FARR receives calls, emails and, in some limited instances, grievance submissions from residents and their family that originate out of misguided expectations related to the service intensity or recovery support level offered by the provider. Florida offers a broad selection of certified homes from which to choose. However; it is important to appreciate “one size does not fit all“. Certification criteria may vary according to support level and most recovery residences serve specific populations and recovery pathways.
Through a voluntary process, Certified Residences provide FARR unrestricted access to interview management, staff and residents to verify implementation of policies, procedures and protocols previously documented by the provider. Certification to the NARR Standard ensures, for all stakeholders, provider compliance with measures demonstrated to enhance the quality of recovery support in a community-based, residential setting.
We recommend careful consideration of NARR support levels before commencing your selection process. One level is not better than another; rather offers distinctly different support characteristics and intensity of service. The effort you invest to familiarize yourself with these options helps to set appropriate expectations and ensure your selection of the support level that is most appropriate given your individual needs and circumstances.
All residents have an inherent right to be treated with respect and dignity by management, staff and peers. All residents have an inherent responsibility to abide by house rules and to actively engage in support of fellow residents. First and foremost, a recovery residence is home to persons in recovery who elect to live together as the functional equivalent of a ‘family unit’ and help one another to enhance their individual recovery capital.
National discussion continues regarding the efficacy of substance use disorder (SUD) treatment modalities. Some advocates for longer term protocols suggest recovery residences provide an ideal platform for engaging clients in partial hospitalization (PHP) and intensive outpatient (IOP) treatment through a blending of the Social Model of Recovery and Medical Model of Recovery philosophies. Studies confirm the efficacy of this approach and more research is underway. Clearly evidenced is that when persons, internally motivated to develop the necessary skills to sustain long-term recovery, live together as a ‘family unit’ for extended periods ranging from four (4) to twenty-four (24) months, greater numbers achieve measurable, positive results through engagement in peer supportive activities while residing in these micro-communities.
How do I gain access to the research referenced above?
Two sections of this website provide links to agencies where you can access research demonstrating the positive outcomes delivered to the consumer through residence in recovery-oriented housing: Navigate to “Community” and to “Affiliations & Resources”. From either of these pages, you may visit The White House-Office of National Drug Control Policy (ONDCP), Substance Abuse and Mental Health Services Administration (SAMHSA) and the National Institute of Health (NIH).
Additionally, Friends of FARR, Affiliate Supporters and Recovery Residences (Certified and Applicants) automatically gain access to the Supporter Portal which affords them access to the Resource Library.
Does FARR publish a Resident Rights & Responsibilities pamphlet?
FARR requires each Certified Residence to provide, as a component of their enrollment process, “Resident Rights & Responsibilities” and “House Rules & Consequences”. We recommend that prospective residents and/or the resident’s family request these documents for advanced review if they are not posted on the Certified Residences website.
Are scholarships available for residents who have no financial resources?
FARR is an accreditation body narrowly focused on voluntary certification of recovery residences to the NARR Standard and providing continuing education and training to owners, managers and staff of Certified Recovery Residences. As such, FARR does not engage directly in providing or sourcing financial scholarships. At the current time, the State of Florida has not provisioned a scholarship fund for this purpose. However; non-profit, Certified Recovery Residences throughout Florida are often willing to enroll an individual whom they deem to meet both financial hardship criteria and demonstrate the requisite willingness to take specific action to change the trajectory of their lives. FARR staff can help direct you towards these non-profit programs.
Are residents required to pay for their own room & board and under what circumstances may a treatment provider cover such expenditures?
This is a difficult question to answer due to the numerous statutory complexities applicable to this issue coupled with the fact that some Florida providers blatantly choose to ignore the law. We asked FARR Affiliate Supporter, Jeffery Lynne of Weiner, Lynne & Thompson P.A. to field this question:
“The only time room & board are paid for are when a patient is in inpatient / residential treatment. Even in these situations, room & board are technically not “paid for” but rather, are assumed to be included within the reimbursement to cover treatment expenses.
There are two key areas to keep in mind when a treatment center is considering providing recovery-orient housing options to their clients: (i) do they have the necessary licensure to provide housing; and (ii) do they run afoul of any civil or criminal laws in doing so.
From a DCF licensing perspective, you are not allowed to mandate/require that your patients reside anywhere unless: (i) you “control” the dwelling; and (ii) the requirement of residency is part of the license itself. For inpatient licenses (Residential Detox; Residential Treatment; Intensive Inpatient), this is self-evident. For outpatient licenses, the only two (2) licenses which allow you to require that your clients reside at your dwellings (whether you own or rent them) are: (a) Day or Night Treatment with Community Housing (aka “PHP” or “Partial Hospitalization”); and (b) Residential Treatment Level 5 housing.
With a PHP program, the clients attend treatment at the clinical location and then live at the residence you provide. A treatment provider can charge them rent or offer the room and board at no additional cost. That is completely up to the provider. Some provide room and board at no additional cost but offer the option to “upgrade” to a nicer residence for a fee. Again, this is completely legal.
What is NOT legal is to entice or induce clients to patronize your treatment center by offering them free room and board (“Come live here for free so long as you attend my treatment center.”). This runs afoul of the Patient Brokering Act, s. 817.505, Fla. Stat., which prohibits offering a potential or existing client anything of value as an inducement to patronize or continue to patronize your health care facility. This includes free or subsidized rent, food, and so forth. This is a criminal law, a third-degree felony, punishable by fines and up to five (5) years in prison, per incident.
On the other hand, if free or subsidized rent, food, or extras are part of the treatment program (and not used as the “selling point” of a program), then I believe a regulator would be hard-pressed to demonstrate that one had the intent to criminally induce a patient. Providing housing is a required component of a PHP license.
Outside of a PHP program, the current DCF rules regulating treatment providers state that you may NOT mandate that clients reside at any particular dwelling associated with your outpatient license (IOP; OP; etc.). However, the license which is termed “Residential Treatment, Level 5” specifically provides that this license DOES allow you to mandate that your residents live at the dwelling you provide. It is a separate license you obtain which is essentially “tied in” to your outpatient license. However, notwithstanding the name, you are not authorized to provide inpatient, residential care, though some unscrupulous providers do try to bill for residential services and I am told have been successful at illegally being compensated by insurance providers. Aside from being Insurance Fraud, the transmittal of those fraudulent bills could also be Mail Fraud and Wire Fraud, all felonies.
DCF has indicated to us that they may elect to eliminate the Residential 5 housing option due to confusion amongst jurisdictions and issues we have discussed with DCF’s General Counsel over the high burden imposed to achieve licensure. We believe they will likely replace it with an alternative similar to “IOP with Community Housing” and “OP with Community Housing” and so forth.
Aside from these two (2) license categories, a treatment provider cannot mandate or require its clients to live anywhere, else they risk running afoul of your licensure.
However, they can offer housing to their clients by letting them know it exists and they are likely going to want to live there. But they can’t make them do so.
Also, they cannot offer them free or subsidized rent. That will be deemed an illegal inducement. They have to pay “fair market value rent” which, for a Recovery Residence, I understand to be in the ballpark of $150-$250 per week for a bed.
Now, that said, if a treatment center is presented with a client who wants to patronize that treatment center due to the quality of the services, but the provider then learns, after the fact, the patient has nowhere to live and otherwise cannot afford rent, they may be able to assist them (often referred to as providing a “scholarship”) but only on a case-by-case basis and only for the very limited period of time until they are able to get work to pay rent. But a provider cannot make this SOP (Standard Operating Procedure) and each client must be specifically vetted to determine actual need. Having them complete an Affidavit may be useful. A provider simply need to demonstrate that they did not have the intent to induce patronage of their facility. Granted, this is all substance over form. Only they know if they are being honest, or using free or subsidized rent to illegally lure a client.
Also, even with honest clients and providers, the clients will get to know one another and may start telling each other that the center is providing free rent. What happens next is that each client then wants the same “perk” so that they can take the money their family sends to them and use for other things. We therefore suggest that their family/next of kin work directly with the provider to pay for rent, food and other necessities.”
Answer graciously provided by:
Jeffrey Lynne, Esq.
Weiner, Lynne & Thompson, P.A.