An opinion from the Idaho Attorney General’s Office says opioid settlement funds spent in recovery centers must go exclusively toward people who have issues with opioids.
The opinion — which Idaho health officials say limits Idaho in ways different from other states and would make it difficult to fund recovery centers — was sent to the Idaho Behavioral Health Council on Aug. 31 and obtained by the Idaho Capital Sun.
“While the full impacts of the Attorney General’s opinion are not yet known, the opinion, if correct, will likely pose significant barriers to state and local government efforts to fund recovery centers and serve individuals suffering from opioid use disorders and related substance use disorders,” said Monica Young, a spokesperson for the Idaho Department of Health and Welfare.
The opinion says recovery centers must ensure the funds are going toward people with opioid use disorder. That departs from what some other states are doing with the funds. Addiction experts say the opinion complicates the already difficult job of treating substance use, reducing access to care, particularly by requiring treatment centers to ask questions of people coming in for treatment.
“Any kind of requirements particularly that require you to go through an ‘intake’ is going to make it difficult for people to access and make it less accessible for those services,” Norma Jaeger, executive director of Recovery Idaho, which promotes awareness of the state’s nine recovery centers, told the Idaho Capital Sun in a phone interview.
The recovery centers provide low barrier access to care and are often a first step toward recovery for people who are afraid about losing their jobs or getting in legal trouble, she said. Making it harder to get care makes people less likely to receive recovery services and makes treatment more expensive by adding more administrative burden in intakes, she said.
Other states and cities have a broader view of how the money should be spent. San Francisco uses the funds for treating the use of stimulants, such as meth and cocaine, KQED reported. Colorado created housing vouchers for people with substance use disorder, according a post by the National Conference of State Legislatures.
Idaho’s attorney general’s office has a narrower view of how the funds can be used.
“If opioid settlement funds are used to support these recovery centers, procedures must be established to ensure that the opioid settlement funds are only used to serve individuals suffering from opioid use disorder,” read the opinion by Idaho Deputy Attorney General Stephanie Guyon.
The Idaho Attorney General’s opinion hints at a “notably strict” read of the national opioid guidelines, said Christine Minhee, an attorney who tracks how states are spending their opioid settlement funds on OpioidSettlementTracker.com.
“A focus on opioid use is obvious, but legally speaking, the document to which they refer … is non-exhaustive. This creates just enough freedom for states to more or less interpret what they’d consider abatement and “Exhibit E enough” as flexibly, stringently, creatively, progressively, or punitively as they might have dealt with SUD (substance use disorder) issues generally up until that point,” Minhee told the Idaho Capital Sun in an email.
The Attorney General’s Office could not be reached for comment.
The Idaho Behavioral Health Council directed questions about the opinion’s interpretation to the Attorney General’s Office.
“The Attorney General’s opinion appears to preclude using state-directed opioid settlement dollars in the same way other states and localities are using their settlement,” according to a statement from the Idaho Behavioral Health Council’s co-chairs, Idaho Department of Health and Welfare Director Dave Jeppesen and Idaho Courts Administrator Sara Omundson.
What the Idaho Attorney General’s opinion said
The Attorney General’s opinion was responding to the Idaho Behavioral Health Council’s question in an Aug. 2 memo, obtained by the Idaho Capital Sun, about if the funds must only be spent on opioid use disorder or people at risk of developing opioid use disorder.
The opinion said that “if a person suffers from SUD (substance use disorder), but it is a non-opioid addiction, then funding for that person’s care does not qualify,” referencing recovery centers and other areas of opioid spending allowed by the settlement.
The opinion referenced language in other examples of how the funds can be spent, identified in a separate document in the national opioid settlement. The opinion listed other spending areas that said the funds could go toward recovery services and other services for people who suffer from opioid use disorder and co-occurring substance use disorders and mental health conditions.
Need to get in touch?
Have a news tip?
The opinion references four other national opioid guidelines on how the funds can be spent that include language on opioid use disorder and co-occurring disorders to:
- Provide housing for people;
- Support or expand peer-recovery centers;
- Support crisis stabilization centers;
- And fund peer support specialists or recovery coaches
The Idaho Behavioral Health Council’s request for the opinion said if funds were used to support recovery centers, “it would be extremely difficult to parse” out between people suffering from opioid addictions or other drugs.
The council made the request to prepare for a meeting “to ensure members of the council had clarity on the allowed uses of the settlement funds when selecting priorities,” Jeppesen and Omundson said.
The council on Aug. 11 recommended four spending areas — including recovery services. The council recommends to the governor how the state should spend its 40% share of the expected $127.8 million in the state’s opioid settlement funds.
The governor’s press secretary, Madison Hardy, said the governor will unveil his budget recommendation in January during his State of the State and Budget Address.
GET THE MORNING HEADLINES DELIVERED TO YOUR INBOX
Money comes with restrictions. But limiting care to opioids puts ‘people in a bind’
Debbie Thomas, chief executive officer of the Walker Center, a drug treatment program in the Magic Valley, said she understood the settlement funds to work how the Attorney General’s opinion described it.
And she says it makes sense to work that way.
“My opinion is that if we as a nation have said that pharmaceutical companies are responsible for an opioid use crisis and we want to hold them accountable for an opioid use disorder, then I personally have no problem with limiting the funds in a specific way,” she told the Idaho Capital Sun.
She recognizes the drug epidemic needs addressed, but organizations that receive funds have to follow the guidelines, she said. Everybody deserves care, and barriers need to be reduced as much as possible, she said.
“If I could get $119 million dollars and spend it, I wouldn’t want any strings attached. I just want to do … the best things I know. But when you take federal dollars, there’s always restrictions and requirements,” Thomas said. “And to be able to keep the money, not have ourselves as a state or organization get into problems with using it, then you have to follow the rules that come with the money.”
Any money spent on treating substance use in Idaho is good money spent, but the money could have greater reach without being limited to opioid use disorder, said Janice Fulkerson, chief operating officer at the Fletcher Group, a nonprofit organization that works in opioid and substance treatment in Idaho.
“The reality of the day to day, when people come in and they’re seeking treatment or they’re seeking recovery services — how do you know? I think it puts people in a bind,” Fulkerson told the Idaho Capital Sun in a phone interview.
Focusing solely on opioid use disorder is not the most helpful approach to treating substance use in Idaho, when the state has limited resources and providers to treat substance use disorder, she said.
“It would be even more beneficial if we had the ability to treat all substance use disorders and not carve this one out,” she said.
Leave A Comment