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County grapples with rules for spending proceeds of national opioid settlement

From employee bonuses to high-speed Internet service, local governments have found no shortage of ways to spend the millions of dollars which the federal government has doled out to blunt the impact of the coronavirus pandemic.

But this relatively wide latitude doesn’t seem to have carried over to another big pot of cash that many communities expect to draw down to deal with an entirely different sort of epidemic.

Earlier this week, Alamance County’s commissioners got a hint of just how restricted they’ll be in their expenditure of this so-called opioid settlement, which four major pharmaceutical firms have agreed to pay out to end a class action lawsuit over the public health impact of their vigorous promotion of painkillers.

Since this settlement was announced last summer, attorneys for the numerous state and local governments have scrambled to divide up the $26 billion that these four companies have pledged to mitigate the drug addiction and overdose deaths attributed to their business practices. In the case of Alamance County, the size of the payout has been set at $8,874,733 over the next 18 years. The disbursement of these funds will, moreover, be “frontloaded” – with the first payments of $340,694 and $749,845 slated come as soon as the spring and summer of this year.

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Limits on use of opioid settlement funds
But while the release of these funds may not be long in coming, it may take the county’s elected leaders some time to decide what to do with this money – given the variety of regulatory strings attached to the settlement.

Ashley Motley, a staff member with the county’s health department, revealed just how painstaking these allocations may be when she appeared before the commissioners on Monday to present a report on the opioid settlement. Motley told the county’s governing board that the expenditure of these funds will ultimately be constrained by both state and federal mandates.

“The funds from this national opioid settlement are required to be used only for opioid remediation activities to battle the opioid crisis,” she went on to inform the commissioners that morning. “Currently there is no specific timeframe for these funds to be spent, so we do have time to think things through…We are [also] going to be held accountable for these funds in numerous different ways.”

Motley proceeded to spell out the ways that the state plans to hold local governments to account for their share of the settlement. She noted, for instance, that the state will require cities and counties to report their expenditures back to the state, which has set up an online “dashboard” to broadcast this information. Each local government must also share its data with a state-level coordination group and will ultimately have to describe the impact of its settlement-subsidized measures to the state government.

Local feedback required; plus consultation with municipalities
In addition to the prospect of state oversight, the county will also need to solicit feedback at the local level before it decides what to do with its share of the settlement. In particular, Motley told the commissioners that the county will have to hold a public meeting with its municipalities about these proposed expenditures.

Motley went on to describe two proposed options for expending the funds which have been developed at the state level. Under the first option, the county will be able to choose from a short-list of “high-impact, evidence-based” measures for curbing opioid addiction. These proposed measures include things like treatment and housing for recovering drug addicts, employment-related services, jail diversion initiatives, and “syringe service program.”

Meanwhile, the second option would allow the county to draw on a broader range of measures, which Motley said are detailed in a 10-page document.

Motley told the commissioners that they don’t have to decide right away which of these options is better suited for Alamance County. She urged them, instead, to first set a date for the mandated public meeting and develop a “strategic planning process” to allow various “stakeholders” to make nonbinding recommendations to the county’s top brass. Motley encouraged the commissioners to conduct the planning process within the next six months to guide them in their selection between the two opioid abatement options.

Motley’s report left a whole host of unanswered questions for the county’s governing board.

One possibility, which occurred to commissioner Pam Thompson, was whether the county could use a portion of the settlement to fund a specialized drug recovery court – a gambit that she said has already enjoyed some success in Orange County.

“We’ve got strong support for that,” Thompson told the rest of the board, “and our former county manager Bryan Hagood thought that this [settlement] could be part of supporting a recovery court…I hope we keep this on the table because our judges are really fired up about something like this.”

Debra Bechtel, the board’s interim county attorney, conceded that recovery court isn’t one of the measures that were initially considered under either of the two opioid abatement options. She added, however, that the idea isn’t explicitly ruled out in either case.

A retired legal counsel for Catawba County who currently works at the Winston-Salem-based Teague Campbell law firm, Bechtel was also one of five county attorneys who helped draft the particulars of the opioid settlement in North Carolina. Despite her rather prodigious insight into the matter, Bechtel acknowledged that there’s much about the disbursement of these funds that the commissioners will ultimately have to figure out for themselves.

“That’s why the strategic planning process which was mentioned is so critical,” she added.

“You want to get people at the table talking at the table about all the different ideas, because you’ve got a lot of people in this community who know a lot about this issue.”
In the end, the commissioners agreed to establish a new county fund in which to deposit their share of the settlement as it trickles in.

In the meantime, they deferred any further consideration of spending strategies until a future meeting. John Paisley, Jr., the chairman of Alamance County’s commissioners, wouldn’t even authorize the health department to schedule the aforementioned meeting with the county’s municipalities without some additional guidance from the interim county attorney.

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