Bill could help set standards for sober living homes

Sober-living-home operators have been accused of exploiting recovering addicts for sex, and even of giving drugs to drug addicts.

Operators and their customers have generated neighborhood complaints, lawsuits and allegations of behavior so rowdy it borders on the criminal.

But houses filled with people struggling with addiction can also be lifelines — and big business, hauling in tens of thousands of dollars each month for their owners. And because sober living residents are protected by the Americans With Disabilities Act — meaning police and zoning officials have to treat them as they would any other family residence — no one knows exactly how many of these houses exist in California. No one inspects sober homes; no one regulates them to ensure quality and safety.

A proposal being debated in Sacramento, from Assemblymember Tom Daly, D-Anaheim, would change some of that.

Assembly Bill 1779 calls for establishing the first ever minimum operating standards for sober homes that get public money to accept patients from the courts or public health systems. It also would deny certification to would-be operators who have previously lost licenses to run addiction treatment centers.

The California Department of Health Care Services would have to create “best practices” and quality control standards for sober homes, including a requirement that these homes keep the anti-overdose drug Narcan on site.

Daly hopes to prevail where myriad other bills seeking to impose order on the industry have failed.

“Despite the growing death toll from opioid and alcohol abuse and addiction, California lacks a uniformset of standards to guide individuals and their loved ones in identifying safe, reliable housingaccommodations that will be conducive to recovery,” Daly said in a statement.

“AB 1779 will enable California to provide accurate and up-to-date information …. And by adopting best practices, including minimum standards for recovery residences, California will take a significant step towards increasing the number of residences that are safe for people in recovery and for the communities where they are located.”

Skeptics

While some applaud AB 1779 as another baby step toward much-needed reform in an industry rife with corruption — “A first step towards beginning to get the sober living industry in line in the state of California,” said activist Ryan Hampton — others don’t.

Critics say setting bare-bones standards on the few homes that get public funding fails to address the much larger problem — thousands of private sober homes in California, financed with private money, that answer to no one.

“This is just another ridiculous bill that the makes the Legislators feel good about themselves, adds layers of bureaucracy and rules that will never be enforced, and ultimately just wastes all of our time and tax money,” said David Hurwitz of San Clemente, who was once the next-door-neighbor to a 12-bed sober living home with a revolving door of recovering addicts.

“Addiction is certainly an issue that needs major attention,” Hurwitz added. “But the entire concept of housing these ‘patients’ in regular neighborhoods during the time they need carefully supervised medical treatment is simply crazy and must be ended.

“I am very skeptical that anything meaningful is ever going to happen.”

As sober living homes have proliferated throughout Southern California, residents from Malibu to San Clemente and Murrieta to Lake Arrowhead — the area known within the industry as the Rehab Riviera — decry how their once-quiet neighborhoods have morphed into virtual recovery campuses, sometimes with many sober living homes clustered within spitting distance of one another.

“Voluntary certification standards…. Same old song,” said Laurie Girand of Advocates for Responsible Treatment in San Juan Capistrano, a nonprofit group advocating for regulation of the recovery industry.

“This is health care, not vitamin supplements,” Girand said. “When are we going to start treating it like health care?”

More than a dozen bills have been introduced this session to try to address California’s scandal-plagued addiction treatment and recovery industry. Many see one as essential: AB 704.  It would require criminal background checks for employees of licensed addiction treatment centers. It was introduced in the Assembly by Jim Patterson, R-Fresno, and is co-sponsored by Sen. Pat Bates, R-Laguna Niguel.

Last year, the Orange County District Attorney’s office launched a Sober Living-Home Investigation and Prosecution task force to take aim at scammers in the field. To date, it has received 158 tips and has multiple open investigations, officials said. It has filed charges against five doctors, two administrators and four alleged “body brokers” (people who get paid to bring patients to addiction centers and sober homes) in what prosecutors call a multi-million-dollar insurance-fraud scheme. Complaints can be made to the task force online or at 714-647-3228.

Todd Spitzer, Orange County’s new district attorney, isn’t sure that Daly’s bill will help with problems reported in the private sector, either.

“He really needs to take a strong look at the area where there’s significant abuse, the residential treatment facilities that are being run by private operators and funded through private insurance,” Spitzer said. “One of biggest complaints we get are about private facilities targeting people across country, bringing them here, then tossing them out when the insurance benefits run out. That’s not happening when government funding is involved. They’re very distinct and different entities, which is why my office is pursuing the private side.

“We have people who are ripping off the system.”

In Huntington Beach, city attorney Michael Gates has teamed up with the D.A.’s office to sue sober homes using a novel legal strategy — charging the homes with operating a medical facility without a licence.

What would AB 1779 do?

Daly’s bill would require sober homes to meet the most recent standards approved by the National Alliance for Recovery Residences before receiving state funding for recovery residence housing. After the U.S. Department of Health and Human Services publishes a “Best Practices for Operating Recovery Housing,” homes getting public money would be encouraged to match those standards.

It also would require that courts and county hospitals refer patients to certified sober homes if spaces are available.

And the element of the law that would deny certification to sober home operators who have lost their addiction treatment licenses, or had those licenses suspended, is an effort to recognize the whack-a-mole nature of the industry. Often, sober home operators driven out of business by neighborhood pressure or legal actions in one location simply resurface in a nearby community.

If AB 1779 is passed, it would mean more work for the Department of Health Care Services, which would have to create an Internet listing with the address of each sober home that’s lost its certification, or whose application for certification was denied, as well as the names of operators whose certification was revoked or denied.

The department also would have to provide lawmakers with data about the frequency and types of complaints received — and the status of those complaints — about specific sober homes.

A spokesman for Daly believes the bill would, indeed, raise the bar for all sober homes. The adoption of best practices — and a certification process with evidence-based standards — would help identify responsible recovery residences. If sober home residents are found to be using drugs or alcohol, owners/operators wouldn’t be able to claim zoning privileges under the Americans with Disabilities Act.

“If a home is in reality a ‘flop house’ for drug activity, it should be shut down,” said David Miller, spokesman for Daly.

Why needed?

State data paints a grim picture of drug use in California. There are about 3.5 million state residents with diagnosable substance use disorders, and two years ago 4,868 California residents died from drug overdoses. If California has followed national trends, both figures have gone up.

Also, it can take years for addicts to reach a full, sustained recovery, with the first 30 to 90 days after treatment viewed as the most critical for preventing relapse. The bill, AB 1779, acknowledges that, saying it is “imperative that recovery residences be expanded as a means of reducing costs associated with multiple treatment episodes.”

Substance use disorder is ranked in the top five clinically-preventable burdens on health care spending, and addicts, prior to entering treatment, tap into health care services at twice the rate of the general population.

“AB 1779 is not an end-all,” Daly’s spokesman, Miller, said. But the goal, he added, is to “establish a framework for changing things for the better, for consumers and communities alike.”