Some frustration lingers over pace of sober home reform in Florida

Worry hovers over what should be a time of unabashed enthusiasm in Florida's sober home community, with the state just four months away from the effective date of a law that will prohibit most treatment center referrals of patients to non-certified recovery residences.

Concern remains over whether the law adopted in 2015 will achieve enough to weaken or weed out unethical home operators who have tarnished the field's reputation, particularly in the state's southeast corner. Meanwhile, the statewide organization designated to perform the certification function is working hard to ensure that it will receive the resources it needs to do the job.

In interviews with Addiction Professional, the state's leading advocate for the recovery residence community, along with two home operators on opposite coasts of the state, listed these among their concerns regarding the sober home landscape in Florida:

• Federal and state law enforcement raids on recovery home operations in the past couple of years have led to no indictments, leading to the perception that authorities lack sufficient evidence to prosecute cases against unscrupulous owners.

• That has contributed toward reinforcing an uneven playing field in which it has become increasingly difficult to compete against entities that offer free rent because they bill residents' insurance for unnecessary intensive outpatient programming and excessive drug testing. “We're competing against the people who say, 'You have to do our IOP. You have to have insurance,'” says Miriam Barkley, owner of Choices Recovery in Fort Lauderdale.

• In a less saturated market on the west coast of the state, comparatively few recovery residences likely meet criteria for certification. “We are actively creating an infrastructure,” says William Atkinson, chief operating officer at Tampa Bay Sober Living, referring to activity in the region. “A lot of homes in this area are not up to code.”

• The Florida Association of Recovery Residences (FARR) has been expanding its capacity to perform the certification function to which it is fully transitioning as an organization, but it will not see state funding dollars for this until at least October. And as of late this month, its budget request ($25,000 in one-time funds and $250,000 annually) had not even been added to the proposed state budget now under consideration for the fiscal year that starts July 1.

Task continues

FARR president John Lehman says his organization is pushing ahead despite the unfinished business on the budget, as it seeks to meet its original expectation of having around 1,000 recovery residence locations in Florida certified by the end of this calendar year. So far, 170 entities encompassing 680 home locations have either been certified or are in the review process. Around half of the budget for the certification activity comes from fees paid by the entities seeking certification.

As for the rest, “We're going to raise this money somewhere, and it likely will be from the public,” Lehman says. FARR is even prepared to go to neigborhood activists with whom it has squared off on sober home siting in the past, he says. It would deliver the message that the public may have to pay for a process designed to distinguish good operators from bad, if the state legislature does not allocate the needed dollars.

Lehman adds that some operators also are urging FARR to re-examine its list of already certified operations to ensure that all are meeting ethical and other standards. The National Alliance for Recovery Residences' (NARR's) standards are the model for FARR's ongoing evaluation of residences. FARR is divesting of all non-certification components, as a new membership organization for recovery residence operators in the state is being established.

Ethical providers struggle

Lehman indicates that some of FARR's most well-respected members continue struggle against competitors who offer recovering individuals and families everything except a recovery-affirming environment, luring residents with the promise of free rent and grocery cards—at least until the residents' insurance stops paying for the outpatient services and drug testing on which these operators' business model is based.

He says, for example, that the organization Sober Living in Delray lost money last year and has resorted to reducing its bed capacity significantly.

Print and broadcast media in South Florida have highlighted numerous questionable practices in the industry in recent months, but most of the operators of these programs continue to do business relatively unfettered. The Palm Beach Post reported in December that one operator of several sober homes in Palm Beach County was thriving despite an ongoing law enforcement investigation into possible human trafficking and healthcare fraud.

Meanwhile, Barkley, whose Choice Recovery operates eight homes in Broward County, expresses frustration that raids on South Floirda sober homes that started a couple of years ago produced little follow-up activity. “I just think it was a lot of gossip,” she says. “It was a grain of sand on the beach.”

There remains much speculation as to whether a law that requires state-licensed treatment facilities to refer patients only to certified sober homes for recovery support will accomplish enough to boost high-quality homes and cripple poorly managed ones. Some observers believe that the law's allowance of referrals to a non-certified home owned by the referring provider constitutes too broad an exception and will water down the law's impact. Still, Tampa Bay Sober Living's Atkinson believes the law will pay dividends in the long run.

“I absolutely hope, and dare say believe, that this will improve the standard of living in sober homes,” Atkinson says.