A three-week squabble over how the state should spend its first $31 million payment from litigation against the opiate industry ended Thursday as the Legislature’s budget committee approved a revised plan for using the money to combat the state’s opioid addiction crisis.
Republicans on the Joint Finance Committee rewrote a plan originally drafted by the state Department of Health Services (DHS), adding requirements to send some of the money to county sheriff departments and other local law enforcement agencies. And it added new provisions directing some of the funds to programs at specific organizations — without naming them.
To make up for those changes, the revised plan eliminates one proposed drug abuse prevention program as well as a proposed program to support families or close associates of people who abuse drugs.
The elimination of the families program brought an anguished response from Sen. Jon Erpenbach — and a personal disclosure about his own connection to the opioid epidemic: that his adult daughter lives with addiction.
“Families don’t know where to go. And families need that,” he said. When the original DHS proposal came out with the support program, “I thought it was a great idea.”
Erpenbach, who will leave the Senate at the end of this year, urged lawmakers to revisit the concept in the future, and to take a bipartisan approach.
“I’m done,” he said. “But you guys will be around. Look into this. Because the more rural you are in this state, the tougher it is to get answers.”
The finance committee passed the revised plan unanimously — but only after Republicans sniped at Gov. Tony Evers and DHS while Democrats expressed frustration at what had been taken out of the original spending plan. Democrats tried to pass the original plan without changes; that failed on a 4-12 party-line vote.
The $31 million that Wisconsin is due to receive by the end of this year comes from a settlement reached in February 2022 in the National Prescription Opiate Litigation, a massive lawsuit brought by local governments and other plaintiffs. The defendants include manufacturers, distributors and retailers who sold opioid drugs that have produced a spiraling addiction crisis across the country.
While 70% of Wisconsin’s share of the settlement money goes directly to local and county governments, 30% goes to the state. The money that Wisconsin is supposed to collect this year is only a fraction of the total amount that may yet be distributed from that lawsuit as well as others that are still pending.
Wisconsin Act 57, enacted in 2021 before the settlement was reached, directs the state’s 30% of the settlement money to DHS, which must submit a proposal on how it will spend the funds. Under the law, the Joint Finance Committee can block the spending plan if just one member objects to it within 14 working days of receiving it.
An early draft this spring was rejected because it was drawn up before the state knew how much money it would receive. DHS submitted a revised plan July 28. The finance committee’s Republican co-chairs announced Aug. 17 that it had been blocked and that they would revise the proposal.
They produced that revision on Thursday.
- By eliminating the family support program, the finance committee Republicans saved $2 million they were able to allocate differently.
- The committee plan also eliminates from the DHS plan $1 million for a new prevention services program focusing on “root causes” for addiction, ranging from housing instability to trauma.
Provisions kept or changed
- The DHS plan included $3 million to expand the department’s distribution of Narcan, a drug to counteract opioid drugs, and $2 million to distribute fentanyl testing strips, used to test drugs for the presence of the synthetic opioid. Fentanyl has been turning up in street drugs and contributing to an overdose epidemic.
The Republican revision keeps both items, and adds a requirement for DHS to “prioritize distribution to law enforcement agencies and first responders” for both.
- The finance committee plan maintains a DHS provision allocating $6 million to federally recognized tribes in the state. It adds language requiring the tribes to identify strategies to address addiction that they plan to use.
- It also maintains a DHS provision for $500,000 to approve the state’s central overdose alert system, which tracks death certificates, hospital discharges, emergency room visits and other sources along with the prescription drug monitoring program that the state Department of Safety and Professional Services administers.
DHS is testing changes in the alert system in 15 counties that enable it to detect overdoses in close to real time and would expand that to other counties. The finance committee plan adds language authorizing DHS to use the money to upgrade the prescription drug monitoring program.
- The new plan maintains the DHS proposal to spend $2.5 million to cover room and board costs for Medicaid patients who get residential treatment.
- But it cuts a DHS plan for school substance abuse prevention curriculum by 75%, to $250,000 instead of the $2 million that DHS originally budgeted.
The plan also requires that private schools share in what remains of the curriculum funding.
“How many school districts will receive grants that will actually allow them to succeed with that amount of money in the allocation?” asked Rep. Beth Meyers (D-Bayfield) of Bob Lang, the Legislative Fiscal Bureau director.
Lang said that could not be determined yet. “I just don’t know how many will actually apply,” he said.
Capital program changes
- The DHS plan allocated $11 million for capital projects to help build new facilities or renovate or expand existing ones for programs that provide drug abuse prevention, treatment, recovery or harm reduction.
The revision drawn up by Republicans cuts that by $1 million. It also adds provisions that direct how DHS spends some of the remaining $10 million.
The plan now requires the department to allocate an unspecified amount of funding to “support the expansion of available beds for treatment of pregnant and postpartum women in a family-centered treatment environment.”
While the language doesn’t name a recipient, it appears to have been drafted to direct funds to Meta House, a Milwaukee drug treatment agency that serves women with residential as well as outpatient programs.
At a news conference Thursday where the Republican leaders of the finance committee previewed their changes, Rep. Jessie Rodriguez (R-Oak Creek) praised the GOP plan and also Meta House, which she said she was scheduled to tour on Friday.
“By providing funding for their expansion, we will support Meta house to carry out their shovel-ready plan to double the capacity of their inpatient program and further build on their programs to provide support and promote long-lasting recovery,” Rodriguez said.
Carryn Sami, Meta House director of development, told the Wisconsin Examiner that the organization couldn’t comment on the legislative language. “It’s true that Meta House is embarking on an expansion plan” to serve more women who are pregnant or who have given birth, she said. “We recognize the need is great and are committed to being part of the solution.”
The new plan also directs DHS “to distribute at least 30% of the remaining funds” in the capital projects program “for projects in counties with fewer than 500,000 residents.”
With the total $5.75 million saved in programs eliminated or reduced, the finance committee plan expands one DHS item and then adds three others.
- The finance committee plan doubles the original plan’s spending for medication assisted treatment services, such as administering methadone to help users stay off of heroin, to $2 million from the original $1 million.
- Another committee addition is a $1 million expansion of a DHS pilot program for some Medicaid patients with substance abuse disorders.
- The committee now requires a quarterly report from the department on the settlement funds it has received, allocated and awarded, amounts spent by recipients and a listing of those individuals, and accomplishments as a result of the awarded funds.
- But the single largest change is $3 million set aside for grants to county sheriff’s departments and other law enforcement agencies, with at least $1 million reserved for counties or municipalities with 70,000 or fewer residents.
At the Republicans’ press conference, Grant County Sheriff Nate Dreckman said that as the operators of county jails, he and his counterparts across the state “have a very high percentage of inmates that come into the jails with some type of substance use disorder.” He said the grant program “is going to allow law enforcement to take steps to help those that come into our care.”
Rep. Mark Born (R-Beaver Dam), the Joint Finance Committee co-chair, said the absence of programs involving law enforcement in the original DHS plan showed it was “a half-baked plan.”
“There was a lack of clear working with stakeholders,” Born said. He charged that Evers and Attorney General Josh Kaul “continue to turn their back on law enforcement and do not want to work with these key people in public safety in our communities.”
He reiterated those criticisms later in the committee meeting. There, Rep. Evan Goyke (D-Milwaukee) pushed back.
“It’s factually inaccurate to say that the DHS didn’t engage with certain stakeholders,” Goyke said. He pointing out that DHS officials had reported meeting with 800 people in listening sessions since January.
“They talked to law enforcement throughout,” he added. “Maybe they didn’t talk to your sheriff or your police chief, but to make some assertion that our lead state agency on this issue somehow neglected to speak with or involve law enforcement — It’s just not true.”
- The finance committee plan also sets aside $750,000 for a grant that DHS would provide to a community-based, after-school youth program to add and expand an opioid prevention program. The organization “must use local law enforcement partnerships in its effort to reduce opioid abuse,” the plan states.
As with the language added to the capital project item, the description of the new program doesn’t name an agency. At the Republican press conference, however, a Wisconsin Boys & Girls Club executive connected the provision to her own organization.
“Opioid abuse is not limited to the big cities,” said Karen DeSanto, executive director of the West-Central Wisconsin branch of the Boys & Girls Club. “It’s a rural problem that follows our interstates and affects every community across Wisconsin.”
DeSanto described the organization’s “SMART Moves” program. “At our clubs, substance abuse prevention is part of our core work,” she said. “We work together every week with local law enforcement.”
The program engages children ages 7 through 18 in discussion and role playing exercises where “they practice resilience and refusal skills” she explained.
“With the funding of SMART Moves by the Joint Finance Committee today, we can help to stop this problem across rural communities before it occurs,” DeSanto said.
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