How Lehigh Valley counties are spending millions for the opioid crisis

Lehigh and Northampton counties must decide over the next two decades how to spend approximately $46 million in opioid settlement funding — and help those with opioid-use disorders in the Lehigh Valley.

It might seem like a lot, but it is a fraction of the $54 billion state and local governments nationwide are receiving in settlements from companies that made, sold, or distributed prescription painkillers and were accused of fueling the opioid crisis.

“Our communities have been hit hard by overdoses, a situation worsened by the pandemic,” said Richard Molchany, Lehigh County’s general services director and spokesperson for the county’s share and use of the settlement funds. “Our goal … is to educate, inspire and support our community.”

Recovery advocates said the counties largely have spent the funds wisely, although some said they wished the state would relax funding rules to allow the money to be used more broadly.

“We should never forget that these settlement dollars come from major companies profiting off fostering addiction in our families and communities,” said Bill Stauffer, executive director of the Pennsylvania Recovery Organization Alliance, a statewide recovery organization. “We should ensure that there is broad inclusion over the long haul to help heal those who have been impacted.”

As of this summer, Lehigh and Northampton counties have spent about $2 million each, mostly on overdose-reversal drugs and an educational campaign about the dangers of illicit drugs that also expands training for emergency responders and increases distribution of reversal drugs to uninsured or underinsured residents.

Future plans include a new addiction treatment center in the more rural, northern end of Lehigh County, and a mobile outreach vehicle to serve Northampton County residents with limited resources.

Northampton County spokesperson Brittney Waylen said the settlement money “allows us to pursue endeavors that were previously beyond our reach due to financial constraints.”

To receive the money, counties had to agree to use it in ways that are consistent with a settlement document called “ Exhibit E .” The document contains a range of recommended and approved strategies for treatment, prevention and responding to the epidemic.

The Pennsylvania Opioids Misuse and Addiction Abatement Trust, a 13-member oversight board with the power to withhold and cut funding if it determines counties spent the money inappropriately, is responsible for distributing the funds to counties.

According to Exhibit E , acceptable uses include:

• Making medication-assisted treatment more accessible;
• Supporting babies who were born with withdrawal symptoms;
• Funding jails to provide opioid treatment to people incarcerated;
• Supporting professionals who help people with opioid use disorders;
• Helping children in foster care because of a guardian’s opioid use; and
• Providing education and employment opportunities to those with opioid use disorders.

Counties can’t spend any opioid settlement funding on administrative expenses, though the earned interest from the funds can be spent on those expenses.

They can spend the money to help with “co-occurring” issues such as mental health challenges, but should try as much as possible to dedicate the funding to addressing opioid addiction rather than other kinds of addictions.

“For instance, if half of the population of a halfway house or drug court typically suffers from opioid use disorder, then half of its funding could come from opioids settlement funds,” according to the trust document.

Exhibit E doesn’t explicitly permit law enforcement as a funding use, the Trust said, but recipients can still seek approval for such a use from the trust and Commonwealth Court.

How Lehigh County has spent its opioid funds

Lehigh County is to receive about $20 million in total opioid settlement payments, Molchany said, including $2.6 million allocated for the district attorney’s office. Up until the end of 2023, the county spent roughly $1.74 million while the district attorney’s office spent about $175,400.

Molchany said an advisory board which includes Allentown police Chief Charles Roca and Lehigh County Drug and Alcohol Services administrators Joe Martellucci and Joshua Bridges, makes recommendations on how the county’s funds should be spent. Any funding decisions are approved by Lehigh County commissioners.

Some of the county’s intended programs, according to Molchany, include creating a new Northern Lehigh Treatment Center that will provide case management and counseling in Slatington; creating a mobile therapy program; expanding the number of beds at the Lehigh County Center for Recovery in Bethlehem; and extending the operating time for the Hospital Opioid Support Team warm handoff program to cover midnight to 8 a.m.

A warm handoff program is a clinical pathway to get those saved from overdoses directly to inpatient or outpatient care.

Molchany said the county is working to provide Lehigh County Coroner Dan Buglio’s office with roughly $30,000 to fund autopsies that can identify when opioids cause death, which can in turn inform the county’s programming as well as law enforcement.

“If we can reduce opioid death, we’re making progress,” Molchany said.

Since 2021, more than 470 people have died of opioid-related deaths, according to data from Buglio’s office.

“We want to reduce the [number] of fatalities related to this,” Buglio said.

Lehigh County District Attorney Gavin Holihan said his office is early into the settlement spending process due to his taking office in January, but added that many of the permitted settlement uses from Exhibit E don’t align with a prosecutor’s traditional functions.

However, rather than use the funds for prosecution, Holihan said he’d want to find community partners and divert the funds to programs such as medication-assisted treatment at the jail or reentry services for people in or coming out of incarceration.

“While there’s people asking or suggesting that the money be spent on a hundred different avenues, the goal here is still law enforcement,” Holihan said. “Therefore, I’m looking for avenues where we can use that money to decrease crime. If it’s not to prosecute crime, then maybe to prevent crime.”

Asked why the district attorney’s office would receive any settlement funds if the permitted uses don’t align with a prosecutor’s functions, Molchany said several district attorney’s offices, including Lehigh County’s, helped create the original litigation and settlement plan.

He added that for this year, Holihan has provided $347,000 for medication-assisted treatment at the Lehigh County Jail.

Chief Public Defender Kimberly Makoul said the opioid crisis has affected many of our office’s clients, particularly with how substance use disorders drive people into the criminal justice system.

While the office is not eligible for funding, Makoul said she approves of how the county’s share is spent, on programs such as medication-assisted treatment in the jail, and that she will “continue to work with Rick Molchany … and together we will evaluate future opportunities.”

Cedar Crest College will complete annual reports to track the efficacy of Lehigh County’s opioid spending, Molchany said, with their first report hopefully to become available by the end of the summer.

How Northampton County has spent its opioid funds

Northampton County’s opioid-settlement payments amount to $26 million in two distributions to be paid during the next 18 years, according to Waylen, the spokesperson. As of July 1, the county had received $2.5 million and spent $1.9 million, she said.

Waylen said of the total amount, $22.8 million goes to the county and nearly $3.2 million goes to the district attorney’s office.

She said much of the funding thus far has gone toward the county’s “Fake is Real” campaign about the dangers of fentanyl, along with educating people about preventing addiction and getting treatment. Since the launch of the campaign in 2023, the county has also distributed more than 3,500 Narcan kits, while more than two dozen free Narcan training sessions have been conducted, she said. Nearly 400 people have received skills to address substance abuse issues.

In addition, Waylen said two rounds of the Deterra drug-disposal pouches were sent to residents, in November and May, with a third and final round scheduled to go out later this year.

Next year, Waylen said, the county will have available a mobile outreach vehicle to provide services in areas where people have limited resource and access to transportation.

“We wanted to start with a fentanyl awareness campaign to alert the county residents to the dangers lurking in their homes and community and offer a solution.” Waylen said. “Fake is Real has evolved into a vast initiative offering education and resources on the Fake is Real website .”

Waylen said a “logical progression” was to move from educating people about the dangers of fentanyl to providing Narcan, the opioid reversal drug, as a remedy to combat overdose, and to make Deterra a countywide initiative. “We thought it would be perfect for our residents to learn how to dispose of unneeded medications properly,” she said.

District Attorney Stephen G. Baratta, who took office before the settlement, said earlier this year he hopes some of the money could be used toward visits at county high schools to discuss the legal ramifications of drug use with students. Former District Attorney Terry Houck previously gave approximately $2 million from the settlement to the county Human Services Department toward Fake Is Real and other measures to fight addiction.

Northampton County’s public defender and coroner offices have not received money from the opioid settlements.

The county’s Fiscal Affairs Department tracks payments as they are received and how much is spent on programs throughout the year, Waylen said.

At least two members of county council, Lori Vargo Heffner, its council president, and longtime council member Ronald Heckman, who has served as Human Services Department director, said they would like the mobile unit running as soon as possible.

“Whatever interventions can be done in the neighborhoods, that’s why this mobile unit will be good,” said Vargo Heffner, whose career has been spent in addiction treatment and prevention.

The council members said for years, the war on addiction has been a difficult battle waged with limited resources.

“I think people [with substance abuse disorder] have been at the bottom of the funding stream for so many years,” Vargo Heffner said.

Heckman hopes the county’s spending under the opioid settlement will lead to positive results.

“Some groups,” he said, “they will take the money, and when you want to know outcomes say, ‘We talk to people.’ That’s great; I talk to people all the time … but what are the outcomes? The groups have to show us what they’ve accomplished.”

Waylen said as the county implements programs, it examines the services to identify areas with “unmet needs.”

Advocates: Education, intervention ‘super important’

Democratic Gov. Josh Shapiro, who negotiated settlements with opioid companies as Pennsylvania’s attorney general, said in 2021 that the funds would “be earmarked to offer and expand life-saving treatment options.”

Residents, advocates and others who deal more directly with opioid and substance abuse addiction say in general, the Lehigh Valley’s counties are doing a good job managing and distributing the settlement money toward what Shapiro suggested.

But some offered differing opinions and criticisms on what county officials are doing.

Stauffer, of Allentown, has been head of Pennsylvania Recovery Organization Alliance since 2012. He also has been in recovery for substance abuse nearly four decades.

The Morning Call asked Stauffer and other professionals to review what the two counties are doing thus far with the opioid settlement dollars. He said the projects are “pretty good,” but went further:

“As it is an 18-year program, are there ways for the counties to engage the impacted communities of recovery more fully to ensure that we get the most from these dollars?” he asked.

Speaking broadly, Stauffer, who has served in several roles in the state and country to support recovery efforts, also said funding at local levels has tended to be highly competitive and political.

“We are seeing money go to entities and services not oriented on getting people into recovery in ways similar to how the tobacco settlement monies were squandered a generation ago,” he said.

Both counties appear to be focusing as much toward victims of the epidemic. Asked specifically if Northampton County has earmarked any dollars for law enforcement measures, Waylen said no, adding its Drug and Alcohol office “is open to exploring other uses for funds” if they fall within Exhibit E.

“As there are often opportunities for law enforcement to obtain grants through the Pennsylvania Commission on Crime and Delinquency, we do not use funds for law enforcement,” she said.

Yamelisa Jimenez Taveras, CEO of Counseling Solutions LV, a bilingual center in Allentown covering health disorders, agreed that county officials need to press the trust to relax the list of opioid-remediation uses at the local level.

“I see the desire to provide the best service possible and truly contract with facilities,” she said. “I think the push has to be on the state to soften parameters and allow counties, who are in touch with the people, to be able to give feedback on what is needed, as opposed to, ‘We know what is best from Harrisburg to know what happens at a smaller scale.'”

For example, Jimenez Taveras said, her counseling center sees clients from other communities who lack resources not getting the same assistance as individuals in Allentown.

Brian Sabo, who once faced a long substance-abuse recovery to become a local leader in the field, said people in Northampton County are getting the help they need.

“[County Drug and Alcohol Director] Kathy Jiorle was open,” said Sabo, a regional director of clinical partnerships at Steps to Recovery Behavioral Health in Hanover Township, Northampton County. “What she did, she asked stakeholders — me, for example — she asked, ‘What does the community need?’ and we gave her a list including the mobile outreach vehicle.”

Sabo, a former Allentown police officer who resigned while battling alcoholism, also said both counties have increased programming that’s available for victims, adding recovery centers in the Slate Belt, Northampton Borough and elsewhere. Help, he said, is “literally one phone call” versus less than 10 years ago, when as many resources weren’t available.

“They make it real convenient,” he said.

But Ben Iobst, an instructor and assistant program manager with Northampton Community College’s National Forensic Training Center who has worked in the area of substance abuse, said more can be done to make the public aware of available help.

“There are a lot of awesome programs, but nobody knows about them,” said Iobst, a retired Allentown police sergeant who, like Sabo, has seen ravages of addiction from the street.

“What do you do when you drive down [Allentown’s] Seventh Street, and somebody is zombified? What are the resources [to deal with an overdose]?”

Donna Jacobsen of Upper Macungie Township, who sat on the Lehigh County Drug and Alcohol Advisory Board, has seen substance abuse firsthand. Her daughter, Lindsay, has recovered from an opioid addiction.

She has worked for years at helping victims and families deal with addiction, including most recently as president of REACH LV Youth Recovery Centers in Emmaus and Palmer Township. The nonprofit provides community programs that serve youth and their families in the phases of recovery.

As far as what both counties are doing with the settlement money, Jacobsen said she has not seen anything indicating the funds are being spent unwisely.

“I feel as though I have seen a positive impact on the money that has come down and is being used,” said Jacobsen. REACH LV receives about $4,000 per month from Lehigh County; the Palmer location has not received money from Northampton County, she said.

Some social service officials wished more help was made available to them. Brenda “Luna” Fernandez, executive director of a nonprofit that helps heal and empower Lehigh Valley women who return to society after time spent in prison, wishes the counties had reached out to her for possible assistance.

“We have clients in addiction,” Fernandez said, whose agency is known as SELF, for Strongly Embracing Life’s Future.  “I was not aware of this; they had not offered any of the money to us.”

Small grassroots groups battle the inherent stigma of being associated with people in recovery and their allies, Stauffer said. In addition, money in the overall opioid settlement — not evident locally — has often gone to law enforcement and other larger entities that can gain political favor and are not associated with addiction recovery.

“They play vital and important roles,” he said, “but enjoy access to funding we cannot dare even dream of. We are concerned that this will be insufficient to do what needs to be done in our communities. To overcome the challenges we face, we need to build the recovery-oriented infrastructure to get more people into and sustain recovery over the long term.”

More direct intervention and less programming would improve results, said Jimenez Taveras.

“I think there are specific needs for individuals with opioid abuse that hopefully will be addressed,” she said. “I would not stop the education, because I think doing the prevention work will help reduce more damage. So both are super important.”

Morning Call reporter Graysen Golter can be reached at ggolter@mcall.com. Morning Call reporter Anthony Salamone can be reached at asalamone@mcall.com .