Cuyahoga has more opioid settlement funds than most Ohio counties. Is the money making a difference?

Cuyahoga County put a big chunk of its opioid settlement dollars into the construction and operating costs of a new center – that diverts people from jail to mental health and substance abuse treatment.

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October 24, 2024

Over the course of 18 years, Ohio and its communities are receiving nearly $2 billion from pharmaceutical companies to compensate for harm caused by opioids. The Ohio Newsroom is following the money. This is our settlement story of the month.

Cuyahoga and Summit counties were the first in Ohio to sue opioid makers and distributors, and the first in the state to receive a payout.

So when the first $123 million settlement reached the county in 2019, longtime county employee Brandy Carney was surprised by the number of people calling her, looking for a chunk of the change.

“It was very daunting,” she said. “There are so many individuals. Everyone's your best friend really quickly.”

Carney’s job now includes managing how the settlement funds will be distributed.

Unlike most other Ohio counties, Cuyahoga has two sources of opioid funds — that lump sum they got in 2019 and a percentage of the Ohio settlements that will be distributed each year for 18 years.

That means the county can give money to organizations that have long been working in the field of addiction.

For example, Cuyahoga awarded close to a million dollars to Hitchcock Center for Women, a treatment center that allows children up to age 12 to stay with their mothers through their recovery — a unique service in Northeast Ohio.

CEO Jason Joyce said the money, along with private donations and other grants, is helping pay for a $25 million dollar expansion of their center with attached short-term housing.

He said capital projects like theirs guarantee the settlement money will have an impact in the community long term.

“This is not only going to be relevant, two, three, four years from now, it's going to be relevant, 30, 40 years from now.”

Dreaming big: Cuyahoga County’s jail diversion center

From the outset, Cuyahoga County also planned to use its settlement funds to start its own big project. The county jail had been overflowing, and plagued with problems, so Carney and other county leaders set their sights on building a jail diversion center.

The idea is that law enforcement would take people with mental health and substance challenges who have committed a low level offense to a facility where they would be stabilized and connected to services, instead of jail.

“We really wanted an opportunity to not have people being penalized when they really need to get support and help for the disease right now,” Carney said.

But right away there were problems. She said the center was often more than half empty. It opened in 2021, during the COVID-19 pandemic, when the number of people in the county jail dropped drastically. And on top of that, police officers told officials they struggled to convince people to go to the diversion center because, unlike jail, it’s voluntary admission.

“We had to adjust,” Carney said. “That's when we said, okay, rather than just police drop offs, anyone can use it — friends, family, self referrals.”

Those people started calling, including Ashley Rosser, who works at Thrive for Change, a local harm reduction group.

She said the diversion center is great because it is open day and night and will take people who might have both a severe mental health issue and substance abuse issue, who other centers may not take. But still she had clients who didn’t want to go.

“They got a big bright yellow police sign. You see it from the street,” said Rosser. “Nobody wants to go there if they think it's for police.”

She said she hopes the county listens to voices of people with lived experiences to improve the center for the people they’re trying to help.

“I would love to know, how are they incorporating those voices into making their program better?” Rosser said. “Because obviously something is happening for them to be empty.”

The case for starting small

Rosser’s organization has been working for four years passing out 20,000 kits of Narcan opioid reversal drugs and reaching people other organizations don’t. As she packs up an outreach event the group hosts every week in Cleveland’s Detroit-Shoreway neighborhood, a man approached her and asked for fentanyl test strips.

Rosser explained how to use them, and he left with some, as well as a box of Narcan.

This work is making a difference, Rosser said. They’ve received reports that 69 of the kits they passed out saved a life in the county this year.

Thrive for Change has applied for opioid settlement funds, but the organization is still waiting to hear back. So far, it hasn’t seen a dollar of those funds, even though the county invested millions in its big diversion center.

She said more money would be a big help.

“We would be able to add more locations, and more locations is more distribution. More distribution is more overdoses reversed,” said Rosser.

There are lots of organizations like hers in Cuyahoga County that want the money. And now that settlement funds are flowing to the rest of Ohio too, other communities will also have to decide what works best.