HomeMy WebLinkAbout08 - PH-4 - Conditional Use Permits PA-16-41 - 10/3/2017CITY COUNCIL AGENDA REPORT
MEETING DATE: OCTOBER 3, 2017
ITEM NUMBER: PH -4
SUBJECT: CONDITIONAL USE PERMITS PA -16-41 AND PA -16-44 TO OPERATE A SOBER
LIVING FACILITY SERVING 28 WOMEN, INCLUDING AN APPEAL OF DENIAL OF
REASONABLE ACCOMMODATION FOR A LAND USE REQUIREMENT, AT 269 AND
271 16TH PLACE
DATE: SEPTEMBER 28, 2017
FROM: DEVELOPMENT SERVICES DEPARTMENT
PRESENTATION BY: SHERI VANDER DUSSEN, CONSULTANT
FOR FURTHER INFORMATION CONTACT: SHERI VANDER DUSSEN (714) 754-5617
Sheri.vanderdussen@costamesaca.gov
RECOMMENDATION
1. Hold a single public hearing for these two applications since the sites are contiguous
and operated as a single facility.
2. Adopt a resolution upholding the Director's denial of the request for reasonable
accommodation and denying Conditional Use Permit PA -16-41 (Attachment 6).
3. Adopt a resolution approving Conditional Use Permit PA -16-44 (Attachment 7).
4. Or, alternatively, make a finding that approval of both of these applications will not
result in an over -concentration of similar uses, and approve Conditional Use Permits
PA -16-41 and PA -16-44.
AUTHORIZED AGENT / APPELLANT
The applicant, Casa Capri Recovery, is represented by Melissa Goodmon. The property
is owned by C & C Investments.
BACKGROUND
These conditional use permits (CUPs) would allow the continued operation of a single
sober living facility housing up to 28 women in eight units on two adjacent properties. The
subject properties are contiguous and operated as a single facility. The Costa Mesa
Municipal Code (CMMC) requires that a group home, residential care facility or state
licensed drug and alcohol facility be at least 650 feet from another property that contains
a similar facility. The applicant submitted a reasonable accommodation request for relief
from the separation requirement. The request for Reasonable Accommodation was
denied by the Director. The applicant appealed that denial to the Planning Commission.
At its meeting of November 14, 2016, the Commission voted 4-0, with one commissioner
absent, to adopt Resolution PC -16-60 to deny the appeal of the reasonable
accommodation decision and to deny PA -16-41 (Attachment 2). A motion to approve the
other CUP (PA -16-44) failed by a vote of 2-2. As a result, PA -16-44 was not approved.
The Commission's actions are summarized in the attached excerpt of the minutes of the
Planning Commission meeting (Attachment 3). The applicant subsequently appealed the
Commission's decision (Attachment 4).
The applications are fully described and analyzed in Attachment 5, the staff report
prepared for the Planning Commission meeting of November 14, 2016. The Planning
Commission staff report may also be found on the City's website via this link:
http://www.costamesaca.gov/ftp/planningcommission/agenda/2016/2016-11-14/PH-
10.pdf
ANALYSIS
The subject properties are located on the south side of 16th Place between Westminster
Avenue and Santa Ana Avenue in the R3 (Multiple -Family Residential) zone. The
General Plan designation for the properties is High Density Residential. The adjacent
and nearby properties enjoy the same zoning and land use designations.
Per the CMMC, a "property" is defined as any single development lot that has been
subdivided bearing its own assessor's parcel number or with an approved subdivision
map or condominium map. This section of the Zoning Code makes it clear that a sober
living home may only occupy a single parcel. The CMMC also requires a separation of
650 feet between sober living and licensed treatment facilities. The subject facility
encompasses two properties. Therefore, the applicant was required to file a separate
CUP for each parcel. The applicant requested a reasonable accommodation to allow the
facilities to be located next door to each other as all of the units are operated as a
single facility.
However, since the Planning Commission denied the CUPs in November 2016, Section
13-323 of the CMMC was amended to provide the Planning Commission and the City
Council the authority to waive the separation requirement if it determines that "such
location will not result in an overconcentration of similar uses." Such waiver does not
require that the City grant a reasonable accommodation. When the City adopted its
separation standard, the intent was to limit sober living homes and licensed alcohol and
drug treatment facilities in residential neighborhoods to approximately one per block.
Other than the subject properties' proximity to one another, there are no other sober
living homes or state licensed facilities within 650 feet.
As depicted on the separation maps (Attachment 1), the nearest facilities in the vicinity
are located as follows:
• One sober living facility serving six or fewer residents with an approved Special
Use Permit is located approximately 800 feet away to the southwest, on the
same side of 16th Place but in the next block;
• One pending application for a CUP to serve ten residents is located
approximately 675 feet away on Knox Place, three blocks away to the southeast.
However, the operator of this facility has placed the CUP process on hold in favor
of obtaining a state license to serve six or fewer residents.
There are also two state licensed facilities on Knox Place, north of Westminster
Avenue, each of which serves eight residents, three blocks away to the southeast.
These facilities are approximately 725 feet away but do not appear on the map. Code
Enforcement is working with the operators of these facilities to ensure they obtain a CUP
to serve more than six residents, or reduce the capacity of the facilities to six or fewer.
Facility Description
The existing sober living facility began operation at this location in July 2011, prior to the
enactment of Ordinance 15-11. The facility consists of two parcels, each developed with a
single building containing four units. Each unit contains two bedrooms and one
bathroom. One bedroom in each building is used for an office. There are 14 beds on
each property. The applicant employs staff members who are on-site 24/7 in lieu of
having a resident manager. According to the applicant's reasonable accommodation
request, Casa Capri has had "a successful record of client treatment with less than a 10%
reoccurrence rate."
These parcels were developed at the same time as a mirror image and share a common
courtyard in the center of the buildings. All units are currently operated as a single facility.
Each parcel contains two garage parking spaces and two open parking spaces, for a total
of eight spaces. Casa Capri clients are not permitted to keep cars at the facility. Casa
Capri does provide shuttle service in cars and mini -vans. These vehicles are not kept
on the subject property. Residents also rely on bicycles and/or public transportation.
Since Casa Capri Recovery has operated this facility, Code Enforcement staff has not
opened any complaint investigations. The property is well maintained.
Reasonable Accommodation
Ordinance 15-11 established requirements for sober living homes, group homes and
licensed drug and alcohol treatment facilities in multi -family zoning districts. When the
City Council adopted this ordinance, it specifically included a provision limiting the
operation of a sober living facility to a single parcel. The City Council also imposed a
separation standard of 650 feet between group homes, sober living homes, and
licensed drug and alcohol treatment facilities. The intent of these limitations is to
ensure that sober living facilities do not occupy a disproportionate number of homes in
any neighborhood, and to avoid overconcentration of sober living units in any area.
The City also sought to ensure that disabled persons recovering from addiction can
reside in a comfortable residential environment versus in an institutional setting. The
City determined that congregating sober living homes in close proximity to each other
does not provide the disabled with an opportunity to "live in normal residential
surroundings," but rather places them into living environments bearing more in common
with the types of institutional/campus/dormitory living that the state and federal laws
were designed to provide relief from for disabled persons.
The Director determined that the use of eight units on two parcels to accommodate 28
residents will create a large facility not in keeping with the City's desire to ensure that
sober living homes do not occupy a disproportionate number of homes in any
neighborhood. Therefore, the Director denied the request for reasonable
accommodation, and the appeal of that decision was later denied by the Planning
Commission. Since the Director's decision in May 2016, the City Council adopted
Ordinance 17-05, which revised the findings necessary to approve a reasonable
accommodation, as well as the procedures for its review. Staff believes the request
may be denied based on the new findings as well. The new findings are reflected in the
attached draft resolution.
If a reasonable accommodation is not granted, the City Council may not approve both
CUPs, unless it makes a finding under Section 13-323 of the CMMC that the location
will not result in an overconcentration of similar uses. If one CUP is denied, however,
the other CUP may be approved without either a reasonable accommodation or a
finding of no overconcentration. The required findings to approve one CUP may be
made, as the facility would not be within 650 feet of a facility providing similar services,
and the applicant has satisfied all other requirements of the CMMC.
In the alternative, should the City Council elect to approve the reasonable
accommodation request, one CUP may be issued for both properties. From a land use
perspective, administering one CUP for both properties makes more sense than
administering two separate CUPs.
Overconcentration Pursuant to CMMC 13-323(b)
Section 13-323(b) was amended by Ordinance 17-05 in May of 2017. As amended, it
provides:
The group home, residential care facility or state -licensed drug and
alcohol treatment facility is at least six -hundred fifty (650) feet from any
property, as defined in Section 13-321, that contains a group home, sober
living home or state -licensed drug and alcohol treatment facility, as
measured from the property line, unless the reviewing authority
determines that such location will not result in an over -concentration of
similar uses. (Emphasis added.)
The effect of this amendment is to allow the Planning Commission and the City Council
to approve deviations to the separation requirement where the evidence shows that
such location will not result in an overconcentration, yet all the findings necessary for a
reasonable accommodation are not met or otherwise cannot be granted. Should the
City Council be unable to make all findings necessary to grant a reasonable
accommodation, i.e., if the finding that accommodation is "necessary" within the
meaning of the federal and state fair housing laws cannot be made, the City Council
retains the ability to waive the separation requirement if supported by the evidence and
issue both CUPs.
LEGAL REVIEW
The draft resolution has been approved as to form by the City Attorney's Office.
ALTERNATIVES
The City Council may take any of the following actions on this appeal:
• Deny the appeal regarding the request for reasonable accommodation; deny one
CUP; and approve one CUP.
• Deny the appeal regarding the request for reasonable accommodation and deny
both CUPs.
• Grant the appeal regarding the request for reasonable accommodation and
approve one CUP for both properties.
• Make a finding that the location of the two properties will not result in an
overconcentration of similar uses pursuant to CMMC 13-323, and approve both
CUPs to allow them to operate as a single facility.
• Remand the matter back to the Planning Commission to consider the issue of
overconcentration pursuant to CMMC 13-323.
Staff is suggesting that PA -16-41 be denied and PA -16-44 be approved, but the City
Council could deny PA -16-44 and approve PA -16-41 instead. Alternatively, if the City
Council finds that continued operation of these units as a single sober living facility will not
result in overconcentration, both CUPs can be approved. Some of these alternatives may
require the hearing to be continued to allow one or more revised resolutions to be
prepared.
CONCLUSION
While the Planning Commission did not approve either CUP, the Commission only
made findings to deny the first CUP. The second CUP was not denied by resolution,
but rather by the fact that the motion to approve that application failed by a vote of 2-2.
The Planning Commission thus never articulated any findings to deny the second CUP.
Staff continues to recommend approval of at least one of the CUPs. The attached
resolution approving CUP PA -16-44 (Attachment 7) includes conditions of approval
reflecting the changes to the group home regulations adopted by the City Council last
May. These conditions address compliance with the California Vehicle Code;
requirements to seek assistance and provide transportation for residents who may be
involuntarily discharged; and the need to keep records regarding compliance with the
discharge provisions.
The sober living home occupies two parcels and thus does not comply with the
separation provisions specified in the CMMC. Denial of one CUP eliminates the conflict
with the CMMC, leaving the second CUP in compliance with the applicable provisions of
the CMMC. Staff recommends that the City Council uphold the denial of the request for
reasonable accommodation, deny one CUP, and approve one CUP. In the alternative,
without reversing the decision of the Planning Commission on the reasonable
accommodation, the City Council may nonetheless make a finding that no
overconcentration will result from the continued operation of the sober living facility on
both parcels, and approve both CUPs.
SHERI VANDER DUSSEN, AICP BARRY CURTIS, AICP
Consultant Economic and Development Services Director
ATTACHMENTS
Applicant:
Melissa Goodmon
Casa Capri Recovery
2801 Bristol Street, Suite 110
Costa Mesa, CA 92626
Property Owner:
C&C Investments
186 Rochester St.
Costa Mesa, CA 92627
1. Separation Maps
2. Resolution PC -16-60 upholding the Director's Denial of a
Reasonable Accommodation and Denying CUP PA -
16 -41
3. Excerpt of the Minutes of the Planning Commission Meeting
of November 14, 2016
4. Appeal filed by Applicant
5. Staff Report prepared for the Planning Commission meeting
of November 14, 2016
6. Resolution Upholding the Decision of the Planning
Commission to Deny the Reasonable Accommodation and CUP
PA -16-41
7. Resolution Approving CUP PA -16-44
Costa Mesa
J l II
N 4PPending Applications
269 16TH PL & 271 16TH PL • City Permitted Sober Living Homes
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ATTACHMENT 2
RESOLUTION NO. PC-16-a,&v
A RESOLUTION OF THE PLANNING COMMISSION OF THE CITY OF
COSTA MESA UPHOLDING THE DIRECTOR'S DENIAL OF CASA CAPRI
RECOVERY'S REASONABLE ACCOMMODATION REQUEST TO ALLOW
THE OPERATION OF A GROUP HOME, RESIDENTIAL CARE FACILITY
OR STATE LICENSED DRUG AND ALCOHOL TREATMENT FACILITY ON
TWO CONTIGUOUS PROPERTIES AT 269 AND 271 161h PLACE; AND
DENYING CONDITIONAL USE PERMIT PA -16-41 TO ALLOW A SOBER
LIVING FACILITY SERVING UP TO 14 WOMEN AT 269 16TH PLACE.
WHEREAS, Case Capri Recovery (the "Applicant") operates a sober living facility
at 269 16th Place, Costa Mesa; and
WHEREAS, an application was filed by the Applicant requesting approval of
Planning Application PA -16-41, a Conditional Use Permit to allow the subject facility to
serve up to 14 women within four existing units; and a request for a reasonable
accommodation to allow this facility to be located within 650 feet of another property that
contains a group home, sober living home or state licensed druag and alcohol treatment
faciltity, allowing the units on these contiguous parcels to operate as a single facility; and
WHEREAS, the City of Costa Mesa recognizes that while not in character with
residential neighborhoods, when operated responsibly, group homes, including sober
living homes, provide a societal benefit by providing disabled persons as defined by state
and federal law the opportunity to live in residential neighborhoods, as well as providing
recovery programs for individuals attempting to overcome their drug and alcohol
addictions, and that therefore providing greater access to residential zones to group
homes, including sober living homes, than to boardinghouses or any other type of group
living provides a benefit to the City and its residents; and
WHEREAS, the City of Costa Mesa has adopted standards for the operation of
group homes, residential care facilities and state licensed drug and alcohol facilities that
are intended to provide opportunities for disabled persons as defined by state and federal
law to enjoy comfortable accommodations in a residential setting; and
WHEREAS, the City of Costa Mesa has found that congregating sober living
homes in close proximity to each other does not provide disabled persons as defined in
state and federal law with an opportunity to "live in normal residential surroundings," but
rather places them into living environments bearing more in common with the types of
institutional/campus/dormitory living that the FEHA and FHAA were designed to provide
relief from for the disabled, and which no reasonable person could contend provides a life
in a normal residential surrounding; and
WHEREAS, the City of Costa Mesa has determined that a separation requirement
for such facilities will still allow for a reasonable market for the purchase and operation of
sober living homes within the City and still result in preferential treatment for sober living
homes in that non -disabled individuals in a similar living situation (i.e., in boardinghouse -
style residences) have fewer housing opportunities than disabled persons; and
WHEREAS, Casa Capri Recovery filed an application with the City's Director of
Economic and Development Services/Deputy CEO (the "Director") requesting an
accommodation from the Costa Mesa Municipal Code's requirement that a group home,
residential care facility or state licensed drug and alcohol facility is at least 650 feet from
another property that contains a group home, sober living home or state licensed drug
and alcohol treatment facility, as measured from the property line (the "Application"); and
WHEREAS, the applications were processed in the time and manner prescribed
by federal, state and local laws, and the Director denied the request for the reasonable
accommodation; and
WHEREAS, Casa Capri Recovery appealed the denial of the reasonable
accommodation request in a timely manner; and
WHEREAS, a duly noticed public hearing was scheduled for November 14, 2016,
before the Planning Commission to hear the appeal and the conditional use perimit; and
WHEREAS, on November 14, 2016, the Planning Commission conducted a duly
noticed public hearing, at which time interested persons had an opportunity to testify
either in support of or in opposition to the applications and determined by a X -X vote to
deny the Application.
NOW THEREFORE, the Planning Commission of the City of Costa Mesa finds
and resolves as follows:
BE IT RESOLVED, therefore, that based on the evidence in the record and the
findings contained in this resolution, the Planning Commission hereby UPHOLDS THE
DIRECTOR'S DENIAL of Casa Capri, LLC's reasonable accommodation request to allow
the operation of a group home, residential care facility or state licensed drug and alcohol
treatment facility on contiguous properties; and DENIES Conditional Use Permit PA -16-
41.
The Secretary of the Commission shall attest to the adoption of this resolution
and shall forward a copy to the applicant, and any person requesting the same.
PASSED AND ADOPTED this 14th d
Robert L. Dickson Jr., Chair
Costa Mesa Planning Commission
STATE OF CALIFORNIA )
)ss
COUNTY OF ORANGE )
I, Jay Trevino, Secretary to the Planning Commission of the City of Costa Mesa,
do hereby certify that the foregoing Resolution was passed and adopted at a meeting of
the City of Costa Mesa Planning Commission held on November 14, 2016 by the following
votes:
AYES: Dickson, Mathews, Sesler, Andranian
NOES: None
ABSENT: McCarthy
ABSTAIN: None
ii
Jay t4vino, Acting Secretary
Costa Mesa Planning Commission
EXHIBIT A
FINDINGS FOR DENIAL
The City's evidence
The City's evidence consists of a staff report with attachments. The staff report
provided the factual background, legal analysis and the City's analysis supporting the
denial of Casa Capri, LLC's reasonable accommodation request, based on the Applicant
not meeting its burden to demonstrate compliance with all required findings per the Costa
Mesa Municipal Code.
A. The Applicant has not met its burden to show that the Application meets the
following findings for approval of Reasonable Accommodation:
•
Applicant has not met its burden to show that the requested accommodation is
necessary to afford individuals recovering from druq and alcohol addiction the
opportunity to the use and enjoyment of a dwelling in the City.
The application established that the requested accommodation (waiver of the
650 -foot separation requirement) may allow a CUP to be granted to enable
Casa Capri, LLC, to continue to operate in compliance with the Costa Mesa
Municipal Code at its current location. In theory, this action would allow one or
more individuals who are recovering from drug and alcohol abuse to enjoy the
use of this dwelling. However, approval of the request is not necessary to allow
one or more individuals who are recovering from drug and alcohol abuse to
enjoy the use of a dwelling within the City.
• Applicant has not met its burden to show whether the existing supply of facilities
of a similar nature and operation in the community is insufficient to provide
individuals with a disability an equal opportunity to live in a residential setting.
Based on the most recent data compiled by City staff, there are approximately
98 sober living homes within Costa Mesa. Of these, 37 are located in single-
family neighborhoods and 61 are within multi -family residential zones.
Additionally, there are approximately 81 state licensed drug and alcohol
residential care facilities in Costa Mesa. Twenty-five are in single-family
residential zones, 55 are in multi -family residential zones and one is in a C1
zone. No evidence has been submitted to indicate that the number of sober
living homes and drug and alcohol residential care facilities existing or
potentially allowed in compliance with the City's standards is inadequate.
• Applicant has not met its burden to show whether the requested
accommodation is consistent with whether or not the residents would constitute
a single housekeeping unit.
According to the City's definition of a sober living home, a sober living home's
residents do not constitute a single housing keeping unit. The requested
accommodation is for a provision of the Costa Mesa Municipal Code that would
not apply to single housekeeping units. Therefore, this finding is not relevant.
• Applicant did not demonstrate that the requested accommodation is necessary
to make facilities of a similar nature or operation economically viable in light of
the particularities of the relevant market and market participants.
The applicant did not provide evidence in its application regarding this factor;
therefore, City staff was not able to make this finding. As noted above, there
is a significant number of sober living facilities in Costa Mesa.
• Applicant was not able to demonstrate that the requested accommodation will
not result in a fundamental alteration in the nature of the City's zoning program.
The City's separation standard of 650 feet was intended to ensure that there
would be no more than one group home, residential care facility or state licensed
drug and alcohol facility on any block. In addition, the Municipal Code limits the
operation of any sober living facility to a single parcel, again to prevent
overconcentration of sober living units. Therefore, approval of the
accommodation request will result in a fundamental alteration of the City's zoning
program, as set forth in Ordinance numbers 14-13 and 15-11, because it would
contribute to the overconcentration of these types of facilities in this residential
neighborhood.
The burden to demonstrate necessity remains with the Applicant. Oconomowoc,
300 F.3d at 784, 787. Applicant must show that "without the required
accommodation the disabled will be denied the equal opportunity to live in a
residential neighborhood." Oconomowoc, 300 F.3d at 784; see also, United
States v. California Mobile Home M_, mq t Co., 107 F3d 1374, 1380 (9th Cir. 1997)
("without a causal link between defendants' policy and the plaintiff's injury, there
can be no obligation on the part of the defendants to make a reasonable
accommodation"); Smith & Lee, Inc. v. City of Taylor, Mich., 102 F.3d 781, 795
(6th Cir. 1996) ("plaintiffs must show that, but for the accommodation, they likely
will be denied an equal opportunity to enjoy the housing of their choice").
The Applicant has asserted that the requested accommodation from the 650 -foot
distance requirement is reasonable. However, a zoning accommodation may be
deemed unreasonable if "it is so at odds with the purposes behind the rule that it
would be a fundamental and unreasonable change." Oconomowoc, 300 F.3d at
784. The Applicant made no mention of the purpose underlying the City's zoning
limitation, or explained how the accommodation requested would not undermine
that purpose. In fact, the Director found that such allowance would fundamentally
alter the character of this neighborhood and is thus unreasonable.
Allowing multiple group homes, sober living homes and/or state licensed drug
and alcohol treatment facilities to cluster in a residential neighborhood does effect
a fundamental change to the residential character of the neighborhood. The
clustering of group homes in close proximity to each other does change the
residential character of the neighborhood to one that is far more institutional in
nature. This is particularly the case with respect to sober living homes. Both
California and federal courts have recognized that the maintenance of the
residential character of neighborhoods is a legitimate governmental interest. The
United States Supreme Court long ago acknowledged the legitimacy of "what is
really the crux of the more recent zoning legislation, namely, the creation and
maintenance of residential districts, from which business and trade of every sort,
including hotels and apartment houses, are excluded." Euclid v. Amber Realty
Co., 272 U.S. 365, 390 (1926).
The California Supreme Court also recognizes the legitimacy of this interest:
It is axiomatic that the welfare, and indeed the very existence of a
nation depends upon the character and caliber of its citizenry. The
character and quality of manhood and womanhood are in a large
measure the result of home environment. The home and its intrinsic
influences are the very foundation of good citizenship, and any
factor contributing to the establishment of homes and the fostering
of home life doubtless tends to the enhancement not only of
community life but of the life of the nation as a whole.
Miller v. Board of Public Works, 195 Cal. 477, 490, 492-93 (1925).
With home ownership comes stability, increased interest in the
promotion of public agencies, such as schools and churches, and
'recognition of the individual's responsibility for his share in the
safeguarding of the welfare of the community and increased pride
in personal achievement which must come from personal
participation in projects looking toward community betterment.'
Ewing v. City of Carmel -by -the -Sea, 234 Cal. App. 3d 1579, 1590 (1991),
citing Miller, 195 Cal. at 493. It is with these purposes in mind that the City of
Costa Mesa has created residential zones, including R2 zones for multi -family
residences.
The requested accommodation, in these specific circumstances, would
result in a fundamental alteration of the City's zoning program, as set forth
in Ordinance numbers 14-13 and 15-11, because it would increase and/or
contribute to the overconcentration of these types of facilities in this
residential neighborhood.
B. The Application does not meet the findings required by the Costa Mesa Municipal
Code for approval of a Conditional Use Permit:
• The proposed use is substantially compatible with developments in the same
general area and would not be materially detrimental to other properties within
the area.
The introduction of one sober living home in compliance with the City's standards
would not be materially detrimental to the area. However, over the last decade,
the number of sober living homes in the City of Costa Mesa has rapidly increased,
leading to an overconcentration of sober living homes in certain of the City's
residential neighborhoods. Overconcentration is both deleterious to the residential
character of these neighborhoods and may also lead to the institutionalization of
such neighborhoods. The City's establishment of distance requirements for sober
living homes is reasonable and non-discriminatory and helps preserve the
residential character of the R2MD, R2HD, and R3 zones, as well as the planned
development residential neighborhoods. It but also furthers the interest of ensuring
that the handicapped are not living in overcrowded environments that are
counterproductive to their well-being and recovery. Allowing a single facility to
operate on two parcels would contribute to an overconcentration of such facilities
in this neighborhood.
• Granting the CUP will not be materially detrimental to the health, safety and
_general welfare of the public or otherwise injurious to property or improvements
within the immediate neighborhood.
As noted above, approval of this application will result in overconcentration of group
homes, residential care facilities and/or state licensed drug and alcohol facilities in
this neighborhood. Short-term tenants, such as might be found in homes that provide
addiction treatment programs of limited duration, generally have little interest in the
welfare of the neighborhoods in which they temporarily reside -- residents "do not
participate in local government, coach little league, or join the hospital guild. They do
not lead a scout troop, volunteer at the library, or keep an eye on an elderly neighbor.
Literally, they are here today and gone tomorrow -- without engaging in the sort of
activities that weld and strengthen a community." Ewin , 234 Cal. App. 3d at 1591.
Strong evidence exists that a supportive living environment in a residential
neighborhood provides more effective recovery than an institutional -style
environment (see Attachments 5 and 6 to the staff report). The City's zoning
regulations address overconcentration and secondary effects of sober living
homes. The goal of the regulations is to provide the disabled with an equal
opportunity to live in the residence of their choice, and to maintain the residential
character of existing neighborhoods.
The City has found through experience that clustering sober living facilities in close
proximity to each other results in neighborhoods dominated by sober living
facilities. In these neighborhoods, street life is often characterized by large
capacity vans picking -up and dropping -off residents and staff, service providers
taking up much of the available on street parking, staff in scrubs carrying medical
kits going from unit to unit, and vans dropping off prepared meals in large numbers.
The City has experienced frequent Fire Department deployments in response to
medical aid calls. In some neighborhoods, Police Department deployments are a
regular occurrence as a result of domestic abuse calls, burglary reports, disturbing
the peace calls and parole checks at sober living facilities. Large and often
frequent AA or NA meeting are held at some sober living homes. Attendees of
these meetings contribute to the lack of available on street parking and neighbors
report finding an unusual amount of litter and debris, including beverage
containers, condoms and drug paraphernalia in the wake of these meetings.
These types of impacts have been identified in other communities as well (see
Attachment 7 to the staff report).
• Granting the conditional use permit will not allow a use which is not in
accordance with the generalplan desi_ nq ation.
The proposed use is consistent with the City's General Plan if it complies with the
City's criteria. However, an overconcentration of group homes, sober living homes
and licensed treatment facilities for alcohol and drug addiction is not consistent
with the General Plan. The City's regulations are intended to preserve the residential
character of the City's neighborhoods. The City Council has determined that an
overconcentration of sober living facilities would be detrimental to the residential
character of the City's neighborhoods.
C. The Costa Mesa Planning Commission has denied Conditional Use Permit PA -16-
15. Pursuant to Public Resources Code Section 21080(b) and CEQA Guidelines
Section 15270(a), CEQA does not apply to this project because it has been rejected
and will not be carried out.
D. The project is exempt from Chapter IX, Article 11, Transportation System
Management, of Title 13 of the Costa Mesa Municipal Code.
ATTACHMENT 3
APPROVED MINUTE EXCERPTS FROM THE
NOVEMBER 14, 2016 PLANNING COMMISSION MEETING
(Public Hearing No. 10 — PA -16-41 and PA -16-44)
10. Application No.: PA -16-41 and PA -16-44
Applicant: Casa Capri, LLC
Site Address: 269 and 271 16t" Place
Zone: R2 -HD
Project Planner: Sheri Vander Dussen
Environmental Determination: The project has been found to be categorically exempt
under Section 15301 of the CEQA Guidelines. Notwithstanding the foregoing, if this action
were found to be a project, it would be exempt from CEQA under Section 15321 for
Enforcement Actions by Regulatory Agencies.
Description: Conditional Use Permits PA -16-41 and PA -16-44 are requests to allow a Sober
Living Facility housing 28 residents in four units on two parcels. The application includes an
appeal of the decision of the Economic and Development Services Director to deny a request
for a reasonable accommodation to allow these facilities to be located within 650 feet of
another property that contains a group home, sober living home or state licensed drug and
alcohol treatment facility.
No ex -parte communications to report.
Sheri Vander Dussen, Interim Assistant Development Services Director/Community
Improvement Division, presented the staff report.
PUBLIC COMMENTS
Steven Polin, attorney for the applicant, talked about an article in the Orange County Register
about sober housing; spoke positively about Casa Capri; and stated concerns with the
negative impacts stated in the staff report.
Melissa Goodman, co-owner of Casa Capri, spoke about her business.
Jeremy Brodrick, co-founder of Casa Capri, spoke about his business and the positive affects
he has had on peoples' lives through his facility.
Darrell Pash, Costa Mesa resident, asked that the Planning Commission uphold the director's
denial of reasonable accommodation to limit the number of occupants.
Kurtis Johnson, Costa Mesa resident, stated concerns with the parking, and supported the
denial being upheld.
Terry Lee, Costa Mesa resident, asked that the rules that have been put into place be
enforced/upheld and stated concern with the density.
Drew Graham, Costa Mesa resident, asked that the Planning Commission uphold the
director's denial and not approve Conditional Use Permit PA -16-44.
Steve Brahs asked that the density for sober living homes be the same standard as an
apartment and the parking be kept on-site.
Drew Graham, Costa Mesa resident, came back up to use the remainder of his time and
asked that the public record show he testified for the following families that charged him to
be here: the Abrogeli family, Vera Family, Kess family, tenants Joy and Adrianna, Christopher
family, Tamalas family, Hopkins family, Thomason family, Doyle family, Burns family, Eidy
family, Kennedy family, Klimer family, Kess family, Swanson family, Beach family, Kleemo
family, Waite family, members from the Newport Heights community whose foundation he
serves and supports.
Mr. Polin responded to public comments.
The Chair closed the public hearing.
MOTION: Move that based in the evidence in the record and findings contained in this
resolution, the Planning Commission upholds the director's denial of Casa Capri
LLC's reasonable accommodation request to allow the operation of a group home
professional care facility or state license drug and alcoholic treatment facility on
contiguous properties and denies Conditional Use Permit PA -16-41.
Moved by Chair Dickson, second by Commissioner Andranian.
RESOLUTION PC -16-60 - A RESOLUTION OF THE PLANNING COMMISSION OF THE
CITY OF COSTA MESA UPHOLDING THE DIRECTOR'S DENIAL OF CASA CAPRI
RECOVERY'S REASONABLE ACCOMMODATION REQUEST TO ALLOW THE
OPERATION OF A GROUP HOME, RESIDENTIAL CARE FACILITY OR STATE
LICENSED DRUG AND ALCOHOL TREATMENT FACILITY ON TWO CONTIGUOUS
PROPERTIES AT 269 AND 271 16' PLACE; AND DENYING CONDITIONAL USE
PERMIT PA -16-41 TO ALLOW A SOBER LIVING FACILITY SERVING UP TO 14 WOMEN
AT 269 16TH PLACE
The motion carried by the following roll call vote:
Ayes: Dickson, Mathews, Sesler, Andranian
Noes: None
Absent: McCarthy
Abstained: None
The Chair explained the appeal process.
MOTION: Move that based in the evidence in the record and the findings contained in
Exhibit A and subject to conditions of approval contained in Exhibit B that the Planning
Commission approve Planning Application PA -16-44 to allow a sober living facility
serving 14 women within four existing units on the property located at 271 16th Place.
Moved by Chair Dickson, second by Vice Chair Mathews.
The motion failed by the following roll call vote:
Ayes: Dickson, Mathews
Noes: Sesler, Andranian
Absent: McCarthy
Abstained: None
The Chair explained the appeal process.
G'ITY CLERK
16 NOV 21 AN 9 59
i)wt 'N' 1e 'a;
City of Costa Mora
ATTACHMENT 4
CITY Of COSTA MESA Appeal of Commission Decision - $9,220,0()
Appeal of Zoning Administrator/Staff' Decision - $89(),00
t.
If EES MUST BE PAID IN FULL AT TIME OF FILING APPE'A11
APPLICATION FOR APPEAL OR REVIEW
Applicant Name" Melinda Goodmoilt
Address: 269 and 271 16th k
Phone: _.._ 949-861-0576
Costa Mesa, CA 92627
eprasenting: Casa Capri, LLC
REQUEST" FOR: Ef APPEAL L.3 REVIEW**
Decision of which appeal or review Is requested; (give application number, if applicable, and the date of the decision, if
4rn.enw �
Denial of Conditional Use Permits PA46-41 and PA 16-44 to provide a sober living
facility serving 28 persons, including appeal of denial of reasonable
accommodations for a land use requirement, at 269 and 27116th Place,
Planning Commission hearing November 14, 2016, Item No. PH -10
Decision by:
Reasons for
Date:
or review:
Denial of the Conditional Use Permit Applications PA -16-41 and 16-44 and refusal
by Planning Commission to consider reasonable accommodations for two
contiguous parcels to be considered a legal, non -conforming use.
a
"If you are serving as the agent for another person, please Identify the person you represent and provide proof of authorization.
**Review may be requested only by Commissions, commission Members, City Councfl, or City Council Members,
For office use only -w do not write below this line REV 0-1.15
SCHEDULED FOR THE CITY COUNCIIJCOMMISSION MEETING OF:
ATTACHMENT 5
PLANNING COMMISSION
AGENDA REPORT
MEETING DATE: NOVEMBER 14, 2016 ITEM NUMBER: D I k o
I TT
SUBJECT: CONDITIONAL USE PERMITS PA 16-41 AND PA 16-44 TO OPERATE A SOBER LIVING
FACILITY SERVING 28 PERSONS, INCLUDING AN APPEAL OF DENIAL OF
REASONABLE ACCOMMODATION FOR A LAND USE REQUIREMENT, AT 269 AND
271 16TH PLACE.
DATE: NOVEMBER 2, 2016
FROM: COMMUNITY IMPROVEMENT DIVISION/DEVELOPMENT SERVICES DEPARTMENT
PRESENTATION BY: SHERI VANDER DUSSEN, INTERIM ASSISTANT DIRECTOR/COMMUNITY
IMPROVEMENT DIVISION
FOR FURTHER INFORMATION CONTACT: SHERI VANDER DUSSEN (714) 754-5617
sheri.vanderdussen@costamesaca.gov
PROJECT DESCRIPTION
Planning Applications PA 16-41 and PA 16-44 are Conditional Use Permits (CUPs) filed
pursuant to City of Costa Mesa Municipal Code, Title 13 Section 13-323, for a sober living
facility housing up to 28 residents in eight units. The subject properties are contiguous and
operated as a single facility, so the applicant also submitted a reasonable accommodation
request for relief from the zoning requirement that a group home, residential care facility or
state licensed drug and alcohol facility is at least 650 feet from another property that contains
a similar facility. The request for Reasonable Accommodation was denied. The applicant
has appealed that denial to the Planning Commission.
Because these sites are contiguous and operated as a single facility, staff has prepared a
single staff report for both applications, and recommends that the Planning Commission
consider both applications in a single public hearing. However, staff recommends that the
Planning Commission adopt separate resolutions for each application.
APPLICANT/PROPERTY OWNER
The applicant, Casa Capri, LLC. is represented by Melissa Goodmon. The property is
owned by Zackary Irani.
ENVIRONMENTAL DETERMINATION
The project is categorically exempt from the provisions of the California Environmental
Quality Act (CEQA) under Section 15301, Existing Facilities.
PROCEDURE
The hearing on the CUP application is governed by the procedures set forth in Section 13-
29(g) of the Costa Mesa Municipal Code. The appeal of the Director's denial of the
reasonable accommodation request is governed by Section 13-200.62(g), which provides
that "the standard of review on appeal shall not be de novo and the Planning Commission
shall determine whether the findings made by the director are supported by substantial
evidence presented during the evidentiary hearing. The planning commission, acting as the
appellate body, may sustain, reverse, or modify the decision of the director or remand the
matter for further consideration, which remand shall include specific issues to be considered
or a direction for a de novo hearing."
The CUP and reasonable accommodation in general have differing review processes and
procedures. However, in this matter, the decision on the CUP is linked to the decision on
the requested reasonable accommodation. Because of this, staff recommends that these
separate items be processed concurrently by the Planning Commission pursuant to Section
13-29(e)(6) and (q), and that the Applicant be afforded the appellate rights of Section 2-
309(4) to both the decision on the CUP and the reasonable accommodation request.
RECOMMENDATION
Uphold the Director's denial of the reasonable accommodation request to allow the subject
facility to be operated on two contiguous parcels, in effect allowing the facilities to be located
within 650 feet of each other; deny CUP PA 16-41; and approve CUP PA 16-44 by adoption
of resolutions.
BACKGROUND/ANALYSIS
The subject properties are located on the south side of 16th Place between Westminster
Avenue and Santa Ana Avenue in the R3 (Multiple Family Residential) zone. The General
Plan designation for the properties is High Density Residential. The adjacent and nearby
properties enjoy the same zoning and land use designations.
Casa Capri Recovery operates a sober living facility serving up to 14 residents on each
of the subject properties, for a total of 28 beds. Under Section 13-6 of the City's Zoning
Code, an alcoholism or drug abuse recovery or treatment facility is a type of residential
care facility as it is a residential facility licensed by the state where care, services, or
treatment are provided to persons living in a community residential setting. Pursuant to
Ordinance 15-11, group homes serving more than six residents are required to obtain a
CUP, even if they are licensed by the state.
Per Costa Mesa Municipal Code, Title 13 Section 13-321, a "property" is defined as any
single development lot that has been subdivided bearing its own assessor's parcel number
or with an approved subdivision map or condominium map. This section of the zoning code
makes it clear that a sober living home may only occupy a single parcel. The subject facility
encompasses two properties. Therefore, the applicant was required to file a separate
Conditional Use Permit for each parcel. The applicant requested a reasonable
accommodation to allow the facilities on each property to be located next door to each
other as all of the units are operated as a single facility.
Conditional Use Permit Requirement for Sober Living Facilities in Multi -Family
Residential Zones
On November 17, 2015, the City Council adopted Ordinance 15-11 revising Title 13 of the
Costa Mesa Municipal Code to add Chapter XVI which established conditions for granting
a CUP to group homes, residential care facilities, and drug and alcohol treatment facilities
serving more than six residents in the City's multiple family residential zones. All group
homes and residential care facilities currently operating in multi -family zones before the
ordinance was adopted must come into compliance with Ordinance 15-11 by December 17,
2016.
Sections 65008(a) and (b) of the California Government Code prohibit discrimination in
local governments' zoning and land use actions based on (among other categories) race,
sex, lawful occupation, familial status, disability, source of income, or occupancy by low
to middle income persons. Section 65008(d)(2) also prevents agencies from imposing
different requirements on single-family or multifamily homes because of the familial
status, disability, or income of the intended residents. Individuals in recovery from drug
and alcohol addiction are defined as disabled under the Fair Housing Act. Therefore, the
City is obligated to treat residents of sober living homes like it treats other residents of the
City. Conditions of approval must reflect this obligation.
CUP Application Deemed Complete
The applicant submitted all of the CUP application requirements for group homes with seven
or more occupants. CUP application requirements include, but are not limited to, the
following items:
• Completed Live Scan forms for all owners/operators who have contact with residents,
corporate officers with operational responsibilities, house managers and counselors;
• The Group Home's Relapse Policy;
• Written policies directing occupants to be considerate of neighbors, including refraining
from engaging in loud, profane or obnoxious behavior that would unduly interfere with a
neighbor's use and enjoyment of their dwelling unit;
• Written policy requiring occupants to actively participate in a legitimate recovery
program;
-- Z Z -
Written policy that prohibits the use of any alcohol or any non-prescription drugs at the
sober living home or by any individual in recovery including the house manager if
applicable on or off site. House Rules must also include a written policy regarding the
possession, use and storage of prescription and over the counter medications, that
includes monitoring and oversight by qualified staff; and
Written policy that precludes any visitors who are under the influence of drugs or alcohol.
Sober Living Homes with Seven or More Occupants Must Obtain an Operator's Permit
pursuant to Title 9, Section 374.
In addition to a CUP, an Operator's Permit application is required for group homes with
seven or more occupants if the facility is not licensed by the State of California. The
applicant submitted a complete application for an Operator's Permit and demonstrated
compliance with all of the City's requirements. The facility meets the operational
requirements for issuance of an Operator's Permit. The requirements include, but are not
limited to, the following:
• The group home is required to have a house manager who resides at the group home
or any multiple persons acting as a house manager who are present at the group home
on a twenty -four-hour basis and who are responsible for the day-to-day operation of the
group home. The facility has identified a resident house manager and has provided
contact information as part of the Operator's Permit application packet.
• Occupants must not require, and operators must not provide, "care and supervision" as
those terms are defined by Health and Safety Code 1503.5 and Section 80001(c)(3) of
title 22, California Code of Regulations. The applicant's description of the facility does
not include the provision of "care and supervision" as defined by the State.
The applicant has indicated that this sober living home shall not provide any of the
following services as they are defined by Section 10501(a)(6) of Title 9, California Code
of Regulations: detoxification, educational counseling, individual or group counseling
sessions; and treatment or recovery planning. Summit Coastal Living will make outside
referrals to qualified facilities upon request.
Upon eviction from or involuntary termination of residency in a group home, the operator
of the group home shall make available to the occupant transportation to the address
listed on the occupant's driver license, state issued identification card, or the permanent
address identified in the occupant's application or referral to the group home. The group
home may not satisfy this obligation by providing remuneration to the occupant for the
cost of transportation. The operator requires that all occupants provide a permanent
address as part of the intake paperwork as well as a security deposit to be held by the
operator or the signature of a guarantor that has agreed to cover the transportation costs
to a detox facility or permanent residence in the event of a relapse.
If a CUP is approved by the Planning Commission, staff will issue the Operator's Permit.
Failure to comply with the terms of the Permit could be grounds to revoke the CUP.
Facility Description
The existing sober living facility began operation at this location in July 2011, prior to the
enactment of Ordinance 15-11. The facility consists of two parcels, each developed with a
single building containing four units. These parcels were developed at the same time as a
mirror image and share a common courtyard in the center of the buildings. All units are
currently operated as a single facility.
A sober living home is a sub -type of group home. Article 2 of Section 13-6 (Definitions)
defines a group home as follows:
"A facility that is being used as a supportive living environment for persons who
are considered handicapped under state or federal law. A group home operated
by a single operator or service provider (whether licensed or unlicensed)
constitutes a single facility whether the facility occupies one or ,more dwelling
units. "
The facility includes eight units in two, two-story buildings on two properties. There are four
units with fourteen beds on each property. Each unit contains two bedrooms and one
bathroom. One bedroom in each building is used for an office. The applicant employs staff
members who are on-site 24/7 in lieu of having a resident manager.
Each parcel contains two garage parking spaces and two open parking spaces, for a total
of eight spaces. Clients are not permitted to keep cars at the facility. Casa Capri does
provide shuttle service in cars and mini -vans. These vehicles are not kept on the subject
property. Residents also rely on bicycles and/or public transportation.
Since Casa Capri Recovery began operation of the facility in 2011, Code Enforcement staff
has not opened any complaint investigations.
General Plan Conformance
The provision of a variety of housing types, including housing for the disabled, is consistent
with the Land Use and Housing Elements of the City's General Plan.
• Goal LU -1 F.1: Land Use and Goal HOU-1.2: Protect existing stabilized residential
neighborhoods, including mobile home parks (and manufactured housing parks)
from the encroachment of incompatible or potentially disruptive land uses and/or
activities.
Consistency. The City's regulations are intended to preserve the residential
character of the City's neighborhoods. This facility has demonstrated its compatibility
with the neighborhood over the past two years.
,-- 2-11---
• Goal HOU-1.8: Housing Element. Encourage the development of housing that fulfills
specialized needs.
Consistency: The proposed request provides for a supportive living environment
for persons who are considered disabled under state and federal law.
REQUIRED FINDINGS
Pursuant to Title 13, Chapter XVI and Section 13-29(g) of the Costa Mesa Municipal Code,
the Planning Commission must make required findings for the CUP, based on evidence
presented in the administrative record. Staff recommends that the Commission uphold the
Director's determination to deny this request for reasonable accommodation to allow these
contiguous parcels to be operated as a single sober living facility. Upholding the denial of
a reasonable accommodation means that one CUP must be denied. Use of one of the
parcels for a sober living facility serving fourteen women would be in compliance with the
City's regulations.
• Pursuant to the purpose and intent of the Multi -Family Residential Group Home
Ordinance the sober living facility would provide a comfortable living environment
that will enhance the importunity for disabled persons including recovering
addicts to be successful in their programs.
The facility encompasses two parcels of land. There are two buildings containing
eight units on these parcels. There are 16 bedrooms in the eight units. The facility
currently houses 28 residents. When Ordinance 15-11 was adopted by the City
Council, it specifically included a provision limiting the operation of a sober living
facility to a single parcel. The intent of this limitation is to ensure that sober living
facilities do not occupy a disproportionate number of homes in any neighborhood,
and to avoid overconcentration of sober living units in any area. The City also
sought to ensure that disabled persons recovering from addiction have the
opportunity to reside in a comfortable residential environment vs. an institutional
setting. The City determined that housing inordinately large numbers of unrelated
adults in a single dwelling or congregating sober living homes in close proximity to
each other does not provide the disabled with an opportunity to "live in normal
residential surroundings," but rather places them into living environments bearing
more in common with the types of institutional/campus/dormitory living that the
state and federal laws were designed to provide relief from for disabled persons.
The existing facility occupies two buildings on contiguous parcels, which is a
violation of the Costa Mesa Municipal Code. Therefore, this finding can only be
made if just one of the CUPs is approved. Operation of a facility four units on this
parcel would be compatible with the neighborhood. The use of a single building in
the neighborhood as a sober living home will not create an overconcentration of
such facilities. The use of four units to accommodate 14 residents will provide a
comfor0ble residential environment. The smaller household size accommodated
in each unit allows the residents to live in a more typical household. Parking needs
can be accommodated on-site, and the facility will not share any common walls
with neighbors who may be concerned about noise.
• The sober living facility would further the purposes of the FEHA, the FHAA, and
Lanterman Act by limiting the secondary impacts related to noise, traffic, and
parking to the extent reasonable.
Residents of this facility are not allowed to have cars or park them at the site. The
operator does use mini -vans and cars to provide transportation to activities such
as school, work and counseling. These vehicles are not stored on-site.
There are four parking spaces provided on each parcel. The zoning code requires
residents of sober living homes to park on-site, or on the street within 500 feet of
the facility. There are no parking restrictions, such as permit parking or red curbs,
which would interfere with the ability of residents or employees of the facility to
secure on -street parking if all on-site parking spaces are occupied. Since residents
are not allowed to keep cars on the property, the amount of parking provided on-
site will be adequate to accommodate staff and guests. The facility is in
compliance with the city's standards.
Smoking and noise impacts are often cited when sober living homes create
problems in neighborhoods. Residents of the facility are required to smoke at the
rear of the site, between the garages. The garages abut an alley. There is a fence
between the smoking area and the alley. The garages and the fence will help
minimize any impacts related to smoking at the subject facility.
• The sober living facility would be compatible with the residential character of the
surrounding neighborhood.
The CMMC specifically limits the operation of group homes to a single parcel. The
subject site includes two contiguous parcels, allowing the facility to include eight
units serving 28 women. This approach results in an overconcentration of sober
living units in this neighborhood, detracting from the residential character of the
neighborhood. The approval of one multi -family building containing four sober
living units would not be inconsistent with the residential character of the
neighborhood as it would not create an overconcentration of facilities, as defined
by the City's ordinances. The applicant has demonstrated an ability to operate the
facility in a manner consistent with the residential character of the neighborhood.
• The group home is at least 650 feet from any Propetlythat contains a group home
sober living home or state licensed drug and alcohol facility, as defined in the code
and measured from the property line.
In a letter dated June 10, 2016, the City's Director of Economic and Development
Services denied Casa Capri's accommodation request to allow this facility to
operate on two contiguous parcels.
Section 13-320 of the Costa Mesa Municipal Code establishes criteria for approval
of group homes in multi -family zones. Group hornes serving disabled persons as
defined by state and federal law are not considered to be boardinghouses. Rather,
these facilities offer disabled persons the opportunity to live in residential
neighborhoods in compliance with state and federal laws. Recovering alcoholics and
drug addicts, who are not currently using alcohol or drugs, are considered disabled
under state and federal law. Any group home serving six or fewer people must be
viewed as a residential use pursuant to state law. Group homes serving more than
six residents are subject to local regulation. Standards for large group homes are set
forth in the zoning code. The intent of the regulations is preserve the residential
character of the City's neighborhoods while providing opportunities for the disabled
to live in comfortable residential surroundings.
The City adopted standards for group homes in response to a proliferation of sober
living homes in the community. The City found that an overconcentration of sober
living homes in the City's residential neighborhoods could be deleterious to the
residential character of these neighborhoods and could also lead to the
institutionalization of such neighborhoods. Sober living homes generally do not
function as a single housekeeping unit because they house extremely transient
populations; the residents generally have no established ties to each other when
they move in and typically do not mingle with other neighbors; the residents have
little to no say about who lives or doesn't live in the home; the residents do not
generally share expenses; the residents are often responsible for their own food,
laundry and phone; when residents disobey house rules they are often just evicted
from the house; and the residents generally do not share the same acquaintances.
The City found that the size and makeup of the households in sober living homes
is dissimilar and larger than the norm, creating impacts on water, sewer, roads,
parking and other City services that are far greater than the average household.
In addition, all the individuals residing in a sober living facility are generally over
the age of 18, while the average household in Costa Mesa has just 2.2 individuals
over the age of 18.
Because of their transient populations, above -normal numbers of
individuals/adults residing in a single dwelling and the lack of regulations, sober
living facilities present problems not typically associated with more traditional
residential uses. These issues may include the housing of large numbers of
unrelated adults who may or may not be supervised; disproportionate numbers of
cars associated with a single housing unit, which causes disproportionate traffic
and utilization of on -street parking; excessive noise and outdoor smoking, which
interferes with the use and enjoyment of neighbors' properties; neighbors who
have little to no idea who does and does not reside in the home; little to no
participation by residents in community activities that form and strengthen
neighborhood cohesion; disproportional impacts from the average dwelling unit to
nearly all public services including sewer, water, parks, libraries, transportation
2-7
infrastructure, fire and police; a history of residents congregating in the same
general area; and the potential influx of individuals with a criminal record.
Nevertheless, the City recognizes that while not in character with residential
neighborhoods, when operated responsibly, group homes, including sober living
homes, provide a societal benefit by providing disabled persons the opportunity to
live in residential neighborhoods. These facilities also provide recovery programs
for individuals attempting to overcome their drug and alcohol addictions.
Therefore, providing greater access to residential zones to group homes, including
sober living homes, than to boardinghouses or any other type of group living
provides a benefit to the City and its residents.
In response to the needs and concerns described above, the City established a
minimum separation of 650 feet between group homes, residential care facilities
and/or state licensed drug and alcohol facilities. The City found that a separation
requirement will still allow for a reasonable market for the purchase and operation
of sober living homes within the City. The requirement will still result in preferential
treatment for sober living homes in that non -disabled individuals in a similar living
situation (i.e., in boardinghouse -style residences) have fewer housing
opportunities than the disabled. The City determined that housing inordinately
large numbers of unrelated adults in a single dwelling or congregating sober living
homes in close proximity to each other does not provide the disabled with an
opportunity to "live in normal residential surroundings," but rather places them into
living environments bearing more in common with the types of
institutional/campus/dormitory living that the state and federal laws were designed
to provide relief from for disabled persons.
The operator of a group home may request reasonable accommodation when
compliance with all of the standards is not possible. Section 13-200.62 (f) of the
zoning code sets forth the required findings to be used in the determination to
approve, conditionally approve, or deny a request for reasonable accommodation.
The Code specifies that all findings must be made in order to approve such a request.
The Federal Housing Act Amendments (FHAA), 42 U.S.C. § 3601 et seq., provide
that a city "commits discrimination under the FHAA if it refuses to make reasonable
accommodations in rules, policies, practices, or services, when such accommodation
may be necessary to afford [the disabled] equal opportunity to use and enjoy a
dwelling." Budnick v. Town of Carefree, 518 F.3d 1109, 1119 (9th Cir. 2008).
The FHAA requires a city to provide a requested accommodation if such
accommodation "(1) is reasonable, and (2) necessary, (3) to afford a handicapped
person the equal opportunity to use and enjoy a dwelling." Oconomowoc Residential
Programs, Inc. v. City of Milwaukee, 300 F.3d 775, 783 (7th Cir. 2002); 42 U.S.C. §
3604(f)(3)(B).
Z9
The applicant requested relief from the zoning code's requirement that a group home,
residential care facility or state licensed drug and alcohol facility is at least 650 feet
from another property that contains a group home, sober living home or state
licensed drug and alcohol treatment facility. Based on the limited information
provided by applicant, and staff's own research into the issue, the Director denied
the reasonable accommodation requested to allow these two contiguous parcels
to be operated as a single sober living facility, for the following reasons.
• Applicant has not met its burden to show that the requested accommodation is
necessary to afford individuals recovering from drug and alcohol addiction the
opportunity to the use and enjoyment of a dwelling in the City.
The application established that the requested accommodation (waiver of the
650 -foot separation and single lot requirements) may allow a CUP to be
granted to enable Casa Capri Recovery to continue to operate in compliance
with the Costa Mesa Municipal Code at its current location. In theory, this action
would allow one or more individuals who are recovering from drug and alcohol
abuse to enjoy the use of one of these dwellings. However, the request is not
necessary to allow one or more individuals who are recovering from drug and
alcohol abuse to enjoy the use of a dwelling within the City.
• Applicant has not met its burden to show whether the existing supply of facilities
of a similar nature and operation in the community is insufficient to provide
individuals with a disability an equal opportunity to live in a residential setting.
Based on the most recent data compiled by City staff, there are approximately 98
sober living homes within Costa Mesa. Of these, 37 are located in single-family
neighborhoods and 61 are within multi -family residential zones. Additionally,
there are approximately 83 state licensed drug and alcohol residential care
facilities in Costa Mesa. Twenty-five are in single-family residential zones, 55 are
in multi -family residential zones, and one is in a C1 zone. No evidence has been
submitted to indicate that the number of sober living homes and drug and alcohol
residential care facilities existing or potentially allowed in compliance with the
City's standards is inadequate.
• Applicant has not met its burden to show whether the requested
accommodation is consistent with whether or not the residents would constitute
a single housekeeping unit.
According to the City's definition of a sober living home, a sober living home's
residents do not constitute a single housing keeping unit. The requested
accommodation is for a provision of the Costa Mesa Municipal Code that would
not apply to single housekeeping units. Therefore, this finding is not relevant.
_2q—
• Applicant did not demonstrate that the requested accommodation is necessary
to make facilities of a similar nature or operation economically viable in light of
the particularities of the relevant market and market participants.
The applicant did not provide evidence in its application regarding this factor;
therefore, City staff was not able to make this finding. As noted above, there
is a significant number of sober living facilities in Costa Mesa.
• Applicant was not able to demonstrate that the requested accommodation will
not result in a fundamental alteration in the nature of the City's zoning program.
The City's separation standard of 650 feet was intended to ensure that there
would be no more than one group home, residential care facility or state licensed
drug and alcohol facility on any block. The City limits the operation of sober living
homes to a single parcel to minimize the opportunity for an overconcentration of
sober living units to occur in a neighborhood. The subject properties are located
adjacent to each other and approval of one CUP will create a separation conflict
with the other property.
The burden to demonstrate necessity remains with the Applicant. Oconomowoc,
300 F.3d at 784, 787. Applicant must show that "without the required
accommodation the disabled will be denied the equal opportunity to live in a
residential neighborhood." Oconomowoc, 300 F.3d at 784; see also, United
States v. California Mobile Home Mgmt Co., 107 F3d 1374, 1380 (9th Cir. 1997)
("without a causal link between defendants' policy and the plaintiff's injury, there
can be no obligation on the part of the defendants to make a reasonable
accommodation"); Smith & Lee, Inc. v. City of Taylor, Mich., 102 F.3d 781, 795
(6th Cir. 1996) ("plaintiffs must show that, but for the accommodation, they likely
will be denied an equal opportunity to enjoy the housing of their choice").
The Applicant has asserted that the requested accommodation from the 650 -foot
distance requirement is reasonable. However, a zoning accommodation may be
deemed unreasonable if "it is so at odds with the purposes behind the rule that it
would be a fundamental and unreasonable change." Oconomowoc, 300 F.3d at
784. The Applicant made no mention of the purpose underlying the City's zoning
limitation, or explained how the accommodation requested would not undermine
that purpose. In fact, the Director found that such allowance would fundamentally
alter the character of this neighborhood and is thus unreasonable.
Allowing multiple group homes, sober living homes and/or state licensed drug
and alcohol treatment facilities to cluster in a residential neighborhood does effect
a fundamental change to the residential character of the neighborhood. Allowing
facilities to be located on contiguous parcels has a similar effect. The clustering
of group homes in close proximity to each other does change the residential
character of the neighborhood to one that is far more institutional in nature. This
is particularly the case with respect to sober living homes. Both California and
_
3C),
federal courts have recognized that the maintenance of the residential character
of neighborhoods is a legitimate governmental interest. The United States
Supreme Court long ago acknowledged the legitimacy of "what is really the crux
of the more recent zoning legislation, namely, the creation and maintenance of
residential districts, from which business and trade of every sort, including hotels
and apartment houses, are excluded." Euclid v. Amber Realty Co., 272 U.S. 365,
390 (1926).
The California Supreme Court also recognizes the legitimacy of this interest:
It is axiomatic that the welfare, and indeed the very existence of a
nation depends upon the character and caliber of its citizenry. The
character and quality of manhood and womanhood are in a large
measure the result of home environment. The home and its intrinsic
influences are the very foundation of good citizenship, and any factor
contributing to the establishment of homes and the fostering of home
life doubtless tends to the enhancement not only of community life but
of the life of the nation as a whole.
Miller v. Board of Public Works, 195 Cal. 477, 490, 492-93 (1925).
With home ownership comes stability, increased interest in the
promotion of public agencies, such as schools and churches, and
'recognition of the individual's responsibility for his share in the
safeguarding of the welfare of the community and increased pride in
personal achievement which must come from personal participation in
projects looking toward community betterment.'
Ewing v. City of Carmel -by -the -Sea, 234 Cal. App. 3d 1579, 1590 (1991),
citing Miller, 195 Cal. at 493.
It is with these purposes in mind that the City of Costa Mesa has created
residential zones, including R2 zones for multi -family residences.
The requested accommodation, in these specific circumstances, would result
in a fundamental alteration of the City's zoning program, as set forth in
Ordinance numbers 14-13 and 15-11, because it would increase and/or
contribute to the overconcentration of these types of facilities in this residential
neighborhood.
Based on denial of a reasonable accommodation, the facility does not comply with the
City's adopted standards for separation between group homes, residential care
facilities and state licensed drug and alcohol facilities. Therefore, the findings required
by CMMC to approve both CUPs cannot be made, either. However, if one CUP is
denied, the other CUP may be approved, since the use of one of these parcels will
fully comply with the City's standards.
• The proposed use is substantially compatible with developments in the same
general area and would not be materially detrimental to other properties within
the area.
The introduction of one sober living home in compliance with the City's standards
would not be materially detrimental to the area. However, over the last decade,
the number of sober living homes in the City of Costa Mesa has rapidly
increased, leading to an overconcentration of sober living homes in certain of the
City's residential neighborhoods. Overconcentration is both deleterious to the
residential character of these neighborhoods and may also lead to the
institutionalization of such neighborhoods. The City's establishment of distance
requirements for sober living homes is reasonable and non-discriminatory and
helps preserve the residential character of the R2MD, R2HD, and R3 zones, as
well as the planned development residential neighborhoods. It also furthers the
interest of ensuring that disabled persons are not living in overcrowded
environments that are counterproductive to their well-being and recovery. The
approval of this request to allow this facility to encompass two parcels will
contribute to an overconcentration of such facilities in this neighborhood.
•
Granting the CUP will not be materially detrimental to the health, safety and
general welfare of the public or otherwise injurious to property or improvements
within the immediate neighborhood.
As noted above, approval of both CUP applications will result in overconcentration of
group homes, residential care facilities and/or state licensed drug and alcohol
facilities in this neighborhood. Short-term tenants, such as might be found in homes
that provide addiction treatment programs of limited duration, generally have little
interest in the welfare of the neighborhoods in which they temporarily reside --
residents "do not participate in local government, coach little league, or join the
hospital guild. They do not lead a scout troop, volunteer at the library, or keep an eye
on an elderly neighbor. Literally, they are here today and gone tomorrow -- without
engaging in the sort of activities that weld and strengthen a community." Ewing, 234
Cal. App. 3d at 1591.
Strong evidence exists that a supportive living environment in a residential
neighborhood provides more effective recovery than an institutional -style
environment (see Attachments 5 and 6). The City's zoning regulations address
overconcentration and secondary effects of sober living homes. The goal of the
regulations is to provide the disabled with an equal opportunity to live in the
residence of their choice, and to maintain the residential character of existing
neighborhoods.
The City has found through experience that clustering sober living facilities in close
proximity to each other results in neighborhoods dominated by sober living
facilities. In these neighborhoods, street life is often characterized by large
—32—
capacity vans picking -up and dropping -off residents and staff, service providers
taking up much of the available on street parking, staff in scrubs carrying medical
kits going from unit to unit, and vans dropping off prepared meals in large numbers.
The City has experienced frequent Fire Department deployments in response to
medical aid calls. In some neighborhoods, Police Department deployments are a
regular occurrence as a result of domestic abuse calls, burglary reports, disturbing
the peace calls and parole checks at sober living facilities. Large and often
frequent AA or NA meeting are held at some sober living homes. Attendees of
these meetings contribute to the lack of available on street parking and neighbors
report finding an unusual amount of litter and debris, including beverage
containers, condoms and drug paraphernalia in the wake of these meetings.
These types of impacts have been identified in other communities as well (see
Attachment 7).
• Granting the conditional use permit will not allow a use which is not in
accordance with the general plan designation.
The proposed use is consistent with the City's General Plan. However, an
overconcentration of group homes, sober living homes and licensed treatment
facilities for alcohol and drug addiction is not consistent with the General Plan. The
City's regulations are intended to preserve the residential character of the City's
neighborhoods. The City Council has determined that an overconcentration of sober
living facilities would be detrimental to the residential character of the City's
neighborhoods. The denial of one CUP and approval of the other CUP will allow a
sober living facility to operate in compliance with the City's regulations.
ALTERNATIVES
A draft resolution denying the appeal of the Director's determination on Reasonable
Accommodation and PA 16-41 has been provided. A draft resolution approving PA 16-44
has also been provided. The Planning Commission could choose to approve CUP PA -16-
44 instead of PA 16-41. Should the Planning Commission wish to approve the reasonable
accommodation request and both CUPs, the hearing should be continued to allow staff to
prepare resolutions for consideration at a subsequent meeting.
LEGAL REVIEW
The draft resolution has been reviewed and approved as to form by the City Attorney's
Office.
„--
CONCLUSION
The applicant has requested an accommodation to allow a sober living facility at 269 161h
Place and 271 16th Place to be operated on two contiguous parcels, resulting in one parcel
containing a group home, sober living home or state licensed drug and alcohol treatment
facility being within 650 feet of another such facility.. The applicant has failed to demonstrate
that all of the required findings can be made. The approval of a sober living facility operated
on contiguous properties is not permitted under the CMMC. Staff recommends denial of the
appeal to waive this separation requirement, denial of PA 16-41, and approval of PA 16-44.
kx�uk Dj/,a�
SHERI VANDER DUSSEN, AICP
Acting Assistant Director
Community Improvement Division
AY TREVINO, AICP
Economic and Development
Services Director
Attachments: 1.
Vicinity and Zoning Maps
2.
Applicant's Request for Reasonable Accommodation dated March
23, 2016
3.
Letter from Director dated May 18, 2016, denying Reasonable
Accommodation
4.
Applicant's Request to Appeal the Denial to the Planning
Commission dated May 23, 2016
5.
Recovery Housing: Assessing the Evidence, Sharon Reif, Ph.D.
at al., Psychiatric Services, March 2014 Vol. 65 No. 3
6.
Residential Treatment for Individuals With Substance Use
Disorders: Assessing the Evidence, Sharon Reif, Ph.D. at al.,
Psychiatric Services, March 2014 Vol. 65 No. 3
7.
Community Context of Sober Living Houses, Douglas L. Polcin,
Ed.D., et al., NIH Public Access Author Manuscript, December 1,
2012 (published in final edited form as Addict Res Theory. 2012
December 1; 20(6): 480-491. doi: 0.3109/16066359.2012.665967)
8.
Draft Resolution Upholding the Denial of the Reasonable
Accommodation Request and PA 16-44
9.
Draft Resolution Upholding the Denial of the Reasonable
Accommodation Request and Approval of PA 1-41
Distribution: Director
of Economic & Development Services/Consultant
Interim Assistant Director, Planning
Interim Assistant Director, Community Improvement
Senior Deputy City Attorney
Public Services Director
City Engineer
Transportation Services Director
Fire Protection Analyst
File (2)
Applicant c/o:
Melissa Goodmon
2801 Bristol Street, Suite 110
Costa Mesa, CA 92626
r 35,
ATTACHMENT 1
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ATTACHMENT 2
Exhibit C -269 and 271 16th Place
Part 10 Reasonable Accommodations
1.Please explain which zoning code provisions, regulations, policies or
conditions from which the accommodation is being requested.
RESPONSE:
Reasonable Accommodation is requested from Ordinance No. 15-11, Section 13-
322-3.b -- "The group home or sober living home is at least 650 feet from any
other property, as defined in Section 13-321, that contains a group home, sober
living home or state licensed drug and alcohol treatment facility, as measured
from the property line"
The properties at 269 and 271 16th Place are adjacent to one another and
therefore are technically within 650 feet of each other.
While the Ordinance does provide for the 650' separation, it would be difficult to
relocate the existing sober living residences at 269 and 271 16th Place because
it is an ideal property with the two adjacent buildings and central common area
that provides a safe and secure place for women working to keep sobriety. This
specific property provides two structures that maintains a residential appearance
with landscaping and curb appeal for residents of surrounding properties, keeps,
smoking and laundry areas interior to the site and has sufficient on-site parking
for any personnel or visitors so as not to impact any surrounding residents with
second hand smoke, noise or on -street parking. The location is also beneficial to
the sober living residents by providing an attractive and safe environment that is
near the counseling that is required to support sobriety as well as offering
pedestrian opportunities as the women embrace sobriety to find employment
nearby.
2. Please explain the basis for the claim for which the individuals are
considered disabled under state or federal law and why the
accommodation Is necessary to provide equal opportunity for housing and
to make the specific housing available to individuals.
RESPONSE:
Under the Fair Housing Act, it is a discriminatory practice to refuse to make "a
reasonable accommodation in rules, policies, practices, or services when
such accommodation may be necessary to afford a handicapped person equal
opportunity to use and enjoy a dwelling." Under the FHA,
a handicap is defined as a physical or mental impairment which substantially
limits one or more major life activities of a person.
�Z_
Persons with drug and alcohol addictions are considered disabled under federal
and state law and are entitled to normal residential opportunities while seeking
treatment.
Casa Capri Recovery has operated a sober living residence for women at the
269 and 271 16`h Place locations for over 4 years. Per the property owner and
Casa Capri Recovery there has been no history of citations or complaints from
the City of Costa Mesa or the Community.
3. Please identify any other information that the director reasonably
determines is necessary for evaluating the request for reasonable
accommodation.
RESPONSE:
Casa Capri Recovery has maintained sober living residences for women at 269
and 271 16th Place for four years. In the four years that the sober living home has
been operated there is no history of warnings, citations or complaints from the
City of Costa Mesa or surrounding residents of the property. The property is well
maintained and an attractive presence in the neighborhood.
Given the House Rules this sober living facility is a good neighbor. Smoking is
only permitted in an area behind the two buildings and surrounded by a fence so
it is not visible from surrounding residences in order to limit smoke being intrusive
to neighbors. Residents are not allowed to have cars but there are 4 spaces on
site so that office staff or any visitors have sufficient on-site parking and on -street
parking is not needed. Residents are shuttled off site via Casa Capri Recovery
vans or cars. No visitors are permitted after 10:00pm and a house manager is on
site at all times when residents are on site. This facility is located on a major
arterial and is located in a mixed commercial and multi -family neighborhood.
The advantage of these properties is that it provides a sober living environment
with house rules for women with drug and alcohol dependencies. The properties
are located in an area of Costa Mesa that is within walking distance of
commercial areas of the city so that residents can find employment near there
sober living residence, Casa Capri Recovery's plan is to have most of the
residents on the property for about a 90 day period so that they can live in a
sober environment with support.
Jeremy Broderick, an owner of Casa Capri Recovery has operated within the
City of Costa Mesa for six years and has served on both the Preserve Our
Neighborhood and Improve Our Neighborhood Task Forces at the invitation of
past Mayor Jim Righeimer. Casa Capri Recovery provides an important service
needed in the community to help women with drug and alcohol dependency and
it has a successful record of client treatment with less than a 10% recurrence
rate.
-43-
4. Please provide documentation that the applicant is a) an individual with a
disability; 2) applying on behalf of one or more individuals with a disability;
or c) a developer or provider of housing for one or more individuals with a
disability.
RESPONSE:
As previously stated, Casa Capri Recovery is a provider of housing for persons
with disability. It provides treatment for drug and alcohol dependency to women
and in addition to the counseling and support provides a sober living residences
at 269 and 271 16th Place that is a safe, pleasant and supervised environment to
assist in the recovery process.
5. Please provide the specific exception or modification to the Zoning Code
provision, policy or practices request by the applicant.
RESPONSE:
Casa Capri Recovery is requesting that the 650 foot requirement from other
sober living facilities be waived on the grounds that the sober living residences
have been operating at 269 and 271 16th Place in Costa Mesa for the last four
years with no history of warnings or citations. The residence is primarily located
around other multi -family units and is within walking distance of commercial
areas to allow for employment for residents. The facility has an excellent record
of resident's attaining recovery.
6. Please provide documentation that the specific exception or modification
requested by the applicant is necessary to provide one or more individuals
with a disability an equal opportunity to use and enjoy the residence.
RESPONSE:
As noted, this sober living residence has been in operation at this location for
four years and has served as a safe and secure residence for women working to
overcome drug and alcohol dependency as a part of the Casa Capri Recovery
process. It is necessary to have a sober living residence component to
complement the day to day counseling and treatment provided by Casa Capri
Recovery. The location of the residence near commercial areas of the City of
Costa Mesa allows residents to live in a secure, residential environment while
also being near potential employment opportunities as well as needs such as
grocery stores, movie theatres and other forms of safe entertainment.
7. Please provide any other information that the Hearing Officer reasonably
concludes is necessary to determine whether the findings required by
Section (e)
can be made, so long as any request for information regarding the
disability of the individuals benefited complies with fair housing law
protections and the privacy rights of individuals affected.
-saij.iado.id 2utpuno.uns aul o; ivawpiap a aq iou
Minn pue algpedwoa sl 0W0q,2utnti sagos a jo uolpzado s,IUanoaa\,f AeM plennpWAA
RESPONSE:
See response number 3.
June 10, 2016
ATTACHMENT 3
CITY OF COSTA NMgSA
P.O. BOX 1200. 77 FAIR DRIVE + CALIFORNIA 92628-1200
SENT VIA FEDEX EXPRESS & ELECTRONIC MAIL
Melissa Goodmon
Casa Capri Recovery
2801 Bristol Street, Suite 110
Costa Mesa, CA 92626
EMAIL: melissa@casacaprirecovery.com
Re: Reasonable Accommodation Request for Properties Located at 269 and 271 16"h Place
Dear Ms. Goodmon,
This letter will serve to respond to the application that you submitted on April 14, 2016
requesting reasonable accommodation for land use requirements applicable to the operation of
state licensed drug and alcohol facilities at 269 and 271 16th Place. You are applying for
reasonable accommodation from the provision in the City of Costa Mesa Municipal Code
("CMMC") section 13-323 (b) that stipulates that the group home, residential care facility or
state licensed drug and alcohol facility must be at least six hundred and fifty feet from any
property, as defined in Section 13-321, that contains a group home, sober living home or state
licensed drug and alcohol treatment facility, as measured from the property line.
The CMMC section 13-200.62 (f) sets forth the required findings to be used in the
determination to approve, conditionally approve, or deny a request for reasonable
accommodation shall be based on the following findings. Compliance with all of the findings is
required forapproval. Based on the facts set forth in your request and in your application for a
conditional use permit, I am unable to make all of the necessary findings to support this
accommodation, as described below.
(1) The requested accommodation is requested by or on the behalf of one (1) or more
individuals with a disability protected under the fair housing laws.
I accept for purposes of your request that you are making this request on behalf of individuals
who are considered disabled under state and federal law.
(2) The requested accommodation is necessary to provide one (1) or more individuals with a
disability an equal opportunity to use and enjoy a dwelling.
As discussed more fully below, I am unable to make this finding.
Community improvement Division (714) 754-5245
FAX (714) 754-4856 • TDD (714) 754-5244 . www.ci.costa-mesa.ca.us
r
(3) The requested accommodation will not impose an undue financial or administrative
burden on the city, as "undue financial or administrative burden" is defined in fair housing
laws and interpretive case law.
While no facts were presented regarding this factor, I do not find that this request would
pose an undue financial or administrative burden on the city.
(4) The requested accommodation is consistent with the whether or not the residents would
constitute a single housekeeping unit.
No facts were presented in your application regarding this factor. Accordingly, I am unable
to make this finding.
(5) The requested accommodation will not, under the specific facts of the case, result in a
direct threat to the health or safety of other individuals or substantial physical damage to the
property of others.
I have reviewed no facts that would indicate that the requested accommodation would result
in a health and/or safety threat.
(6) Whether the requested accommodation is necessary to make facilities of a similar nature
or operation economically viable in light of the particularities of the relevant market and
market participants.
No evidence was presented in regarding this factor; accordingly, I am unable to make this
finding.
(7) Whether the existing supply of facilities of a similar nature and operation in the
community is sufficient to provide individuals with a disability an equal opportunity to live in a
residential setting.
No evidence was presented that the existing supply of similar facilities in Costa Mesa is
insufficient to provide individuals with a disability an equal opportunity to live in a residential
setting. Accordingly, and as discussed below, I am unable to make this finding.
(8) The requested accommodation will not result in a fundamental alteration in the nature of
the city's zoning program.
As discussed in greater detail below, I am unable to make this finding.
The City's land use requirements pertaining to sober living homes and residential care
facilities are intended to preserve the residential character of neighborhoods, to provide
housing opportunities to the disabled, and to the extent possible, free the disabled from
institutional style living. The 650 foot separation requirement between group homes and
residential care facilities to other group homes or state licensed drug and alcohol facilities
provides disabled persons with opportunities to live in normal residential settings and to use
and enjoy a dwelling in a manner similar to the way a dwelling is enjoyed by the non -
disabled.
Your request to waive the 650 foot separation requirement may allow CUPS to be granted to
enable Casa Capri Recovery to continue to operate in compliance with the CMMC at the
subject properties. While this action might allow one or more disabled persons to enjoy the
use of one of these dwellings, I do not find that the request is necessary to allow one or more
disabled persons to enjoy the use of a dwelling within the City. Further, no information was
presented to indicate that one or more disabled persons who currently reside at the property
would still be in residence as of the date the oroperty must come into compliance with City
Community L v.. ,-mcnt Division (714) 754-5245
FAX (714) 754-4856 • TDD (714) 754-5244 • www.dcosta-mesa.ca us
ordinances regarding group homes pursuant to 12-324(a)(2), as discussed below. No facts
were presented to support a finding that the existing supply of similar facilities in the
community is insufficient to provide individuals with a disability an equal opportunity to live
in a residential setting.
Similarly, no evidence was presented to indicate that there are no sites for such facilities
elsewhere in the City that would comply with the separation requirement. Based on the
most recent data compiled by staff, there are approximately 105 sober living homes and 12
of those facilities are female -only facilities. There are also approximately 64 state licensed
drug and alcohol residential care facilities in the City and 20 of those facilities serve only
females. The subject properties are located within 650 feet of each other.
The requested accommodation in these specific circumstances would result in a fundamental
alteration of the Zoning program, as set forth in ordinance numbers 14-13 and 15-11,
because it would increase, and/or contribute to the overconcentration of sober living
facilities in this residential neighborhood. Accordingly, the reasonable accommodation
request is denied, because I did not receive sufficient evidence to make the findings
required by Section 13-200.62(f).
This determination can be appealed to the Planning Commission by filing an application for
appeal with the City Clerk. Any appeal must be filed within seven (7) days of this date of denial,
which is June 17, 2016 by 5:00 p.m., pursuant to Sections 2-305(2) and 2-307 of the Costa Mesa
Municipal Code. A fee of $690.00 must accompany the application. In your request for an
appeal, please summarize the reasons for the appeal. If the application for appeal is not
submitted by the deadline, your time to appeal will have expired.
Please be aware that Section 12-324(a)(2) of the Costa Mesa Municipal Code requires group
homes or residential care facilities serving more than six residents to have a conditional use
permit approved by the City or cease operation by December 17, 2016.
If you have further questions, please do not hesitate to contact Katie Angel at (714) 754-5618.
Sincerely,
GaryA�Ynst ong, AICP
�
Economic and Development Services Director/Deputy CEO
cc: Tarquin Preziosi, Esq.
Fidel Gamboa, Acting Neighborhood Improvement Manager
Katie Angel, Management Analyst
Community Improvement Division (714) 754-5245
FAX (714) 754-4856 • TDD (714) 754-5244 . www.ci.costa-mes&ca.us
ATTACHMENT 4
lr EGEIVLL
CITY CLERK Cost. Mesa
16 JUN 13 p{,j Z. 31 City of Costa Mesa
CITY DIF 0 Appeal of Commission Decision - $1,220.00
D Y._ _ -- --.---
�Appeai of Zoning Administrator/Staff Decision - $690.00
(FEES MUST BE PAID IN FULL AT TIME OF FILING APPEAL)
APPLICATION FOR APPEAL OR REVIEW
Applicant Name' Melissa Goodmon
Address: 269 & 271 16th Place Costa Mesa CA 92627
Phone: 949-861-0576 Representing: Casa Capri LLC
REQUEST FOR: p APPEAL [:]REVIEW'"
Decision of which appeal) or review is requested: (give application number, If applicable, and the date of the decision, if
4 r%eiwn
Decision by: —
Reasons for requesting appeal or review: Q�
� sc w �a�✓Vv1�'� � � o�"Q�..
j C4 Vv\
b I1
C
Date: to 11, 0
Signature:
"If you are serving as the agent for another person, please idontify the person you represent and provide proof of authorization.
"Review may be requested only by Commissions, Commission Members, City Council, or City Council Mombers.
For office use only - do not wilts below this line REV 9-1-15
SCHEDULED FOR THE CITY COUNCIL/COMMISSiON MEETING OF:
AG —
ATTACHMENT 5
Aexeeeing the Evidence Have Series
Recovery Housing: Assessing the Evidence
Sharon Reify P&D.
Ptvahy George,, P&D.
Tisa RIMS& P".
RiehaM M Dougherty, PhD.
Allen S. Daniels, E".
Sushmita Showa Ghose, P&D.
Mirisur E. Delphian-Rittmon, M.D.
2k&*km: Recovery housing is a direct service with multiple components
that provides supervised, short-term housing to individuals with m&
stance use dborders or co-occurring mental and substance use disorder.
It commonly is used after inpatient or residential treatment. This artWe
describes recovery housing and assesses the evidence base for the ser.
vice. Methods; Authors searched PubMed, PsycUffU, Applied Social
Sciences Index wind Abstracts, Sociological Abahacts, and Social Services
Abatracts. They identified sbh individual articles fromr 1996 through 2012
that reported on randomized controlled trials or quasi-expedm entad
studies; no reviews or metwanalyses were found. They chose firom three
levels of evidence (high, moderate, or lows) based on benchmarks for the
number of studies and quality of their methodology. They also described
the evidence of service effectivenew Results: 'IUs level of evidence for
reoovery housing was moderate, Studies cornestantly showed positive
outer, but the results were tengered by research design limitations,
such as lack of consistency in defining the program elements and outcome
measures, small samrp1m, and single cite evaluations, and by the linsited
number of studies. Results on the effectiveness of recovery housing sug.
gested positive substance use outcomes and improvements in functioning,
including employment and ditndnai activity. Cowdnaion. Recovery
housing appears to be an important component in the continuum of dare
for some individuals. However, replication of study findings with greater
specificity and in more settings is needed. (Pvjchiatric Servicr 85:$95-300,
20I4, dart: 10.1178/appi ps.201300243)
Acress to stable and supportive
housing is recognized in the
addictions field as an impor-
tant component of establishing and
maintaining recovery from substance
use disorders (1). Research suggests
that maintaining recovery gains may
be dtflicult for individuals who are not
Dr. Reif is with the Institute for Behavioral Health, Hellor School for SooW Policy and
Management, Brancleets Unhx?,My, Waltham, Maesadrusetis. Dr. George, Dr. Daniels,
and Dr. Ghose are with Westat, Roaville, Maryland. Dr Bmude and Dr. Dougherty are
with DMA Health Strategies, Lsrhrgton, Manadursetir, Dr. Delphin-R"non is with the
O,iloe of Policy, Planning, and innovation, Substance Abuse and Mental Health Somgcas
Administration (SAMHSA), RockW/le, Maryland Send aottospordence to Dr. George at
pmethygeorgo@westatoom. This literature r>,vtav is part of a aeries that will bs peb4dwri
In Psychiatric Services over the nest several months, The revieuu wens omwguioned by
SAMHSA through a cmftsc+ with Truven Health Analytics. The revieuas were oonducted
by mperts in each topic ane, who wrote the reviews along with authors from Truven
Health Analytim, Wwtat, DMA Health Strategies, and SAMHSA..Each article in the series
wws peer reviewed by a special panel If Psychiatric Services reviewers.
PSYCHMTIUC SERYM ♦ ps.peychkauy !nc.org ♦ March 2014 VoL 65 rw, 3
S0_
living in stable housing situations (2),
and environmental cues may play a
role in triggering relapse (3), There is
a need to identify housing settings
that promote recovery atter the com-
pletion of residential treatment or
during the receipt of outpatient treat-
ment for substance use disorders,
Recovery housing is one example of
a type of service used in the field to
address the needs of individuals with
substance use disorders,
This article reports the results of a
literature review that was undertaken
as part of the Assessing the Evidence
Base (AEB) Series (see box on next
page). For purposes of the AEB Series,
the Substance Abuse and Mental Health
Services Administration (SAMHSA) has
defined recovery housing as a direct
service with multiple components that
provides supervised, short-term hous-
ing to individuals with substance use
disorders or co-o=rring mental and
substance use disorders. Recovery
housing alms to increase an individual's
stability, improve his or her functioning,
and move the resident toward a Hie in
the community by supporting absti-
nence and recovery. Table 1 contains a
descr"on of the components of this
service,
Policy makers and other leaders in
behavioral health care need informa-
tion about the effectiveness of recovery
housing and its value as a service
within the continuum of care. The
objectives of this review were to de-
scribe models of recovery housing for
individuals with substance use disorders
or co-ocmxring substance use and men-
tal disorders, rate the level of research
evidence (that is, metiiodological Tlaltty),
2"
About dw AEB Series
The Assessing the Evidence Base (AEB) Series presents literature reviews
for 13 commonly used, recovery -focused mental health and substance use
services. Authors evaluated research artioles and reviews spec& to each
service that were published from 19M through 201E or 2013, Each AEB
Series article presents ratings of the strength of the evideroe for the servioe,
descriptions of service effedivenow, mud recommendations far future im-
plementation and research. The target audience includes state mental health
and substance use program directors and their senior staff', Medicaid staff;
other purchasers of health care services (for example, mmieged care
organizations and oommercW insurance), leaders in community health or
ganirations, providers, consumers and family members, and others interested
in the empirical evidence base for these servioes. The research was sponsored
by the Substance Abuse and Mental Health Services Administration to help
inform decisions about which services should be covered in public and
commerdalty funded plarm Detail about the reseamr methodology and bases
for the conclusions are included in the introduction to the AEB Series (10),
and describe the effectiveness of the
service. To be useful for a broad au-
dience, this article presents an overall
assessment of research quality and fo-
cuses on key findings of the review.
Ili wovay housing wid
tate coatlautm of care
Recovery housing for individuals with
substance use disorders generally
consists of alcohol- and drug-free
residences, such as sober living houses
AN. Recovery housing is often pro-
vided to individuals after they have
been in an Inpatient or residential
treatment program or during their
first few months of recovery or sobri-
ety. Recovery housing is not a formal
treatment; rather, it is a service that
supports recovery during or after treat-
ment, Thus there is guidance about
r"WIN r
Description of recovery housing
what constitutes recovery housing, but
there are no clear standards.
Sober living houses usually are
peer -con residenoes where small- to
medium-sized groups of individuals in
recovery live in single or shared bed-
rooms with common living areas.
Individuals are expected to work,
contribute rent, and participate in
the responsibilities of running the
household. Abstinence is an expec-
tation, and individuals who relapse
may be asked to leave the house
because their behavior threatens
the recovery of others. Sober living
houses generally do not incorporate
it strictured recovery program, al-
though residents often are required or
strongly encouraged to attend a 12 -
step mutual -help group (6), and they
may choose to participate in formal
Feature
Description
Service definition
Recovery housing is a direct service with multiple
components that provides individuals with mental
and substance use disorders with supervised,
short-term housing, Services may include case
management, therapeutic recreational activities,
and peer coaching or sup(�ort,
Service goals
Increase the Individual's stability; improve the
person's functioning; help the individual move
toward a life that is Integrated into the
community
populations
Individuals with substance use disorders or those
with oo-occurring mental and substance use
disorders
Settings of service delivery
Settings may vary and include sober living houses,
treatment or aftercare. Less common
are sober living houses that are
affiliated with outpatient treat-
ment facilities and require individu-
als to attend outpatient treatment (7).
oxford House is a specific type of
recovery home in which members
evaluate and vote on candidates who
may become residents to help ensure
that they will fit in with the current
housing members and meet eqec-
tations for the residence (4). Oxford
Houses have a national network. They
do not require individuals to be engaged
actively in formai treatment, but resi-
dents may choose to participate in self-
help groups or outpatient treatment.
The models of mecovery housing ds -
scribed above generally are considered
part of the continuum of care that spans
from outreach through formal treat-
ment and extends into informal treat-
ment, maintenarxce, and aftercare needs.
In this approach, recovery housing is
an essential part of preparing for or
transitioning to an independent life in
the community. Recovery housing fre-
quently facilitates access to support
services and treatment utilization, such
as case management, therapeutic recre-
ational activities, and peer coaching or
support, often working in partnership
with treatment or recovery programs,
recovery housing options may provide
transportation, in-house counseling,
or mentoring.
Recovery housing Is often used by
individuals who do not or no longer
require higher levels of care, such as hos-
pitalization or long-term residential
treatment. Individuals who utilize re-
covery housing may need assistance
with activities of daily living (such as
managing finances) or reminders and
support to attend treatment, take medi-
cations, or abstain from alcobol and drag
use, For these individuals, recovery hous-
ing may be a step on the way to inde-
pendent living. It should be noted that
there is concern that individuals who
utilize abstinence -contingent housing
may be at risk for housing instability if
relapse occurs during the process of
recovery.
In summary, recovery housing is a
type of service used for individuals
with substance use disorders who are
stepping down from lopatlent or resi-
dential care orwho are not ready or able
to live Independently. This literature
296 .. - PSYCHIA'T'RIC =W(ZS ♦ ps.psychtauyoalmexorg ♦ M uvh tots Vo6 65 No, 3
S1—
review examined the available research
on recovery housing to determine its
relative value as a treatment approach.
Methods
Seamb strategy
To provide a summary of the evidence
and effectiveness for recovery housing
services, we conducted a survey of
major databases: PubMed (U.S. Na-
tional Library of Medicine and Na-
tional Institutes of Health), PsydNFO
(American Psychological Association),
Applied Social Sciences Index and
Abstracts, Sociological Abstracts, and
Social Services Abstracts. We searched
for and reviewed meas -analyses, re-
search reviews, and individual studies
from 19W through 2012. We also ex-
amined bibliographies of reviewed stud -
les. We used combinations of the
following search terms: recovery hous-
ing, sober housing, halfway house,
group home, and substance abuse.
Inclusion and exclusion c rA"Ya
This review included the following
types of articles: randomised controlled
trials (RCTs), quasi -experimental stud-
ies, single -group repeated -measures de-
sign studies, and review articles such
as meta-analyses and systematic re-
views; U.S. and international studies in
English; and studies that focused on
recovery housing for individuals with
substance use disorders or co-oc ening
mental and substance use disorders, in-
cluding abstinence -contingent recov-
ery housing.
Excluded were studies of residen-
tial treatment, supportive housing,
supported housing, and permanent
supportive housing, because these topics
are covered in the review of permanent
agVottive housing in this series (8).
Housing First models focus on per-
manent housing rather than on short-
term, recovery -focused housing; they
are also discussed in the article on
permanent supportive housing and
excluded here. Other housing models
for individuals with substance use
disorders that do not require total ab-
stinence as a requirement for resi-
dence (for example, `wet houses" or
,•damp houses^) were awkided from this
review because they are associated
with Housing First models. Residen-
tial treatment and therapeutic com-
munities are covered In a review of
research on residential treatment for
substance use disorders in this series
(9). Also excluded were articles about
shelters or other housing -only options
without a recovery focus, We excluded
studies that used only a pre -post
bivariate analysis or a case study
approach without comparison groups.
Also excluded were studies that solely
analyzed costs associated with the
service, because our focus was on
outcomes associated with clinical
effectiveness,
Mrongth of the evldenaa
The methodology used to rate the
strength of the evidence is described
in detail in the introduction to this
series (10). We independently exam-
ined the research designs of the studies
of recovery housing identified during
the literature search and chose from
three levels of evidence (high, moder-
ate, or low) to indicate the overall
research quality of the collection of
studies. Ratings were based on prede-
fined benchmarks that considered the
number of studies and their methodo-
logical quality. In rare instances when
natio were dissimilar, a consensus
opinion was reached.
In general, high ratings indicate
confidence in the reported outcomes
and are based on three or more RCTs
with adequate designs or two RCTs
plus two quasi -experimental studies
with adequate designs. Moderate
ratings indicate that there is some
adequate research to judge the ser-
vice, although it is possible that future
research could influence reported
results, Moderate ratings are based
on the following three options: two or
more quasi -experimental studies with
adequate design; are quesi-eapertmental
study plus one RCT with adequate
des; or at least two RCTs with some
methodological weaknesses or at least
three quasi -experimental studies with
some methodological weaknesses. Low
ratings Indicate that research for this ser-
vice is not adequate to draw evidence -
based oonchwous. Low ratings Indicate
that studies have wompertmentel designs,
there are no RCTs, or there is no more
than one adequately designed quasi-
experimental study,
We accounted for other design
factors that could increase or decrease
the evidence rating, such as hcw the
PSYCtR VJC SFIMCES t pe.psychWryontine,org • Muer 20(4 Vol, 65 No. 9
service, populations, and interventions
were defined; use of statistical meth-
ods to account for baseline differences
between experimental and comparison
groups; identification of moderating or
confounding variables with appropri-
ate statistical controls; examination of
-attrition and follow-up; use of psycho-
metrically sound measures; and indi-
cations of potential research blas.
Effectiveness of the saervlce
We described the effectiveness of the
seiAce--that is, how well the out-
comes of the studies met the goals of
recovery housing. We compiled the
flndings for separate outcome mea-
sures and study populations, summa-
rized the results, and noted differences
access investigations, We considered
the quality of the research design in
their conclusions about the strength of
the evidence and the effectiveness of
the service.
Res"
Level of evidence
A search of the literature revealed
very limited research in this area. No
meta-analyses or research reviews on
recovery housing were found. We iden-
tified five articles describing RCTs that
compared some version of recovery
housing to some control condition (4,
11-14) and one quasi -experimental
study with a within -group, repeated -
measures design. (I5). However, four
of the five articles describing RCTs
reported on the same base study;
therefore, only three distinct studies
on this topic met the Inclusion criteria.
All studies were conducted in the
United States. Features of the studies
and their findings are summarized in
Table 2.
The level of evidence for recovery
housing was moderate. There were
more than two RCTs of specific types
of recovery housing models, but they
had some methodological limitations.
Methodological flaws, such as missing
or inconsistent definition of program
elements and small sample sizes, were
prevalent and influenced the rating.
Because of the variability in how re-
mvery housing was defined, fidelity
rarely was discussed. The outcome mea-
sures varied across research studies and
included measures of substance use,
quality of life, and other outcomes. This
297
rabic s
Studies of recovery housing included in the review
Study design Outoomes
Study and population measured Summary of findings Comments
Randomized
controlled trials
Jason at al.,
Oxford House versus
2006` (4)
usual aftercare; no
exclusions noted
Jason at al.,
Oxford House versus
2007" (12)
usual aftercare; no
exclusions noted
Groh at al.,
Oxford House versus
2009' (l 1)
usual aftercare; no
mdusions noted
Jason at al.,
5011-(13)
Tuten at al„
2012 (14)
Quasi experimental
study
Pokfln et al.
5010 (16)b
Oxford House versus
usual aftercare; no
exclusions noted
Three groups: reoavery
house alone, recovery
house plus reinforcemant-
based treatment, and
usual caro; participants,
16-80 )ears old, were
opioid ole endent and
W oom ed medication -
assisted atoxifioatIoN study
excluded individuals
recem
medication, n,those
experiencing acute medical
or psychological illness,
and pregnant women
Sober living houses
associated with
outpatient treatment
versus freestanding sober
living houses; no
exclusions noted
These uncles repotted on the same overall study.
h
Also reported iu Polon at al., 2010 (9)
2"
Substance use,
criminal activity,
employment
Substance use,
criminal charges,
employment
Subeimce use,
oriminal aotivity,
employment
Substance use,
employment,
self-regulation
Abstinence
(opioid and
cocaine),
consistent
abstinence
Substance use,
Addiction
Severity Index,
psychiatric
3MPtOM3
At 24 months, Oxford House
group had significantly lower
substance use, higher
monthly income, and
lower incarceration rates,
Oxford House group had
signifioantly more positive
outcomes for each measure
over time (up to 24 months)
E5��
ars,omes
were noted,
Abstinence mi can
increasad for O�'ord
House group versus usual
care for those who had
high 12 -step involvement
For those with low 12 -step
involvement, abstinenoe rates
were similar across groups.
Individuals with posttraumatic
stress disorder (PTSD) in
usual aftercare had worse
self-ragulatton at 2 years
than those without PTSD
in either group. For those
with no PTSD, employment
rates were higher In Oxford
House group than in usual
aftercare, For those with and
without PTSD, relapse rates
were higher in usual aftercare
than In Oxford House.
Abstinence decreased
over dme for participants
in two recovery house
conditions and increased
over time for dross in
US" care condition,
with significant differences
between recove house
groups and usual Oars at
t3 months. Length of stay
mediated abstinence,
Significant decline in "peak
density" of drug use was
noted over 8 months in both
groups, Lav severity of aknlrol
and drug two at baseline was
either maintained or further
improved. Employment
significantly improved in both
groups. 12 -month outcomes
were similar to 8 -month
outcomes,
Brief report with little
detoll on methods or
parwwt
oharncteristics
Statbdcal controls for
demographic and
baseline characteristics
(no demogsaphlo
differences reported by
group); no information
sported on response
rates at follow-up
No baseline
sociodemographic
dif£ererc es; analyses
did not control for
oovariates
Small sample of
participants with
PTSD; required
employmentof
O e
o Haute
residents led to
somewhat biased
outcome; only self -
ren analyses
in uded covariates
inclusion and exclusion
criteria limited
genorslizability;
abstinence measured
only for opioids and
cocaine; urine samples
collected to complement
self-report
Self-selection into
housing and
daaracteriadcs of
clients in two groups
differed; some
evidence of recovery
success required
before entry into
sober living house;
thus some floor effect
for outcomes
PS1:glilli" t>a<ntfCZ 4 pa.psycbh&Y00DM,rr4 ♦ March 2014 VOL 65 No. 3
lack of consistency in models and out-
comes made it difficult to assess evi-
dence across programs, Most of the
studies did not distinguish among sub-
stances used by participants, but the
programs required abstinence at the
time of entry Into housing,
6f"ectivenesr of av service
Studies examining Oxford House
models for individuals with substance
use disorders showed positive effects.
In an ACP, ]aeon and colleagues (Vi -
13) recruited individuals who were
completing residential substance use
treatment and randomly assigned
them to Oxford House or to treat-
ment as usual (for example, outpatient
substance use treatment, aftercare, and
mutual help). The researchers, who
are long-term collaborators with Ox-
ford Houses, facilitated Oxford House
entry by identifying those with open-
ings for new residents and assisting
with the application process. Two
years after entering the Oxford
House, individuals had significantly
less substance use, more employ-
ment, and higher incomes than those
who received usual care. Further,
longer stays in an Oxford House were
related to better outcomes; this was
particularly true for younger OxfiDM
House residents, who bad better out-
comes if they stayed at least six months.
Researchers also found that among
individuals with co-occurring post-
traumatic stress disorder who were
randomly assigned to an Oxford House
or to treatment as usual, individuals in
the treatment -as -usual oondition bad
lower levels of self-regulation com-
pared with those in the Oxford House
condition (13). Replication of this study
is warranted because it used small sam-
ples. Oxford House residence com-
bined with involvement in a 12 -step
program had a positive effect on self-
report of abstinence over a 24 -month
period (11).
Tuten and colleagues (14) exam-
ined drug abstinence outcomes of
individuals who were randomly as-
signed after opioid detoxification to
a recovery home with a reinforcement -
based outpatient treatment condition,
a recovery home only condition, or usual
care (that is, aftercare referrals and
community-based resources). They
found that the groups had sdgnifl-
Evidence jiff dw qfectivene of
recovery lrnorousing: moderwe
Areas prand a10" usen� ed by overall positive resale:
Drug
• Employment
' Payr]Uatzic symptoms
cantly different rates of abstinence at
the one- and three-month follow-up as-
sessments; those in the recovery home
with reinforcement -based outpatient
treatment had the highest rates of ab-
stinence, and those in the usual -care
condition had the lowest rates of ab-
stinenoe. Individuals in the recovery
home with reinforcement -based out-
patient treatment remained signifi-
cantly more likely than individuals in
the usual -care condition to abstain
from opioid and cocaine use at the six-
moath follow-up aysessmeot, In a dngfe-
group, repeated -measures study of
individuals receiving outpatient treat-
mont combined with residence in a
sober living house. Polcin and col-
leagues (15) found improvements at
six months postbasellne on measures
of alcohol and drug use, arrests, and
days worked, Significant declines in
alcohol and drug use were maintained
at 12 months postbssellne, and no sig-
nificant increases in alcohol or drug
use were found at 18 months,
Discudon and concladom
This review found a moderate level of
evidence for the effectiveness of re-
covery housing (see box on this page).
Findings in the literature suggest that
recovery housing can have positive
effects on many aspeds of recovery
and that this service has an Important
role to play in supporting Individuals
with substance use disorders, This re-
commendation is tempered by the fad
that the six articles Identified through
the hterature review represented only
three distinct studies. Further, these
studies had methodological limitations,
Lndudingattrition, nonequivalent groups,
small samples, single -site evaluations,
and lack of statistical controls.
With limited literature, it is difficult
to draw conclusions across studies;
however, these studies highlight areas
of recovery housing that have policy
and practice Implications. It should
PSYGI&Tff SEUICES 4 ps,psychiatryonme.om ♦ March 2014 VOL 65 No. 3
�-4
be noted that with an abstinence re-
quirement for entering housing, there
is often a floor effect. That is, when
participants have very low substance
use at baseline, it is unlikely that fur-
ther improvements over time will be
found in substance use measare&—
a traditional outcome in studies of
substance use disorders. Rather, out-
come measures are likely to reflect
maintenance of abstinence or limited
substance use over time. Changes in
employment and criminal activity in-
stead may be the key outcomes.
Two studies indicated that out-
comes were better with longer stays
In the recovery house (12,14). In ad-
dition, several studies indicated that
success In the recovery house may also
depend on other client characteristics,
such as involvement in a 12 -step pro-
gram, age, or a diagnosis of posttrau-
matic stress disorder (11-13). 'These
differential effects should be exam-
ined further, and it is likely that other
variations in outcomes may be identi-
Red in additional studies.
The primary recommendation for
future research is for methodologically
rigorous randomized or nonrandomized
controlled trials that are conducted
with larger samples and across multi-
ple sites. Further, several of the studies
(for example, studies of Oxford House)
were conducted by researchers who
were collaborators. In most cases, the
conditions were not blind to the inter-
viewers
nterviewers or the evaluators. Because these
issues may lend themselves to bias, ex-
ternal evaluations would also be an im-
portant next step. The research in this
area woukl benefit from more consistent
appuvadies that would faralldate better
crow,comperisons and meta-analyses.
We identified other topics for
future research, In addition to the need
for greater methodological rigor, The
effects of recovery housing on long-
term recovery in multiple domains of
functioning should be examir;9d. For
2"
example, the literature should focus
on improvements in psychiatric symp-
toms and substance use and severity
that extend beyond housing and
quality -of -life outcomes. Further stud-
ies of approaches to recovery housing
for individuals with substance use dis-
orders should be undertaken to deter-
mine whether models other than the
Oxford House approach are valuable.
Also, evaluation of which organizational
and stnietmal aspects of sober living
houses are effective would help with
program development and clarity in
defining the :recovery housing model.
Finally, It is Important to assess
retxa+ery housing for specific subpop-
ulations (for example, by diagnosis,
age, sex, and Immigrant status), Most
studies described participants' demo-
graphic characteristics, and some
studies controlled for these character-
istics In their analyses. However, few
studies specifically analyzed race or
ctfrnicity through interaction terms,
stratification, or other approaches, As
with any consideration of individual
fives and successful recovery, it is
essential to consider subgroup differ-
ences. 'Ibis may be important partic-
ularly when we consider how people
five, interact, or incorporate their
cultural beliefs and backgrounds—
key concerns when evaluating the
role of housing. These characteristics
may affect willingness to live inde-
pendently or in group settings, for
example, and they may also affect the
roles of staff` or residents in managing
aspects of recovery. Preliminary re-
search is beginning to examine ap-
proaches to adapt features of recovery
homes to better meet the cultural
needs of specific racial -ethnic popula-
tions (16). However, more research Is
required to explore the effectiveness
of these adaptations. We encourage
future researchers to evaluate whether
certain approaches are as successful for
a variety of subgroups as they are for
the broader population.
Recovery housing has value as part
of the full spectrum of options that
support recovery from substance use
disorders. however, a key issue for
300
recovery housing as a service is funding.
In most uses, recovery housing does
not include formal therapeutic treat-
ment; therefore, it is not reimbursable
by public or prate insurance, Rather,
recovery houses aro often supported by
charitable donations and contributions
from the residents. Palley makers, in-
cluding payers (for example, directors
of state mental health and substance
use treatment systems, administrators
of managed care companies, and county
behavioral health administrailn n), must
consider alternative mechaalsms that
would support recovery housing as
they determine how best to incorpo-
rate this approach Into a full contin-
uum of care, Consumers will benefit
from increased access to sober living
opportunities as a long-term step to-
ward a life in reoovery in the commu-
nity, Future rigorous research on this
service will improve our ability to
target the consumers who would re-
oeivu the most benefit.
Aaknowledgmersts and disclosures
Development of the Assessing the Evi-
dence Base Series was supported by con-
tracts HHS52832007000281/HHSSP834800Kr,
HHSS283200700006VHHSS28342003T, and
HHSS=2W700D17L4IHSS2830000IT from
2010 throu8h 2013 from the Substance Abuse
and Mental Health Services Administration
(SAMHSA), The authors acknowledge the
conMbutlons of Tion Thomas, M.S,W„ Kevin
Malone, B.A., and Suzanne Wields, M.S.W.,
from SAMHSA, John O'Brien, M.A., from the
Centers for Medicare bt Medicaid Services;
Garrett Moran, Ph.D,, from Westat; John
Easterday, Ph.D., finch Lee, Ph.D.. Rosanna
Caffey, Ph.D,, and Tami Mark, PLD„ from
Truven HealthAualyticsj and AmityQutnn, M.A„
from Brandeis University. The views expressed hn
this .stole are those of the authors and do not
neoessadly repraamt the views of SAMHSA,
The anthors report no oompedng interests.
ltefersncss
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8, Rog DJ, Marshall T, Dougherty RH, at aL
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11. Groh DR, Jason LA, Ferrari )R, at al:
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18 Jason LA, Olson BD, Ferrari JR, at A An
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and abstinence. North American joumal of
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14, Tutea M, Defullo A, Jones HE, at al:
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15, Pololn D, Korcha R, Bond J, at al; Re.
covert' from addiction In two types of sober
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18. Contreras R, Alvarez J, D4pV J, at al; No
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PSYC MAIC Sf3MMS • ps psychiatryoa e.org 4 March 20[4 VoL 65 No. 5
-SS-
ATTACHMENT 6
Assessing the Evidence Base Series
Residential Treatment for
Individuals With Substance Use
Disorders: Assessing the Ndence
Sharon Reif, Ph.D.
Preethy George, Ph.D.
Lisa Braude, Ph.D.
Richard H. Dougherty, Ph.D.
Allen S. Daniels, Ed.D.
Sushmita Shoma Ghose, Ph.D.
Miriam E. Delphin-Rittmon, Ph.D.
O titer Residential treatment is a commonly used direct intervention
eople with substance use dls-
for individuals with substance use or co-ooeurring amental and substance
orders have a wide variety of
use disorders who need structured care. Treatment occurs in nonhospital,
needs across the range of symp-
lieemsed residential faodWes. Models vary, but all provide We housing and
tom severity, To address these needs,
medical care in a 244our recovery environment. 'ibis article describes
a continuum of care that includes in -
residential treatment and assesses the evidence base for this service.
tensive treatment services is in place.
HOOROw Authors evaluated research reviews and individual studies fiiom
Recognition is growing that safe and
1995 dwough 2012.11hey searched major databases: PubMed, PsycINFO,
stable living environments are impor-
Applied Social Scienoes index laid Abohmets, Sociological Abstracts, and
tent in the recovery proms for indi-
Social Services Abstracts. 'They chose from three levels of evidence (high,
victuals with substance use disorders
moderate, and low) and described the evidence of service effectiveness.
who need st mdured care. Residential
Renault.: on the basis of eight reviews and 21 individual studies not included
treatment is a structured, 24 -boor level
in prior reviews, the level of evidence for residential treatment liar sub•
of care that enables a £)cors on in-
stance use disorders was rated as moderate. A number of randomized
tensive recovery activities. It alms to
controlled rials were identified, but various methodological weaknesses in
help people with substance use disor-
study designs --primarily the appropriateness of the samples and equina-
ders and a high level of psychosocial
lenoe of oomparison group.* -decreased the level of evidence. Results for
needs become stable in their rmovery
the effectiveness of residential treatment compared with other types of
before engagement in outpatient set-
treabnent for substance use disorders were mored. Findings suggested ei.
tings and before return to an un.
ther an improvement or no difference in treatment outcomes. Cortotinkme:
supervised environment, which may
Residential treatment for substatwe use disorders shows value and merits
otherwise be detrimental to their re.
ongoing consideration by policy makers for inclusion as a covered benefit
emery process, This article describes
in public and commercially funded plans. However, research with greater
residential treatment and assesses the
spedfidty and wmistency is needed (P*dch aMc Semites 815:301-312,
evidence base for this service.
2014; dolt 10.1178/appi.ps.201300542)
This article reports the results of
a literature review that was undertaken
as part of the Assessing the Evidence
Dr. Bois with the lwtitute for Behavioral Health, Heller School for &xil:a Poitoy and
Base Series (see box on next page). For
Management, Brandeis Unftwrwy, Waltham, Mwndwsetia, Dr. George, Dr. Daniels,
purposes of this series, the Substance
and Dr. Chow ars uAth Westar. Poakr>&, Maryland. Dr. Braude and Dr. Dougherty am
Abuse and Mental )health Services
with DMA Heath Sirnregin, Lexington, Masswhusetts. Dr. Delphha-Ritown is with the
Administration (SAMHSA) has de.
Of W of Polley, Planning, and innovation, Substance Abase and Mental Health 5e+vtoes
scribed residential treatment for sub-
AdrWriOwdim (SAMHSA), Aoc�n.;tlle, Maryland Send oormspondenm to Dn Gwrge at
preet}tyge wseat.con This literawm mxew is part of a series that wW be published in
stance use disorders as a direct service
Psyd Aabw Services over the twit several montthe. 77m nmia m were caonm iniorW by
with multiple cum nents that is de-
po
livered in a licensed facility used to
SAMIMA through a contrast u*h 7 ttjwn Health Analytics, The rm*Am wen conducted by
experts in each topic area, who wrote the neuieue along with authors fiam Trueen Health
evaluate, diagnose, and treat the symp.
Andytim, "W'eatat, DMA Health Stmoglea, and SAM118A. Each snide in the aerie.: was
toms or disabilities associated with an
peer reotewed by a spwW panel of Psychiatric Services reegew .
adult's substance use dbroder. SAMHSA
PSMUTAIC SEMMS 4 pe.Wchtatryonllne.ocv 4 March 2014 vol. 65 Nu, 3
Abort the ABB Series
The Assessing the Evidence Base (AEB) Series presents literature reviews
for 13 commonly used, recovery -focused mental health and substance use
services, .Authors evaluated research articles and reviews specific to each
service that were published from 1995 through 2012 or 2013. Each AEB
Series article presents ratings of the strength of the evidence for the service,
descriptions of service effectiveness, and recommendations for future
implementation and research. The target audience includes state mental
health and substance use program directors and their senior staff, Medicaid
staff, other purchasers of health care services (for example, managed care
organizations and commercial insurance), leaders in community bealth
organizations, providers, consumers and family memhers, and others
Interested in the empirical evidence base for these services. The research
was sponsored by the Substance Abuse and Mental Health Services
Administration to help inform decisions about which services should be
covered in public and commercially funded plans. Details about the
research methodology and bases for the conclusions are included in the
introduction to the AEB Series (8).
has defined three levels of clinically
managed residential services. All provide
24-hour care, but they u&r treatment
with varying intensity and focus depeud-
ing on the readden fs needs, Table 1 pres-
ents a description of the components of
this service.
5waination of the effectiveness of
residential troahnent for people with
substance use disorders and for various
subgroups is challenged by lack of a dear
definition of service metlxhds, treatment
duration, and treatment standards. The
ohjectKw of this review were to describe
models and components of residential
treatment for substance ace disorders,
rate and discuss the level of evidence
(that is, methodological quality) of
eadsting studies, and describe the ef-
fectiveness of the service on the basis
of the research literature, We focus on
treatment for substance use disorders,
although individuals in treatment may
also have co-occurring mental disor-
ders, Effectiveness studies primarily
compared residential treatment .for
substance use disorders to other levels
of care (for example, intensive out-
patient treatment), Outcomes mea-
sured included drug and alcohol use,
prychiattic symptoms, and other mea-
sures of psychosocial functioning.
Description of
resklentfal treatment
Residential treatment for substance use
disorders is a setting in which services
occur, rather than a discrete treatment
intervention, Avariety of therapeutic
interventions may be implemented
across different residential treatment
settings, however, a common defining
characteristic of residential treatment
is that it provides housing for individ-
uals who are in need of rehabilitation
services.
Residential treatment occurs in non-
hospital or freestanding residential
facilities. Treatment for substance use
disorders typically takes place in facil-
ities that are licensed by each state's
Single State Agency for Substance
Abuse Servlces, Residential treatment
is part of the primary rehabilitation
phrase of treatment arc! may be pre-
ceded by detoxifioadon, if warranted.
Residential treatment should be fol-
lowed by less intensive treatment and
aftercare services within a continuum
of care. A separate article in this series
addresses Intensive outpatient pro-
grams for substance use disorders (1).
Residential treatment for substance
use disorders is used for a wide range of
populations with a range of sociodemo-
graphic d aatorisHcs. For example,
residential triatrnent is appropriate for
individuals who have co-occurring men-
tal and substance use disorders because
of the challenges associated with having
multiple disorders and their common
need for intensive treatment iu a safe
environment. Residential treatment is
also appropriate for individuals who are
homeless, parttaulruly because of the en-
vironmental challenges of achieving
and maintaining sobriety or other as-
pects of recovery without stable housing,
The American Society of Addiction
Medicine (ASAM) has spearheaded the
complex task of developing specifications
for addiction treatment at various levels
of care and criteria to identify which
indivkh;als are most appropriate for
which types of services (20). The ASAM
patient placement criteria (ASAM PPG
2R) (2) consist of six dimensions;
intoxicationftvithdrawai, medical conch -
tions, mental health conditions, stage
of changdmotivatiou, recovery/relapse
risks, and the recovery environment,
Assessments on these dimensions are
often used to place people into the
level of care that matches their partic-
ular needs and provides a framework for
treatment planning.
The ASAM PPC -2R (2) states that
"the defining characteristic of all f resi-
dential] Level III programs is that they
serve individuals who need safe and
stable living environments in order to
develop their reouvery skills" Individu-
als are considered appropriate for
residential treatment, in particular,
if they demonstrate a need for medical
care, safe and stable housing, or a struc-
tured 24-hour recovery environment,
Residential treatment services include
a Live-in setting that is housed in or
affiliated with a permanent facility;
organbadon and staffing by addiction
and mental health personnel; a planned
regimen of care with defined policies,
procedures, and clinical prot000ls; and
mutual- and self help group meetings,
The ASAM criteria informed the
service -level definitions that are pre-
sented in Table 1, Residential treat ant
programs have specific programmatic
and staffing requirements from the
states in which they are licensed, which
frequently (but not always or wholly)
coincide with ASAM criteria.
ASAM describes most residential
programs as clinically managed, mean-
ing that they have a structured envi-
ronment with skilled treatment staff
but no on-site physician, individuals
are recommended for residential dare
if their withdrawal and biomedical
needs are minimal, meaning that they
did not experience acute withdrawal
symptoms or they have already con-
cluded the physical withdrawal process
and no longer have a health risk related
to withdrawal. Residents may have
PSYCHIATRIC SERVICES ♦ pe.psyahlatryonJlne.org 4 Much 2014 Vul, 65 No. 3
moderato psychiatric and general med-
ical needs and significant challenges
In the areas of treatment readiness,
relapse potential, recovery skills, and
environmental stability. The length )f
stay in nonhospital residential treat-
ment has shortened considerably over
time; most planned stays now range
from weolts to months, depending on
the program and the person's needs,
Most studies of residential treatment
use an acute care model in which
outcomes are evaluated after treat-
ment, rather than a chronic care model
inwhich outcomes are evaluated during
ongoing treatment --as is the case for
a chronic condition such as hyperten-
sion or other medical cornorbidity (4).
Evaluations of treatment effeedveness
for chronic disorders take place during
the continuing care phase of treatment
while patients are still rmniving sup-
portive cars (albeit while living in the
community), and permanent change is
not expected in the absence of ongoing
care. A oontinuum-oftcene model for suh-
staum use treatment is critical whereby,
after completion of residential treat -
merit, participants are engaged continu-
ously In less intensive forms of treatment
to promote smooth transitions to self-
management in the community (5,6).
Residential treatment models vary
widely and have evolved over the years,
this evolution presents challenges to
efforts to compare research outcomes.
The traditional "Minnesota model' was
a planned M -day residential treatment
approach that is fairly rare today, as is
the traditional hospital inpatient pro-
gram with which residential treatment
frrgrrently has been compared.
A specific type of residential treat-
ment setting is a therapeutic commu-
nity. Therapeutic commurildes and
other social model programs generally
have a consistent approach, in which
all aspects of the residential commu-
nity are used as part of the treatment
experience. The National Institute
on Drug Abuse dofines care within a
therapeutic community as provided
24 hours per day in a nonhospital
setting, with planned lengths of stay
of six to 12 months. Treatment focuses
on social and psychological causes and
consequences of addiction. Treatment
is structured and comprehensive, to
"focus on the 're -socialization' of the
individual and use the program's entire
Table 1
Description of residential treatment for substance use disorders
Feature Description
Service definition Residential treatment for individuals with substance use
disorders Is a direct service with multiple components
delivered in a licensed facility used to evaluate, diagnose,
and treat the symptrwms or disabilities associated with an
adult's substance use disorder.
Levels of service intensity;
Low, Clinically managed, low -Intensity residential servicos
provide 24-1hour supportive cane in a structured environment
to prevent or minimize a person's risk of relapse or continued
substance use. 'Phis level of caro may include services such as
interporsonal and group -living skills training, individual and
group thorapy, and intonshv outpationt Uvatmunt.
Medium; Clinically managed, modium-intensity residential
services provide 24-hour care and treatment for persons with
co-ocrourring substance use and mental disorders who also
have significant temporary or permanont cognitive deficits.
This Ievel of care includes services that are slowly paced and
repetitive; services that are focused primarily on preventing
rolaE , continued problems, or continued substance use; awed
services that promote reintegration of the person into the
community,
High; Clinically managed, high-tntenstty residential services
provide 24-hour care and treatment. This level of care is
designed for persons who have multiple deAcits that prevent
recovery, such as criminal activity, psycholo cal problems, and
Impaired functioning. This level of care incudes services that
roduoo Oho risk of Ayse, reinforce prosodul behaviors, assist
witb healthy reintegration into the community, and prnvide
skill building to address functional deficits.
Service goal Provide individuals with safe and stable living environments in
which to duvolop their recovery skills and aid in their
rehabilitation from substance use disorders
Populations individuals with substance use disorders; individuals with
co-occurring mental and substance use disorders; individuals
who are homeless
Settings for service Nonhospital residential facilities; therapeutic communities
delivery
community—including other residents,
staff, and the social oontext—as active
components of treatment . , , [in] de-
veloping personal accountability and
responsibility as well as socially pro-
ductive lives" (7). A social model
residential approach is similar to a
therapeutic community.
Leaders in substance above and men-
tal health policy arenas r",d information
about the effectiveness of residential
treatment for substance use disorders as
they determine which interventions
should be included as oavered bmAts in
public and commercially finxled health
plans and as they make nolicy decisions
P5Y'CiIIATM SWCES t ps.psychiatryonllnaorg 0 March 2014 VoL 65 No. 3
415-Q"--
about treatment interventions. This re-
view aimed to provide state beha*ral
health directors and their staff, purchas-
ars of health services, policy otilcials, and
community health care administrators
with an accessible summary of the
evidence for residential treatment for
substance use disorders and a discus-
sion of areas needing further research,
Methods
Search strategy
To provide a summary of the evidence
for and effectiveness of residential
treatment for substance use disorders,
we conducted a literature search of
articles pubhshexd from 1985 through
2012. We searched major databases;
PubMed (U.S. National Libiwy of
Medicine and National institutes of
Health), PsyoINFO (American Psy-
chological Association), Applied So-
cial Sciences Index and Abstracts,
Sociological Abstracts, and Social
Services Abstracts. We used combi-
nations of the following search terms:
residential treatment, substance use,
substance abuse, dual diagnosis,
Inclusion and exclusion cHterla
The following types of articles were
Included: randomized controlled trials
(RCTs), quasi -experimental studies,
and review articles such as meta-
analyses and systematic reviews; U.S,
and International studies in English;
studies that focused on residential
treatment for adults with substance
use disorders or co-occurring mental
health and substance use disorders;
and studies that included outcomes
such as measures of substance use.
Studies were excluded that exam-
ined residential treatment solely with
adolescent populations and that ex-
amined residential treatment in crim-
inal justice settings, Clients treated
within the criminal justice system are
likely to have other motivators for
success (for example, to remain out of
jail or prison), and thus the services
and outcomes examined in these
studies are not directly comparable
to residential treatment services and
outcomes examined elsewhere, Also
excluded were studies that focused
only on cost-effectiveness, did not
have a comparison group, measured
only length of stay or other ofleTts that
occurred (during treatment, or used
only pre -post analyses without statis-
tical controls for baseline differences.
Existing review articles wore given
priority in this summary of the evi-
dence. Individual articles are detailed
here only if they were not previously
included In a published review,
Stmn,gtb of the evidence
The methodology used to rate the
strength of the evidence is described
in detail in the introduction to this
series (8). The research designs of the
identified studies were examined to
determine that they met the inclusion
criteria. Three levels of evidence (high,
moderate, and low) were used to
indicate the overall research quality
of the collection of studios. Ratings
were based on predefined benchmarks
that took int:) account the number of
studies and their methodological qual-
Ity, In rare instancos when the ratings
were dissimilar, a consensus opinion
was reached,
in general, high ratings indicate
confidence in the reported outcomes
and are based on three or more RCTs
with adequate designs or two RCTs
plus two quasi -experimental studies
with adequate designs. Moderate ratings
Indicate that there is some adequate
research to assess the service, although it
is possible that future research could
Influence reported results. Moderate
ratings are based on the following three
options: twv or more quest -experimental
studies with adequate design; one quasi-
experimental study plus one RC1' with
adequate design; or at Ieast two RCTs
with some methodological weaknesses
or at least three quasi-expeArrw ital
studies with some methodological weak-
nesses. Low ratingi indicate that re-
search for this service is not adequate to
draw evidence -based conclusions, Law
ratings indicate that studies have non -
experimental designs, there are no
RCTs, or there is no more than one
adequately designed quasi -experimental
study.
We accounted for other design fao-
tors that could increase or decrease the
evidence rating, such as how the ser-
vice, populations, and interventions
were defined; use of statistical methods
to account for baseline dgerenoes be-
tween experimental and comparison
groups; identification of moderating or
confounding variables with appropriate
statistical controls; examination of attri-
tion and follow-up; use of psyuhomet-
Acally sound measures; and indications
of potential research bias, The evidence
was rated as stronger when service and
population definitions ware clear and
appropriate, htatistical controls were
used to account for baseline differ-
ences, and potential confounding vari-
ables and research bias (including
attrition) ware minimized.
4 ectiveness of the service
We described the effectiveness of the
serviexr---that Is, how well the outcomes
of the studies met thepals of residen-
tial treatment, We compiled the fhud-
ings for separate outcome measures
and study populations, summarized the
results, and noted differences across
investigations. We evaluated the quality
of the research design in our conclu-
sions about the stmugth of the evidence
and the effectiveness of the service.
Although meta -analytic techniques
would be valuable to assess the evi-
dence across studies, the wide hetero-
geneity of the studies precluded this
approach.
Results and discussion
Overall, we found a moderate level of
evidence in the literature for the
effectiveness of residential treatment
for substance use disorders. Numerous
RCTs and quasi -experimental studies
were identified, but there were marry
methodological challenges within these
studies. However, on the whole, the
reviews and Individual studies that
were conducted found that residential
treatment is an effective service for
some typos of patients, The level of
evidence and the effectiveness of the
service are described further below.
Level of evidence
The literature search identified eight
research reviews published since 19M
that largely overlapped in the studies
they included. The reviewed studies
focused on adult participants with co-
occurring mental and substance use
disorders ($-11), inpatient populations
(12,19), and therapeutic communities
(14-16). We further evaluated seven
Individual RCTs that compared some
version of residential treatment to a
control condition (17-23) and 14 quasi-
experimental studies (24-37). Table 2
and Table 3 summarim the features of
the studies included in this review and
their findings. The level of evidence for
residential treatment for substance use
disorders was graded as moderate, be-
cause this service met the criteria of
having two or more RCTs with meth-
odological weaknesses.
The studies lacked rigorous exper-
imental design or quasi -experimental
methods that controlled for patient
characteristics. A focus on selected pop-
ulations (for example, male veterans)
and on a limited number of treatment
sites limited the generalizability of sev-
errii shrdies. Most effectiveness studies
PSYCEUAM SBRWCFS ♦ pe.psychlatryonllne.org 4 March 2014 Vol. 65 Vo. 3
i�
Y
�.;
I it 1 11 1, 1
N
CP
c- cB r
P3YCHI TIUC SERVICES 4 p&pridilwtryonline ors 4 Mamh 2014 Vol, 65 No. 3
r;
rable 3
Individual studies of residential treatment of substance use (!,orders included in the review'
Study
RGT
Burnam
at al., 1986
(17)
McKay at al„
1"5 (21)
Gu ishatal.,
ti88 (20),
Guyfth etal.,
1998 (19)e
Rychtadk
at al., 2000
(22)
Creonwood
at al., 2001
(28),
Witbrodt
of al., 2007
'23)
Design
and population
Social model residential versus
social model nonresidon-
Gal versus no intervention,
horneloss individuals had a
dual diagnosis of substance
dependence and either
schizopphrenia or now aF
R)ottvo d)snrder, mostly male
VA inpatient addiction reha-
bilitation versus VA dayy
treatment; mato alcohettc
veterans; excluded those
with unstable residence,
drug dependence, some
medical problems, recent
psychosis, schizophrenia
Therapeutic community ver-
sus therapeutic community
model day treatment; ex-
cluded homeless individuals,
those with severe psychiatric
problems, hose clinically
judged appropriate only
for residential treatment
Therapeutic community ver-
sus therapeutic community
model day treatment; ex-
cluded homeless individuals,
those with severe nrhiatric
jmblems, those clinicall
udged appropriate only for
residential treatment
Freestanding residential ver-
sus intensive outpatient ver-
sus outpatient treatment;
partici with alcohol use
disorders; excluded home-
less individuals, those with
addiction treatment in pant
30 days, those with serious
psyclriatrio symptoms
11orapeutie community versus
therapeutic community
model day treatment; ex -
eluded homer individuals,
those with severe psychiat-
ric probierns, those ohnk*by
judged appropriate only for
rostdentlal treatment
Social model residential ver-
sus social model day hos-
pital; also oxamined chants
not randomly assigned to
each setting; part of health
plan system; no random as-
signment if individual had
filo environmental risk for
res se or more than min-
imal medical or psycholog-
ical problems
Outcomes
measured Summary of findings Comments
Substa" use sorority of At 3 -month follow-up, no
mental !lines symp
group differences were
homsing,
toms, housing
found except for
residential treatment hatl
a positive effect if the anal-
ysis also accounted for ser-
Aws received outside the
RC.T,
SubAanco use, other
No main effects were found
problems
across groups.
ASI composite scores,
psychtatrle symp-
toms, social support
A81 composite scores,
psychtattio ma
social support
o
Abstinence, substance
use
Substance use
A dnenoe
Both groups improved in
employment, legal prob-
lems, substanoe use prob-
lems, and depressive
symptoms, Residential
treatment participants
also improved in medical
and social problems, psy-
chiatrio symptoms, and
social support.
Both groups improved over
time, Those in residential
treatment had better ASI
social composite scores
and fewer prychological
symptoms.
Abstinence improved across
rups. Interactions were
ound for setting for those
with higher alcohol i nvoke-
mont and poorer cogni-
tive functioning at baseline;
they showed more Improve-
ment in a residential setting,
Abstinence Improved in both
groups. The day treatment
group had a higher relapse
rate at 6 months but not at
12 or 18 months.
Abstinence was noted for
about two-thirds of each
group at 6 months. No
difference was found by
setting, in adjusted models
for either randomly as-
signed or self-selected
(not randomly assigned)
ollents.
Contamination with outsido
services was noted, al-
though outside service use
was tracked. Differential
participation rates and
high attrition were also
uotod.
The groups were not oquiv-
alent despite statistical
controls, and many exclu-
sions criteria were used.
Excicrsiow eliminated many
individuals Wmly to be most
appropriate for residential
treatment Hi&h dropout
was noted in the 2 weeks
after randomization,
Exclusims eliminated many
individuals likely to be
most appropriate for resl-
deniial treatment High
dropout was noted in the
2 weeks after randomizatIm
Few differences were notexi
between groups at baseline.
Exclusions eliminated many
individuals lilmly to be most
appropriate for residential
treatment.
Exclusions eliminated many
individuals likely to be most
appropriate for residential
treatment, high dropout
was noted in the 2 weeks
after randomization,
Significant difiuronces were
found across groups in var-
ious measures of severity,
The authors adjusted for
these unaurers in regression
models. Diffesnmtial attrition
was noted at folknv-up.
Gontinuea on next page
PSYCMTRIC SMMCHS ♦ ps,psychiatryonllne,QM 4 March 2014 Vol, 65 No. 5
Table 3
Carhnued from previous page
Design Outcomes
Study and population measured Summary of findings Clomments
Quasi-
experimental
Mous et al.,
1896 (33)
Hsor of al.,
1988 (27°
VA community-b&wd residen-
tial versus VA hospital -bawd
residential; male veterans
discharged from acute in-
paticut care for substance
use disorders
Short-term inpatient and long-
term residential versus out-
pationt treatment; DATOS
study: patients treated in
participating community
treatment programs
In Vent readmission
(for mental or sub-
stance use disorder)
Substance use
Harrison and Inpatient, mostly Minnesota Abstinence
Asehe, model, and a few thera-
1988 (28) peutle oommun 866 vonrus
vu ationt; excluded those
vel cognitive Impairment
that precluded consent
Pettinati
et al., 1989
(35)
Schildhaus
of al., 2000
(36)d
McKay et al.,
2002 (31)
Inpatient versus outpatient;
alcohol-depondont but not
drug do ndent patients;
excluded those with sovero
withdrawal or serious med-
ical problems
Residential (mostl� therapeu-
tic communities, versus in-
patient treatment; SROS
study; participants treated
in community treatment
facilities
'Fill continuum' of residon-
tinl bofere outpatient treat-
ment versus "'partial
continuum" of intensive
outpatient treatment as
entry point; no exclusions
noted
Mojtalnu and Residential (mostly therapeu-
Zivin, 2003 tic communities) versus In -
(32)d patLsnt and outpatient, SRO.S
study: participants treated
in community treatment
facilitta9
Drinking status
Substance use, criminal
behavior
Substance use, ASI
composite scores
Abstinence, substance
use
A lower probability of read-
mission was noted for par-
tiotpunts in community
residontial rogrsms com-
pared with Lospital-based
programs.
Inpatient and residential pro -
gems were best for non -
dally cocaine and heroin
users.
No difference in abstinence
was found by group.
No effect by group was found
on return to significant
drinking, Survival analysts
showed a steeper initial
rate of return to drintdng
for the outpatient group.
No difference in outcomes
was found for participants
in residential and Inpatient
settings,
Both groups improved over
time on all otitcomes. A slg-
nificant auvortty x modality
interaction was found, wish
larger improvements for
those with h6gh alcohol se-
verity scores In the fill! con-
thwum compared with tlttrso
in tho partial continuum.
Overall, no dtfferenee was
found between residential
and ou tient treatment.
Some effects were seen
with propensity score
matching.
Hser at al., Residential versw outpatient Treatment success (in-
Those In residential treat -
2004(28) treatment without metha- eludes drug use, ASI
ment were more likely to
done; no exclusions noted drug sovority scorn,
oompk o treatment and
criminal activity, rest-
had longer stays, which
dvneo in community)
in turn predicted bettor
outcome.
PSYCHIATRIC SERVICES ♦ ps.psyclaWtryoeNne,ors • March 2014 Vol. M Wo. 3
y- (p2-
Baseline differences between
groups were found for psy-
chiatric diagnosis and In-
patient care but not for
demographio characteris-
tics. Additional treatment
was documented only if
received in VA.
There was no control for
basolino patient charac-
terlStiCS aside from pre-
treatment drug use. Data
were collected after I week
In treatment, which intro-
duced potential blue by ox-
cluding _early dropouts.
Group dtfferencus worn noted
in sooiodemotraphic char-
acteristics. Analyses con-
trolled for many baseline
variables, but group place-
ment was based on very
different individual
oharacteristics.
Analyses controlled for base-
line severity but no other
patient characteristics.
This 5 -year follow-up study
controlled for many vari-
ublos before, during, and
after troatmant using ret-
rospective data
Basoline differences were
noted between groups,
including severity soeres.
Croups had differentlal
Imus with rocniltment.
High attrition was noted.
This 5 -year follow-up study
used a propensity some
approach to control for
baseline characteristics,
but control for other
characteristics duringg
follow,up, such as ad-
ditional treatment, was
unclear.
This shady used path analysis
with stat!stical controls,
Nearly half of the sample
had mu ng data, and thoso
partcipants were axcluded
from analyses.
G'onitnuar on nest page
Table 3
Continued from previous page
Design Outcomes
Study and population measured Summary of findings Comments
Ilgon at al.,
2005 (_
Brecht et a1.,
5006 (24)
VA "in ationt" (Inpatient,
residential, or therapeutic
community—like domicil-
iary) versus "outpatient"
(outpatient or latenslve
outpatient); vetorans, no
substance abuse treat-
ment in past 90 days;
mostly male
Reeldontiat versus outpation
Abstinence; sidcide at-
tempts; ASI alcohol,
drug, and psyeholog-
ical cnmposito scores
t Methamphetamine use,
treatment as Usual; meth- criminal activity,
amphotumine users employment
Ilgen at al., Residential versus outpatient Suicidal behavior
2007 (29) community settings; no ex-
clusions noted
not of al, VA "Inpatient" (inpatient, Substance use severity
2007 (37)° rosldential, or therapeutto
commnnity-like domlctilary
treatment) versus "outpa-
tient' bWAtutent (outpatient
or interufve outpatient); vot-
erans; mostly male
De Leon I-nng-term teskl nod; inat&.ed Substarue use, arrests
at al„ 2009 undertmate d arrd overtreeted
(25)0 patient,; DAMS study, po-
tlnnts treated in participat-
ing c onununity treatment
programs
Morrows Integrated treatment for pa- Substance use, psychf-
et al, 2011 tients with schizophrenia atric symptoms
(34) and co-ocourrirg substance
use disorder In a residential
setting vorsus treatment us
usual; both groups recnult-
arl from Inpatient psychi-
atric hospitals and continued
with outpatient care; psy-
chotio disorder for at loast
5 }vara and substance use
disorder; aged 18-45 years
only
At 6 montlis, inpatient groups
had lower alcohol and drug
comportte mmm than artpa-
tlent groups. An interaction
effect was found such that
Individuals with R recent
suicide attompt were more
ilkely to be abstinent If
treated as inpatients.
Reduced methamphetamine
use and crime were meted
in the residential group, No
difference was found for
employment.
'1$e residential setting was
associated with fewer m cldo
attempts during treatment.
No difference between
groups was found to the
year altar treatment.
No main effect was found for
treatment setting. Some
small interaction effects
were noted; these with
it higher severity of sub-
stance use at baseline had
better outcomes In Inpa-
tient aril residential than
In out anent setting,,.
Patients hall better outcomes if
they were matched to res-
idential treatment than if
they were appropriate for
residential treatment but tui-
c6teatodin an outpatient
setting. Similar outcomes
were noted in residential
treatment if patiente were
matched or ovortroated (ap-
propriate for outpatient
treatment but treated in
a residontW setting).
At 3 months, the Intu$mted
residential group had re-
duced substance use, im-
P"'od psyahtahic sympicros,
and higher quality of life
and functlaning exrmpared
with 6. treatment -a, -usual
group.
Analyses controlled only for
baseline AST measures and
not for other patient char-
acteristics. Control vari-
ables wore not spocifiod,
"Inputient" combined sev-
eral very diffemnt types of
care.
Data were collected
retrospectively.
Baseline differences between
groups were noted, but
analyses used dtntistical con
trolls. Substance use out-
come was not measured.
Signifloant group differenoes
were notes{ at basahnn, but
regression models con-
trolled for them Dill'eren-
tial attrition and nonrosponse
bias were noted.
Data were collected after
1 week In treatment,
which introduced po-
tential Has by excluding
early dropouts,
No baseUne differences were
noted but differmW drop-
out
ropout limited analyses to 3
months. Some tentative
conclusions were drawn
for 6- and 12-muntb fellow -
ups. Dropout rates varied
between groups,
` Articles are in ehror nlogical order by typo of mrnareh design, Abbreviations: ASI, Addiction Severity Index; DATOS, Drug Abuse Treentmont Outcome
Study,, RGr, randomlmd controlled trial; SROs, Services Research Outeomm Study; VA, Veterans Affairs
k"" Articles with the same suparwript roportcd w no aspects of the same study.
described here evaluated patients modalttles for substance use disomlers treatment condition or to a lower level
who chose or were referred by clinl- were rare tx�trse treatment providers of Care than was elinimlly appropriate,
eians to a speoiflc treatment modality. had concerns about randomly assigning Some RCTs were conduoted with a
RCM that evaluated spedflo treatment individuals in need of treatment to a no- large limitation.- the researchers required
PftfiATiiit; SRMCELS ♦ ps.psychlatryonline.org 4 March 2014 Vol. 65 No. 3
Individuals in the intervention group
to be appropriate for the outpatient
care that was received by the com-
parison group, to avoid undertroating
individuals who might not be treated
safely if randomly assigned to out-
patient care. This design created a
false comparison, because individu-
als appropriate for residential treat-
ment (and thus not appropriate for
outpatient care) were excluded. Cli-
ents with more severe needs (for
example, individuals without stable
living arrangements or individuals
with general medical or psyohiat-
ric diagnoses) were often excluded
from the intervention group, de-
spite the possibility that they were
likely to benefit from residential
services.
Many studies that suggested im-
proved outcomes after residential treat-
ment were excluded from this review
because they lacked a comparison group
or used pro -post mesuremont without
statistical wntrols. Other methodolog-
ical concerns in the literature included
retrospective data collection, lack of
control for the amount of treatment
received, and lack of detailed de-
scriptions of the service components.
Comparison groups often varied by
chamoteristics of the setting (for ex-
ample, type of setting or treatment
duration) and by troatrnent content
(for example, services or theoretical
approach), thereby confounding the
comparisons, Each of these bmita-
dons influenced the conclusions that
could be drawn.
P ectiveness of the service
The effects of residential treatment
services were mixed, with some studies
indicating positive findings and others
showing no significant differences in
outcomes between clients in rosidoa-
Hal treatment settings and those in
other types of treatment. For example,
the Walden House residential thera-
peutic community was compared with
a therapeutic community model that
used a day treatment program (18-20),
At six months, both groups had reliable
improvement in drug and alcohol use
and employment, The Walden House
group also had significant improve-
ments in medical and social problems,
psychiatde symptoms, and social sup-
port, Most outcomesseen at six months
were maintained through 18 months
(19); the day treatment group had
a higher likelihood of relapse at six
months but not at 12 or IS months
(18), In quasi-exporimental studies,
Individuals receiving residential treat-
ment had less methamphetamine use
and crime (24), higher treatment
completion rates and longer treatment
stays (28), and reduced suicide
attempts during treatment (29) com-
pared with individuals receiving out-
patient treatment. Individuals in
inpatient residential treatment had
lower alcohol and drug severity scores
at six months than those in outpatient
treatment, after control for baseline
severity (30). De Leon and colleagues
(25) found some evidence supporting
treatment matching; clients matched
to long -terns residential care had
better one-year outcomes than those
undertreated in outpatient drug-free
settings, Individuals with co-ocourring
mental and substance use disorders in
integrated residential treatment set-
tings had reduced Illicit drug and
alcohol use, improved psychiatric
domains, higher reported quality of
life, and improved social and commu-
nity functioning than those in treat-
ment as usual (9-11,15).
Reflecting the inconsistency in the
literature, other studies showed no
siguilleant differences between Individ-
uals receiving residential treatment and
those receiving treatment in compari-
son conditions on outcomes such as
abstinence from drug use, psychosocial
variables, reduced drug use, criminal
aettvity, arrest rates, or rates of return-
ing to prison (21-23,26,27,32,35-37).
In an RCT, researchers compared
treatment in a residential social model
and in a nonresidential social model for
homeless individuals with co-ocoturring
mental and substance use disorders
(17). No significant differences, aside
from housing, were found between
residential and nonresidential treat-
ment groups at the three-month
follow-up. When the analysis con-
trolled for total services accessed, the
residential group had signifioantly
fewer days of alcohol use at the three-
month follow-up, but no other signif-
icant effects were found,
The inconsistency in findings is
documented by the literature reviews
we examined. P-jblished reAews of
PffCIIIATRIC SERVICES 4 ps.psychlatryonLncarg ♦ March 2014 vol, 65 No. 3
residential treatment reported on stud-
ies that had serious methodological
limitations, resulting in the need for
"an RC1' with a well-defined popula-
tion, a standardized program, and a
blind assessment of outcomes" (9),
Finney and colleagues (12,13) con-
ducted two reviews that summarized
the evidence on treatment settings—
the fust in 1996 and the second in
2009. The 19% review included re-
search on `inpatient" treatment cam -
pared with outpatient treatment or
detoxification only (12). Although com-
prehensivo at the time, tine review was
confounded for our purposes by the
inclusion of both hospital inpatient
approaches and nonhospital residen-
tial approaches and the exclusion of
individuals with severe problems or
without stable housing. In addition,
many approaches describtsd in the
review article are no longer commonly
used in the field; thus the article is not
discussed further here. The 2009 re-
view by Finney and colleagues (13)
found evidence supporting the effec-
tiveness of treatment that matched
patients to different treatment set-
tings, such as via the ASAM PPC -2R,
However, the review provided little
information about methods used In
the included studies.
Three reviews examined the effects of
therapeutic communities on substance
use outcomes (14-16). A C'.ochrane Col-
lahomtion review indicated that in-
sufficient evidence exists to state that
therapeutic communities are more
effective than other levels of care;
however, methodological limitations
tempered the researchers' conclusions
(15). High attrition was a common Lim-
itation in the reviewed studios. Some
evidence suggested that specific pop-
ulations, such as homeless individuals
with co-oet. Ging mental disorders or
individuals in prisons, had better out-
comes in therapeutic communities than
control groups. The second review
found that individuals in therapeutic
communities demonstrated improved
outcomes compared with individuals
in control conditions; however, the
findings were limited by various meth-
odological issues, such as overlap be-
tween the treatment and comparison
conditions and inconsistent program
fidelity (16). The third review found
significant decreases in substance use
Evidencefor the effectkmess of residential
treatment for substance use disorders, moderate
Overall mixed results suggest either an improvement or no difference in outcomes
such as;
• Drug and alcohol use
• L�mpployment
• Merited and social problems
. Psychiatric symptoms
• Social support
while individuals were in therapeutic
communities but indicated that meth-
odological problems tempered the ex -
tont to which conclusions could be
drawn about the long -terry, offects of
therapeutic communities (14). Similar
to other reviews, the third review found
that therapeutic communities may pro-
vide a better treutruent option for In-
dividuals with severe psychosocial
problems, depending on the length of
stay In tine program.
Thew reviews (6-11) focwscd on
populations with co-ocauring mental
and substance use disorders, The ex-
perimental group usually received in-
tegrated residential treatment (for
individuals with co-occurring disor-
ders), and control groups received
"treatment as usual" with less intense
or nonintegrated residential treatment.
These reviews found that individuals
with co-occurring mental and substance
use disorders can be treated success-
fully In residential settings, whether
or not treatment is integrated. At
minimum, Integrated treatment was
equally as effective as standard treat-
ment for this population, and most
of the studies found that integrated
treatment was more effective than
standard treatment in regard to sub-
stance use, mental health, and other
outcomes.
Conclusions
This review found a moderate level of
evidence for the efl"ectivenew of rest-
dendal treatment (see box on this
page), Despite the prevalence of meth-
odological concerns—primarily the ap-
propriateness of the samples and
equivalenoo of comparison groups—
some evidence indicates that residen-
tial treatment is effective for some
types of patients. Further, much of the
literature suggests that residential
treatment is equally 9.4 effective as
comparison modalities, and a few stud -
les suggest that it is more effective,
However, until research with more
rigorous methods is conducted, these
conclusions remain tentative,
We echo the call of others for
further research to better determine
which clients benefit from residential
treatment, what duration of treatment
confers positive effects, and what types
of effective clinical interventions are
provided within the program. Further
studies should examine the compo-
nents of residential treatment that
might relate to effectiveness, such as
types of clinical staff, use of peer
support, number of beds, or lengths
of stay currently used, To attain ideal
outcomes, it is essential for new
evaluations of residential treatment
for substance use disorders to take
a chronic rare approach to ensure that
it treatment modality is not evaluated
in a vacuum and that continuing care is
an outcome as well as an essential part
of the treatment episodo.
Any new research in this area must
be methodologically rigorous and use
appropriate comparison groups to
ensure that conclusions are valid.
Systematic, rigorously conducted stud-
ies are essential for policy makers to
make decisions about the inclusion of
residential treatment in health plans
and the allocation of resources to
residential treatment activities.
Spocdfically, research needs to Iden-
tify which individuals respond best to
residential treatment programs. Studies
should use appropriate control groups.
Future research needs to reflect cur-
rent approaches to residential treat-
ment and examine the role of treatment
factors (such as staffing and length of
stay) in contemporary approaches to
residential treatment. Rewrch must
include posttreatment variables, such as
mutual -help participation, when evalu-
ating outcomos. Examining effective
treatments for individuals with sub-
stance use disorders requires furthering
our understanding of how to improve
treatment retention, length of stay, treat-
ment
reatment completion, and participation in
aftercare.
Finally, it is important to determine
whether treatment services are equally
effective for different populations. Given
the significance of health disparities in
access to and receipt of substance use
treatment, implementing effective and
culturally responsive care is essential.
Most studies described the demo-
graphic characteristics of the sample,
and some studies controlled for these
characteristlac in analyses. However,
no studies specifically analyzed race or
ethnietty through interaction terms,
stratification, or other approaches. Ex-
amining the effectiveness of treatment
across different groups requires anal-
yses comparing outcomes of specific
subgroups within and across treatment
types. Additional work should analyze
the role of culture-specdilc approaches --
for example, multilingual staff, Ween -
courage researchers to incorporate such
analyses as we continue to evaluate this
t eatment modality,
In addition to calling for rigorous
research on the current system, we
note that the moderato love] of evi-
donce for the effectiveness of resi-
dential treatment of substance use
disorders has relevance for consumers
and their families as well as for policy
makers. Consumers have a wide range
of needs, and they would benefit from
a variety of sendoes to address those
needs. Residential treatment for sub-
stance use disorders fills a nicfle for
consumers who require stable hying
environments that incorporate thera-
peutic treatments to help them move
toward a I& in recovery. Similarly, to
reduce the likelihood of treatment
failure, policy makers should ensure
that a full range of treatments is
available to meet consumer needs.
With research demonstrating a moder-
ate level of evidence, policy makers can
highlight the benefit of including
r Ademtial treatment as akey sorvkx in
the continuum of care,
As the treatment system for sub-
stance use disorders continues to evolve,
PS' IMTRIG SERVICM 6 p..psychlatrWc3nl1m. rg t March 2014 vol. 65 No. 3
—(05—
particularly within the current context
of broader health care system change,
it is essential to understand the role
and effectiveness of treatment options.
Residential treatment has been used
for substance use disorders for many
years, and there are clear indications
for continuing these services. How-
ever, for policy makers and payers
(for example, state mental health and
substance use directors, managed care
compariles, and county behavioral health
administrators) to be able to make rec-
ommendations about which services
to cover and include in a treatment
continuum, they must be able to eval-
uate those services as they currently
exist. Residential treatment shows
value for ongoing inclusion and cov-
e ritge as part of the continuum of care,
but additional rigorous research Is
necessary to understand how and for
whom it best fits.
Aeknowledgmmes and dheloeums
Development of the Assessing the Evi-
dence Baso Series was snrpported by contracts
HHS $2832007000291ill tISS 28342002T,
HHSS283200700110614111SS26342003T, and
H13SS2832007000171/FIHSS28300001T from
2010 through 2013 liom the Substance Abuse
and. Menial Health Services Administration
(SAMHSA), The authors acknowledge the con-
tributions of Kevin Malone, BA., and Snu'anne
Flnld% M,S.W., form SAMHSA; John O'Brien,
M.A„ from the Couters for Mediocre & Mad-
fcatd Services; Garrett Moran, Ph.D„ from
Westatt John Hastorday, Ph,D„ Llndu Lee,
Ph.D., Rosanna Coffey, Ph,D., and Taml Mark,
Ph1)., from TruvenfIr-althAnaiyrt Constance
Horgan, &.D„ from Brandeis Universityt and
Carol MaDeld. M.A., from Capitol Decisions,
Ino. The vkrm eqlressod In this article are those
of the authors and do not necessarily mpresent
the views of SAMHSA.
The authors report no mmpoting interests
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Submissions Invited for Column on Integrated Care
The integration of primary care and behavioral health care is a growing research
and policy focus. Many people with mental and substance use disorders die de-
cades earlier than other Americans, mostly from preventable chronic medical
illnesses. In addition, primary care settings are now the gateway to treatment
for behavioral disorders, and primary care providers need to provide screening,
treatment, and referral for patients with general medical and behavioral health
needs,
To stimulate research and discussion in this critical area, Psychtat►fo Se3m*a
has launched a column on integrated tare. The column focuses on service dehv-
ery and policy issues encountered on the general medical—psychiatric interface.
Submissions aro welcomed on topics related to the identl$cation and treatment
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Reviews of policy issues related to the care of comorbid general medical and psy-
chiatric conditions are also welcomed, as are descriptions of ourrent integration
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Benjamin G. Druss, M.D., M,P,H., is the editor of the Integrated Care column,
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PSYCHIATRIC SSRYICBS to ps.psychiatryonllne.org 4 March 2014 Vol. 65 No. 3
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ATTACHMENT 7
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Author Manuscript
Published in final edited form as:
Addict Res Theory, 2012 December 1; 20(6):480-491. dol:103109/16066359.2012.665967,
Community Context of Sober Living Houses
Douglas L Polcin, Ed.D., Diane Henderson, B.A., Wren Trocki, Ph.D., Krety Evans, B.A.,
and Fried Wfttrnan, Ph.D.
Alcohol Research Group, Public Health institute, 8476 Chrietle Avenue, Suke 400, Emeryville, CA
94808-1010, Phone (510) 597-3440, Fax (510) 9855459
Douglas L. Polch: DPokkCarg.org
Abstroct
The success or failure of programs designed to address alcohol and drug problems can be
profoundly influenced by the communities where they are located. Support from the community is
vital for long term stability and conflict with the community can harm a program's reputation or
even result in closure. This study examined the community contend of sober living houses (SLHa)
in one Northern California community by interviewing key stakeholder groups. SLHs are alcohol
and drug free living environments for individuals attempting to abstain from substance use.
Previous research on residents of SLHs showed they make long-term improvements on measures
of substance use, psychiatric symptoms, arrests, and employment. Interviews were oompkted with
house managers, neighbors, and key informants from local government and community
organizations. Overall, stakeholders felt SLHs were necessary and had a positive Impact on the
community. It was emphasized that SLHs needed to practice a "good neighbor" policy that
prohibited substance use and encouraged community service. Size and density of SLHs appeared
to influence neighbor perceptions. For small (six residents or less), sparsely populated houses, a
strategy of blending in with the neighborhood seamed to work. However, It was clear that larger,
densely populated houses need to actively manage relationships with community stakeholders.
Strategies for improving relationships with Immediate neighbors, decreasing stigma, and
broadening the leadership structure aro discussed. Implications for a broad array of community
based programs are discussed.
Keywords
Sober Living Houses; Residential Treatment; Environmental Influences; Neighborhood; NUMBY
The premise of this paper is that it Is insufficient to study the effectiveness of community
based services without examining characteristics of the community context in which time
services aro delivered. How services, are perceived by key stakeholder groups will affect
whether they are implemented, the level of support they receive, and the types of barriers
they encounter (Guydish, at at., 2007; Jason, et al., 2005; Poloin, 2006). As an example, we
describe a study of the community context of Sober Living Houses (SLHs), which are
alcohol- and drug-free living environments for individuals attempting to achieve sustained
abstinence. The study compliments previous research showing that SLH residents make
improvements in a variety of areas, including reductions in substance use, arrests,
psychiatric severity and unemployment (Polcin at al., 2010). The community context of
SLHs is assessed by conducting qualitative Interviews with stakeholders, including
managers ofthe houses, neighbors, and local key informants in one Northern California
Correspondence to: Douglaa L. Polcin, DPolcinearq. org,
—40 iF� —
Poloin at al. Page 2
County. A typology of factors supporting and hindering operations and expansion of SLHs
In the community is provided.
Z Alcohol -and drug-free housing
Few problems in the treatment of addictive disorders have been more challenging than
helping clients find long-term, alcohol- and drug -flee living environments that support
gsustained recovery. The progress that clients make in residential treatment programs is often
EF jeopardized by the lack of appropriate housing options when they leave (Braucht, at al.,
1995), For clients attending aftercare or outpatient treatment, progress is attar jeopardized
X by their return to destructive living environments at the and of the treatment day (Hitchcock,
03
at al., 1995). Theso are often the same environments that originally contributed to their
a addiction. Finding affordable housing has also become more difficult because of tight
housing markets in urban areas and the rise in unemployment.
One approach to the need for alcohol- and drug-free living environments has been to refs
individuals to residential treatment programs. However, as funding for residential services
has decreased over the years it has become an option for very few. Even when clients are
admitted to residential services, the length of treatment is typically short, often only a few
weeks. Although some programs have developed "half -way" or "stop -dawn" living
facilities, these too have maximum lengths of time after which residents must leave
Z regardless of their readiness. Cost is an additional issue for hallway houses because
T frequently public and private funders aro unwilling to pay for services that are not medically
aoriented. In addition, halfway houses tend to be available only to Individuals who have
completed rigorous inpatient troument, which diminishes the potential pool of individuals
who might make use of than.
Sober living houses
Polcin et al (2010) suggested sober living houses (SLHs) were an underutilized housing
option for a variety of individuals with addictive disofders, including time completing
residential treatment, attatding outpatient treatment, being released from criminal justice
incarceration, and seeking non -treatment alternatives to recovery. SLHs offer an altarwtive
alcohol- and drug -abstinent living environment for individuals attempting to establish or
maintain sobriety (Whtman, 1993, 2009). Residenta are free to come and go during the day
and are not locked into a group schedule, as is typical in most treatment programs. This
allows residents to pursue activities vital to recovery such as finding work or attending
school. Residents in most SLHs are afforded social support through shared meals,
socialization with recovering peas, house meetings, and access to a house manager. To help
Z residents maintain abWrm rce, SLH's use a peer oriented, mutual -help model of recovery
Tdust emphasizes social model recovery principles (Polcin & Borkman, 2008). As such, they
D emphasize learning about *Motion through personal recovery experience and drawing on
one's own recovery as a way to help others.
Although management of SLHs varies, some Include a residents' council as a way to
empower residents in operation of the facility, While SLHs offer no formal counseling or
case management, they do either mandate or strongly encourage attendance at self-help
groups such as Alcoholics Anonymous or Narcotics Anonymous. Costs of living at the
facility aro primarily covered by resident %tea. Although some residents are able to draw
upon entitlement programs or financial help ff'om thou tkmilies, most must find work to
meet house rent and fees. Because SLHs are typically not part of formal treatment systems,
they aro available to a broad range of Individuals provided they follow basic house rules,
such as maintaining abstinence fiom substances, paying rent and fees, attending house
meetings and participating in upkeep of the facility.
Ada@d Ru Avory, Author marauorip4 available in PMC 2014 January 27.
Polclti d al.
Page 3
SLHs aro nimilar to Oxford Houses for recovery, which are widely known in the U.S, and
developing in other countries as well (Jason, et @1., 2005). Similarities between the two
Z housing models include prohibition of alcohol and drug use, social support for sobriety,
encouragement or a requirement to attend 12 -step meetings and work a program of recovery,
= and no limit on how long residents can live in the house. The main difference is that Oxford
Dhouses have more regulations for structure, size, density and management of the houses.
Similar to our outcome studies of SLHs, which are described below, research on Oxford
houses has documented significant improvement of resident functioning over time. For a
more complete description of similarities and differences between the two housing models
sea Poloin and Borkman (2010).
�C3 Jason and colleagues (2005) studied neighbor perceptions of Oxford Houses and found very
W favorable views. However, they did not study other key stakeholders in the community, such
as local government officials and criminal justice stalt They also did not aim to understand
�. the impact of regulatory policies on the houses or what various stakeholders felt would
improve relationships. Finally, the study was limited to Oxford houses and might not
generalize to other types of recovery houses, including SLHs.
Purpose
0A
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The purpose of this study was to provide data that depicted the community context whore
SLHs operate. We wished to understand views about SLHs among key stakeholder groups
and ways they support and hinder SLHs. To achieve our aim, we conducted qualitative
interviews with key stakeholders in the same geographic area where we conducted a
quantitative program evaluation of SLHs, Sacramento County (i.e., Polcin, at al., 2010). We
wanted to assess areas where stakeholder groups were in agreement about SLHs as well
areas where they disagreed. The ultimate goal was to create it typology of factors supporting
and hindering SLHs within as well as across stakeholder groups.
METHODS
Sample
To assess the community context of SLHs we conducted 43 in-depth qualitative interviews
with 1) neighbors of SLHs (N=20); 2) SLH managers (N-17), which included the owner of
the houses and the coordinator, and 3) key informants (N=6), Key informants Included
representatives from the criminal justice system, local government, housing services, and
drug and alcohol tmatmenL The overall sample oonsi ted of 1S women (43%), 3 from the
SLH manager group, 4 key informants and 11 neighbors. Eighty six percent of the samplo
was white and ages ranged f om N to 70. See Table l for a list of characteristics by
stakeholder group.
Data collection alta
Clean and Sober Transitional Living (CSTL) in Fair Oaks, California was one of our data
collection sites for our earlier quantitative study (Polcin at al., 2010). Because the current
study was designed to complement our previous work, we interviewed house managers at
CSTL and neighbors who resided near one of the 16 CSTL houses. Key informants were
recruited from Sacramento County, the county in Califomia where CSTL is located.
CSTL is alightly more structured than some SLHs because the houses aro divided into six
phase I and ten phase 11 houses. Phase 1 houses are adjacent to each other and operate as one
unit, which includes shared dining and meeting spaces, These houses are loomed on a
frontage road next to a busy commercial street (i.e., not imbedded within a larger residential
area). Tho close proximity provides residents a sense of community that feciiitetes their
Addfd flea Theory, Author manuscript; evallablo in PMC 2014 January 27.
— Y
Pololn of al.
Page 4
Proosclurss
CSLT tests for drugs and alcohol at random and may conduct a test at any time if substance
use is suspected. A positive test is grounds for dismissal from the house. However, a
resident with a positive urine screen may appeal to the judicial committee for reinstatement.
Other dischargeable offenses include drug use on the property, acts of violence, and sexual
misconduct with other residents. For a more complete description of CSTL see the Polin
and Henderson (2008).
Our quantitative research on 250 CSTL residents who were tracked over an 18 -month period
showed significant improvement in multiple areas of functioning, including alcohol and
drug use, employment, arrests, and psychiatric symptoms (Polon at al., 2010). Importantly,
residents were able to maintain improvements even after they left the SLHs. By 18 months
nearly all had left, yet improvements were for the most part maintained Although
individuals with a wide variety of damogmphio characteristics showed Improvement, time
who benefited the moat were those who were most involved in 12 -step groups such as
Alcoholics Anonymous and time who had social networks with fcw or no heavy substance
users.
All participants taking part in qualitative interviews were contacted by a research
interviewer and asked if they were willing to participate. They were informed about the
overall purpose of the study and if they agreed to participle they ai$ned an informed consent
document. Interviews lasted about one hour and participants were offered $20 for their time.
All study procedures were approved by the Public Health Institute institutional Review
Board in Oakland, Califomia.
Content of the intervlem
The overall goal of the qualitative interviews for all three stakeholder groups (i.e., house
managers, neighbors and key informants) was to identify areas of strength and weakness for
SLHs as well as barriers to expansion. Therefore, there was considerable overlap in the
questions asked of the threw groups. Examples of questions asked of all three groups
included:
What aro the strengths of SLHs? What are the weaknesees? What type of impact
have SLHa had on the surrounding neighborhood/community? What are the key
barriers to operating and expanding SLHs? How might SLHs be improved?
Ad*cS Rai Theory. Author manuscript; available In PMC 2014 January 27.
commitment to the program. Although much less restrictive than residential treatment
programs, flume is some degree of external control and structure. Phase I residents have a
curfew, must sign in and out when they leave and must have five 12 -step meetings per week
Z
signed by the meeting chairperson. A minimum of 30 days in a phase I house is required
Ibefore
transitioning to phase H. The stability developed in phase I helps residents to be more
D
successful in phase II, which Includes increased fioedom and autonomy. Phase II houses are
conventional single-famfly homes and are disposed in residential neighborhoods rather than
part of a single complex,
Although CSTL houses aro owned by one Individual, them aro a number of ways that
residents aro involved in managernent and operations. There is a "resident congress" that
"judicial
develops rules for the community, a committee" committee comprised of residents
who enforce rules, and senior pears who monitor the behaviors of residents and bring rule
violations to the attention of the judicial oommittee. In addition, each house slao has one
.-«
designated house manager and residents have an opportunity for input into the operation of
CSTL through this person.
Proosclurss
CSLT tests for drugs and alcohol at random and may conduct a test at any time if substance
use is suspected. A positive test is grounds for dismissal from the house. However, a
resident with a positive urine screen may appeal to the judicial committee for reinstatement.
Other dischargeable offenses include drug use on the property, acts of violence, and sexual
misconduct with other residents. For a more complete description of CSTL see the Polin
and Henderson (2008).
Our quantitative research on 250 CSTL residents who were tracked over an 18 -month period
showed significant improvement in multiple areas of functioning, including alcohol and
drug use, employment, arrests, and psychiatric symptoms (Polon at al., 2010). Importantly,
residents were able to maintain improvements even after they left the SLHs. By 18 months
nearly all had left, yet improvements were for the most part maintained Although
individuals with a wide variety of damogmphio characteristics showed Improvement, time
who benefited the moat were those who were most involved in 12 -step groups such as
Alcoholics Anonymous and time who had social networks with fcw or no heavy substance
users.
All participants taking part in qualitative interviews were contacted by a research
interviewer and asked if they were willing to participate. They were informed about the
overall purpose of the study and if they agreed to participle they ai$ned an informed consent
document. Interviews lasted about one hour and participants were offered $20 for their time.
All study procedures were approved by the Public Health Institute institutional Review
Board in Oakland, Califomia.
Content of the intervlem
The overall goal of the qualitative interviews for all three stakeholder groups (i.e., house
managers, neighbors and key informants) was to identify areas of strength and weakness for
SLHs as well as barriers to expansion. Therefore, there was considerable overlap in the
questions asked of the threw groups. Examples of questions asked of all three groups
included:
What aro the strengths of SLHs? What are the weaknesees? What type of impact
have SLHa had on the surrounding neighborhood/community? What are the key
barriers to operating and expanding SLHs? How might SLHs be improved?
Ad*cS Rai Theory. Author manuscript; available In PMC 2014 January 27.
Potoin d al. Pane 5
Because the throe groups had different relationshlps with SLH facillties, there were also
some differences in content of interviews. For excmple, house managers were asked:
Z What types of individual do well in SLEW What types of individuals need a
Tdifferent environment? How often are residents asked to leave because they cannot
pay rent and fees? How do you think management of the houses affects residents'
D experiences and outcomes? Aro there specific local government policies that
Impact SLHs, such as housing, zoning or health policies? Describe some of the
resistance, if any, that was encountered when this hoarse first opened. How were the
o^1 resistanoes over come? What actions were not effective? Describe how complaints
C or concerns Ilam neighbors aro handled.
m
3 There were also questions that were specific to neighbors. Interviews with neighbors began
by asking them whether they know about SLHs in the neighborhood and when they fust
became aware of them. If they had no knowledge about SLHs the Interviews was
terminated. If they were aware of SLHs in the neighborhood they were asked:
How would you describe them as neighbors? Have you or other neighbors bad
complaints? Describe any .interactions that you have had with SLHs in your
neighborhood. Describe any specific ways that you think SLHs Impact alcohol and
drug problems in your community. What do you think of SLHs compared with
other approaches to addiction, such as formal treatment programs or criminal
Z_ justice co+-.sequer>ces?
10 = In addition to general questions asked of all the participants, key informaat interviews
contained questions designed to elicit information about policies and local taws that might
impact SLH& We queried these officials about their own views about SLHs, the roles SLHs
might play in the terga addiction recovery system, and ways they think public policy could
O be modified to provide more support to SLHs, Exmnples of questions Included:
What rob does housing play for individuals attempting to establish sustained
recovW What is your sense of how well housing needs for individual with
alcohol or drug problems are being addressed in your community? How would you
describe your department's relationship with 9LHs? Describe how SLHs support
and hinder the mission of your department, How do local politics affect SLHs in
your area?
Analytic plan
A triangulation design (Croswell & Plano -Clark, 2007) was created by drawing on data from
the three different stakeholder groups (SLH managers, key informants and neighbors), A
Z prelimtnary coding list was developed prior to the analysis of the interviews. These codes
were based on key research interests, such as factors supporting and hindering SLHs. To
analyze the qualitative interviews, we transcribed all sessions and entered text into a
Dqualitative data management program, NVivo, for coding and analysis (Bazoloy & Richards
2000; Richards 2002). Team members then coded transcripts independently and met to
check coding accuracy and improve coding validity (Carey, Morgan, & Oxtoby, 19%).
RESULTS
The final coding scheme reflecting themes scross all throe stakeholder groups Included
codes depicting drug and alcohol problems in the local community, strengths and
weaknesses of SLHs, barriers to operation and expansion, perceived impact of SLHs on the
surrounding community, views about SLH% In comparison to other approaches to alcohol
and drug problems (e.g., more intensive treatment and incarceration), and suggestions for
Improving SLHs. Some additional codes were applicable to some stakeholder groups but not
Addkf An Meary. Author mer woript; available in PMC 2014 January 27.
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Pokht at al. Page 6
others, For example, codes for neighbors included knowledge about SLHs and interactions
with SLHs near them. SLH manager interviews yielded codes depicting views about
characteristics of good candidates for SLHs, the extent to which cost functioned as a barrier,
the perceived Impact of zoning laws and other local policies, SLH relationships with various
professionals and local gavemment, and past confute with neighbors and how those
conflicts were resolved Codes that were relevant to key informants inchrded ways SLHs
support goals of their departments and perceived impact of policies on SLHa.
Kwwledge about SLH*
SLH managers provided extensive comments explaining how SLHs work to promote
recovery. Typical was this dowription from a phase I manager,
...I believe that it [SLHs) definitely plays a substantial role in that it — I would say
the biggest role it plays Is it offers relief from isolation and that it can make people
aware ... That one doesn't have to worry about bills or that everything is inclusive is
a very significant role as well.
However, managers were only vaguely aware of problems and challenges the houses faced
in relation to the larger community. They noted these issues were handled by the owner of
CSTL. Managers offered Rttlo information in response to questions addressing the larger
context of SLHs, such as the typos of relationships CSTL has with local and state
government, the effects of regulatory mechanisms (e.g., zoning laws}, and how issues such
as NIMBY (not in my back yard) were addressed at the community level.
Key Informants varied in their perceptions about how much they knew about SLH. Those
who felt most familiar with SLHs In general and CSTL speoifically were those who worked
most closely addressing alcohol and drug problems. Surprisingly, the representative from
housing services had very little information about SLHs, Whon asked how familiar she/ho
was with SLHs the reply was, "not very." Although other key Informants felt they had some
general knowledge about SLHs, it was nonetheless limited. For example, one key informant
stated, "I don't know that we spend a lot of time hanging out at programs to see what's
going OIL"
Many of the neighbors also had a iimited understanding of SLHs. In some cases they had no
idea a SLH existed In the neighborhood; it seemed to thorn like any other house. For those
who were aware that there was a SLH in their neighborhood there was often a fairly vague
notion of the population served and how the program operated. Without information, some
neighbors expressed fears that the residents were mostly parolm or that they inoluded sex
of tinders. They did not seem to be aware that a minority (about 250%) of CSTL residents
was referred from the criminal Justice system (i.e., jail or prison) and CSTL does not accept
individuals convicted of sex offenses.
Who stmeeds and who fall*
Many of the respondents, and especially house managers, had very strong ideas about who
would be a auoomful candidate within the sober living environment. Paradoxically, many
house manager respondents said that a person had to 'hit bottom' to benefit, yet they also
noted potentially successful candidates needed to have enough strength to check themselves
into a recovery program and to have the motivation to "push through." Success was viewed
as morn likely for residents of the SLH who had accepted substance abuse as a disease, one
that isn't going away on its own.
....[to be successful] they have had to accomplish what we refer to u the first step
in the program of AA... that there's no denying of their alcoholism, that they're
passed that point; that they're willing to accept that they're an alcoholic, that their
Addld Rei Mory, Author manuscript; available in PMC 2011 fanuary 21.
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Poloin at ai.
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House managers also felt residents who aro dual diagnosed with psychiatric disorders were
more likely to have a low probability of success, It was felt that such individuals needed
marry more services than those provided for by the SLH and that some aspects of the
housing situation might oxacerbate these other problems (e.g. people with social phobia
having to come in contact with many strangers on a daily basis or people with paranoia
having to sharp space with other residents), In addition, it was foit that people with more
severe mental disorders such as schizophrenia might need skilled personnel to monitor
medications.
Well definitely those with dual diagnosis that we aro not prepared to handle — and
there are special cases I mean obviously if there is some Illness that runs deeper
than alcoholism there's no way they can get the help they need hero, nor do they
pretend that they can offer that sort of help...' And it's not like people here don't
go see psychiatrists or therapists or whatever because I know them are more than
one that do but just if the problems are running much deeper.
People who had been coerced Into coming to the SLH were also thought to be unlikely to
succeed in the long-term. If an individual had chosen treatment instead of prison or parole,
or wore forced by the courts, it was thought that they would be less likely to be successful,
Such individuals often end up as 'fake it to make it' individuals who try to get by with the
bare minimum of effort.
... they just want to be clean enough just to satisfy the court; once they've got that
done they're on their merry way.
Strengths and voeaknomm
Virtually all of the house managers and a majority of neighbors and key informants as well
mentioned that the strengths of sober living houses are that they provide structure and
support for a recovering substance abuser. The rule models provided by the longer term
residents, the social support and encouragement of staff and residents, the house rules and
regulations and the availability of AA meetings all help to keep a person from relapsing.
one of the house managers described the Importance of social support for abstinence:
... a lot of people in their usual neighborhoods are family, Like it's not [a good
area] for thorn to got clean 'cause they know a lot of people who they did drugs
Addrot Rea Awry, Author mrnusodA available in PMC 2014 hmuary 27.
-7-4—
lives are unmanageable and they need to do sometbing about it I think that
anybody who comes in these places too soon it's not going to work you.
Z
It was suggested that people who were too young and unmotivated might fall. Such
�p
Individuals were not as likely to have hit bottom, were often still supported (or'enabled') by
family members and just did not have the long history of failures to motivate than.
D
Prospects for success or failure were also influenced by the right kind of financial support.
Most respondents fek that people who paid for their housing themselves from their own
earnings did the best as opposed to those who had a family member footing the bill.
A lot of the kids around here, the parents just let 'em run amuck and they did
whatever they want and now they're in trouble and they're goin' "Mommy help
me" and when they screw it up they still get help from mommy, A lot of theca kids
around hero have been through a lot of programs. , . Tboy're just not ready,
On the other hand, marry of the managers, all of whom were in recovery, said that they
would never have made it unless the first few months had been paid for by a social agency,
the criminal justice system, a family member or some other external form of support Some
felt that more people would be suocessfut fifths fluids for maintaining themsalves at the SLH
were more easily available, especially for beginning recovery.
_Z
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House managers also felt residents who aro dual diagnosed with psychiatric disorders were
more likely to have a low probability of success, It was felt that such individuals needed
marry more services than those provided for by the SLH and that some aspects of the
housing situation might oxacerbate these other problems (e.g. people with social phobia
having to come in contact with many strangers on a daily basis or people with paranoia
having to sharp space with other residents), In addition, it was foit that people with more
severe mental disorders such as schizophrenia might need skilled personnel to monitor
medications.
Well definitely those with dual diagnosis that we aro not prepared to handle — and
there are special cases I mean obviously if there is some Illness that runs deeper
than alcoholism there's no way they can get the help they need hero, nor do they
pretend that they can offer that sort of help...' And it's not like people here don't
go see psychiatrists or therapists or whatever because I know them are more than
one that do but just if the problems are running much deeper.
People who had been coerced Into coming to the SLH were also thought to be unlikely to
succeed in the long-term. If an individual had chosen treatment instead of prison or parole,
or wore forced by the courts, it was thought that they would be less likely to be successful,
Such individuals often end up as 'fake it to make it' individuals who try to get by with the
bare minimum of effort.
... they just want to be clean enough just to satisfy the court; once they've got that
done they're on their merry way.
Strengths and voeaknomm
Virtually all of the house managers and a majority of neighbors and key informants as well
mentioned that the strengths of sober living houses are that they provide structure and
support for a recovering substance abuser. The rule models provided by the longer term
residents, the social support and encouragement of staff and residents, the house rules and
regulations and the availability of AA meetings all help to keep a person from relapsing.
one of the house managers described the Importance of social support for abstinence:
... a lot of people in their usual neighborhoods are family, Like it's not [a good
area] for thorn to got clean 'cause they know a lot of people who they did drugs
Addrot Rea Awry, Author mrnusodA available in PMC 2014 hmuary 27.
-7-4—
Poloin at at. Page B
with. So being like a place where you can live with other people trying to do the
same thing and are all about the same tiling is really supportive and it helps you
Z stay positively influenced to stay clean and get your life together...
Another house manger emphasized the importance of a supportive oommunity:
%Community, everybody Vain' along, everybody holpin' each other. Everybody's
always helpin' each other around hero. If they see that you're down and out they'll
9 ask you 'What's wrong?' or start the coffee or whatever and that's what it is people
C around here care about each other.
On the other hand, the factor of density was mentioned as an arca of strength and as a
weakness, sometimes by the same respondents, Density of the SLH was viewed as an area of
strength for house residents because it allows a range of services to be on hand (including
meals, meeting places, AA and other types of classes) as well as a wide range of role models
and positive normative proasm. Yet, because there are separate houses, the residents do not
have the feeling of being in an inedtution; with one exception, the houses arra approximately
family -sized and offer the opportunities to build skills, develop social relationships and offer
a degree of privacy. However, there is one neighborhood whom there are six adjacent houses
together in one complex. Some neighbors experienced this high density arrangement as
having a negative impact on the surrounding neighborhood,
Z hnpect on SLH rssidatrtta and the surrounding community
= Participants across all three stakeholder groups generally felt SLHs had a positive Impact on
Dthe residents who lived in than and the surrounding community. This was particularly
evident when respondents considered the consequences of Ignoring alcohol and drug
problems or alternative approaches to dealing with them, such as criminal justice
Incarceration. House managers were particularly strong proponents of this view.
I think we've raised property valuo. Thera is no crime going on hero. You've got
seven houses here and the polios don't get called. Cara aren't broken into, there's
C no burglary you know. I mean the level of integrity of the hundred people that live
hart is gonna be three times as high as the people living on the street ... one over....
Key informants, especially those who worked closely with SLHs and drug tieetrnent, also
had positive views about the impact of SLHs, For example, one stated, "I would think that
it's just more people that aren't out there drinking and using." Other key informant
comments included:
Ad*d Rau Theory, Author manuscript; available In PMC 2014 7anuary 27,
S —
If they work I think they have a great impact. -They're good citizens, neighbors,
don't c rcate a nuisance within our community, and I think they have a great impact,
Z
Z
The more you can be in a home as opposed to an instidution or shelter to me that Is
beneficial to not only the individual but it's acbmily probably beneficial to the
community at large too...
... ifthem were a lot of calls for service out them I'd be hearing about It...then we
know there are other things going on that we've gotta address but it's usually not
been [the peel with CSTL,
A number of neighbors had family members or friends who had a history of addiction
problems. Their concern about family and Mends who had addiction problems appeared to
influence their views about the impact of SLHs.
Well I don't think that incarcerating people rehabilitates them. You know It's like
my daughter if she was in that situation whore she could at least was trying to get
herself cleaned up and can go to a home, I'd be all for that.
Ad*d Rau Theory, Author manuscript; available In PMC 2014 7anuary 27,
S —
Polcin ea el, Page 9
..,my younger sister had a problem and so she's — so I know she's been in a couple
In and out ... It's rare you talk to anyone you know honestly that doesn't have a
Z sister or brother, a parent, an unclo, you know what I mean..
_ .,.Yeah they need help you know we have a daughter that's a meth user and so I'm
{j all for anything that will help... Yeah and we've been estranged ftom her for the
9 last 20 years... .
Although views about the impact of SLHs were generally favorable, concerns were raised
about the potential for detrimental impact to residents and the surrounding community if the
houses were not well managed. This was the view even among house managers. The owner
of CSTL emphasized the importance of standards and Integrity.
We have a class here called Sober Living Specialist and it's a 36 -hour class that 1
put together.... What we're trying to do is create minimum standards and a high
level of integrity. And it goes beyond just having a house, I mean you've got
recovery integrity, you have fists) integrity, you have community integrity you
know. So we talc about ADA [Americans with Disabilities Act], we talk about
FHA (Fair Housing Act]; we talk about structure and management; we talk about
how to keep your books and pay taxes and be financially in integrity. We talk about
confidentiality and do no harm and a code of ethics,
Z Phase I and pha" 11 houses—Despite generally positive views about the impact of
T SLHs on surrounding communities, key informants and some phase I neighbors raised
a concerns about the impact when houses were too densely located in one neighborhood. One
key informant commented:
Well, it changes the atmosphere; I think that when you walk through, you drive
through and there's a group of adults sitting outside you often wonder what's that
all about, Is it a halfway house, is it sober living? What's going on is it just about a
big family and you know those sorts of things. So it makes you wonder about the
neighborhood
When we looked at the characteristics of the neighbors who had concerns it became clear
rt that they lived in the vicinity of the six phase I houses that were densely located along a two
block area in one complex, One neighbor stated, "I hate to any this, but I would say it's been
negative. One would've been fine (laughs) but the whole block is too many for this small
strati," Some complaints of neighbors had to do with nuisance Issues such as noise and
parking.
...'lite only thing that gets people in the neighborhood kind of upset is If you have
Z too many cars and sometimes if there's too many people there, if they have too
many guests IVU get the neighbor across the street upset. , .
D ...I don't see them as strict enough., .I mean they're lifting weights at all hours of
the night, there is no — back there is no control of their language at all... every now
and then obviously there are screaming and yelling matches and sometimes they
are — they're just you know people have lost their owl.
they [should) cut the size of it and not have so many people over there in so
many houses and that they exercise control when they have these large groups and
stuff over there. Because these groups have to be coming from more than just those
houses because there's bean times when I saw hundred or more people them and
cars are parked not only up and down the entire street but over in the Safeway
parking lot there's so many people there. And I just don't understand why they
need that many people at one time.
Addict Rea Theory. Auihor manuserip4 available in PMC 2014 Jut=y 27.
Poioin ot al. Page 10
A few phase I neighbors expressed fears about safety, the potential for an increase in crime,
and declining values of rouses in the neighborhood. However, when pressed by rho
interviewer, they had difficultly providing examples of these issues. A phase I neighbor
Z stated she assumed housing values would fall as a result of the SLH in their neighborhood,
Tbut did not elaborate or provide examples of declining values. Another neighbor described
concerns about crime:
...there were a couple of incidences where in the night ... we had a couple of break-
ins and you don't know if it was them or not.
Interviewer; So I'm wondering if the break-ins were close to each other and how
lit long ago It was or how recently?
e Well, one of them was S years ago, the other one was in '89.
The concerns raised by some neighbors of phase I houses wore not unanimous. DOW
pointe of view fiom phase I neighbors included:
Well, for me like I say to me it's positive that there's boon a positive impact...the
orime situation has reduced. l mean we were broken into three times here before_
madhouse came.
Addkv Rw Amy, Author rmnusript; available in PMC 2014 January 27.
It seems to be a big success. They have on you know spocific nights of the week
Z
and specific nights of the month they have a lot of people gathered there in support
of the people that are graduating from the program or hopefully successfully
T
moving on from that program. So I have a lot of support for that, I've known
y
several people In my lifetime through fKarxia or employees that have been working
for us that had issuea with drugs and needed to clean up. And so I think it's a huge
benefit to helping people get back on track and finding that support system and
0
other people that am going through the same situations that can be there for each
C
other and be a good support structure for each other.
Another phase I neighbor succinctly summed up the pros and corns of having a large
community of phase I houses:
...because you have it the way it is tbo level of support is incredible as opposed to
having the phase Z houses which aro more isolated. But of course you have to work
to get that and ... having large phase I houses is probably a good thing but it you
know It is in a residential neighborhood area and so you create a traffic issue and
the streets line up, I moan that's what they have to do. And we were real worried
`cause we thought that whole fkoontago area was gonna be gone on this latost
modification and it was like okay now what are they gonna do? But it isn't, and
Z
they are considerate, they do a good job, but it is a lot— they have a lot of people on
=
Sunday night.
DReactions
from neighbors of phase II houses were nearly all positive. Neighbors were either
unaware that a SLH existed in their neighborhood and when they did know about one they
were perceived as good neighbors. One neighbor of a phase II house reported a positive
incident with a SLH resident who lived next door. During a violent late night altercation
with his wife, he was forced to leave his home. He found refuge and counsel from his next-
door neighbor. It was then he learned this was a SLH. In another neighborhood, a single
mother reported feeling "safe" because of the SLH residents living across the street. They
kept an eye on her house and repotted to her when a group of teenagers climbed the fence to
79
her property. She also commented that the SLH residents wore good role models for her
teenage son.
Addkv Rw Amy, Author rmnusript; available in PMC 2014 January 27.
Pokin at al. pap t i
Residents of phase Il houses were viewed as quiet and they maintained their properties well.
A few reports suggested there was admiration among neighbors for the changes the residents
Z were attempting to make in their lives:
T..I would hope that people would be more observant and respwtflil to them
M because they chose to take a different road with their life ... they're trying to make a
difference for their lives and themselves and their fitmilies so I would hope people
Cwould respect that.
One phase II SIGH manager told a story of a neighbor expressing appreciation for their work
recovering from alcohol and drug problems.
...she likes to bake a lot so she brought me like cake, right and she's like'hi, I'm
so and so. I live next door and I ust came down hero to s
j upport You and tell you
that I'm so proud of you and I like what you guys aro doing hero and keep doing
' the right thing' and I was like "who aro you?"... they're like an awesome old couple
next door and they have a couple grandchildren and like I said I walk out of the
house, they ask me how I'm doing.
Improving the community context
All three stakeholder groups felt the reputation of CSTT, in the local community benefited
Z from a variety of volunteer activities In which residents participated. These included
involvements in activities such as hosting a Christmas holiday party open to the local
community and volunteering to support various events (e.g., parades, Veteran's Day
y activities and seasonal festivals). One house manager noted:
...so we do stuff like volunteer so that we don't got a [bad] name. Because you
know a lot of us we stole a lot, we hurt a lot of people through our actions. So when
we give back it shows the community that we're not like that now. We're trying to
change. We're still people. We just had probiam and we're fixing it now.
Phase I neighbors felt providing more information about SI,Hs and developing forums for
more interaction would be good ways to improve relationships:
"Well maybe if they had more interaction with the community as far as letting the
community know what's goin' on, what their goals are, what their success rate is.
Other suggestions from phase I neighbors included distributing brochures about CSTL to
local neighbors, inviting them to attend a question and answer meeting at the mai facility,
and promoting a neighborhood barbeque. One man appeared to be frustrated not having the
phone number for whom to call if there were concerns. Another felt intimidated by the
Z residents and feared he would be misunderstood if he raised his concerns. One neighbor
suggested CSTL residents get involved in volunteer work, apparently not aware that CSTT,
T residents were already involved in a variety of volunteer activities.
D
It is important to note drat like neighbors of CSTL, house managers also felt increased
contact and communication would improve relationships. Managers felt many concerns that
p neighbors had were based on fear rather than infomration about the program:
I would challenge the skeptics to come spend a day or two around horn and see bow
the people aro; we how these places work; see what they promote, what kind of
lifestyle they promote and you know see If their opinion hadn't changed in that
period of time.
Another house manager felt similarly:
Addle Ras 79wory. Author manusedpt; availabis in PMC 2014 January 27,
Poloin et al, Pogo 12
Like come on in and check it out. Bring a city council member, bring a newspaper
reporter, you know bring whoever you'd like and come and see. It's not a cult.... its
Z people trying to better themselves.
2 Finally, like one of the neighbour the coordinator of CSTL expressed a wish that residents
b could be involved in more volunteer activities, mentioning breast cancer awareacss as an
D example.
D
Regulatory Impact on SLHs
0
There is no state or local licensing of SLHs. Because anyone can set up a SLH and operate it
as they wish, stakeholders felt there was a need for standards for SLHs. When asked about
c obstacles to expanding SLHs, several hoose managers noted that standards woe important
for both the houses and the operators, "I think there should be more strict guidelines on who
can operate these places." One of the key informants noted, "...you know licenses or having
somebody in the neighborhood that would involve you know the code of enforcement
peoplo." 'There was a clear sense among all participants that poorly nut houses were a threat
to all SL -h and they therefore needed to be dealt with "swiftly because they are the ones
that make It bad for everybody else." None of the participants mentioned that CSTL was a
member of the Califorrmia Association of Addiction and Recovery Resources (CAARR),
which does certify SLHa for compliance with basic safety, health, and operations standards.
Z There were differences of opinion among stakeholders about the need for a special use
zoning permit. A few neighbors and key informants felt that any house containing more than
D six individuals required a special use permit or it would violate zoning laws. The owner
challenged that contention citing the Americans with Disabilities Act and the Fair Housing
Act:
since we are considered disable Americans, which the tow public and rho whole
government want to ignore... we're protected by the Fair Housing Act which says
that people with addiction have to be treated like any other family. They can live
togodw, they can have more than six people. Now If the county wants to limit it to
six people and then anything over six people you get a use permit then that should
apply to every family in Sacramento County u well.
When we asked house managers about the impact of regulatory laws and policies on SLH
operations the neatly unanimous response was that time issues that were dealt with
exclusively by the owner of CSTL. This individual is active in the local community and also
has connections In state government. It Is important to note that some of the earlier critics of
CSTL now support the program. The owner attributes much of this shift to femiliarhy; the
Z fact that critics were able to get to know him personally and observe what actually goes on
in the houses.
D Typology of fectorts supporting and hindering SLHs
Table 2 shows a summary of factors that support and hinder SLHs from the vantage point of
different stakeholders.
DISCUSSION
Overall, there was significant support for SLHs across stakeholder groups. To some extent,
our finding that phase 11 houses were either viewed favors" ' by neighbors or were not
perceived as different from any other house in the neighbon.00d replicates the study by
Jason et al (2005) of Oxford Houses, Even when neighbors or key Informant had criticisms
of phase I houses, they nevertheless supported the Importance of this type of service in the
Ad a Ru Mory. Author manuscript: available in PMC 2014 January 27.
(q—
J'otoin at el, P&p 13
community and viewed It as prefbrable to ahemative responses to alcohol and drug problems
(e.g., criminal Justice),
Z Concerns about phase I houses appeared to center mostly on issues such as the larger size
and higher density of these houses In one area, as wolf as related concerns about noise and
D trafik. Only a few mentioned issues related to resident behavior, such as offensive language
and leaving cigarette butts in the area. It is worth noting that even the most critical phase I
neighbors supported the importance of recovery programs and sober housing as a concept.
They tended to want the program to have more control over resident behavior and find
solutions to the high density of houses and corresponding problems such as limited parking.
CSTL faces a dilemma in that the larger, higher density phaco I houses were viewed as
helpful to recovery by house managers and even by one of the neighbors. The large complex
of 4acent phase I houses creates a sense of independent living blended with extensive
support and some degree of structure, both of which are f t to be essential to recovery. The
design also allows the owner, coordinator, house managers, and acnior peers to monitor the
behavior of new residents and address problems promptly. One could argue that the
increased oversight and sense of community in phase I prepares residents for success in
phase II, and thus leads to stable phase II houses in the community. Given the current
scenario, the program might consider collaborating with neighbor about ways to address
issues such as parking and traffic congestion, Examples might Include holding some
Z meetings off-site or developing alternative places to park when large meetings aro held at
the facility. Efforts to maintain a "good neighbor" policy by enforcing rules that limit noise,
D offensive language, cigarette butts, etc. aro clearly Important.
In a number of areas there was significant agreement among stakeholder groups. Most of the
factors supporting and hindering SLHs were identified by participwrts from at least two
Qi groups. For example, the importance of volunteering was mentioned by most of the house
managers as well as some neighbors. Size and density were viewed as hindrances by
neighbors, especially those who 1 ived near phase I houses, as well as some of the key
informants. Both house managers and key informants viewed characteristics and activities of
the owner as important to the success of CSTL. Neighbors and managers both felt increased
communication and familiarity with SLH operations could help improve relationships.
Nuisance problems (e.g., parking) were viewed as a hindrance by neighbors and key
informants and all three groups felt that even a limited number of poorly run houses could
threaten the viability of all SLHs, Adopting "good neighbor" practices was viewed as
essential by nearly all participants,
Communication with nelghbom
Z One of the clearest findingswas that both house
managers and phase I neighbors fait the
T need for more communication and interaction, Phase lI neighbors, In contrast, were fairly
D unanimous in their praise of SLHs in their neighborhood and thus felt little need to take
action to improve relationships. Given the current stability and successes of phase II houses,
the beat approach might be to leave well enough alone.
Phase I neighbors and managers proposed specific suggestions for increasing
communication that could be readily implemented, These included neighbors attending open
c houses at the program, the program distributing brochures about CSTL to local neighbors,
neighbors spending a day at the program to experience what actually goes on, the program
implementing it neighborhood barbeque and developing regular meetings with managers and
neighbors to address questions and concerns that arise.
Addlcf Ra Th"y. Audwr manuswip4 available in PMC 2014 January 27,
CCS
Polein of W. Page 14
It should be mentioned that the owner of CSTL reported some previous efforts In this regard
that were not very suocassful. One involved going door to door in the neighborhood to
introduce the program, which yielded some negative comments and threats. Tho other
Z involved some ice cream socials that were poorly attended. On at least two occasions letters
were sent out to neighbors containing a brief description about CSTL and contact numbers.
D It is not clear why these efforts were not more successful. It could be that developing a
meaningful and sustained impact on the surrounding neighbors will require regular and
varied activities, such as regular social events, more substantive forums to address
neighborhood issues and problems, and a monthly or quarterly brochure that is distributed to
each neighbor.
In
Although CSTL residents are involved in extensive volunteer work In the local area, there
may be a need for mora of those activities In the Immediate neighborhood. Several
immediate neighbors did not appear to be award of volunteer activities in which CSTL
•� residents panticipato and they suggested volunteering would Improve relationships with the
community.
Addressing stigma
House managers believed that stigma plays a strong role In biasing some neighbors against
SLHa and their residents. Ills view was shared by participants in our previous work (e.g.,
Z Polcin et al., in press), whore addiction counselors and mental health therapists rated stigma
= as the main obstacle to expanding SLHs. Stigma was rated as a higher obstacle than
practical issues such as not have sufficient financial resourm to pay for residence in a SLH.
D In our interviews for this study we found negative assumptions about SLHs when neighbors
expressed concerns about increasing crime and decreasing housing values but were not able
to support their claims with specific examples.
Q
A good way of addressing stigma was suggested by several house managers. They argued
convincingly that the more the local community understood about the day to day operations
of CSTL and the residents who lived there the more they would support SLHs in this and
other communities. Instead of relying on preconceived biases and notions, they would
inoreasingly base their views on observations about what occurs and interactions with
residents. Contact with stigmatized groups as a way to decrease stigma is a strategy
supported by a variety of stigma researchers (e.g., Corrigan et al., 2001). It might be
particularly helpful to create forums whom successtlrl residents could interact with
neighbors and share the stories about addiction and recovery. In addition to decreasing
negative assumptions about addicts and alcoholics, such Interactions might offer hope to
families who have a member suffering from a substance use disorder.
Z
2 Managing community relations
DA member of managers and key informants noted how the owner was well connected within
D the local community (e.g., president of the local chamber of commerce) and used those
connections in service of CSTL. A notable limitation of this scenario is that mobilizing
community influences in ways that support CSTL was the purview solely of the owner.
'• Thae is considerable risk that if this individual were not around, the relationships with local
$ and state officials would evaporate. It was striking how little house managers and residents
knew about critical issues directly affecting the viability of CSTL, such as zoning laws, the
Fair Housing Act, Americans with Disabilities Act, and Initiatives at the state level to limit
SLHs. Inoreming their knowledge of and involvemeW in these issues would leave the
program leas vulnerable. This could be accomplished through delegating house managers to
attend selected meetings and discussion with rho owner about how to best represent the
interests of CSIs..
Addle Rat 77wwy. Author manworip4 avallable in PMC 2014 Unuuy 27,
Pololn at Q. Page is
Implicstlons for community batssd programs
Study findings suggest important considerations, not only for SLHs, but for community
Z based programa more generally. One area where them was nearly unanimous agroemem
Tacross stakeholder groups was the Importance of being good neighbors. Therefore,
V community based programs need to have policies and resourom that ensure upkeep of the
D Acilities to standards consistent with the local neighborhood, Further, there need to be
policies in place to contain potentially destructive behaviors, such as drug use and other
g behaviors that would be experienced as unacceptable (e.g., destruction of property). For
example, "Housing First" models for substance use disorders that tolerate alcohol and drug
use would not do well in the neighborhoods we studied. To avoid open community
resistance, it would seem that these types of harm reduction services would need to be
located in area where substance use is more tolerated. In addition, community based
programs need to have mechanisms for handling complaints from neighbors, While CSTL
r. was praised by key Informants for responding to oomplairrta promptly, a few phase I
neighbors were unsure whom to contact and others felt intimidated and that left them feeling
frustrated and more negative toward the program. Phase lI neighbors did not express this
uncertainty and seemed comfortable approaching residents of phase 11 houses.
It was clear from our k dMiews that the owner of CSTL had a tong history of successfully
Z managing challenges to CSTL and navigating through the political and regulatory
environmenL He appeared to persevere using a combination of knowledge about his rights
10
T and applicable laws, involvement in local and state politics, and personal relationships that
D he was able to develop with individuals who were once his adversaries. Such an Individual
can be invaluable to the development of successful organizations. However, amara ars
serious questions about how the program could maintain its position In the community and
o its political strength if this individual were not around. CSTL and other community based
programs might do well to consider shared models of leadership and responsibility (e.g.,
Polcin, 1990) for promoting the program's agenda within political and regulatory circles.
UmKsUons
There aro some inherent limitations in our study that are important to note. First, all of the
interviews took place in one Northern California County and the issues retative to SLHs
there might not generalize to other geographic regions. Second, all of the house managers
Addkt Rw Theory, Auttar mane ript; avalMle in PMC 2014 January 27.
-- V -
Another consideration is how to handle the issue of anonymity. We found that small,
sparsely populated phase II houses were viewed favorably or were unknown to neighbors.
Z
Ono workable option for community programs in such circumAmoca might be to maintain a
T
relatively low profile and simply blend in with the locommunity. However, when
local community.
A
programs aro larger and their presence is obvious, it may be necessary to directly address the
conomm of local neighbors, especially to countered negative assumptions associated with
tstigma.
Such a strategy requires forums for such interaction m o0mv. Both house managers
s
and neighbors had suggestions in this regard, ranging from neighborhood barbeques to
$
Information meetings that describe the program and respond to neighbor questions and
T
concerns.
CAll
of our stakeholder groups emphasized the importance of volunteer work- The specific
types of activities that community Programs get involved in might be dependent in part on
.
the types of clients served and their capabilities. However, it scans that some very public
wary of showing involvement in and support for the community is important to garner
support. In part, volunteer work might be viewed as important because volunteer work
contradicts assumptions associated with the stigma of addiction, such as crime and
exploitation of others.
It was clear from our k dMiews that the owner of CSTL had a tong history of successfully
Z managing challenges to CSTL and navigating through the political and regulatory
environmenL He appeared to persevere using a combination of knowledge about his rights
10
T and applicable laws, involvement in local and state politics, and personal relationships that
D he was able to develop with individuals who were once his adversaries. Such an Individual
can be invaluable to the development of successful organizations. However, amara ars
serious questions about how the program could maintain its position In the community and
o its political strength if this individual were not around. CSTL and other community based
programs might do well to consider shared models of leadership and responsibility (e.g.,
Polcin, 1990) for promoting the program's agenda within political and regulatory circles.
UmKsUons
There aro some inherent limitations in our study that are important to note. First, all of the
interviews took place in one Northern California County and the issues retative to SLHs
there might not generalize to other geographic regions. Second, all of the house managers
Addkt Rw Theory, Auttar mane ript; avalMle in PMC 2014 January 27.
-- V -
Polon et of. Page 16
were pari ofCSTL and all of the neighbors resided near CSTL facilities. Although CSTL
has implemented the Bober living house principles promoted by the California Association
Z of Addiction and Recovery Resources in California, there may be individual factors that aro
unique to CSTL that limit generalization of results. Other SLHs with different characteristics
(e.g., size, management, cost and house rules) might have different issues. Finally, the
y results are specific to SLHs and might not generalize to other types of housing, such as
halfway, step down and Oxford houses.
Acknowledgments
Supported by NIDA Oram R21 DA025208
pppC Tbo authors would Iike to thank Tion Troui nen, owner of Clem and Sober Tr;mittonal Living, for hc4&1
comments on earlier drafts of rho manusortpi.
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Alcoholism, Volume 18: Alcoholics Anonymous and Spirituality in Addiction Recovery. New
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therapeutic factors in sober living houses. Journal of Psychoactive Drugs. 2008; 40:153-159.
[PubMed: 187206641
Polcin Dl„ Korcha R, Bond J, Galloway GP. Sober Living Houses for Alcohol and Dnig Dependence:
l8 -Month Outcomes. Journal of Substance Abuse'ihxttment. 2010,,39:356-365. [PubMed:
20299175]
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a
Wittman FD. Affordable housing for people with alcohol and other drug problems. Conttmporaty
Drug Problems. 1993; 20(3):541-609.
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of drugs, alcohol and addictive behavlor. 3. Farmington Hilts, MI: Gale Group Publishing; 2009.
hllpJ/www.CWtes.cafn/drugs-alcoisol-oticyclopedialuicobal-drug trc-housing
AdAW fin Mmy. Author manuscript; available in PMC 2014 January 27,
Polcin at al
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—S5—
els
ATTACHMENT 8
RESOLUTION NO. PC -16-
A RESOLUTION OF THE PLANNING COMMISSION OF
THE CITY OF COSTA MESA APPROVING PLANNING
APPLICATION PA -16-44 FOR A SOBER LIVING
FACILITY OPERATED BY CASA CAPRI RECOVERY
HOUSING 14 WOMEN WITHIN 4 EXISTING UNITS ON
PROPERTY LOCATED AT 269 E. 16TH PLACE
THE PLANNING COMMISSION OF THE CITY OF COSTA MESA HEREBY RESOLVES
AS FOLLOWS:
WHEREAS, an application was filed by Casa Capri Recovery, requesting approval
of Planning Application PA -16-44, a Conditional Use Permit for a Sober Living Facility
housing 14 women within four existing attached units;
WHEREAS, the project has been reviewed for compliance with the California
Environmental Quality Act (CEQA), the CEQA Guidelines, and the City of Costa Mesa
Environmental Guidelines, and has been found to be categorically exempt from CEQA
under Section 15301 for Existing Facilities.
WHEREAS. the CEQA categorical exemption for this project reflects the
independent judgment of the City of Costa Mesa.
WHEREAS, a duly noticed public hearing was held by the Planning Commission
on November 14, 2016 with all persons having the opportunity to speak for and against
the proposal.
BE IT RESOLVED that, based on the evidence in the record and the findings
contained in Exhibit A, and subject to the conditions of approval contained within Exhibit
B, the Planning Commission hereby APPROVES Planning Application PA -16-41.
BE IT FURTHER RESOLVED that the Costa Mesa Planning Commission does
hereby find and determine that adoption of this Resolution is expressly predicated upon
the activity as described in the staff report for Planning Application PA -16-41 and upon
the applicant's compliance with each and all of the conditions in Exhibit B and compliance
of all applicable federal, state, and local laws. Any approval granted by this resolution
shall be subject to review, modification or revocation if there is a material change that
occurs in the operation, or if the applicant fails to comply with any of the conditions of
approval.
BE IT FURTHER RESOLVED that if any section, division, sentence, clause,
phrase or portion of this resolution, or the documents in the record in support of this
resolution, are for any reason held to be invalid or unconstitutional by a decision of any
court of competent jurisdiction, such decision shall not affect the validity of the remaining
provisions.
PASSED AND ADOPTED this 14th day of November, 2016.
Robert L. Dickson Jr., Chair
Costa Mesa Planning Commission
U —
STATE OF CALIFORNIA
COUNTY OF ORANGE
)
)ss
I, Jay Trevino, Secretary to the Planning Commission of the City of Costa Mesa,
do hereby certify that the foregoing Resolution was passed and adopted at a meeting of
the City of Costa Mesa Planning Commission held on November 14, 2016 by the following
votes:
AYES: COMMISSIONERS
NOES: COMMISSIONERS
ABSENT: COMMISSIONERS
ABSTAIN: COMMISSIONERS
Jay Trevino, Acting Secretary
Costa Mesa Planning Commission
&9—
EXHIBIT A
FINDINGS FOR APPROVAL
A. The application presented substantially complies with Costa Mesa Municipal Code
Section 13-29(g)(2) in that:
Finding: The proposed development or use is substantially compatible with
developments in the same general area and would not be materially detrimental to
other properties within the area.
Facts in Support of Findings: A sober living home is a supportive living
environment for persons who are recovering from drug and/or alcohol addiction.
Since the Planning Commission has denied the applicant's request to operate
a sober living home on the adjoining property at 269 16th Place (PA -16-41), the
subject property is not within 650 feet of any other state licensed drug and
alcohol facility or sober living home that is currently permitted pursuant to City
of Costa Mesa land use requirements. This separation helps to preserve the
residential character of neighborhoods and facilitates General Plan Land Use
Element Goal LU -1F.1 and Housing Element Goal HOU-1.2 in that it protects
existing stabilized residential neighborhoods, including mobile home parks (and
manufactured housing parks) from the encroachment of incompatible or
potentially disruptive land uses and/or activities. The configuration of the
buildings and the site's proximity to an alley on the easterly property line help
mitigate potential impacts.
The sober living home has operated at this location for more than five years.
During that time, the City has not received any complaints from surrounding
residents regarding the operation of the facility. The facility has not generated
excessive requests for emergency services. The property is well maintained.
The applicant has demonstrated that this facility is operated in a manner that
does not conflict with the residential character of the neighborhood. There will
be no more than two occupants per bedroom. Residents are not allowed to keep
vehicles at the facility; shuttle service is provided. There is adequate space to
accommodate vehicles belonging to the staff and visitors on the driveway and
on the street.
Finding: Granting the conditional use permit will not be materially detrimental to the
health, safety and general welfare of the public or otherwise injurious to property or
improvements within the immediate neighborhood.
Facts in Support of Findings: As part of the application process, the sober
living operator was required to Live Scan all owners/operators who have
contact with residents, corporate officers with operational responsibilities and
house managers. Additionally, the applicant submitted a copy of the House
Rules, Relapse Policy and all forms distributed to residents. These
documents demonstrate that the facility will be operated in a manner
consistent with the provisions of the Costa Mesa Municipal Code. There have
not been any code enforcement complaints since Casa Capri Recovery began
operating at the property more than five years ago. Further, the facility has
not generated calls for emergency services in excess of those commonly
generated by residences in the area.
The Costa Mesa Municipal Code and the conditions of approval require the
owner to operate the facility in a manner that will allow the quiet enjoyment of
the surrounding neighborhood. Existing mature landscaping and fences
provide a buffer from adjacent properties and the adjoining street and
sidewalk, helping to minimize impacts to the surrounding neighborhood. The
operator will provide contact information to neighbors if there are any
concerns regarding operation of the facility. The sober living home is subject
to a City inspection of the interior and/or exterior of the facility to verify that the
approved use has not been altered and that the property complies with all
applicable code(s) upon 24 hours written notice (or up to 48 hours under
special circumstances).
The operator is an active member of The Sober Living Network, a non-profit
organization that sets the most comprehensive standards for sober living
homes in the nation. This organization conducts annual inspections to insure
member facilities are in compliance. The standards promulgated by this
organization can be found at www.soberhousing.net. These standards
reinforce the City's regulations.
The facility will house up to 14 residents in four attached units. Combined,
these units include eight bedrooms and four bathrooms. There are also four
kitchens, four indoor living areas, and an outdoor living area. The project
complies with the City's parking standards. The proposed occupancy of the
facility is reasonable. The owner has demonstrated an ability to operate the
facility in a manner that is compatible with the neighborhood.
Finding: Granting the conditional use permit will not allow a use, density or intensity
which is not in accordance with the general plan designation and any applicable
specific plan for the property.
Facts in Support of Findings: The use is consistent with Housing Element
Goal HOU-1.8 of the General Plan, which encourages the development of
housing that fulfills specialized needs by providing living opportunities for
disabled individuals. The facility provides an accommodation for the disabled
that is reasonable and actually resembles the opportunities afforded non -
disabled individuals to use and enjoy a dwelling unit in a residential
neighborhood. The facility offers a comfortable living environment that will
enhance opportunities for the disabled, including recovering addicts, to be
successful in their programs.
— (qo
The subject property contains four existing units on a single parcel. The
proposed use is consistent with the general plan designation.
B. The project has been reviewed for compliance with the California Environmental
Quality Act (CEQA), the CEQA Guidelines, and the City's environmental procedures.
The project is categorically exempt from the provisions of the California
Environmental Quality Act (CEQA) under Section 15301 for Existing Facilities.
C. The project is exempt from Chapter XII, Article 3 Transportation System
Management, of Title 13 of the Costa Mesa Municipal Code.
.-q I -
EXHIBIT B
CONDITIONS OF APPROVAL
Ping. 1. Once issued by the City, the owner shall maintain in good standing, an
operator's permit as required by Article 23, Chapter 2 of Title 9.
2_ The total number of occupants in the sober living home shall be no more
than 14.
3. The use shall be limited to the type of operation described in the staff report
and applicant's project description submitted with the application on May 9,
2016, subject to conditions. Any change in the operational characteristics
including, but not limited to, home rules and regulations, intake procedures
or relapse policy, shall be subject to Community Improvement Division
review and may require an amendment to the conditional use permit, subject
to either Zoning Administrator or Planning Commission approval, depending
on the nature of the proposed change. The applicant is reminded that Code
allows the Planning Commission to modify or revoke any planning
application based on findings related to public nuisance and/or
noncompliance with conditions of approval [Title 13, Section 13-29(0)].
4. Applicant shall defend, with the attorney of City choosing, and shall indemnify
and hold harmless the City, its officials and employees, against all legal
actions filed challenging City's approval of the applicant's project and/or
challenging any related City actions supporting the approval.
5. A copy of the conditions of approval for the conditional use permit must be
kept on premises and presented by the house manager to any authorized
City official upon request. New business/property owners shall be notified of
conditions of approval upon transfer of the business or ownership of land.
6. The project is subject to compliance with all applicable Federal, State, and
local laws.
7. All vehicles associated with the residence, including residents and staff,
shall be limited to parking on the property and/or on the street within 500
feet of the property.
8. It shall be the applicant's responsibility to maintain current information on
file with the City regarding the name, address and telephone number of
the property manager and/or owner.
9. The property shall be maintained in accordance with landscape
maintenance requirements contained in Costa Mesa Municipal Code
Section 13-108.
10. Each dwelling unit shall be limited to one mailbox and one meter for each
utility.
-q2-
CID
11. The facility shall operate at all times in a manner that will allow the quiet
enjoyment of the surrounding neighborhood consistent with Title 20 of the
Costa Mesa Municipal Code. The applicant and/or manager shall institute
whatever measures are necessary to comply with this requirement.
12. If any building alterations are proposed, the applicant shall comply with
requirements of the California Building Code as to design and
construction.
13. The applicant shall obtain a fire clearance from the Costa Mesa Fire
Department pursuant to the requirements of the current version of the
California Fire Code within 30 days of the date of approval of this Permit.
14. Applicant shall provide neighbors with the telephone number of the on-site
manager and/or property owner, for the purposes of allowing neighbors to
lodge complaints or describe concerns about the operation of the facility.
15. The sober living home shall not provide any of the following services as
they are defined by Section 10501 (a)(6) of Title 9, California Code of
Regulations: detoxification; education counseling; individual or group
counseling sessions; and treatment recovery or planning.
16. The applicant is responsible to ensure that occupants, if any, who are
subject to the requirements of Health & Safety Code section 11590 et seq.
(Registration of Controlled Substance Offenders), Penal Code section 290
et seq. (Sex Offender Registration Act), and/or any condition of probation
or parole, are in compliance with any applicable requirements and
conditions of their registration, probation and/or parole while they are
occupants or residents of the subject property.
17. Vehicles picking up or dropping off passengers at the facility shall not block
traffic or create hazardous conditions and shall comply with all applicable
provisions of the California Vehicle Code and Title X of the Costa Mesa
Municipal Code.
18. The applicant shall comply with any and all water conservation measures
adopted by the Mesa Water District that apply to multi -family residences
and/or properties.
19. The applicant shall post a copy of the Good Neighbor Policy in at least one
highly visible location inside the facility and in at least one highly visible
location in all side and rear yards.
20. Operator shall ensure that no trash and debris generated by tenants is
deposited onto the City's rights of way pursuant to Section 8-32 of the
Costa Mesa Municipal Code.
q3
21. The applicant shall comply with reservation procedures implemented by
the City's Parks and Community Services Department to reserve park
shelters or picnic areas for special events.
22. This CUP is subject to review if the applicant fails to comply with any of
the conditions of approval listed in this resolution and/or the facility creates
an excessive amount of calls for City services.
23. Pursuant to Section 9-374 of the Costa Mesa Municipal Code, upon
eviction from or involuntary termination of residency in a group home, the
operator of the group home shall make available to the occupant
transportation to the address listed on the occupant's driver's license, state
issued identification card, or the permanent address identified in the
occupant's application or referral to the group home. The group home may
not satisfy this obligation by providing remuneration to the occupant for the
cost of transportation.
CODE REQUIREMENTS
The following list of federal, state and local laws applicable to the project has been
compiled by staff for the applicant's reference. Any reference to "City" pertains to the City
of Costa Mesa.
Ping. 1. Use shall comply with all requirements of Chapter XVI of the Costa Mesa
Municipal Code relating to development standards for sober living homes in
multi -family residential zones.
Bldg. 2. At the time of plan submittal or permit issuance, the applicant shall comply
with the requirements of the California Code of Regulations, also known
as the California Building Standards Code, as amended by the City of
Costa Mesa, including, as applicable, the adopted California Building
Code, California Electrical Code, California Mechanical Code, California
Plumbing Code, California Green Building Standards Code and California
Energy Code.
ATTACHMENT 9
RESOLUTION NO. PC -16-
A RESOLUTION OF THE PLANNING COMMISSION OF
THE CITY OF COSTA MESA UPHOLDING THE
DIRECTOR'S DENIAL OF CASA CAPRI RECOVERY'S
REASONABLE ACCOMMODATION REQUEST TO ALLOW
THE OPERATION OF A GROUP HOME, RESIDENTIAL
CARE FACILITY OR STATE LICENSED DRUG AND
ALCOHOL TREATMENT FACILITY ON TWO
CONTIGUOUS PROPERTIES AT 269 AND 271 16th PLACE;
AND DENYING CONDITIONAL USE PERMIT PA -16-41 TO
ALLOW A SOBER LIVING FACILITY SERVING UP TO 14
WOMEN AT 269 16TH PLACE.
WHEREAS, Case Capri Recovery (the "Applicant") operates a sober living facility
at 269 1611 Place, Costa Mesa; and
WHEREAS, an application was filed by the Applicant requesting approval of
Planning Application PA -16-41, a Conditional Use Permit to allow the subject facility to
serve up to 14 women within four existing units; and a request for a reasonable
accommodation to allow this facility to be located within 650 feet of another property that
contains a group home, sober living home or state licensed druag and alcohol treatment
faciltity, allowing the units on these contiguous parcels to operate as a single facility; and
WHEREAS, the City of Costa Mesa recognizes that while not in character with
residential neighborhoods, when operated responsibly, group homes, including sober
living homes, provide a societal benefit by providing disabled persons as defined by state
and federal law the opportunity to live in residential neighborhoods, as well as providing
recovery programs for individuals attempting to overcome their drug and alcohol
addictions, and that therefore providing greater access to residential zones to group
homes, including sober living homes, than to boardinghouses or any other type of group
living provides a benefit to the City and its residents; and
WHEREAS, the City of Costa Mesa has adopted standards for the operation of
group homes, residential care facilities and state licensed drug and alcohol facilities that
are intended to provide opportunities for disabled persons as defined by state and federal
law to enjoy comfortable accommodations in a residential setting; and
WHEREAS, the City of Costa Mesa has found that congregating sober living
homes in close proximity to each other does not provide disabled persons as defined in
state and federal law with an opportunity to "live in normal residential surroundings," but
rather places them into living environments bearing more in common with the types of
institutional/campus/dormitory living that the FEHA and FHAA were designed to provide
relief from for the disabled, and which no reasonable person could contend provides a life
in a normal residential surrounding; and
-qs--
WHEREAS, the City of Costa Mesa has determined that a separation requirement
for such facilities will still allow for a reasonable market for the purchase and operation of
sober living homes within the City and still result in preferential treatment for sober living
homes in that non -disabled individuals in a similar living situation (i.e., in boardinghouse -
style residences) have fewer housing opportunities than disabled persons; and
WHEREAS, Casa Capri Recovery filed an application with the City's Director of
Economic and Development Services/Deputy CEO (the "Director") requesting an
accommodation from the Costa Mesa Municipal Code's requirement that a group home,
residential care facility or state licensed drug and alcohol facility is at least 650 feet from
another property that contains a group home, sober living home or state licensed drug
and alcohol treatment facility, as measured from the property line (the "Application"); and
WHEREAS, the applications were processed in the time and manner prescribed
by federal, state and local laws, and the Director denied the request for the reasonable
accommodation; and
WHEREAS, Casa Capri Recovery appealed the denial of the reasonable
accommodation request in a timely manner; and
WHEREAS, a duly noticed public hearing was scheduled for November 14, 2016,
before the Planning Commission to hear the appeal and the conditional use perimit; and
WHEREAS, on November 14, 2016, the Planning Commission conducted a duly
noticed public hearing, at which time interested persons had an opportunity to testify
either in support of or in opposition to the applications and determined by a X -X vote to
deny the Application.
NOW THEREFORE, the Planning Commission of the City of Costa Mesa finds
and resolves as follows:
BE IT RESOLVED, therefore, that based on the evidence in the record and the
findings contained in this resolution, the Planning Commission hereby UPHOLDS THE
DIRECTOR'S DENIAL of Casa Capri, LLC's reasonable accommodation request to allow
the operation of a group home, residential care facility or state licensed drug and alcohol
treatment facility on contiguous properties; and DENIES Conditional Use Permit PA -16-
41.
The Secretary of the Commission shall attest to the adoption of this resolution and
shall forward a copy to the applicant, and any person requesting the same.
PASSED AND ADOPTED this 14th day of November, 2016.
Robert L. Dickson Jr., Chair
Costa Mesa Planning Commission
,q-7-
STATE OF CALIFORNIA
)ss
COUNTY OF ORANGE
I, Jay Trevino, Secretary to the Planning Commission of the City of Costa Mesa,
do hereby certify that the foregoing Resolution was passed and adopted at a meeting of
the City of Costa Mesa Planning Commission held on November 14, 2016 by the following
votes:
AYES: COMMISSIONERS
NOES: COMMISSIONERS
ABSENT: COMMISSIONERS
ABSTAIN: COMMISSIONERS
Jay Trevino, Acting Secretary
Costa Mesa Planning Commission
EXHIBIT A
FINDINGS FOR DENIA
The City's evidence
The City's evidence consists of a staff report with attachments. The staff report
provided the factual background, legal analysis and the City's analysis supporting the
denial of Casa Capri, LLC's reasonable accommodation request, based on the Applicant
not meeting its burden to demonstrate compliance with all required findings per the Costa
Mesa Municipal Code.
A. The Applicant has not met its burden to show that the Application meets the
following findings for approval of Reasonable Accommodation:
•
Applicant has not met its burden to show that the requested accommodation is
necessary to afford individuals recovering from drug and alcohol addiction the
opportunity to the use and enioyment of a dwelling in the City.
The application established that the requested accommodation (waiver of the
650 -foot separation requirement) may allow a CUP to be granted to enable
Casa Capri, LLC, to continue to operate in compliance with the Costa Mesa
Municipal Code at its current location. In theory, this action would allow one or
more individuals who are recovering from drug and alcohol abuse to enjoy the
use of this dwelling. However, approval of the request is not necessary to allow
one or more individuals who are recovering from drug and alcohol abuse to
enjoy the use of a dwelling within the City.
•
Applicant has not met its burden to show whether the existing supply of facilities
of a similar nature and operation in the community is insufficient to provide
individuals with a disability an equal opportunity to live in a residential setting.
Based on the most recent data compiled by City staff, there are approximately
98 sober living homes within Costa Mesa. Of these, 37 are located in single-
family neighborhoods and 61 are within multi -family residential zones.
Additionally, there are approximately 81 state licensed drug and alcohol
residential care facilities in Costa Mesa. Twenty-five are in single-family
residential zones, 55 are in multi -family residential zones and one is in a C1
zone. No evidence has been submitted to indicate that the number of sober
living homes and drug and alcohol residential care facilities existing or
potentially allowed in compliance with the City's standards is inadequate.
• Applicant has not met its burden to show whether the reauested
accommodation is consistent with whether or not the residents would constitute
a single housekeeping unit.
- q Q__
According to the City's definition of a sober living home, a sober living home's
residents do not constitute a single housing keeping unit. The requested
accommodation is for a provision of the Costa Mesa Municipal Code that would
not apply to single housekeeping units. Therefore, this finding is not relevant.
• Applicant did not demonstrate that the requested accommodation is necessary
to make facilities of a similar nature or operation economically viable in light of
the particularities of the relevant market and market participants.
The applicant did not provide evidence in its application regarding this factor;
therefore, City staff was not able to make this finding. As noted above, there
is a significant number of sober living facilities in Costa Mesa.
• Applicant was not able to demonstrate that the requested accommodation will
not result in a fundamental alteration in the nature of the City's zoning program.
The City's separation standard of 650 feet was intended to ensure that there
would be no more than one group home, residential care facility or state licensed
drug and alcohol facility on any block. In addition, the Municipal Code limits the
operation of any sober living facility to a single parcel, again to prevent
overconcentration of sober living units. Therefore, approval of the
accommodation request will result in a fundamental alteration of the City's zoning
program, as set forth in Ordinance numbers 14-13 and 15-11, because it would
contribute to the overconcentration of these types of facilities in this residential
neighborhood.
The burden to demonstrate necessity remains with the Applicant. Oconomowoc,
300 F.3d at 784, 787. Applicant must show that "without the required
accommodation the disabied will be denied the equal opportunity to live in a
residential neighborhood." Oconomowoc, 300 F.3d at 784; see also, United
States v. California Mobile Home Mgmt Co., 107 F3d 1374, 1380 (9th Cir. 1997)
("without a causal link between defendants' policy and the plaintiff's injury, there
can be no obligation on the part of the defendants to make a reasonable
accommodation"); Smith & Lee, Inc. v. City of Taylor, Mich., 102 F.3d 781, 795
(6th Cir. 1996) ("plaintiffs must show that, but for the accommodation, they likely
will be denied an equal opportunity to enjoy the housing of their choice").
The Applicant has asserted that the requested accommodation from the 650 -foot
distance requirement is reasonable. However, a zoning accommodation may be
deemed unreasonable if "it is so at odds with the purposes behind the rule that it
would be a fundamental and unreasonable change." Oconomowoc, 300 F.3d at
784. The Applicant made no mention of the purpose underlying the City's zoning
limitation, or explained how the accommodation requested would not undermine
that purpose. In fact, the Director found that such allowance would fundamentally
alter the character of this neighborhood and is thus unreasonable.
Allowing multiple group homes, sober living homes and/or state licensed drug
and alcohol treatment facilities to cluster in a residential neighborhood does effect
a fundamental change to the residential character of the neighborhood. The
clustering of group homes in close proximity to each other does change the
residential character of the neighborhood to one that is far more institutional in
nature. This is particularly the case with respect to sober living homes. Both
California and federal courts have recognized that the maintenance of the
residential character of neighborhoods is a legitimate governmental interest. The
United States Supreme Court long ago acknowledged the legitimacy of "what is
really the crux of the more recent zoning legislation, namely, the creation and
maintenance of residential districts, from which business and trade of every sort,
including hotels and apartment houses, are excluded." Euclid v. Amber Realty
Co., 272 U.S. 365, 390 (1926).
The California Supreme Court also recognizes the legitimacy of this interest:
It is axiomatic that the welfare, and indeed the very existence of a
nation depends upon the character and caliber of its citizenry. The
character and quality of manhood and womanhood are in a large
measure the result of home environment. The home and its intrinsic
influences are the very foundation of good citizenship, and any
factor contributing to the establishment of homes and the fostering
of home life doubtless tends to the enhancement not only of
community life but of the life of the nation as a whole.
Miller v. Board of Public Works, 195 Cal. 477, 490, 492-93 (1925).
With home ownership comes stability, increased interest in the
promotion of public agencies, such as schools and churches, and
`recognition of the individual's responsibility for his share in the
safeguarding of the welfare of the community and increased pride
in personal achievement which must come from personal
participation in projects looking toward community betterment.'
Ewing v. City of Carmel -by -the -Sea, 234 Cal. App. 3d 1579, 1590 (1991),
citing Miller, 195 Cal. at 493. It is with these purposes in mind that the City of
Costa Mesa has created residential zones, including R2 zones for multi -family
residences.
The requested accommodation, in these specific circumstances, would
result in a fundamental alteration of the City's zoning program, as set forth
in Ordinance numbers 14-13 and 15-11, because it would increase and/or
contribute to the overconcentration of these types of facilities in this
residential neighborhood.
B. The Application does not meet the findings required by the Costa Mesa Municipal
Code for approval of a Conditional Use Permit:
• The proposed use is substantially compatible with developments in the same
general area and would not be materially detrimental to other properties within
the area.
The introduction of one sober living home in compliance with the City's standards
would not be materially detrimental to the area. However, over the last decade,
the number of sober living homes in the City of Costa Mesa has rapidly increased,
leading to an overconcentration of sober living homes in certain of the City's
residential neighborhoods. Overconcentration is both deleterious to the residential
character of these neighborhoods and may also lead to the institutionalization of
such neighborhoods. The City's establishment of distance requirements for sober
living homes is reasonable and non-discriminatory and helps preserve the
residential character of the R2MD, R2HD, and R3 zones, as well as the planned
development residential neighborhoods. It but also furthers the interest of ensuring
that the handicapped are not living in overcrowded environments that are
counterproductive to their well-being and recovery. Allowing a single facility to
operate on two parcels would contribute to an overconcentration of such facilities
in this neighborhood.
• Granting the CUP will not be materially detrimental to the health, safety and
general welfare of the public or otherwise injurious to property or improvements
within the immediate neighborhood.
As noted above, approval of this application will result in overconcentration of group
homes, residential care facilities and/or state licensed drug and alcohol facilities in
this neighborhood. Short-term tenants, such as might be found in homes that provide
addiction treatment programs of limited duration, generally have little interest in the
welfare of the neighborhoods in which they temporarily reside -- residents "do not
participate in local government, coach little league, or join the hospital guild. They do
not lead a scout troop, volunteer at the library, or keep an eye on an elderly neighbor.
Literally, they are here today and gone tomorrow -- without engaging in the sort of
activities that weld and strengthen a community." Ewing, 234 Cal. App. 3d at 1591.
Strong evidence exists that a supportive living environment in a residential
neighborhood provides more effective recovery than an institutional -style
environment (see Attachments 5 and 6 to the staff report). The City's zoning
regulations address overconcentration and secondary effects of sober living
homes. The goal of the regulations is to provide the disabled with an equal
opportunity to live in the residence of their choice, and to maintain the residential
character of existing neighborhoods.
The City has found through experience that clustering sober living facilities in close
proximity to each other results in neighborhoods dominated by sober living
facilities. In these neighborhoods, street life is often characterized by large
capacity vans picking -up and dropping -off residents and staff, service providers
taking up much of the available on street parking, staff in scrubs carrying medical
kits going from unit to unit, and vans dropping off prepared meals in large numbers.
The City has experienced frequent Fire Department deployments in response to
medical aid calls. In some neighborhoods, Police Department deployments are a
regular occurrence as a result of domestic abuse calls, burglary reports, disturbing
the peace calls and parole checks at sober living facilities. Large and often
frequent AA or NA meeting are held at some sober living homes. Attendees of
these meetings contribute to the lack of available on street parking and neighbors
report finding an unusual amount of litter and debris, including beverage
containers, condoms and drug paraphernalia in the wake of these meetings.
These types of impacts have been identified in other communities as well (see
Attachment 7 to the staff report).
• Granting the conditional use permit will not allow_ a use which is not in
accordance with the .general plan designation.
The proposed use is consistent with the City's General Plan if it complies with the
City's criteria. However, an overconcentration of group homes, sober living homes
and licensed treatment facilities for alcohol and drug addiction is not consistent
with the General Plan. The City's regulations are intended to preserve the residential
character of the City's neighborhoods. The City Council has determined that an
overconcentration of sober living facilities would be detrimental to the residential
character of the City's neighborhoods.
C. The Costa Mesa Planning Commission has denied Conditional Use Permit PA -16-
15. Pursuant to Public Resources Code Section 21080(b) and CEQA Guidelines
Section 15270(a), CEQA does not apply to this project because it has been rejected
and will not be carried out.
D. The project is exempt from Chapter IX, Article 11, Transportation System
Management, of Title 13 of the Costa Mesa Municipal Code.
ATTACHMENT 6
RESOLUTION NO. 17-
A RESOLUTION OF THE CITY COUNCIL OF THE CITY OF
COSTA MESA UPHOLDING THE DIRECTOR'S DENIAL OF
A REASONABLE ACCOMMODATION REQUEST TO
ALLOW THE OPERATION OF A GROUP HOME,
RESIDENTIAL CARE FACILITY OR STATE LICENSED
DRUG AND ALCOHOL TREATMENT FACILITY ON TWO
CONTIGUOUS PROPERTIES AT 269 AND 27116t' PLACE;
AND DENYING CONDITIONAL USE PERMIT PA -16-41 TO
ALLOW A SOBER LIVING FACILITY SERVING UP TO 14
WOMEN AT 269 16TH PLACE
THE CITY COUNCIL OF THE CITY OF COSTA MESA HEREBY RESOLVES AS
FOLLOWS:
WHEREAS, an application was filed by Casa Capri Recovery with respect to the
real property located at 269 16th Place; and
WHEREAS, the proposed project consists of a Conditional Use Permit to allow the
subject facility to serve up to 14 women within four existing units; and a request for a
reasonable accommodation to allow this facility to be located within 650 feet of another
property that contains a group home, sober living home or state licensed druag and
alcohol treatment faciltity, allowing the units on these contiguous parcels to operate as a
single facility; and
WHEREAS, the City of Costa Mesa recognizes that while not in character with
residential neighborhoods, when operated responsibly, group homes, including sober
living homes, provide a societal benefit by providing disabled persons as defined by state
and federal law the opportunity to live in residential neighborhoods, as well as providing
recovery programs for individuals attempting to overcome their drug and alcohol
addictions, and that therefore providing greater access to residential zones to group
homes, including sober living homes, than to boardinghouses or any other type of group
living provides a benefit to the City and its residents; and
WHEREAS, the City of Costa Mesa has adopted standards for the operation of
group homes, residential care facilities and state licensed drug and alcohol facilities that
are intended to provide opportunities for disabled persons as defined by state and federal
law to enjoy comfortable accommodations in a residential setting; and
WHEREAS, the City of Costa Mesa has found that congregating sober living
homes in close proximity to each other does not provide disabled persons as defined in
state and federal law with an opportunity to "live in normal residential surroundings," but
rather places them into living environments bearing more in common with the types of
institutional/campus/dormitory living that the FEHA and FHAA were designed to provide
ATTACHMENT 6
relief from for the disabled, and which no reasonable person could contend provides a life
in a normal residential surrounding; and
WHEREAS, the City of Costa Mesa has determined that a separation requirement
for such facilities will still allow for a reasonable market for the purchase and operation of
sober living homes within the City and still result in preferential treatment for sober living
homes in that non -disabled individuals in a similar living situation (i.e., in boardinghouse -
style residences) have fewer housing opportunities than disabled persons; and
WHEREAS, Casa Capri Recovery filed an application with the City's Director of
Economic and Development Services (the "Director") requesting an accommodation from
the Costa Mesa Municipal Code's requirement that a group home, residential care facility
or state licensed drug and alcohol facility is at least 650 feet from another property that
contains a group home, sober living home or state licensed drug and alcohol treatment
facility, as measured from the property line; and
WHEREAS, the applications were processed in the time and manner prescribed
by federal, state and local laws, and the Director denied the request for the reasonable
accommodation; and
WHEREAS, Casa Capri Recovery appealed the denial of the reasonable
accommodation request in a timely manner; and
WHEREAS, on November 14, 2016, the Planning Commission conducted a duly
noticed public hearing, at which time interested persons had an opportunity to testify
either in support of or in opposition to the applications and determined by a 4-0 vote to
deny the Application; and
WHEREAS, the Applicant appealed the decision of the Planning Commission on
November 16, 2016; and
WHEREAS, a duly noticed public hearing was held by the City Council on October
3, 2017, with all persons having the opportunity to speak for and against the proposal;
and,
WHEREAS, the project has been reviewed for compliance with the California
Environmental Quality Act (CEQA), the CEQA Guidelines, and the City environmental
procedures, and has been found to be exempt from CEQA under Section 15301, Existing
Facilities; and
WHEREAS, the CEQA categorical exemption for this project reflects the
independent judgment of the City of Costa Mesa.
BE IT RESOLVED, therefore, that based on the evidence in the record and the
findings contained in this resolution, the Planning Commission hereby UPHOLDS THE
DIRECTOR'S DENIAL of the Applicant's reasonable accommodation request to allow the
ATTACHMENT 6
operation of a group home, residential care facility or state licensed drug and alcohol
treatment facility on contiguous properties; and DENIES Conditional Use Permit PA -16-
41.
BE IT FURTHER RESOLVED that if any section, division, sentence, clause,
phrase or portion of this resolution, or the documents in the record in support of this
resolution, are for any reason held to be invalid or unconstitutional by a decision of any
court of competent jurisdiction, such decision shall not affect the validity of the remaining
provisions.
PASSED AND ADOPTED this 3rd day of October, 2017.
KATRINA FOLEY
Mayor, City of Costa Mesa
ATTEST: APPROVED AS TO FORM:
CITY CLERK OF THE CITY ATTORNEY
CITY OF COSTA MESA
ATTACHMENT 6
STATE OF CALIFORNIA)
)ss
COUNTY OF ORANGE )
I, BRENDA GREEN, City Clerk and ex -officio Clerk of the City Council of
the City of Costa Mesa, hereby certify that the above Council Resolution Number 17
as considered at a regular meeting of said City Council held on the 5th day of September,
2017, and thereafter passed and adopted as a whole at the regular meeting of said City
Council held on the 3rd day of October, 2017, by the following roll call vote:
AYES:
NOES:
ABSENT:
IN WITNESS WHEREOF, I have hereby set my hand and affixed the Seal of the
City of Costa Mesa this day of , 2017
EXHIBIT A
FINDINGS FOR DENIAL
ATTACHMENT 6
The City's evidence consists of a staff report with attachments. The staff report
provided the factual background, legal analysis and the City's analysis supporting the
denial of Casa Capri, LLC's reasonable accommodation request, based on the Applicant
not meeting its burden to demonstrate compliance with all required findings per the Costa
Mesa Municipal Code.
A. The Applicant has not met its burden to show that the Application meets the
following findings for approval of Reasonable Accommodation:
• The requested accommodation is requested by or on the behalf of one (1) or
more individuals with a disability protected under the fair housing laws.
The City accepts that this request for reasonable accommodation was
submitted on behalf of persons who are considered disabled under state and
federal law.
• The requested accommodation is necessary to provide one (1) or more
individuals with a disability an equal opportunity to use and enjoy a dwelling.
The application established that the requested accommodation to waive the
650 -foot separation requirement may allow a CUP to be granted to enable
Casa Capri Recovery to continue to operate in compliance with the Costa Mesa
Municipal Code at its current location. In theory, this action would allow one or
more individuals who are recovering from drug and alcohol abuse to enjoy the
use of these dwellings. However, approval of the request is not necessary to
allow one or more individuals who are recovering from drug and alcohol abuse
to enjoy the use of a dwelling within the City
The requested accommodation will not impose an undue financial or
administrative burden on the city, as "undue financial or administrative
burden" is defined in fair housing laws and interpretive case law.
There is no evidence that approval of this request will impose an undue
financial or administrative burden on the City.
• The requested accommodation is consistent with surrounding uses in scale and
intensity of use.
ATTACHMENT 6
The accommodation would allow an overconcentration of sober living units in
this neighborhood. The Costa Mesa Municipal Code limits the operation of
sober living homes and licensed drug and alcohol treatment facilities to a single
parcel to ensure the disabled are allowed to live in a normal residential setting.
The requested accommodation will not, under the specific facts of the case,
result in a direct threat to the health or safety of other individuals or substantial
physical damage to the property of others.
There is no evidence that approval of this request would result in a direct
threat to the health or safety of anyone, or substantial physical damage to the
property of others.
• If economic viability is raised by the applicant as part of the applicant's showing
that the requested accommodation is necessary, then a finding that the
requested accommodation is necessary to make facilities of a similar nature or
operation economically viable in light of the particularities of the relevant market
and market participants generally, not just for that particular applicant.
Economic viability was not listed as a factor by the applicant.
• Whether the existing supply of facilities of a similar nature and operation in
the community is sufficient to provide individuals with a disability an equal
opportunity to live in a residential setting.
The City has received applications for 66 sober living homes and 11 licensed
treatment facilities that are subject to compliance with Ordinance Nos. 14-13
and 15-11. Twelve (12) sober living homes serving six or fewer residents have
been approved by the City, and one sober living home serving 13 men has
been approved. In addition, there are 63 state -licensed drug and alcohol
residential care facilities in Costa Mesa that are exempt from City regulation, or
have already obtained the required conditional use permit. No evidence has
been submitted to indicate that the number of sober living homes and drug and
alcohol residential care facilities existing or potentially allowed in compliance
with the City's standards is inadequate.
The requested accommodation will not result in a fundamental alteration in
the nature of the city's zoning program.
Ordinance 15-11 established requirements for sober living homes, group
homes and licensed drug and alcohol treatment facilities in multi -family zoning
districts. When the City Council adopted this ordinance, it specifically included
a provision limiting the operation of a sober living facility to a single parcel. The
intent of this limitation is to ensure that sober living facilities do not occupy a
disproportionate number of homes in any neighborhood, and to avoid
overconcentration of sober living units in any area. The City also sought to
ATTACHMENT 6
ensure that disabled persons recovering from addiction can reside in a
comfortable residential environment versus in an institutional setting. The City
determined that housing inordinately large numbers of unrelated adults in a
single dwelling or congregating sober living homes in close proximity to each
other does not provide the disabled with an opportunity to "live in normal
residential surroundings," but rather places them into living environments
bearing more in common with the types of institutional/campus/dormitory living
that the state and federal laws were designed to provide relief from for disabled
persons. The use of eight units on two parcels to accommodate 28 residents
will create a large facility not in keeping with the City's desire to ensure sober
living homes more closely resemble a typical residential environment.
The City's separation standard of 650 feet was intended to ensure that there
would be no more than one group home, residential care facility or state licensed
drug and alcohol facility on any block. In addition, the Municipal Code limits the
operation of any sober living facility to a single parcel, again to prevent
overconcentration of sober living units. Therefore, approval of the
accommodation request will result in a fundamental alteration of the City's zoning
program, as set forth in Ordinance 15-11, because it would contribute to the
overconcentration of these types of facilities in this residential neighborhood.
The burden to demonstrate necessity remains with the Applicant. Oconomowoc,
300 F.3d at 784, 787. Applicant must show that "without the required
accommodation the disabled will be denied the equal opportunity to live in a
residential neighborhood." Oconomowoc, 300 F.3d at 784; see also, United
States v. California Mobile Home Mgmt Co., 107 F3d 1374, 1380 (9th Cir. 1997)
("without a causal link between defendants' policy and the plaintiff's injury, there
can be no obligation on the part of the defendants to make a reasonable
accommodation"); Smith & Lee, Inc. v. City of Taylor, Mich., 102 F.3d 781, 795
(6th Cir. 1996) ("plaintiffs must show that, but for the accommodation, they likely
will be denied an equal opportunity to enjoy the housing of their choice").
The Applicant has asserted that the requested accommodation from the 650 -foot
distance requirement is reasonable. However, a zoning accommodation may be
deemed unreasonable if "it is so at odds with the purposes behind the rule that it
would be a fundamental and unreasonable change." Oconomowoc, 300 F.3d at
784. The Applicant made no mention of the purpose underlying the City's zoning
limitation, or explained how the accommodation requested would not undermine
that purpose. In fact, the Director found that such allowance would fundamentally
alter the character of this neighborhood and is thus unreasonable.
Allowing multiple group homes, sober living homes and/or state licensed drug
and alcohol treatment facilities to cluster in a residential neighborhood does effect
a fundamental change to the residential character of the neighborhood. The
clustering of group homes in close proximity to each other does change the
residential character of the neighborhood to one that is far more institutional in
ATTACHMENT 6
nature. This is particularly the case with respect to sober living homes. Both
California and federal courts have recognized that the maintenance of the
residential character of neighborhoods is a legitimate governmental interest. The
United States Supreme Court long ago acknowledged the legitimacy of "what is
really the crux of the more recent zoning legislation, namely, the creation and
maintenance of residential districts, from which business and trade of every sort,
including hotels and apartment houses, are excluded." Euclid v. Amber Realty
Co., 272 U.S. 365, 390 (1926).
The California Supreme Court also recognizes the legitimacy of this interest:
It is axiomatic that the welfare, and indeed the very existence of a
nation depends upon the character and caliber of its citizenry. The
character and quality of manhood and womanhood are in a large
measure the result of home environment. The home and its intrinsic
influences are the very foundation of good citizenship, and any
factor contributing to the establishment of homes and the fostering
of home life doubtless tends to the enhancement not only of
community life but of the life of the nation as a whole.
Miller v. Board of Public Works, 195 Cal. 477, 490, 492-93 (1925).
With home ownership comes stability, increased interest in the
promotion of public agencies, such as schools and churches, and
`recognition of the individual's responsibility for his share in the
safeguarding of the welfare of the community and increased pride
in personal achievement which must come from personal
participation in projects looking toward community betterment.'
Ewing v. City of Carmel -by -the -Sea, 234 Cal. App. 3d 1579, 1590 (1991),
citing Miller, 195 Cal. at 493. It is with these purposes in mind that the City of
Costa Mesa has created residential zones, including R2 zones for multi -family
residences.
The requested accommodation, in these specific circumstances, would result in a
fundamental alteration of the City's zoning program, as set forth in Ordinance No.
15-11, because it would increase and/or contribute to the overconcentration of
these types of facilities in this residential neighborhood.
B. The Application does not meet the findings required by the Costa Mesa Municipal
Code for approval of a Conditional Use Permit:
• The proposed use is substantially compatible with developments in the same
general area and would not be materially detrimental to other properties within
the area.
ATTACHMENT 6
The introduction of one sober living home in compliance with the City's standards
would not be materially detrimental to the area. However, over the last decade,
the number of sober living homes in the City of Costa Mesa has rapidly increased,
leading to an overconcentration of sober living homes in certain of the City's
residential neighborhoods. Overconcentration is both deleterious to the residential
character of these neighborhoods and may also lead to the institutionalization of
such neighborhoods. The City's establishment of distance requirements for sober
living homes is reasonable and non-discriminatory and helps preserve the
residential character of the R21VID, R2HD, and R3 zones, as well as the planned
development residential neighborhoods. It but also furthers the interest of ensuring
that the handicapped are not living in overcrowded environments that are
counterproductive to their well-being and recovery. Allowing a single facility to
operate on two parcels would contribute to an overconcentration of such facilities
in this neighborhood.
• Granting the CUP will not be materially detrimental to the health, safety and
general welfare of the public or otherwise injurious to property or improvements
within the immediate neighborhood.
As noted above, approval of this application will result in overconcentration of group
homes, residential care facilities and/or state licensed drug and alcohol facilities in
this neighborhood. Short-term tenants, such as might be found in homes that provide
addiction treatment programs of limited duration, generally have little interest in the
welfare of the neighborhoods in which they temporarily reside -- residents "do not
participate in local government, coach little league, or join the hospital guild. They do
not lead a scout troop, volunteer at the library, or keep an eye on an elderly neighbor.
Literally, they are here today and gone tomorrow -- without engaging in the sort of
activities that weld and strengthen a community." Ewing, 234 Cal. App. 3d at 1591.
Strong evidence exists that a supportive living environment in a residential
neighborhood provides more effective recovery than an institutional -style
environment. The City's zoning regulations address overconcentration and
secondary effects of sober living homes. The goal of the regulations is to provide
the disabled with an equal opportunity to live in the residence of their choice, and
to maintain the residential character of existing neighborhoods.
The City has found through experience that clustering sober living facilities in close
proximity to each other results in neighborhoods dominated by sober living
facilities. In these neighborhoods, street life is often characterized by large
capacity vans picking -up and dropping -off residents and staff, service providers
taking up much of the available on street parking, staff in scrubs carrying medical
kits going from unit to unit, and vans dropping off prepared meals in large numbers.
The City has experienced frequent Fire Department deployments in response to
medical aid calls. In some neighborhoods, Police Department deployments are a
regular occurrence as a result of domestic abuse calls, burglary reports, disturbing
the peace calls and parole checks at sober living facilities. Large and often
ATTACHMENT 6
frequent AA or NA meeting are held at some sober living homes. Attendees of
these meetings contribute to the lack of available on street parking and neighbors
report finding an unusual amount of litter and debris, including beverage
containers, condoms and drug paraphernalia in the wake of these meetings.
These types of impacts have been identified in other communities as well.
• Grantina the conditional use aermit will allow a use which is not in accordance
with the general plan designation.
The proposed use is consistent with the City's General Plan if it complies with the
City's criteria. However, an overconcentration of group homes, sober living homes
and licensed treatment facilities for alcohol and drug addiction is not consistent
with the General Plan. The City's regulations are intended to preserve the residential
character of the City's neighborhoods. The City Council has determined that an
overconcentration of sober living facilities would be detrimental to the residential
character of the City's neighborhoods.
C. The Costa Mesa Planning Commission has denied Conditional Use Permit PA -16-
41. Pursuant to Public Resources Code Section 21080(b) and CEQA Guidelines
Section 15270(a), CEQA does not apply to this project because it has been rejected
and will not be carried out.
D. The project is exempt from Chapter IX, Article 11, Transportation System
Management, of Title 13 of the Costa Mesa Municipal Code.
ATTACHMENT 7
RESOLUTION NO. 17-
A RESOLUTION OF THE CITY COUNCIL OF THE CITY OF
COSTA MESA REVERSING THE DECISION OF THE
PLANNING COMMISSION AND APPROVING CONDITIONAL
USE PERMIT PA -16-44 FOR A SOBER LIVING FACILITY
OPERATED BY CASA CAPRI RECOVERY HOUSING 14
WOMEN WITHIN FOUR EXISTING UNITS ON PROPERTY
LOCATED AT 269 E. 16TH PLACE
THE CITY COUNCIL OF THE CITY OF COSTA MESA HEREBY RESOLVES AS
FOLLOWS:
WHEREAS, an application was filed by Casa Capri Recovery with respect to the
real property located at 271 16th Place; and
WHEREAS, the proposed project consists of a Conditional Use Permit to allow the
subject facility to serve up to 14 women within four existing units; and
WHEREAS, a duly noticed public hearing held by the Planning Commission on
November 14, 2016, with all persons having the opportunity to speak for and against the
proposal, and the project was deemed denied after a motion to approve the application
failed by a vote of 2-2; and
WHEREAS, the property owner appealed the decision of the Planning Commission
on November 16, 2016; and
WHEREAS, a duly noticed public hearing was held by the City Council on October
3, 2017, with all persons having the opportunity to speak for and against the proposal;
and,
WHEREAS, the project has been reviewed for compliance with the California
Environmental Quality Act (CEQA), the CEQA Guidelines, and the City environmental
procedures, and has been found to be exempt from CEQA under Section 15301, Existing
Facilities; and
WHEREAS, the CEQA categorical exemption for this project reflects the
independent judgment of the City of Costa Mesa.
BE IT RESOLVED that, based on the evidence in the record and the findings
contained in Exhibit A, and subject to the conditions of contained within Exhibit B, the City
Council hereby reverses the decision of the Planning Commission and APPROVES
Conditional Use Permit PA -16-44.
BE IT FURTHER RESOLVED that the Costa Mesa City Council does hereby find
and determine that adoption of this Resolution is expressly predicated upon the activity
ATTACHMENT 7
as described in the staff report for Conditional Use Permit PA -16-44, and upon the
applicant's compliance with each and all of the conditions in Exhibit B, and compliance of
all applicable federal, state, and local laws. Any approval granted by this resolution shall
be subject to review, modification or revocation if there is a material change that occurs
in the operation, or if the applicant fails to comply with any of the conditions of approval
and/or mitigation measures.
BE IT FURTHER RESOLVED that if any section, division, sentence, clause,
phrase or portion of this resolution, or the documents in the record in support of this
resolution, are for any reason held to be invalid or unconstitutional by a decision of any
court of competent jurisdiction, such decision shall not affect the validity of the remaining
provisions.
PASSED AND ADOPTED this 3rd day of October, 2017.
KATRINA FOLEY
Mayor, City of Costa Mesa
ATTEST: APPROVED AS TO FORM:
CITY CLERK OF THE CITY ATTORNEY
CITY OF COSTA MESA
ATTACHMENT 7
STATE OF CALIFORNIA)
)ss
COUNTY OF ORANGE )
I, BRENDA GREEN, City Clerk and ex -officio Clerk of the City Council of
the City of Costa Mesa, hereby certify that the above Council Resolution Number 17
as considered at a regular meeting of said City Council held on the 5th day of September,
2017, and thereafter passed and adopted as a whole at the regular meeting of said City
Council held on the 3rd day of October, 2017, by the following roll call vote:
AYES:
NOES:
ABSENT:
IN WITNESS WHEREOF, I have hereby set my hand and affixed the Seal of the
City of Costa Mesa this day of , 2017
EXHIBIT A
FINDINGS FOR APPROVAL
ATTACHMENT 7
A. The application presented substantially complies with Costa Mesa Municipal Code
Section 13-29(g)(2) in that:
Finding: The proposed development or use is substantially compatible with
developments in the same general area and would not be materially detrimental to
other properties within the area.
Facts in Support of Findings: A sober living home is a supportive living
environment for persons who are recovering from drug and/or alcohol addiction.
Since the City Council has denied the applicant's request to operate a sober
living home on the adjoining property at 269 16th Place (PA -16-41), the subject
property is not within 650 feet of any other state licensed drug and alcohol facility
or sober living home that is currently permitted pursuant to City of Costa Mesa
land use requirements. This separation helps to preserve the residential
character of neighborhoods and facilitates General Plan Land Use Element
Goal LU -1 F.1 and Housing Element Goal HOU-1.2 in that it protects existing
stabilized residential neighborhoods, including mobile home parks (and
manufactured housing parks) from the encroachment of incompatible or
potentially disruptive land uses and/or activities. The configuration of the
building and the long driveway on the southeasterly property line help mitigate
potential impacts.
The sober living home has operated at this location for more than six years.
During that time, the City has not received any complaints from surrounding
residents regarding the operation of the facility. The property is well maintained.
The applicant has demonstrated that this facility is operated in a manner that
does not conflict with the residential character of the neighborhood. There will
be no more than two occupants per bedroom. Residents are not allowed to keep
vehicles at the facility; shuttle service is provided. There is adequate space to
accommodate vehicles belonging to the staff and visitors on the site and on -
street parking is available within 500 feet, pursuant to the CMMC.
Finding: Granting the conditional use permit will not be materially detrimental to the
health, safety and general welfare of the public or otherwise injurious to property or
improvements within the immediate neighborhood.
Facts in Support of Findings: As part of the application process, the
Applicant was required to Live Scan all owners/operators who have contact
with residents, corporate officers with operational responsibilities and house
managers. Additionally, the applicant submitted a copy of the House Rules,
Relapse Policy and all forms distributed to residents. These documents
demonstrate that the facility will be operated in a manner consistent with the
ATTACHMENT 7
provisions of the Costa Mesa Municipal Code. There have not been any code
enforcement complaints since Casa Capri Recovery began operating at the
property more than six years ago.
The CMMC and the conditions of approval require the owner to operate the
facility in a manner that will allow the quiet enjoyment of the surrounding
neighborhood. Existing mature landscaping and fences provide a buffer from
adjacent properties and the adjoining street and sidewalk, helping to minimize
impacts to the surrounding neighborhood. The operator will provide contact
information to neighbors if there are any concerns regarding operation of the
facility. The applicant is required to maintain a copy of the Conditions of
Approval on the premises at all times.
Casa Capri Recovery has received the Joint Commission's Gold Seal of
Approval for Behavioral Health Care Accreditation. The Joint Commission
develops behavioral health care standards in consultation with health care
experts and providers and quality improvement measurement experts. It is the
nation's oldest and largest standards -setting and accrediting body in health
care. The operator is an active member of The Sober Living Network, a non-
profit organization that sets the most comprehensive standards for sober living
homes in the nation. This organization conducts annual inspections to insure
member facilities are in compliance. The standards promulgated by this
organization can be found at www.soberhousing.net. These standards
reinforce the City's regulations. The applicant is also a member of other
professional organizations promoting quality care, such as the National
Association of Addiction Treatment Providers.
The facility will house up to 14 residents in four attached units. Combined,
these units include eight bedrooms and four bathrooms. There are also four
kitchens, four indoor living areas, and an outdoor living area. The project
complies with the City's parking standards. The proposed occupancy of the
facility is reasonable. The owner has demonstrated an ability to operate the
facility in a manner that is compatible with the neighborhood.
Finding: Granting the conditional use permit will not allow a use, density or intensity
which is not in accordance with the general plan designation and any applicable
specific plan for the property.
Facts in Support of Findings: The use is consistent with Housing Element
Goal HOU-1.8 of the General Plan, which encourages the development of
housing that fulfills specialized needs by providing living opportunities for
disabled individuals. The facility provides an accommodation for the disabled
that is reasonable and actually resembles the opportunities afforded non -
disabled individuals to use and enjoy a dwelling unit in a residential
neighborhood. The facility offers a comfortable living environment that will
ATTACHMENT 7
enhance opportunities for the disabled, including recovering addicts, to be
successful in their programs.
The subject property contains four existing units on a single parcel. The
proposed use is consistent with the general plan designation.
B. The project has been reviewed for compliance with the California Environmental
Quality Act (CEQA), the CEQA Guidelines, and the City's environmental procedures.
The project is categorically exempt from the provisions of CEQA under Section
15301, Existing Facilities.
EXHIBIT B
CONDITIONS OF APPROVAL
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Ping. 1. Once issued by the City, the owner shall maintain in good standing, an
operator's permit as required by Article 23, Chapter 2 of Title 9.
2. The total number of occupants in the sober living home shall be no more
than ten, plus one resident house manager.
3. The use shall be limited to the type of operation described in the staff report
and applicant's project description submitted with the application on January
4, 2016, subject to conditions. Any change in the operational characteristics
including, but not limited to, home rules and regulations, intake procedures
or relapse policy, shall be subject to Community Improvement Division
review and may require an amendment to the conditional use permit, subject
to Planning Commission approval, depending on the nature of the proposed
change. The applicant is reminded that Code allows the Planning
Commission to modify or revoke any planning application based on findings
related to public nuisance and/or noncompliance with conditions of approval
[Title 13, Section 13-29(0)].
4. Applicant shall defend, with the attorney of City choosing, and shall indemnify
and hold harmless the City, its officials and employees, against all legal
actions filed challenging City's approval of the applicant's project and/or
challenging any related City actions supporting the approval.
5. A copy of the conditions of approval for the conditional use permit must be
kept on premises and presented by the house manager to any authorized
City official upon request during normal business hours (9:00 a.m. to 5:00
p.m., Monday through Saturday). New business/property owners shall be
notified of conditions of approval upon transfer of the business or ownership
of land.
6. The project is subject to compliance with all applicable Federal, State, and
local laws.
7. All vehicles associated with the residence, including residents and staff,
shall be limited to parking on the property and/or on the street within 500
feet of the property.
8. It shall be the applicant's responsibility to maintain current information on
file with the City regarding the name, address and telephone number of
the property manager and/or owner.
9. The property shall be maintained in accordance with landscape
maintenance requirements contained in Costa Mesa Municipal Code
Section 13-108.
CID
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10. Each dwelling unit shall be limited to one mailbox and one meter for each
utility.
11. The facility shall operate at all times in a manner that will allow the quiet
enjoyment of the surrounding neighborhood consistent with Title 20 of the
Costa Mesa Municipal Code. The applicant and/or manager shall institute
whatever measures are necessary to comply with this requirement.
12. If any building alterations are proposed, the applicant shall comply with
requirements of the California Building Code as to design and
construction.
13. The applicant shall obtain a fire clearance from the Costa Mesa Fire
Department pursuant to the requirements of the current version of the
California Fire Code within 30 days of the date of approval of this Permit.
14. Applicant shall provide neighbors with the telephone number of the on-site
manager and/or property owner, for the purposes of allowing neighbors to
lodge complaints or describe concerns about the operation of the facility.
15. The sober living home shall not provide any of the following services as
they are defined by Section 10501 (a)(6) of Title 9, California Code of
Regulations: detoxification; education counseling; individual or group
counseling sessions; and treatment recovery or planning.
16. The applicant is responsible to ensure that occupants, if any, who are
subject to the requirements of Health & Safety Code section 11590 et seq.
(Registration of Controlled Substance Offenders), Penal Code section 290
et seq. (Sex Offender Registration Act), and/or any condition of probation
or parole, are in compliance with any applicable requirements and
conditions of their registration, probation and/or parole while they are
occupants or residents of the subject property.
17. Due to the proximity to Lindbergh School, the applicant shall not allow any
person to reside at the subject property who is prohibited from doing so
under applicable law, including, but not limited to Welfare & Institutions
Code section 6608.5(f) and/or Penal Code section 3003(g)(1)(3).
18. Vehicles picking up or dropping off passengers at the facility shall not block
traffic or create hazardous conditions and shall comply with all applicable
provisions of the California Vehicle Code and Title X of the Costa Mesa
Municipal Code.
19. The applicant shall comply with any and all water conservation measures
adopted by the Mesa Water District that apply to multi -family residences
and/or properties.
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20. The applicant shall post a copy of the Good Neighbor Policy in at least one
highly visible location inside the facility and in at least one highly visible
location in all side and rear yards.
21. Operator shall ensure that no trash and debris generated by tenants is
deposited onto the City's rights of way pursuant to Section 8-32 of the
Costa Mesa Municipal Code.
22. The applicant shall comply with reservation procedures implemented by
the City's Parks and Community Services Department to reserve park
shelters or picnic areas for special events.
23. This CUP is subject to review if the applicant fails to comply with any of
the conditions of approval listed in this resolution and/or the facility creates
an excessive amount of calls for City services.
24. Pursuant to Section 9-374 of the Costa Mesa Municipal Code, upon
eviction from or involuntary termination of residency in a group home, the
operator of the group home shall make available to the occupant
transportation to the address listed on the occupant's driver's license, state
issued identification card, or the permanent address identified in the
occupant's application or referral to the group home. The group home may
not satisfy this obligation by providing remuneration to the occupant for the
cost of transportation.
25. By December 1 of every year, the applicant shall submit written
confirmation that all parking spaces on the property remain accessible for
parking. This confirmation shall be accompanied by photographs that
document the accessibility of each space for automobile parking.
26. All drivers of vehicles at the group home shall comply with all applicable
provisions of the Vehicle Code, including but not limited to those
provisions regulating licensure, parking, standing and stopping.
27. At least 48 hours prior to an occupant's eviction from or involuntary
termination of residency in this group home, the operator thereof shall:
a. Notify the person designated as the occupant's emergency contact
or contact of record that the occupant is no longer a resident at the
home;
b. Contact the Orange County Health Care Agency OC Links Referral
Line and/or another entity designated by the City to determine the
services available to the occupant, including but not limited to,
alcohol and drug inpatient and outpatient treatment;
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c. Notify the city's Network for Homeless Solutions that an occupant is
no longer a resident at the home, and determine the services
available therefrom;
d. Provide the information obtained from b. and c. and any other
treatment provider or service to the occupant prior to his or her
release on a form provided by the City and obtain the occupant's
signed acknowledgement thereon;
If the occupant's behavior results in immediate termination of residency
pursuant to rules approved by the City as part of the Operator's Permit for
this facility, the operator shall comply with this condition prior to evicting
the resident.
28. Prior to an occupant's eviction from or involuntary termination of
residency in a group home, the operator thereof shall make available to
the occupant transportation to the address listed on the occupant's
driver license, state issued identification card, or the permanent address
identified in the occupant's application or referral to the group home.
Should the occupant decline transportation to his or her permanent
address or otherwise has no permanent address, then the operator
shall make available to the occupant transportation to another group
home or residential care facility that has agreed to accept the occupant.
The group home operator may not satisfy this obligation by providing
remuneration to the occupant for the cost of transportation.
29. The group home operator shall maintain records for a period of one
year following eviction from or involuntary termination of residency of an
occupant that document compliance with Conditions 23 and 24;
provided, however, that nothing herein shall require an operator of a
group home to violate any provision of state or federal law regarding
confidentiality of health care information.
CODE REQUIREMENTS
The following list of federal, state and local laws applicable to the project has been
compiled by staff for the applicant's reference. Any reference to "City" pertains to the City
of Costa Mesa.
Ping. 1. Use shall comply with all requirements of Chapter XVI of the Costa Mesa
Municipal Code relating to development standards for sober living homes in
multi -family residential zones.
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Bldg. 2. Prior to making alterations to the property and throughout construction,
the applicant shall comply with the requirements of the applicable adopted
California Building Code, California Electrical Code, California
Mechanical Code, California Plumbing Code, California Green Building
Standards Code and California Energy Code and the California Code of
Regulations, also known as the California Building Standards Code, as
amended by the City of Costa Mesa.