A new plan has been proposed for $1 million in Luzerne County opioid settlement funds that must be programmed by the end of August so they don’t have to be returned, according to Tuesday’s council work session agenda.
Scrambling was necessary because county Manager Romilda Crocamo asked county council earlier this month to halt a prior recommendation to spend $985,500 of the settlement funds on a yearlong multimedia advertising campaign with Nexstar Media Group, which includes WBRE and WYOU TV.
Crocamo sought cancellation of that proposal after learning there was no existing human services division contract with Nexstar that would justify an award without publicly seeking proposals from other interested entities.
According to Tuesday’s council work session agenda, three new allocations are recommended by the Commission on Opioid Misuse and Addiction Abatement, which council formed to recommend uses for $25 million the county is expected to receive over 18 years from the state’s settlement against opioid manufacturers and wholesale distributors:
• Warm hand-off and/or certified recovery specialist services, $208,468.
• Expanded medication-assisted treatment at the county correctional facility, $625,404.
• Opioid prevention education programs in schools, $208,468.
Warm hand-off/recovery specialist
Traditional referrals provide information about how to reach services but may leave it up to those needing help to make contacts and arrangements on their own.
Warm hand-off programs set up services in the presence of the person with substance use disorder, increasing the likelihood treatment will proceed.
Certified recovery specialists are credentialed to use their own personal experience recovering from substance use disorder to serve as a “role model, mentor, advocate and motivator for others experiencing a battle with opioid addiction,” the agenda said.
County Drug and Alcohol Administrator Ryan Hogan has said recovery specialists may be more successful connecting because they provide nonjudgmental encouragement, proof that sobriety is attainable and assistance navigating a multitude of outpatient and in-patient treatment options.
County Mental Health/Developmental Services Administrator Tara Fox said she is particularly excited about this proposed opioid earmark because the warm hand-off program and recovery specialists would service two new crisis centers the county is opening.
Walk-in crisis centers provide continuous observation and supervision when in-patient hospital treatment is not required for those in distress.
The nonprofit Family Service Association of Northeastern Pennsylvania will operate the Wilkes-Barre crisis center at 31 W. Market St., which is being covered by Managed Care Reinvestment Funds. County American Rescue Plan Act funding was earmarked for the Hazleton crisis center that will be operated by the nonprofit Northeast Counseling Services at 750 E. Broad St.
Fox said both centers are expected to open by the start of 2025.
Adding substance use disorder services to mental health assistance at these centers is in line with the state and federal governments’ vision of intertwined care, Fox said.
“In our system, we call it ‘no wrong door,’ so no matter where you go you get the services you need,” Fox said, adding she “can’t wait” for the crisis centers to be operational to help those struggling and reduce the burden on hospital emergency rooms.
Integrating both screening and treatment for mental and substance use disorders improves the quality of care and health outcomes for those living with co-occurring disorders by treating the “whole person,” the county administration said.
The warm hand-off and recovery specialists also could provide increased assistance to residents with substance use disorder who are leaving incarceration to help them adjust, officials said.
The county has experience with a warm hand-off program it has been providing for years that attempts to reach overdose victims before they are released from hospitals.
Medication-assisted treatment
The county’s prison system had started a Suboxone program in 2023 for inmates experiencing opioid withdrawal.
This was a significant development because some inmate suicides were largely blamed on the painful effects of opioid detoxification behind bars without the aid of a prescribed medication such as Suboxone (buprenorphine), which is used to reduce symptoms.
Council had agreed to use a portion of the opioid settlement funds to pay for this treatment in 2023 and 2024.
County prisons are now required by the state to provide such programs. Inmates increasingly enter the prison with substance use disorder and mental health issues, officials have said.
Now the commission is recommending the county expand this prison program to add the use of Sublocade for medication-assisted treatment.
While buprenorphine is administered orally daily, Sublocade is delivered through a monthly injection, according to county information.
Although the number fluctuates, 60 inmates were participating in the medication-assisted treatment program on July 9. Participation has been as high as 100.
The average monthly cost for 30 patients to be on Sublocade would be $54,000.
Adding Sublocade as an option would be particularly important for inmates unable to access a clinic for daily dosing of buprenorphine upon release, the county said. Sublocade also can’t be stashed inside the mouth before it is fully dissolved to share with others — a process known as diversion that the prison system is always vigilant about preventing, the county said.
The average monthly cost for 30 patients to be on Sublocade would be $54,000.
Prevention
These opioid prevention education programs would be administered through the county’s drug and alcohol agency.
Crocamo, who chairs the commission, said the panel is pleased to announce the recommendation for these “crucial projects.”
All three comply with eligible uses established through a litigation settlement order. The court established the Pennsylvania Opioid Misuse and Addiction Abatement Trust to approve county projects and oversee compliance.
“These initiatives aim to address the devastating impact of opioid addiction and provide much-needed support to our community,” Crocamo said.
With time of the essence, the commission also concentrated on expanding successful projects that are already operational or in the works, she said.
“By obligating these monies which augment funding to programs which Luzerne County currently supports, we are confident that the county will meet the Trust-imposed requirements and deadlines,” Crocamo said.
Another $1 million in prior county opioid settlement receipts must be earmarked by the end of this year, she has said.
The commission was activated in May with council’s appointment of citizen Mary Butera, who serves along with Crocamo, Hogan, council Chairman John Lombardo, county District Attorney Sam Sanguedolce, county Human Services Division Head Lynn Hill and county Correctional Services Division Head James Wilbur.
County council has final say in the opioid settlement earmarks.
County Councilman Jimmy Sabatino said he is pleased with the latest proposal and plans to support it.
”I’m happy to see that the committee recommended this settlement funding being used in the most effective way — to meet those with substance use disorder where they are to help combat this disease,” Sabatino said. “Warm hand-off programs are an incredibly effective use of this funding and will undoubtedly help to aid recovery and provide tangible results for our community.”
Council’s Tuesday work session follows a 6 p.m. voting meeting at the county courthouse on River Street in Wilkes-Barre, with instructions for the remote attendance option posted under council’s online meetings link at luzernecounty.org.
Council approval at a subsequent voting meeting would be required for the earmarks to take effect.
Reach Jennifer Learn-Andes at 570-991-6388 or on Twitter @TLJenLearnAndes.
