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How to curtail sober home abuses? Task force proposes getting tough


Palm Beach County’s Sober Home Task Force unveiled its recommendations to the Legislature on Monday, focusing on giving state officials and law enforcement greater powers to police the fraud-ridden drug treatment industry.

Under the proposals , the Department of Children and Family Services would be allowed to oversee some sober homes, so-called “marketers” in the industry would have to be licensed and police would be better able to investigate abuses.

“Somewhere down the line, the Legislature is going to have to make some decisions, and we want to help them make the right ones,” DCF Assistant Secretary for Substance Abuse and Mental Health John Bryant said.

The draft report is the result of months of work by the task force. It parallels many recommendations from a special grand jury convened by State Attorney Dave Aronberg .

Earlier this year, the Legislature gave Aronberg $275,000 to oversee the task force and make recommendations by year-end to clean up the industry. A larger body of the task force will review the proposal on Wednesday.

Since August 2015, The Palm Beach Post has been detailing abuses in the industry, culminating in the Nov. 20 special report,  Heroin: Killer of a Generation , which detailed the 216 people who died from heroin-related overdoses in Palm Beach County in 2015.

Aronberg’s chief assistant, Al Johnson, acknowledged that legislators are unlikely to approve everything the task force recommends. But they can approve enough to make a difference, he said.

Easier law enforcement

The panel has focused on two parts: cracking down on bad operators and regulating the industry. Already, police have arrested nine people on charges of taking kickbacks to steer patients to particular treatment facilities, a practice known as “patient brokering.”

“Basically, the only way you’re going to remedy this issue and the abuses within it is if somebody goes to jail,” Bryant said.

But police face a significant hurdle before making arrests: dealing with medical records and patient privacy laws, known as Title 42 regulations, makes it tough to make cases.

“These laws are very restrictive. There is a lot of red tape to do simple investigations,” Assistant State Attorney Justin Chapman said. “We heard about a girl who died in a sober home, put her in a closet for two days to collect her insurance money. We know where she was going for treatment … but I’ve got to assemble a team to get a Title 42 packet.”

Johnson added, “Law enforcement officers are afraid to knock on a door of a sober home because of fear of violating Title 42.”

They’re recommending changing state law to align with federal law, which allows law enforcement to investigate cases without violating patient privacy laws.

Under their other proposals:

  • Unethical marketing practices, such as lying to patients or their families, would be illegal.
  • The attorney general would be allowed to go after patient brokers, and patient brokering would be considered a “racketeering activity” that allows the office to investigate cases in multiple jurisdictions.
  • Police would receive training money to go after unscrupulous treatment centers and sober-home operators.

Better enforcement

Much of the task force’s work has been built around cleaning up the “Florida model” of recovery: a brief stint in detox, a month in rehab, and then life in a sober home while attending outpatient treatment at a facility during the day.

In other places, patients typically spend more time in a facility learning how to be sober before moving to a sober home. In Florida, many sober homes are merely “flop houses,” run by unscrupulous owners who prey on their residents’ vulnerable state.

As The Post has reported,  urine testing to make sure residents remain clean can produce huge profits , inducing owners to require costly, unnecessary tests and pass the charges on to insurance companies. In some cases, owners encourage patients to relapse so that the profitable cycle can start again.

Because insurance usually pays for the treatment and nearly anyone can open a recovery center, the drug-treatment gravy train has exploded into the county’s fourth-largest industry.

The “Florida model” has been called “innovative,” but Bryant blasted it on Monday.

“Frankly, it is not (innovative),” he said. “It is abusive. It is not well-thought-out. It’s marketing.”

To regulate the industry, the panel recommends:

  • “Commercial” sober homes, defined as homes where the residents are still undergoing treatment, would be licensed by DCF.
  • “Marketers,” or people who divert patients to a particular treatment center, usually for an illegal kickback, would have to be licensed and adhere to basic standards.
  • DCF would establish a separate investigative division to follow up on complaints against treatment centers and sober homes.
  • DCF, which only has nine people doing licensing for all of South Florida, would hire many more people, paid for by bigger fees for treatment centers and commercial sober homes.

Johnson pointed out the absurdity that marketers, who are making medical decisions by steering addicts to a particular treatment center, require no training, certifications or licenses.

“We license hair cutters, for crying out loud,” Johnson said.



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