With drug overdose deaths jumping by more than 20,000 to 93,000 last year, the need for safe, effective recovery housing has never been greater. That’s because the internal and external resources needed to initiate, stabilize, and sustain long-term recovery are virtually impossible to develop without it. The challenge is even greater in rural areas where few resources are available to counter the higher rates of substance use disorders, morbidity, overdose, and mortality found there.

But there is an answer: An innovative model of recovery housing (RH) that’s proven not only effective but also financially self-sustaining.

The model comes from Kentucky where former Governor Ernie Fletcher and Corrections Commissioner John Rees leveraged many federal, state, and local resources Fletcher had become familiar with while a three-term congressman and Chairman of the Policy Subcommittee on Healthcare. The Recovery Kentucky program they put together now boasts 18 facilities (nine for men and nine for women) that have helped thousands of rural Kentuckians rebuild their lives while saving millions in taxpayer dollars.

That model is now being promoted nationwide by the Fletcher Group, a nonprofit founded by Fletcher in 2018. The Fletcher Group Rural Center of Excellence (RCOE) is one of only three RCOEs in the nation that is federally funded to help prevent and treat substance use disorders in rural communities. (The other two are the Center on Rural Addiction at the University of Vermont in Burlington and the University of Rochester Medicine Recovery Center of Excellence in Rochester, New York.) The Fletcher Group RCOE’s Outreach and Engagement Specialists target those rural counties with the highest rates of overdose mortality in 10 states: Kentucky, Ohio, West Virginia, Georgia, Tennessee, Mississippi, Washington, Oregon, Idaho, and Montana.

How the Model Works

The uniquely holistic, person-centered social recovery model achieves noteworthy economy and effectiveness through peer-led mentorship and peer-guided support meetings emphasizing personal accountability, all in keeping with the “Recovery Dynamics” principles that have evolved from AA and Narcotics Anonymous 12-step programs.

Throughout a residency of up to two years, clients benefit from a complete continuum of evidence-based and trauma-informed care, including medications and other treatments administered by staff professionals. In coordination with community resources (workforce training, social enterprise, meaningful employment, housing, transportation, and education, etc.), a nurturing culture of care provides the ideal platform for connecting mind with body so that individuals can develop the life skills needed for lasting sobriety, stability, and self-sufficiency.

It’s also a model that pays for itself. So-called "braided funding" — the leveraging of funds and resources (including tax credits) that already exist within federal, state, and local agencies, faith-based entities, and the private sector — can enable new facilities, housing 100 or more residents to be built without debt. Day-to-day operating costs, including those needed for building repair and upkeep, are met through per diems contracted with departments of corrections as well as Community Development Block Grants, Section 8 Housing, SNAP benefits, and other partnerships.

The Financial Role of the Criminal Justice System

Jail overcrowding, the high cost of prisoner care, the cost of prosecuting drug offenses, and the growing number of individuals affected by mental illness in the prison system pose huge challenges to local governments. The Fletcher Group provides an alternative, non-punitive approach to the expensive ad hoc manner in which the criminal justice system traditionally deals with those experiencing homelessness and addiction. And because the model’s per diem operating costs are so much lower, criminal justice systems are financially motivated to divert drug-involved individuals to homes where they can receive the treatment and support they need to recover.

Looking Ahead

To further improve the capacity and quality of rural recovery housing, the Fletcher Group will also soon debut what’s called “The Portal” — a one-stop shopping hub for all things related to rural recovery housing. It will break new ground by providing a Housing Locator to help individuals find housing, especially in rural areas where resources are often lacking; a Resident Management System to help RH staff quickly input, tabulate and archive daily records; and an online Best Practice Training Center to enhance the knowledge of RH operators, staff, and others.

By combining evidence-based treatments and best practices with a sustainable housing model, the “Recovery Ecosystem” model promoted by the Fletcher Group may well be rural America’s best shot at breaking the cycle of dependency, thereby enabling lives to be rebuilt, families to reunite, and communities to achieve the health and well-being they need to prosper.

How Social Investors Can Help

  • Support the Fletcher Group’s efforts to provide the evidence-based technical assistance needed within your community, region, or state.
  • Help connect your community to the resources provided by the Fletcher Group.
  • Reach out to substance use treatment providers, healthcare organizations, churches, government agencies, and other anchor institutions to discuss the Fletcher Group’s “Recovery Ecosystem” model of recovery housing.
  • Financially support the “Recovery Ecosystem” model of recovery housing in your community through capital-development campaigns to cover promotional and start-up costs.
  • Support the recovery housing standards established by the National Alliance for Recovery Residences (NARR).
  • Support recovery housing research, specifically the response of residents to different models of recovery housing.
  • Support the development of technology that can document and evaluate recovery housing services in order to better define “best practices.”
  • Support public policies that incorporate funding for recovery housing and recovery housing services.


Original contribution by Fletcher Group Communication Director Richard Faylor. For general questions and to contact staff, write to mday@fletchergroup.org. Sign up for the Fletcher Group’s monthly newsletter by scrolling to the bottom of the fletchergroup.org home page.