Buncombe's Plans for Opioid Expenditures - TribPapers

Buncombe’s Plans for Opioid Expenditures

Chair Brownie Newman wasn't seeing how the strategies selected for dealing with the opioid crisis were going to stop the bleeding.

Asheville – At the September 20 briefing of the Buncombe County Commissioners, Victoria Reichard, the county’s first behavioral health manager, provided an update on the planning process for spending opioid settlement funds. Out of a total of $26 billion disbursed nationwide, the county has been promised $16,175,039, to be released in varying amounts over 17 years. Reichard and others have decided to spend $518,500 of the $1,998,101 allocated for next year and roll the rest over into years that the county does not receive so much. One reason was not wanting to put the commissioners in the awkward position of having to expand the general budget in years of lean disbursements. Another was to balance the desire to treat “clear and present dangers” without delay with taking time to identify less-visible needs in the community in the name of equity.

Reichard spoke of a steering committee of 45 “community stakeholders” that was going to be visioning priorities for the funds over the next three years. She spoke in power verbs and then reviewed the twelve strategies allowed by the option the county selected from the state’s memorandum of agreement. These were: collaborative strategic planning, evidence-based addiction treatment, recovery support services, recovery housing support, employment-related services, early intervention, naloxone distribution, post-overdose response teams, syringe service programs, criminal justice diversion programs, addiction treatment for incarcerated persons, and reentry programs. She said the county currently supports all strategies.

Reichard then noted that grant funding for three programs offering “crucial, lifesaving services” was scheduled to end this year. Those programs included a cluster of activities designed to help people released from jail reassimilate into society ($148,500); training and compensating recovering addicts for coaching others with addiction ($180,000); and paying a therapist and purchasing medications for helping people in withdrawal ($140,000). In addition, the county would fund “in-depth engagement with impacted communities and subject matter experts” for early intervention, recovery housing support, and collaborative strategic planning ($50,000). Reichard said she would return early next year with updates on a root cause analysis, visioning, and the three-year funding strategy.

Commissioner Jasmine Beach-Ferrara asked if funding for Safer Together, which is operated by the county and provides wraparound services for people at high risk of opioid overdose, was going to be supplanted by settlement funds. Reichard replied that there is a chance that the state will renew funding, but added that such considerations change every day in her line of work. Beach-Ferrara then stated her wish that, if state funding were procured, the county would use the allocation to expand the program. The two then spoke about the great need for more medical and nurturing interventions.

Reichard said she recently heard there were 100 “community reversals,” or successful administrations of naloxone to friends or family members who overdosed on opioids. Although the number was reported without parameterization, Reichard was sure it was an underestimate. Having the capacity to admit more people to programs providing wraparound services was going to be important because people are not always willing and able to commit to lifestyle changes. It is not just a matter of getting enough courage to take the first step toward recovery; people must get their acts together enough to make their appointments on time, etc. After talking about availing settlement funds to grassroots initiatives with insufficient overhead to, for example, manage government grants, Beach-Ferrara expressed her wish that all initiatives addressing the various aspects of opioid treatment and recovery be cooperating elements in an integrated, countywide system.

Reichard thanked Beach-Ferrara for talking about the bigger picture and added, “What’s our foundation? What do we know – whether it’s opioids, methamphetamine, or something else that’s infiltrating our community?Do we, as a county, have the infrastructure and that foundation to provide support for services? And then, we’re using opioids to maybe tackle that one specific [problem], but we’re also expanding additional access support. Obviously, the opioid settlement is not going to be able to support all of these strategies that are needed over the next 17 years. So, what do we want to invest in that we know will be flexible, no matter what we’re facing? What epidemic could pop up tomorrow? We’re already seeing polysubstance use as a big issue.

Chair Brownie Newman observed the programs selected appeared to be geared toward people who already suffer from addiction. He then asked the golden question. “Are the opioid settlement funds—are any of them—intended to be invested in terms of future prevention type of work—whatever that might look like?” Of prevention programs, Reichard said, “They’re not necessarily occurring through these resources, but that collaborative strategic planning is where we’ll be looking more at – and again, what does this look like? How do we tap into some of those providers that are doing that work with young people? How do we get feedback from young people about what they truly need? You know, being part of a group that was looking at the face of the recovery, how do we let young people know that if they need help to reach out, and those young people said, “We don’t care about a poster, you know. Give us something on Tik-Tok, like show us a little video. ”

She continued, “This is a time where we’re really going to need to dive in and hear from our young people what is needed, what those resources are.” One thing that I am hearing, though—and even from those families—’Where do I go for these services? Where are the supports? ” So, being able to recognize, do we have the support and services available, but we need to educate our community more on how to access them? Are there some low-hanging fruits? Or do we really need to create a new program? A lot of training has been done in Buncombe County for mental health youth first aid. Is that something we need to add? Is there not enough? Or do we need to now add something new and different or maybe more specific? So, really in these next couple of months, as the funds for collaborative strategic planning will help us learn more about what our community needs for early intervention. What will make that different? ”

Newman rephrased his question and asked for follow-up at a later meeting.