Lawmakers debate the best way to regulate sober living homes
Montana lawmakers and state officials are debating the best way to regulate sober living homes in the state. Montana Free Press reporter Mara Silvers spent months examining the industry that operates with minimal state oversight. Mara shares her reporting with MTPRs Austin Amestoy.
Austin Amestoy: Okay, let's start with the basics Mara. What are these facilities exactly and what's their purpose?
Mara Silver: Sure. So in a nutshell, sober living homes are supposed to be a non-institutional communal home-like setting where people can live together with the values of peer support and community connection to work through their addiction and get on a road to long term recovery. But one of the biggest, I guess, distinctions between a sober living home and other types of settings is that they're not institutional, right? They're not a prison. They're not a substance use disorder treatment facility or a hospital. They're not a jail. There were a couple people who spoke about this at the legislature just this last week. One of them was Brian Hallberg, who's a resident at a sober living home in Montana right now, and he talked about what his life is like now with this living environment.
Brian Hallberg: "I go to AA, I have a sponsor, I work the steps. I do what I'm supposed to do because I want to. I need to. I'm being an adult for the first time in my life and all these other programs that I've been in, they don't teach you how to be an adult."
Mara Silver: So on the other hand, sober living homes and recovery residences aren't regulated by the state like other medical facilities, so they don't have to get a license to operate. They don't have to employ licensed addiction counselors or therapist or social workers. And sometimes they might even be operated just by a private landlord who's charging tenants rent.
Austin Amestoy: Right. And there have been reports and lawsuits in other states about some allegedly exploitative business practices, right? What are some examples of that?
Mara Silver: Yeah, there's really quite a range. Unsafe living conditions with people packed pretty tightly together, operators who are giving out financial kickbacks for patient referrals and maybe one of the biggest ones that has actually prompted historical and current class action lawsuits is businesses that require residences to work without pay or work in exchange for housing and for services.
Austin Amestoy: Okay, so do we know how much of this is happening in Montana?
Mara Silver: That part is just really hard to say. Montana doesn't track these organizations at a statewide level in any kind of consistent way, and there's just not a consistent avenue for resident complaints. And so some of the complaints are often anecdotal or inconsistent. I will say that there was one group that I did quite a bit of reporting on called Hope Center Ministries. They're part of a national organization that has recovery residences all around the country, but they have two in Montana, one in Clancey and one just outside Butte. The director of that program declined to do an interview with me for the story, but I spoke to a couple of former residents who highlighted a couple things about how the program works, and one of them is a vocational training program. Or basically the situation where residents go to work at job sites in nearby towns and for the majority of the program, the residents don't get their own paychecks directly. Their wages are part of a revenue source for the ministry. But, in the last eight weeks of the yearlong program, if they make it that far, they can start earning their wages directly. So, that's one of the examples of how a home can operate in Montana. Although I don't think that type of vocational training program is very common in Montana, it is one of the things that I learned about in my reporting.
Austin Amestoy: The Legislature is now considering a bill that would apply some new regulations to sober living homes. So what's that bill proposing?
Mara Silver: So this is Senate Bill 94, sponsored by Senator Barry Usher, who's a Republican from the Billings area. It would require recovery residences to register with the state health department, and it would also put some basic safety requirements in place, like having opioid overdose medication on site and training residents and staff how to use it.
Austin Amestoy: Right. So it's early, but who's come out in support or against this bill so far?
Mara Silver: So, for example, the Montana Primary Care Association was opposed to this originally. They wanted some amendments to make it clear that recovery homes aren't treatment facilities and that treatment facilities wouldn't be de-prioritized in a judge's consideration about where to send somebody. The Recovery Residences Alliance of Montana, the group that I talked about earlier, they also opposed this bill because they want to be the only certifying organization in the state. They have state approval right now, they're working with the state health department, and they said that this bill, as it's written, would open the door to other accrediting groups with different standards being able to come in and maybe certify different homes.
Austin Amestoy: How do the contents of this bill differ from the regulatory approach the state health department has been taking up to this point?
Mara Silver: You know, it's it's hard to say. I don't know what this bill would have looked like if the state health department had drafted it itself or had asked a lawmaker to carry it on the department's behalf. I think that it's possible for this bill to go through and for the work that RAM and the department are doing to just continue. So at this point, it seems like the state health department is going to keep supporting RAM as the preferred organization that can accredit recovery homes.
Austin Amestoy: Once again, Mara Silvers with the Montana Free Press. Mara, thanks for sharing your reporting with me
Mara Silver: Thank you.