Prevent Further Voluntary, Third-Party Certification Schemes
The addiction treatment industry loves to give itself gold stamps. Third-party certifiers like California Consortium of Addiction Programs and Professionals (CCAPP), the National Alliance of Recovery Residences (NARR) and accrediting organizations like the Commission on Accreditation of Rehabilitation Facilities (CARF) love the income stream they obtain by providing stickers and stamps to facilities. Unfortunately, even the providers recognize that these approvals are worthless:
"Even though some of them voluntarily get accredited by accrediting bodies, I myself have three different accreditations by the joint commission and two certifications by the joint commission-- the Joint Commission and other accrediting bodies don’t really bother themselves too much with my business practices, so if I want to be some scam artist out there hustling admissions into my facility, even though I’m accredited and have to meet a certain set of standards to keep that accreditation, what I do in my business practices is largely NOT something they monitor or look into when they come do their site visits and their monitoring."
-- CEO Tony Senella of Tarzana Treatment Centers, January
Senate Informational Hearing: Substance Use Disorder Treatment in California, 1/31/18 |
Regardless of whether the third-party certifying entity is a nonprofit or not, the certifier's and its facilities' bottom line and survival are what matters most to it, so to protect its income stream.
In contrast with certification by third-parties, government does not accept direct payment in exchange for licensing, which ensures that it is the least corrupt arbiter of business-consumer relations. When the government moves to license services and businesses, it squeezes out third-party certifiers. To stall government action, the National Association of Recovery Residences (NARR) has been pushing a state and federal agenda to make third-party certification the arbiter of Addition Treatment and Recovery Housing quality. It knows that all governments and budgets are under scrutiny, so it provides a convenient way for government to pretend it is raising standards without having to get involved. The reality? Either the bar is low or it is riddled with loopholes or the worst operators don't adhere to the "voluntary" standards; in other words, the worst continue to operate as they always have.
2021 - AB 1098 Daly
A copy of a bill at the federal level, H.R. 8868, the Excellence in Recovery Housing Act. (Trone, Chu, Levin), which proposes to have industry develop standards, and again, to mandate referrals, including for those exiting the court system, only to the houses that have been third-party certified. Sponsored by CCAPP.
2021 - AB 1158 Petrie-Norris
A bill proposing licensed houses must carry commercial insurance policies, and insurers must require proof of certification by the National Alliance of Recovery Residences.
The following bills, which Advocates for Responsible Treatment has opposed, have failed to pass in the legislature:
2019 - AB 940 Melendez
Based on conversations with their office, this is another “certify-and-route-addicts-to-certified-houses” bill sponsored by the California Consortium of Addiction Programs and Professionals. Brought to you by the people who last year wanted to declare such houses a “residential use” of property, which would prevent cities from regulating them. It also includes a $50,000 penalty for body brokering.
2019 - AB 1779 Daly
ALSO defines “Recovery Residence” (already defined in code) without addressing the commercial aspect of operating houses, a common industry ploy. Requires the state to adopt National Association of Recovery Residence standards before federal standards are set. Cities that can prove fraudulent activity at a house can complain to the state that a house doesn’t have certification, thereby lining the pockets of the certifying entity. Everyone, including the court system, must send people to certified houses ahead of uncertified houses, so that they can make more money from private insurance. Requires opioid overdose reversal medication in the house.
2019 - SB 10 Beall (Waldron, Nielsen, Carrillo)
Because there are no standards for peer providers and people are increasingly engaged in providing support and counseling, and there’s money to support certification, someone thought this bill was a good idea. This bill would require DHCS to contract with yet another third party to establish a peer, parent, transition-age, and family support specialist certification program—the state itself would likely not be doing the certification. It requires that the person have had a mental illness, substance use disorder or both and have a strong dedication to recovery, but does not require they be tested for ongoing drug abuse. This seems primarily to be a way of legitimizing informal advising and helping people get paid for it. It is possible that industry believes it can get insurance reimbursements for employing people with certificates.
2018 - AB 2214 Melendez/Rodriguez, Acosta/Gallagher, Gray, Lackey, Nazarian, Bates
In exchange for voluntary certification, a house will be immune to oversight from cities or the state and will be referred clients from the penal system FIRST, ahead of more effective, more affordable housing with oversight of the probation system. Brought to you by the California Consortium of Addiction Programs and Professionals.
2017 - AB 285 Melendez - Republican
The concept is right: can’t call yourself a “Sober Living Environment” unless you’ve been certified, but the certification agency isn’t the state, which makes it likely to amount to a rubber stamp by industry on itself..
2021 - AB 1098 Daly
A copy of a bill at the federal level, H.R. 8868, the Excellence in Recovery Housing Act. (Trone, Chu, Levin), which proposes to have industry develop standards, and again, to mandate referrals, including for those exiting the court system, only to the houses that have been third-party certified. Sponsored by CCAPP.
2021 - AB 1158 Petrie-Norris
A bill proposing licensed houses must carry commercial insurance policies, and insurers must require proof of certification by the National Alliance of Recovery Residences.
The following bills, which Advocates for Responsible Treatment has opposed, have failed to pass in the legislature:
2019 - AB 940 Melendez
Based on conversations with their office, this is another “certify-and-route-addicts-to-certified-houses” bill sponsored by the California Consortium of Addiction Programs and Professionals. Brought to you by the people who last year wanted to declare such houses a “residential use” of property, which would prevent cities from regulating them. It also includes a $50,000 penalty for body brokering.
2019 - AB 1779 Daly
ALSO defines “Recovery Residence” (already defined in code) without addressing the commercial aspect of operating houses, a common industry ploy. Requires the state to adopt National Association of Recovery Residence standards before federal standards are set. Cities that can prove fraudulent activity at a house can complain to the state that a house doesn’t have certification, thereby lining the pockets of the certifying entity. Everyone, including the court system, must send people to certified houses ahead of uncertified houses, so that they can make more money from private insurance. Requires opioid overdose reversal medication in the house.
2019 - SB 10 Beall (Waldron, Nielsen, Carrillo)
Because there are no standards for peer providers and people are increasingly engaged in providing support and counseling, and there’s money to support certification, someone thought this bill was a good idea. This bill would require DHCS to contract with yet another third party to establish a peer, parent, transition-age, and family support specialist certification program—the state itself would likely not be doing the certification. It requires that the person have had a mental illness, substance use disorder or both and have a strong dedication to recovery, but does not require they be tested for ongoing drug abuse. This seems primarily to be a way of legitimizing informal advising and helping people get paid for it. It is possible that industry believes it can get insurance reimbursements for employing people with certificates.
2018 - AB 2214 Melendez/Rodriguez, Acosta/Gallagher, Gray, Lackey, Nazarian, Bates
In exchange for voluntary certification, a house will be immune to oversight from cities or the state and will be referred clients from the penal system FIRST, ahead of more effective, more affordable housing with oversight of the probation system. Brought to you by the California Consortium of Addiction Programs and Professionals.
2017 - AB 285 Melendez - Republican
The concept is right: can’t call yourself a “Sober Living Environment” unless you’ve been certified, but the certification agency isn’t the state, which makes it likely to amount to a rubber stamp by industry on itself..