Health department’s newest plan for opioid funds highlights prevention, support

Nasal Narcan, used to reverse an overdose, stocked in a Milwaukee County harm reduction vending machine. The state Department of Health Services plans to use its next opioid settelment allotment to fund prevention programs, harm reduction efforts and family support programs. (Isiah Holmes | Wisconsin Examiner)

The state health department’s latest plan for spending Wisconsin’s share of settlement money 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 that will come to the state over the 12 months from July 1 through June 30, 2025 — is devoted to those three priorities.

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

The opioid epidemic stretches nationwide, but data from DHS indicate it’s even more dramatic in Wisconsin. In 2022,  80% of drug overdose deaths in the state involved opioids, compared with 76% for the U.S. as a whole. Synthetic opioids accounted for 23 Wisconsin overdose deaths per 100,000 population in 2022; for the U.S., they’re 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 that state and local governments filed against pharmaceutical companies that produced opioid drugs. Roughly 70% of the money will go straight to local governments and 30% to the state.

Wisconsin gets a payment each year under the settlement program , and under legislation enacted in 2021 the Legislature’s Joint Finance Committee retains the right to change the state’s plan for each year’s payment.

The state will start receiving its next payment, $36 million for the 2025 fiscal year, after July 1. DHS submitted its plan for the funds this week to the finance committee. Under its passive review process, if the committee doesn’t act to block it in 14 days, the department’s plan is approved.

Kirsten Johnson, Wisconsin Department of Health Services (DHS) secretary-designee. (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 are working,” Johnson said. DHS aims “to sustain the work that’s been initiated over the course of the last few years.”

The Legislature’s budget-writing committee rewrote the first two DHS plans — $31 million submitted in 2022 for the 2023 fiscal year and $8 million submitted in 2023 for the 2024 fiscal year that ends June 30 — before authorizing the department to spend the money.

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

Prevention, education

In the 2025 plan, DHS is proposing 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 combined 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 | Dept. of Justice

“Seeing funds go toward prevention is something we’re hearing from folks on the front lines can make a difference — and that they’re hoping to see that kind of support,” said Attorney General Josh Kaul.

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

Increasing that funding “will allow DPI to better meet the needs of school districts who clearly expressed a desire for additional funds” when applying, according to the DHS plan. At the same time DPI could sustain current school programs and also aid tribal schools, independent charter schools and private choice schools, the proposal states.

The DHS proposal would continue and increase funding for an after-school program through the Boys and Girls Club that lawmakers on the finance committee inserted in the department’s 2023 plan two years ago.

Help for families and peer support

The $5 million that DHS seeks for family resource and support centers renews and increases a request the department made in its 2023 plan that lawmakers zeroed out in order to direct plan money elsewhere.

The proposed funds would be used to launch a new pilot program of centers to provide services to people who are supporting family members or others who are using drugs or have experienced or died from an overdose.

In 2022 and 2023 DHS officials spoke with Wisconsinites as the department collected information about how best to use future settlement funds, according to the plan. “Resoundingly, unmet needs to build up social support systems for families and caregivers” came up in those discussions, “demonstrating an existing gap in wrap-around services for family-focused care,” the plan states.

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

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

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

The proposed funding would cover grants to train and employ as many as 75 peer support service providers, establishing a corps of peer support workers and opening the door to reimbursing the cost through Medicaid in the future. Applicants who would serve parts of the state currently lacking providers and populations disproportionately affected by the opioid epidemic would get first priority.

The plan allocates $3 million to provide about 10 one-time grants to support expanding recovery housing statewide. It also would continue providing coverage approved in earlier plans for room and board costs 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 become sober and heal,” Johnson said.

In addition, a total of $5.5 million is allocated for the overdose-treatment medicine Narcan, for fentanyl testing 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 supplies outside of traditional service providers’ hours of operation and in locations previously not providing harm reduction tools,” the plan states.

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

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

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