Massachusetts Communities Receive Opioid Lawsuit Settlement Funds
Part One
By Luke Schmaltz, VOICES Newsletter Editor
According to the Centers for Disease Control, Massachusetts suffers one of the highest opioid-related death rates in the nation. Mass.gov reports, over the last two decades, the crisis has escalated exponentially, resulting in thousands of fatalities. In 2022, the rising numbers culminated in an all-time high of over 2,300.
After an unprecedented series of nationwide lawsuits, corporations have been ordered to pay MA in excess of $1 billion over the next 18 years. Manufacturers, distributors, and retailers being held accountable include Johnson & Johnson, Allergan, Teva, AmerisourceBergen, Cardinal and McKesson, Walgreens, CVS, and Walmart. The settlements are earmarked for funding harm reduction, treatment, prevention, and recovery in the fight against the substance use disorder (SUD) crisis.
Under the terms of an agreement reached by the state and its municipalities, 40% of all opioid lawsuit settlement funds will be allocated to municipalities, while the remaining 60% will go to a statewide opioid recovery and remediation fund.
Elected officials are tasked with filling out and submitting the paperwork. However, community members, outreach leaders, recovery professionals, and peer supporters are charged with helping their municipalities determine how the money is spent.
In order to achieve this, it is crucial that community organizations, people with lived experience, and all concerned residents engage in discussions with their local government. Such communication can ensure that these well-deserved monies are invested in programs which can address, offset, and mitigate the damage being done by the ongoing epidemic.
Currently, there are strategies being implemented across the state for assessing and deciding what to do with the money. The louder and more frequent the conversation, the more assured the populace can be that the allotted payments will serve the public. So far, this has proven true in places like Cape Cod, Boston, and Braintree. Meanwhile, there are other areas where residents and outreach organizations are not aligned in their strategies, and the communities at large are being shut out of the spending conversation.
Leadership in Cape Cod
Beverly Costa-Ciavola serves as the Director of the Cape Cod Neighborhood Support Coalition and the Chair of the Falmouth Commission on Substance Use. Her team has developed a comprehensive model for communicating with residents, diagnosing the needs of the community, and furnishing this information to the proper agencies so that informed spending decisions can be made.
“We have support from the Department of Human Services in the Town of Falmouth,” she begins. “They have asked us for our input, a conversation started by my colleague Susie Hauptman who is the Director of Human Services.”
“We have chosen a very specific route to take, and we recently held a community forum. The new town manager came, along with one of the new town selectmen and it went really well,” she says. “What we are committed to doing, is hearing from our community members who are impacted by the opioid crisis – not the service providers, not the ‘Don’t bring that into my backyard’ naysayers.”
“What we decided to do, was hire a consultant to help us formulate a strategic plan on how we would approach our community in a very thoughtful, specific way. It has been an amazing experience.”
Deliberate Strategies
“We created a design team, which consists of myself, the Director of Human Services for Falmouth, two people in recovery, and Kate Lena, the coordinator of the Barnstable County Substance Use & Prevention Council. Then, we asked for additional input from some of the others on the Substance Use Commission with lived experience and others in the community that we knew had lived experience. These people comprised our advisory board.”
“We came up with a formula for getting out there in the community in a very specific way. In the beginning, we wanted to do this quickly and get the money out to where it should be going. Then, we realized we need to be more thoughtful about this. The money is going to last a long time, and we want to do this right. We wanted to create a plan that could be brought back in three to five years and re-done, so that we are always gathering new information from people in our community.”
Filling the Void
Costa-Ciavola describes an environment in Cape Cod that is attuned to substance use recovery including workout facilities, recovery treatment programs, support groups, and more. “We did not want to just give money to things that are already here,” she explains. “It’s not that we won’t, we probably will, but first we wanted to see where the gaps are, what people are looking for, not just the services that are already being provided.”
At the intelligence-gathering stage, Costa-Ciavola and her team adopted the World Cafe Method. “It is a model of doing outreach and gathering information from a community,” she explains. “You break people up into small groups at round tables, you post three or four questions one at a time, you give them 15 minutes to discuss it at their table with someone taking notes, and when the time is up everybody moves to another table, but not with the same people. Then at the end, there is a final exercise where you write the top three or four answers from each of the questions on sticky notes and put them up on the wall. The facilitator then takes those and puts them in a format we can understand so that we can give back to the public.”
A recent meeting attracted over 50 attendees, which Costa-Ciavola explains is a successful turnout for a town the size of Falmouth. “We had people from the faith community, tons of people from the recovery community, we had two recovery gyms there, regular folks from the community, folks from the Wampanoag Tribe, the head of the Chamber of Commerce, and people from the local Cape Verdean population.”
While the intent of the meeting was to determine how to spend the settlement funds, this was not a direct question posed to the attendees. “We didn’t want to make money the focus,” Costa-Ciavola explains. “What we wanted to focus on is what is missing. We had four questions total, and now the design team will review that information, we will look at all of the people who were there, and we will determine what is missing.”
Initial Success
“We got tremendously positive feedback from the event. Our next step is to say, ‘OK, who wasn’t at the table,’ and to do some smaller targeted groups, like a focus group, with maybe the Council on Aging, leaders from the business community, people from the recovery centers, and some of the sober home managers and owners. This will be our second phase set for the end of July or the beginning of August. Then, if we still feel like there are people we have not reached, we will have one on one interviews. And then we are going to compile a document for our town manager and the select board with our recommendations. It will not necessarily say how the money should be spent. It will say, ‘Here are the people who are in recovery, the family members of people who are in treatment, and the people who are still active in their substance use.’ And hopefully, it will trickle down to how we spend the money.”
“The Human Services Department will most likely be the jumping off point for the money,” Costa-Ciavola continues, “So, we will have already appropriated the funds into a line item, then Susie Hauptman’s advisory board will put out an RFP (request for proposal) to providers with specific things that people in our community are needing and wanting. Providers would then be tasked with confirming whether they can provide these requests.”
Next, the design team will create a shareable template which can be used by other towns in Cape Cod as well as by municipalities across the state. While demographics are different from one region to another, this model can theoretically be applied and customized for informed, optimal outcomes – not only statewide, but nationwide as well.
In forthcoming installments of this series, VOICES will examine how similar processes are being explored in other areas of Massachusetts.
If you are concerned with how the opioid lawsuit settlement money is going to be spent, and you are engaging with your local government, VOICES would like to hear from you. Please email [email protected].