Recovery homes refine operational standards, embrace states` support

As they embark on their organization's Best Practices Summit next month in Washington, D.C., leaders in the National Alliance for Recovery Residences (NARR) see numerous signs of the maturation of their segment of the continuum of support. While in many communities the fight to uphold basic housing rights still must be waged aggressively, some states are weighing in to ensure that high-quality recovery homes are targeted in treatment centers' referral of patients for post-treatment recovery support.

National leaders are eagerly awaiting implementing actions in Massachusetts, for example, where a law is on the books to establish a statewide certification organization and to require as of next July that any treatment center accepting government funds refer patients only to approved recovery homes. “Massachusetts will support and fund the formation of a [NARR] affiliate from scratch,” says Dave Sheridan, the NARR president who also leads the Sober Living Network in California.

Updating standard

As NARR leaders gather Oct. 5-6 for their Best Practices Summit (and as many plan to be out in force at the UNITE to Face Addiction rally taking place on the National Mall on Oct. 4), the organization will be preparing to release a revision of its national standard document that was first unveiled in 2011. Originally released as a statement of principles, the standard now will be designed for use as a road map allowing NARR's state affiliates to evaluate and monitor member homes' operations. Around 20 states currently have a NARR affiliate organization or are in the process of forming one.

Beth Sanders, a former NARR president and the executive director of Hope Homes Recovery Services, says the revised standard will blend elements of the original standard, the “social model” principles that define a recovery home's sense of community and that distinguish it from the hierarchical boundaries necessary in a treatment center, and core principles of recovery articulated by the Substance Abuse and Mental Health Services Administration (SAMHSA).

Sheridan says the revised standard can be used to help document whether a recovery residence is adhering to the basic principles of peer-based recovery, such as whether it creates intentional opportunities for residents to interact through house meetings and structured activities.

He adds that NARR is requiring its state affiliates to align their own standards to the national standard, but not necessarily to adopt the national standard word for word. In states such as Georgia, an effective working standard from a statewide association existed long before NARR was ever created, he says.

Sheridan says a significant challenge in drawing up a national document has been to create minimum standards of high-quality performance without compromising operators' ability to run viable homes (such as by imposing certain physical facility standards that would be difficult for operators to meet from a financial standpoint).

State-level activity

NARR leaders are highly energized over state legislative activity in recent years in states such as Ohio, Florida and Massachusetts. In many cases, advocates have been instrumental in turning the conversation from one of stopping the growth of recovery homes in neighborhoods to one of taking measures to help high-quality operations flourish and to isolate unethical providers from potential referral sources.

In both Florida and Massachusetts, some treatment centers will be restricted by law from referring their discharged patients to a sober home that has not proven it meets standards of operation. These standards include ethical provisions, an important consideration for a field that has been hurt by practices such as excessive billing for drug tests and payments for referrals.

Susan Binns, who heads NARR's conference committee and is founder and president of YANA (You Are Not Alone) House, a women's recovery home in Nashville, Tenn., says she hopes there will come a time when all referrals to recovery housing will go to homes that meet national standards.

“My belief is NARR and its affiliates have the opportunity to perhaps lessen the disorder,” says Binns. “It is a thoughtful, dedicated effort to change a necessary, difficult phase of recovery and this industry.”