Washington State requires WAQRR certification for provider referrals for sober living
Washington state’s sober living homes have the option to become certified through Washington’s NARR affiliate, WAQRR, or Washington Alliance for Quality Recovery Residences, founded in 2017.
In 2019, the state of Washington passed a bill that stated that all sober living homes - sometimes referred to as recovery houses or even “boarding houses” by state legislators - must receive certification through WAQRR in order to receive referrals from addiction treatment providers in the state. The deadline for this requirement was 2023, so all sober living homes in Washington who seek referrals from providers must go through WAQRR’s certification process. Those that do opt for this appear on a registry available publicly.
Although sober living homes in Washington that do not seek certification through WAQRR cannot legally receive referrals from providers, there are still several loop holes that non-certified sober living homes can exploit in Washington. One of those is that non-certified sober living homes can still accept publicly-funded vouchers from people exiting prison.
Washington sober living home operators will also want to note that homes seeking certification and acceptance into the WAQRR registry are eligible to apply for a $4,000 loan to help cover general operating expenses as well as costs associated with meeting NARR standards. The application for this loan can be found here.
Finally, there are some ongoing NIMBY challenges in Washington state at the city and county level that sober living homes operators would do well to consider. For example, Camas, Washington attempted to restrict sober living homes and addiction treatment centers from within city limits entirely in 2022, in what would likely amount to a violation of the Fair Housing Act and the ADA should it have been successful. These challenges are not uncommon in Washington or elsewhere in the country, for that matter, but it is important to note that not every Washington state community is exceedingly sober living home friendly.
For more on behavioral health business strategy and management in Washington state, see:
Thinking of Opening an Addiction Treatment Center in Washington? Here’s What You Need to Know.
Secrets of Medicaid Billing for Addiction Treatment in Washington
The Smart Way to Open a Sober Living Home in Washington
Arizona is experiencing the biggest sober living home scandal in the history of the state, increasing regulations on the way
Unfortunately, Arizona’s sober living home landscape is likely to change dramatically in the next several years due to a huge scandal involving quite a few bad actors in the recovery residence community. In 2021, there were 52 licensed sober living homes in Arizona. By 2023 there were 470.
In the last few years, Arizona experienced a huge swell in the number of sober living homes opening in the state. Scammers targeted the high reimbursement rates found in the American Indian Health Program for people with SUD living in sober living homes. These bad actors scouted especially vulnerable populations like houseless individuals on reservations, picking them up in unmarked vans, often plying them with drugs and alcohol, and driving them to distant locations where they were asked to sign up for AHCCCS benefits and enroll in shoddy sober living home programs. Some indigenous leaders and activists believe bad actors specifically targeted Native Americans because of the pre-existing large number of missing individuals in the Arizona Native community. It’s estimated that a total of $2.8 billion dollars has been misappropriated in connection to this specific AHCCCS scam.
In response, the only bills that the legislature has mounted so far involve raising the fines for bad actors in the sober living home community from $500 per incident to $1000.
The state already requires licensure for sober living homes through the Arizona Department of Health Services and has done so since 2019. You can read about the state licensure process here. While an Arizona Recovery Housing Association (AzRHA) certification can expedite the process, the NARR affiliate’s certification process is separate from the state-required ADHS process.
Families of sober living home scam targets are also suing the state of Arizona for allowing what they’re calling the largest Medicaid scam in the history of the state to victimize their loved ones.
Because of the high profile of this situation, it behooves all sober living home operators in Arizona to go above and beyond in demonstrating their reputability and commitment to gold star care for people with SUD, particularly Native American residents. Obtaining a certification with AzRHA is a good first step in this direction.
It’s also important to note that many reputable behavioral health providers are now encountering billing issues and Medicaid reimbursement hang ups in the wake of this scandal. If your organization has not yet encountered issues, don’t be surprised if your revenue cycle experiences disruption as a result of this major event for the Arizona behavioral health community.
5 Tips for Opening a Sober Living Home in Arizona
How to Start a Addiction Treatment Center in Arizona the Easy Way
Medicaid Billing for Addiction Treatment in Arizona
Tennessee is a hotbed for NIMBY disputes and fair housing court cases for sober living homes
In 2022, Tennessee began requiring all referring providers to refer only to certified sober living homes, effectively shutting down referrals for all non-certified recovery residences in Tennessee. If providers do make referrals to non-certified sober living homes, they can lose their license. This law was called House Bill 215.
Another law, called the SAFE Act, requires non-accredited sober living homes to post a sign stating that they are not certified in a common area, like a kitchen or living room.
In Tennessee, all accreditations for sober living homes are overseen by the Tennessee NARR affiliate, TN-ARR. TN-ARR hosts “Operator Hours” over zoom to gather members and sober living home operators to ask questions about day-to-day operations at sober living homes and crowd-source answers from peers.
Tennessee is home to a lot of NIMBY activity against sober living homes. There have been high-profile incidents recently in Memphis and Chattanooga. In 2024, Memphis moved to ban sober living homes from Midtown, stating that “rooming houses,” “transitional homes,” and “social services institutions” require special use permits and are only allowed in commercial and industrial districts, rather than residential areas.
This decision is a bold one, given that Chattanooga just entered into a three-year consent decree with the federal government over their violation of fair housing and disability rights and discrimination laws in regards to sober living homes. In retribution for Chattanooga’s discriminatory ban on sober living homes, the federal government is requiring the city to change its zoning ordinances to specifically allow sober living homes in residential areas. All city employees involved in the discriminatory incident are required to undergo training in disability rights. The city must pay the federal government $5000 and the organization it discriminated against a total of $32,000.
For more on sober living home and addiction treatment state regulations news in Tennessee, see:
5 Things Every Tennessee Sober Living Home Business Startup Should Know
Medicaid Billing Secrets for Addiction Treatment in Tennessee
Here’s What it Takes to Open an Addiction Treatment Center in Tennessee
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