Data driven decisions directing settlement spending

May 18, 2024

The Surry County Office of Substance Abuse Recovery sponsored a Second Chance Job Fair in April that helped make connections for people in treatment, recovery, or who have been involved in the legal system to find a job.

Surry County is slated to receive $9,085,956 to be spread out through June 30, 2039, from the settlements with the drug makers and distributors who are to blame for much of the nation’s opioid epidemic.

While that may sound like a lot of money, consider that it is being spread over the totality of those years and not being sent in one lump sum.

Most of the budget for the Surry County Office of Substance Abuse Recovery is not from the opioid settlement funding but rather from the county’s budget and grants. Director Mark Willis said the fact the county has funded his office at all is a bit of a rarity across the state.

His office and its programs were designed prior to the millions of dollars in opioid settlement funds that are heading across the country and finding their way, most often, to the county level. Some cities got their own allotment but put it back into their county’s fund to better serve all residents, as Raleigh did.

When a community needs assessment was conducted to find out what Surry County residents thought about the issue of drugs in this county, Willis said they got more than the number of responses needed to make it a viable study.

Surry County Office of Substance Abuse Recovery assistant director and data analyst Jaime Edwards said the surveys are just “a cornerstone” of a lengthy data collection effort that predates the settlement funding and guides the current mission.

Governor Roy Cooper set out a plan to deal with the opioid crisis back in 2017 and many of those guidelines drove Surry County’s planning. When Attorney General Josh Stein helped win millions of dollars from the drug manufacturers and distributors, the negotiated settlement set out terms for spending the money.

Willis said the existing strategies the county had made based, in part, on the community needs assessment and the Cooper’s 2017 strategy meant their plans already lined up with the memorandum of agreement with little modification.

He said that the long-term proposals, data sets, and the resolution signed by the county commissioners outlining this year’s spending of the settlement can be found online, “So that the taxpayers can understand the process.” He added that many of the proposals were made at county board meetings and videos can be found online.

The plans in place were directed by evidence, data, and with guidance from the community needs assessment he said, “All of these are the county’s programs, not mine. We didn’t make the model; the public drove it.”

Some of the recent frustration that members of the public felt when discussing the settlement and these seemingly far off programs is a lack of understanding. A portion of the opioid settlement is being spent on promotion and education of the county’s efforts, but Willis admits that can be a tall order.

Another portion of frustration is with the process itself, or the lack thereof, for the county to share in the settlement with community groups. Surry County cannot create a system out of thin air to form a task force, empanel experts, and hear the requests that will follow as Willis told community stakeholders at a recent meeting.

Lacking a system or guidance in place by the state to disburse settlement funds to community groups does not mean there is a lack of any plan. Before the settlements were even known to be on the horizon, Willis explained that Surry County had asked department heads from social services, EMS, and others to try and quantify and qualify the effects of the opioid crisis on their operations.

He was able to put the annual amount spent by the county on substance abuse at between $3 to $4 million and that amount would continue to rise without intervention. With the settlement money the county is now in the implementation phase of its plan and hopes to reduce that dollar amount while improving community health.

At their July meeting the commissioners approved the 2023-2024 spending plan that included $179,796 for collaborative strategic planning to include the Surry County Office of Substance Abuse Recovery in engagement of stakeholders, build on established partnerships, and evaluate potential strategies.

The Intervention Team received $149,893 from this year’s funding to support its mission of reaching out to residents who have had an overdose to try and connect them to treatment or social support systems to help them in a time of dire need.

Many in recovery lack the transportation necessary to see treatment and Ride the Road to Recovery has risen to meet the challenge of getting residents from disparate corners to the medical care they need.

From the settlement funds $47,344 will go to support this program that has expanded from its original goal of getting folks to treatment centers like Daymark to include rides for primary medical care, judicial follow up, and social support services.

The county began a program to help those in treatment and recovery get back to work and $59,379 will be directed to supporting the efforts of the business advisor who recruits the participating companies and promotes Recovery Friendly Workplaces.

The advisor works in conjunction with a certified peer support specialist who connects those in jail with treatment services and an opportunity to find post incarceration employment; an allocation to support those efforts was $50,481.

When the new jail opens both Surry County Office of Substance Abuse Recovery and the Surry County Sheriff’s Office have expressed a level of excitement to begin addiction treatment services to those in jail in earnest. The new jail will have dedicated space for such efforts, something its predecessor did not.

Willis said he was given an estimate from the sheriff’s office that more than three-quarters of those in the jail have a substance abuse issue and the county has lacked a way to offer treatment to them.

Cycles of addiction are hard to break so getting a head start on treatment before someone is released from jail may be what they need to not go back to the same places and faces that got them there. The settlement will fund $138,000 toward getting these programs going in earnest in the new facility.

Another $52,110 is set aside to fund the services of substance abuse office’s outreach programs in the schools regarding early intervention. Willis said spending settlement funding in this way is really a no brainer as most will agree that protecting the next generation from substance use disorder is of great benefit to the community.

How the county spends settlement funding each year is determined by a vote from the county commissioners and that spending plan is then sent to Raleigh. Every dollar spent must be accounted for and shown to be spent in alignment with the agreement and that there must be a measurable impact of that spending.

If there are elements that do not work, Edwards said the plan can be tweaked along the way using data driven decision making, “The plan of action years from now may look totally different to the one they are working on today.”

“And what works in Durham, may not work here,” Willis agreed.

As the community’s needs change and the drugs also evolve, Edwards posed the question, “How do we make the plan so resilient that we can plug in another substance and use the same model?”

He said the answer is to hold true to evidence-based practices that focus on a recovery-oriented system of care.

That technique can pay compounding dividends as cycles of addiction repeat not only with people, but within families and between generations, “People who get clean may have a larger impact on their kids than education or outreach can.”

Having the data has been a key element to the county’s plan and that there was data collection happening pre-settlement means that Surry County is now ahead of many other counties when it comes to planning.

The juxtaposition is pronounced as it was Willis who was once calling the other 99 counties when he was hired to ascertain what they were doing to fight to opioid epidemic and found mostly crickets.

Now, other counties have picked up the phone to call for guidance on making plans and to ask how to get their county commissioners on board, something Reeves said is not a problem with the Surry County Board of Commissioners whom she said were on board early. “We can’t thank them enough.”

She said she welcomes the public to also get on board and said they are always invited to ask questions of the Surry County Office of Substance Abuse Recovery team, or better, to join with them in helping in the ongoing struggle against substance use disorder in this county.