The Florida Shuffle - Letter to Senator Harrell

Posted: October 21st, 2022

February 5, 2022

The Honorable Gayle Harrell

State Senator, District 25

The Capitol

Tallahassee, FL. 32399-1100

Dear Senator Harrell,

I would like to begin by thanking you for sponsoring bill SB 804, along with the Community Affairs Committee, which was signed into law by Governor DeSantis and went into effect on July 1, 2021. The law requires mandated credentials for rehabilitation services, sober living facilities, and other SUD resources that had been unregulated. I applaud your efforts and insight in understanding that more significant regulations/laws were needed to assure people suffering from substance use disorder issues were receiving treatment from qualified/regulated facilities. Too many families have been taken advantage of financially by substance abuse service providers with little to no medical/mental health credentials needed to help this suffering population. Millions of dollars have been wasted in these nefarious facilities, while thousands have lost their lives to OUD by placing their trust in them, so again, I say thank you.

I would now like to call your attention to the “money-making machine” referred to as the “Florida Shuffle.”  As seen in the diagram below, multiple “players” have made billions of dollars in these complex, well-orchestrated, immoral, and unethical relationships. Detox facilities, inpatient and outpatient facilities, drug lab testing sights, “marketers,” and halfway houses/sober homes’ primary goal is to keep the SUD patient relapsing; hence the “shuffle” starts all over again, and insurance companies, taxpayers, and families are paying the bill. As you know, the ACA puts no yearly/lifetime limit on rehabilitation, so corrupt providers are incentivized to keep SUD patients relapsing, which often means their death.   

As a society, we need to do more to help our fellow citizens, many of whom are adolescents, from falling prey to this system/process. Lives are being lost, families are being destroyed, and participants in this operation continue to profit. Enough is enough, and we need your help.

In closing, I want to thank you once again for your commitment to “cleaning up” the substance abuse service industry and for advocating for the SUD population and their families, but there is still much work to be done, as you know. So, again, I thank you for your kind attention and look forward to hearing from you soon. 


Thomas Woods

Thomas Woods, MDiv

Why I selected the “Florida Shuffle”

I selected the issue referred to as the “Florida Shuffle” because it was the first significant series of investigations into the vast corruption among the myriad of “resources” that were uncovered to be anything but helpful, even deadly (Sachs, 2019). Instead, what multiple investigations discovered by law enforcement, state auditing agencies, local and national news, and through testimony by people with SUD, to name a few, uncovered was a massive “syndicate” of rehabilitation centers, laboratories, sober living facilities, and outpatient SUD facilities whose primary purpose was to keep the addicts relapsing for the sake of profit.

The “FS” starts by using deceptive marketing tactics to attract desperate families from other states (75% of all SUD patients in Florida are from out of state) one-way airfare to the patient to one of these inpatient rehab facilities. Once they are in rehab, the patient goes through whatever course of treatment is offered. This is all paid for by private insurance along with exploiting the Affordable Care Act (ACA) and the Mental Health Parity and Addiction Equity Act (MHPAEA) of 2008 (Sachs, 2019). After completing treatment, the patient is then moved to outpatient treatment and needs a place to live. The patient will then be directed to specific sober homes where rent must be paid. The “FS” then, using the Americans with Disabilities Act (ADA) and the Fair Housing Act (FHA), knowing that these pieces of legislation prevent any regulation or inspection of the premises, are very often crime-ridden flophouses where drug activity and other criminal acts are the norms. Rent, however, is significantly reduced or waived by the sober home, who in turn receive kickbacks from the outpatient facilities and labs in charge of urine testing these patients. The kickback money comes from the thousands of dollars charged to the insurance companies by the labs and the facilities (see diagram above). Once insurance benefits have been used up, the “FS” actors will use the ACA, after the patient inevitably relapses and has no way home (and may not be wanted home) theses “rogue providers” then re-admit the patient to another facility and the cycle begins again (Sachs, 2019).

 Under the ACA, there is no yearly or lifetime limit on rehab, so the corrupt providers are incentivized to keep addicts in a perpetual cycle of relapse and recovery until that person’s death.


The irony of the FHA and ACA policies is that they have been exploited to benefit the criminal activity by a myriad of facilities and corrupt resources that use them in funding this “death march.” 


How the issue affects social work?

 The issue for social workers is self-evident when dealing with clients who are suffering from SUD. The “FS” is also now branching out all over the country since its exposure, so social workers in finding vetted, credible resources for their clients with SUD need to show competency, knowledge, and skills in helping to place these clients in credible facilities (Downey, 2022).

The reason I chose Senator Gayle Harrell

 Senator Harrell led the charge in creating a statewide opioid task force that has led to multiple arrests and hundreds of millions in fines levied against the corrupt SUD providers. She has also been personally affected by OUD within her family, which to me, means she has “skin in the game” and is not just giving “lip service” (, 2022). She has had a long history of fighting the opioid crisis on many different fronts. (big pharma, corruption in SUD providers, more extended incarceration periods, etc.)  I will, however, admit that it was the fact that she had been directly affected by the loss of a family member that let me know this was indeed a person that was going to fight for the justice needed on multiple fronts.  





The News Service of Florida, (2019). DeSantis signs new laws on opioids, gardens and street racing. Fort Myers Broadcasting, Tallahassee, FL. Retrieved from:

Downey, R. (2022). Senate passes bundle of substance abuse and mental health bills. Florida politics, Retrieved from:

What is the Florida Shuffle? (2019).  Retrieved from: https://fixthe

Harrell, G. Retrieved from:

Sachs, S., (2019). Florida rehab programs, recovery residences face extra regulation from new law. WFLA, Retrieved from://