Using opioid settlement dollars, Summit County funding addiction programs in county ERs
Emily Mills
Summit County is using more of the $104 million settlement it received as part of a federal opioid trial nearly two years ago for addiction and recovery services.
County Council last week approved giving a $1 million grant to the Summa Foundation on behalf of Summa Health to expand its First Step program, currently operating at its Barberton and Akron emergency departments, to its Green emergency department. Members also approved a $1 million grant to the Cleveland Clinic Foundation on behalf of Cleveland Clinic Akron General to establish the Recovery’s in Reach Program at its emergency departments throughout Summit County.
Council also approved a $500,000 grant agreement with the Akron Community Foundation to establish the Opiate Small Grant Program fund, which will provide grants of up to $25,000.
All three are being funded using the opioid settlement dollars — received as part of the federal trial involving Summit and Cuyahoga counties that focuses on the pharmaceutical industry's role in the opioid epidemic — to organizations and programs helping those with addiction.
So far, Summit County has distributed more than $5.5 million in settlement funds to local organizations in the county and more than $380,000 in medications received in settlement agreements.
According to Summit County Public Health data, Summit County emergency departments had at least 1,059 overdose visits in 2020.
“The opioid epidemic is ongoing in Summit County, and experts believe the COVID-19 pandemic has likely led to an uptick in overdoses and deaths,” Summit County Executive Ilene Shapiro said. “Working with a diverse group of local experts on the [Opioid Abatement Advisory Council], we are committed to using our opiate litigation settlement funds to fund projects that will make a difference in the fight against this epidemic and help individuals with substance use disorder choose recovery. These latest grant awards provide critical funding to two important players in the fight, health care providers and grassroots organizations.”
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The Summit County Opioid Abatement Advisory Council is determining how the money will be used by making recommendations to the county to fund programs addressing four priority areas: treatment, harm reduction, system coordination and evidence-based prevention and education.
The OAAC makes recommendations, and then a key stakeholders group — made up of Shapiro, Summit County Public Health Commissioner Donna Skoda, Akron Mayor Dan Horrigan, Barberton Mayor William Judge and Coventry Township trustee George Beckham — approves the recommendations, with County Council approval following after that.
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Deborah Matz, director of the county's Department of Law and Risk Management, said the OAAC members and the key stakeholders determined "it's a good idea to get some money into the community to really begin to address directly opiate overdoses."
Summa is one of the first health systems within the county and state to initiate the First Step model within an emergency services environment, said Jaimie McKinnon, vice president of Summa Health Behavioral Health Institute.
“We are pleased to bring this unique addiction services program to our patient population via telemedicine, available 24/7,” she said. “This grant will also provide integration of program processes and protocols in the acute care setting, like inpatient units, which will undoubtedly increase access to potentially life-saving care coordination for comprehensive addiction services.”
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Cleveland Clinic Akron General said its program will help improve follow-up care for patients who are seen with substance use disorder as a primary or secondary health issue in any of the hospital’s four 24-hour emergency departments in Summit County. The grant will support the program for one year.
In 2020, 263 visits to one of the system’s emergency departments (on the main campus or the Green, Stow or Bath Health & Wellness Centers) was due to an overdose.
Akron General Department of Emergency Medicine Chair Dr. Steven Brooks said emergency departments often serve as “the front door” for patients who need help dealing with addiction issues.
Emergency patients identified as needing help with addiction will be matched with a peer recovery coach, provided through Catholic Charities, onsite who will make sure they get proper long-term supportive care. Other partners include BrightView Health, a drug and alcohol treatment center; the Cleveland Clinic Alcohol and Drug Recovery Center; and Community Health Center Addiction Services.
“This effort will help fill in the missing piece in helping people with addiction issues get proper follow-up services after an emergency visit,” Brooks said.
Greta Johnson, assistant chief of staff to Shapiro, said the goal is to have this type of treatment in every emergency room in Summit County.
“It treats addiction the way it treats any other medical emergency,” Johnson said. “If you're having a heart attack when you go to the emergency room, you immediately get assessed, you get a care plan, and addiction's being treated in the same way with this program.”
Summit County Opioid Healing Fund
On the Opiate Small Grant Program fund, also called the Summit County Opioid Healing Fund, the OAAC determined that many small nonprofit agencies in the community provide grassroots assistance to people with substance use disorders and their families, but they’re not typically funded by larger agencies.
“They don't typically get recognized by larger funders, even though what they do on a person-to-person basis can be very, very successful and impactful,” Matz said.
The county previously partnered with the Akron Community Foundation to develop the Summit County COVID-19 Non-Profit Emergency Relief Grant Program. Because the program went well, the county again decided to partner with the foundation for the opiate grant program.
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The grant application is planned to open July 15 and close Aug. 9, with grants announced in September. The eligibility criteria are still being developed, but the money can be used for operations and programs.
After County Council District 5 representative Veronica Sims asked questions about the overall plan for spending the money, including questioning "what is our lens for equity,” council is planning to have an overview presentation at its Aug. 2 meeting, its first after its summer recess ends and its first in-person meeting since April 2020.
“There were kind of these immediate needs that we were trying to take care of first while we look at a more long-term planning around prevention and how we want our system to look,” said Elizabeth Foster, Summit County Public Health epidemiology and data surveillance supervisor, who is working with the OAAC.
Previous funding by county, Opioid Abatement Advisory Council
The OAAC and the key stakeholders group are presenting recommendations and related legislation on how to spend the settlement money to County Council separately, rather than in one giant list.
Previously, the county gave $1 million each to Summa and Akron General for their respective CenteringPregnancy programs. The county gave an additional $500,000 to Summa, which has offered the program since 2010, to expand its program, including to pregnant opiate-addicted women in the Summit County Jail.
Summa Dr. Cheryl Johnson and Pauletta Hatchett, manager for pregnancy health and at-risk populations, said in a statement that a team from the VIP Care Program — which stands for Very Important Patient/Pregnancy/Postpartum — is leading the CenteringPregnancy expansion.
VIP Care services include educating and assisting patients with birth planning; addiction care and recovery support; housing referral applications and women’s shelter housing; advocacy representation at Summit County Children Services; transportation (bus passes and Uber gift cards) and food assistance; and assistance getting clothing, diapers and infant care items.
Pre-Centering program sessions to provide education and treatment initiation and address the social determinants of health will be offered at the Summit County Jail this summer.
The initial $2 million in CenteringPregnancy funding came from a settlement with Johnson & Johnson, reached before the October 2019 trial.
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The county has also provided three rounds of funding to Summit County Public Health: $180,000 for harm reduction strategies and $463,852.24 and $160,000 for project management services to assist the OAAC. The harm reduction strategies include naloxone, needle exchanges, fentanyl testing strips and a new peer recovery coach housed in Akron Municipal Court's prosecutor's office.
Summit County Community Health Fund
As part of the settlement, the Henry Schein company, a distributor of medical and dental supplies that was dismissed as a defendant in the trial, specifically directed money to the Akron Community Foundation, which established the HSC/Summit County Community Health Fund.
The $1 million in the fund is being used to give grants to local nonprofit organizations and research and medical institutions for addiction-related programs.
Awardees in the first grant cycle included $150,000 to Cleveland Clinic health system to expand access to addiction and recovery treatment and increase the number of MAT-certified (medication-assisted treatment) staff; and $50,000 to Friends of The Summit to support addiction relapse prevention efforts and alleviate mental health or emotional challenges that accompany addiction through its "Rock and Recovery" program.
Portage Path Behavioral Health received $150,000 to expand dual diagnosis programming, which helps clients recover from coexisting mental illness and substance use disorders.
Portage Path added three new co-occurring groups that are currently up and running: a men's trauma group, Roots of Recovery; a co-ed evening intensive outpatient program, Crossroads: New Directions; and the Family Education & Support Program for family and friends of clients being treated for dual diagnosis.
The Northeast Ohio Medical University Foundation received $115,000 to expand the university's medication-assisted treatment (MAT) training program to students and area physicians.
According to the university, fewer than half of the physicians who are MAT-certified actually treat patients with opioid use disorder. NEOMED surveyed physicians to determine the barriers to offering the treatment and developed a four-hour supplemental training program to address them.
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Akron Children's Hospital received $100,216 for the Peer Recovery for Addicted Mothers program, which will provide peer-based recovery services to new mothers with infants in the neonatal intensive care unit due to neonatal abstinence syndrome.
Dr. William Goldman, medical director of Akron Children’s Addiction Services Program, said that although the COVID-19 pandemic delayed its start, the pilot program is now underway at the Children’s NICU on Summa's main campus.
Children’s contracted with Catholic Charities to bring aboard two peer recovery coaches and additional staff for moms with babies in the nursery and in recovery for any substance abuse.
The goal is to enroll 80 mothers and aim for a 70% success rate in completing the program. The grant funds will cover salaries and educational opportunities for staff and supports for the moms, like gas, ride-sharing and food gift cards, child care, baby clothes and diapers.
“We know that mothers are among the most motivated groups to overcome addiction, and that similar peer mentoring programs have proven effective,” Goldman said. “Medical management is only one part of the puzzle. Peer recovery coaches can help navigate the turbulent waters of recovery, giving our families the greatest opportunity for success. We hope to reduce stigma, offer secure footing to help launch these young families towards bright futures and use what we learn from this pilot to expand the program to other Akron Children’s special care nurseries and NICUs over time.”
A second round of funding totaling $355,000 included grants to the American Heart Association, CHC Addiction Services, IBH Addiction Recovery and Portage Path. The fund’s remaining $64,000 will be distributed to addiction-related programs through the community foundation’s upcoming Health & Human Services grant cycle. Nonprofits can apply online starting Sept. 1 at akroncf.org/GrantApplication.
The broader settlement also includes medications from some of the companies.
As part of its settlement with Endo, which was reached before the October 2019 trial, the county received three orders, totaling $380,000 in value, of Vasostrict and adrenaline chloride solution, which are often used to treat overdoses. Orders were supplied to Western Reserve Hospital, Summa and Cleveland Clinic Akron General.
Contact Beacon Journal reporter Emily Mills at emills@thebeaconjournal.com and on Twitter @EmilyMills818.