Thursday, June 16, 2016

State task force releases recommendations for voluntary certification of recovery houses

Posted: Tuesday, June 14, 2016 6:45 pm

A Pennsylvania task force has released a long-awaited proposal for creating the state's first voluntary certification process for recovery houses, an unregulated industry that has come under public scrutiny in recent years.
The report — submitted earlier this month to the Pennsylvania Department of Drug and Alcohol Programs by the Certified Drug and Alcohol Recovery Housing Task Force — includes a definition for recovery residences and building standards, an ethics code and minimum policies and procedures for operating the homes, which house individuals recovering from substance addiction.

"We have worked very hard on these preliminary recommendations," said William Stauffer, executive director of the Pennsylvania Recovery Organizations Alliance, who served as the task force chairman.
If the recommendations are implemented, recovery house owners would decide whether to sign up for the certification. If they don't sign up, they likely would lose state funding and referrals.
Nationally, recovery houses have become a lucrative and fast-growing area of the housing industry that available behavior research has shown can be an important transitional step toward maintaining long-term sobriety for many people.
But most states, including Pennsylvania, lack operating standards, employee training requirements, a review process or certification for the homes, whose residents are protected from discrimination under federal housing and disability laws. The lack of third-party oversight has made it difficult for families and local officials to know much about recovery houses, including where they're located, who runs them and if they provide a sober and safe environment for residents.
In Bucks County, at least 121 recovery houses are operating, according to an analysis this news organization did earlier this year. More than three-quarters of the homes are located in Bristol Township — many concentrated in adjacent Levittown neighborhoods bounded by Route 413, Route 13, New Falls Road and Levittown Parkway.
Some states recently have enacted a voluntary certification process as a way to bring more supervision and consistent standards to recovery residences and weed out poorly run operations. In those states, behavioral health, drug treatment and courts can refer clients to only certified recovery houses. Certified houses in those states also have access to additional state funding and resources.
The Pennsylvania task force is calling for new rules and regulations designed to oversee and track the progress of recovery house residents. The rules would include creating a formal orientation process and keeping track of residents' medical and personal histories, fees, activity logs, treatment referrals and case management services. House operators would be required to maintain resident records in a secured storage area.
Certified houses also would be required to collect basic data, including when residents arrive and leave and the reason they moved out. Residents who are involuntarily removed from a house must be provided a written notice that includes the reason for getting booted. The termination notice also must be maintained in the resident's record.
New residents who are not referred from a drug treatment center would have to undergo an assessment by the county's state-funded drug and alcohol services provider within 14 days after admittance, under the recommendations. Recovery residences that provide services beyond housing would be required to develop written recovery plans for residents that must be updated every 90 days and detail the specific service planning, educational approaches, support and treatment referrals used. Operators would be required to develop written policies involving medication used by residents including drugs with abuse potential.
Any unusual incidents — including overdoses, deaths, suicide attempts, sexual or physical assaults, outbreaks of contagious diseases, alleged misuse of resident's funds or property, fire or structural damage — would have to be reported to the Department of Drug and Alcohol Programs within 48 hours, under the requirements. 
The new standards for certified homes would apply not only to owners and operators but also house officers and employees.
House operators would be required to have a written description of duties, including minimum qualifications and responsibilities, and undergo a criminal background check. They also would be required to post their contact information in a common location inside the recovery home.
Under the new requirements, owners, operators and employees who are in recovery would have to maintain sobriety, and hire other individuals who have maintained sobriety for at least one year. They also would submit to alcohol and drug testing at the DDAP's request.
Former residents also would have to maintain sobriety for at least 18 months before they could be hired to work in the same recovery house where they once lived.
Under the ethical code, anyone who works for or operates a recovery house would not be able to engage in any financial benefits with other health care providers that involve incentives for patient referrals.
Owners and employees also would not be allowed to get involved in a resident's financial affairs and would be barred from any romantic or sexual involvement with any resident or anyone the house is assisting, even after the person leaves the house.
The draft standards also require that certified recovery houses maintain housing quality "consistent" with the nature of the immediate neighborhood. The regulations set time limits for addressing maintenance or mechanical problems and requires homes to carry general liability insurance.
The building recommendations include requirements that homes have a living room with furnishings that are in a good state of repair and that garbage be stored in non-combustible covered containers and removed at least weekly.
Recovery homes would have a limit of four residents per bedroom, which must have a source of natural light, one bathroom for every eight residents and no group showers or open toilet stalls.
Homes would be required to have a minimum of two exits on every floor, including a basement, at least one smoke detector and fire extinguisher on each floor, and a carbon monoxide detector with heating systems involving gas as a byproduct or with an attached garage. Houses also would have to have a written fire safety policy that includes evacuation procedures, and unannounced fire drills every 90 days.
Along with its draft standards, the task force recommended additional funding allocations to county level drug and alcohol service providers for case management services. It also recommended that DDAP consider providing funding assistance to recovery home operators who could be required to upgrade their houses and obtain additional training to meet the voluntary standards.
The state Department of Drug and Alcohol Programs allows its county agencies to use state grants for the delivery of drug and alcohol prevention services to pay for temporary stays at recovery houses. Bucks County is one of 12 counties during the most recent fiscal year to use the DDAP money for that purpose.
The task force itself was an outgrowth of a 2014 Pennsylvania House bill introduced by state Rep. Frank Farry, R-142, of Langhorne. The bill sought to statutorily require the DDAP to define recovery-based housing and create statewide standards for it.
This news organization was unsuccessful in reaching drug and alcohol programs Secretary Gary Tennis for comment on the next step. Earlier this year, a department spokesman said the full set of recommendations would be reviewed by the DDAP, which then would determine what regulatory body should oversee the implementation.
The DDAP licenses and oversees only drug and alcohol treatment centers and programs that provide medical care.
State Rep. Tina Davis D-141, of Bristol Twonship, who has introduced two bills in the House addressing recovery house regulation, believes the task force did a thorough job with its recommendations, though she still has concerns, particularly involving the proximity of house locations.
"When you have four or five on one street, it affects people's parking, the amount of trash, and possibly other things," she said.
Don Colamesta, chairman of the Bucks County Recovery Housing Association, which promotes peer self-regulation of recovery houses, had not seen the new draft standards Tuesday and declined to comment on them.
"We support regulation of recovery houses," he added. "That's why we have been doing it for years."

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