II 

117TH CONGRESS 

1ST SESSION S. 2901 

To amend title V of the Public Health Service Act to provide for increased 

oversight of recovery housing, and for other purposes. 

IN THE SENATE OF THE UNITED STATES 

SEPTEMBER 29, 2021 

Mr. WHITEHOUSE (for himself and Mr. PORTMAN) introduced the following 

bill; which was read twice and referred to the Committee on Health, Education, Labor, and Pensions 

A BILL 

To amend title V of the Public Health Service Act to provide 

for increased oversight of recovery housing, and for other 

purposes. 

1 Be it enacted by the Senate and House of Representa2 tives of the United States of America in Congress assembled, 

3 SECTION 1. SHORT TITLE. 

4 This Act may be cited as the ‘‘Excellence in Recovery 

5 Housing Act’’. 


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1 SEC. 2. CLARIFYING THE ROLE OF SAMHSA IN PROMOTING 

2 THE AVAILABILITY OF HIGH-QUALITY RECOV3 ERY HOUSING. 

4 Section 501(d) of the Public Health Service Act (42 

5 U.S.C. 290aa) is amended— 

6 (1) in paragraph (24)(E), by striking ‘‘and’’ at 

7 the end; 

8 (2) in paragraph (25), by striking the period at 

9 the end and inserting ‘‘; and’’; and 

10 (3) by adding at the end the following: 

11 ‘‘(26) collaborate with national accrediting enti12 ties and reputable providers and analysts of recovery 

13 housing services and all relevant Federal agencies, 

14 including the Centers for Medicare & Medicaid Serv15 ices, the Health Resources and Services Administra16 tion, other offices and agencies within the Depart17 ment of Health and Human Services, the Office of 

18 National Drug Control Policy, the Department of 

19 Justice, the Department of Housing and Urban De20 velopment, and the Department of Agriculture, to 

21 promote the availability of high-quality recovery 

22 housing for individuals with a substance use dis23 order.’’. 


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1 SEC. 3. DEVELOPING GUIDELINES FOR STATES TO PRO2 MOTE THE AVAILABILITY OF HIGH-QUALITY 

3 RECOVERY HOUSING. 

4 Title V of the Public Health Service Act is amended 

5 by inserting after section 550 of such Act (42 U.S.C. 

6 290ee–5) the following: 

7 ‘‘SEC. 550A. DEVELOPING GUIDELINES FOR STATES TO 

8 PROMOTE THE AVAILABILITY OF HIGH-QUAL9 ITY RECOVERY HOUSING. 

10 ‘‘(a) IN GENERAL.—Not later than 1 year after the 

11 date of enactment of this section, the Secretary, acting 

12 through the Assistant Secretary, shall develop, and pub13 lish on the website of the Substance Abuse and Mental 

14 Health Services Administration, consensus-based guide15 lines and nationally recognized standards for States to 

16 promote the availability of high-quality recovery housing 

17 for individuals with a substance use disorder. Such guide18 lines shall— 

19 ‘‘(1) be developed in consultation with national 

20 accrediting entities, reputable providers and analysts 

21 of recovery housing services, and States and be con22 sistent with the best practices developed under sec23 tion 550; and 

24 ‘‘(2) to the extent practicable, build on existing 

25 best practices and suggested guidelines developed 


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1 previously by the Substance Abuse and Mental 

2 Health Services Administration. 

3 ‘‘(b) PUBLIC COMMENT PERIOD.—Before finalizing 

4 guidelines under subsection (a), the Secretary shall pro5 vide for a public comment period. 

6 ‘‘(c) EXCLUSION OF GUIDELINE ON TREATMENT

7 SERVICES.—In developing the guidelines under subsection 

8 (a), the Secretary may not include any guideline or stand9 ard with respect to substance use disorder treatment serv10 ices. 

11 ‘‘(d) SUBSTANCE USE DISORDER TREATMENT SERV12 ICES.—In this section, the term ‘substance use disorder 

13 treatment services’ means items or services furnished for 

14 the treatment of a substance use disorder, including— 

15 ‘‘(1) medications approved by the Food and 

16 Drug Administration for use in such treatment, ex17 cluding each such medication used to prevent or 

18 treat a drug overdose; 

19 ‘‘(2) the administering of such medications; 

20 ‘‘(3) recommendations for such treatment; 

21 ‘‘(4) clinical assessments and referrals; 

22 ‘‘(5) counseling with a physician, psychologist, 

23 or mental health professional (including individual 

24 and group therapy); and 

25 ‘‘(6) toxicology testing.’’. 


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1 SEC. 4. COORDINATION OF FEDERAL ACTIVITIES TO PRO2 MOTE THE AVAILABILITY OF HIGH-QUALITY 

3 RECOVERY HOUSING. 

4 Section 550 of the Public Health Service Act (42 

5 U.S.C. 290ee–5) is amended— 

6 (1) by redesignating subsections (e), (f), and 

7 (g) as subsections (g), (h), and (i), respectively; and 

8 (2) by inserting after subsection (d) the fol9 lowing: 

10 ‘‘(e) COORDINATION OF FEDERAL ACTIVITIES TO

11 PROMOTE THE AVAILABILITY OF HIGH-QUALITY RECOV12 ERY HOUSING FOR INDIVIDUALS WITH A SUBSTANCE

13 USE DISORDER.— 

14 ‘‘(1) IN GENERAL.—The Secretary, acting 

15 through the Assistant Secretary, and the Secretary 

16 of Housing and Urban Development shall convene 

17 an interagency working group, co-chaired by the As18 sistant Secretary and the Secretary of Housing and 

19 Urban Development and comprised of representa20 tives of each of the Federal agencies described in 

21 paragraph (2) (referred to in this section as the 

22 ‘working group’) for the following purposes: 

23 ‘‘(A) To increase collaboration, coopera24 tion, and consultation among such Federal 

25 agencies, with respect to promoting the avail26 ability of high-quality recovery housing. 


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1 ‘‘(B) To align the efforts of such agencies 

2 and avoid duplication of such efforts by such 

3 agencies. 

4 ‘‘(C) To develop objectives, priorities, and 

5 a long-term plan for supporting State, Tribal, 

6 and local efforts with respect to the operation 

7 of high-quality recovery housing that is con8 sistent with the best practices developed under 

9 this section. 

10 ‘‘(D) To coordinate inspection and enforce11 ment among Federal and State agencies. 

12 ‘‘(E) To coordinate data collection on the 

13 quality of recovery housing. 

14 ‘‘(2) FEDERAL AGENCIES DESCRIBED.—The 

15 Federal agencies described in this paragraph are the 

16 following: 

17 ‘‘(A) The Department of Health and 

18 Human Services, including— 

19 ‘‘(i) the Centers for Medicare & Med20 icaid Services; 

21 ‘‘(ii) the Substance Abuse and Mental 

22 Health Services Administration; 

23 ‘‘(iii) the Health Resources and Serv24 ices Administration; and 

25 ‘‘(iv) the Indian Health Service. 


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1 ‘‘(B) The Department of Housing and 

2 Urban Development. 

3 ‘‘(C) The Department of Agriculture. 

4 ‘‘(D) The Department of Justice. 

5 ‘‘(E) The Office of National Drug Control 

6 Policy. 

7 ‘‘(F) The Bureau of Indian Affairs. 

8 ‘‘(G) The Department of Labor. 

9 ‘‘(H) Any other Federal agency as the co10 chairs determine appropriate. 

11 ‘‘(3) MEETINGS.—The working group shall 

12 meet on a quarterly basis. 

13 ‘‘(4) REPORTS TO CONGRESS.—Beginning not 

14 later than 1 year after the date of enactment of this 

15 section and annually thereafter, the working group 

16 shall submit to the Committee on Energy and Com17 merce, the Committee on Ways and Means, the 

18 Committee on Agriculture, and the Committee on 

19 Financial Services of the House of Representatives 

20 and the Committee on Health, Education, Labor, 

21 and Pensions, the Committee on Agriculture, Nutri22 tion, and Forestry, and the Committee on Finance 

23 of the Senate a report describing the work of the 

24 working group and any recommendations of the 


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1 working group to improve Federal, State, or local 

2 policy with respect to recovery housing operations. 

3 ‘‘(5) AUTHORIZATION OF APPROPRIATIONS.— 

4 To carry out this subsection, there are authorized to 

5 be appropriated such sums as may be necessary for 

6 fiscal years 2022 through 2027.’’. 

7 SEC. 5. NAS STUDY AND REPORT. 

8 (a) IN GENERAL.—Not later than 60 days after the 

9 date of enactment of this Act, the Secretary of Health and 

10 Human Services, acting through the Assistant Secretary 

11 for Mental Health and Substance Use, shall enter into an 

12 arrangement with the National Academies of Sciences, 

13 Engineering, and Medicine to conduct a study, which may 

14 include a literature review and case studies as appropriate, 

15 on— 

16 (1) the quality and effectiveness of recovery 

17 housing in the United States, including the avail18 ability in the United States of high-quality recovery 

19 housing and whether that availability meets the de20 mand for such housing in the United States; and 

21 (2) State, Tribal, and local regulation and over22 sight of recovery housing. 

23 (b) TOPICS.—The study under subsection (a) shall 

24 include a literature review of studies that— 


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1 (1) examine the quality of, and effectiveness 

2 outcomes for, the types and characteristics of cov3 ered recovery housing programs listed in subsection 

4 (c); and 

5 (2) identify the research and data gaps that 

6 must be filled to better report on the quality of, and 

7 effectiveness outcomes related to, covered recovery 

8 housing. 

9 (c) TYPE AND CHARACTERISTICS.—The types and 

10 characteristics of covered recovery housing programs re11 ferred to in subsection (b) consist of the following: 

12 (1) Nonprofit and for-profit covered recovery 

13 housing. 

14 (2) Private and public covered recovery housing. 

15 (3) Covered recovery housing programs that 

16 provide services to— 

17 (A) residents on a voluntary basis; and 

18 (B) residents pursuant to a judicial order. 

19 (4) Number of clients served, disaggregated to 

20 the extent possible by covered recovery housing serv21 ing— 

22 (A) 6 or fewer recovering residents; 

23 (B) 10 to 13 recovering residents; and 

24 (C) 18 or more recovering residents. 


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1 (5) Bedroom occupancy in a house, 

2 disaggregated to the extent possible by— 

3 (A) single room occupancy; 

4 (B) 2 residents occupying 1 room; and 

5 (C) more than 2 residents occupying 1 

6 room. 

7 (6) Duration of services received by clients, 

8 disaggregated to the extent possible according to 

9 whether the services were— 

10 (A) 30 days or fewer; 

11 (B) 31 to 90 days; 

12 (C) more than 90 days and fewer than 6 

13 months; or 

14 (D) 6 months or more. 

15 (7) Certification levels of staff. 

16 (8) Fraudulent and abusive practices by opera17 tors of covered recovery housing and inpatient and 

18 outpatient treatment facilities, both individually and 

19 in concert, including— 

20 (A) deceptive or misleading marketing 

21 practices, including— 

22 (i) inaccurate outcomes-based mar23 keting; and 

24 (ii) marketing based on non-evidence25 based practices; 


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1 (B) illegal patient brokering; 

2 (C) third-party recruiters; 

3 (D) deceptive or misleading marketing 

4 practices of treatment facility and recovery 

5 housing online aggregators; and 

6 (E) the impact of such practices on health 

7 care costs and recovery rates. 

8 (d) REPORT.—The arrangement under subsection (a) 

9 shall require, by not later than 18 months after the date 

10 of entering into the agreement— 

11 (1) completing the study under such subsection; 

12 and 

13 (2) making publicly available (including through 

14 publication on the internet) a report that contains— 

15 (A) the results of the study; 

16 (B) the National Academy’s recommenda17 tions for Federal, State, and local policies to 

18 promote the availability of high-quality recovery 

19 housing in the United States; 

20 (C) research and data gaps; 

21 (D) recommendations for recovery housing 

22 quality and effectiveness metrics; 

23 (E) recommended mechanisms to collect 

24 data on those metrics, including with respect to 

25 research and data gaps; 


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1 (F) recommendations to eliminate restric2 tions by recovery housing that exclude individ3 uals who take prescribed medications for opioid 

4 use disorder; and 

5 (G) a summary of allegations, assertions, 

6 or formal legal actions on the State and local 

7 levels by governments and nongovernmental or8 ganizations with respect to the opening and op9 eration of recovery housing. 

10 (e) DEFINITIONS.—In this subsection: 

11 (1) The term ‘‘covered recovery housing’’ means 

12 recovery housing that utilizes compensated or volun13 teer onsite staff who are not health care profes14 sionals to support residents. 

15 (2) The term ‘‘effectiveness outcomes’’ may in16 clude decreased substance use, reduced probability of 

17 relapse or reoccurrence, lower rates of incarceration, 

18 higher income, increased employment, and improved 

19 family functioning. 

20 (3) The term ‘‘health care professional’’ means 

21 an individual who is licensed or otherwise authorized 

22 by the State to provide health care services. 

23 (4) The term ‘‘recovery housing’’ means a 

24 shared living environment that is or purports to 

25 be— 


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1 (A) free from alcohol and use of nonpre2 scribed drugs; and 

3 (B) centered on connection to services that 

4 promote sustained recovery from substance use 

5 disorders. 

6 (f) AUTHORIZATION OF APPROPRIATIONS.—To carry 

7 out this section, there is authorized to be appropriated 

8 $1,500,000 for fiscal year 2022. 

9 SEC. 6. FILLING RESEARCH AND DATA GAPS. 

10 Not later than 60 days after the completion of the 

11 study under section 5, the Secretary of Health and 

12 Human Services shall enter into an agreement with an ap13 propriate entity to conduct such research as may be nec14 essary to fill the research and data gaps identified in re15 porting pursuant to such section. 

16 SEC. 7. GRANTS FOR STATES TO PROMOTE THE AVAIL17 ABILITY OF HIGH QUALITY RECOVERY HOUS18 ING. 

19 Section 550 of the Public Health Service Act (42 

20 U.S.C. 290ee–5), as amended by section 4, is further 

21 amended by inserting after subsection (e) (as inserted by 

22 section 4) the following: 

23 ‘‘(f) GRANTS FOR IMPLEMENTING NATIONAL RECOV24 ERY HOUSING BEST PRACTICES.— 


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1 ‘‘(1) IN GENERAL.—The Secretary shall award 

2 grants to States (and political subdivisions of 

3 States), Tribes, and territories— 

4 ‘‘(A) for the provision of technical assist5 ance by national accrediting entities and rep6 utable providers and analysts of recovery hous7 ing services to implement the guidelines, nation8 ally recognized standards, and recommendations 

9 developed under section 3 of the Excellence in 

10 Recovery Housing Act and this section; and 

11 ‘‘(B) to promote the availability of high12 quality recovery housing for individuals with a 

13 substance use disorder and practices to main14 tain housing quality long term. 

15 ‘‘(2) STATE ENFORCEMENT PLANS.—Beginning 

16 not later than 90 days after the date of enactment 

17 of this paragraph and every 2 years thereafter, as a 

18 condition on the receipt of a grant under paragraph 

19 (1), each State (or political subdivision of a State), 

20 Tribe, or territory receiving such a grant shall sub21 mit to the Secretary, and make publicly available on 

22 a publicly accessible website of the State (or political 

23 subdivision of the State), Tribe, or territory— 

24 ‘‘(A) the plan of the State (or political sub25 division of a State), Tribe, or territory, with reVerDate Sep 11 2014 16:05 Sep 30, 2021 Jkt 019200 PO 00000 Frm 00014 Fmt 6652 Sfmt 6201 E:\BILLS\S2901.IS S2901

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1 spect to the promotion of high-quality recovery 

2 housing for individuals with a substance use 

3 disorder located within the jurisdiction of such 

4 State (or political subdivision of a State), Tribe, 

5 or territory; and 

6 ‘‘(B) a description of how such plan is con7 sistent with the best practices developed under 

8 this section and guidelines developed under sec9 tion 550A. 

10 ‘‘(3) REVIEW OF ACCREDITING ENTITIES.—The 

11 Secretary shall periodically review, by developing a 

12 rubric to evaluate accreditation, the accrediting enti13 ties providing technical assistance pursuant to para14 graph (1)(A). 

15 ‘‘(4) AUTHORIZATION OF APPROPRIATIONS.— 

16 To carry out this subsection, there is authorized to 

17 be appropriated $10,000,000 for each of fiscal years 

18 2023 through 2027.’’. 

19 SEC. 8. AUTHORIZATION OF APPROPRIATIONS. 

20 Section 550 of the Public Health Service Act (42 

21 U.S.C. 290ee–5), as amended by sections 4 and 7, is fur22 ther amended by amending subsection (i) (as redesignated 

23 by such section 4) to read as follows: 

24 ‘‘(i) AUTHORIZATION OF APPROPRIATIONS.— 


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1 ‘‘(1) IN GENERAL.—To carry out this section, 

2 there is authorized to be appropriated— 

3 ‘‘(A) $2,000,000 for fiscal year 2022; and 

4 ‘‘(B) $11,000,000 for each of fiscal years 

5 2023 through 2027. 

6 ‘‘(2) RESERVATIONS OF FUNDS.—For each of 

7 fiscal years 2022 through 2027, of the amounts ap8 propriated under paragraph (1) for such fiscal year, 

9 the Secretary shall reserve— 

10 ‘‘(A) not less than $1,000,000 to carry out 

11 subsection (e); and 

12 ‘‘(B) not less than $10,000,000 to award 

13 grants under paragraphs (1) and (2) of sub14 section (f).’’. 

15 SEC. 9. REPUTABLE PROVIDERS AND ANALYSTS OF RECOV16 ERY HOUSING SERVICES DEFINITION. 

17 Section 550(h) of the Public Health Service Act (42 

18 U.S.C. 290ee–5(i)), as redesignated by section 4, is 

19 amended by adding at the end the following: 

20 ‘‘(4) The term ‘reputable providers and analysts 

21 of recovery housing services’ means recovery housing 

22 service providers and analysts that— 

23 ‘‘(A) use evidence-based approaches; 

24 ‘‘(B) act in accordance with guidelines 

25 issued by the Assistant Secretary; 


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1 ‘‘(C) have not been found guilty of health 

2 care fraud, patient brokering, or false adver3 tising by the Department of Justice, the De4 partment of Health and Human Services, or a 

5 Medicaid Fraud Control Unit; 

6 ‘‘(D) have not been found to have violated 

7 Federal, State, or local codes of conduct with 

8 respect to recovery housing for individuals with 

9 a substance use disorder; and 

10 ‘‘(E) do not employ individuals with a past 

11 conviction of criminal, domestic, or sexual vio12 lence, or significant drug distribution, in the 

13 care or supervision of individuals.’’. 

14 SEC. 10. TECHNICAL CORRECTION. 

15 Title V of the Public Health Service Act (42 U.S.C. 

16 290aa et seq.) is amended— 

17 (1) by redesignating section 550 (relating to 

18 Sobriety Treatment and Recovery Teams) (42 

19 U.S.C. 290ee–10), as added by section 8214 of Pub20 lic Law 115–271, as section 550B; and 

21 (2) moving such section so it appears after sec22 tion 550A (added by section 3 of this Act). 

Æ 


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