The latest attempt to create certification requirements for recovery houses advanced out of Delaware's House Health and Human Development Committee on Wednesday.
Delaware currently has no registry for recovery houses, so assembling an accurate tally of recovery houses across the state is challenging. Some Delaware recovery homes have federal certification, meaning they comply with federal standards and receive protection from local regulation — namely restrictive zoning — under the Americans with Disabilities Act, but dozens of others operate without oversight on the federal or state level.
Horror stories about neglect and poor management by unregulated recovery homes, which can charge those in recovery or their families a premium for a bed,
prompted lawmakers to propose state certification requirements in 2019.
Then-bill sponsor Rep. Kendra Johnson opted not to move forward with that original bill after pushback from several major recovery housing providers, including some, like Sussex County-based Thresholds, Inc., that participate in the Division of Substance Abuse and Mental Health's Treatment Referral Network.
An updated version of the bill reappeared in the State House of Representatives near the end of the 2022 legislative session, but it did not reach the House floor before the session's end.
The latest iteration of the bill, sponsored by freshmen state Rep. Kerri Evelyn Harris, would task the Division of Substance Abuse and Mental Health with assembling standards and determining a regular inspection schedule for recovery houses, enabling the state to create a registry of all certified houses. Providers would be required to re-certify every two years.
While the standards to which recovery houses would be held are generally not defined in the bill, it does include some basic expectations, including that recovery houses would make a "reasonable effort" to find alternative accommodations for anyone they eject, including for violating relapse policies; the bill assumes that recovery houses require residents to remain sober.
Once a recovery house receives certification, it would be eligible to receive state and local funding and, more crucially, referrals from state agencies, including the court system and DSAMH itself.
Bill sponsor State Rep. Kerri Evelyn Harris says the certification process would enable the state to hold recovery houses accountable on an ongoing basis.
"[This ensures] that you can’t slip through the cracks by meeting the national standards just to open and then let the best practices fall by the wayside," she said. "This will make sure we are constantly checking back.”
Behavioral Health Planning and Advisory Council Chair George Meldrum told the committee that while recovery houses will never be able to entirely avoid tragedy, increased regulation could improve outcomes.
“I've seen people get kicked out of recovery houses in the middle of the night — most memorably, a man on crutches," he said. "Regardless of what happens, we are dealing with a highly vulnerable population. We can have the most regulated facility and we’re still going to have people die. The problem is that if we have fewer regulations and less oversight, we’re going to have a higher rate of overdoses.
But some service providers worry that the state could set certification requirements and inspection timelines that smaller recovery house operators — even those that follow national best practices — would struggle to meet. "Monthly inspections, a requirement that you always have staff there — for a small organization, that would prove difficult," says Dave Humes, co-founder of atTaCK addiction, a statewide organization that operates small recovery homes in New Castle and Sussex Counties.
Similar problems arose after Pennsylvania opened applications for a similar recovery home certification process in 2021. Of the estimated hundreds of recovery homes across the state, only a few dozen applied for certification within the first year.
If a recovery home opts not to seek certification in Delaware, Harris says the house could certainly continue to operate, though she hopes the prospect of state referrals could incentivize providers to seek certification.
The bill now heads to the House Appropriation Committee, which will consider the $400,000 proposed budget to certify and inspect recovery homes.
