Worcester among Mass. cities to receive opioid settlement funds for recovery services

When 16-year-old Javier Baez underwent knee surgery in 2007, his doctors prescribed three opioids to relieve his pain. He slowly became addicted to his medicine and ended up becoming an intravenous drug user for over a decade.

“It ended up going from me using prescribed pills to not being able to get them from doctors anymore because they started cracking down,” Baez said. “I was really affected by the opioid epidemic. It changed my life; it brought me to places that I didn't think it would ever take me.”

According to the Centers for Disease Control and Prevention, approximately 30,000 Massachusetts residents received new prescriptions for short-acting opioids in 2011. By March 2016, Massachusetts became the first state to restrict the initial supply of opioid painkillers prescribed by doctors.

Baez started his recovery journey in 2018. With his lived experience with an opioid use disorder, he is now one of the three recovery coaches at Lynn Community Health Center, helping people get into treatment, finding the best recovery pathway for them and connecting them with aftercare services.

Those services are likely to benefit from the over $900 million in settlements with opioid distributors, manufacturers, pharmacies and consulting firms reached by former Attorney General Maura Healey over the past two years.

Under the State-Subdivision Agreement, 40% of the opioid settlement money — or Municipal Abatement Funds — goes to city and town governments to expand and strengthen prevention, harm reduction, treatment and recovery services. Supporting and training peer specialists are among the options for using settlement funds.

Baez said creating a diverse peer recovery workforce will be a good use of the settlement funds.

“When it comes to addiction, it's a very sensitive and vulnerable subject, and you need somebody that can culturally understand you,” he said. “I am Hispanic. I wasn't able to find that in the places that I was going through recovery because there wasn't enough money and support being put into creating a peer workforce of people of color.”

Worcester among 10 in state due for $

As of March 31, municipalities across the state had received over $42 million from the settlement with opioid distributors — Cardinal, McKesson and AmerisourceBergen — and drug manufacturer Johnson & Johnson. According to data from the office of Attorney General Andrea Campbell,  the top 10 municipalities to receive opioid settlement funds are Boston, Cambridge, Worcester, Springfield, New Bedford, Brockton, Fall River, Lynn, Lawrence and Taunton.

Katheleen Conti, assistant director of media relations in the Massachusetts Department of Public Health, wrote in an email that municipal allocations were determined by the national opioid litigation settlement, based on federal data about opioid use disorder, overdose deaths and opioid shipments into Massachusetts between 2006 and 2016.

“It is the obligation of the municipalities, by accepting the settlement funds, to comply with the Massachusetts subdivision agreement and to ensure that the programming selected by municipalities is supported by evidence,” Conti wrote.

The agreement entails seven categories of services and strategies for local leaders to decide what will be best for the community. Specifically, the money can be used to expand OUD treatment facilities; connect people to care; support pregnant or parenting women with OUD; prevent misuse; and provide housing, employment training, and transportation for those with OUD.

“I would love to see some of the money go to supporting people going into sober houses,” said Michelle Simons, addiction workforce grant coordinator and a recovery coach trainer at North Shore Community College. “It will be fantastic because people will be able to slow down a little bit when they get out of a residential or another treatment facility, and be able to really focus on their recovery for the year and not feel so much pressure to dive back into society.”

The agreement also allows law enforcement agencies in cities and towns to join the Police Assisted Addiction Recovery Initiative for training and developing alternative responder models.

“We want to make sure that people are getting access to treatment and resources and making sure that they're not being put through the criminal justice system,” said Travis Rapoza, the initiative's program manager. He said the organization provides monthly opioid settlements office hours and a national opioid settlement funds guide to help its partners best use the money.

Analyzing community's priorities

With many options to use $6.03 million in the next 15 years, Lynn's public health department has formed a 12-member working group, comprising representatives from various city departments, medical providers and individuals with personal experience, to analyze the community's priorities and make recommendations to the mayor's office on how to allocate the newly obtained fund.

Jennifer Almonte, the public health nurse in Lynn, said the working group has met three times since March to discuss community engagement strategy and some priorities that the members witness in their professional fields. She added that the city hopes to “give people affected by the opioid crisis a platform to elevate their voices” and include them in the decision process.

Candice McClory, an opioid program specialist in Lynn, said one piece of feedback she has received from the community is the need to establish an ID retrieval program.

“In order to go to a shelter, go to detox or get a job, you need an ID, and unfortunately, nine times out of 10 if you're in very early recovery, or you're still actively using opioids, you don't have an ID or you don't have money to access an ID,” McClory said.

Almonte said the ID retrieval program fulfills one of the commitments of using the abatement funds, which encourages innovation and fixes existing shortcomings.

Almonte added that another priority for Lynn is to work with the community to help educate the public about Narcan and make sure it's accessible to everyone. According to the Department of Public Health, there have been more than 400 confirmed opioid overdose deaths in Lynn between 2012 and 2021.

“I think ultimately what we're trying to do is save lives. A lot of people are dying. There are tools out there that we could use to not have people die of an overdose,” Almonte said. “We're trying to be as thoughtful as possible with these funds. Once they know exactly what the needs of the community are, we'll be able to figure out where the funds should be directed.”

While Lynn is still “investigating” the community’s needs, Almonte said the working group wants to organize public forums and focus groups in the future to gather more feedback. Upon finalization of the strategy, she added that all opioid-related treatment programs in the city will be able to apply for the grant to strengthen their services.

Other communities are also working through options for the funds.

Worcester to receive $14M

With Worcester expected to receive more than $14 million in the next two decades, Community Healthlink received $500,000 in settlement funds last October for its new mental health community crisis response model.

Dave Sweeney, the spokesperson for Community Healthlink, said the model is a valuable tool and will work with the city and first responders to respond to specific urgent calls that come in and help people in crisis and in dire situations.

“The city's decision to invest in this work has been fairly innovative and it’s significant to help people who are in a behavioral health crisis and are dealing with substance use disorders,” he said. “It makes great sense to allocate these funds from the opioid settlement back into the community to help people that were really victimized by the opioid crisis.”

Tom Matthews, the city’s media and public relations administrator, wrote in an email that Opioid Settlement Fund revenues received in fiscal 2023 will be allocated to the Office of Health and Human Services and the Division of Public Health for approved activities associated with opioid abatement strategies.

“The city is currently looking at building a data network that pulls together health data from the city’s various hospitals to use for informed decision making surrounding funding solutions for public health,” he wrote. “The city will review and assess future appropriations to reflect real-time needs and will be responsible for completing annual reporting on these funds to ensure they are expended on eligible uses.”

Elsewhere in Massachusetts, Salem health agent David Greenbaum wrote in an email that the city is in the “beginning stages of strategic planning” for assessing the community’s needs and looking at a “comprehensive approach” to spending the funds.

In New Bedford, public information officer Holly Huntoon wrote that the city is still finalizing plans for disbursing abatement funds.

'Every dollar counts' in crisis

And in Plymouth County, which has received a small percentage of all settlement funds, Treasurer Thomas J. O'Brien said “every dollar counts in the battle with the opioid crisis,” and that the county is planning to award the money to one of the local organizations in June.

Wendy Kent, the consultant with Lynn’s health department, said she anticipates municipalities with smaller amounts of funds will form regional efforts and share resources to “help these dollars go even further.”

“It's everybody's collective responsibility throughout the municipal government and throughout every sector,” Kent said. “It’s important to take advantage of this opportunity to really create much better collaboration and infrastructure so that the needs of the community are being met.”

Starting in fiscal 2023, cities and towns that receive annual abatement distributions of $35,000 or more are required to submit annual reports of their municipal abatement fund expenditures to the Executive Office of Health and Human Services.

As opioid settlement funds roll into Massachusetts and its municipalities, 60% of them go to the state’s Opioid Recovery and Remediation Fund. The fund's advisory council was established with former Gov. Charlie Baker's signing into law of Chapter 309 of the Acts of 2020.

According to its annual report, the council allocated $9.25 million to four specific initiatives overseen by the Department of Public Health's Bureau of Substance Abuse Services in 2022, including increased access to medical treatment, expansion of harm reduction services, supportive housing programs and community engagement.

Charles Anderson, president and CEO of the Dimock Center and member of the advisory council, said the council voted in 2022 to provide $15 million in Opioid Recovery and Remediation funds to support student loan repayment for direct-care staff in substance-use disorder treatment programs.

“Loan repayment can really help diversify the workforce. Sometimes it's a barrier to doing this because of what it's going to cost,” Anderson said, adding that all medical and administrative settings should strive to ensure equity when using opioid settlement funds.

David Rosenbloom, professor of public health at Boston University and a member of the Opioid Recovery and Remediation Fund advisory council, said he hopes the council will invest to better understand outcomes related to opioid treatment, including survival rates, continuation in treatment and return to normal life.

“One of the great failures of existing substance use disorder policy is that nobody measures the outcomes and nobody is held responsible for achieving good outcomes,” he said. “I hope we do a better job of analyzing these outcomes.”

Anderson added that the ultimate measure of success is seeing fewer people die from opioid overdoses, and the state should refine the interim measurement tool of collecting “equitable responses across all groups, especially those who are disproportionately impacted by the opioid crisis.”

Rosenbloom said the opioid settlement funds seem like a lot of money, but they are spread out over almost two decades and are small in comparison with the problem and the number of years over which the money will be spent.

“The benefit of the opioid settlement money is that it's the most flexible because it can be used outside the normal bureaucratic and political processes that govern other uses of public funds,” he said. "We hope that an overall strategy will develop that takes into account both the need for treatment accessibility, acceptability, effectiveness, duration, longer treatment and the social supports that make recovery possible.”

This article originally appeared on Telegram & Gazette: Worcester among Mass. cities to receive opioid settlement funds for recovery services