Missouri lawmakers and providers heard wide agreement on Thursday that expanding recovery housing, peer respite beds and housing‑first approaches would reduce emergency medical and criminal‑justice costs and help people sustain recovery.

Brendan Steenburgen, executive director of the Missouri Coalition of Recovery Support Providers (MoCRISP), told the House Task Force on Substance Abuse Prevention and Treatment that the statewide network now certifies thousands of recovery beds but still faces unmet demand. "We at MoCRISP envision a world where there is no 1 who's homeless because of addiction, and no 1 who has had their family torn apart because of addiction, and no 1 who has to see a loved 1 die because their life spiraled out of control," Steenburgen said.

Why it matters: Witnesses said stable, purpose‑built housing is often the condition people need to start and remain in treatment. Providers and clinicians described how lack of housing blocks medication adherence, clinic follow‑up and opportunities for family reunification, and they urged lawmakers to use state budget, settlement and federal levers to scale proven options.

Key testimony and data: MoCRISP said it represents more than 140 member providers, has certified over 3,400 active recovery beds statewide and operates 12 recovery community centers. Steenburgen said core state general‑revenue funding for MoCRISP has been about $4.1 million and that a pending budget allocation would add $6 million from cannabis tax revenue to expand recovery support services. He said five peer respite centers have served roughly 1,400 people in their first year and that respite stays typically average 10–14 days. MoCRISP cited outcome data (state opioid response/GPRA) showing, after 12 months in recovery support services, 84 percent abstinence, 97 percent stable housing, 73 percent employment or school enrollment and 98 percent with no new arrests.

Funding flows and bottlenecks: Multiple witnesses described frictions between federal State Opioid Response (SOAR/SOR) grants and state Recovery Support Services (RSS) funding routed through the Department of Mental Health (DMH). Nathan Nolan of Street Medicine St. Louis and other providers said SOAR funds often flow through treatment agencies before reaching recovery houses, producing delays of months and uneven placement. By contrast, RSS money routed through DMH access sites can be paid within weeks. "It does not seem to be an urgency for treatment providers," said a MoCRISP‑aligned provider describing the attachment of housing vouchers to treatment workflows.

Rural gaps and transportation: Speakers repeatedly flagged rural shortages. MoCRISP and on‑the‑ground providers said many rural counties have no recovery providers and that transportation to distant treatment sites is a major barrier; a task force member noted that North of I‑70 the provider map becomes sparse. Witnesses urged targeted investments to expand providers in underserved counties and to fund transportation options for people living far from treatment or housing.

Street outreach, medical respite and housing‑first approaches: Street Medicine St. Louis described outreach to unhoused people and urged housing‑first and medical‑respite models for people with acute health needs. Physician Nathan Nolan recounted a patient who would not tolerate a medication trial while living in a tent and who later succeeded after entering recovery housing: "Once I get indoors, I can focus on that," Nolan said, summarizing what many clients tell outreach teams. Witnesses described medical respite beds (short clinical stays to complete antibiotics or stabilize patients after hospitalization) as a way to shorten hospital stays and improve outcomes.

Fair‑chance housing and documentation barriers: The Black Harm Reduction Coalition and family‑health navigators raised tenant screening and documentation as barriers. Sandra Mann urged statewide fair‑chance housing guidance so landlords and housing authorities consider individual circumstances rather than automatic exclusions for prior drug convictions or eviction records. Family Care Health Center staff reported very long Section 8 waiting lists (the center cited 14,000 names in one locality) and noted common problems: missing IDs, disrupted phone contact and lost paperwork that prevent people from following up when housing openings occur.

Reentry and veterans: Criminal Justice Ministries described a transitional model that partners short‑term, fully furnished transitional units with longer‑term lease transitions, public and private supports and peer navigation. A former resident and current case manager told the task force that receiving immediate, furnished housing after release made long‑term recovery and education possible for him; he encouraged replication of reentry‑to‑housing pipelines.

What witnesses recommended: Expand state RSS funding for recovery housing and respite centers; streamline federal SOAR funds or create mechanisms so housing payments reach providers faster; pilot Medicaid (Section 1115) or other CMS demonstrations for housing‑related supports; fund medical respite beds; increase funding for peer workforce and community health workers; implement fair‑chance housing guidance and improve coordinated care navigation and outreach (EPIC and similar models were cited). Several witnesses also urged the task force to press DMH and other agencies to clarify who holds responsibility for the documented funding flows.

Next steps and task force directions: Chair Black asked providers to supply lists of local providers and suggested department witnesses (DMH, Medicaid/DSS, OSCA) appear in later hearings to explain funding mechanics, housing regulations and drug‑court interactions. MoCRISP agreed to provide provider lists and other materials to the task force staff.

Ending: Providers and clinicians told the task force they do not lack ideas but need predictable funding, faster transfer of federal housing dollars to on‑the‑ground programs, and coordinated state policies—especially to reach rural areas and people who are unhoused. "Recovery is not just abstinence. It's about creating foundation where people can rebuild their life safely and with dignity," Sandra Mann said, summarizing the coalition's message.