspension and the effective date thereof and at the same time shall
serve the licensee with an accusation. Upon receipt of a notice of
defense to the accusation by the licensee, the director shall, within
15 days, set the matter for hearing, and the hearing shall be held
as soon as possible, but not later than 20 days, exclusive of
weekends, after receipt of the notice. The temporary suspension shall
remain in effect until the hearing is completed and the director has
made a final determination on the merits. However, the temporary
suspension shall be deemed vacated if the director fails to make a
final determination on the merits within 20 days after the original
hearing has been completed. Failure to cease operating after the
department issues an order temporarily suspending the license shall
constitute an additional ground for license revocation and shall
constitute a violation of Section 11839.8. The department shall
suspend the program's license if the hearing outcome is adverse to
the license. The department shall notify the program of the license
suspension within five days of the director's final decision.
(c) A program may, at any time after it is served with an order,
petition the superior court to review the department's issuance of an
order or rejection of a corrective action plan.
11839.17. (a) In cases where a program is closing and the licensed
entity that has agreed to assume temporary operation of the closing
program is unable to do so, the department may assume temporary
operation of the closing program or designate another licensed entity
willing to do so. In cases where the licensed entity that has agreed
to assume temporary operation is the subject of a pending licensing
action or order issued pursuant to Section 11839.16, the department
may issue an order prohibiting the entity from assuming temporary
operation and may assume temporary operation of the closing program
or designate another licensed entity willing to do so. This section
shall not be construed to require the department or any other
licensed entity to assume any of the closing programs' financial
obligations.
(b) For purposes of this section, "temporary" means no more than
90 days.
11839.18. Any licensee may petition the director for waiver of
licensure fees or late payment penalties for the current fiscal year
based upon financial hardship. Prior to the granting of relief, the
licensee shall demonstrate hardship by production of appropriate
financial records. The director may, in his or her discretion, grant
all or part of the relief sought, but shall consider the
reasonableness of the relief in light of the other expenditures
undertaken by the licensee, giving particular scrutiny to the
licensee's own profits, earnings, or other compensation, and expenses
such as interest, mortgage, or loan payments, as well as noncash
expenses such as accruals and depreciation.
11839.19. (a) The department shall not license the establishment of
a narcotic treatment program without a written application by the
treatment facility that meets evaluative criteria required by the
department.
(b) The department shall not require disclosure of the identity of
patients or former patients or of any records containing identifying
information except as provided in Section 11845.5.
11839.20. (a) It is the intent of the Legislature in licensing
narcotic treatment programs to provide a means whereby the patient
may be rehabilitated and will no longer need to support a dependency
on opiates.
(b) It is the intent of the Legislature that each narcotic
treatment program shall have a strong rehabilitative element,
including, but not limited to, individual and group therapy,
counseling, vocational guidance, and job and education counseling.
(c) The Legislature declares the ultimate goal of all narcotic
treatment programs shall be to aid the patient in altering his or her
lifestyle and eventually to eliminate the improper use of legal
drugs and the use of illicit drugs.
(d) The department shall adopt any regulations necessary to ensure
that every program is making a sustained effort to end the drug
dependency of the patients.
11839.21. The State Department of Health Services shall establish
criteria for acceptable performance from those laboratories
performing urinalysis or other body fluid analysis and shall not
permit utilization of laboratories unable to meet an acceptable level
of performance. The results of any performance evaluation of any
laboratory shall immediately be made available to the local programs
upon request. Nothing in this section shall prohibit body fluid
analysis to be performed by a licensed narcotic treatment program
upon approval of the State Department of Health Services.
11839.22. The state department shall require a system to detect
multiple registration by narcotic clients.
11839. The department, with the approval of the Secretary of the
Health and Human Services Agency, may contract with any public or
private agency for the performance of any of the functions vested in
the department by this chapter. Any department of the state is
authorized to enter into such a contract.
11839.1. The Legislature finds and declares that it is in the best
interests of the health and welfare of the people of this state to
coordinate narcotic treatment programs to use replacement narcotic
therapy in the treatment of addicted persons whose addiction was
acquired or supported by the use of a narcotic drug or drugs, not in
compliance with a physician and surgeon's legal prescription, and to
establish and enforce minimum requirements for the operation of all
narcotic treatment programs in this state.
11839.2. The following controlled substances are authorized for use
in replacement narcotic therapy by licensed narcotic treatment
programs:
(a) Methadone.
(b) Levoalphacetylmethadol (LAAM) as specified in paragraph (10)
of subdivision (c) of Section 11055.
11839.3. (a) In addition to the duties authorized by other
statutes, the department shall perform all of the following:
(1) License the establishment of narcotic treatment programs in
this state to use replacement narcotic therapy in the treatment of
addicted persons whose addiction was acquired or supported by the use
of a narcotic drug or drugs, not in compliance with a physician and
surgeon's legal prescription, except that the Research Advisory Panel
shall have authority to approve methadone or LAAM research programs.
The department shall establish and enforce the criteria for the
eligibility of patients to be included in the programs, program
operation guidelines, such as dosage levels, recordkeeping and
reporting, urinalysis requirements, take-home doses of methadone,
security against redistribution of the replacement narcotic drugs,
and any other regulations that are necessary to protect the safety
and well-being of the patient, the local community, and the public,
and to carry out this chapter. A program may admit a patient to
narcotic maintenance or narcotic detoxification treatment seven days
after completion of a prior withdrawal treatment episode. The arrest
and conviction records and the records of pending charges against any
person seeking admission to a narcotic treatment program shall be
furnished to narcotic treatment program directors upon written
request of the narcotic treatment program director provided the
request is accompanied by a signed release from the person whose
records are being requested.
(2) Inspect narcotic treatment programs in this state and ensure
that programs are operating in accordance with the law and
regulations. The department shall have sole responsibility for
compliance inspections of all programs in each county. Annual
compliance inspections shall consist of an evaluation by onsite
review of the operations and records of licensed narcotic treatment
programs' compliance with applicable state and federal laws and
regulations and the evaluation of input from local law enforcement
and local governments, regarding concerns about the narcotic
treatment program. At the conclusion of each inspection visit, the
department shall conduct an exit conference to explain the cited
deficiencies to the program staff and to provide recommendations to
ensure compliance with applicable laws and regulations. The
department shall provide an inspection report to the licensee within
30 days of the completed onsite review describing the program
deficiencies. A corrective action plan shall be required from the
program within 30 days of receipt of the inspection report. All
corrective actions contained in the plan shall be implemented within
30 days of receipt of approval by the department of the corrective
action plan submitted by the narcotic treatment program. For programs
found not to be in compliance, a subsequent inspection of the
program shall be conducted within 30 days after the receipt of the
corrective action plan in order to ensure that corrective action has
been implemented satisfactorily. Subsequent inspections of the
program shall be conducted to determine and ensure that the
corrective action has been implemented satisfactorily. For purposes
of this requirement, "compliance" shall mean to have not committed
any of the grounds for suspension or revocation of a license provided
for under subdivision (a) of Section 11839.9 or paragraph (2) of
subdivision (b) of Section 11839.9. Inspection of narcotic treatment
programs shall be based on objective criteria including, but not
limited to, an evaluation of the programs' adherence to all
applicable laws and regulations and input from local law enforcement
and local governments. Nothing in this section shall preclude
counties from monitoring their contract providers for compliance with
contract requirements.
(3) Charge and collect licensure fees. In calculating the
licensure fees, the department shall include staff salaries and
benefits, related travel costs, and state operational and
administrative costs. Fees shall be used to offset licensure and
inspection costs not to exceed actual costs.
(4) Study and evaluate, on an ongoing basis, narcotic treatment
programs including, but not limited to, the adherence of the programs
to all applicable laws and regulations and the impact of the
programs on the communities in which they are located.
(5) Provide advice, consultation, and technical assistance to
narcotic treatment programs to ensure that the programs comply with
all applicable laws and regulations and to minimize any negative
impact that the programs may have on the communities in which they
are located.
(6) In its discretion, to approve local agencies or bodies to
assist it in carrying out this chapter provided that the department
may not delegate responsibility for inspection or any other licensure
activity without prior and specific statutory approval. However, the
department shall evaluate recommendations made by county alcohol and
drug program administrators regarding licensing activity in their
respective counties.
(7) The director may grant exceptions to the regulations adopted
under this chapter if he or she determines that this action would
improve treatment services or achieve greater protection to the
health and safety of patients, the local community, or the general
public. No exception may be granted if it is contrary to, or less
stringent than, the federal laws and regulations which govern
narcotic treatment programs.
(b) It is the intent of the Legislature in enacting this section
in order to protect the general public and local communities, that
self-administered dosage shall only be provided when the patient is
clearly adhering to the requirements of the program, and where daily
attendance at a clinic would be incompatible with gainful employment,
education, and responsible homemaking. The department shall define
"satisfactory adherence" and shall ensure that patients not
satisfactorily adhering to their programs shall not be provided
take-home dosage.
(c) There is established in the State Treasury the Narcotic
Treatment Program Licensing Trust Fund. All licensure fees collected
from the providers of narcotic treatment service shall be deposited
in this fund. Except as otherwise provided in this section, if funds
remain in this fund after appropriation by the Legislature and
allocation for the costs associated with narcotic treatment licensure
actions and inspection of narcotic treatment programs, a percentage
of the excess funds shall be annually rebated to the licensees based
on the percentage their licensing fee is of the total amount of fees
collected by the department. A reserve equal to 10 percent of the
total licensure fees collected during the preceding fiscal year may
be held in each trust account to reimburse the department if the
actual cost for the licensure and inspection exceed fees collected
during a fiscal year.
(d) Notwithstanding any provision of this code or regulations to
the contrary, the department shall have sole responsibility and
authority for determining if a state narcotic treatment program
license shall be granted and for administratively establishing the
maximum treatment capacity of any license. However, the department
shall not increase the capacity of a program unless it determines
that the licensee is operating in full compliance with applicable
laws and regulations.
11839.4. The department shall impose a civil penalty of one hundred
dollars ($100) per day for a program that fails to timely submit a
corrective action plan, or to timely implement any corrective action
when it has been found to not be in compliance with applicable laws
and regulations as required in Section 11839.3.
11839.5. In addition to the duties authorized by other provisions,
the department shall be responsible for licensing narcotic treatment
programs to use replacement narcotic therapy in the treatment of
addicted persons whose addiction was acquired or supported by the use
of a narcotic drug or drugs, not in compliance with a physician and
surgeon's legal prescription. No narcotic treatment program shall be
authorized to use replacement narcotic therapy without first
obtaining a license therefor as provided in this chapter. The
department may license narcotic treatment programs on an inpatient or
outpatient basis, or both. The department may also grant a state
narcotic treatment license.
11839.6. (a) The department shall establish a program for the
operation and regulation of office-based narcotic treatment programs.
An office-based narcotic treatment program established pursuant to
this section shall meet either of the following conditions:
(1) Hold a primary narcotic treatment program license.
(2) Be affiliated and associated with a primary licensed narcotic
treatment program. An office-based narcotic treatment program meeting
the requirement of this paragraph shall not be required to have a
license separate from the primary licensed narcotic treatment program
with which it is affiliated and associated.
(b) For purposes of this section, "office-based narcotic treatment
program" means a program in which interested and knowledgeable
physicians and surgeons provide addiction treatment services, and in
which community pharmacies supply necessary medication both to these
physicians and surgeons for distribution to patients and through
direct administration and specified dispensing services.
(c) Notwithstanding any other provision of law or regulation,
including Section 10020 of Title 9 of the California Code of
Regulations, an office-based narcotic treatment program in a remote
site that is affiliated and associated with a licensed narcotic
treatment program may be approved by the department, if all of the
following conditions are met:
(1) A physician may provide office-based addiction services only
if each office-based patient is registered as a patient in the
licensed narcotic treatment program and both the licensed narcotic
treatment program and the office-based narcotic treatment program
ensure that all services required under Chapter 4 (commencing with
Section 10000) of Division 4 of Title 9 of the California Code of
Regulations for the management of narcotic addiction are provided to
all patients treated in the remote site.
(2) A physician in an office-based narcotic treatment program may
provide treatment for a maximum of 20 patients under the appropriate
United States Drug Enforcement Administration registration. The
primary licensed narcotic treatment program shall be limited to its
total licensed capacity as established by the department, including
the patients of physicians in the office-based narcotic treatment
program.
(3) The physicians in the office-based narcotic treatment program
shall dispense or administer pharmacologic treatment for narcotic
addiction that has been approved by the federal Food and Drug
Administration such as levoalphacetylmethadol (LAAM) or methadone.
(4) Office-based narcotic treatment programs, in conjunction with
primary licensed narcotic treatment programs, shall develop protocols
to prevent the diversion of methadone. The department may develop
regulations to prevent the diversion of methadone.
(d) For purposes of this section, "remote site" means a site that
is geographically or physically isolated from any licensed narcotic
treatment program. Therefore, the requirements in this subdivision
regarding a remote site do not apply to an office-based narcotic
treatment program that holds a primary narcotic treatment program
license.
(e) In considering an office-based narcotic treatment program
application, the department shall independently weigh the treatment
needs and concerns of the county, city, or areas to be served by the
program.
(f) Nothing in this section is intended to expand the scope of the
practice of pharmacy.
11839.7. (a) (1) Each narcotic treatment program authorized to use
replacement narcotic therapy in this state, except narcotic treatment
research programs approved by the Research Advisory Panel, shall be
licensed by the department.
(2) Each narcotic treatment program, other than a program owned
and operated by the state, county, city, or city and county, shall,
upon application for licensure and for renewal of a license, pay an
annual license fee to the department. July 1 shall be the annual
license renewal date.
(3) The department shall set the licensing fee at a level
sufficient to cover all departmental costs associated with licensing
incurred by the department, but the fee shall not, except as
specified in this section, increase at a rate greater than the
Consumer Price Index. The fees shall include the department's share
of pro rata charges for the expenses of state government. The fee may
be paid quarterly in arrears as determined by the department. Fees
paid quarterly in arrears shall be due and payable on the last day of
each quarter except for the fourth quarter for which payment shall
be due and payable no later than May 31. A failure of a program to
pay renewal license fees by the due date shall give rise to a civil
penalty of one hundred dollars ($100) a day for each day after the
due date. Second and subsequent inspection visits to narcotic
treatment programs that are operating in noncompliance with the
applicable laws and regulations shall be charged a rate of one-half
the program's annual license fee or one thousand dollars ($1,000),
whichever is less, for each visit.
(4) Licensing shall be contingent upon determination by the
department that the program is in compliance with applicable laws and
regulations and upon payment of the licensing fee. A license shall
not be transferable.
(5) (A) As used in this chapter, "quarter" means July, August, and
September; October, November, and December; January, February, and
March; and April, May, and June.
(B) As used in this chapter, "license" means a basic permit to
operate a narcotic treatment program. The license shall be issued
exclusively by the department and operated in accordance with a
patient capacity that shall be specified, approved, and monitored
solely by the department.
(b) Each narcotic treatment program, other than a program owned
and operated by the state, county, city, or city and county, shall be
charged an application fee that shall be at a level sufficient to
cover all departmental costs incurred by the department in processing
either an application for a new program license, or an application
for an existing program that has moved to a new location.
(c) Any licensee that increases fees to the patient, in response
to increases in licensure fees required by the department, shall
first provide written disclosure to the patient of that amount of the
patient fee increase that is attributable to the increase in the
licensure fee. This provision shall not be construed to limit patient
fee increases imposed by the licensee upon any other basis.
11839.8. The director may deny the application for initial issuance
of a license if the applicant or any partner, officer, director, 10
percent or greater shareholder, or person proposed to be employed by
the applicant under the authority of subdivision (c) of Section 2401
of the Business and Professions Code:
(a) Fails to meet the qualifications for licensure established by
the department pursuant to this article. However, the director may
waive any established qualification for licensure of a narcotic
treatment program if he or she determines that it is reasonably
necessary in the interests of the public health and welfare.
(b) Was previously the holder of a license issued under this
article, and the license was revoked and never reissued or was
suspended and not reinstated, or the holder failed to adhere to
applicable laws and regulations regarding narcotic treatment programs
while the license was in effect.
(c) Misrepresented any material fact in the application.
(d) Committed any act involving fraud, dishonesty, or deceit, with
the intent to substantially benefit himself or herself or another or
substantially injure another, and the act is substantially related
to the qualification, functions, or duties of, or relating to, a
narcotic treatment program license.
(e) Was convicted of any crime substantially related to the
qualifications, functions, or duties of, or relating to, a narcotic
treatment program license.
(f) The director, in considering whether to deny licensure under
subdivision (d) or (e), shall determine whether the applicant is
rehabilitated after considering all of the following criteria:
(1) The nature and severity of the act or crime.
(2) The time that has elapsed since the commission of the act or
crime.
(3) The commission by the applicant of other acts or crimes
constituting grounds for denial of the license under this section.
(4) The extent to which the applicant has complied with terms of
restitution, probation, parole, or any other sanction or order
lawfully imposed against the applicant.
(5) Other evidence of rehabilitation submitted by the applicant.
(g) With respect to any other license issued to an applicant to
provide narcotic treatment services, violated any provision of this
article or regulations adopted under this article that relate to the
health and safety of patients, the local community, or the general
public. Violations include, but are not limited to, violations of
laws and regulations applicable to take-home doses of methadone,
urinalysis requirements, and security against redistribution of
replacement narcotic drugs. In these cases, the department shall deny
the application for an initial license unless the department
determines that all other licensed narcotic treatment programs
maintained by the applicant have corrected all deficiencies and
maintained compliance for a minimum of six months.
11839.9. (a) The director shall suspend or revoke any license
issued under this article, or deny an application to renew a license
or to modify the terms and conditions of a license, upon any
violation by the licensee of this article or regulations adopted
under this article that presents an imminent danger of death or
severe harm to any participant of the program or a member of the
general public.
(b) The director may suspend or revoke any license issued under
this article, or deny an application to renew a license or to modify
the terms and conditions of a license, upon any of the following
grounds and in the manner provided in this article:
(1) Violation by the licensee of any laws or regulations of the
Substance Abuse and Mental Health Services Administration or the
United States Department of Justice, Drug Enforcement Administration,
that are applicable to narcotic treatment programs.
(2) Any violation that relates to the operation or maintenance of
the program that has an immediate relationship to the physical
health, mental health, or safety of the program participants or
general public.
(3) Aiding, abetting, or permitting the violation of, or any
repeated violation of, any of the provisions set forth in subdivision
(a) or in paragraph (1) or (2).
(4) Conduct in the operation of a narcotic treatment program that
is inimical to the health, welfare, or safety of an individual in, or
receiving services from, the program, the local community, or the
people of the State of California.
(5) The conviction of the licensee or any partner, officer,
director, 10 percent or greater shareholder, or person employed under
the authority of subdivision (c) of Section 2401 of the Business and
Professions Code at any time during licensure, of a crime
substantially related to the qualifications, functions, or duties of,
or relating to, a narcotic treatment program licensee.
(6) The commission by the licensee or any partner, officer,
director, 10 percent or greater shareholder, or person employed under
the authority of subdivision (c) of Section 2401 of the Business and
Professions Code at any time during licensure, of any act involving
fraud, dishonesty, or deceit, with the intent to substantially
benefit himself or herself or another, or substantially to injure
another, and that act is substantially related to the qualifications,
functions, or duties of, or relating to, a narcotic treatment
program licensee.
(7) Diversion of narcotic drugs. A program's failure to maintain a
narcotic drug reconciliation system that accounts for all incoming
and outgoing narcotic drugs, as required by departmental or federal
regulations, shall create a rebuttable presumption that narcotic
drugs are being diverted.
(8) Misrepresentation of any material fact in obtaining the
narcotic treatment program license.
(9) Failure to comply with a department order to cease admitting
patients or to cease providing patients with take-home dosages of
replacement narcotic drugs.
(10) Failure to pay any civil penalty assessed pursuant to
paragraph (3) of subdivision (a) of Section 11839.16 where the
penalty has become final, unless payment arrangements acceptable to
the department have been made.
(11) The suspension or exclusion of the licensee or any partner,
officer, director, 10 percent or greater shareholder, or person
employed under the authority of subdivision (c) of Section 2401 of
the Business and Professions Code from the Medicare, medicaid, or
Medi-Cal programs.
(c) Prior to issuing an order pursuant to this section, the
director shall ensure continuity of patient care by the program's
guarantor or through the transfer of patients to other licensed
programs. The director may issue any needed license or amend any
other license in an effort to ensure that patient care is not
impacted adversely by an order issued pursuant to this section.
11839.10. (a) The department shall cease review of an application
for a license if either of the following occur:
(1) An application for a license indicates, or the department
determines during the application inspection process, that the
applicant was issued a license under this article and the prior
license was revoked within the preceding two years. The department
shall cease any further review of the application until two years
have elapsed from the date of the revocation.
(2) An application for a license indicates, or the department
determines during the application inspection process, that the
applicant was denied a license or had a license suspended under this
article within the preceding year. The department shall cease any
further review of the application until one year has elapsed from the
date of the denial or suspension.
(b) The department may cease review of an application for license
renewal if either of the following occur:
(1) The applicant has not paid the required license fee.
(2) The county in which the licensee is located certifies to the
department's satisfaction that there is no need for the narcotic
treatment program because of a substantial decline in medically
qualified narcotic treatment patients in the licensee's catchment
area, or clearly demonstrates that other applicants for licensure can
provide more efficient, cost-effective, and sufficient narcotic
treatment services in the catchment area, or that the license should
not be renewed due to one of the grounds that are enumerated in
Section 11839.9.
(c) Upon cessation of review, the license shall be permitted to
expire by its own terms. However, if the licensee subsequently
submits the items, the absence of which led to the cessation of
review, the department may reinstate the license.
(d) Cessation of review shall not constitute a denial of the
application for purposes of Sections 11839.8 and 11839.9.
11839.11. A narcotic treatment program license shall automatically
terminate if the Substance Abuse and Mental Health Services
Administration withdraws or revokes its approval of the program, or
if the United States Department of Justice, Drug Enforcement
Administration, revokes the program's registration.
11839.12. Except as provided in Section 11839.16, proceedings for
the suspension, revocation, or denial of a license or cessation of
review of a renewal license under this article, except where there
has been a failure to pay required fees, under this article shall be
conducted in accordance with Chapter 5 (commencing with Section
11500) of Part 1 of Division 3 of Title 2 of the Government Code and
the department shall have all the powers granted thereby. In the
event of conflict between this article and the Administrative
Procedure Act, the Administrative Procedure Act shall prevail.
11839.13. (a) The withdrawal of an application for a license after
it has been filed with the department shall not, unless the
department consents in writing to the withdrawal, deprive the
department of its authority to institute or continue a proceeding
against the applicant for the denial of the license upon any ground
provided by law or to enter an order denying the license upon any
ground provided by law.
(b) The suspension, expiration, or forfeiture by operation of law
of a license issued by the department, or its suspension, forfeiture,
or cancellation by order of the department or by order of a court of
law, or its surrender without the written consent of the department,
shall not deprive the department of its authority to institute or
continue a disciplinary proceeding against the licensee upon any
ground provided by law or to enter an order suspending or revoking
the license or otherwise taking disciplinary action against the
licensee upon any ground provided by law.
11839.14. For purposes of this article, a conviction means a plea
or verdict of guilty or a conviction following a plea of nolo
contendere. Any action that the department is permitted to take
following the establishment of a conviction may be taken when the
time for appeal has elapsed, or the judgment of conviction has been
affirmed on appeal or when an order granting probation is made
suspending the imposition of sentence, notwithstanding a subsequent
order pursuant to Section 1203.4 or 1203.4a of the Penal Code
permitting the person to withdraw his or her plea of guilty and to
enter a plea of not guilty, or setting aside the verdict of guilty,
or dismissing the accusation, information, or indictment. For
purposes of this article, the record of conviction, or a certified
copy thereof, shall be conclusive evidence of the conviction.
11839.15. The director may bring an action to enjoin the violation
of Section 11839.7, or the violation of a departmental order issued
pursuant to Section 11839.16, in the superior court in and for the
county in which the violation occurred. Any proceeding under this
section shall conform to the requirements of Chapter 3 (commencing
with Section 525) of Title 7 of Part 2 of the Code of Civil
Procedure. The rebuttable presumption set forth in paragraph (7) of
subdivision (b) of Section 11839.9 shall be applicable. If the court
finds the allegations to be true, it shall issue its order enjoining
the narcotic treatment program from continuance of the violation.
11839.16. (a) (1) The director shall, in addition to any other
remedy, issue an order that prohibits a narcotic treatment program
from admitting new patients or from providing patients with take-home
dosages of a narcotic drug if the director determines, pursuant to
the compliance inspection procedures set out in paragraph (2) of
subdivision (a) of Section 11839.3, that a program has done any of
the following:
(A) Failed to provide adequate security measures over its narcotic
drug supply as agreed in the program's approved protocol.
(B) Failed to maintain a narcotic drug reconciliation system that
accounts for all incoming and outgoing narcotic drugs.
(C) Diverted narcotic drugs.
(D) Repeatedly violated one or more departmental or federal
regulations governing narcotic treatment programs, which violations
may subject, or may have subjected, a patient to a health or
life-endangering situation.
(E) Repeatedly violated one or more departmental or federal
regulations governing the provisions of take-home medication.
(F) Operated above combined licensed capacity for maintenance and
detoxification programs at a single location.
(2) (A) The order becomes effective when the department serves the
program with a copy of the order. The order shall state the
deficiencies forming the basis for the order and shall state the
corrective action required for the department to vacate the order.
The order, as it pertains to subparagraph (F) only, shall
automatically be vacated when the department receives the program's
written notification that licensed capacity has been achieved. If the
order is issued pursuant to subparagraph (A), (B), (C), (D), or (E),
the department shall vacate the order when the program submits a
corrective action plan that reasonably addresses the deficiency or
substantially conforms to the required action set out in the order.
(B) The department shall notify the program that the corrective
action plan is accepted or rejected within 10 working days after
receipt of the plan. If the department rejects the corrective action
plan, it shall detail its reason in writing. The department order is
vacated when the department either accepts a corrective action plan
and ensures substantial conformity with the required action set out
in the order or fails to reject a plan within 10 working days after
receipt of the plan.
(3) In addition to any other remedies, a failure of the program to
comply with the order of the department under this subdivision shall
give rise to a civil penalty of five hundred dollars ($500) a day
for each day that the order is violated.
(4) All civil penalties collected by the department under
paragraph (3) shall be deposited in the Narcotic Treatment Program
Licensing Trust Fund, and shall be used to offset the department's
costs associated with collecting the civil penalties, or associated
with any civil, administrative, or criminal action against the
program when appropriated for this purpose.
(b) (1) The director may, in addition to any other remedy, issue
an order temporarily suspending a narcotic treatment program license
prior to any administrative hearing for the reasons stated in
subparagraphs (A) to (E), inclusive, of paragraph (1) of subdivision
(a) when the department determines pursuant to the compliance
inspection procedures set out in paragraph (2) of subdivision (a) of
Section 11839.3, that the action is necessary to protect patients of
the program from any substantial threat to their health or safety, or
to protect the health or safety of the local community or the people
of the State of California. Prior to issuing the order, the director
shall ensure continuity of patient care by the program's guarantor
or through the transfer of patients to other licensed programs. The
director may issue any needed license or amend any other license in
his or her effort to assure that patient care is not impacted
adversely by the suspension order.
(2) The director shall notify the licensee of the temporary
suspension and the effective date thereof and at the same time shall
serve the licensee with an accusation. Upon receipt of a notice of
defense to the accusation by the licensee, the director shall, within
15 days, set the matter for hearing, and the hearing shall be held
as soon as possible, but not later than 20 days, exclusive of
weekends, after receipt of the notice. The temporary suspension shall
remain in effect until the hearing is completed and the director has
made a final determination on the merits. However, the temporary
suspension shall be deemed vacated if the director fails to make a
final determination on the merits within 20 days after the original
hearing has been completed. Failure to cease operating after the
department issues an order temporarily suspending the license shall
constitute an additional ground for license revocation and shall
constitute a violation of Section 11839.8. The department shall
suspend the program's license if the hearing outcome is adverse to
the license. The department shall notify the program of the license
suspension within five days of the director's final decision.
(c) A program may, at any time after it is served with an order,
petition the superior court to review the department's issuance of an
order or rejection of a corrective action plan.
11839.17. (a) In cases where a program is closing and the licensed
entity that has agreed to assume temporary operation of the closing
program is unable to do so, the department may assume temporary
operation of the closing program or designate another licensed entity
willing to do so. In cases where the licensed entity that has agreed
to assume temporary operation is the subject of a pending licensing
action or order issued pursuant to Section 11839.16, the department
may issue an order prohibiting the entity from assuming temporary
operation and may assume temporary operation of the closing program
or designate another licensed entity willing to do so. This section
shall not be construed to require the department or any other
licensed entity to assume any of the closing programs' financial
obligations.
(b) For purposes of this section, "temporary" means no more than
90 days.
11839.18. Any licensee may petition the director for waiver of
licensure fees or late payment penalties for the current fiscal year
based upon financial hardship. Prior to the granting of relief, the
licensee shall demonstrate hardship by production of appropriate
financial records. The director may, in his or her discretion, grant
all or part of the relief sought, but shall consider the
reasonableness of the relief in light of the other expenditures
undertaken by the licensee, giving particular scrutiny to the
licensee's own profits, earnings, or other compensation, and expenses
such as interest, mortgage, or loan payments, as well as noncash
expenses such as accruals and depreciation.
11839.19. (a) The department shall not license the establishment of
a narcotic treatment program without a written application by the
treatment facility that meets evaluative criteria required by the
department.
(b) The department shall not require disclosure of the identity of
patients or former patients or of any records containing identifying
information except as provided in Section 11845.5.
11839.20. (a) It is the intent of the Legislature in licensing
narcotic treatment programs to provide a means whereby the patient
may be rehabilitated and will no longer need to support a dependency
on opiates.
(b) It is the intent of the Legislature that each narcotic
treatment program shall have a strong rehabilitative element,
including, but not limited to, individual and group therapy,
counseling, vocational guidance, and job and education counseling.
(c) The Legislature declares the ultimate goal of all narcotic
treatment programs shall be to aid the patient in altering his or her
lifestyle and eventually to eliminate the improper use of legal
drugs and the use of illicit drugs.
(d) The department shall adopt any regulations necessary to ensure
that every program is making a sustained effort to end the drug
dependency of the patients.
11839.21. The State Department of Health Services shall establish
criteria for acceptable performance from those laboratories
performing urinalysis or other body fluid analysis and shall not
permit utilization of laboratories unable to meet an acceptable level
of performance. The results of any performance evaluation of any
laboratory shall immediately be made available to the local programs
upon request. Nothing in this section shall prohibit body fluid
analysis to be performed by a licensed narcotic treatment program
upon approval of the State Department of Health Services.
11839.22. The state department shall require a system to detect
multiple registration by narcotic clients.
