Sober Living, Day 4: Lawmakers must force industry to shape up, many say

california

This is the last in a four-part series. Read Part 1: Outrage | Part 2: Litigation | Part 3: Legal bills

The legal feud that pit sober living operators Joseph and Rebecca Scolari against their former neighbors in the Talega neighborhood of San Clemente ended not with a bang – or a huge payout – but with a whimper.

Each side spent hundreds of thousands of dollars on legal fees. Each side said the conflict made them physically ill.

And, unlikely as it seems, each side agrees on at least one key point — theres got to be a better way to regulate sober living homes.

Today, the five-bedroom house at the center of the fight, on Via Lampara, is much as it was before the whole draining episode: Sunny. Tidy. Quiet.

The Scolaris, who owned the home for more than three years and ran it as a sober living home for a good part of that, have sold the house and moved on. The neighbors who sued them can sit in their beautifully-landscaped (if cheek-to-jowl) backyards, and once again enjoy the scenery without blinking back cigarette fog routinely exhaled by the dozen or so recovering addicts who congregated outside in its sober living heyday.

But residents say that in many Southern California neighborhoods — in Costa Mesa, Long Beach, Los Angeles, Pasadena, Murrieta — chaos still reigns. The system that lets sober living homes proliferate with no minimum standards, no regulation, and no oversight remains stubbornly in place.

“There is no question these people need help,” said David Hurwitz, the San Clemente neighbor who led the battle against the Scolaris, referring to recovering addicts. “But (unregulated sober living) isnt helping them, its hurting them.”

State and federal governments need to create laws to better protect recovering users and neighbors alike, both sides agree.

“I support, 100 percent, some sort of regulation that doesnt jeopardize the rights of addicts,” said Joseph Scolari, who ran Sober Network Properties until litigation prompted him to close up shop.

“There are a lot of good operators,” he added. “But, unfortunately, there are also a lot of bad operators.”

And right now, its hard to tell one from another, or to get official, unbiased information about how sober living providers perform.

A 12-bed house in a place like Talega can bring in $30,000 a month – about $18,000 for rent, plus $12,000 for food, rent and transportation services, as the Scolari-Hurwitz suit revealed. By comparison, the same house rented as a residence would run about $5,000 a month.

“Nobody can tell me that having an Animal House next door is a way to take care of people who have alcohol and drug problems,” said Gerald Klein, one of Hurwitzs attorneys. “Three, four people in a house, and you might not have a problem. But 10 to 20 people in a house?

“When its all about money, its not about treatment.”

U.S. Rep. Dana Rohrabacher, R-Huntington Beach, wants to give local governments the power to say no.

“These so-called homes are really businesses in all but name,” said Rohrabacher. “Putting drug addicts and alcoholics next door to ordinary families in residential neighborhoods is wrong, absolutely wrong… Its the fault of bad federal policy that has tied the hands of our local city governments.”

Seeking change[hhmc]

Rohrabachers attempt to change that – coming, as it is, in the middle of a heated re-election battle – is House Resolution 5724. The law would give city and county governments the power to decide where sober living homes can operate, or if theyre allowed at all. The mayors of Huntington Beach and Laguna Niguel are firmly on board.

But critics say the bill is discriminatory, and that it deems addicts — a description that applies to more than 20 million Americans — as unfit to live among decent people.

Other federal lawmakers are taking a different approach.

The “Ensuring Access to Quality Sober Living Act” – House Resolution 4684, by Rep. Judy Chu, D-Monterey Park, and Rep. Mimi Walters, R-Irvine, and Senate Bill 2678, by Sen. Tim Kaine, D-VA – would require the federal Substance Abuse and Mental Health Services Administration to develop “best practices” for sober living facilities, and provide technical assistance on how to oversee sober living homes, to states. The idea, Chu said in a statement about the proposal, is to give families of addicts “confidence in the facilities that are looking after their loved ones.”

The House bill has been approved, sent to the Senate and referred to the Senate Committee on Health, Education, Labor, and Pensions. Kaines version would require that states receiving federal money to fight drug abuse must follow those best practices .

As federal lawmakers debate those proposals, theres also action on the state front. In Sacramento, a cluster of recently-introduced bills aim to strengthen Californias feeble regulation of the addiction treatment industry. These include:

SB 1228, by Sen. Ricardo Lara, D-Bell Gardens, which would forbid state-licensed treatment facilities from referring patients to sober living homes that arent also licensed or certified – thus ushering in some standards for an industry that now has none.

SB 1317, by Sen. Anthony Portantino, D–La Cañada Flintridge, and Sen. Pat Bates, R-Laguna Niguel, which would require the California Department of Health Care Services to figure out how to report about suspected unlicensed treatment facilities, and how to determine if complaints are substantiated or unsubstantiated.

SB 992 , by Sen. Ed Hernandez, D-West Covina, which would require sober living homes that are financially connected to treatment centers to publicly disclose those relationships. It would also require many to be licensed and regulated the the state; protect those on medication-assisted treatment from being barred from sober living homes; and deny for five years a new license to operators whove had a license suspended or revoked.

AB 2214, by Reps. Freddie Rodriguez, D-Pomona, and Melissa Melendez, R-Lake Elsinore, which would set up a voluntary certification process for sober living homes; give the California Department of Health Care Services the authority to respond to complaints about them; and require government agencies to refer patients only to certified recovery residences when possible.

SB 1290, by Sen. Pat Bates, R-Laguna Niguel, which would forbid licensed centers from paying for patients, and create a “Commission on Substance Abuse and Recovery” to help the Legislature do a complete overhaul of treatment industry regulations, much as was done in Florida.

Sunshine State rules[hhmc]

Once, the seaside city of Delray Beach was ground zero for addiction treatment in Florida, much as Costa Mesa and Malibu currently are the dual ground zeroes in Southern California.

Just a few years ago, addicts from other states routinely were lured to rehab centers in Delray Beach, often by promises of free treatment, a pattern common today on Southern Californias Rehab Riviera.

So-called “body brokers” — people who troll the streets and courthouses looking for addicts — delivered those addicts, and their insurance plans, to the Delray Beach rehabs that paid them the most, not the centers that provided the best chance of success; again, mirroring a practice now common in Southern California.

And when the Delray Beach operators could extract no more money from their clients, they kicked them out. Many went right back to using drugs and overdosed. The same scene is common in Southern California.

But while the fraud and abuse that once plagued Delray Beach echo whats happening today in Southern Californias rehab industry, Floridas response was more muscular than anything seen to date here.

In 2016, after alarming spikes in opioid overdose deaths that came with the rise of sober living homes in the area, Palm Beach County State Attorney Dave Aronberg appointed a task force to probe industry abuses and recommend solutions.

That task force came back with an interesting idea — the state should look harder at the rehab operators than it looked at the addicts.

“The Legislature needs to recognize that the substance abuse treatment industry is a part of the healthcare system,” that task force wrote. “Currently, there is little oversight of the industry… Recovery residences connected to treatment providers… are not regulated at all.”

A 21-member grand jury also was impaneled to analyze Floridas reaction – or failure to react – to those abuses.

“Over the past decade, bad actors have been using (the Americans with Disabilities Act and the Fair Housing Act) to hide their exploitation of the very people that these laws were meant to protect,” the grand jury said in its report. “Many unregulated (recovery) homes have become unsafe and overcrowded flophouses where crimes like rape, theft, human trafficking, prostitution and illegal drug use are commonplace. The Grand Jury finds that the problem is the unregulated businesses that house these residents, not the residents themselves.”

The task force and grand jury urged major changes, which became law last July.

Today, sober living marketers in Florida must be licensed by the states Division of Consumer Services. False and misleading marketing statements are illegal.

Buying or selling patients is now a felony that can be punished by fines up to $500,000 and prison time.

License fees are higher; more training is required for workers; sober homes must be voluntarily certified by an independent nonprofit; and the state can make unannounced inspections and immediately suspend licenses.

Results have come quickly.

The number of opioid deaths in Palm Beach County in the first four months of 2018 plunged 62 percent over the same period in 2017 – from 283 to 88 — reflecting a sharp decline in the number of sober living homes, Aronberg said.

A criminal task force focused on the rehab industry has made 47 arrests, with 16 convictions to date.

California has been slower to act.

“Your local leaders are facing what Palm Beach County faced at the beginning,” Aronberg said. “It sounds like theres still not total buy-in on the need to reform these laws.”

Earlier this year, Aronberg came to Orange County at the invitation of the Association of California Cities to swap war stories and strategies.

“The first step California needs to take is to enact tough anti-brokering laws at the state level,” Aronberg said during the meeting. “Your laws are weak.”

Aronberg likes Bates SB 1290, which would lead to a complete overhaul of regulation of the rehab industry and was modeled after the Florida law he championed.

“Theres a misconception that this discriminates against individuals in recovery when the exact opposite is true – its designed to protect them from exploitation and death,” he said.

Another positive, in Aronbergs view, is Orange County District Attorney Tony Rackauckas new “Sober Living Home Accountability Task Force,” which is looking at insurance fraud and human trafficking.

Proceed with caution[hhmc]

Larissa Mooney is a board-certified psychiatrist and director of the UCLA Addiction Medicine Clinic. She is deeply skeptical of any effort to allow cities to categorically ban sober living homes, as Rohrabachers bill would.

“If it feels like a frat party in your neighbors yard, that is a problem,” Mooney said. “It shouldnt be a free-for-all. But I know a lot of people who have been very much helped by having a few months in sober living to facilitate their recovery, in an environment with people who are trying to reach the same goal.

“There are homes out there that are very quiet and you wouldnt even know are there.”

Organizations such as the Sober Living Network are trying to bring homes to a higher standard with some sort of accreditation process, she said, and an increasing number of facilities want accreditation that will set them apart from less scrupulous operators.

A sensible public policy approach, she said, could involve smart regulation; some limit on the number of beds; clear rules; and comprehensive oversight. “To the extent we work toward standardizing and regulating sober living homes, that will end up hopefully in improving the quality of care,” she said.

From where former operator Scolari now sits – on the sidelines of the sober living industry – a good place to start would be limiting the number of residents in a home. Two of the treatment providers he worked with – Sobertec and Sovereign – had up to 12 and 14 beds in a single house.

Capping sober living residences at seven, Scolari said, would help clients as well as neighborhoods. A certification process for owners-operators – to probe their backgrounds and business ethics – would be useful, too.

One of Mooneys colleagues at UCLA – Walter Ling, psychiatry professor and Founding Director of UCLAs Integrated Substance Abuse Programs – said that the line between a sober living home and a flop house can be very thin, “so there is wisdom in following the money.”

“My own experience with sober living facilities went back to the 1970s, when there were people like Jack Sanow, who worked day and night, gave everything and did everything, except make money,” Ling said. “It is a mixed bag these days; it is always good to have some adult overseeing the operations at some level.

“People in the recovery business are not, by and large, the self-governing type.”

More in the series

The key to sobriety remains “getting a life,” Ling argued – steady work, real relationships, personal responsibility, community involvement. A period of stable living can be a good start, he said, but its only a first step toward those bigger goals.

Its that challenge that attracts Scolari, who said he might return to the industry someday.

“Seeing first-hand an addict coming into recovery, and seeing them graduate and get excited about the next chapter of life – theres nothing like it,” Scolari said. “It takes a lot of capital, a lot of hard work.

“Im not certain its for my family right now,” he said. “But I still have a lot of passion for the industry.”

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