2015 was filled with newspaper articles and TV news segments covering law enforcement investigations squarely aimed at patient brokering and insurance fraud. Allegations paint a picture of an industry rife with corruption and greed. While these practices certainly exist, and must be rooted out and eradicated, operators complicit in this conspiracy are not in compliance with FARR Certification requirements. When FARR receives credible allegations of patient brokering or insurance fraud against any sober home operator, including those who have achieved prior certification, it is our practice to forward the grievant and any documentation supporting the allegation, to the proper authority. We have adhered to this policy religiously throughout 2015 and will continue to do so.
Effective April 1, 2016, both FARR and the Florida Certification Board (FCB) will introduce certain certification criteria established by Florida Statutes 397.487 and 397.4871. On this date; FARR Compliance Audits will officially commence. Any and all certified recovery residences determined to be noncompliant with NARR Quality Standards, Code of Ethics and other criteria mandated by statute, and who do not successfully resolve event(s) of noncompliance, will experience suspension or revocation. Our mission is to enhance the quality of recovery support. Protecting the integrity of FARR Certification is paramount to fulfillment of that mission.
While we have witnessed a plethora of negative reporting, there is good news: for every unethical operator, there are many more who remain focused on delivery of quality services. These operators don’t enjoy the spotlight. They proceed quietly in the background, helping those who seek recovery from the disease of addiction. This article provides guidance on to how to find them and select one most suited to your needs.
The Importance of Selection
As persons diagnosed with a substance use disorder, once we make a decision to alter our life’s trajectory, our usual course of action is to first detoxify, then admit ourselves to an acute care in-patient facility or partial hospitalization program. Once this stage is complete, many of us seek referral to a transitional setting. In some instances, this may include referral to intensive out-patient clinical services while residing in a nearby recovery residence. This last step provides
us the opportunity to live with peers and begin to model behaviors reflected in the daily activities of more experienced members of the recovery community. The value in residing, as a family member, with peers who are intently focused on developing recovery management skills cannot be overstated. Recovery is contagious. Magic happens every day in these recovery communities.
What to ask?
When shopping for a recovery residence, families and future residents consider only programs that have successfully evidenced compliance with national quality standards and ethics that demonstrate their eligibility to receive referral for licensed behavioral healthcare providers under Florida Statute 397.487. These programs are recognized by our state as vital to the continuum of care.
- What Recovery Residence Support Level (I-IV) is most appropriate for me at this stage in my recovery? FARR certifies locations by Support Level. To learn more about support levels, please visit http://farronline.org/selection-guide/.
- What are my recovery goals? What resources and barriers exist to achieving these goals? Does the recovery residence offer support to assist me?
- What recovery path is supported by this program? Is the support adequate to meet my needs? Programs that claim to support “all pathways to recovery” often fail to offer specific support for any. While there are exceptions to the rule, the majority of those who make this claim are more interested in filling a bed than assisting residents to build solid recovery foundations.
- Does my personal profile mesh with the priority population served? Gender specific recovery residences produce better outcomes, particularly for emerging and young adults (18-30) early in their recovery. Co-ed programs encourage distractions at a time when intent focus on recovery activities is vital.
- Is the residence accessible to external recovery support infrastructure, including mutual aid, recovery cafes, community and faith centers. Is public transportation easily attained? How far will I need to travel to grocery stores, hospitals and employment?
- What are the House Rules and Consequences to which residents are held accountable? Are senior peers empowered by the recovery residence administrator to participate in leadership and accountability? Programs relying entirely on staff to enforce rules rarely develop recovery communities. They may offer a safe environment, but an essential quality of bonding is conspicuously absent. The magic alluded to earlier emerges directly from a well-structured culture of peer support within the recovery community.
When selecting a recovery residence, know that offers of free or deeply discounted rent in exchange for enrollment in an intensive outpatient program (IOP) is illegal and punishable under Florida Statute 817.505 as a third degree felony. This exchange is considered an inducement by the behavior healthcare provider
to engage the resident in services that might not otherwise be sought. Regrettably, Florida experiences more than our fair share of this activity. Inducements now often extend to include free gym memberships and grocery store gift cards. These “bennies” are certainly enticing; don’t get sucked in. Providers who invest heavily in attempts to circumvent state and federal laws to defraud insurers are not interested in promoting a resident’s well-being. Their interest is in residents adhering to an excessive urinalysis testing schedule while attending the associated IOP. These programs are warehouses, not recovery residences. You will not find a recovery community comprised of peers actively engaged in recovery activities in residence here. These operators are solely driven by profit and are willing to assume the risk of prison in order to line their pockets. Caveat Emptor: beware the gift of a free horse.
This means that families often need to make a tough choice. Forego an opportunity to secure free housing for their loved one and absorb the cost of rent in a certified recovery residence until the resident achieves financial self-sufficiency. This may take the resident as long as sixty days and cost between $1,500 and $3,000 out-of-pocket, depending on the certified program. As difficult as this choice is, consider this: FARR frequently receives complaints from a grievant concerning their recent statement of insurance benefits. The resident was billed tens of thousands of dollars by an independent laboratory for excessive urinalysis tests that the insurance company did not cover. This balance is termed “patient responsibility”. When authorities unravel the complex system of fraud, it always involves a sober home offering free rent while the resident remains enrolled in a third-party IOP. In turn, the IOP sends the urine samples to an independent laboratory for confirmation testing. Dig down just a bit deeper, as the Federal Bureau of Investigation is now, and a financial relationship between these three parties emerges. It’s the Golden Triangle. Avoid it any all cost.
Jay Corrigan is the Community Services and Training Coordinator at the Florida Association of Recovery Residences. As a person in long-term recovery, Jay has left the corporate sector and dedicated his life to a newfound career built around helping those who seek assistance in their battles with substance abuse issues.