Old Halfway House Options Include Sober House or Treatment Facility
By Joe Morey
After the LCO Behavioral Health Services Department relocated from the old Halfway House on Haskins Road to the old Woodcrafters Building, an idea of an “Oxford House” type of facility was implemented at the vacant location.
An Oxford House is a “Sober” house where the individuals living within the home manage themselves and their recovery. The idea of an Oxford House began in 1975 when a Maryland halfway house was being shut down over budget issues and the 13 men living there decided to rent the facility and run it themselves.
Oxford Houses are democratically self-run by the residents who elect officers to serve for terms of six months, which is similar to a college fraternity or a sorority. Officers have fixed terms of office to avoid bossism or corruption of egalitarian democracy.
“The old halfway house was originally proposed as a ‘Oxford House’ type model that would be self-run by those accepted and advised by a board of people in long term recovery,” said Dottie Crust, LCO Comprehensive Community Services (CCS) Facilitator. “The nature of that type of facility is to get the opportunity to be in a setting conducive to recovery while learning skills to be back out in the workforce, parenting, responsibility and ownership of the long-term health of the facility.”
Crust added, “Oxford houses have a ton of information on how they got started and the need for sober housing that did not have the high costs of professional care attached as that could be obtained in the community.”
In the case of LCO’s Oxford House, program rules outline what allows you to be in the program and included involvement in an active recovery program with a counselor and CCS facilitator, Crust added.
“If you aren’t working right away the theory was to be working your hours owed for staying in a volunteer position that would help with getting back into a routine, giving back to the community, and would be approved by the board,” said Crust.
There was a guidebook that was given to the Tribal Governing Board (TGB) along with the proposal in November and the target date to open was November 26, 2018, according to Crust.
“The package was sent to Legal for approval and I never received any feedback or advice on the model,” Crust said. “Meanwhile, during that period of November through January, Dr Bae of the clinic was involved and stated that most of the costs for the facility could be sent back to Indian Health Services for reimbursement.”
Crust said the proposal changed from minimal (Oxford House) with internet for job search etc, heat, electric, pest control, locks on doors for about $25,000 per year with the eventual re-coup of that money as the house began to become self-sustaining, ability to begin within a month, to having cable tv, board positions paid for per meeting, a paid residential manager, and services provided at the facility.
“With this change would come the necessity of licensing the house for a community-based residential facility to be able to collect monies for the services provided,” Crust said.
In the previous model, Crust noted the thought was that residents would have volunteers come in to host recovery meetings seven days a week and random urine analysis tests would be conducted from their counselors who they would see at the Bizihiki building.
There is concern among tribal government officials whether the old Halfway House is actually being used in the Oxford House philosophy, which is a three-fold principal of (1) self-help is the bedrock of recovery, (2) disciplined democracy is key to living together, and (3) self-support builds efficacy in sobriety comfortable enough to avoid relapse.
“It’s been placed on hold by Don Smith due to the government shutdown and funding issues,” said Rose Gokee, LCO TGB member.
Gokee said the house never actually transitioned.
“A draft of policies was sent to Legal but needed extensive work,” Gokee said. “We need two people to stay there and work and fix it up.”
Crust mentioned, “The theory of the Oxford house is that if repairs were needed the residents themselves would be responsible for soliciting funds or finding funding for those repairs.”
Gokee said the Drug Task Force also provided some input and would like to see it as a treatment facility. She said Dottie Crust, who is Chairwoman of the task force, has taken the lead on the direction of the old halfway house, which will eventually need approval from the TGB.
“The new health center director, Sarah Cormell, is aware that TGB will be looking to her for insight on utilization of the new facility,” Gokee said.
“Policy development has been a deterrent and a challenge,” Gokee said. “Contact has been made with Lac Du Flambeau regarding their Hope House they currently operate. We’ll be taking a future tour of their facility with the hope to obtain a copy of their policies to use as a model.”
Crust noted, “At this point if we are going to put the work into converting back into a treatment model and to be able to recoup at least medical costs of counseling, supervision, etc., we will need to get the HFS 75 licensure for residential as well. This would be an estimated six months to a year to revamp the building, apply for grants, advertise and hire professional staff, apply for licensing and get the State to come out from CBRF and HFS 75 to tour and approve.”
Even with that portion covered, the average cost aside from what can be billed medically from insurance or medical assistance averages $3,000 per month per resident, Crust added. “Which would need to be paid through our Indian Health Services funding. Don Smith and Sara Klecan were in on a meeting and at the time Don was not aware of any funding that would cover this and would come from the general funding for treatment care. We are paying this $3000 a month for persons being sent to residential care now, and that would be able to be converted to our facility if that would be approved by the Health Center.”
Crust said interim director at the clinic, Don Smith, didn’t want the clinic to have the responsibility because they already have a stretched budget, and she understood that.
“The ideal answer would be for the Tribal Council to dedicate that first $25,000 for the first year and keep the building on the Tribe’s insurance which is probably in place as it has sat empty since 2015,” Crust said. “My advice to the council would be to invest the $25,000 now and let the Oxford type model run for the six months to a year it would take for the residential model to get put into place. The more people and services we get planted in the communities the better chance of long-term recovery for our Tribal members. We already have several strong individuals willing to be on the board as a volunteer for the Oxford house model that have 6 to 30 + years in recovery.”
Crust said the policy manual and other paperwork are still available from the old halfway house and that could be used as a model.
Chairman Taylor asked Crust to put together the costs involved and a proposal to present the facility as a treatment center.
“I am going to discuss with the grant manager at SAMSHA if I can do this under the Tribal Opioid Response Grant, as it is a need,” Crust said.
Crust added, “I am almost sure that we could fill the house with ten to twenty females willing and eligible for the Oxford type program within the week. The need is great!”
Crust said the tribe also has a need for a men’s facility and noted that Rose Gokee had talked about the old cranberry marsh house.