[Congressional Record Volume 164, Number 97 (Tuesday, June 12, 2018)]
[House]
[Pages H5036-H5038]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




          ENSURING ACCESS TO QUALITY SOBER LIVING ACT OF 2018

  Mr. WALDEN. Mr. Speaker, I move to suspend the rules and pass the 
bill (H.R. 4684) to direct the Secretary of Health and Human Services, 
acting through the Director of the Center for Substance Abuse Treatment 
of the Substance Abuse and Mental Health Services Administration, to 
publish and disseminate best practices for operating a recovery 
housing, and for other purposes, as amended.
  The Clerk read the title of the bill.
  The text of the bill is as follows:

                               H.R. 4684

       Be it enacted by the Senate and House of Representatives of 
     the United States of America in Congress assembled,

     SECTION 1. SHORT TITLE.

       This Act may be cited as the ``Ensuring Access to Quality 
     Sober Living Act of 2018''.

     SEC. 2. NATIONAL RECOVERY HOUSING BEST PRACTICES.

       Part P of title III of the Public Health Service Act is 
     amended by adding at the end the following new section:

     ``SEC. 399V-7. NATIONAL RECOVERY HOUSING BEST PRACTICES.

       ``(a) Best Practices.--The Secretary of Health and Human 
     Services, in consultation with the Secretary for Housing and 
     Urban Development, patients with a history of opioid use 
     disorder, and other stakeholders, which may include State 
     accrediting entities and reputable providers, analysts, and 
     stakeholders of recovery housing services, such as the 
     National Alliance for Recovery Residences, shall identify or 
     facilitate the development of best practices, which may 
     include model laws for implementing suggested minimum 
     standards, for operating recovery housing.
       ``(b) Dissemination.--The Secretary shall disseminate the 
     best practices identified or developed under subsection (a) 
     to--
       ``(1) State agencies, which may include the provision of 
     technical assistance to State agencies seeking to adopt or 
     implement such best practices;
       ``(2) recovery housing entities; and
       ``(3) the public, as appropriate.
       ``(c) Definitions.--In this section:
       ``(1) The term `recovery housing' means a shared living 
     environment free from alcohol and illicit drug use and 
     centered on peer support and connection to services, 
     including medication-assisted treatment services, that 
     promote sustained recovery from substance use disorders.
       ``(2) The term `State' includes any of the several States, 
     the District of Columbia, each Indian tribe or tribal 
     organization (as those terms are defined in section 4 of the 
     Indian Self-Determination and Education Assistance Act), and 
     any territory or possession of the United States.
       ``(d) Authorization of Appropriations.--To carry out this 
     section, there is authorized to be appropriated $3,000,000 
     for the period of fiscal years 2019 through 2021.''.

  The SPEAKER pro tempore. Pursuant to the rule, the gentleman from 
Oregon (Mr. Walden) and the gentleman from New Jersey (Mr. Pallone) 
each will control 20 minutes.
  The Chair recognizes the gentleman from Oregon.


                             General Leave

  Mr. WALDEN. Mr. Speaker, I ask unanimous consent that all Members may 
have 5 legislative days to revise and extend their remarks and insert 
extraneous materials into the Record on the bill.
  The SPEAKER pro tempore. Is there objection to the request of the 
gentleman from Oregon?
  There was no objection.
  Mr. WALDEN. Mr. Speaker, I yield myself such time as I may consume.
  Mr. Speaker, I rise today to express my strong support for H.R. 4684, 
Ensuring Access to Quality Sober Living Act of 2018.
  This legislation will require the Department of Health and Human 
Services to develop and disseminate best practices for operating 
recovery housing.
  We heard a lot about these issues in the course of our investigation 
and in our legislative work. Recently, an increasing number of reports 
have revealed the nefarious practice of patient brokering. This is 
where individuals known as ``patient brokers'' treat men and women with 
a substance use disorder as a commodity. They push them to seek 
treatment at certain outpatient facilities and to live at affiliated 
recovery residences while undergoing treatment.
  In exchange for steering patients towards specific facilities and 
housing, patient brokers then receive generous financial kickbacks. 
Oftentimes, the residence and the treatment center involved in the 
kickback scheme lack any oversight, transparency, or accountability. 
This legislation will help ensure that recovery residences maintain 
safe and supportive environments for those who are in recovery.
  I would like to thank my California colleagues, Judy Chu, Mimi 
Walters, and Raul Ruiz, along with Florida Representative Gus 
Bilirakis, for addressing this important issue and bringing this 
legislation to the committee and to the floor.
  Mr. Speaker, I reserve the balance of my time.

[[Page H5037]]

  

  Mr. PALLONE. Mr. Speaker, I yield myself such time as I may consume.
  Mr. Speaker, I rise in support of H.R. 4684, the Ensuring Access to 
Quality Sober Living Act of 2018, introduced by Representative Chu.
  This bill would require the Department of Health and Human Services 
to work with stakeholders, including individuals with substance use 
disorders and recovery housing groups, to develop best practices for 
operating recovery housing.
  The Energy and Commerce Committee's bipartisan investigation into 
disreputable sober homes and associated patient brokers and treatment 
facilities has made clear that we must do more to ensure that 
individuals with an opioid use disorder are not being taken advantage 
of by entities seeking to treat such individuals as commodities rather 
than people in need of treatment.
  In fact, in far too many instances, these homes and providers offered 
no treatment at all. In other instances, where treatment is offered, it 
is only provided to increase the provider's profits. In the worst 
instances, these rogue providers go so far as to help individuals stop 
their illicit use of opioids for the duration of their insurance limit 
for a given treatment service, only to supply opioids to these same 
individuals after they are released so they can relapse and their 
insurance once again can be milked for the duration of the benefit 
limit.
  Such providers are not only harmful to patients trying to stop their 
illicit use of opioids and enter recovery, this substandard treatment 
also costs many individuals their lives.
  Mr. Speaker, our investigation also has revealed that individuals 
with opioid use disorder and their families are particularly 
susceptible to such schemes, because there is not adequate information 
available to help them determine whether a facility is a quality 
provider of recovery housing or to detect the fraudulent intent of such 
actors. Many rely on bad information obtained through internet searches 
or questionable referrals from individuals who are actually patient 
brokers and paid to deliver patients to the highest bidding sober home 
or treatment provider.
  The bill before us, the Ensuring Access to Quality Sober Living Act, 
aims to prevent the often tragic consequences of the patient brokering 
schemes that send individuals to low-quality sober homes and treatment 
providers.
  I want to thank Ms. Chu for all she has done to move this bill. This 
legislation requires Health and Human Services, in coordination with 
the Department of Housing and Urban Development, and with stakeholders, 
to establish best practices that will aid States in establishing 
standards for the recovery houses, help recovery housing providers in 
establishing and maintaining housing that meets the highest quality of 
service delivery, and help individuals and their families identify what 
to look for in a quality provider of recovery housing.
  Mr. Speaker, I urge my colleagues to support this bill, and I reserve 
the balance of my time.
  The SPEAKER pro tempore. Without objection, the gentleman from Texas 
will control the remainder of the time for the majority.
  There was no objection.
  Mr. BURGESS. Mr. Speaker, I yield myself 2 minutes.
  Mr. Speaker, we heard about this issue in both the Health 
Subcommittee that I chair as well as the Oversight and Investigations 
Subcommittee on Energy and Commerce chaired by Mr. Gregg Harper.
  We had a roundtable of family members who had lost family due to the 
opioid crisis. They spoke very eloquently about this issue. Two in 
particular stand out, Gail Smith and Lisa Daniels, both mothers who had 
lost sons to the opioid crisis. Both sons had been brokered into 
recovery homes that really didn't have their best interests at heart 
and ultimately succumbed to their disease of addiction.

  This is significantly important legislation. I obviously encourage 
all of my colleagues to be supportive.
  Mr. Speaker, I reserve the balance of my time.
  Mr. PALLONE. Mr. Speaker, I yield such time as she may consume to the 
gentlewoman from California (Ms. Judy Chu), the sponsor of the 
legislation.
  Ms. JUDY CHU of California. Mr. Speaker, I rise today to urge support 
for H.R. 4684, the Ensuring Access to Quality Sober Living Act.
  As we work to address our Nation's opioid crisis, it is important 
that we address recovery, in addition to treatment and prevention. 
Addiction is a lifelong condition. After seeking treatment, individuals 
suffering from addiction need stable living environments, mental health 
services, and peer support to maintain their sobriety. Recovery is what 
this bill seeks to address.
  I introduced this bill because of my constituent, Ryan Hampton. Ryan 
was once a promising White House intern who was succeeding in college 
and who had his whole life ahead of him. But in his early twenties, he 
broke his knee hiking and was prescribed opiates for the pain. He soon 
became dependent on prescription drugs. He was labeled a drug seeker 
and was discharged from medical care.
  Unfortunately, this did nothing to address his addiction. Without 
seeing any other options, he turned to heroin. Within a few months, 
Ryan was homeless and living on the streets. It wasn't until after he 
overdosed that Ryan got the help he needed.
  After he recovered, Ryan eventually was able to be in a treatment 
center. He told me that he considered himself one of the lucky ones. By 
the time I met Ryan, he was a year and a half sober and an active 
advocate for the recovery community. He used his second chance to speak 
on behalf of others battling this devastating addiction--people like 
his friend, Tyler. Tyler was living in a sober living home, or a 
recovery residence, when he died of a heroin overdose.
  Sober homes are great a resource for those newly out of treatment. 
They provide a safe and stable living environment to help people 
transition back into their lives without addiction. Sober homes have an 
added responsibility because the risk of overdose for those individuals 
can be the highest while in recovery.
  Unfortunately, some sober homes can be unequipped to handle at-risk 
patients or do not employ staff with specialty training for individuals 
in recovery. Sadly, some of these facilities are bad actors that do not 
encourage recovery, but exploit vulnerable individuals recently 
released from treatment in order to collect insurance payments.

                              {time}  1500

  For example, Tyler's home didn't have naloxone on site, which is a 
drug that can counteract an overdose. Outraged and heartbroken, Ryan 
came to me to seek a solution. People like Tyler, who do everything 
right to get themselves sober, should know that they can trust the 
sober living homes and others on whom they rely for support.
  Together, we worked on a bill that I introduced to create best 
practices as well as standards for sober living facilities. I cannot 
express my pride enough when, just a few years after addiction forced 
him onto the streets, Ryan appeared before Congress this spring to 
testify in front of the Energy and Commerce Subcommittee on Health to 
share his story and to encourage investment in recovery the way that we 
are investing in prevention and treatment.
  That is exactly what H.R. 4684 would do. It would allow the 
Department of Health and Human Services to establish a set of best 
practices that sober homes could adopt so that individuals in treatment 
and their families can help differentiate the bad actors from the good. 
These benchmarks would take into account existing standards developed 
by the National Alliance for Recovery Residences, such as requiring 
that all fees and charges be explained to residents and that naloxone 
be available and accessible for use in emergency. As Ryan said in his 
congressional testimony, not having naloxone on hand is like not having 
lifeboats on a ship.
  H.R. 4684 would also provide technical assistance to States that wish 
to adopt or implement these standards so that the recovery community 
has the support it needs.
  Unfortunately, Tyler's story is not unique. I have heard from 
advocates in Arizona, Pennsylvania, Missouri, Ohio, and countless 
others who are concerned

[[Page H5038]]

for their friends and neighbors living in unregulated sober living 
facilities. That is why I am so thrilled to have H.R. 4684 on the floor 
here today. We need to stand behind those who have done the difficult 
task of seeking and completing treatment and ensure that the homes in 
which they live are able to meet their needs.
  I would like to thank Representatives Ruiz, Walters, and Bilirakis 
for joining me as original cosponsors of this bill and for supporting 
it during their work on the Energy and Commerce Committee.
  Mr. Speaker, I urge my colleagues to support this bill.
  Mr. BURGESS. Mr. Speaker, I yield such time as she may consume to the 
gentlewoman from California (Mrs. Mimi Walters), a valuable member of 
the Energy and Commerce Committee and cosponsor of the bill before us.
  Mrs. MIMI WALTERS of California. Mr. Speaker, I rise today in support 
of H.R. 4684, the Ensuring Access to Quality Sober Living Act.
  Mr. Speaker, as the opioid epidemic grows, so does the need for 
legitimate addiction treatment facilities. Southern California is home 
to more than 1,100 licensed facilities and countless unlicensed sober 
living homes, many of which have engaged in activities that exploit 
patients and endanger communities. Some facilities engage in patient 
brokering while others fail to treat the underlying cause of addiction, 
putting patients at risk of relapse.
  Mr. Speaker, the Ensuring Access to Quality Sober Living Act would 
require the Department of Health and Human Services to establish best 
practices for sober living homes to ensure patients receive high-
quality care. This bill would put an end to fraudulent behavior and 
unethical practices conducted by some sober living homes while helping 
those struggling with addiction rebuild and reclaim their lives.
  I thank my fellow Californian, Congresswoman Chu, for her work on 
this important issue, and I urge my colleagues to support this 
legislation.
  Mr. PALLONE. Mr. Speaker, I have no additional speakers.
  Mr. Speaker, I urge my colleagues to support this bill, and I yield 
back the balance of my time.
  Mr. BURGESS. Mr. Speaker, I urge support, and I yield back the 
balance of my time.
  Mr. BILIRAKIS. Mr. Speaker, I rise in support of H.R. 4684, the 
Ensuring Access to Quality Sober Living Act.
  Patient brokering is and continues to be an issue in Florida and 
across our nation. In light of the Nation's opioid crisis, an increased 
demand for recovery from substance use disorder has sadly attracted bad 
actors into the recovery space in order to make a quick buck by taking 
advantage of patients and families in crisis.
  Currently, regulations for addiction recovery providers vary from 
state-to-state and are virtually non-existent in some states. As a 
result, patients and families are unable to confidently identify 
quality sober living environments.
  Upon learning that various mental health and substance use disorder 
facilities were making payments to individuals for the referral of 
patients identified in Alcoholics Anonymous meetings, homeless 
shelters, and other similar environments, Florida's legislature passed 
The Patient Brokering Act to prevent it by making the perverse practice 
a third-degree felony punishable by up to 5 years in prison. However, 
monitoring and enforcement continue to pose a challenge.
  As communities and states, like Florida, crack down, these parasites 
simply relocate, rebrand, and victimize a new community--leaving broken 
patients and families searching for quality recovery in their wake. 
Unfortunately, the lack of and adherence to an industry-wide standard 
in the addiction recovery space has led to the industry becoming an 
incubator for fraud, waste, and abusive practices.
  Law enforcement cannot solve this problem alone. It is vital that we 
work in a bipartisan manner to address laws and regulations, or lack 
thereof, which exacerbates this national crisis. H.R. 4684, the 
Ensuring Access to Quality Sober Living Act does just that. H.R. 4684 
authorizes the Substance Abuse and Mental Health Services 
Administration to develop best practices for sober living facilities in 
addition to providing technical assistance and support to states 
providing renewed confidence to families whose loved ones are in 
recovery in sober homes across this country.
  Mr. Speaker, in crafting the opioid legislation that the House will 
be considering this week, Members of the Energy and Commerce Committee 
took the time to hear directly from those who have lost loved ones to 
this crisis. H.R. 4684 represents an important step in addressing 
concerns voiced by these courageous advocates.
  Ryan Hampton's testimony reminds us that no one should have to learn 
their friend died of an overdose in a sober living facility due to a 
lack of basic operational training.
  Lisa Daniels' and Gail Smith's testimony reminds us that no one 
should lose a child and learn later that their child was a victim of 
patient brokering and only ended up in a substandard recovery facility 
due to criminal business practices.
  I urge my colleagues to support this critical, common-sense bill to 
improve patient safety in sober homes across our country.
  Ms. JACKSON LEE. Mr. Speaker, I rise in strong support of H.R. 4684, 
the Ensuring Access to Quality Sober Living Act of 2018.
  Opioid abuse has become a public health crisis with devastating 
consequences, including; overdoses, rising incidence of neonatal 
abstinence syndrome, homelessness, and unemployment.
  H.R. 4684 ensures that the Substance Abuse and Mental Health Service 
Administration has the resources to provide the best practices for 
operating recovery houses and to distribute the information to states, 
and to provide technical assistance to states seeking to adopt such 
practices.
  It is undeniable that, to ensure their path to recovery, victims of 
substance abuse are in need of proper recovery housing that is free 
from alcohol and drug use.
  People suffering from addiction are in dire need of healthy living 
environments to ensure a successful transition.
  Recovering addicts coming from an environment that does not provide 
the proper assistance, face many challenges and problems when they 
later reenter society.
  Every day, over 115 Americans die after overdosing on opioids, with 
more than 64,000 deaths reported in the year 2016.
  In 2015, 2,588 opioid overdose related deaths were reported in my 
home state of Texas with Harris County accounting for 318 of those 
deaths.
  It has been reported that 91 percent of victims in recovery will 
experience a relapse, 59 percent of those will experience a relapse 
within the first two weeks of sobriety, and 80 percent within a month 
after discharging from a detox facility.
  H.R. 4684 will not only provide addicts with qualified recovery homes 
but healthy family oriented settings.
  Medical research suggests that recovery residencies should be 
structured like a family home, a community living environment which is 
centered on peer support and connection to services.
  These provisions of the bill will provide victims of opioid addiction 
with much needed guidance.
  I urge my colleagues to join me in supporting H.R. 4684 to show their 
support in this extremely critical moment in time and ensure that those 
who have fallen victim to the opioid epidemic are provided with 
qualified recovery housing.
  The SPEAKER pro tempore. The question is on the motion offered by the 
gentleman from Oregon (Mr. Walden) that the House suspend the rules and 
pass the bill, H.R. 4684, as amended.
  The question was taken; and (two-thirds being in the affirmative) the 
rules were suspended and the bill, as amended, was passed.
  The title of the bill was amended so as to read: ``A bill to direct 
the Secretary of Health and Human Services to identify or facilitate 
the development of best practices for operating recovery housing, and 
for other purposes.''.
  A motion to reconsider was laid on the table.

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