However, there are also unscrupulous actors running sober living homes who profit off the misery of their occupants. Landlords exploit individuals with substance-use disorders for money or sex, and even encourage relapse over recovery. There is rampant abuse of the system, including patient brokering, devious marketing practices, kickbacks from treatment providers and insurance fraud. And neighborhood residents complain about noise, traffic problems, and public alcohol and drug use, particularly where sober living homes are in close proximity to each other.
Across the country, there is a growing proliferation of sober living homes, with thousands in operation in hundreds of communities. Our own communities -- Palm Beach County, Fla., and Orange County, Calif. - certainly have their share. We see not only the benefits of these facilities but also the problems that flow from a lack of regulation and oversight - a shortcoming that local governments have little power to rectify.
No treatment is provided in sober living homes. Instead, those seeking sobriety usually attend outpatient rehab at a nearby facility. It is no accident that the surge of these homes is occurring against the backdrop of an opioid-abuse epidemic that claims more than a hundred lives nationwide each day.
Unfortunately, local governance is almost nonexistent due to a federal regulatory architecture that usurps community authority. The 1990 Americans with Disabilities Act (ADA) requires that states, cities and homeowner associations provide "reasonable accommodations" to individuals with disabilities, including recovering addicts. Provisions of the ADA and the 1968 Federal Fair Housing Act (FHA) are intended to ensure that those seeking sobriety can do so as a protected class as long as they are in the process of recovery.
But the problems with sober living homes aren't happening in the halls of Congress. They're happening on the streets and in the neighborhoods of our communities. Better regulation is needed, and solutions are available at the federal, state and local levels of government.
At the federal level, a starting point is the Recovery Home Certification Act of 2018. Sponsored by two House members from California, Republican Steve Knight and Democrat Anna Eshoo, it would establish quality standards for sober living homes. In addition, the Department of Justice (DOJ) and the Department of Housing and Urban Development (HUD) need to issue a new joint clarification under the ADA and FHA to allow local governments to enact reasonable guidelines for the health, safety and welfare of sober living residents. A DOJ/HUD clarification in 2016 provided little effective guidance, leading only to increased confusion.
Action is also needed at the state level. In Florida, the Palm Beach County State Attorney's Office empaneled a grand jury to dig deep into the problem and look at possible legislative and administrative fixes. Out of this came the need to significantly strengthen the existing anti-patient-brokering and anti-kickback laws already on Florida's books. State legislators in California and around the country should follow suit.
And local governments have their roles. Continuing to enact creative regulatory approaches to provide much-needed supervision is a must. Prescott, Ariz., and Delray Beach and Boynton Beach in Florida are the leaders in enacting local ordinances that provide regulatory oversight to sober living homes while not breaching the ADA or FHA.
The solutions will not be easy or rapid, yet even now we are building a national coalition of communities to create reform to provide residents, rather than facilities, with the protections intended under the ADA and FHA. As the opioid epidemic continues to permeate into our communities, a nationwide collaboration is critical to addressing these challenges.
