Erie County legislators did not expect it to be so hard spending $500,000 fighting the opioid epidemic.
Indeed, legislators wanted to award the grant money fast given the rate of one county resident dying of a suspected overdoses every day of the year.
But instead, of 13 spending proposals submitted by community organizations to address the drug crisis, the Legislature has approved only one. Lawmakers will convene a special meeting in August, when the Legislature is normally in recess, to decide on other proposals.
A proposal from the International Institute of Buffalo to spend $50,000 to assist human trafficking victims is among the three proposals recommended by the Erie County Health and Mental Health departments. Its proposal would help victims forced into sexual slavery and controlled through addiction to opioid drugs.
Legislators and other organization leaders who were denied funding criticized some of the recommended proposals recommended by the administration as lacking the ability to provide direct, immediate assistance to those struggling with opioid addiction.
Another of the recommended proposals calls for transforming Neighborhood Health Center into a "best practices" primary care site, with new and expanded policies, training, screening and intervention for patients struggling with substance abuse.
"The experts on the panel are incredibly tone deaf on this," said Legislator Patrick Burke, D-Buffalo, who had initially wanted the Health Department to be allowed to allocate $1 million in county funding without Legislature oversight.
"How is this going to help people today?" asked Avi Israel, a victims advocate who heads the Save the Michaels organization. "How is that going to help the person thrown out of ECMC?"
After lengthy discussion, the Legislature agreed to approve only one recommendation: $235,000 in funding for Evergreen Health Services, to reduce risk to drug users, expand access to opioid replacement therapy, offer four mobile locations for syringe exchanges and other harm reduction services, and supplement the county's drug prevention campaign.
Though the Legislature normally recesses for the month of August, legislators agreed to hold a special meeting next Thursday to allocate the balance of the $500,000 to other proposals following a morning work session.
A sense of urgency exists for lawmakers and treatment providers. The opioid drug crisis is believed to have led to the deaths of 226 county residents so far this year. That compares to 301 confirmed deaths for all of last year.
Health Commissioner Gale Burstein and Mental Health Commissioner Michael Ranney vigorously defended the recommendations of their panel group. They said their recommendations are based on proven strategies, meet underserved needs and will provide expanded services throughout the county and will be sustainable.
"We really want to start these projects as soon as possible because we have a crisis on our hands," said Burstein. "So we were also looking at how quickly we could have programs up and running because we want to save lives, and we want to get people into the appropriate, evidence-based care as soon as we can."
In June, the Erie County Legislature offered up to a half-million dollars in one-time grant money to community organizations with worthy proposals. The Health Department subsequently received 13 proposals — ranging from public education radio announcements to studies of marijuana as a "reverse gateway drug" to reducing opioid addiction.
In the end, the Health Department asked the Legislature to approve three proposals that provide support to primary care physicians, offer expanded and rural access to opioid replacement therapy, and create a training program to assist victims of human trafficking who are controlled through opioid addictions.
The Health Department panel, composed of representatives from both the Health and Mental Health departments, described the proposal by the International Institute as "highly unique" and addressing an issue not frequently discussed.
Ten other proposals were submitted but ultimately rejected by the county panel — to the consternation and disappointment of some outspoken groups.
"There was a very wide range of ideas," Burstein said. "Unfortunately, we have a limited budget so we were only able to fund three."
One proposal among those rejected was the launch of a study to examine whether marijuana could effectively reduce opioid addiction.
Nicolas Eyle, a drug policy consultant with St. Ann's Corner of Harm Reduction, a human services organization in the Bronx, criticized the county's selection process as flawed.
"When I see people proposing the same old stuff and getting money for things that have been done before, it's ridiculous," said Eyle, who argued his proposal was disqualified on technical grounds based on vague wording in the county's request for proposals.
His organization was the only one to propose a research study. Burstein and Ranney said Thursday the research proposal was unlikely to be a top contender for the county money in any regard.
Israel who had submitted a proposal for all $500,000 of the county grant money, heavily criticized the administration's recommendations as lacking immediate impact on the crisis.
"With the exception of Evergreen," he said, "the other two proposals are garbage."
He also suggested Burstein was underqualified to review the proposals because "she's just a pediatrician," though Burstein's resume includes decades of experience in the public health field. Legislator Majority Leader Joseph Lorigo called his comment "uncalled for."
In the end, however, Israel said the Legislature's decision to delay final approval of the recommendations shows "the power of the people."
Other organizations submitted proposals but were not recommended by the county administration:
- Save the Michaels proposed to fund lay family coaches who would work with families to address the issue of limited access to detox services. Coaches would help families become recovery coaches and facilitate in-home detox as an alternative to inpatient detox.
- Entercom Radio proposed offering public education regarding the opioid epidemic through digital and radio advertising promoting prevention and treatment.
- Airis Pharmaceutical Solutions proposed to offer opioid diversion risk management services for entities with controlled substance registrations with the Drug Enforcement Agency.
- In His Name Outreach proposed to offer faith-based, outpatient withdrawal management services and opioid replacement therapy counseling, including certified recovery coaches, a recovery support phone-call network, and 24-month follow-up program.
- The World Through Your Eyes pitched a general advocacy program including advocacy for harm reduction strategies, access to medication-assisted treatment, prevention educational programming and law-enforcement assisted diversion.
- Daemen College proposed a public education campaign using theater and post-performance discussion as a vehicle for youth development, and a parent website with information on opioid abuse.
- Native American Community Services of Erie and Niagara Counties proposed developing a family-centered and evidence-based prevention education program for Erie County targeting the Native American community.
- Hamburg United Methodist Church proposed recovery support services for the Spark of Hope Support Center in Hamburg.
- EVERFI submitted a proposal to provide online opioid prevention programming to Erie County high school students.