Recovery House urges flexibility, funding for longer residential stays in S.36 recovery bill testimony

A Recovery House representative told the Senate Health and Welfare Committee the state's recovery and residential treatment system should preserve individualized care and stepped levels of treatment rather than adopt fixed, statutory lengths of stay.

The witness described Recovery House's multi‑site model and said the organization offers services at multiple ASAM (American Society of Addiction Medicine) levels: ASAM 3.7 medically monitored high‑intensity inpatient care at Serenity House, ASAM 3.1 clinically‑managed low‑intensity residential programs at Grace House and a newly opened 16‑bed McGee House, and recovery‑residence supports. Typical low‑intensity residential stays at Grace and McGee run about 90 days, the witness said; high‑intensity inpatient episodes are individualized.

The testimony pushed back on testimony the committee had heard earlier that residential treatment in Vermont is uniformly limited to 14 days. Recovery House said discharging a patient at an arbitrary 14‑day mark solely for funding reasons is inappropriate and that the state should not write fixed lengths of stay into statute. The witness said Medicaid uses episodic payments for residential treatment and that at 14 days Medicaid typically covers about 65% of program costs for high‑intensity stays in Recovery House's experience; longer stays increase costs while reducing revenue under current Medicaid payment rules.

Recovery House proposed three specific changes to S.36: - Remove language prescribing fixed lengths of stay in statute; allow clinicians to determine clinical need and episode length. - Replace any language that equates a single episode duration with "success," recognizing recovery as ongoing and multifactorial. - Develop a funding mechanism for people who clinically require longer stays in high‑intensity residential treatment; the witness noted that Medicaid reimbursement at 14 days covered roughly 65% of costs in their experience and that stays longer than that incur higher costs with diminished revenues.

The witness also described two illustrative client cases showing transitions between levels of care (from inpatient to lower‑intensity residential to recovery housing) and said the organization uses public inebriate beds and coordinated transitions to step‑down services. The witness cited a recidivism figure reported to the committee—12% for those attending residential treatment—and said the larger policy question is how to improve engagement in the whole continuum of care, including housing, transportation and recovery residences, so people can stay in remission.

No formal legislative action was taken during the testimony.