November 23, 2020

Senators Warren and Baldwin Seek GAO Investigation of Mandatory Work Requirements at Drug and Alcohol Rehabilitation Facilities Receiving Federal Funding

A recent investigation found that individuals at these facilities are being required to work, unpaid, as part of their treatment program, creating a "huge, unpaid shadow workforce"; "Individuals struggling with substance use disorder who attend rehabilitation programs should never be subjected to predatory conditions that threaten their recovery and violate their rights under the law"

Text of Letter (PDF)

Washington, DC - United States Senator Elizabeth Warren (D-Mass.), a member of the Health, Education, Labor, and Pensions (HELP) Committee, and Senator Tammy Baldwin (D-Wis.), Ranking Member of the Subcommittee on Employment and Workplace Safety, sent a letter requesting that the Government Accountability Office (GAO) investigate mandatory vocational requirements at drug and alcohol rehabilitation facilities that receive federal funding. Their request follows a recent investigation by the Center for Investigative Reporting which found that individuals at some drug and alcohol rehabilitation facilities are being required to work, unpaid, as part of their treatment program, creating a "huge, unpaid shadow workforce."

Some rehabilitation facilities have mandatory work requirements, described as vocational therapy, in which facilities send participants to work for contractors of or directly at private companies, with these individuals receiving little to no pay for their labor. This practice appears to be a violation of federal labor law, but has escaped federal enforcement.

"Requiring individuals to work without compensation is a violation of the Fair Labor Standards Act (FLSA), which establishes standards for labor protections including minimum wage and overtime pay," the senators wrote.

Additionally, the senators noted there appears to be little evidence that uncompensated work therapy programs have treatment benefits. Substance Abuse and Mental Health Services Administration (SAMHSA) guidance affirms that "few studies have addressed the effectiveness of vocational services in substance abuse treatment settings," and that programs investigated through those existing studies "did not demonstrate much long-term effect and did not decrease substance use." 

"Individuals struggling with substance use disorder who attend rehabilitation programs should never be subjected to predatory conditions that threaten their recovery and violate their rights under the law. Federal funding dedicated to supporting individuals and communities navigating substance use disorder must be used in service of evidence-based prevention, treatment, and recovery," the senators wrote.

The senators asked the GAO to investigate (1) the extent to which federal funding was provided to rehabilitation facilities with mandatory work requirements; (2) whether the evidence shows that mandatory work requirements support addiction treatment and recovery; and (3) what oversight exists to ensure individuals in rehabilitation programs are fairly compensated, and that programs follow relevant labor and employment law.

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