It was such a superbly clever bill. With the wave of a (bureaucratic) magic wand, it could have imposed some order on an unruly, high-dollar industry that deals in life and death.
But, like other sparks of legislative brilliance — like, say, requiring the vast majority of California’s addiction treatment centers to actually be licensed — it smashed into a brick wall in Sacramento.
Assemblywoman Cottie Petrie-Norris’s bill, AB 2087, would have done something elegant and logical to protect vulnerable people seeking sobriety, as well as the neighborhoods that host them: It would have simply required that businesses and employees distributing prescription drugs to their clients/patients actually be licensed to dispense or furnish prescription drugs to their clients/patients.
It would have also allowed folks to sue businesses that didn’t adhere to the law.
Now, in case you haven’t been following every burp and gurgle of our reporting on the addiction treatment industry over the past five years, it’s exceedingly common (in both licensed treatment centers and unlicensed sober homes) for “house managers” or “house techs” to keep prescription meds under lock and key, then dole them out daily to the clients/patients who need them so the patients can “self-administer” their prescriptions.
They’re not pharmacists. House managers’ or techs’ main credential is often that they’ve been sober for a few months, and/or that they went through the program they now work for. But this “self-administer” loophole allows treatment and recovery businesses to evade licensure — and things can go terribly awry.
Death before dawn
In the early morning hours of Aug. 26, 2021, a raging Henry Richard Lehr left the Gratitude Lodge detox house in Newport Beach exhibiting signs of paranoid delirium. He screamed about wanting to leave, about being chased, about wanting to go home. He broke into a handsome home on a nearby cul-de-sac; the man inside had a gun; and in seconds, Lehr — an aspiring singer-songwriter with a “phonographic” memory who struggled with alcohol and other substances — was dead. He was 23.
Lehr received a cocktail of contra-indicated medications, Petrie-Norris said when introducing the bill in the Legislature.
“It’s clear that this young man should have been in a facility with much greater supervision and monitoring,” Petrie-Norris said. “This tragic example really does highlight in my mind the need for this bill, and the need for us to strengthen oversight when it comes to the distribution of medications, particularly in recovery residences.”
This bill was the latest to be called “Jarrod’s Law,” after Wendy McEntyre’s son, who died from an overdose in a sober living home in the San Fernando Valley. Twenty-four men were living in the three-bedroom house, and one brought “speedballs” to share.
“The staff responsible for his care did nothing to save or revive him,” McEntyre told the legislators. “He was left aspirating for hours alone until his last breath, all while the fire department was just two blocks away, but were never called.
“This complete negligence and lack of care opened my eyes to the unfortunate fact that I am not alone. Families continue to send their loved ones to treatment in hopes of them finally getting help. Only their loved ones are facing circumstances much worse than addiction.”
Deaths continue to pile up, but go unreported and unnoticed, she said (though we’ll be telling you more about all this shortly). We need to close this extremely dangerous loophole, she said.
Christian Atchason told legislators about how he signed up for a $120,000, six-month program in 2020 with a provider in Newport Beach and Costa Mesa. There was a “house tech” working from the garage of an unlicensed home, administering morning, noon and evening meds to dozens of patients, he said.
Atchason was eventually “curbed” — the lingo for being kicked out when insurance benefits expire — but the provider continued ordering medications in his name anyway, he said. He wound up homeless, which aggravated vertebrae damage; but he fared better than others who were in treatment with him. Several died, he said.
There was no formal opposition on file.
But analyses of the bill said that existing law already prohibits dispensing prescription drugs without a license.
And that existing law already allows people to sue for unfair business practices.
And that expressly granting the right to sue in these instances could clog the courts and cost the state — wait for it — another $265,600 or so a year.
And money is so tight these days! (Oh, wait, isn’t there a $49 billion surplus in the state budget or something…?)
“It died in appropriation,” Petrie-Norris said. “The official explanation is that bills die because they cost the state money and don’t make it through in the rank of expenditures. It’s somewhat of a black box.
“From my perspective, this is just the latest in four years of failed legislation trying to regulate this industry and protect patients,” she said.
“For me, not enough of my colleagues recognize the urgency of this issue. As we know, this is concentrated in our communities on the Orange County coast and a handful of other places. It’s not widespread.
“For us to move the needle, we need individuals and their families — who have had these experiences and have been harmed — we need them to speak out, to raise awareness, so more of the Legislature understands that this is urgent. It’s fair to say that it’s a matter of life and death.”
McEntyre is disappointed, too, but vows to keep working to raise the bar.
“Medication administration IS A LICENSABLE SERVICE and it’s criminal that (the California Department of Health Care Services) is allowing self-administration to avoid a licensure,” she said by email.
We’ve said this too many times over the past five years, but here it is again: There’s always next year. But how many people will die between now and then?
Source: Orange County Register