[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.
____________________