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ARIZONA STATE SENATE
Fifty-Sixth Legislature, Second Regular Session
AMENDED
sober living homes
Purpose
Modifies requirements of the Department of Health Services (DHS) relating to the licensing, oversight and regulation of sober living homes. Prescribes guidelines for the inspection and penalizing of sober living homes that are noncompliant with applicable state and local regulations.
Background
A sober
living home is any premises, place or building that provides alcohol-free
or
drug-free housing that: 1) promotes independent living and life skills
development; 2) may provide activities that are directed primarily toward
recovery from substance use disorders; 3) provides a supervised setting to a
group of unrelated individuals who are recovering from substance use disorders;
and 4) does not provide any medical or clinical services or medication
administration on-site, except for verification of abstinence (A.R.S.
§ 36-2061).
Statute requires the Director of DHS (Director) to establish minimum standards and requirements for the licensure of sober living homes to ensure the public health, safety and welfare. The Director may use the current standards adopted by any recognized national organization approved by DHS as guidelines in prescribing the minimal standards and requirements but must include outlined statutory policies and procedures (A.R.S. § 36-2062).
Sober living homes that are not currently licensed but have been certified by a certifying organization may operate in Arizona, with the certification acting in lieu of licensure until the sober living home is licensed. Certified sober living homes must apply for licensure to DHS within 90 days after initial licensure rules are final and DHS must alert the applicable certifying organization when this occurs (A.R.S. § 36-2064).
On determination by the Director that there is reasonable cause to believe a sober living home is not adhering to state laws governing sober living homes, the Director and any duly assigned DHS employee or agent may enter the premises of the sober living home at any reasonable time to determine the home's state of compliance with state and local sober living home regulations. If an inspection reveals that a sober living home is noncompliant with state and local regulations, the Director may take action, including suspension or revocation of licensure. Noncompliant sober living homes are subject to a daily civil penalty of up to $500 for each violation (A.R.S § 36-2063).
There is no anticipated fiscal impact to the state General Fund associated with this legislation.
Provisions
DHS Minimum Standards and Requirements
1. Requires DHS standards and requirements for the licensure of sober living homes to include policies and procedures to be implemented if a license is suspended or revoked.
2. Requires DHS minimum health and safety standards for sober living homes to include policies and procedures that require each sober living home to maintain an environment that:
a) promotes the recovery, health and safety of residents and the safety of the surrounding neighborhood and community at large; and
b) is free from alcohol and illegal substances at all times and requires abstinence from alcohol and illicit drugs.
3. Requires DHS minimum health and safety standards for sober living homes to include policies and procedures for:
a) notifying DHS death, permanent or severe harm or overdose of a resident;
b) providing activities that promote independent living and life skills development; and
c) providing activities directed primarily toward recovery from substance use disorders.
4. Directs DHS to identify on each license the maximum number of residents who are allowed to live in the sober living home, including any manager or other staff living on the premises.
5. Requires DHS or its third-party contractor to conduct a physical, on-site inspection of a sober living home to verify compliance with sober living home regulations:
a) before issuing an initial license or approving any proposed change in the maximum number of residents or any construction or modification of a sober living home;
b) at least annually for each sober living home;
c) upon request by local law enforcement; and
d) on determination by the Director that there is reasonable cause to believe that a sober living home is not adhering to sober living home regulations.
Disciplinary Action
6. Authorizes the Director to deny, revoke or suspend a sober living home license if any owner, officer, agent or employee of the sober living home:
a) violates sober living home statutes or rules;
b) commits a felony rising out of or in connection with the operation of a sober living home; or
c) knowingly aids, allows or abets in submitting false or inaccurate information required under law.
7. Allows the Director to order the immediate termination of any specific service, procedure or practice of a sober living home, on notice to the owner of the sober living home, if there is reasonable suspicion that a violation has occurred that immediately affects the life or safety of residents.
8. Authorizes the Director to continue to pursue any court, administrative or enforcement action against a licensee even if the sober living home has closed or is in the process of being sold or transferred.
9. Allows DHS to revoke or suspend a sober living home license or deny an application if:
a) the applicant, licensee or a controlling person has a sober living home or health care institution license that is in an enforcement or court action related to the health and safety of residents;
b) DHS has determined that the issuance of a license is likely to jeopardize resident safety;
c) the applicant, licensee or a controlling person has had, in any state or jurisdiction, an application or license to operate a sober living home or health care institution denied, suspended or revoked unless the denial was based on the failure to complete the licensing process or pay a required licensing fee within the required time frame;
d) the applicant, licensee or a controlling person has had a health professional license or certificate denied, revoked or suspended; or
e) the applicant, licensee or a controlling person provides false or misleading information to DHS.
10. Allows DHS to deny a change in ownership of a sober living home if it is determined that the transfer, whether involving a direct or indirect owner, may jeopardize patient safety.
11. Requires DHS or its third-party contractor to investigate a sober living home after receiving a complaint identifying an alleged violation by the sober living home.
12. Stipulates that, if a licensee, owner, officer, agent or employee of a sober living home refuses to allow DHS or its agent to inspect the premises, the action is deemed reasonable cause to believe that a substantial violation has occurred.
13. Declares a licensee's record of conviction, or a copy of the record certified by the applicable clerk of the court or judge, as conclusive evidence of a conviction for purposes of denial, revocation or suspension of licensure.
14. Allows the Director, if there is reasonable suspicion that a violation has occurred that immediately affects the life or safety of residents, to order one or more of the following sanctions until the sober living home is in substantial compliance with applicable statutes and rules:
a) the immediate restriction of the acceptance and reacceptance of residents to the sober living home;
b) the selected transfer of residents out of the sober living home;
c) the reduction of capacity; and
d) the termination of any specific service, policy, procedure or practice.
15. Requires a sanctioned sober living home to notify DHS in writing when it believes it is in substantial compliance.
16. Requires DHS to conduct an inspection, within 14 days, of a sanctioned sober living home that provides notification of substantial compliance.
17. Stipulates that, if DHS determines a sanctioned sober living home has achieved substantial compliance, the Director must rescind any sanctions.
18. Stipulates that, if DHS determines a sanctioned sober living home is not in substantial compliance after notification, all sanctions remain in effect.
19. Establishes a process and timeline for further inspections of a sanctioned sober living home that fails its initial follow-up inspection.
20. Requires sober living home notifications of substantial compliance to be made by certified mail.
21. Allows a licensee subject to an intermediate sanction by the Director to request a hearing, in writing and within 10 days of sanctioning, to review the Director's action.
22. Requires the Office of Administrative Hearings (OAH) to conduct an administrative hearing within seven business days after the notice of appeal has been filed.
23. Authorizes the Director to issue a cease and desist order against a sober living home that does not hold a current or valid license or that exceeds the scope of authorized activities or services.
24. Allows the Attorney General or a county attorney to bring an action for injunction to restrain a sober living home violation or to enjoin future operation of maintenance of the sober living home until it is in compliance.
25. Allows DHS, before issuing a cease and desist order or bringing an action for an injunction, to issue the owner or agent of a noncompliant sober living home a certified letter stating the factual basis for DHS's belief that the sober living home is operating in violation, which may include a description of the available enforcement options if the violations continue.
Civil Penalties
26. Increases the cap on civil penalties for violations of sober living home regulations from $500 to $1,000.
27. Requires DHS, in determining the amount of a civil penalty, to consider:
a) repeated violations of statutes or rules;
b) patterns of noncompliance;
c) types and severity of violations;
d) the potential for and occurrences of actual harm, including to staff or residents;
e) threats to health and safety, including to staff or residents;
f) the number of persons affected by the violations;
g) the number of violations;
h) the size of the facility; and
i) the length of time that the violations have been occurring.
28. Authorizes a civil penalty for violation of sober living home regulations to be assessed for each resident or person determined to be impacted by DHS.
29. Subjects a person operating a sober living home that has failed to obtain or maintain licensure to an additional civil penalty for each violation.
30. Subjects a sober living home with a business relationship with a person or entity found to be engaging in fraudulent, abusive or misleading health-care related practices to daily civil penalty, including license suspension or revocation.
Local Jurisdictions
31. Requires DHS to notify a local jurisdiction of all initial licenses issued in that jurisdiction in the preceding month, if the local jurisdiction provides contact information to DHS for notifications relating to sober living homes.
32. Specifies that DHS is not obligated to provide any notification relating to sober living homes to a local jurisdiction that does not provide its contact information.
33. Requires a sober living home to obtain and maintain current documentation from the local jurisdiction verifying compliance with all local zoning, building, fire and licensing ordinances and rules, and provide the documentation to DHS:
a) upon request;
b) upon initial application for licensure; and
c) when requesting approval for proposed change in the maximum number of residents or any construction or modification to the sober home.
34. Requires municipalities with zoning ordinances that restrict the distance between sober living homes or that enact building or fire code requirements for the operation of sober living homes to establish a procedure in which a deviation from the requirements may be granted as a reasonable accommodation under the Fair Housing Act.
35. Prohibits municipalities from reclassifying a single-family home under a local building or fire code solely because the home is subject to a sober living home license application.
36. Requires DHS to notify, within five business days, a political subdivision that requests an update on the status of a complaint investigation and to provide its findings, including copies of investigative reports without personal identifying information, if requested.
37. Requires DHS to notify the designated employee of the local jurisdiction of all approvals and denials for licensure and renewal and all requests for changes affecting a sober living home in that jurisdiction within 30 days of receipt of an application for licensure, licensure renewal or request for changes.
Fingerprinting Requirements
38. Requires, as a condition of licensure for sober living homes that receive government-funded referrals or public funding, the licensee and each staff member of the sober living home to:
a) have a valid fingerprint clearance card; or
b) apply for a fingerprint clearance card within 20 days of beginning employment or contracted work.
51. Requires licensees to make a documented, good faith effort to verify the current status of each paid staff member's fingerprint clearance card.
52. Directs a licensee or paid staff member to submit a completed application provided by the Department of Public Safety within 20 days of beginning employment or contracted work.
53. Prohibits, with exception, a sober living home from allowing a paid staff member to continue employment or contracted work if the person has been denied a fingerprint clearance card or had a card revoked or suspended.
54. Exempts from fingerprint clearance card requirements, until a decision is made by the Board of Fingerprinting, licensees and staff members who are eligible for and provide documentation of having applied for a good cause exemption but who have not yet received a decision.
55. Allows a sober living home to employ or continue to employee a staff member who is denied a fingerprint clearance card if the staff member:
a) successfully completes treatment for substance use or, if applicable, recidivism reduction as prescribed by rule; and
b) passes a background and screening evaluation conducted by the sober living home, including prior employment or personal reference checks, demonstrating that the individual is not a threat to the health or safety of the residents of the home
56. Enacts fingerprint clearance card requirements six months after the effective date.
Certified Sober Living Homes
57. Removes the ability of a certified sober living home to use certification in lieu of licensure until it becomes licensed.
58. Adds both of the following to the requirements of a certified sober living home seeking licensure without inspection:
a) the home does not receive any monies from the state or federal government; and
b) the home has not been subject to an enforcement action within the preceding year.
59. Allows the Director to accept proof that a sober living home is certified in lieu of all required compliance inspections if:
a) the Director receives a copy of the sober living home's certification report for the licensure period and the sober living home; and
b) the sober living home is certified by a certifying organization.
60. Allows DHS, if a certification report is not valid for a sober living home's entire licensure period, to conduct a compliance inspection of the sober living home during the time period in which DHS does not have a valid certification report.
Miscellaneous
61. Prohibits investigative reports prepared by DHS or its third-party contractor from including personal identifying information of sober living home residents.
62. Prohibits DHS from contracting with any owner, operator, administrator, accrediting body or association of sober living homes.
63. States that any application for license renewal constitutes permission for and complete acquiescence in any entry or inspection of the premises during the pendency of the application.
64. Prohibits sober living home license applicants from self-attesting to compliance in lieu of an inspection.
65. Prohibits a person, behavioral health professional, health care provider, health care institution or sober living home, regardless of whether the entity is only providing substance use disorder services, from paying or soliciting any commission, kickback or bribe for patient referrals or enrollment in a sober living home.
66. Requires behavioral health professionals to refer patients only to licensed sober living homes.
67. Requires DHS, on request, to disclose the address of a sober living home to a third-party contractor of DHS.
68. Asserts that a sober living home is not prohibited from publishing or self-disclosing its address.
69. Requires DHS to include in its annual report the number of complaints against licensed sober living homes:
a) received by DHS each year;
b) investigated by DHS or its third-party contractor; and
c) that resulted in inspections by DHS or its third-party contractor.
70. Directs DHS, by January 31 of each year, to submit to the Health and Human Services Committees of the Senate and House of Representatives, or their successor committees, a report on licensed and unlicensed sober living homes, including the number of applicable:
a) complaints received against licensed sober living homes;
b) enforcement actions taken against licensed and unlicensed sober living homes each year;
c) complaints against residences, places, dwelling units or other premises suspected of being unlicensed sober living homes; and
d) investigations resulting from complaints against unlicensed sober living homes, including how many of those investigated met the legal requirements for sober living home licensure and how DHS took action on its findings.
72. Asserts that the Legislature recognizes the need to protect both the people in recovery and the public from unscrupulous and incompetent operators of sober living homes and finds that substantial compliance with and enforcement of the requirements of state law are necessary and required to ensure the public health, safety and welfare.
73. Requires third-party contractors to be paid from the Health Services Licensing Fund.
74. Redefines sober living home as any premises, place or dwelling unit, or person that provides any premises, place or dwelling unit, that may provide verification of abstinence and does at least one of the following:
a) provides alcohol-free and drug-free housing in a supervised, monitored or peer-led environment for individuals who are in recovery or seeking recovery from any substance use disorder; or
b) advertises, markets, holds itself out or implies through any means, including oral, written, electronic or printed means, that it provides or will provide a living environment directed toward recovery from any substance use disorder, including housing that:
i. provides or arranges for residents to receive any assistance or activity directed toward recovery from any substance use disorder; or
ii. arranges for residents to receive any service or treatment directed toward recovery from any substance use disorder.
75. Excludes each of the following from the definition of sober living home:
a) any premises, place or dwelling unit that is licensed to provide on-site medical services, behavioral health services or medication administration;
b) any person who provides a premises, place or dwelling unit directed toward recovery from any substance abuse disorder exclusively to residents who are related to the person by affinity or consanguinity of the first or second degree, an individual who is a close friend of the person or individuals for whom the person serves as a legal guardian, and the person is not operating the premises, place or dwelling unit as a business and does not require, collect or receive any form of compensation for profit from the residents, including insurance or rent; and
c) any housing for persons in recovery from substance use disorders that is self-run, self-supported, alcohol and drug free, chartered and monitored by a nationally recognized nonprofit credentialing entity, established in accordance with federal law and held to the standards of that nationally recognized nonprofit credentialing entity.
76. Defines terms.
77. Makes technical and conforming changes.
78. Becomes effective on the general effective date.
Amendments Adopted by Committee
· Makes technical changes.
Amendments Adopted by Committee of the Whole
1. The committee amendment was withdrawn.
2. Prohibits a person, health care provider, health care facility or sober living home, regardless of whether the entity is only providing substance use disorder services, from paying or soliciting any commission, kickback or bribe for patient referrals or enrollment in a sober living home.
3. Requires DHS minimum health and safety standards for sober living homes to include a requirement that each sober living home maintain an environment that:
a) promotes the safety of the surrounding neighborhood and community at large; and
b) is free from alcohol and illegal substances at all times and requires abstinence from alcohol and illicit drugs.
4. Removes the requirement that DHS obtain documentation from the local jurisdiction of a sober living home verifying compliance with local ordinances and rules before approving the licensing or modification of the sober living home.
5. Requires a sober living home license application to require the sober living home to obtain written administrative clearance from the local jurisdiction verifying compliance with all local zoning, building, fire and licensing ordinances.
6. Requires the name and contact information of the designated employee of the local jurisdiction who is authorized to provide administrative clearance to be posted on the jurisdiction's website or the website of an association representing the jurisdiction.
7. States that any application for license renewal constitutes permission for and complete acquiescence in any entry or inspection of the premises during the pendency of the application.
8. Modifies the authorities of the Director to deny, revoke or suspend a sober living home license in outlined circumstances.
9. Allows the Director to order the immediate termination of any specific service, procedure or practice of a sober living home, on notice to the owner of the sober living home, if there is reasonable suspicion that a violation has occurred that immediately affects the life or safety of residents.
10. Prescribes guidelines and requirements for administrative hearings relating to corrective actions taken against a sober living home.
11. Declares the operation or maintenance of a sober living home that does not hold a license or that exceeds its authority a public nuisance and outlines processes for cease and desist of the sober living home.
12. Increases, from 10 to 15, the number of days DHS has:
a) to notify a political subdivision of the status of a complaint about a sober living home; and
b) after concluding the investigation of a complaint, provide the political subdivision with its findings and enforcement actions taken.
13. Increases, from 10 to 30 days after application, the number of days by which DHS must notify the designated employee of a local jurisdiction of all approvals and denials for licensure and requests for changes affecting a sober living home.
14. Modifies the statement of legislative intent and findings.
15. Redefines sober living home.
16. Makes technical and conforming changes.
Amendments Adopted by the House of Representatives
1. Requires municipalities with zoning ordinances that restrict the distance between sober living homes or that enact building or fire code requirements for the operation of sober living homes to establish a procedure in which a deviation from the requirements may be granted as a reasonable accommodation under the Fair Housing Act.
2. Prohibits municipalities from reclassifying a single-family home under a local building or fire code solely because the home is subject to a sober living home license application.
5. Requires a sober living home to obtain and maintain current documentation from the local jurisdiction verifying compliance with all local zoning, building, fire and licensing ordinances and rules, and provide the documentation to DHS:
a) upon request;
b) upon initial application for licensure; and
c) when requesting approval for proposed change in the maximum number of residents or any construction or modification to the sober home.
7. Removes the requirement DHS investigations into alleged violations of a sober living home be commenced within 30 calendar days of receiving a complaint.
9. Stipulates that, if a licensee, owner, officer, agent or employee of a sober living home refuses to allow DHS or its agent to inspect the premises, the action is deemed reasonable cause to believe that a substantial violation has occurred.
10. Prohibits DHS from contracting with a sober living home accrediting body.
11. Allows the Director to order specified sanctions against a non-compliant sober living home whose violations immediately affect the life or safety of residents.
12. Requires sanctioned sober living homes to notify DHS in writing when it believes it is in substantial compliance and outlines notification requirements, timelines and procedures.
13. Allows a licensee subject to an intermediate sanction by the Director to request a hearing with OAH, in writing and within 10 days of sanctioning, to review the Director's action.
14. Authorizes the Director to issue a cease and desist order against a sober living home that does not hold a current or valid license or that exceeds the scope of authorized activities or services.
15. Allows the Attorney General or a county attorney to bring an action for injunction to restrain a sober living home violation or to enjoin future operation of maintenance of the sober living home until it is in compliance.
17. Requires DHS to notify a local jurisdiction of all initial licenses issued in that jurisdiction in the preceding month, if the local jurisdiction provides contact information to DHS for notifications relating to sober living homes.
18. Asserts that a sober living home is not prohibited from publishing or self-disclosing its address.
19. Modifies DHS reporting requirements relating to sober living homes.
21. Authorizes the Director to continue to pursue any court, administrative or enforcement action against a licensee even if the sober living home has closed or is in the process of being sold or transferred.
21. Establishes and outlines fingerprint clearance card requirements for sober living homes that receive government-funded referrals or public funding.
22. Redefines sober living home.
23. Defines terms.
24. Makes technical and conforming changes.
Senate Action House Action
HHS 2/6/24 DPA 6-1-0 HHS 3/21/24 DPA 6-4-0-0
3rd Read 3/12/24 20-8-2 3rd Read 6/14/24 52-6-2
Prepared by Senate Research
June 14, 2024
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