Section 11834.026 Of Article 1. General Provisions From California Health And Safety Code >> Division 10.5. >> Part 2. >> Chapter 7.5. >> Article 1.
11834.026
. (a) As used in this section, "incidental medical
services" means services that are in compliance with the community
standard of practice and are not required to be performed in a
licensed clinic or licensed health facility, as defined by Section
1200 or 1250, respectively, to address medical issues associated with
either detoxification from alcohol or drugs or the provision of
alcoholism or drug abuse recovery or treatment services, including
all of the following categories of services that the department shall
further define by regulation:
(1) Obtaining medical histories.
(2) Monitoring health status to determine whether the health
status warrants transfer of the patient in order to receive urgent or
emergent care.
(3) Testing associated with detoxification from alcohol or drugs.
(4) Providing alcoholism or drug abuse recovery or treatment
services.
(5) Overseeing patient self-administered medications.
(6) Treating substance abuse disorders, including detoxification.
(b) Incidental medical services do not include the provision of
general primary medical care.
(c) Notwithstanding any other law, a licensed alcoholism or drug
abuse recovery or treatment facility may permit incidental medical
services to be provided to a resident at the facility premises by, or
under the supervision of, one or more physicians and surgeons
licensed by the Medical Board of California or the Osteopathic
Medical Board who are knowledgeable about addiction medicine, or one
or more other health care practitioners acting within the scope of
practice of his or her license and under the direction of a physician
and surgeon, and who are also knowledgeable about addiction
medicine, if all of the following conditions are met:
(1) The facility, in the judgment of the department, has the
ability to comply with the requirements of this chapter and all other
applicable laws and regulations to meet the needs of a resident
receiving incidental medical services pursuant to this chapter. The
department shall specify in regulations the minimum requirements that
a facility shall meet in order to be approved to permit the
provision of incidental medical services on its premises. The license
of a facility approved to permit the provision of incidental medical
services shall reflect that those services are permitted at the
facility premises.
(2) The physician and surgeon and any other health care
practitioner has signed an acknowledgment on a form provided by the
department that he or she has been advised of and understands the
statutory and regulatory limitations on the services that may legally
be provided at a licensed alcoholism or drug abuse recovery or
treatment facility and the statutory and regulatory requirements and
limitations for the physician and surgeon or other health care
practitioner and for the facility, related to providing incidental
medical services. The licensee shall maintain a copy of the signed
form at the facility for a physician and surgeon or other health care
practitioner providing incidental medical services at the facility
premises.
(3) A physician and surgeon or other health care practitioner
shall assess a resident, prior to that resident receiving incidental
medical services, to determine whether it is medically appropriate
for that resident to receive these services at the premises of the
licensed facility. A copy of the form provided by the department
shall be signed by the physician and surgeon and maintained in the
resident's file at the facility.
(4) The resident has signed an admission agreement. The admission
agreement, at a minimum, shall describe the incidental medical
services that the facility may permit to be provided and shall state
that the permitted incidental medical services will be provided by,
or under the supervision of, a physician and surgeon. The department
shall specify in regulations, at a minimum, the content and manner of
providing the admission agreement, and any other information that
the department deems appropriate. The facility shall maintain a copy
of the signed admission agreement in the resident's file.
(5) Once incidental medical services are initiated for a resident,
the physician and surgeon and facility shall monitor the resident to
ensure that the resident remains appropriate to receive those
services. If the physician and surgeon determines that a change in
the resident's medical condition requires other medical services or
that a higher level of care is required, the facility shall
immediately arrange for the other medical services or higher level of
care, as appropriate.
(6) The facility maintains in its files a copy of the relevant
professional license or other written evidence of licensure to
practice medicine or perform medical services in the state for the
physician and surgeon and any other health care practitioner
providing incidental medical services at the facility.
(d) The department is not required to evaluate or have any
responsibility or liability with respect to evaluating the incidental
medical services provided by a physician and surgeon or other health
care practitioner at a licensed facility. This section does not
limit the department's ability to report suspected misconduct by a
physician and surgeon or other health care practitioner to the
appropriate licensing entity or to law enforcement.
(e) A facility licensed and approved by the department to allow
provision of incidental medical services shall not by offering
approved incidental medical services be deemed a clinic or health
facility within the meaning of Section 1200 or 1250, respectively.
(f) Other than incidental medical services permitted to be
provided or any urgent or emergent care required in the case of a
life threatening emergency, this section does not authorize the
provision at the premises of the facility of any medical or health
care services or any other services that require a higher level of
care than the care that may be provided within a licensed alcoholism
or drug abuse recovery or treatment facility.
(g) This section does not require a residential treatment facility
licensed by the department to provide incidental medical services or
any services not otherwise permitted by law.
(h) (1) On or before July 1, 2018, the department shall adopt
regulations to implement this section in accordance with the
Administrative Procedure Act (Chapter 3.5 (commencing with Section
11340) of Part 1 of Division 3 of Title 2 of the Government Code).
(2) Notwithstanding the rulemaking provisions of the
Administrative Procedure Act, the department may, if it deems
appropriate, implement, interpret, or make specific this section by
means of provider bulletins, written guidelines, or similar
instructions from the department until regulations are adopted.