Agenda Item Request
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Update on current action plan for the allocation of the Cumberland County Opioid Settlement Funds.
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Background and Purpose of Request
From: Liz Blackwell-Moore
Subject: Cumberland County Opioid Settlement Spending Update
Overview
Cumberland County Government began receiving direct payments from several Opioid Settlements in 2022 and will continue to receive payments for the next 18 years. Each year, the total payment amount will fluctuate but the County expects to receive an average of $211,260 annually. All subdivision recipients of the opioid settlement funds in Maine must spend the money on approved uses for opioid abatement identified in the Opioid Settlement MOU. <https://www.maine.gov/ag/docs/Maine%20Subdivision%202023%20Memorandum%20of%20Understanding%20Regarding%20Opioid%20Settlement%20Funds.pdf>
Cumberland County’s Process for Determining Spending:
In 2023, Cumberland County Public Health staff, including the Director, the Behavioral Public Health Manager, the Chronic Disease Prevention Manager, and the Substance Use Prevention Team Lead, completed an assessment process to determine the needs for addressing opioid use disorder and substance use disorder over the next 3-5 years. The assessment process included information from an extensive County Health Improvement Planning process that took place in 2022, as well as a 2023 survey of organizations to understand current efforts to prevent and address OUD in Cumberland County. This assessment was then used to set priorities for investment and create a 2023-2027 Action Plan. The Plan was approved by County Commissioners in September of 2023. A more detailed write up of the process, the assessment and the Action Plan, can be found HERE <https://www.cumberlandcountyme.gov/departments/public_health_department/behavior_health_program/opioid_settlement_funds.php> on the county’s website.
Priority Areas for Investment:
As settlement dollars are allocated across Cumberland County, an opportunity exists to fill a critical need and coordinate efforts in ways that maximize impact and return on investment while simultaneously building critical community capacity to make a long-term impact on the problem. Priority areas for investment over the next 3-5 years include:
|
Coordination |
Interventions |
Prevention |
|
• Support capacity building & coordination of acute overdose response and follow up efforts • Support coordination of municipal opioid settlement spending • Support data collection, analysis, and sharing |
• Support services for Housing First • Increase # of detox beds • Invest in innovations in treatment • Increase youth treatment options • Coordination of SUD services |
• Facilitate community-led process for Building Community Resilience • Invest in whole family, two generation programming • Increase early interventions for youth & families impacted by OUD and SUD |
Total opioid settlement spending from 2023-June, 2026 (approximates):
Total Spent to date: Approximately $380,000
Coordination:
$190,000 has been spent since 2023 on about .5 FTE for the Behavioral Public Health Manager, Brandon Irwin. Some examples of the coordination work Brandon completed with the time he bills to Opioid Settlement funds includes:
• SIM Mapping: Brandon organized a Sequential Intercept Mapping Workshop facilitated by SAMHSA in Spring of 2024. The goal of the workshop was to identify the top 5 priorities and create action plans for improving systems and services for people who use drugs or have a substance use disorder and are involved in the criminal legal system. The workshop included over 70 partners from criminal legal and behavioral health systems as well as people with substance use disorders and experience in the criminal legal system.
• Behavioral Health and Justice Coalition: The SIM workshop led to the creation of the Behavioral Health and Justice Coalition along with 3 workgroups that are currently working on assessing the Cumberland County landscape of first responder deflection (Police or EMS embedded behavioral health liaisons); improving coordinated reentry from jail; improving the process of released from jail to treatment.
• Grant Writing and Management:: Brandon managed the RFP process and the subaward to Greater Portland Health for our opioid response innovation and capacity building grant in 2024. He also wrote a successful MeHAF grant for a behavioral public health coordinator and currently supervises Kathryn Gallagher on her work supporting the Behavioral Health and Justice Coalition work.
$5,000 was used to host the SIM mapping event in March of 2024. SAMHSA provided the facilitation and reports for the project, but we provided funds for renting a space, food, supplies, and stipends for people with lived experience who could not come to the event through their work.
Interventions:
$21,000 was used in 2023 for recovery housing for people involved in the Pathways of Hope project when there was a gap between funding cycles. Ongoing funding of recovery housing and treatment for people in the Pathways of Hope project at Portland Recovery Community Center is provided to Cumberland County Public Health through a Maine Public Safety grant.
$80,000 was awarded to Greater Portland Health for innovations in treatment through a competitive RFP process facilitated by CCPH. Greater Portland Health used the grant funds to support the staff on the new mobile medical van as they do harm reduction and opioid use disorder treatment outreach to people at highest risk of overdose deaths in Cumberland County. GPH has since received additional funds from other sources to continue offering services through the mobile van. More information about the project can be found HERE. <https://www.cumberlandcountyme.gov/departments/public_health_department/behavior_health_program/opioid_settlement_funds.php>
$77,000 was used in 2023-2024 to pay for Medication for Opioid Use Disorder for people with OUD who are incarcerated at the Cumberland County Jail.
Prevention:
$5,500 was used to pay Claire Schroeder, a prevention consultant, to interview people who work with families and in communities most impacted by opioids to understand their needs. She also worked with the prevention team at CCPH to create a prevention intervention focused on that group of people. The intervention created through this process was the basis for a recent federal SAMHSA grant application written by CCPH that could award $425,000 a year for 5 years for substance use prevention in Cumberland County.
Plans for Future Spending:
CCPH plans to continue funding coordination efforts by paying for at least half of the salary of the Behavioral Public Health Manager, Brandon Irwin. We also have a plan to fund to a prevention pilot focused on middle school age young people who are in communities and families most impacted by opioids.
We will continue assessing funding needs for innovative interventions. We may also use funds for medication for addiction treatment for people with a substance use disorder in the Cumberland County jail and for recovery housing for people at highest risk for overdose death or involvement in the criminal legal system as needed.
Requestor
Liz Blackwell-Moore, Director of Public Health
Presentation
Yes
Funding Amount and Source
See attached memo regarding allocation action plan.