In 2011, the National Alliance for Recovery Residences (NARR) established national standards for recovery residences (including sober housing). These standards were developed using a collaborative approach with input from regional and national recovery housing organizations. MASH is an affiliate of NARR and used these standards to create Massachusetts standards for certified sober homes. NARR has since released two updates to the standards, first in October 2015 and then in 2018. The third version of the NARR standards provides more explicit guidance to providers, including metrics for evaluating the peer support components of a residence’s recovery environment.
In Massachusetts, sober homes and recovery residences are different models for substance abuse recovery. Recovery residences — formerly known as halfway houses — are licensed residential treatment programs, while Massachusetts sober homes are peer-led and do not provide treatment. Sober homes provide mutual support, emphasize independent living skills, and depend on peer leadership. They are not licensed and are not funded by the state.
Sober Housing Quality Standards
Core Principle: Operate with Integrity
1.1 A written mission statement that corresponds with NARR’s core principles
1.2 A vision statement that corresponds with NARR’s core principles as stated in this document
2.1 An affidavit that attests to complying with non-discriminatory state and federal requirements.
2.2 Marketing materials, claims and advertising that are honest and substantiated as opposed to:
- False or misleading statements or unfounded claims or exaggerations;
- Testimonials that do not really reflect the real opinion of the involved individual;
- Price claims that are misleading;
- Misleading representation of outcomes.
2.3 Prior to the initial acceptance of any funds, the operator must inform applicants of all fees and charges for which they will be, or could potentially be, responsible. This information needs to be in writing and signed by the applicant.
2.4 The operator must maintain accurate and complete records of all resident charges, payments and deposits. A resident must be provided with a statement of his/her personal charge and payment history upon request.
2.5 The operator must disclose refund policies to applicants in advance of acceptance into the home, and before accepting any applicant fees.
2.6 Staff must never become involved in residents’ personal financial affairs, including lending or borrowing money, or other transactions involving property or services, except that the operator may make agreements with residents with respect to payment of fees.
2.7 Policy and procedure that ensures refunds consistent with the terms of a resident agreement are provided within 10 business days, and preferably upon departure from the home.
2.8 Policies and procedures that ensure all residents are age eighteen or older at time of admission.
3.1 Identifying the type of accounting system used and its capability to fully document all resident financial transaction, such as fees, payments and deposits.
3.2 Policy and procedure for disclosing to potential residents their financial obligations, including costs for which they might become liable, such as forfeiture of any deposits and fees as a result of prematurely leaving the home.
3.3 Policies about the timing of and requirements for the return of deposits, if financial deposits are required.
3.4 The ability to produce clear statements of a resident’s financial dealings with the operator (although it’s not a requirement that statements be automatically produced).
3.5 Policies and procedures that ensure the follow conditions are met, if the residence provider or a staff member employs, contractors or enters into a paid work agreement with residents:
- Paid work arrangements are completely voluntary. Residents do not suffer consequences for declining work. Residents who accept paid work are not treated more favorably than residents who do not.
- Paid work for the operator or staff does not impair participating residents’ progress towards their recovery goals.
- The paid work is treated the same as any other employment situation.
- Wages are commensurate with marketplace value, and at least minimum wage. The arrangements are viewed by the majority of the residents as fair.
- Paid work does not confer special privileges on residents doing the work. Work relationships do not negatively affect the recovery environment or morale of the home. Unsatisfactory work relationships are terminated without recriminations that can impair recovery.
Core Principle: Collect data for continuous quality improvement
4.1 Procedures that collect resident’s demographic information
4.2 Adoption of procedures that collect, evaluate and report accurate process and outcomes data for continuous quality improvement, once data items and protocols to be developed by NARR are adopted by MASH.
Core Principle: Operate with Prudence
5.1 Documentation that the owner/operator has current liability coverage and other insurance appropriate to their level of support.
5.2 Written permission from the owner of record to operate a recovery residence on the property.
5.3 Document that there are no taxes or other municipal assessments that constitute liens on the real estate upon which the recovery residence is located by providing a municipal lien certificate issued by the treasurer or collector’s office in the city or town in which the recovery residence is situated.
Core Principle: Uphold resident rights
6.1 A process that ensures residents receive an orientation on agreements, policies and procedures prior to committing to terms.
6.2 Written resident’s rights and requirements (e.g. House Rules and grievance process) posted in common areas
6.3 Written resident agreement that includes recovery activities provided (required and optional), including house meetings.
6.4 Resident documents that fully disclose policies regarding possessions (personal property) left in a home.
7.1 Grievance policy and procedures, including the right to take grievances that are not resolved by the house leadership to the operation’s oversight organization for mediation
7.2 Policy and procedure for identifying the responsible person(s) in charge to all residents
8.1 Applicant screening policies and procedures provide current residents a voice in the acceptance of new members
8.2 Policies and procedures that defend residents’ fair housing rights
9.1 Policies and procedures that keep resident’s records secure, with access limited to authorized staff only
Core Principle: Are recovery-oriented
10.1 Demonstrating that residents participate in the development of their recovery including an exit plan and/or lifelong plan
10.2 Documenting that the operator cultivates alumni participation
11.1 Policies and procedures that identify the priority population, which at a minimum includes persons in recovery from substance use but may also include other demographic criterion.
11.2 A staffing or leadership plan that reflects the priority population’s needs
Core Principle: Are peer staffed and governed
12.1 Some rules made by the residents that the residents (not the staff) enforce?
12.2 A resident council or process is in place that ensures resident’s voices can be heard
12.3 The resident council has a voice in the governance of the home
13.1 Residents’ responsibilities increase with their length of stay or progress in their recovery.
13.2 Staffing or leadership plan that formally includes a peer component
13.3 Written job description or house manager duties and/or contracts for peer staff and leaders
14.1 A home staffing or leadership plan that includes current residents and where possible, former residents that model recovery principles
14.2 Leader and/or staff job descriptions and selections are based in part on modeling recovery principles
15.1 Integrated recovery support in the daily activity schedule
15.2 The schedule includes formal and informal opportunities for staff and resident interaction in support of recovery
16.1 Documentation that a house manager or operator in functioning as the house manager possesses an appropriate level of knowledge and understanding of the MASH standards and practices as evidenced by the completion of MASH training class Recovery Residence 101 and subsequent training as may be required by MASH from time to time
16.2 Written staffing or workforce development plan.
17.1 Policies and procedures for supervision of staff
17.2 Ongoing skills development, oversight and support policies and NARR procedures appropriate to staff roles and level of support
Recovery Support Domain
Core Principle: Promote health
18.1 Policies and procedures that encourage each resident to develop and participate in their own personalized recovery plan (Person-driven recovery)
18.2 Policies and procedures that encourage residents to make their own outside appointments
19.1 Staff that are knowledgeable about local community-based resources
19.2 Resource directories or similar resources are readily available to residents
21.1 Weekly schedule of recovery support services recognized by the respective NARR Affiliate organization
21.2 Weekly schedule of recovery-oriented presentations, group exercises, and activities
21.3 Staffing plan that corresponds to the delivery of this service
Core Principle: Provide a home
22.1 Policies and procedures, such as applicant screenings, that establish the home’s priority population and cultivate physically and emotionally safe environments for discussing the needs, feelings and sustaining recovery-supportive connections
23.1 Written and enforced policies and procedures that address:
- Alcohol and/or other prohibited drug-seeking or use
- Possession of hazardous and other prohibited items and associated searches
- Drug-screening and or toxicology protocols*
- Prescription and non-prescription medication usage and storage consistent with the relevant state law
*Note: “The MassHealth agency does not pay for the following services: […] (4) tests performed only for purposes of civil, criminal, administrative, or social service agency investigations, proceedings, or monitoring activities; (5) tests performed for residential monitoring purposes; […] (9) test that are not medically necessary as defined in 130 CMR 450.204: Medical Necessity; …”130 CMR 401.411: Noncovered Services and Payment Limitations.
24.1 Written resident rights, requirements, agreements, social covenants and/or “House Rules”
24.2 Requirements and protocols for peer leadership and/or mentoring policies that foster individual and community accountability
Core Principle: Inspire purpose
25.1 A weekly schedule of the typical resident’s activities
25.2 Are residents encouraged to (at least one of the following):
- Work, going to school, or volunteer outside of the residence community
- Participate in mutual aid or care giving
- Participate in social, physical or creative activities
- Attend daily or weekly programming
25.3 Person-driven recovery planning & peer governance
Core Principle: Cultivate community
26. Creating a “functionally equivalent family” within the household. As evidenced by meeting at least 50% of the following:
26.1 Are residents involved in food preparation?
26.2 Do residents have control over who they live with?
26.3 Do residents help maintain and clean the home e.g. chores?
26.4 Do residents share in household expenses?
26.5 Family or house meetings at least once a week?
26.6 Do residents have access to the common areas of the home?
27.1 Encouraging residents to engage one another in informal activities and conversation
27.2 Encouraging staff to engage residents in informal activities and conversations
27.3 Coordinating community gatherings, recreational events and/or other social activities among residents and/or staff
28.1 Residents are informed of or linked to mutual aid, recovery community centers, recovery ministries recovery-focused leisure activities and recovery advocacy opportunities;
28.2 Mutual aid meetings are hosted on site and there are typically attendees from the greater recovery community
28.3 The recovery residence helps participants find a recovery mentor or mutual aid sponsor if they are having difficulty finding one
28.4 Participants are encouraged to find a recovery mentor or mutual aid sponsor before leaving the recovery residence
28.5 Residents are formally linked with the community such as job search, education, family services, health and/or housing programs
28.6 Residents engage in community relations and interactions to promote kinship with other recovery communities and goodwill for recovery services
28.7 Sober social events are regularly scheduled
Property and Architecture Domain
Core Principle: Promote recovery
29.1 Furnishing are typical of those found in single family homes or apartments as opposed to institutional settings
29.2 Entrances and exits that are home-like (vs institutional or clinical)
29.3 70 sq. ft. for first bed; 50 sq. ft. additional beds
29.4 One sink, toilet and shower per eight female residents and one sink, toilet and shower per ten male residents
29.5 Each resident has personal item storage
29.6 Each resident has food storage space
29.7 Laundry services are accessible within onsite or within walking distance to all residents
29.8 Working appliances
29.9 A staffing plan that provides for addressing repairs and maintenance in a timely fashion
30.1 Community room (space) large enough to reasonably accommodate community living and meetings.
30.2 A comfortable group area, a living room or sofas, for participants to informally socialize
30.3 A kitchen and dining area(s) that encourages residents to share meals together
30.4 Entertainment or recreational areas and/or furnishings that promote social engagement
30.5 Furniture that is in good condition
Core Principle: Promote safety
31.1 Affidavit from the owner or operator attesting that the residence meets nondiscriminatory local health and safety codes OR document from government agency or credentialed inspector attesting to the property meeting health and safety standards
31.2 Signed and dated safety self assessment checklist which includes:
- Functioning smoke detectors in the sleeping rooms
- Functioning carbon monoxide detectors
- Functioning fire extinguishers in plain sight and/or clearly marked locations
- Interior and exterior of the property is in a functional, safe and clean condition and free of fire hazards
31.3 Smoke-free living environment policy and/or designated smoking area outside of the residence
31.3 Naloxone (Narcan) available and accessible; evidence that staff and residents are oriented in its use
32.1 Post emergency numbers, procedures and evacuation maps in conspicuous locations
32.2 Collect emergency contact information from residents and orient them to emergency procedures
Good Neighbor Domains
Core Principle: Are good neighbors
33.1 If recovery residence is in a residential neighborhood, there are no external indications that the property is anything other than a single family household typical of its neighborhood The property and its structures are consistently maintained
34.1 Policies and procedures that provide neighbors with the responsible person(s) contact information upon request
34.2 Policies and procedures that require the responsible person(s) to respond to neighbor’s concerns even if it is not possible to resolve the issue
34.3 New resident orientation includes how residents and staff are to greet and interact with neighbors and/or concerned parties
35.1 Policies that are responsive or preemptive to neighbor’s reasonable complaints regarding:
- Lewd or offensive language
- Cleanliness of public space around the property
35.2 Parking courtesy rules where street parking is scarce