Residential Recovery - How the Federal Government Regulates It
The Americans with Disabilities Act of 1990, while primarily addressing the employment rights of the disabled, has been amended and interpreted to define which characteristics of a person qualify as a disability, including disabilities of "concentrating, thinking, communicating." Recovering Addicts thus have the potential to be considered disabled under Federal Law, though a person who is actively abusing substances is NOT considered disabled because of their addiction (they might have other disabilities). Left ambiguous is WHEN an addict becomes disabled during recovery or when/if they might ever be no longer considered disabled after recovery.
The Fair Housing Act, in turn, mandates that the disabled have equal rights to housing, given "reasonable accommodations." It extends the right to claim housing discrimination to a landlord providing housing for the disabled. This would, for example, prevent condo management from pressuring a landlord to refuse to provide housing to a tenant with a disability. Left ambiguous is the definition of "reasonable" accommodations. Owners of residential recovery businesses take full advantage of this ambiguity, claiming that blatantly commercial uses of residential properties are, in fact, reasonable accommodations for the properties' disabled occupants. Ultimately, it is the goal of these businesses to convince state and local governments that their properties cannot be regulated at all because they are protected by these Acts.
The Fair Housing Act, in turn, mandates that the disabled have equal rights to housing, given "reasonable accommodations." It extends the right to claim housing discrimination to a landlord providing housing for the disabled. This would, for example, prevent condo management from pressuring a landlord to refuse to provide housing to a tenant with a disability. Left ambiguous is the definition of "reasonable" accommodations. Owners of residential recovery businesses take full advantage of this ambiguity, claiming that blatantly commercial uses of residential properties are, in fact, reasonable accommodations for the properties' disabled occupants. Ultimately, it is the goal of these businesses to convince state and local governments that their properties cannot be regulated at all because they are protected by these Acts.
The courts have not specified particular reasonable accommodations for recovering addicts, but here is a sample list:
Here is a sample list of accommodations that are likely unreasonable, if anyone is equally prohibited from such behaviors:
- Living with people with similar disabilities
- Electing a leader amongst the occupants
- Hiring an assistant to help people
- Making rules that everyone in the house follows
Here is a sample list of accommodations that are likely unreasonable, if anyone is equally prohibited from such behaviors:
- Operating a boarding house
- Having other, unlicensed commercial uses
- Remodeling a house without permits
- Crowding more than 6 (or whatever the local regulations allow) adults on the property
The Role of the Affordable Care Act
In 2010, the passage of the Affordable Care Act made addiction rehabilitation an "essential health benefit." This requires all ACA insurance providers to cover addiction rehabilitative services, and residential recovery fees fall into this category. Additionally, the ACA prohibits insurance providers from denying someone coverage or giving someone suboptimal coverage because of a pre-existing condition. Residential recovery has increased in popularity in the past decade because expensive stays in desirable locales like California and Florida are now covered by people's insurance. If a recovering addict relapses, they are entitled to new insurance that covers treatment.
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Recent Steps by the Federal Government
Prior to 2018, the federal government had begun to take some steps that may increase regulation of recovery residences.
Representative Knight introduced HR 5100, which would set up a system through which the Director of the Center for Substance abuse Treatment and Recovery would establish model criteria for recovery homes and award grants to states that operate homes based on those criteria. The bill would also criminalize patient brokering with a fine and up to five years in prison and require that the Comptroller General of the United States conduct a study analyzing the effectiveness of the Act and what practices continue to work best at the state level.
Representative Rohrabacher proposed HR 5724, which would amend the Fair Housing Act to exclude recovery facilities in residential neighborhoods and precludes federal healthcare programs for paying for programs in such facilities unless they are in complete compliance with all laws and regulations.
Representative Bilirakis introduced HR 6092, which would develop "common indicators" that could be used to identify potentially fraudulent or disreputable recovery housing operators. Senators Rubio and Nelson introduced an identical bill in the Senate called SB 2828.
As well, the Subcommittee on Oversight and Investigations of the House Committee of Energy and Commerce has been holding hearings about the adverse behaviors of rogue rehabs. Recent hearings have included:
Energy and Commerce: "Examining Concerns of Patient Brokering and Addiction Treatment Fraud"
Energy and Commerce: "Examining Advertising and Marketing Practices within the Substance Use Treatment Industry"
Unfortunately, little progress has been made at a federal level since the 2018 election.
Representative Knight introduced HR 5100, which would set up a system through which the Director of the Center for Substance abuse Treatment and Recovery would establish model criteria for recovery homes and award grants to states that operate homes based on those criteria. The bill would also criminalize patient brokering with a fine and up to five years in prison and require that the Comptroller General of the United States conduct a study analyzing the effectiveness of the Act and what practices continue to work best at the state level.
Representative Rohrabacher proposed HR 5724, which would amend the Fair Housing Act to exclude recovery facilities in residential neighborhoods and precludes federal healthcare programs for paying for programs in such facilities unless they are in complete compliance with all laws and regulations.
Representative Bilirakis introduced HR 6092, which would develop "common indicators" that could be used to identify potentially fraudulent or disreputable recovery housing operators. Senators Rubio and Nelson introduced an identical bill in the Senate called SB 2828.
As well, the Subcommittee on Oversight and Investigations of the House Committee of Energy and Commerce has been holding hearings about the adverse behaviors of rogue rehabs. Recent hearings have included:
Energy and Commerce: "Examining Concerns of Patient Brokering and Addiction Treatment Fraud"
Energy and Commerce: "Examining Advertising and Marketing Practices within the Substance Use Treatment Industry"
Unfortunately, little progress has been made at a federal level since the 2018 election.