Senate approves bill proponents say will add accountability for recovery residences

Sen. Mike Woelfel, D-Cabell, speaks on Senate Bill 475 in the West Virginia Senate on Wednesday, Jan. 31, 2024 in Charleston, W.Va. (WIll Price | West Virginia Legislative Photography)

The West Virginia Senate on Wednesday unanimously passed a bill that would add more oversight and accountability measures for recovery residences in the state.

Senate Bill 475 has bipartisan support, with proponents for the bill saying it would help to ensure that recovery residences are operating in an appropriate manner. The effort to add state-sponsored accountability measures to recovery residences has been ongoing for years in the Legislature.

“I want to speak to this because I think we’ve been around the edges of trying to address this, and I do agree with [Sen. Mike Woelfel, D-Cabell] that this is the most comprehensive legislation that is going to address an issue,” said Sen. Bob Plymale, D-Cabell. “I work in Huntington, I see the issue that is going on there and I think that this bill is one of the more important ones that we’ll pass this year.”

Under the proposed bill, all recovery residences in West Virginia would be required to register with — which is different from being licensed by — the Office of Health Facility Licensure and Certification before being able to operate in the state. Residences already in existence would have six months from the law’s effective date to file with the office, per the bill code.

Those that fail to file with OHFLAC would be subject to a $20,000 fine for each day they operate without being registered with the state. Individuals, likely those who run or manage the facilities, could be charged with a misdemeanor as well as a monetary fine ranging from $1,000 to $5,000.

The bill also adds recovery residences to portions of code that prohibit patient brokering and human trafficking. Patient brokering, according to the state health department , is an illegal practice “used by some rehabilitation facilities” where a facility pays a third party to find patients or clients for a program. Oversight for such actions is nonexistent in recovery residences that are not certified or licensed by the state of West Virginia.

Woelfel, a sponsor of SB 475, said that an example of patient brokering is when a rehabilitation facility or recovery residence “busses” in patients from another region or state, takes their money and benefits but does not provide them with adequate care.

“When the benefits are gone, they’re out on the street with no way home and obviously there is a likelihood of relapse,” Woelfel said.

Per the proposed code, recovery residences in the state that are not certified through the West Virginia Alliance of Recovery Residences would be ineligible to receive any sort of state benefit — including Medicaid, Temporary Assistance for Needy Families and the Supplemental Nutrition Assistance Program — from clients using their facilities. It’s common practice for some recovery programs to use these benefits while residents are living in their facilities to cover some living expenses.

Under current code, certification through the alliance is voluntary, but facilities that don’t partake in the process are ineligible to receive state funding or referrals for care from the state, including from the Division of Corrections and Rehabilitation.

With the Senate’s vote on Wednesday, SB 475 will now advance to the House, where several lawmakers are already awaiting its consideration.

On Wednesday morning, the House Committee on Prevention and Treatment of Substance Abuse considered and passed a bill that, while somewhat similar to SB 475, would have taken the proposal further by requiring licensure through OHFLAC.

House Bill 5239 is similar in its wording to SB 334 from the 2021 session, which made it illegal to operate needs-based syringe service programs. That bill required harm reduction programs in the state to apply for licensure from OHFLAC while also implementing new, hard to achieve standards for the programs.

Recovery residences and harm reduction programs, however, are fundamentally different from each other. The former is health care while the latter pertains to living situations. Health services offered in recovery residences are often rendered through a contract with third party providers, not by the residences themselves.

Lawmakers on the House Committee, while passing the bill, expressed concern about including recovery residences in portions of code that, generally, apply to health care entities like treatment facilities.

Del. Jim Butler, R-Mason, asked WVARR Executive Director Emily Birckhead if recovery residences in the state would be able to offer resources necessary to gain OHFLAC licensure, which are focused mostly on medical interventions and services.

“No, and I would say that they shouldn’t,” Birckhead said. “These [services listed in HB 5239] are all treatment services, so my view is that [the bill] lumps recovery residences and residential treatment services in one category, and requires all the services listed …”

Del. Mike Pushkin, D-Kanawha, said he believed that SB 475 is, partially, “in conflict” with the House bill despite them trying to address similar problems. Pushkin said he’s talked with “folks he trusts” who work in the recovery field and who are not against the proposals made in SB 475, but who are wary of the efforts in HB 5239.

“[HB 5239] would require [recovery residences] to do a lot of things that they’re just not equipped to do, and I don’t think that solves anything,” Pushkin said. “This is about housing, yes recovery housing, but not treatment.”

HB 5239 passed the House Prevention and Substance Abuse Committee via voice vote and will advance to the House Judiciary Committee for consideration before being taken up for a vote on the House floor.

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