Central Mass. cities, towns haven't spent opioid settlement funds: What's the holdup?
FITCHBURG — Stephen Curry could have access to a big pile of cash.
As that city's public health director for the past 16 years, Curry would like to spend some of the $300,000 that Fitchburg received from a nationwide opioid settlement with manufacturers and distributors of the painkillers. The drugs are responsible for hundreds of thousands of addictions and deaths in the U.S, including 159 deaths in Fitchburg from 2015 to 2022.
“Twenty is too many,” said Curry, referring to the 20 confirmed opioid-related overdose deaths in 2022 in the city, the most recent year of published numbers by the state health department. “One (death) is too many.”
One of Curry's favorite efforts is Fitchburg's street outreach program, which helps residents struggling with substance use disorders, and he would like to see some of the settlement money used to boost the program's work. But the rub is Fitchburg hasn’t spent a penny of the $300,000 to help those suffering from the ravages of opioids.
Not alone in unspent cash
Fitchburg isn’t an anomaly in unspent opioid settlement cash. Many Massachusetts cities and towns are sitting on a large amount of money.
Of the $42 million distributed statewide in fiscal year 2023, a period that extended from July 1, 2022, to June 30, 2023, 4.3% ($1.8 million) was spent on prevention, harm reduction, treatment and recovery programs. That’s how the money must be spent, according to the state-subdivision agreement, a court-agreed deal between Massachusetts and its municipalities.
The agreement sends 40% of settlement dollars to cities and towns, and 60% to the Massachusetts Opioid Recovery and Remediation Fund to mitigate the harm caused by opioids. Communities that received $35,000 or more and participate in the state-subdivision agreement were required to submit a report on how they planned to use and/or spend the funds.
A total of 195 cities and towns fell in the category and all submitted a report, according to the state health department. In total, 220 municipalities reported they spent none of their funds.
Little spending in Central Mass.
In Central Massachusetts, many cities and towns, big and small, have spent little, to none, of their opioid settlement cash. Some communities in the unspent category include Shrewsbury ($286,140), Auburn ($134,274), Webster ($106,385), Oxford ($103,302) and Leicester ($85,175), according to state data.
Leominster, the second-largest city in Worcester County (population 43,222), spent $30,000 of its $349,430 in settlement money. Mayor Dean Mazzarella was not available for comment.
As for Worcester, the second-largest city in Massachusetts (population 206,000), it spent all of its $845,393 in settlement funds to date. A breakdown of Worcester’s spending includes $345,393 for salaries in the city’s health and human services department for outreach recovery services for the homeless. The remainder ($500,000) went to Community Healthlink to operate a crisis response team that connects people to mental health and substance use resources.
Largest cities sitting on cash
Some of the state’s largest cities that received the biggest share of the settlement pie, based on the impact of the opioid crisis in those communities, haven’t spent a dime. They include Boston ($4.6 million), Cambridge ($1.9 million), Springfield ($1.5 million), New Bedford ($1 million), Lynn ($704,000) and Lawrence ($653,000).
The long list of municipalities sitting on unspent cash highlights the challenge when it comes to how to use the funds, said Amie Shei, president and chief executive officer at the Health Foundation of Central Massachusetts. It’s a challenge made more difficult, said Shei, because local public health departments have been underfunded for years.
“It would be great if the funds are directed to the particular needs of communities, to have an opportunity for local input,” said Shei. “But at the same time, we know local public heath infrastructure has been under resourced and understaffed for years.
“It’s a tall order for local public health officials to decide the best use of the funds, to identify evidence-based strategies to invest in.”
Massachusetts is expected to receive more than $900 million in the years ahead for substance use prevention, harm reduction, treatment and recovery support.
Why the unspent cash?
There are several possible reasons why a minuscule amount of settlement cash is doing its work.
The state-subdivision agreement sets requirements that dictate how the money is spent, including that decisions should be rooted in data; funds should expand and improve existing state and local prevention, treatment and recovery programs; and residents most impacted by the opioid crisis should have a say in how the money is spent.
Another factor is funds were distributed after fiscal 2023 started, so they couldn’t flow into that year’s budget cycle.
Additionally, there appears to be another reason for the spending delay and that is the slow-moving wheels of local government. When communities received the funds in fiscal 2023, they had to go through official municipal channels before they could appropriate the money for their intended use, including receiving town meeting approval or other avenues that take months to slog through.
Curry cited as much to explain the delay in Fitchburg. So did Shrewsbury Town Manager Kevin Mizikar, Auburn Town Manager Edward Kazanovicz, and a spokesman for Marlborough Mayor Christian Dumais.
Change in state law could free up cash
A breakthrough arrived in December when a change in state law allowed municipalities to establish a special revenue fund where future settlement cash can be deposited. The result is, when the money arrives in years to come, municipalities can spend it right away, instead of becoming a victim to a snail's-pace bureaucracy.
In Shrewsbury, Mizikar explained the law change is welcome news as the town is expected to receive more than $1 million in settlement funds over the next 16 years. The money will likely be spent wisely, as Shrewsbury isn't immune from the opioid crisis: 43 of the town’s residents died from an opioid-related overdose between 2015 to 2022.
“This is a critical public health challenge,” said Mizikar. “We need to do our part to help, to prevent every possible future addiction or death that we can. It’s really important to us.”
Help from a Boston consultant
JSI is on board to help Massachusetts communities figure out how to spend their opioid settlement cash. The Boston-based consultant teamed up with the state health department for the work and Cheryl Juaire plans to participate in the consultant's training programs.
Juaire lives in Marlborough and lost two sons to opioid overdoses. The town received more than $190,000 in settlement cash that is unspent and Juaire would like to see the funds put to use immediately. However, she understands Dumais was sworn in as mayor Jan. 1 and needs time to set his priorities.
A spokesman for Dumais said the mayor submitted to the city council an order to establish a special revenue fund for the opioid money. It could appear on the council's Monday agenda for an eventual vote.
As Juaire sees it, the state should have made sure the settlement dollars were spent as soon as they arrived in cities and towns. “(Cities and towns) got money, but people don’t have a clue about what they’re doing...It’s a mess and should have been handled right from the beginning.”
Time to work together
Curry, the Fitchburg public health director, said it's up to the mayor and city council to decide how to spend the $300,000 in settlement money. He stressed that cities and towns should explore pooling their settlement cash to fight the opioid epidemic, an idea encouraged by the state-subdivision agreement.
But Curry cautioned that collaboration isn't always possible.
"Working together makes sense, but it's easier said than done. Some communities, smaller towns that don't have the same issues that Fitchburg does, maybe they have their own ideas about how to address problems and that's fine," he said.
Contact Henry Schwan at henry.schwan@telegram.com. Follow him on X: @henrytelegram.
This article originally appeared on Telegram & Gazette: Central Mass. cities, towns slow spending opioid settlement funds
