Counties fight for more freedom to spend opioid money, $247 million more on the way – Butler Eagle

Officials from the Pennsylvania Opioid Misuse and Addiction Abatement Trust met Nov. 21 in Harrisburg. The Pennsylvania Opioid Misuse and Addiction Abatement Trust has the authority to withhold opioid settlement funds if it decides local governments spent the money inappropriately.Ed Mahon / Spotlight PA

HARRISBURG — As local governments prepare to receive about $247 million more to combat the opioid epidemic, some Pennsylvania counties are pushing back against decisions by a state oversight panel to reject their spending plans.

The board of the Pennsylvania Opioid Misuse and Addiction Abatement Trust has great power to oversee the spending of potentially billions in opioid settlement money paid by companies to resolve claims over their role in the opioid crisis.

The board was criticized for rejecting a youth program in Somerset County and initiatives to support residents of Philadelphia’s Kensington neighborhood. Members’ use of private meetings to discuss what expenses are allowable has also drawn criticism.

Philadelphia, for example, alleged in a complaint that board members secretly expressed a preference for “just say no” strategies when considering whether to reject the city’s plans.

The board on Nov. 21 approved the distribution of the next round of opioid settlement funds, which now includes money from several new companies. The state’s distribution plan calls for payments to be made around mid-December.

Counties and other local governments received their first opioid settlement payments in 2022 and are expected to spend the money in a manner consistent with a settlement document called Exhibit E, which outlines approved and recommended strategies. The list includes medications to reverse opioid overdoses, treatments for people in prisons or jails, programs that provide clean syringes to drug users, prevention programs and opioid-related treatments.

If districts spend the money inappropriately, the trust has the power to cut future funding.

However, there have been disagreements about what kind of spending is appropriate and how much discretion local governments have. A community leader in Kensington called the board’s rejection of programs in June “a retraumatizing moment.”

Somerset County in southwestern Pennsylvania and Philadelphia recently appealed Commonwealth Court decisions rejecting the trust’s spending decisions. Trust officials declined to comment on the appeals beyond what is stated in court filings.

A successful appeal would have “big impact” and could “bring some uniformity and perhaps relief to other counties,” Jaclyn Shaw, an attorney for Somerset County, told Spotlight PA.

Somerset County is challenging the trust’s decision to deny $30,000 for a youth program that provides weekly opportunities for outdoor activities and mentoring, according to the appeal. In their appeal filed in October, Somerset County attorneys said the program was “evidence-based” and compliant with Schedule E. They also want the trust to be forced to create standard operating procedures that allow beneficiaries to obtain pre-approval of their expected expenses .

In response, the Opioid Trust’s attorneys claimed the program was noncompliant, argued the Opioid Authority did not have the authority to institute a “pre-approval process,” and asked the court to dismiss the appeal.

Philadelphia’s appeal requires more money. She questions the trust’s decisions to reject millions of dollars for programs to support residents of the Kensington area, which the city calls the “epicenter of the opioid crisis.” A controversial initiative offers home repairs with the stated goal of preventing homelessness and promoting housing stability. Another supports “small businesses to prevent empty buildings and land littered with trash,” the city’s appeal says.

In Philadelphia’s appeal, filed Nov. 4, the city’s lawyers argued that the trust’s interpretation of Exhibit E was too narrow and said the city’s money was being used for evidence-based efforts that should be allowed.

The attorneys also called for more clarity from the Commonwealth Court, saying that the state’s opioid trust “should only reject expenditures if they are clearly not related to an opioid use disorder, a co-occurring substance use disorder, or mental health issues, overdoses, or the relief thereof.” Impact of the opioid epidemic.

There has already been back and forth over the Kensington programs. The full board rejected $7.5 million in resident assistance programs in June, but a trust committee later overturned some of the rejections. Philly’s appeal details $3.4 million in funds that it claims were wrongfully rejected, although figures previously released by the trust indicate a lower amount.

Counties were required to submit their first comprehensive spending reports to the Opioid Trust in March. A court order governing opioid settlement funds in Pennsylvania was recently amended to clarify that other local government agencies that receive funds as a result of their roles in opioid litigation must also file those expenditure reports.

This change resolves an apparent ambiguity first reported by Spotlight PA and WESA in May 2023 that enabled spending decisions by a number of district attorneys, Cities and other local governments must act unchecked.

Trust members voted on a new set of spending reports on November 21. They again rejected Philadelphia programs, including one that described home maintenance for people in North and West Philadelphia with addiction and recovery histories.

Despite these denials, trust chairman Tom VanKirk emphasized the large number of programs across the state that the trust has approved.

“This is not because the trust is becoming more lenient or making larger exceptions to Schedule E,” he said. “I think everyone learned from this process.”

Secret meetings criticized Since the opioid trust’s creation in 2022, board members have often met in secret, blocked the public from speaking at their meetings and released only limited information about the trust’s expenses.

The trust’s use of closed-door meetings – which Spotlight PA and WESA first publicly questioned last year and again in March – has been a point of contention during these spending disputes.

In an earlier complaint to a trust committee, Philadelphia criticized statements made by trust members at closed meetings.

“In the working group meeting, which was closed to the public and consisted of five board members, board members actually expressed a subjective preference for programs that target individuals or involve ‘just say no’-type strategies,” according to Philadelphia In The complaint said: “The working group also improperly considered other factors such as Philadelphia’s other pending litigation and possible future opioid settlements.”

Separately, Somerset County attorneys raised the private meetings in their appeal to Commonwealth Court. The appeal states that the county “does not agree that working group meetings should not be open to the public, otherwise they constitute deliberations by a subdivision of the board that are otherwise subject to public opinion and comment.”

A court order defining the trust’s role says its meetings and procedures are subject to the Sunshine Act, a state law that imposes transparency requirements on a variety of agencies. The statutory definition of an agency includes a board and “any committees thereof authorized by the board to take regulatory action or give advice in matters relating to agency business.”

Trust officials have previously defended the use of private meetings, although those responses did not directly address Sunshine Act requirements for advisory committees. Following reporting from Spotlight PA and WESA, one of the board members questioned the legality of the private meetings.

While the Trust’s actions have limited public participation, Spotlight PA has taken several steps to give the public greater insight into opioid settlement spending decisions. Most recently, the newsroom created an interactive database that allows the public to track spending decisions and determine whether they were approved by the foundation. The database covers approximately $70 million worth of spending decisions, spanning approximately 450 programs or responses. The figures include both funds reported as spent and planned expenditure.

Since launching the database, Spotlight PA has heard from people in different parts of the state who have reported issues about which they have concerns or questions, including why one county reported not spending money and why another appeared to be spending money on a program issued that is located in another district. Cathleen Palm, a Berks County resident who advocates for child protection policies, publicly praised the transparency the database brought to these issues.

“You can check the priorities in each county,” Palm posted online. “Better yet, type in “infant” or “child” or even “soccer” and you’ll see what comes up. This will provide even more clarity on what communities have identified as the most pressing needs they want to spend these dollars on when it comes to children and families.”

Ed Mahon reported this story when he attended USC Annenberg Center for Health JournalismData Scholarship 2024.

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