April 12, 2024

The Department of Health’s latest plan for opioid funds emphasizes prevention, support • Wisconsin Examiner

The state health department’s latest plan for spending Wisconsin’s share of settlement funds from national opioid drug lawsuits focuses on prevention, peer support for people struggling with addiction and support programs for their families.

More than a third of the plan — proposed for $36 million to come to the state in the 12 months from July 1 through June 30, 2025 — is dedicated to these three priorities.

Prevention “is critical to public health,” Kirsten Johnson, secretary general of the Wisconsin Department of Health Services (DHS), said during a media briefing Wednesday about the new plan. “We really need to invest in prevention to prevent future deaths.”

The opioid epidemic extends across the country, but DHS data shows it is even more dramatic in Wisconsin. In 2022, 80% of drug overdose deaths in the state involved opioids, compared to 76% in the U.S. as a whole. Synthetic opioids were responsible for 23 overdose deaths in Wisconsin per 100,000 residents in 2022; for the US they are responsible for 22.7 deaths per 100,000.

Wisconsin expects to receive a total of $750 million over several years from settlements reached in national lawsuits brought by state and local governments against pharmaceutical companies that produced opioid drugs. About 70% of the money goes directly to local governments and 30% to the state.

Wisconsin receives a payment each year below settlement programand under legislation passed in 2021, the Legislature’s Joint Finance Committee retains the right to change the state’s plan for the annual payment.

The state will start receiving its next payment, $36 million for fiscal year 2025, after July 1. plan for the funds this week to the Finance Committee. Under the passive review process, if the committee does not take action to block it within fourteen days, the department’s plan will be approved.

Kirsten Johnson, Secretary-designate of the Wisconsin Department of Health Services (DHS). (DHS photo)

“We’re really trying to target and focus on the things that we know are effective, that are evidence-based, that communities have told us are important to them, and that work,” Johnson said. DHS aims to “continue the work begun over the past several years.”

The Legislature’s Budget Committee rewrote the first two DHS plans: $31 million submitted in 2022 for fiscal year 2023 and $8 million filed in 2023 for fiscal year 2024 ending June 30 – before the department is authorized to spend the money.

“We have taken into account what has been done over the years,” Johnson said. “This year we have more funding than specifically in the last cycle, so it’s really an opportunity for us to invest in additional funding. [areas and] to continue to invest in the things we have previously put forward.”

Prevention, education

In the 2025 plan, DHS proposes to spend $5 million on community, education and after-school prevention programs; $5 million to create support and resource centers for the families of people with opioid addiction; and $5 million for peer support services in opioid treatment programs.

The education and after-school prevention programs together received $1 million two years ago. That was after the finance committee revised the 2023 plan, which had proposed three times that amount for community and school-based prevention alone.

Attorney General Josh Kaul | Department of Justice

“Seeing funds go towards prevention is something we hear from people on the front lines. It can make a difference – and they hope to see that kind of support,” said Attorney General Josh Kaul.

The prevention funding in the DHS 2025 plan includes spending $2 million on school-based prevention programs, implemented in partnership with the state Department of Public Instruction (DPI). In 2023, the Finance Committee reduced that year’s request from $2 million to $250,000.

Increasing that funding “will allow DPI to better meet the needs of school districts that have clearly expressed a desire for additional funds in their application,” the DHS plan says. At the same time, DPI could support current school programs and also support tribal schools, independent charter schools and private schools, the proposal said.

The DHS proposal would go ahead and increase funding for an after-school program through the Boys and Girls Club, which lawmakers on the Finance Committee included in the department’s 2023 plan two years ago.

Help for families and support from peers

The $5 million DHS is seeking for family resource and support centers is an extension and increase of a request the department made in its 2023 plan that lawmakers zeroed out to spend the plan money elsewhere.

The proposed funds would be used to launch a new pilot program of centers to provide services to people supporting family members or others who use drugs or have overdosed or died from them.

In 2022 and 2023, DHS officials spoke to Wisconsin residents as the department gathered information on how best to use future settlement funds, according to the plan. “Clearly, unmet needs to build social support systems for families and caregivers” emerged in those discussions, “demonstrating an existing gap in comprehensive family-centered care services,” the plan said.

“I hear a lot from family members who are concerned about a loved one” who has a substance use disorder, Kaul said. Factors beyond treatment are important for people trying to recover, he added, including jobs, housing and transportation.

“Having family and other social support can play a crucial role,” Kaul said. Family support helps family members, “but can also help those family members support their loved one’s recovery.”

The request for $5 million for peer support services was not included in previous DHS plans, but the new plan describes the concept already in use in treatments.

The proposed funding would cover grants to train and hire as many as 75 peer support service providers, create a corps of peer support workers and open the door to reimbursement for costs through Medicaid in the future. Applicants who would serve areas of the state where there are currently no providers and populations disproportionately affected by the opioid epidemic would receive first priority.

The plan allocates $3 million to provide approximately ten one-time grants to support the expansion of recovery housing statewide. It would also continue to provide coverage approved in previous plans for room and board for Medicaid patients enrolled in residential drug treatment programs.

The housing funds “are really intended to increase the number of … recovery places and places where people can sober up and heal,” Johnson said.

In addition, a total of $5.5 million will be allocated for the overdose treatment drug Narcan, for fentanyl test strips and for harm reduction vending machines with supplies that can reduce the risk of overdose or infection for drug users. “These machines increase access to public health and wellness services outside the hours of traditional providers and in locations that previously did not offer harm reduction tools,” the plan says.

The plan also allocates $1 million to continue a program that provides law enforcement agencies with Narcan, which lawmakers added to the DHS 2023 plan.

“Fentanyl has led to the overdose deaths we are seeing,” Kaul said. “And so the kind of harm reduction measures that we’re talking about, like getting Narcan into the hands of first responders, has been critical to preventing this from getting worse.”

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