Oversight of Pa. addiction recovery homes will begin soon, but operators slow to opt-in

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HARRISBURG — The Wolf administration is preparing to enforce its long-awaited licensing system for addiction recovery homes, which have operated with limited oversight for years.

But with only two months before a major deadline, only a few dozen houses have submitted applications for a license, raising concerns that not enough operators will get on board with a reform meant to provide greater support for people struggling with addiction.

Recovery homes are supposed to offer safe places to live, while enforcing rules to help people avoid drugs and alcohol. They vary in size, but eight to 12 residents is a typical range, advocates told Spotlight PA, and homes often are owned by nonprofits, small businesses, or people who have personal experiences with recovery.

They provide an important service. But recovery advocates say some homes take advantage of vulnerable residents, crowd people into rooms, and condone illegal drug use. Without protections in place, the Wolf administration has argued, an unknown number of unregulated and substandard houses provide low-quality to no supportive services — potentially increasing the chance residents will relapse, overdose, and die.

In 2017, lawmakers gave the Department of Drug and Alcohol Programs the power to license recovery homes. But Wolf administration officials missed a deadline to formally introduce the rules for the new licensing system. And when they did propose the rules, they received strong pushback from some recovery home operators, advocates, and county officials who warned that requirements such as financial audits placed too much of a burden on homes.

In response, the department eliminated the financial audit requirement, scaled back other rules, and began accepting recovery house applications in late 2021. While operators will be able to apply for a license at any time, requirements under state regulations take effect in early June.

A big question is how many homes will sign up. No one knows exactly how many recovery homes there are in Pennsylvania, but they are believed to number in the thousands. Last year, the Wolf administration estimated about 600 houses would seek one of the state’s new licenses. But applications got off to a “slow start,” Jennifer Smith, secretary for the Department of Drug and Alcohol Programs, recently told lawmakers.

“I think a lot of the hesitation is fear of not knowing what that process looks like and thinking that it might be more daunting than what it really is,” Smith said at a March 3 budget hearing.

She suggested those concerns will fade as more homes undergo the licensing process.

As of April 11, there were four licensed homes and 30 applications under review, according to a department spokesperson.

About 100 more incomplete applications for recovery houses were in the state’s online application portal but hadn’t been submitted yet.

“There’s clearly a long way to go,” said William Stauffer, executive director of the Pennsylvania Recovery Organizations Alliance, which advocates for people in recovery. “And I think the jury is out. Will we have enough that can afford to go through it? … And then we need to consider what happens to people who are unable to afford the more expensive licensed houses.”

Licensed homes will have to pay an annual $250 fee to the Department of Drug and Alcohol Programs. To be licensed, the homes must comply with increased staff training requirements, follow other department policies, meet certain safety standards, and pass state inspections. The Wolf administration has acknowledged operators are likely to pass extra costs onto residents, but it said situations will vary, and licenses also bring benefits.

Applying for a license is voluntary, but there are incentives. Only licensed homes, for instance, can receive referrals from state agencies or state-funded facilities — which includes addiction treatment facilities that receive state money. Any person whose treatment is funded with federal or state money can also only be referred to a licensed home.

And only licensed homes can receive funding from federal, state, or county agencies. Beginning June 9, unlicensed homes receiving public funding could receive fines of up to $1,000 per day, the department recently warned.

In late March, the state announced another incentive for licensed homes: more than $1 million in grant money earmarked to help 22 to 25 homes pay for health and safety upgrades.

Despite those incentives, state Rep. Doyle Heffley (R., Carbon), who asked Smith about the number of licenses during the March budget hearing, worries there won’t be enough licensed recovery homes. That means many people will be pushed into homes that operate with no oversight.

“That’s what we were trying to get away from,” Heffley told Spotlight PA.

Operators of the state’s first two licensed recovery homes had kind words for the process, and are optimistic about the potential impact of the new system.

“It’s going to make owners … step up their game,” the Rev. Michelle Simmons, founder and executive director of the Philadelphia nonprofit Why Not Prosper, told Spotlight PA.

Her organization, which serves formerly incarcerated women, received a license for one of its recovery homes, and Simmons plans to seek licenses for its other facilities. Those licenses build credibility and open up new funding opportunities, she said.

While the state’s licensing system is new, Simmons said she has previous experience working with voluntary certification rules.

“For people that have got all their paperwork straightened out, it’s going to be kind of like a breeze,” Simmons said.

But people starting from scratch, Simmons said, should find a mentor.

In Monroe County’s Coolbaugh Township, Amanda Ramirez said the Department of Drug and Alcohol Programs was helpful during the application process and explained technical issues such as what type of fire exit was acceptable. Ramirez, 34, has owned a recovery home with her husband and mother for several years. After her brother Justin Bacher died from a fentanyl overdose last year, they renamed the home to honor him.

Ramirez said her family did a lot of outreach in the community to build a good reputation for their recovery home. She sees the licensing process as a way to stand apart.

“We’re going to have protocols to follow. We’re going to have inspections. We have people to answer to,” Ramirez said. “That was something that was really important to us. … We really just want the best.”

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