New York state is sorting out how to spend over $2 billion in settlement money from pharmaceutical companies that played a role in the opioid crisis.
Southern Tier counties, many still battered by rising overdose rates, are deciding how best to spend funds they’ve received from signing on to settlements.
The number of New Yorkers who died from an opioid overdose increased by 14 percent from 2020 to 2021.
Before the pandemic, Broome County had cut its overdose numbers in half. But this year, numbers are back up, with 80 people dead in 2022 from suspected fatal overdoses.
The Southern Tier received about $4.8 million in total settlement funds for 2022; Broome County received around $1.6 million for the year.
“We were able to go to court, and hold these companies liable for what they did," Broome County Executive Jason Garnar said. "And it's contingent on us to use this money, and not just supplement it. To use this money in new ways to save lives and not just... find a different way to pay for programs that we're already doing."
Garnar said the county is working with the Broome Opioid Awareness Council, a group made up of treatment providers, community stakeholders and elected officials, to put together a request for proposal (RFP). That way, local organizations that work to combat the opioid crisis can apply for funding.
None of Broome County’s settlement funding has been spent yet. Garnar said the county is focused on developing a long-term plan for the funds. He said it’s been complicated, given that different chunks of money are coming in from different settlements at different times.
“We want to create sustainable programs, programs that will last X amount of years, we just don't want to throw money at something, and then move on to something else,” Garnar said.
Garnar said given that the county already has a few new treatment, detox and supportive housing programsstarting up, he’d like to see some of this money go towards overdose prevention and harm reduction.
“We're not as rich in harm reduction services as we are in treatment services.”
Alexis Pleus is the executive director of TruthPharm, alocal non-profit and advocacygroup. She’s on the Broome Opioid Awareness Council, but she said they haven’t had any input on the RFP process yet.
Pleus said she feels funds should go toward evaluating whether local treatment programs are actually working for people in the community and helping to prevent overdoses. She'd also like to see the money go towards gaps in services, and smaller community organizations that can’t bill insurance or Medicaid to stay afloat.
“In Broome County as an example, we're not as rich in harm reduction services as we are in treatment services. So I'd like to see more money in harm reduction services,” Pleus said.
Harm reduction doesn’t require a person to stop using drugs to get care. Services can include syringe exchange, safe injection or consumption sites—also known as overdose prevention centers—and distributing Naloxone, an overdose reversing drug.
New York’s opioid settlement fund advisory board has recommendedthe state spend at least 22 percent of its funds on harm reduction measures. The board also suggested the state fund overdose prevention centers, but that recommendation was rejectedby Governor Kathy Hochul’s administration.
“That money gets tied up pretty quick.”
Steuben County is one of the few counties in the Southern Tier that has already allocated money for 2022.
“We know the need is here now. And we have received most of the money that we expect for 2022, so we wanted to start making those investments now,” Steuben County Executive Jack Wheeler said.
They didn’t do a formal RFP process. Wheeler said that’s because in a rural community like Steuben, there simply aren’t that many organizations working in the substance use field.
Steuben County received just under $700,000 for 2022. Most of that money has gone towards expanding Catholic Charities’ peer recovery program, hiring two new social workers for the county, youth prevention efforts and other programs that support people in recovery.
“It's a lot of money, there's no doubt about it, it's a lot of money. But when you look at the scope of the issue, and the cost of staffing, the cost of being able to address that, that money gets tied up pretty quick,” Wheeler said.
Sara Whaley is faculty at Johns Hopkins Bloomberg School of Public Health. As part of the school’s overdose prevention initiative, she works with states and counties to help them spend opioid settlement funds in the most effective ways.
“As it trickles down to the local level, it could be, you know, less than we think. And so making sure that it's used strategically is going to be the most crucial point to ensure its effectiveness,” Whaley said.
That means planning long term, Whaley said, and actually evaluating what’s been working in a community and what hasn’t. She said counties should communicate with each other, and look at what resources are and are not available across county borders.
Whaley said the public should get to see what happens with this money. That could mean putting together public-facing websites to show spending, and holding community meetings or town halls throughout the process.
And she said getting input from the community, especially people who have been the most impacted by the overdose crisis, is extremely important.
“[There are] organizations that are on the ground doing the work, they're the ones that know what's needed. And also including the voices of people who use drugs…these are the people that the money is supposed to be helping,” Whaley said.