By Greta Jochem
masslive.com
SPRINGFIELD, Mass. — Millions of dollars have been paid to Massachusetts cities and towns from settlements with drug manufacturers and pharmacies for their role in the opioid overdose crisis.
And yet scant amounts of the money provided last year was spent, records show, even as opioid overdose deaths hit a state high in 2022.
More than $40 million was given to city and town governments across the state in fiscal year 2023, which ended in June. But only about 5% of it had been spent by the year’s close, according to reports most municipalities were required to submit to the state.
“There has been a lot of community questions on what’s being done with these funds,” said Kim Slade, substance use outreach coordinator in the Westfield Health Department.
Some people in recovery and their advocates express frustration that leaders have been slow to start spending the money. Several Hampden County city leaders say technical state financial issues delayed the process.
The state is also asking that municipalities make data-driven spending decisions and consult with people impacted by the opioid overdose crisis, a process that takes time.
Several years ago, then-Attorney General Maura Healey announced lawsuit settlements with opioid-related businesses, including manufacturers Teva and Allergan, distributor Johnson & Johnson and pharmacies Walmart, CVS and Walgreens.
Nearly a billion dollars will flow into the state over 18 years in settlement payments. Another suit against Purdue Pharma could bring in even more money; that settlement is tied up in a bankruptcy deal before the Supreme Court.
Money will arrive in cities and towns on a regular schedule through 2038. Many communities have started or are organizing outreach to gather community input. West Springfield, for example, is surveying residents in an online form about how it can best use its roughly $900,000 in expected funding. Westfield is launching a survey and plans a public event.
No deadlines
Of the settlement funds secured by the state, about 40% will go directly to municipalities that signed onto settlement agreements. The rest will fuel a statewide Opioid Recovery and Remediation Fund.
While specific state guidelines spell out how funds can be used, there is no deadline by which cities and towns must spend the money, according to the Attorney General’s Office.
West Springfield spent about $9,000 of its funds to buy vape detectors from Zeptive for middle and high school bathrooms. Now, when a student vapes in those bathrooms, a detector, if it does its job, can pick up the aerosol and alert an administrator by text.
The CARE Coalition, a group that works in the schools, pitched the idea to the city, said Ananda Lennox, the coalition’s coordinator.
The detectors are somewhat controversial, she said, but there’s been increased public pressure to do something about a rising youth vaping issue. Drug use is complicated and “nobody likes the expression ‘gateway drug,’” Lennox said. But nicotine is often the drug people start using at the youngest age, which can set the stage for later drug use, she said, and detectors could help interrupt the behavior.
The cost of the detectors represents a sliver of the city’s overall funding — about $200,000 last fiscal year and an expected total of $900,000 in payments through 2038.
Last month, the city and the CARE Coalition launched an online community survey asking people to name gaps in service and ways to address the opioid overdose crisis.
As of last week, about 30 people had responded; a third of the respondents had a family member or loved one who died from addiction or was in recovery. The survey will remain online and open for responses with no set deadline.
Chicopee surveyed residents in 2022 and 2023 about use of the money and got more than 100 responses, according to Police Capt. Holly Cote, a member of the committee planning use of the settlement money. Cote said the committee, with representatives from various city departments, is most interested in prevention and education efforts, but is still in its review process.
Slow rollout
Westfield has so far received $289,000 and expects to take in more than a million dollars through 2038.
Last fiscal year, it spent around $2,241, according to state records.
Mark Jachym, a Westfield resident in recovery, sees the rollout as slow and is frustrated. Funds started flowing to the city in mid-2022.
“In the meantime, I’ve had friends, I’ve had neighbors passing away because of overdoses,” he said. He’d like to see transportation programs to help get people to detox and treatment centers, or billboards advertising the Massachusetts Overdose Prevention Helpline.
Westfield Mayor Michael McCabe said managing the windfall has been complicated.
“The rollout has been difficult because of the way the payments are allocated,” he said. When the first check came in 2022, “totally out of the blue,” the city didn’t have a vision yet how to spend it, McCabe said.
The money initially had to go into city’s general revenue fund, per state law, and those funds can’t be spent until they are appropriated. McCabe wanted it in a special fund that could be used over time.
In Massachusetts, if general revenue isn’t spent before the end of the year, it becomes free cash, complicating the finances. Under state law, municipalities were unable to make special revenue accounts for opioid settlement funds. In general, money to cities and towns has to go into a general fund unless state law makes an exception.
Officials in Springfield, Holyoke and Westfield said this technical issue posed a problem that delayed use of the settlement money.
The issue was recently fixed. A change made in December means municipalities can put opioid settlement funds into a specialized account, according to the Department of Revenue.
In Westfield, the city spent $2,000 last year on a substance use outreach coordinator. The initial hire didn’t stay in the job, McCabe said, and Slade started in the position this fall.
Slade is launching a Westfield community survey this month to get input and is working with Westfield State University on a public event. The city is also teaming up with Tapestry Health to support existing overdose awareness meetings in the city and gather input on how to use the settlement funds, Slade said.
“It’s got to be community-driven and community-informed,” she said.
McCabe wants to see funding support treatment. “I think the biggest mistake of our time isn’t having the ability to get help when they need it,” he said.
McCabe wanted to team up with other cities and combine funds to create a treatment center, but colleagues in nearby city halls were not interested. “That’s my big idea,” McCabe said. “It didn’t go anywhere.”
Zero of $427,000 spent in Holyoke
Holyoke hasn’t spent any of its funds yet, totaling $427,000 last fiscal year. As in Westfield, issues with state financial and accounting rules slowed the city down, Holyoke Mayor Joshua Garcia said.
Garcia favors a new Community Response Division that would address housing and quality-of-life issues with positions like a housing navigator and homeless liaison. He’s still trying to understand if it’s possible to use opioid funds for that under the state rules.
Gabriel Quaglia is in recovery and started a harm reduction advocacy group, the Folding Chair Project, in Holyoke. He hopes to see cities do more outreach to get input, particularly from people with lived experience, a factor the state asks municipalities to take into account.
“I haven’t heard much of anything, which is part of the problem,” Quaglia said. “The community has to come up with the solutions, and that’s not what I see happening,” he said.
Quaglia wants new harm reduction efforts and transportation to existing services. He noted the city lost treatment options when MiraVista Behavioral Health Center announced last spring it was closing its Holyoke detox unit.
Springfield fronts money
By 2038, Springfield will receive the most funding of any western Massachusetts community, an estimated $7.2 million.
The state’s database says the city last year didn’t yet spend the $1.5 million it received. Mayor Domenic Sarno’s office said it was tripped up by the state finance rules that Westfield and Holyoke struggled with, so the city fronted about $421,000 for several initiatives and planned to reimburse itself.
More than $100,000 went to expand staff hours of specialized fire department medical units in two of the city’s areas with the highest overdose rates.
Stocked with medical supplies like AEDs, EpiPens, and naloxone, the units go to calls that could be overdoses, Capt. Drew Piemonte said. It also allows the city to send just the medical unit to the call and not an entire fire truck, which are much larger and costlier to operate, he said.
The city’s Department of Health and Human Services received $200,000 for a mobile medical van it can use for care in an underserved area. Because of supply chain issues, the city has not yet gotten the van, but it has another one it could use in the meantime, if that’s what public input recommends, said Health and Human Services Commissioner Helen Caulton-Harris.
The city formed a coalition in 2019 to respond to the opioid overdose crisis, she said.
“One of the areas we continually hear is the fact that there are potentially not enough treatment beds in the western region,” Caulton-Harris said. “We are also hearing that transportation is a challenge as far as getting individuals into treatment.”
To get input on spending, the city is in the process of surveying people with substance use disorder and is planning community forums, Caulton-Harris said. Days and times for public events have not yet been announced.
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