COVID Supplement Survey Question Guide

RECOVERY RESIDENCE SURVEY RESIDENCE AND ORGANIZATION INFORMATION

The intent of these questions is to verify information contained on the NSTARR database with the most recent information on the randomly sampled residence and its parent organization. Respondents should review the information about the residence, make any necessary changes, and indicate whether all information is correct and no changes are needed or all missing/incorrect information has been corrected.

If the residence does not have a parent organization, or the residence and the organization are one and the same, check the box that says “This residence is not part of a larger organization, program, or group of residences.” If the residence is part of a larger, organization, program, or group of residences, review the information listed about this organization and indicate whether all information is correct and no changes are needed or all missing/incorrect information has been corrected.

RESIDENCE CHARACTERISTICS

Questions in this section ask about general physical and operational characteristics of the residence listed on the cover page. These questions should be answered by someone who has been to the residence and knows about the day-to-day operations of it. Unless otherwise specified in the question, questions in this section should be answered using the “present” timeframe.

What term do you use to refer to this residence?
The intent of this question is to collect information on how the respondent characterizes the recovery residence. Recovery residences go by a variety of different names. Some of these differences come about from how residences are classified in different states and localities, but some of these differences reflect how individuals characterize the nature of the recovery environment. Only by asking questions about how recovery residences are referred to in different parts of the county and how this corresponds to characteristics of the residence can the field begin to find commonalities among residences regardless of the name used to refer to them. Respondents should select the one option that they use most often to refer to the residence. If they use a term that is not listed, respondents should provide the term that they use to refer to the residence in the space provided.

If the option “Oxford House” is selected, responses to some questions may be pre-filled to reduce the amount of time to complete the survey based characteristics of the Oxford House model. These responses should be still be reviewed and can be changed based on whether pre-filled responses fit the specific Oxford House being surveyed.

What term best describes the physical structure of this residence?
The intent of this question is to collect information about the residence’s physical structure. Respondents should select the one option that best fits. If the categories that are provided do not capture the nature of the residence’s physical structure, respondents should provide a description that better fits. A unit in a hospital or a correctional facility should be coded as “Unit in a treatment program or other sort of facility/compound/campus.”

Multiple members of different families may live in a single family residence; only select duplex/multiple family structure if there are physical separations create separate dwelling units within the structure.

Based on how they are currently being used, how many of the resident bedrooms are…
The intent of this question is to better understand how space is allocated for residents. Respondents should indicate how many sleeping rooms are:

  • Single rooms: one resident sleeping in the room
  • Double rooms: two residents sleeping in the room
  • Triple rooms: three residents sleeping in the room
  • More than three beds in a room: more than three residents sleeping in the room

Respond based on how the rooms are currently used when the residence is at maximum capacity. Do not include sleeping rooms that are designated for staff.

What is the capacity of this residence?
The intent of this question is to collect information on the maximum number individuals that could be living in the residence at any time. This should be reported in terms of total number of beds. Include bed(s) designated for house manager(s) if managers live among residents.

What is the current number of residents?
The intent of the question to gather information on how many residents are currently living at the residence. Include the house manager(s) if the manager(s) live among residents.

Does this residence currently have a waitlist?
The intent of this question is to assess whether there are individuals who are waiting to enter the residence. By waitlist, we mean a list of individuals who qualify or have been approved to move into the residence but who are waiting for a bed to open up so that they can move in.

What amenities are provided in the residence? (Check Yes if it is provided to any residents or No if it is not provided to any residents)
The intent of this question is to determine what is available to residents as part of the fees they pay for their stay. For the purposes of this survey, if something listed is available to residents for an additional fee, it is NOT considered an amenity. Respond Yes to any items that are offered as amenities regardless of whether the amenity is used by all residents, some residents, or none at all. If there are other amenities offered that are not listed, select “Other” and describe the additional amenities.

For private bathrooms, we would like to know if private bathrooms are available to the residents (not staff members).

For indoor lounge area, we mean an indoor area where residents can socialize with one another for activities such as fitness, games, or other pastimes/recreational activities.

Which residence characteristics (e.g., physical space and how it is used) have changed because of COVID-19? (Check Yes or No to each; check Yes if it remains changed because of COVID-19)
The intent of this question is to identify how general residence policies and practices have changed since COVID-19 was declared a national emergency in the US (roughly March 2020). Respondents are asked to reply Yes or No to each facet of the residence’s characteristics questioned in this section.

  • How many residents stay in the sleeping rooms
  • Number of total beds designated for the residence
  • Ability to fill beds in the house
  • Characteristics of the residents (e.g., gender, age, ethnicity, etc.)
  • Whether or how meals are provided
  • Amenities offered
POLICIES AND PRACTICES

Questions in this section ask about the policies and practices of the residence listed on the cover page. These questions should be answered by someone who has been to the residence and knows about the day-to-day operations of it. Unless otherwise specified in the question, questions in this section should be answered using the “present” timeframe.

Does this residence accept residents who are… (Check Yes if any or No if none)
The intent of this question is to gather information about the types of residents that the residence intends to or would provide recovery housing. Respond based on policies or practices, regardless of whether individuals with the following characteristics have applied to or lived at the residence. If any of the following characteristics would restrict access to living at the residence, even if there may be exceptions, respond “No.” Respondents should answer Yes or No for each resident characteristic asked about below:

  • Male?
  • Female?
  • Less than 18 years old? NOTE: This refers to accepting residents in recovery who are less than 18 years old
  • Bringing their child/children to live in the residence with them? NOTE: This refers to allowing residents and their children to move into the residence
  • On probation/parole?
  • HIV+?
  • In mental health treatment or have a co-occurring mental health condition?

Does this residence accept residents who are under a physician’s care and are taking…(Check Yes if any or No if none)
The intent of this question is to gather more specific information about the residence accepting potential residents who may currently be taking medications prescribed by a physician. Respondents should answer Yes or No for each type of medication.

  • Buprenorphine: Brand names for buprenorphine include Belbuca, Subutex, Butrans, Sublocade.
  • Naltrexone: Brand names for naltrexone include ReVia, Vivitrol, Depade. Naltrexone is approved to treat alcohol use disorder and opioid use disorder and available in a pill form (for AUD) and an extended-release injection
  • Disulfiram or Acamprosate: These are both medications use to treat alcoholism. Disulfiram is sold under the trade name Antabuse and is approved to treat alcohol use disorder. It helps patients stop drinking by reacting with alcohol consumed, resulting in unpleasant symptoms like nausea, flushing, and dizziness that discourage alcohol use. Acamprosate is sold under the brand name Campral and also can treat alcohol use disorder. It is most effective when paired with counseling to help patients reduce or stop drinking completely.

What is the typical length of stay? (Specify)
The intent of this question is to determine how long residents typically stay at the residence. Respondents should use the following categories:

  • Less than 30 days
  • 30-90 days
  • 3-6 months
  • More than 6 months but less than a year
  • A year or longer

If more than one year, respondents should specify the length of time. Respond 90 days as 30-90 days; respond 3 months as 3-6 months.

While staying at the residence, are residents required to… (Check Yes or No to each)
The intent of this group of questions is to gather information regarding rules and expectations for residents living in the residence. Respond “Yes,” even if there may be exceptions to the requirement. Respondents should check Yes or No to each question.

  • Participate in household chores?
  • Attend house meetings?
  • Be back in the house at a certain time of the day (curfew)?
  • Remain abstinent from tobacco/cigarettes/e-cigs?
  • Remain abstinent from alcohol?
  • Remain abstinent from illicit drugs?
  • Other requirements

If respondents report “Other requirements,” they should provide a brief description of these requirements.

How often does the residence hold house meetings? (Check one)
The intent of this question to collect information on how often house meeting are held at the residence. Respondents should use the response options provided below. If there is no regular schedule for meetings, respondents should respond based on how frequently meetings end up happening.

  • Daily
  • Several times a week
  • Once a week
  • Every two weeks
  • Once a month
  • Other

If “Other” is selected, respondents should describe the frequency that meetings are held.

Are residents allowed to… (Check Yes or No to each; Check Yes even if just some residents are allowed)
The intent of this set of questions is to gather additional information regarding resident restrictions and privileges. Respond “Yes” regardless of whether there may be exceptions to the restriction or privilege or variations in when or how they are applied. Respondents should check Yes or No to each of the following prompts:

  • Spend the night away from the residence?
  • Invite guests to the residence?
  • Smoke tobacco (e.g., cigarettes, e-cigs, etc.) in the residence?
  • Self-administer medications prescribed to them?

What best describes how your residence handles testing for alcohol/drug use? Does the residence… (Check one)
The intent of this question is to gather information on how frequently residents are tested for alcohol/drug use. Respondents should select the category that best captures testing frequency:

  • Routinely test all residents for alcohol/drug use?: This refers to testing on a regular schedule—at intake, after overnights, first of the month, etc.
  • Randomly test residents for alcohol/drug use?: This refer to their being no schedule for when testing might happen
  • Test particular resident(s) only when alcohol/drug use is suspected? : This refer to testing only happening when use is suspected
  • Do no testing for alcohol/drug use?: There is no alcohol or drug testing among those living in the residence.
  • Something else: Testing at a schedule not captured with any other category

If “Something else” is checked, respondents should describe what this schedule is. Use this category if some combination of the above frequencies is used (e.g., regular testing and testing when use is suspected).

Does this residence use any of the following consequences for residents who break rules about substance use? (Check Yes or No to each)
The intent of this question is to collect information on what happens when residents break rules about substance use. Because there could be multiple consequences, respondents should check Yes or No to each prompt. However, if respondents answer “Yes” to No consequences, they should skip to next question.

  • No consequences
  • Extra chores
  • Fines
  • Mandated treatment
  • Eviction/Asked to leave
  • Something else

If respondents select “Something else,” they should provide a brief description of the other consequence(s).

Which residence policies and practices (e.g., regarding intake, acceptance, length of stay, program requirements, etc.) have changed because of COVID-19? (Check Yes or No to each; check Yes if it remains changed because of COVID-19)

The intent of this question is to identify how general residence policies and practices have changed since COVID-19 was declared a national emergency in the US (roughly March 2020). Respondents are asked to reply Yes or No to each facet of the residence’s characteristics questioned in this section.

  • Intake procedures
  • Type of residents accepted
  • Length of stay
  • Resident requirements
  • Resident privileges
  • Testing for alcohol and drug use
  • Consequences for alcohol and drug use
  • Social activities for residents
  • Alumni involvement

Do you have a process for evaluating potential COVID-19 infection among current and/or new residents (testing, taking temperature and/or quarantine of new residents, checking vaccination status)?
This question refers to any processes that might be used to evaluate whether a current or prospective resident may be infected with the COVID-19.

What is the COVID testing protocol for residents? (Check Yes or No to each)
The intent of this question is to identify testing protocols used in the residence. Respondents are asked to reply Yes or No to each prompt. By testing, we mean viral testing that indicates whether someone is currently infected with COVID.

  • Residents are tested upon moving into the residence
  • Residents who leave the residence overnight are tested prior to re-entering the residence
  • Residents are routinely tested
  • Residents are tested when exposure/infection is suspected
  • There is no COVID testing protocol for residents

If there is no COVID testing protocol, select “Yes” to the prompt “There is no COVID testing protocol for residents” and “No” to all others.

Have you had any known COVID-19 infections within your residence(s)?
Respondents should check Yes or No to whether there have been any residents that have tested positive for COVID at the residence.

How many current residents have been fully vaccinated? (2 shots for Pfizer or Moderna; 1 shot for Jansen/Johnson & Johnson)
The intent of this question is to get a sense of how many residences have been fully vaccinated (both shots if received the Pfizer or Moderna vaccines or one shot of Johnson and Johnson) at the residence.

Which of the following situations apply to this residence? (Check Yes or No to each)
Different states, counties, and local areas vary in their mandated and recommendations related to COVID. The intent of this question is to determine whether the residence is currently under any COVID-specific (mandatory or voluntary) restrictions. Respondents should check Yes or No to each option. If no restriction, check Yes to “No restrictions currently” and No to all other options.

  • No restrictions currently
  • Voluntary quarantine due to fear of exposure
  • Voluntary quarantine due to confirmed/suspected case in household
  • Mandated self-isolation/quarantine by medical professional due to confirmed/suspected case (not allowed to go out for any reason including for groceries)
  • Stay-at-home order by local government and/or employer urging people to stay home (e.g., can still take walks and socialize outdoors while maintaining social distancing)
  • Shelter-in-place order by local government (i.e., only permitted outdoors for essential purposes)

How has COVID-19 impacted your admissions requests? (Select one)
This question asks the respondent to think about how COVID-19 has affected admissions requests to the residence, selecting whether COVID-19 has increased, decreased, or not impacted admissions requests.

Have any residents left the residence due to concerns regarding COVID-19?
This question asks whether any residents have left the residence due to concerns about COVID-19. If Yes, respondents are then asked to answer Yes or No to a list of potential reasons. If residents left for any other reason not listed, respondents should check Yes to “Something else” and provide a description of that reason.

Which policies have you implemented as recommended by the Centers for Disease Control and Prevention (CDC)? (Check Yes or No to each)
The CDC had published guidance COVID-19 prevention and infection control. The intent of this question is to query types of guidance implemented at the residence. Respondents should check Yes or No to each prompt.

  • Disinfecting surfaces
  • Using hand sanitizers
  • Washing hands frequently for 20 seconds
  • Wearing masks and/or face shields
  • Wearing gloves
  • Not sharing towels, sheets, or other personal items
  • Washing clothes frequently
  • Taking temperatures
  • Quarantine of those with symptoms or known exposure
  • Other

If the residence has implemented a policy based on CDC guidance that is not listed, they should check Yes to the “Other” option.

How often are shared areas (e.g., kitchen, exercise area, laundry facilities, shared bathrooms, elevators) cleaned and disinfected?  (Select one)
This question assesses how often shared areas or common areas in the residence are cleaned. Shared areas are spaces to which all residents have access. Examples of shared areas include the kitchen, exercise areas, laundry facilities, shared bathrooms, elevators, etc. Respondents should select the one option that best captures the frequency for these types of spaces.                       

How often are surfaces that are frequently touched (light switches, door knobs, faucets) cleaned and disinfected? (Select one)
This question assesses how often surfaces that are frequently touched in the residence are cleaned. Shared areas are spaces to which all residents have access. Examples of frequently touched surfaces include light switches, door knobs, faucets, etc. Respondents should select the one option that best captures the frequency for these types of surfaces.

Has access to any shared areas been limited due to concerns about COVID? This could include creating a schedule so that only 1 person is in a shared area at a time, or so that people can maintain social distance in shared areas. 
Shared areas are spaces to which all residents have access. Examples of shared areas include the kitchen, exercise areas, laundry facilities, shared bathrooms, elevators, etc. This question asks whether access to these types of areas has been limited due to concerns about COVID.

Are residents (and staff) required to maintain social distancing (at least 6 feet/2 meters apart) in the residence?
Social distancing means keeping a safe space (at least 6 feet/2 meters apart) between individuals in order to reduce the potential transmission of COVID-19. This question is asking whether individuals are required to practice social distancing in the residence.

Which of the following has the residence done to help maintain social distancing? (Check Yes or No to each)  
Respondents who indicated that residents are required to maintain social distance in the residence are asked about how this is done. Respondents should answer Yes or No to each of the social distancing strategies listed:

  • Cancelled group activities/events
  • Switched in-person activities to online format
  • Re-arranged furniture so people sit at least 6 feet (2 meters) apart
  • Installed Plexiglas dividers
  • Changed schedules to reduce close contact (such as staggering meal times)
  • Formed small groups or social “pods” that are allowed to interact with each other but not with people
  • Limiting the number of people allowed in shared spaces (including stairwells, elevators) at one time
  • Closed shared areas (such as kitchens, laundry areas, exercise rooms, activity rooms)

How would you describe the residence’s policy on masks or other face coverings to reduce the spread of COVID? (Select one)
The CDC recommends that people wear masks in public settings, at events and gatherings, and places where COVID can be transmitted person-to-person. The intent of this question is to gather information on the residence’s policy regarding mask use within the residence. Respondents should select the option that best captures the residence policy on mask use.                  

What procedures are in place for residents who routinely leave the residence (for work, meetings, or other outside appointments)? (Check Yes or No to each)
Residents who routinely leave the residence and engage with others at work or in public spaces may be at risk of becoming infected with COVID-19 or infecting others. The intent of this question is together information about policies and practices the residents are expected to engage in when interacting with others outside of the residence. Respondents should answer Yes or No to each prompt:

  • Residents are expected to wear a mask
  • Residents are expected to socially distance
  • Residents’ temperatures are taken before leaving the residence
  • Residents’ temperatures are taken before re-entering the residence
  • Residents are expected to wash/sanitize hands before leaving the residence
  • Residents are expected to wash/sanitize hands before re-entering the residence
  • Residents are not allowed to leave the residence

When a resident violates house rules regarding COVID safety, what happens? (Check Yes or No to each)
The intent of this question is to gather information about what happens when residents break house rules pertaining to reducing the risk of COVID infection. Respondents should answer yes or no to each prompt. If there are no house rules regarding COVID, respondents should check Yes to “There are no house rules regarding COVID safety” and No to all other prompts.

Which of the following does your residence have available to residents? (Check Yes or No to each)
The intent of this question is to gather information about what may be available to residents to reduce the risk of COVID infection. Respondents should check yes or no to each prompt.

If there were a suspected COVID case at the residence, how likely would it be that…
The intent of this question is to gather information about what might happen if a resident was suspected of being infected with COVID. Respondents should answer each potential action based on the likelihood that it might occur using responses ranging from Very unlikely to Very likely.

  • The resident would self-isolate or quarantine alone in a private room with a private bathroom
  • The resident would be asked to stay in their own room as much as possible, but they would need to use shared areas occasionally (like a shared bathroom)
  • A roommate would be given another place to stay while the person was sick
  • The resident would not be able to be isolated because there is not enough space
  • People who had been in close contact with the infected resident would be notified about possible exposure
  • People who had been in close contact with the infected resident would be asked to self-isolate
  • The resident would leave for another facility
  • Residents would be tested for COVID-19

A house meeting would be held to discuss the best solution for the residence.

PROGRAMMING

Questions in this section ask about different types of services that are provided to all individuals who live in this residence as part of their stay, regardless of whether they choose to use these services.  Respondents should check Yes only if the service is delivered by the organization operating the residence (directly or via formal contract agreements and provided “in house”) and is included in fees charged to residents as part of their stay.  Services that are available to residents at additional costs, that residents are “referred” out to receive, or that are provided through informal agreements or “warm handoffs” to other service provides should not be counted here. Services that are provided through mutual aid from other residents should also not be counted. These questions should be answered by someone who has been to the residence and knows about the day-to-day operations of it. Unless otherwise specified in the question, questions in this section should be answered using the “present” timeframe.

Does this residence provide any social, recovery support, or continuing care services (e.g., assistance or advocacy, transportation, recovery coaching, onsite-mutual help, group meetings, social activities, telephone check-ins, etc.) to residents as part of their stay?
The intent of this question is to determine whether any social, recovery support, or continuing services are provided to residents as part of their stay. By onsite mutual help groups, we mean meetings focused specifically on substance use or recovery, such as 12-step (AA, NA, etc.), SMART, LifeRing, Women for Sobriety, etc. If any of the areas listed are provided, respond Yes. If none of the areas listed above are provided, skip the following question.

Does this residence provide any substance use treatment services (e.g., drug/alcohol groups, individual therapy/counseling sessions medications for alcohol/drugs, etc.) to residents as part of their stay?
The intent of this question is to determine whether any substance use treatment services are provided to residents as part of their stay. If any of the areas listed are provided, respond Yes. If none of the areas listed above are provided, skip the following question.

Does this residence provide any medical services (e.g., physical exams, infectious disease testing, bloodwork, monitoring by a nurse/physician, non-traditional medical services, nutrition counseling, etc.) to residents as part of their stay?
The intent of this question is to determine whether any medical services are provided to residents as part of their stay. If any of the areas listed are provided, respond Yes. If none of the areas listed above are provided, skip the following question.

Which medical services are provided to residents as part of their stay? (Check Yes or No to each)
The intent of this group of questions is to gather information on the types of medical services that are provided to residents as part of their stay. Respondents should answer Yes or No to each type of service.

  • Physical exam by a physician/nurse
  • COVID-19 testing
  • Medical monitoring (by a nurse or physician)
  • Other

If an “Other” type of service is provided, respondents should provide a brief description on this service.

Does this residence provide any psychological/psychiatric services (e.g., psychiatric evaluation, psychological testing, individual or group psychotherapy/counseling, biofeedback, or relaxation or anger management groups, etc.) to residents as part of their stay?
The intent of this group of questions is to gather information on the types of psychological or psychiatric services that are provided to residents as part of their stay. These may be referred to as mental health services. Respondents should answer Yes or No to each type of service.

Does this residence provide any parenting/family services (e.g., couples counseling, parenting classes, childcare, supervised visitation, advocacy in regaining parental rights, domestic violence groups/classes, individual/group counseling for family members, etc.) to residents as part of their stay?
The intent of this question is to determine whether any parenting or family services are provided to residents as part of their stay. If any of the areas listed are provided, respond Yes. If none of the areas listed above are provided, skip the following question.

Does this residence provide any education or employment services (e.g., literacy or ESL instruction, employment readiness counseling/coaching, job training/referral, etc.) to residents as part of their stay?) 
The intent of this question is to determine whether any education or employment services are provided to residents as part of their stay. If any of the areas listed are provided, respond yes. If none of the areas listed above are provided, skip the following question.

Which aspects of programming (e.g. services provided) at the residence have changed because of COVID-19? (Check Yes or No to each; check Yes if it remains changed because of COVID-19)
The intent of this question is to identify how aspects of programming have changed since COVID-19 was declared a national emergency in the US (roughly March 2020). Respondents are asked to reply Yes or No to each facet of the residence’s characteristics questioned in this section

Before COVID, how would you describe the availability of in-person mutual help meetings to residents living at the residence? (Select one)
This question assesses the availability of in-person mutual help group meeting (12-step meetings as well as alternative mutual help group meetings like SMART, LifeRing, Women for Sobriety, and All Recovery meetings) to residents before COVID pandemic (roughly March 2020). Respondents should select the one category that best describes the availability. If availability before COVID is unknown, the respondent can select “Don’t know/cannot answer.”

How would you describe the current availability of in-person mutual help meetings to residence living at the residence? (Select one)
This question assesses the current availability of in-person mutual help group meeting (12-step meetings as well as alternative mutual help group meetings like SMART, LifeRing, Women for Sobriety, and All Recovery meetings) to residents. Respondents should select the one category that best describes the availability.

Before COVID, how much were residents using online mutual help meetings? (Select one)
This question assesses the amount that residents were using online mutual help group meetings (12-step meetings as well as alternative mutual help group meetings like SMART, LifeRing, Women for Sobriety, and All Recovery meetings) before COVID pandemic (roughly March 2020). Respondents should select the one category that best describes the amount used. If availability before COVID is unknown, the respondent can select “Don’t know/cannot answer.”

How much are residents currently using online mutual help meetings? (Select one)
This question assesses the amount that residents are currently using online mutual help group meetings (12-step meetings as well as alternative mutual help group meetings like SMART, LifeRing, Women for Sobriety, and All Recovery meetings). Respondents should select the one category that best describes the amount used.

RESIDENCE ORGANIZATIONAL CHARACTERISTICS
Questions in this section ask about residence “organizational” characteristics. Some residences may operate as stand-alone service delivery entities. Other residences may be operated by or under the auspices of a parent organization that operates several recovery residences. These questions gather information about recovery housing provided at the residence listed on the cover page, but these questions may be best answered by someone who is familiar with the financial or administrative aspects of this residence or the entity that operates it. Unless otherwise specified in the question, questions in this section should be answered using the “present” timeframe.

 [IF THE RESIDENCE LISTED ON THE COVER PAGE IS AN OXFORD HOUSE]

Some of the following items have been populated with information provided by leadership at Oxford House, Inc. Review the pre-populated information to verify that it accurately reflects the organizational characteristics of your residence. Provide responses to all questions that do not have pre-populated responses.
The intent of these instructions is to inform respondents for Oxford Houses that some of the information in this section will be pre-populated. However, all of the pre-populated information must be reviewed to verify its accuracy. All unanswered questions are those that may vary across Oxford House residences and must be answered by the respondent for their Oxford House residence.

How long has this residence been in operation at the above location? (Select one)
The intent of this question to ascertain how long the residence has been located at the address listed on the cover page.

If the residence has been located there for less than 1 year, the respondent should specify the number of months. Round half months up to the nearest whole month (e.g., 6 and a half months would be recorded as 7 months). If the residence has been there for more than one year, the respondent should specify the number of years. Round half years up to the nearest whole year (e.g., 2 and a half years would be recorded as 3 years).

Is this residence operated by a … ?
The intent of this question is to ascertain the auspices under which the residence is operated. What is the nature of the entity that is protecting, backing, or supporting this residence?

Respondents are asked to identify whether their residence is operated by:

  • A private for-profit entity (LLC, sole-proprietorship, etc.): This is a business classification for which the profits belong to the owner/owners/shareholders.
  • A private not-for-profit organization: This is a business classification for which the profits are used to further its objective, rather than distributed to the organization’s shareholders, leaders, or members. Respondents who select this option are then asked to identify whether the residence is a:
    • Recovery community organization defined as being led and governed (at least 51%) by persons by persons in recovery of affected family members;
    • Religious/Faith-based organization
  • A public institution: This is a type of not-for-profit organization that is backed through public funds and controlled by the funder. Respondents are asked to further identify whether this entity is funded by:
    • Federal government (e.g., VA, DOD, Indian Health Services)
    • State government
    • County/local government
    • Tribal government

If none of the above listed classifications fit, the respondents should check “Something else” and provide a description of the nature of the entity owning/operating the residence.

Do any persons (employees, contractors, volunteers) provide services (operational, recovery support, social, or more clinically-oriented) to those living in the residence? (If No, skip to question X)
The intent of this question is to ascertain whether the residence has “staff” who provide support to residents who live there.

Who provides services to residents living in this residence?
If the response to the question about whether there are persons who provide services to residents is “Yes,” respondents are asked to indicate whether residents have access to or come into contact with a variety of different types of helping individuals. Respondents should check Yes even if the position is not exclusively providing services to residents in that residence. For example, an operator with several residences may engage a therapist who provides services to residents at the residence listed as well as other residences own/operated by the larger parent entity. NOTE: The same individuals may “wear many hats” and perform duties across several different roles. Respond with the position that best captures the individual’s job title. For example, if the house manager also performs intakes with new residents and supports individuals in the capacity of a recovery coach/peer specialist, count the individual as the house manager. Other individuals who provide direct support and services to resident can also be added (e.g., transportation specialists), but do not include individuals who do not have direct contact with residents, even if they are paid.

Respondents are then asked whether the individual in the position is paid by the entity operating the residence. For these questions, payment can include waiver or reduction of fees associated with living in the residence (NOTE: this is why we don’t say “employed”). Payment can also include paid contracts with other community organizations in which the entity is not directly paying the individual but paying the organization. If the entity does not pay an individual or an organization for these services, the individual providing them is not paid (they are volunteers), even if they are a “professional” and are paid in another capacity to provide these services elsewhere.

Respondents are also asked whether individuals “work” onsite, meaning whether they provide services at the residence. Respondents should check Yes if, at any point, the individual comes to the home to provide this service even if they may generally provide services/support at another location. For example, if there is a therapist who does individual sessions in an offsite office but comes to the residence to run groups, respondents should check that the therapist works onsite. If there is a house manager, respondents are asked to indicate whether the house manager lives onsite.

NOTE: These questions were adapted from the Addiction Treatment Inventory (ATI), which provides guidance on how to calculate FTEs for various positions for multiple people occupying the same role and providing services across multiple services delivery units (e.g., multiple therapists and therapists who might split their time across different programs). Since this survey is self-administered, and we wanted to make this as easy as possible, we dropped trying to ascertain “how many” (full or part-time) people are responsible for providing services to residents at the residence. This prohibits analyses of concepts like resident to staff ratio, but it will provide a snapshot of the different types of individuals available to support residents.

What percent of the staff for the residence are in recovery?
The intent of this question is to assess the percent of staff helping residents who are in recovery. “Staff” refers to the individuals listed in the prior question. Calculate the percent based on whether the individual holding the position identifies as a person in recovery.

Does the [entity/organization/institution] operating this residence have contracts or formal (written/signed) referral agreements with a …
The intent of this question is to collect information on formal linkages with other service providers across a variety of different service delivery sectors. In this survey “formal” means written agreements or contracts with a provider or other human service entity. Respond with the provider in the category that best represents the services delivered. For example, if the residence has a contract with a substance use treatment program that also provides mental health services, code the contract as one with a substance use treatment program. Provide a description of any provider that does not fit into the categories of substance use treatment program, mental health clinic, health clinic, criminal justice entity.

How are fees for residents’ stays recovered?
The intent of this question is to collect information on “billing” for resident stays and who is responsible for paying fees associated with resident stays. Since many different entities may be responsible for paying residents fees, respondents should check Yes to all that apply.

  • Residents’ stays are billed to contracts with public entities: This option refers to resident fees being billed to contracts with public entities that pay for some or all a resident’s stay. If contracts with such public entities exist, the respondent should answer questions about whether these are contracts with federal, state, or local (either city or county) entities.
  • Residents’ stays are billed to contracts with private institutions: This option refers to resident fees being billed to private entities such as through contracts with treatment programs, hospitals, or other service providers.
  • Residents’ stays are billed to residents: This option refers to fees being charged to residents or other individuals (e.g., family members) who pay “out of pocket” for residents’ stays.
  • Residents’ stays are billed to residents’ insurance: This option refers to fees being billed to insurance. If resident fees are billed to insurance, respondents should indicate which types of insurance are billed using the categories of private insurance, public insurance (such as Medicare, Medicaid, VA, or other state-financed health insurance other than Medicaid).
  • Residents’ stays are covered by public grant/award: This option refers to residents’ stays being paid for with funds granted by a public award. This arrangement differs from a contract in that the public entity is not billed/invoiced for the resident fees. Rather an award is given in one lump sum for a specified purpose.
  • Residents’ stays are covered by private grant/award: This option refers to residents’ stays being paid for with monies from a private entity. This arrangement differs from a contract in that the private entity is not billed/invoiced for the resident fees. Rather an award is given in one lump sum for a specified purpose.

If resident fees are covered in any other way, the respondents should describe this in the “Other” category.

Thinking about the last fiscal year, what percent of revenue/funding for this residence came from the sources below? 
The purpose of this question is identify the overall financial/reimbursement picture of the residence in the past year. By past year, we mean past fiscal year, which may or may not be the same as the past calendar year. This involves breaking down the percentage of reimbursement received from the sources listed in the table. While the data are certainly meant to be an estimation, this should not be perceived as meaning a “guess”. Information necessary to complete this portion of the interview may be obtained from other staff or from administrative records. The total percentage of revenues should be add to 100%. Respondents should provide a clear description of any other sources of revenue in the row marked “other. These categories correspond to those listed in the prior question.

  • Contracts with public entities: This includes revenue from public contracts regardless of level (federal/state/local). Examples include contracts with criminal justice (e.g., probation, parole or drug courts) or family services systems or public health or behavioral health departments.
  • Contracts with private institutions: This includes revenue from contracts with treatment or other service providers
  • Residents’ or responsible party’s self-pay: This includes revenue from residents as well as other family members who may pay for a resident’s stay
  • Residents’ private insurance
  • Resident’s public insurance (e.g., Medicare, Medicaid, or other public insurance)
  • Grants/awards from public entities: Grants and awards are differentiated from contracts based on how funds are dispersed.
  • Grants/awards from private entities: Grants and awards are differentiated from contracts based on how funds are dispersed.
  • Donations from individuals: Donations from individuals are differentiated from grants/award from private organizational entities.
  • Written off/unrecovered: This represents the percent of the annual revenue that is not recovered (percent of annual expenses that are “in the red”).

Respondents should provide a clear description of any other sources of revenue in the row marked “Other.”

Which of this residence’s organizational characteristics (e.g., staffing, linkages, sources of revenue, and certification status) changed because of COVID-19? (Check Yes or No to each; check Yes if it remains changed because of COVID-19)

The intent of this question is to identify which of the residence’s organizational characteristics have changed since COVID-19 was declared a national emergency in the US (roughly March 2020). Respondents are asked to reply Yes or No to each facet of the residence’s organizational characteristics queried in this section.

  • It is operated by a different entity: This refers back to Is this residence operated by a … ? If the response to this question would have been different before March 2020, code Yes.
  • Staffing mix has changed: This refers back to questions about staffing (the type of individuals who support residents and their characteristics). If responses to these questions would have been different before March 2020, code Yes.
  • Formal linkages with outside providers/programs/agencies have changed: If responses to the question about formal linkages would have been different before March 2020, code Yes.
  • Sources of revenue have changed: This refers to questions about recovery of resident fees and revenue sources. If responses to these questions would have been different before March 2020, code Yes.
  • Certification/licensing/accreditation has changed: If responses to the question about Certification/licensing/accreditation has changed would have been different before March 2020, code Yes.

IF ANY STAFF CHECKED ABOVE: What precautions are in place for staff to address COVID-19?
The intent of this question is to gather information on the types of precautions that are in place for staff at the residence. Staff refer to individuals who provide services (operational, recovery support, social, or more clinically-oriented) to those living in the residence. Respondents should check Yes or No to each prompt listed.

IF ANY STAFF CHECKED ABOVE:  Has the number of staff for the residence changed since COVID-19?
The intent of this question is to gather information on how the number of staff has changed since COVID-19 (since March 2020). Staff refer to individuals who provide services (operational, recovery support, social, or more clinically-oriented) to those living in the residence. Respondents should check Yes or No. If staffing has changed, following up prompts will query the reasons behind this change.

Has this residence spent MORE on any of the following categories since COVID-19? (Check Yes or No to each)
The intent of this question is to gather information on increased expenses due to COVID-19. Respondents should check Yes or No to each prompt.

Has this residence applied for funding through any of the following programs? (Check Yes or No to each)
This question collects information on whether the residence applied for funding through different federal programs. Respondents should check Yes or No to each. If the residence applied for funding, a follow-up question is asked about whether funding was received.

Is this residence at risk of closing?
The intent of this question is to gather information about whether the residence may be at risk of closing. Respondents who answer “Yes” are asked to check the primary reason for this.

PROGRAM ORIENTATION & ENVIRONMENT

Questions in this section are about the residence orientation and environment as well as factors that may affect it. These questions should be answered by someone who knows about the day-to-day operations of the residence. However, it may be helpful to collect input from someone who might have been involved in establishing the residence or who is familiar with the overall mission or vision of the organization/entity that operates it.

To what extent is your residence run based on 12-step principles? (Check one)
The intent of this question is to gather information on how closely the programming in the residence or the residence orientation is based on 12-step principles (those outlined in the Big Book). Respondents should select one option from the following:

  • Not at all
  • A little
  • Somewhat
  • Quite a bit
  • Completely

On a scale from 0-100%, to what extent is the residence consistent with the social model philosophy?
Social model programs are ones in which the basis of authority is experiential knowledge of recovery. Respondents who would describe their residence as a social model program are asked to indicate (on a scale from 0-100%) the extent to which their program is consistent with the social model philosophy.

These next questions ask about the environment in the residence.
The intent of these questions is to get a sense of the environment within the residence. Respondents should respond to each prompt checking: Not at all; A little; Somewhat; Quite a bit; A lot;

  • To what extent do residents provide emotional support to each another?
  • To what extent do residents socialize together?
  • To what extent do residents support each other to address practical problems, such as where to find needed services, how to find employment, transportation, etc.?
  • To what extent do residents go to 12‐step or other mutual-help meetings together?
  • How effective are house meetings in terms of resolving problems and conflicts?
  • To what extent are residents involved in decisions that affect the house?
  • To what extent do residents work a 12-step or other recovery program on a daily basis within residence? This would include things like using 12‐step or other mutual-help principles to address conflicts and other problems.
  • To what extent do residents point out potential harm that could result from relapse or not continuing to work a strong recovery program?

As a result of current or potential changes in the recovery housing field, I find it hard to predict what changes will occur in…”
These questions concern uncertainty that this residence might face as a result of current or potential changes in the recovery housing field. Respondents should think about how much they agree or disagree with the following statements using this scale: Strongly agree; Agree; Neither agree nor disagree; Disagree; Strongly disagree; Do not know.

  • …this residence’s funding.
  • …the local treatment and recovery support services system.
  • …referrals of residents to or from this residence.
  • …regulatory requirements.
  • …our use of information technology such as electronic health records and outcomes measurement.
  • …coordination of services for residents.
  • …the kinds of staff members hired.

Because of COVID-19, how concerned is the leadership of this residence about …?
The intent of these questions is to collect information regarding the extent to which COVID is currently perceived as a threat to the residence and those living in it. Respondent should answer each prompt using the following scale: To a Great Extent; Somewhat; Very Little; Not at All; Don’t know/prefer not to answer.

  • … someone being infected at the residence
  • … the impact of being infected on residents’ health, including dying
  • … residents being isolated from other people
  • … residents losing a job / income
  • … residents losing savings
  • … residents not having enough money for food and/or rent
  • … residents infecting each other
  • … a resident’s family member who lives elsewhere being infected
  • … a resident’s friend who lives elsewhere being infected
  • … residents infecting other people in the community (outside the residence)
  • … how long it will take for things to go back to normal for our residents
  • … resident relapse because of isolation or stress

Which one of these sources has been useful in deciding how to address COVID-19 in this residence? (Check Yes or No to each)
The intent of this question is to find out the where residences have been getting information to make decisions about how to address COVID-19 in the residence. Respondent should answer Yes or No to each prompt.

  • Family or friends
  • Peers in recovery
  • International health organizations (e.g. World Health Organization)
  • Centers for Disease Control and Prevention (CDC)
  • Federal government
  • State health department
  • Local government (city or county)
  • Social network sites (e.g. Facebook)
  • National news
  • Local news
  • Websites about recovery
  • Other community resource
  • Something else (describe): ___________________________________________________

Respondents who respond “Yes” to Something Else should describe this source of information.

Compared to before the COVID-19 pandemic, are there now more CONFLICTS in the residence about… (Check Yes or No to each)
The intent of this question is to gather information on how COVID has affected the environment in the residence by probing whether it has raised potential conflicts between residents. Respondents should respond Yes or No to each topic listed.

Compared to before the COVID-19 pandemic, is there is now more TOGETHERNESS in the residence because of… (Check Yes or No to each)
The intent of this question is to gather information on how COVID has affected the environment in the residence by probing whether it has increased togetherness (i.e., closeness, comradery, cohesiveness) among residents. Respondents should respond Yes or No to each topic listed.

In thinking about COVID-19, how has it impacted your Recovery Residence?
The intent of this question is to assess the general impact of COVID-19 on different areas of the residence, including the staff and residents. To indicate the amount of impact in each area, respondents should use the following options: No impact; A little; Moderately; A lot.

  • Staff mood
  • Residents’ overall well-being
  • Staff/Resident relations
  • Residents attending meetings
  • Residents’ physical well-being
  • Residents’ physical exercise
  • Residents’ eating
  • Residents’ sleeping
  • Residents’ mood
RESPONDENT CHARACTERISTICS

This section collects basic information on the individual completing this survey. If more than one person helped complete this survey, this information should reflect the characteristics of the person who completed most of it and could be contacted if project staff had questions about any of the responses in the survey.

What is your job title/role at this residence?
Respondents should check the one option that best described their job title. If no such category exists, respondents should check “Something else” and provide a brief description.

  • Owner/Operator
  • Program Director
  • Administrative Assistant
  • House Manager
  • Therapist/Counselor/Recovery Coach
  • House President
  • Senior Resident
  • Something else

How long have you had this title at this residence? (Check one)
Respondents should check whether they have had this title for more or less than one. If less than one year, respondents should specify the number of months. If more than one year, residents should specify the number of years. Responses should be rounded to nearest whole years and months.

How would you describe yourself? (Check one)
The intent of this question is to collect information on current gender identity. Respondents should select one option.

How old are you?
Respondents should indicate their age in years. Responses should be rounded to nearest whole year.

Are you Hispanic, Latino or Latinx? (Check one)
This question collects information on the respondent’s ethnicity. Respondents should indicate whether they are Hispanic/Latino/Latinx.

Are you… (Check one)
This question collect information on the respondent’s race. Respondents should select one category. Those who are some other race should provide a brief description in the space provided.

  • White/Caucasian
  • African American/Black
  • Asian
  • Native Hawaiian or Other Pacific Islander
  • American Indian/Alaskan Native
  • More than one race
  • Some other race

Is there is anything you want to explain about your survey responses or tell us about your residence?

Respondents should use the space to share any explanations about responses to the survey questions. This space can also be used to explain anything that might be important to know about this residence.

How many other individuals were consulted with to complete this survey?
Given that some question might be best answered by individuals in different roles, the intent of this question is to identify the number of other individuals who provided information needed to complete this survey.

Please provide your name, phone number and email address so we can contact if we can email you the e-gift card as a thank you for completing this survey.

Respondents are asked to provide this information to make sure that the e-gift care is sent to the correct person using the correct email address and phone number.  This information will not be published or shared.

If we have follow-up questions about the residence and you are not the person we should contact, please provide that person’s name, phone number and email address.

Respondents are asked to identify a contact person and provide contact information to make sure that the information collected in this survey is accurate. This information would only be used to address questions about any of the responses provided. This information will not be published or shared.