Robert P. Fairbanks II, How It Works: Recovering Citizens on Post-Welfare Philadelphia. Chicago: The University of Chicago Press, 2009.
Philadelphia has a national reputation or its network of drug and alcohol assistance centers available to abusers to seek services. Philadelphia is responding it a crisis, as the Kensington section of Philadelphia leads the nation in per capita heroin and cocaine purchases. Temple University assists several centers. It is important, though, for a person to have insurance and identification in order to receive most formal services.
Many recovery centers provide unofficial, unregulated services to people with problems with drugs and/or alcohol. There are 30,000 abandoned homes in Philadelphia that attract recovery centers, as they often materialize inside an abandoned home. There are approximately 400 to 500 recovery homes in Philadelphia. None are government regulated. Most operate by word of mouth. Many attract people from out of state. Newark and Baltimore hospitals are known to give substance abusers one way bus or transit tickets to Philadelphia. Churches and local governments in Puerto Rico give abusers one way plane tickets to Philadelphia.
It is debatable how good the services are that are provided, and they may vary greatly amongst the recovery homes themselves. To some, the provide hope and improve the lives of the most troubled substance abusers. To others, they provide unqualified services in illegal and shoddy housing conditions.
A person typically enters a recovery house by agreeing to place one’s General Assistance, Social Security, and food stamps into a group pool. In return, the person receives housing and participation in a traditional 12 step recovery program to attempt to overcome problems with drugs and/or alcohol.
These homes create challenges for residents. Most exist in neighborhoods where drugs are readily available.
Many recovery homes have strong local political support. Home recovery residents provide Election Day campaign labor for State Rep. John Taylor, who in return is an advocate for these homes. Recovery home residents were also noted being involved in campaign for officials such as Mayor John Street, Rep. Chaka Fattah, and Sen. Arlen Specter. One group of centers, One Day at a Time, provided 50 to 60 Election Day workers form Sen. Specter. Specter then helped provide a $250,000 unrestricted grant to One Day at a Time.
Residents are used for lobbying purposes and are sent in buses sent to Harrisburg seeking support from state legislators. Some political leaders oppose these homes. City Council member James Kenney argues many of the homes are operated by corporations with no credentials, no insurance, and provide substandard housing in return for profit.
Some houses have failed and, instead of helping people, have reverted into becoming homes supporting drug use and other criminal activities, such as prostitution.
Since the recovery home facilities operate without licensing, there is little government does to close exploitative recovery centers. The only government oversight is for basic housing matters from the city’s License and Inspections Department (L&I). It takes a complaint made to L&I to get an investigation as whether a place is warehousing people. The License and Inspections Department has no official category for “recovery house”. The author argues L&I lacks the funds and means to inspect all of the homes. The author also suspects some recovery homes may bribe L&I inspectors to overlook infractions.
Day care centers are licensed and inspected by L&I. Licensing could require the homes to follow proper zoning which could be enforced by L&I. Some believe this could reduce houses that warehouse, or overpopulate their homes. Some believe this would matter little, as some believe L&I is ineffective. Further, L&I is concerned only with the physical structure and not the program quality. L&I seldom issues “cease and desist” orders because they know the residents would then lose housing and many would be back on the street. State Sen. LeAnna Washington has fought to keep recovery homes open to reduce homelessness and to keep addicts from committing crimes.
The author interviewed L&I officials as well as state Public Welfare Department officials. They agreed they lack the finances and staff to inspect and monitor recovery houses.
Recovery homes are recognized by people in related institutions. Hospital employees, probation officers, and social workers refer patients to some recovery homes.
Most recovery homes teach residents the traditional Alcoholics Anonymous instruction that a resident has no ability to overcome drug and/or alcohol problems alone. The residents love all ability of self-governance. Indeed, the author argues “a central purpose of this book, therefore, is to understand something more broadly about the relationship between the techniques of self-government---as embodied in recovery---and systems of power” within their communities, including political, social, and spiritual/religious institutions.
To some, the recovery homes teach people how to become responsible for themselves, become responsible citizens, and achieve upward social mobility. These homes are seen as improving moral values and encouraging civil participation. Some advocates sees recovery home residents as resources for community improvement, The residents can work on cleaning-up neighborhoods and work on neighborhood crime watches.
The author sees the recovery homes are a reflection of current social services ideology where government programs dating back to the New Deal are responding more to private markets. Recovery homes are private institutions operating for a profit.
This book explores how some recovery home operators have utopian visions of improving society by resolving the difficulties faced by illegal drug use actions.
The author argues recovery homes are an unintended consequence of state law and the welfare reform movement that has led to a rise in informal delivery of social services; some of which take advantage of their clients. The author finds many recovery home residents return to their drug and/or alcohol use. This keeps these residents in these homes and these homes continue having a large supply of clients. The author discovered much informal transfer of patients between legitimate recovery program and the illegal recovery homes. Thus, the recovery homes have become part of community structure which tolerates them, declines to intervene to stop them, and often works with them.
The recovery homes operate to make a profit. Residents are recruited by word of mouth. Some advertise with flyers. Operators of recovery homes often recruit residents at Alcoholics Anonymous meetings. The residents often must attend recovery meetings, pay rent, and perform work, such as cleaning and repairing the house. The system breaks down regular, as clients often leaves, sometimes without notice, as it is difficult to enforce rules within an illegal and informal system.
The author found one person estimates a house could have monthly bills of around $600 with small houses earning $2,500 to $3,500 monthly with large houses earning $5,000 monthly before bills. Another stated an even larger house had $5,000 monthly costs while earning $20,000 monthly profit. Another observer noted that a row home can be purchased in Kensington for $5,000 to $20,000 or rented for $350 to $500 per month, with the owner charging $180 to $200 per month plus half of one’s food stamps. The author notes many homes struggle financially. The market system responds as operators of successful homes entice residents from failing houses to leave and move into their homes.
Recovery houses prefer residents who receive public assistance. Their checks are more dependable than most others’. The operators are careful not to claim to be a rehabilitation facility, as these are regulated and require licensing. The author observed an Attorney General inspector checking on the status of a house and how the operator knew not to cross that legal line. The author also observed recovery homes bending the law and violating the law in order to complete paperwork to obtain utilities.
Pennsylvania enacted its Welfare Reform Act 75 in 1982. The law redefined eligibility for public assistance such that a person could no longer receive public assistance unless the person fell into one of several categories, such as having a disability or for being a substance abuser. This had the unintended consequence of creating cheap housing capturing the public assistance paid to substance abusers.
In 1995, Pennsylvania eliminated transitional needy General Assistance benefits for substance abusers. In addition, Social Security Insurance was not allowed for substance abusers. This led many substance abusers to become classified as chronically needy in order to receive public assistance benefits. This had the unintended consequence of making recovery home more economically stable.
The criminal justice system is a part of the recovery home network. Treatment Court offenders and paroles are sometimes sent to recovery houses. Clients sometimes move from government-funded homes to non-funded homes.
Philadelphia city government officially approves only Coordinating Office for Drug and Alcohol Abuse Program (CODAAP) homes. Some of these homes have contracts to handle cases from the criminal justice an system and for handling homeless people during below freezing weather. In 2004, the City of Philadelphia funded 23 CODAAP homes. This compares to the estimated 400 to 500 homes in Philadelphia operating outside this official system.
A CODAAP funded recovery house has the approval of local community groups and District City Council member, liability insurance, 50 square feet minimum per occupant, one bathroom per six occupants, no bunk beds, has a business privilege license and business tax number, and has a designated managing agent who receives any summonses, notices, or orders from L&I. CODAAP requires staff to complete ten weeks of training.
In a CODAAP home, a person who uses drugs or alcohol is almost always evicted from that home. In recovery homes, users usually continue residing there, although they may be fined.
Most recovery homes will not accept methadone maintenance residents. Doing so often would destroy a recovery home’s reputation, even within the informal world of recovery.
Recovery homes have been found by L&I to have as many as 30 people within beds, furniture, or utilities. Some were found to be crack houses or brothels. Violence amongst residents has occurred.
The author notes he has heard about, as has been reported in the media, that some recovery homes have engaged in food stamp fraud. After they pool the residents’ food stamps, they allow unscrupulous food store operators to overcharge them for the food purchased. The overcharged amounts were then split between the involved food store operators and the recovery home employees.
The author notes distinctions between nonprofit recovery homes, whose reputations are better, and for profit recovery homes, some of which are known as “money mills” that provide little or no services. Some for profit homes have good reputations, indicating there is a large variation in how for profit homes are operated.
The author, a male, researched mostly male recovery homes. There are also about as many, and maybe even more, recovery homes for women. The author found one coed recovery house. Some formal women’s recovery homes operate with the child welfare system. Most women’s recovery homes operate informally. Most do not permit children.
Many recovery homes are racially segregated. There are Christian recovery homes that mostly serve Puerto Ricans, speak Spanish, involved Bible study, ban cigarettes, and have admitted some African Americans and whites. Many residents in Christian recovery homes arrive directly from Puerto Rico, often sent by a church or local government in Puerto Rico.
Some owners operate a system of houses. There are intake homes where newly admitted resident become familiar with the procedures. They often undergo a two to four week blackout period where they are not allowed outside contact except for meetings with governments officials, such as probation officers or welfare case workers, health care appointments, and 12 step sponsors. Some undergo withdrawal in intake homes during this period.
A person needs a legal address to receive welfare in Philadelphia. A recovery house provides that address. A rental agreement or a voter registration card serves as this proof. A person must be determined by the Public Welfare Department to have been declared as having a chemical addiction and has no ability to work for nine months in order to enter many recovery homes.
Many houses charge a $40 intake fee or security deposit that is credited towards the first month’s rent. Some unable to pay have this fee waived.
After the blackout period in these systems, a person often moves into a recovery house. When the recovery house residency is completed, a person may move into a transitional house, also known as a worker house or a three-quarter house. The total period spent in these homes typically covers the nine months of public assistance provided for unemployable people with chemical dependencies. Many continue staying in the homes for years afterwards, so long as the public welfare system determines they are unable to work. Some stay through the five years lifetime maximum of welfare benefits. Some even stay afterwards using their food stamps as payments to remain in the houses.
Some recovery houses operate as food clubs. These often require residents to pool their food stamps. The homes typically return half the amount to residents for laundry and cigarettes. A person not collecting food stamps is required to pay the equivalent in cash. An advantage of this system is that people are fed well and often gain weight, which is especially good for those who have been emaciated from drug use. Further, everyone is treated similar, which reduces fights and stealing when residents purchase their own food.
Many residents perform labor within their recovery homes. This is part of their transformative process in recovery. The residents generally see working as giving something back. Houses where everyone works are viewed as being more harmonious than ones where some work and others are slackers. The author argues the best recovery homes show residents the meanings of freedom, consent, rules, and economic realities. Homes that exert too much control over residents are apt to fail as residents would be likely to leave such homes for other programs.
Most recovery home operators know that new residents often have hustler personalities where they may claim to want to recover when they don’t. It is the goal of the recovery home programs to turn them into people who desire to recover. The resolve to be sober is a key part of the philosophy of Alcoholics Anonymous. A person needs discipline to overcome dependency, but it must also be the person’s choice to do so.
The author finds most recovery homes eventually fail. Many homes require a profit, tend to become overcrowded to get more rental income and tend to reduce upkeep spending. Some residents “endure levels of destitution even more extreme than that which they endured while using drugs”.
Some recovery homes have connections to local employers for day labor so residents may earn some money. It is noted that this work could not be enough that it would lead to a cut off of public assistance benefits. Some recovery house operations receive some of the pay in their roles as middlemen in finding jobs and residents to fill them. This makes operators important parts of the temporary low wage markets.
A problem recovery homes face is when someone replaces into using drugs and/or alcohol. Relapses are a common difficulty. There is not only the problem of trying to keep residents off of drugs and alcohol but relapsed people often require money for their renewed habits. Relapsed residents may steal money and belongings from other residents and from the house. There is a strong black market in Kensington that absorbs these sales.
It is difficult to get feel for service health reimbursements for the paraprofessional counselors in recovery houses. These counselors lack formal training and have been prone to backslide themselves.
Scandals have hit recovery homes. It was disclosed in 1995 the New Jersey Probation and Parole Department illegally placed approximately 1,000 drug felons in Pennsylvania recovery homes without providing required notification to Pennsylvania officials. The scandal did not drive state or local governments to regulate recovery centers. It is theorized the houses are tolerated as they are providing housing to people who otherwise might become a public sector burden on limited public sector resources. There is a lack of government spending on drug and alcohol treatment services and on homeless shelters, which some years are even reduced. Recovery centers grew to fill some of the void created by this underfunding.
A person receiving public assistance is allowed to collect assistance payments from others for a recovery house pool. It is fraud for someone receiving public assistance to receive funds above one’s own public assistance. Thus many house managers on public assistance violate the law when they receive a percent of the pooled money. This illegality confuses the managers who understand the state wants them to find employment, and the recovery system encourages it, and then they are penalized when they do work.
As for the welfare system, the author observes “by scrutinizing where the money is coming from, and not to where it is going, the regulatory structure of welfare sweats the recipient-operator while absolving absentee landlords.”
The author believes the issue of regulating recovery houses is the wrong issue. He sees licensing as encouraging civil order while preserving classic liberal sensibilities against creating too much state authority. He believes the state will not have the proper resources to inspect and oversee recovery houses. The author finds the current informed recovery system operates to end fraud and abuse within its own system. Yet the more successful programs often vary in correlation with race and economic class.
The author views recovery homes as “survival strategy based on the exigencies of state policy and urban political economy”. They exist as it is hard to live off of welfare benefits, while pooling benefits allows a survival mode to succeed. This is “a new system of poverty management designed for the governance of insecurity in the postindustrial city.”