State public health officials conclude in a long-awaited report that they are legally powerless to regulate private rooming houses for recovering substance abusers, but propose financial inducements for property managers in this fast-growing and controversial corner of the rental market to get training.
In the report sent to legislators last week, the Department of Public Health calls for a carrot-and-stick approach: voluntary training for managers of these so-called sober homes, combined with legislation that would prohibit state agencies, including the probation and corrections departments and their vendors, from referring clients to any sober home that did not undergo the instruction.
The training, which the state predicts will cost about $250,000 each year for an initial estimate of 300 sober homes, will focus on educating managers about relevant laws and agencies affecting them and their tenants, and the nationally-accepted “best practices’’ of being “a good neighbor’’ in their communities.
“We give people a roadmap,’’ said Hilary Jacobs, deputy director of the Bureau of Substance Abuse Services within the Department of Public Health.
The 16-page report, ordered by the Legislature in August 2010, comes amid growing complaints over the past five years that some landlords, aware that droves of men and women were getting out of detoxification facilities with no place to go, were taking about $150 a week from them and promising a supportive environment, only to put them in unsafe, chaotically run boarding houses where relapses were common.
The remedy, however, was elusive because of these properties’ unusual legal status: Recovering substance abusers are part of a protected disabled class of citizens, according to federal housing laws, and cannot be subject to any extra layer of regulation because of their disability.
Also, by focusing mostly on housing and only some peer-to-peer therapeutic support, sober homes do not qualify as substance-abuse treatment facilities subject to existing state public health regulations.
Though some state and local officials were sympathetic to the public health department’s legal predicament, others with relatives who suffered in sober homes expressed deep frustration that the report only offered management training.
“I’m amazed and appalled that the state has no control,’’ said Karen Rivers, who said her son died last December of a drug overdose at a Salem sober home.
She said a well-run sober home is a godsend to recovering addicts, but so many are just dumping grounds for the forgotten, and landlords just want to “fill the rooms and make money.’’
Michael Kineavy, chief of policy and planning for the city of Boston, where numerous troubled sober homes operate, said the Public Health Department’s proposal to offer training to sober home managers has some value, but he worries that some of the worst sober home operators would simply become part of the “underground market’’ that “take advantage of people.’’
Most tenants - many with criminal records, mental health issues, and few emotional supports - are also rather docile about the conditions they face in sober homes, fearful of being thrown onto the streets.
The report did not address one growing problem in sober homes: the expanded use of major private labs to conduct frequent drug-screening urine tests on residents to check for sobriety, much of which has been reimbursed by Medicaid. The state attorney general’s office has initiated cases against a half-dozen labs over the past five years related to kickbacks to sober home operators who signed exclusive contracts with them, some worth millions of dollars.
Jacobs said the report did not touch on drug testing of tenants because the attorney general’s office has exposed much of the problem, and her staff focused on how the state could offer new solutions.
Though the report went out of its way to say many sober homes are well-run, it acknowledged it has no idea how many such properties exist. For instance, the report stated that, five years ago, the state invited 200 sober home operators to attend a meeting about how to better coexist in their neighborhoods; fewer than 30 showed up, and 18 filled out a survey requested by the state.
The report estimated at least 300 exist in the state, and acknowledged it may be “only a fraction’’ of the true numbers. Currently, the health department’s website on sober homes has only 10 properties that voluntarily registered. The report said this low number shows that “there is no incentive or benefit to the operators for voluntary participation.’’
Under existing laws, anybody can rent out their property and advertise it as a sober home as long as tenants are recovering substance abusers, saying they will try to stay sober, and the landlord complies with existing local housing and safety codes. For many municipalities that have sober homes triggering neighborhood complaints, the only recourse is to file legal action related to unsafe housing conditions.
Boston city officials have encouraged residents to complain to the mayor’s hotline about troubled sober homes, and many have come under increased attention by the city’s Inspectional Services Department for unsafe or overcrowded conditions, including several large properties in Roxbury and Dorchester in the past year.
State Senator John Keenan, a Democrat from Quincy who heads the Joint Committee on Mental Health and Substance Abuse, said he hopes the report triggers further discussion, including how to educate the public, and tenants, about how to better report abuses of the problematic sober homes.
“Some are well-intentioned, and some are not well-intentioned,’’ he said, adding that the committee has not decided how to address the recommendations in the report.