Someone passed a box of tissues to Sequoyah Thiessen. Child abuse, she told the Senate Health Committee, drove her to drugs at age 15. But at 22, she vowed to get sober.
Thus began a hellish descent into California’s private-pay, insurance-money-fueled segment of the addiction treatment system.
“Treatment,” she told the senators, was an oxymoron there. She endured violence, sexual harassment, emotional manipulation, cult-like environments, grotesque living conditions, forced relapses, constant displacement.
“My sobriety was commodified over and over again,” she said, struggling to maintain composure. “I was held hostage, I was not allowed to leave. … I witnessed immeasurable exploitation of myself and others. I constantly felt like a pawn and I was forced to watch treatment owners rack up immense wealth while simultaneously destroying people’s lives — and sometimes ending them. …They funded my sickness for their own gain.”
Against all odds, Thiessen said, she’s now sober and a student in Los Angeles — but only because she extracted herself from the woefully under-regulated treatment system.
The emotional testimony of Thiessen — and others who shared tales of exploitation — formed the steely spine of hearings on two reform bills by State Sen. Tom Umberg, D-Santa Ana, on Wednesday, April 23. They’re among a batch of bills seeking to do what Thiessen said must be done: Have California acknowledge a moral responsibility for this crisis, and do more to protect vulnerable patients.
Senate Bill 35 would require state regulators to investigate complaints about unlicensed treatment homes within 10 days of receiving them, and finish those probes within 60 of starting them (currently, the timeline can extend for months — or even longer than a year).
If violations are found, state regulators would have to actually visit the site to ensure that corrections are made — what a concept! — and if regulators can’t do all that on time, county behavioral health officials could step in to investigate and enforce provisions.
That’s an updated compromise on Umberg’s eminently sensible SB 913, which aimed to empower city officials to pick up the state’s enormous slack, but was killed last year. This version avoids a policing-type response in favor of mental health experts, which eased many concerns.
Transparency?
Meanwhile, Umberg’s Senate Bill 83 would take a desperately needed step toward forcing regulators to stop hoarding life-or-death information. Officials would have to post at least some of the gory details about facilities in regulatory crosshairs — but are operating nonetheless.
Right now, there’s an almost-useless list of programs with suspended or revoked licenses, or that are on probation, or that were operating without a license. But good luck trying to find out exactly who runs these places, and if they have other licensed homes, and what the alleged violations were. The information is just not there, and public records requests for it to the Department of Health Care Services, which regulates the universe of expressly non-medical addiction treatment centers in California, still take months to complete (and often produce a pathetic trove of redacted documents that can be almost useless anyway).
SB 83 would simply require the state to post “an identification and summary of each violation issued for licensed adult residential alcohol or other drug recovery or treatment facilities” on its website. Which is to say, give consumers at least a clue about what it knows, so they can make more informed decisions.
Landon Morrison and girlfriend Christine Hand were in Oklahoma two years ago when they heard about awesome treatment opportunities in California with a company called 55 Silver. They came out with big hopes — and found nothing as they expected it to be. Myriad LLCs associated with the owners were hard to untangle — some licensed, some not — and some had clashed with state regulators. Yet there was no way for a consumer to know that.
“Had SB 83 been enacted then,” Morrison told the committee, “we could have made a very different decision.”
Hand and Morrison have complained to every agency they could think of, but have heard little back. Their experience, and the company, were detailed in a series of stories by SCNG last year. The company has denied any wrongdoing.
Thousands of people are stuck in corrupt environments in licensed and unlicensed facilities alike, they told the committee. SB 83 could save lives.
Both bills, supported by the League of California Cities, advanced — something that hasn’t always been easy for rehab-related legislation.
“We’re pleased,” Umberg said after unanimous votes for both bills. One would empower counties to do what’s necessary to hold wayward homes accountable, and the other is essentially a consumer protection, he said. “For the first time, it seems like there’s critical mass in the Legislature to create some sort of transparency and accountability for wrong-doing in this space,” he said.
Plethora of reform proposals
Umberg’s bills are among many to spring from a recent audit of the Department of Health Care Services by the State Auditor, which found serious problems with the addiction treatment system in California. Among them are:
Assembly Bill 3, by Assemblymember Diane Dixon, R-Newport Beach, targeting overconcentration. It would not consider licensed residential treatment facilities to be residential uses of property if they’re located within 300 feet of another such facility, both facilities share the same owner, director, programs or amenities, and the total number of residents in both facilities is greater than six. Her AB 877 would explicitly notify health insurance companies that residential treatment in California is mostly non-medical, and should be billed that way. Dixon’s AB 1356 would require the state to follow up 60 days after a death is reported at a facility.
AB 423, by Assemblymember Laurie Davies, R-Laguna Niguel, would require business-operated recovery residences to register their location with officials. AB 424, also by Davies, would require DHCS to share the status of investigations with people who complain. Her AB 425 would raise the bar on state-certified programs, requiring them to have the same American Society of Addiction Medicine quality standards as licensed homes; and her AB 1090 would start a pilot program, placing a state investigator dedicated to Orange County in Orange County.
AB 492, by Assemblymember Avelino Valencia, D-Anaheim, would require the state to notify the city or county that a license has been issued in its boundaries. It would have to include the name and mailing address of the person holding the license, as well as the facility’s location.
Santa Ana Mayor Valerie Amezcua was among those urging the committee to back Umberg’s SB 35. “It will help hold the department accountable, address violations, protect public health and safety,” she said. “It also requires the department to do follow-up site visits and investigate other facilities run by the same operator, to ensure they’re also in compliance. It’s supporting healthier communities.”
Amezcua put her notes down, looked at the senators and spoke directly. “My city has been impacted greatly,” she told them. “Suicides. Illegal activity. Homelessness. Noise. Many unlicensed treatment programs. This bill is very important. It will have an impact not just in Santa Ana, but all over the state.”
Competing bills would make it easier for operators to cluster treatment homes together, so, as always, it’ll be a fight. A treatment professionals group objected to SB 35’s reforms, saying they’re discriminatory and violate fair housing laws. Courts, however, have found that actions to protect a disabled class are not discriminatory.
This year, things may be different. “I’m cautiously optimistic,” Umberg said.
Word to the wise: If you’re seeking addiction treatment, experts suggest finding a public, rather than private, program, even though that seems counterintuitive. Public programs have more oversight, higher quality bars and state-of-the-art medical approaches to treatment.