HOUSE OF REPRESENTATIVES STAFF ANALYSIS
BILL #: CS/CS/CS/HB 1065 Substance Abuse Treatment
SPONSOR(S): Health & Human Services Committee, Ways & Means Committee, Children, Families &
Seniors Subcommittee, Caruso
TIED BILLS: IDEN./SIM. BILLS: SB 1180
REFERENCE ACTION ANALYST STAFF DIRECTOR or
BUDGET/POLICY CHIEF
1) Children, Families & Seniors Subcommittee 15 Y, 0 N, As CS Curry Brazzell
2) Ways & Means Committee 21 Y, 0 N, As CS Rexford Aldridge
3) Health & Human Services Committee 18 Y, 0 N, As CS Curry Calamas
SUMMARY ANALYSIS
The Department of Children and Families (DCF) administers a statewide system of safety-net services for
substance abuse and mental health prevention, treatment, and recovery. DCF provides treatment for
substance abuse through a community-based provider system.
A recovery residence is a residential dwelling unit, or other form of group housing, that provides a peer-
supported, alcohol-free, and drug-free living environment. Florida requires residence to meet certain quality
standards to be certified. CS/CS/HB 1065 amends the definition of certified recovery residence to include
standards regarding the level of care provided at those residences. The bill requires four levels of care that
distinguish the residences based on their provided care. The levels of care include:
Level I: These homes house individuals in recovery who are post-treatment, with a minimum of 9
months of sobriety. These homes are run by the members who reside in them.
Level II: These homes provide oversight from a house manager. Residents are expected to follow
rules outlined in a resident handbook, pay dues, and work toward achieving milestones.
Level III: These homes offer 24-hour supervision by formally trained staff and peer-support services
for residents.
Level IV: These homes are dwelling offered, referred to, or provided to patients by licensed service
providers. The patients receive intensive outpatient and higher levels of outpatient care. These
homes are staffed 24 hours a day.
The bill authorizes the Department of Children and Families to issue one license for all eligible service
components operated by a service provider. The bill prohibits any recovery residence from denying an
individual access to the residence solely on the basis the individual has been prescribed federally approved
medication for the treatment of substance use disorders.
The bill prohibits a local ordinance or regulation from regulating the duration or frequency of a resident’s stay in
a certified recovery residence located within a multifamily zoning district. The bill authorizes an increase in the
number of residents actively managed in a recovery residence at any given time from 100 residents to 150
residents, if certain requirements are met.
The bill has no fiscal impact on state or local government.
The bill provides an effective date of July 1, 2024.
This docum ent does not reflect the intent or official position of the bill sponsor or House of Representatives .
STORAGE NAME: h1065d.HHS
DATE: 2/23/2024
FULL ANALYSIS
I. SUBSTANTIVE ANALYSIS
A. EFFECT OF PROPOSED CHANGES:
Background
Substance Abuse
Substance abuse refers to the harmful or hazardous use of psychoactive substances, including alcohol
and illicit drugs.1 Substance use disorders is the recurrent use of alcohol and/or drugs leading to
clinically significant impairment, including health problems, disability, and failure to fulfil
responsibilities.2 Substance use disorders can happen with both legal substances such as alcohol,
nicotine or prescription drugs and illicit or illegal drugs. 3 In the United States, the most common
substance use disorders are from alcohol, opioid, stimulants, hallucinogens, cannabis, and tobacco. 4
Substance Abuse Treatment in Florida
The Department of Children and Families (DCF) administers a statewide system of safety-net services
for substance abuse and mental health (SAMH) prevention, treatment, and recovery. DCF provides
treatment for substance abuse through a community-based provider system that offers detoxification,
treatment and recovery support for adolescents and adults affected by substance misuse, abuse or
dependence:5
Detoxification Services: Detoxification services use medical and clinical procedures to assist
individuals and adults as they withdraw from the physiological and psychological effects of
substance abuse.6
Treatment Services: Treatment services 7 include a wide array of assessment, counseling,
case management, and support services that are designed to help individuals who have lost
their abilities to control their substance use on their own and require formal, structured
intervention and support. Some of these services may also be offered to the family members of
the individual in treatment.8
Recovery Support: Recovery support services, including transitional housing, life skills
training, parenting skills, and peer-based individual and group counseling, are offered during
and following treatment to further assist individuals in their development of the knowledge and
skills necessary to maintain their recovery.9
Licensure of Substance Abuse Service Providers
DCF regulates substance abuse treatment, establishing licensure requirements and licensing service
providers and individual service components under ch. 397, F.S., and rule 65D-30, F.A.C. Licensed
1
World Health Organization, Sub stance Ab use, https://www.afro.who.int/health-topics/substance-abuse (last visited Feb 6, 2024).
2 The Rural Health Information Hub, Defining Sub stance Ab use and Sub stance Abuse Use Disorders,
https://www.ruralhealthinfo.org/toolkits/substance-abuse/1/definition (last visited Feb. 6, 2024).
3 Id.
4 Id.
5 Department of Children and Families, Treatment for Sub stance Ab use https://www.myflfamilies.com/services/samh/treatment, (last
visited Feb. 6, 2024).
6 Id.
7 Id. Research indicates that persons who successfully complete substance abuse treatment have better post-treatment outcomes
related to future abstinence, reduced use, less involvement in the criminal justice system, reduced involvement in the child protective
system, employment, increased earnings, and better health.
8 Supra, note 5.
9 Id.
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service components include a continuum of substance abuse prevention, 10 intervention,11 and clinical
treatment services.12
Clinical treatment is a professionally directed, deliberate, and planned regimen of services and
interventions that are designed to reduce or eliminate the misuse of drugs and alcohol and promote a
healthy, drug-free lifestyle.13 “Clinical treatment services” include, but are not limited to, the following
licensable service components: 14
Addictions receiving facility;
Day or night treatment;
Day or night treatment with community housing;
Detoxification;
Intensive inpatient treatment;
Intensive outpatient treatment;
Medication-assisted treatment for opiate addiction;
Outpatient treatment; and
Residential treatment.
DCF must issue a separate license for each service component operated by a service provider. The
license is only valid for the specific service components listed for each specific location identified on the
license. A licensed service provider must apply for a new license at least 60 days before the addition of
any service components or 30 days before the relocation of any service sites. 15
Recovery Residences
Recovery residences (also known as “sober homes” or “sober living homes”) are non-medical
residential settings designed to support recovery from substance use disorders, helping individuals
transition from highly structured residential treatment programs back into their day-to-day lives. Most
recovery residences require or encourage attendance in a 12-step, mutual-help organization and are
self-funded through resident fees.16
In Florida, a recovery residence is a residential dwelling unit, or other form of group housing, which is
offered or advertised through any means, including oral, written, electronic, or printed means, by any
person or entity as a residence that provides a peer-supported, alcohol-free, and drug-free living
environment. In 2019 the definition was amended to also include as a recovery residence a community
housing component of a licensed day or night treatment facility with community housing. 17
Recovery residences can be located in single-family and two-family homes, duplexes, and apartment
complexes. Most recovery residences are located in single-family homes, zoned in residential
neighborhoods.18 To live at a recovery residence, occupants may be required to pay a monthly fee or
10 S. 397.311(26)(c), F.S. Prevention is a process involving strategies that are aimed at the individual, family, community, or substance
and that preclude, forestall, or impede the development of substance use problems an d promote responsible lifestyles. See also,
Department of Children and Families, Sub stance Ab use: Prevention https://www.myflfamilies.com/services/samh/substance-abuse-
prevention, (last visited Feb. 6, 2024). Substance abuse prevention is best accomplished through the use of ongoing strategies such as
increasing public awareness and education, community-based processes and evidence-based practices. These prevention programs
are focused primarily on youth, and, in recent years, have shifted to the local level, giving individual communities the oppo rtunity to
identify their own unique prevention needs and develop action plans in response. This community focus allows prevention strategies to
have a greater impact on behavioral change by shifting social, cultural and community environments.
11 S. 397.311(26)(b), F.S. Intervention is structured services directed toward individuals or groups at risk of substance abuse and
focused on reducing or impeding those factors associated with the onset or the early stages of substance abuse and related pr oblems.
12 S. 397.311(26), F.S.
13 S. 397.311(25)(a), F.S.
14 Id.
15 S. 397.407, F.S.
16 Douglas L. Polcin, Ed.D., MFT, and Diane Henderson, B.A., A Clean and Sob er Place to Live: Philosophy, Structure, and Purported
Therapeutic Factors in Sob er Living Houses, 40(2) J Psychoactive Drugs 153–159 (June 2008).
17 Chapter 2019-159, Laws of Fla.
18 Hearing before the Subcommittee on the Constitution and Civil Justice of the Committee on the Judiciary, House of Representat ives,
One Hundred Fifteenth Congress, Sept. 28, 2018, https://www.govinfo.gov/content/pkg/CHRG-115hhrg33123/html/CHRG-
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rent, which supports the cost of maintaining the home. Generally, recovery residences provide short-
term residency, typically a minimum of at least 90 days. However, the length of time a person stays at a
recovery residence varies based on the individuals’ treatment needs. 19
Day or Night Treatment: Community Housing Component
Community housing is a type of group home that provides supportive housing for individuals who are
undergoing treatment for substance abuse.
Day or night treatment is one of the licensable service components of clinical treatment services. This
service is provided in a nonresidential environment with a structured schedule of treatment and
rehabilitative services.20 Some day or night treatment programs have a community housing component,
which is a program intended for individuals who can benefit from living independently in peer
community housing while participating in treatment services at a day or night treatment facility for a
minimum of 5 hours a day for a minimum of 25 hours per week. 21
Prior to 2019, the community housing component of a licensed day or night treatment program was not
included in the definition of “recovery residence”. In 2019, after the Legislature amended the definition
of “recovery residence” to include the community housing component, DCF addressed the statutory
change to the definition of “recovery residence” in a memo. The department stated that as a result of
the change in definition, providers licensed for day or night treatment with community housing must be
certified as a recovery residence in order to accept or receive patient referrals from licensed treatment
providers or existing recovery residences.22 The memo did not specifically address whether the
community housing component requires certification if the only individuals residing there were clients of
the licensed day or night treatment program.
Voluntary Certification of Recovery Residences and Recovery Residence Administrators
A certified recovery residence is a recovery residence that holds a valid certificate of compliance and is
actively managed by a certified recovery residence administrator. 23 Florida has a voluntary certification
program for recovery residences and recovery residence administrators, implemented by private
credentialing entities.24 Under the voluntary certification program, two DCF-approved credentialing
entities administer certification programs and issue certificates: the Florida Association of Recovery
Residences (FARR) certifies the recovery residences and the Florida Certification Board (FCB) certifies
recovery residence administrators.25
Certified Recovery Residences
As the credentialing entity for recovery residences in Florida, FARR is statutorily authorized to
administer certification, recertification, and disciplinary processes as well as monitor and inspect
recovery residences to ensure compliance with certification requirements. FARR is also authorized to
115hhrg33123.htm . See also The National Council for Behavioral Health, Building Recovery: State Policy Guide for Supporting
Recovery Housing (2017), https://www.thenationalcouncil.org/wp-content/uploads/2018/05/18_Recovery-Housing-
Toolkit_5.3.2018.pdf?daf=375ateTbd56 (last visited Feb. 6, 2024).
19 American Addiction Center, Length of Stay at a Sob er Living Home, (October 2022), available at
https://americanaddictioncenters.org/sober-living/length-of-stay, (last visited Feb. 6, 2024).
20 S. 397.311(26)(a)2., F.S.
21 S. 397.311(26)(a)3., F.S.
22 DCF Memo to the Substance Abuse Prevention, Intervention, and Treatment Providers, dated July 1, 2019 (on file with the House
Children, Families, & Seniors Subcommittee).
23 Ss. 397.487–397.4872, F.S.
24 Id.
25 The DCF, Recovery Residence Administrators and Recovery Residences, available at
https://www.myflfamilies.com/services/samh/recovery-residence-administrators-and-recovery-residences (last visited January 25,
2024).
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deny, revoke, or suspend a certification, or otherwise impose sanctions, if recovery residences are not
in compliance or fail to remedy any deficiencies identified. However, any decision that results in an
adverse determination is reviewable by the Department. 26
In order to become certified, a recovery residence must submit the following documents with an
application fee to the credentialing entity:27
A policy and procedures manual containing:
o Job descriptions for all staff positions;
o Drug-testing procedures and requirements;
o A prohibition on the premises against alcohol, illegal drugs, and the use of prescription
medications by an individual other than for whom the medication is prescribed;
o Policies to support a resident’s recovery efforts; and
o A good neighbor policy to address neighborhood concerns and complaints.;
Rules for residents;
Copies of all forms provided to residents;
Intake procedures;
Sexual predator and sexual offender registry compliance policy;
Relapse policy;
Fee schedule;
Refund policy;
Eviction procedures and policy;
Code of ethics;
Proof of insurance;
Proof of background screening; and
Proof of satisfactory fire, safety, and health inspections.
If the owner, director, or chief financial officer of a certified recovery residence is arrested for, or found
guilty of, or enters a plea of guilty or nolo contendere to, regardless of adjudication, any offense
prohibited under s. 435.04(2), F.S., while acting in that capacity, the certified recovery residence must
immediately remove the person from their position and notify the credentialing entity within 3 business
days after such removal. If the recovery residence fails to do so, the credentialing entity