Treatment Component

Some recovery residences provide clinical services, and from a policy and regulatory perspective, you need to understand the impact of including a treatment component.

What is “Treatment”?

Clinical services are provided by licensed or certified clinical addiction professionals. Clinical services mean care provided competently and consistently by a licensed or credentialed provider at any level of care.

Regulations that are often applied to any organization providing clinical services include:

• Treatment facility license: e.g., residential and/or outpatient (state laws)
• IMD Rule (federal laws)
• HIPAA, HITECH, and 42 CFR Part 2 (federal laws)
• Anti-kickback (federal, some states laws)
• STARK law (federal)
• Patient brokering (federal and state laws)
• Referral restrictions (Growing number of states)

Clinical Services within Dwellings

If addiction treatment services are provided within a recovery residence, the dwelling may need to be licensed as residential treatment. Different states regulate this differently.

Bundling Outpatient with Recovery Housing

It is common for some residents in a recovery home to be enrolled in the outpatient services of their choice, which they pay for separately. However, some recovery residences (and/or treatment providers) have begun to bundle outpatient services with recovery housing. At the same time, this is often referred to as the “Florida Model,” their numerous versions of this combination. Many residents benefited from outpatient and recovery housing, and providers can bundle services ethically and legally; however, “bad players” have exploited these models, leading to widespread corruption in the industry.

Not All Treatment Programs with a Residential Component are Recovery Residences

Although treatment evolved out of recovery residences in the 1900s, many treatment programs have shifted so far from the social model that they no longer resemble recovery residences. Distinctive characteristics include:

• Home-like environment, both architecturally and functionally
• Peer-driven culture, structure, and accountability
• Residents are given more responsibility as they progress in their recovery
• More actively linked to alumni, mentors, and local recovery communities
• Views recovery is a wholistic, life-long, and person-driven process
• Resident-driven length of stay