Substance use disorder: addiction treatment referral agencies.

The bill text was reformatted from a printed legislative layout (with line numbers, page headers like 'SB 43 -2-', and page footers) to a clean web-based presentation format. No substantive policy language was changed.

Website navigation elements (skip to content, home, accessibility, FAQ, bill search, version history links) were added as part of the web rendering of the bill.

The digest line for state-mandated local program changed from 'State-mandated local program: yes no' to 'Local Program: YESNO', reflecting a notation update in how the fiscal impact designation is displayed.

Removed the amendment to Section 11832.2 that defined 'alcohol or other drug program' and its component services (treatment services, detoxification services, medications for addiction treatment), and that exempted recovery services from certification requirements.

State-mandated local program status changed from 'no' to 'yes' due to the new misdemeanor provision creating obligations for local law enforcement.

Removed the amendment to Section 11834.26 that imposed operational requirements on licensed facilities, including: records and procedures standards, prohibition on denying admission based on valid prescriptions for medication-assisted treatment, mandatory relapse plans, naloxone stocking and staff training requirements with civil liability protection, and accommodations for social model programs.

Added new Article 3 (Section 11833.073) making it unlawful for a licensed referral agency to participate in or operate a group advertising and referral service unless: referrals are patient-initiated, advertising complies with Business and Professions Code Section 651, no solicitors are employed, fees are not dependent on referral volume or professional fees, member programs charge usual and customary fees, the standard form contract is filed with the department (kept confidential), and if more than 50 percent of referrals go to 50 or fewer member programs that fact is disclosed in all public communications.

Removed the definition of 'recovery services' (community services providing emotional and practical support for continued remission, including mutual aid groups, recovery coaching, recovery housing, recovery community centers, etc.) and its exemption from licensing requirements.

Added authority for the department or five or more individual or member programs to petition a superior court for an injunction restraining violations of the group advertising and referral service provisions.

Created a misdemeanor penalty for any individual, association, partnership, corporation, or other entity operating a group advertising and referral service for addiction treatment without providing its name and address to the department.

Entirely new Chapter 7.45 (Sections 11833.06 through 11833.072) of the Health and Safety Code establishes a licensing regime for referral agencies that refer persons for remuneration to certified substance use disorder programs or licensed facilities. A written license is now required before operating such an agency.

Local public agencies performing referral services without cost to recipients of adult alcoholism or drug abuse recovery or treatment services are exempted from the new referral agency licensing requirements when otherwise authorized by law.

Referral agency licensees are prohibited from having a direct or indirect financial interest in any program or facility they do business with, creating a conflict-of-interest barrier between referral agents and treatment providers.

All certified programs and licensed facilities must report to the department, no later than July 15, 2026 and annually each July 15 thereafter, all money transfers between the program or facility and a recovery residence during the previous fiscal year.

Disclosure requirements in Section 11833.05 are expanded to include not only ownership or financial interest in a recovery residence but also any contractual relationship with an entity that regularly provides professional services or substance use disorder treatment or recovery services to clients of the program or facility.

Licensed facilities must maintain at least two unexpired doses of naloxone (or other FDA-approved opioid antagonist) on premises at all times and have at least one trained staff member who knows the location and administration of the medication. Trained staff receive civil and criminal immunity for good faith administration except in cases of gross negligence or willful misconduct.

Licensed facilities are prohibited from denying admission to an individual solely because the individual holds a valid prescription for FDA-approved medication-assisted treatment or narcotic replacement treatment.

Licensed facilities must develop a written plan addressing what happens when a resident relapses, including how the treatment stay and plan will be adjusted, how the resident will be supervised while under the influence, and discharge and continuing care planning. The plan does not require discharge.

An annual fee is required for referral agency license application and renewal, capped at the reasonable regulatory cost of administering the licensing program. Civil penalties collected are directed to fund administration of the chapter.

The fiscal committee designation changed from 'no' to 'yes,' indicating the amended bill now has a state fiscal impact due to the new regulatory and enforcement obligations.

The department may suspend or revoke a referral agency license for violations and assess a civil penalty equal to fees received as a result of the violation. A separate civil penalty equal to the remuneration illegally received applies to unlicensed referrers, enforceable by the Attorney General in civil action.

'Recovery services' are defined broadly to include mutual aid groups, recovery coaching, recovery housing, recovery community centers, recovery-based education, social and recreational infrastructures, social media, recovery-specific cafes, clubhouses, sports leagues, and creative arts programs. 'Recovery residence' is defined to include sober living homes and similar unlicensed dwellings.

Recovery services are exempted from both program certification requirements (Section 11832.2) and facility licensing requirements (Section 11834.26), meaning providers of purely recovery-focused community services do not need a state certification or license.

The amendment to Penal Code Section 740 (requiring misdemeanors and infractions to be prosecuted by written complaint under oath) was removed from the bill. This provision was unrelated to the substance use disorder subject matter of the rest of the bill.

Recovery services (mutual aid groups, recovery coaching, recovery housing, recovery community centers, sober living homes, etc.) were removed from the list of services that make an entity a 'program' requiring certification under Section 11832.2. Entities providing only recovery services no longer need departmental certification.

Recovery services were removed from the list of nonmedical services a facility must provide to be licensed under Section 11834.26. A licensee now only needs to provide treatment services or detoxification services, not recovery services.

The fiscal committee vote changed from 'no' to 'yes,' indicating the bill now carries a state fiscal impact requiring fiscal committee approval.