By Victoria Ford
Major decisions about how millions of dollars get spent to tackle Ocean County’s opioid epidemic are made inside wood-paneled rooms in the Ocean County Justice Complex.
In attendance at the first public meeting of the Ocean County Opioid Advisory Council on Thursday, May 25 inside the Ocean County Board of Commissioners room were about a dozen activists representing Sea Change Recovery Community Organization and the New Jersey Resource Project, both based in the southern portion of the county and partners in the Not One More campaign to end the overdose crisis.
Less than an hour after council members were sworn in and three committees were established (executive, bylaws and membership, and proposal review), the council unanimously approved a three-year plan that determines how to spend the county’s $15 million share (paid out over 18 years) of New Jersey’s $641 million from the national opioid litigation settlements.
Ocean County opted in to the 2021 nationwide settlement agreements to resolve all opioid litigation brought by states and subdivisions against the three largest pharmaceutical distributors – McKesson, Cardinal Health and AmerisourceBergen – plus a separate agreement with Janssen Pharmaceuticals and its parent, Johnson & Johnson. The big three will pay out $21 billion over 18 years, and J&J will pay up to an additional $5 billion over a nine-year period, Busch said.
Ocean County will receive direct distributions from the applicable national opioid litigation resolution. Recently, new settlements have been reached with Teva, Allergan, CVS, Walgreens and Walmart. Ocean County has also opted into the additional settlements, but those distributions are not yet known.
Funds must be used for evidence-based services and programs to remediate the opioid epidemic, in accordance with the 2022 memorandum of agreement between state and local governments on opioid litigation recoveries, which establishes binding terms for the distribution and spending of funds, and from which the opioid advisory council was formed.
“The 113 enumerated uses focus on treatment of opioid use disorder, prevention of opioid use disorder and drug-related deaths and other strategies to combat the opioid epidemic,” according to the plan overview.
Jamie Busch, assistant director of the Ocean County Department of Human Services, summed up.
The purpose of the unanimously approved 2023-26 plan is to document current needs and perceptions. The intended goal of the findings is to inform action steps toward best utilizing the national opioid settlement funds, reducing identified barriers or enhancing current programs and services.
The two main overarching approved-use categories are treatment and prevention of substance use disorder. An “other strategies” category includes broad items such as training and research.
Treatment encompasses support for individuals and families in treatment and recovery for opioid use disorder, for pregnant and parenting women and for criminal justice-involved persons. Prevention refers to over-prescribing and improper dispensing, misuse, overdose deaths and other harms.
At the top of the list of core strategies for opioid remediation is naloxone (or other FDA-approved overdose reversal drug). Second is distribution of medication-assisted treatment, e.g. methadone. Next is to expand screening for substance use disorders in pregnant women and evidence-based treatment, recovery supports and wraparound services including MAT for pregnant and parenting women.
Also on the list are treatment and recovery support for babies with neonatal abstinence syndrome, crisis navigators and on-call teams to begin MAT, warm hand-off transition services, recovery services to include co-occurring disorders, recovery support for incarcerated/reintegrating people, syringe services, prevention efforts, data collection and research.
The council’s role is to provide input, advice and recommendations to the Ocean County Board of Commissioners and to participating municipalities regarding the use of funds. Commissioner Barbara Jo Crea serves as liaison to the Department of Human Services and to the advisory council.
Council members serve three-year terms and must have lived experience with substance use and addiction issues or expertise in substance use disorder treatment/prevention, or provide behavioral health or substance use disorder treatment in the community.
Some are named by Ocean County title: Prosecutor Bradley Billhimer; Alcoholism and Drug Abuse Director Kimberly Reilly; Mental Health Administrator Tracy Maksel; Appropriation of Funds Officer Julie Tarrant; Administrator Michael Fiure; Director of Management and Budget Tristin Collins.
Others include Ocean County Public Health Coordinator Daniel Regenye; Stephen Willis, Esq., co-founder of Hope Sheds Light; Tara Chalakani of Preferred Behavioral Health Group; and Kimberly Veith of Bright Harbor Healthcare.
Alternates are Renee White, Esq., Laura Messina, Lori Enquist-Schmidt and Pamela Capaci.
The council’s four main priorities, as Busch outlined, are public awareness/education, care management and comprehensive wraparound services for individuals with substance use disorder and their families, prevention/early intervention, and workforce development.
The plan includes a list of providers and treatment agencies, culled from resource directories and Treatment Atlas, which is a statewide initiative, an online resource directory with quality data about providers.
During public comment, Stephen Davies of Barnegat asked where the decisions get made regarding the open contracting processes. The proposal review committee will make recommendations to the county board of commissioners, which has the final say.
Jody Stewart of Little Egg Harbor is an organizer with the New Jersey Organizing Project and New Jersey Resource Project as well as a member of Sea Change, founded by Elizabeth Beaty of Holgate.
“We don’t have anything in our area,” she said. “No community center for people, except for Elizabeth (Beaty) over here. She’s the one doing the outreach.” The grassroots and government entities must work together instead of fighting, Stewart said, to find ways to breathe and move forward so “not one more” life is claimed by overdose.
Elissa Tierney also spoke on behalf of Sea Change from personal experience and the barriers she has faced as a citizen and a perceived “addict.”
“We are a huge population, yet we are left vulnerable and unprotected when it comes to medical treatment,” Tierney said. “We need compassion and medical support.”
No timeline has been established yet for requests for proposals, Busch said. But none of the funds already received by the county have yet been distributed.
Agencies interested in applying for funding need to sign up for the OpenGov portal on the county’s website, in accordance with the state contracting process.
Before the vote, Sea Change RCO and St. Francis Community Center were added to the list of providers.
“We are on the front lines of New Jersey’s overdose crisis,” according to the Not One More campaign’s official recommendations to the council. “As people directly impacted by addiction and substance use disorder, we want to make sure that Ocean County’s opioid settlement funds go towards compassionate, evidence-based care and treatment solutions.
“We have three main spending priority recommendations: 1. A drop-in center in Ocean County, where people can access resources, recovery support and harm-reduction supplies. We recommend that this center be based within the Sea Change Recovery Community Organization.
“2. Affordable and accessible transportation to and from treatment. In Ocean County’s rural and suburban communities, a lack of reliable public transportation often creates a barrier to receiving treatment. We need to ensure that the solutions we develop with this funding are within reach for everyone.
“3. Improved hospital care for people with substance use disorder. We need certified peer recovery specialists and case managers supporting patients stabilizing in hospitals. Healthcare providers and hospital staff also must be better trained to provide compassionate care and evidence-based solutions like medication-assisted treatment and harm reduction, treating all patients with dignity and respect for their autonomy.”
“Sounds like you’re doing great work,” Billhimer said to Beaty. He acknowledged “an opportunity, here, for us to work with you.” The need for a drop-in facility, transitional housing and transportation services has been a persistent problem in Ocean County for a long time, Billhimer said.
Council alternate Pam Capaci of Hope Shed Light said she knows firsthand the dangers of the drug abuse and recovery realms. “I want you to know there are voices on this council that have walked in your shoes and are here trying to represent you,” she said.
“This is the people’s money,” Beaty said. “It belongs to the people who have died, who have been left behind. We are trusting you to be good stewards of this money.”
Rather than funding the systems that have helped create the crisis, she said, Sea Change wants “to make sure we’re funding new working solutions.”
The council’s official website is nj.gov/opioidfunds.