2023-120 Drug and Alcohol Treatment Facilities
Are Sometimes Concentrated In Residential Areas, As Allowed, But State Oversight Is Not Always Timely or Thorough
Published: October 24, 2024
Audit Recommendations Disclosure
When an audit is completed and a report is issued, auditees must provide the State Auditor with information regarding their progress in implementing recommendations from our reports at three intervals from the release of the report: 60 days, six months, and one year. Additionally, Senate Bill 1452 (Chapter 452, Statutes of 2006), requires auditees who have not implemented recommendations after one year, to report to us and to the Legislature why they have not implemented them or to state when they intend to implement them. Below is a listing of each recommendation the State Auditor made in the report referenced and a link to the most recent response from the auditee addressing their progress in implementing the recommendation and the State Auditor’s assessment of auditee’s response based on our review of the supporting documentation.
Recommendations to the Legislature
Recommendation 1
If the Legislature seeks to address concerns about the overconcentration of treatment facilities in residential communities, it could potentially enact legislation to address the issue without violating federal housing and disability law. In one possible example, the Legislature could require Health Care Services to issue regulations under the Administrative Procedure Act for making specific findings of fact when a license applicant’s proposed facility will result in overconcentration, to deny or impose additional requirements on the license when overconcentration would create an institutional setting for residents or impede their integration into the community. In another possible example, the Legislature could amend the statutory exemption from local zoning regulations to exclude new licensees that will effectively have more than six residents, such as closely located facilities that will share owners, directors, and amenities, and have more than six residents in total among them.
Recommendations to Department of Health Care Services
Recommendation 2
To ensure that it inspects all treatment facilities as required by state law, Health Care Services should do the following by October 2025:
- Provide management with information about the timeliness of compliance inspections. Such reporting should include the license expiration date for each facility, the status of the inspections, and the date by which the inspections must be completed to meet the 90-day inspection target.
- Implement a mechanism in its licensing database that notifies its staff of the dates for upcoming compliance inspections for their caseload so they can plan accordingly.
- Fill its vacant positions.
Recommendation 3
To ensure that it assigns complaints to analysts for investigation within 10 days as required by regulations, Health Care Services should update its policies and staff training by April 2025 to clarify the requirement.
Recommendation 4
To improve the timeliness of its investigations and align investigations of counselor complaints, which have interim deadlines for key investigation steps, with other complaint types, Health Care Services should implement guidelines by October 2025 that specify the length of time analysts should take to complete key steps in the investigation process for different types of investigations.
Recommendation 5
To ensure that it is conducting thorough investigations of unlicensed treatment facilities, Health Care Services should conduct site visits beginning in December 2024 in all instances in which there is an allegation that an unlicensed facility is advertising or providing treatment services without a license.
Recommendation 6
To ensure that unlicensed treatment facilities do not continue to provide services without a license after an investigation substantiates the allegation, by April 2025, Health Care Services should develop and implement a follow‑up procedure, such as by performing another site visit, to confirm the unlicensed facility has ceased providing such services.
