The tragic loss of life and the impact of addiction on families and communities has been escalating in New York State annually almost every year for well over a decade. New York State’s response has been inadequate and lives have been lost as a consequence.
John J. Coppola, MSW
Because of a strong federal response to the COVID-19 pandemic and our nation’s addiction and overdose crisis, and because of New York State’s aggressive action holding corporations responsible for behaviors that fueled the overdose and addiction crisis, new funding is available to support a strong prevention, treatment, recovery, and harm reduction effort. New federal funds and opioid settlement funds, which will be available for many years, provide New York State with an opportunity to launch a strong, sustained effort to address the epidemic levels of addiction and overdose that plague New York families and communities.
The Alcoholism and Substance Abuse Providers of New York State (ASAP), currently merging with The Coalition for Behavioral Health (The Coalition) to form InUnity Alliance, working with substance use disorder prevention, treatment, recovery, and harm reduction service providers; mental health service providers, and stakeholders from across New York State, have generated a comprehensive list of funding and service needs to guide deployment of federal funding and settlement funds in a manner that addresses current community needs and remedies structural weaknesses caused by historic underfunding. ASAP and The Coalition have created the InUnity Alliance Policy Center as a centerpiece of its merger. The InUnity Alliance Policy Center will work with the Opioid Settlement Fund Advisory Board to ensure that the magnitude of services supported by newly available funds match the magnitude of the addiction and overdose crisis.
Guiding Principles
The InUnity Alliance is using the following Guiding Principles as a foundation for the development of our recommendations and encourages the Opioid Settlement Fund Advisory Board to use these guiding principles in their work:
- The magnitude of New York’s response to record levels of overdose and addiction must be strong enough for every community to have access to SUD services on demand
- Justice, Equity, Diversity, and Inclusion should be used as a prism for funding decisions
- Ensuring adequate staffing for SUD prevention, treatment, recovery, harm reduction, and mental health programs must be a priority.
- Reimbursement/funding must be sufficient to cover the full cost of delivering services
- Funding from opioid settlements, federal block grant increases, and taxes on opioids and marijuana should be allocated in an equitable manner that responds to the diverse needs of communities and regions with emphasis on communities and people who are underserved and experience health disparities
- The Opioid Settlement Fund should be considered an ongoing funding source that can be used for ongoing projects and services. The work of the Opioid Settlement Fund Advisory Board will span close to two decades. Opioid Settlement Funds should not be considered one-time funding. They are long term funds that can be used to correct historic underfunding and inequity, structural racism, and a history of failure to meet the magnitude of the problem with a solution of equal or greater magnitude.
Recommendations
Opioid Settlement Funds should be allocated for the following prevention, treatment, recovery, and harm reduction services priorities:
- Workforce Crisis
- Fiscal viability of all service providers
- Strengthening existing programs to address gaps in service
- Expanding services in underserved communities
- Infrastructure support
Workforce Crisis
- Funding should be used for workforce retention to cover costs such as: childcare, health/dental insurance, pay equity, student loan repayment, tuition assistance, scholarships (BIPOC Scholarship fund to support increased senior management/clinical roles), employee wellness services, and more. (Tuition assistance and student loan forgiveness would only be possible with settlement funds because SAMHSA does not approve use of their funds for this purpose)
- Special support to hire additional staff who reflect the culture and experiences of the people and community served
- Statewide workforce training focused on use of evidence-based tools
- Support for recovery coaches and recovery peer advocates including recruitment, training, certification, job placement
- Reimbursement for certification fees (CASAC, CPP, CRPA, etc.)
Fiscal Viability
- A permanent Fiscal Stabilization Fund should be established to provide emergency assistance to programs experiencing cash flow or deficit issues when revenue does not cover the full cost of delivering services
Strengthen Existing Programs to Address Gaps in Service
- Address unmet needs especially in under-served BIPOC communities
- Incorporate anti-racism principles into continuum of services statewide using training and technical assistance
- Strengthen services for LGBTQ+, women/with children, people involved with criminal legal system, aging persons, and persons living in underserved communities
- Provide harm reduction and help people access treatment particularly people who use drugs and have risk for overdose, and people with co-occurring MH disorders
- Ensure that programs state-wide receive funding for naloxone
- Strengthen/expand existing recovery services
- Strengthen addiction peer services in treatment, recovery, harm reduction settings
- Expand prevention services targeting individuals, families, and communities.
- Fund evidenced-based environmental prevention strategies and community coalitions to link prevention resources and expand reach to vulnerable populations
Expand services in underserved communities
To address issues related to health equity and inequity in service infrastructure, funding should be provided to expand existing programs and create new capacity to address unmet need.
- Provide funding for new services in underserved communities that address specific underserved populations and specific services that are lacking
- Support creation of the Leadership Institute addressing BIPOC leadership development
Infrastructure Support
- Support continued access to telehealth via purchase of equipment, connectivity and technologies that create force multipliers for staff (laptops with web cams, smart TVs, hardware and data plans to support tele-health)
- Create technology infrastructure for data collection, analytics, reporting tools, and regional/statewide dashboards and analytics so that programs can access data to inform decision-making and create a robust data collection/survey system for annual surveys, ad hoc requests for information, and enhanced responses to crisis situations like COVID
- Provide funding for clinical technology tools (recovery apps, notebooks for journaling etc.)
- Ensure that programs are always equipped with PPE
The Opioid Settlement Fund Advisory Board has a vital voice in the decision-making process regarding how New York State will use Opioid Settlement Funds. This voice is critical as funding decisions are made during the State’s budget process for close to two decades. InUnity Alliance and our Policy Center are committed to working with the Advisory Board to address the impact of the opioid overdose and addiction crisis and the historic underfunding of substance use prevention, treatment, recovery, and harm reduction.
John J. Coppola, MSW, is Executive Director of the NY Association of Alcoholism and Substance Abuse Providers (ASAP) / InUnity Alliance.
To learn more about the work of the InUnity Alliance Policy Center and our advocacy work, contact Kyle Plaske, Deputy Director at 518-596-4542 or KPlaske@asapnys.org.
