THE MASSACHUSETTS attorney general’s office is wise to the operators of shady drug testing clinics and their kickback schemes with some so-called “sober houses’’ inhabited by recovering addicts. But the absence of regulation in this area practically assures that abuses will happen time and time again.
Sober houses fall somewhere between rooming houses and residential treatment centers. At their best, they provide a supportive, shared living environment for tenants who prove sobriety through random urine screenings. At their worst, operators of sober homes pocket the weekly rent as well as bribes for steering their indigent tenants to unethical testing labs, which pad Medicaid bills with frequent and unnecessary tests.
Disreputable sober houses have been hiding too long under the blanket protection of the federal Americans with Disabilities Act and Fair Housing Act, which place the homes beyond the reach of state and local regulators. As long as they comply with building and fire codes, operators are free to set up shop where no state substance abuse experts can check on the quality of their work.
If federal law insists on classifying people recovering from substance abuse disorders as disabled, it also needs to give state officials sufficient oversight power to ensure that the disabled are not being exploited.
High-profile enforcement actions are currently the only line of defense. Attorney General Martha Coakley’s Medicaid Fraud Division recently made an example of Calloway Laboratories of Woburn, which agreed to a $20 million settlement to resolve allegations that it bribed sober home operators through straw companies and used fake doctors’ signatures on Medicaid claims. Two employees of a sober house were also indicted in the case. The criminal indictments are welcome along with the dollars returned to the Medicaid program. But the state still needs to put prevention policies in place to break the cycle of abuse.
The state Department of Public Health has been dragging its feet on the completion and release of study ordered by the Legislature back in 2010. The state legislative committee on mental health and substance abuse needs that report to move ahead with its work. One possible approach for lawmakers might be to require sober houses to provide some level of on-site services that would justify the involvement of regulators. Another might be to establish and enforce minimum standards, such as requiring that all operators of sober houses have several years of experience working with substance abusers.
The only thing that is certain now is that too many sober houses are out of control.