Podcast: Help Idaho Address the Opioid Crisis

Logan Finney, Idaho Reports: The opioid crisis. We’ve all heard about it over the past few years, and as part of a nationwide settlement with prominent opioid pharmaceutical manufacturers, the state of Idaho has created the state-directed opioid settlement fund. $2 million will be available annually for opioid abatement activities from that fund.

Here to discuss that, and how Idahoans can give their input on how that money should be used, I’m joined by Stefanie Guyon from the Idaho Attorney General’s Office, Director Dave Jeppesen from the Idaho Department of Health and Welfare, and Administrator Sara Omundson from the state court system. Thank you all for joining us.

Guyon: Thank you.

Jeppesen: Thank you.

Omundson: Thank you, Logan.

IR: Let’s start with Sara. We had you and Director Jeppesen on this podcast way back in 2021 to talk about the Idaho Behavioral Health Council. For a refresher for me and our audience, can you remind us what groups are part of this council and what mission you’re charged with?

Omundson: Sure! So this council was brought together by all three branches of government. So there is an executive order that creates the council. There’s a joint resolution from the legislature that supports the council, and there’s a proclamation from the Idaho Supreme Court that supports the council. So all three branches came together, but there’s a lot of different representation on the council itself.

We not only have a family member of a consumer of the behavioral health system, we also have members from different parts of government, including the Department of Education, Department of Corrections, obviously the courts and Health and Welfare. We have a doctor, Dr. Pate, who joins us. There’s lots of representation from a number of different groups throughout the state government.

We wanted to bring everyone together because we knew there was lots of great work going on, including in the public sector, in the private sector. But there wasn’t a lot of coordination of all of those efforts. So we wanted to bring folks together and find a way that we can coordinate on a strategic plan, that we were all sort of rowing the boat in the same direction. How do we focus our efforts in the same direction?

IR: Director Jeppesen, over at the Department of Health and Welfare, of course you guys have a pretty clear connection to behavioral health. What sort of advantages have you seen, having the rest of Idaho state government rowing in that same direction with you?

Jeppesen: Logan, it’s been pretty phenomenal, actually. You know, the behavioral health is a big topic. I get it. But most of your listeners know somebody with a behavioral health issue or concern, whether it’s mental health or substance use. And you know that the number of folks that are needing services continues to increase against a backdrop of trying to find solutions and systemic solutions, to bring those to bear so we can provide services to individuals and sort of have this broad, broad paint brush, this broad stroke approach. It’s been really powerful. And if nothing else, there’s been so many groups and individuals and organizations, both in government and out of government, that are doing great work and to be able to kind of bring that together and say, ‘Oh, you’re doing that over here, I’m doing this over here, let’s get together and make this happen together’ has been really, really powerful.

And then on top of that, having the three branches of government approach, as well as county governments and local governments and members of the community, has really provided the backdrop so that when suggestions or requests go to the legislature, particularly around funding, we’ve seen tremendous success both in legislation passing as well as funding coming to really address those parts of the behavioral health system that we need to address right now.

So it’s made a material impact on moving forward in the system of behavioral health in the state. And in the last two years, it’s I would say stunning how much progress that we’ve made. We still have a long ways to go, but the progress we’ve made is really encouraging.

IR: Yeah, that ‘long waysto go still’ brings us to why I have you all here today. Stephanie, you work with the Attorney General’s Office. Can you tell us about the opioid settlement and what exactly the state of Idaho is getting out of it?

Guyon: Well, the settlement I would say began in August of 2021, when the Attorney General’s Office first signed on to the settlements involving Johnson & Johnson and the distributors, opioid distributors. And the purpose of the settlements is to provide injunctive relief for the state of Idaho to ensure that there is opioid remediation, and that the companies are respecting that, and also to provide funding for the state of Idaho to help combat our problems with opioids and achieve some remediation there.

And the pot of money, so to speak, continues to grow as additional ones are signed and payments are received through the years. This is not a settlement where we’re receiving all the money upfront. The companies are making payments on a yearly basis, in some cases more often than that. Our most recent settlements involve Teva Pharmaceuticals, Allergan Pharmaceuticals and the three pharmacies CVS, Walgreens and Walmart. And while those settlements have not been finalized yet, we did sign on to them.

Of course, we have achieved 100% participation by the local subdivisions and health districts and other entities throughout the state of Idaho. So we will benefit from the highest level of funds through that settlement and expect hopefully to get all of those completed and wrapped up this summer.

IR: For folks who have been in Idaho for a while, they might be familiar with something called the Millennium Fund, which is a fund that was set up from tobacco settlements in the nineties. That money is used for a variety of things, including tobacco cessation programs. Is this a similar type of idea? That Idahoans were harmed by opioids, so the state is going to use the settlement funds to help address that problem?

Guyon: It’s similar in that this is a statutorily created fund. The legislature set up the the opioid- It’s a statute, I can’t cite it right now. But that’s where all the money goes, into that fund, the money for the state of Idaho. And when I say the state of Idaho, I just mean the state. It’s the state, and not the local subdivisions, not the health districts, because they have their own separate distributions and funds. So although we have some experience dealing with the distributions with the subdivisions and health districts, primarily our office is concerned with how the state of Idaho’s money is distributed.

IR: The Behavioral Health Council is currently taking recommendations, taking public input about how this money should be spent. Can you tell me a little bit more about what exactly the Behavioral Health Council is looking for and what sort of comments from Idahoans would be most helpful?

Jeppesen: Logan, yes, I’m happy to do that. In statute, the Legislature directed that the Idaho Behavioral Health Council would provide recommendations to the governor and then to the Legislature through what’s known as the Joint Finance and Appropriations Committee, about how those opioid funds should be spent. And that’s I think a very healthy and a really good thing to do, is to have those from the behavioral health community provide input as to how these funds should best be used to, you know, to deal with and help those that have been impacted by the opioid crisis.

And so when that charge came to us as a council, our first thought was – as we’ve done all the way through our council process – is to reach out to all of the stakeholders, whether that’s providers or families or the community, government officials, to really say give us input on how you best think these funds ought to be spent. And so we’re in the middle of that process now. We’re asking for public input.

You can go to the behavioralhealthcouncil.idaho.gov website, and it’s very easy there to provide input on how you think these funds should be spent. You can also email IBHC@dhw.idaho.gov to provide that input. And we’re really looking for tangible ideas, practical things that relate to the opioid crisis and how these funds can best be used.

I’ll give you an example. In Idaho, we have recovery centers, and last year one of our suggestions was it really feels like a good use of the opioid money to help fund recovery centers. That’s a key part of helping people with opioid addictions. There’s many people out there that have personal experience, that have lived experience, that know what actions, what treatment courses. There’s medical assisted therapy, for example, that’s been proven as a good treatment for those with opioid addiction. And or, you know, what’s missing in the system of helping people with opioid addictions. And so we’re really looking for input from anyone who has an idea or suggestion of how these funds can best be used, to get those over to the Idaho Behavioral Health Council.

We’re going to review those in our meeting in August. And so over the next month here, month and a half, we’re really looking for input from the public on what they think of how that money could best be used.

IR: Stefanie, under the opioid settlements, the parties have outlined some acceptable uses for the funding, basically what sort of things they can be used on. Can you tell us broadly about those projects that the funding can be used for, and maybe give us some examples of things they couldn’t be used for?

Guyon: Sure. A high-level goal of all of these settlements is opioid remediation, and by that we mean ways that we can deal with the opioid crisis on a statewide level, a public level, as opposed to, let’s say, an individual level. And in order to achieve that goal, the parties reached out to experts and consultants to get a list of different ways in which states could achieve the best way to achieve opioid remediation.

And so we put together a 12 page list of all the different ways that funding can be used to help with the opioid crisis. And the list is extremely detailed and extremely broad, covering everything from research to actual treatment centers, law enforcement and the courts. So there are a lot of really good, really detailed ways that the state can use the money. And whenever we get a question about what can we use this money on, or ‘Can I use it for this?’ We always refer people back to what’s called Exhibit A, which is the list of appropriate ways to use the money, and to find something on that list to spend the money on. And it’s like I said, it’s really broad. Lots of ways to spend the money.

Ways that we would prefer people not spend the money, and may lead to problems later on… We’ve had requests from subdivisions about using the money to fund a drug dog program. And well, that’s a great program. Yes, it certainly needs funding. It’s not something that’s appropriate under the settlement, because it is not necessarily opioid specific and it is not remediation. It is more looking towards law enforcement goals, whether that’s finding individuals who are using drugs or promoting or selling. And we just don’t think that is part of what this settlement’s goals are.

Other ways that it can’t be spent. It can’t be spent for individual treatment. So if, and again, we get these requests all the time, about can the money be used to help me as a constituent go to treatment or get medical care or psychological care, whatever it is? And unfortunately, that’s something that the money can’t go for. It can certainly go to treatment clinics and other programs, but it is meant to benefit the public in general and not necessarily specific individuals.

IR: Sure. So we could use it to stand up a treatment clinic in my community, but I couldn’t get a grant to go to that clinic, for example.

Guyon: Correct.

Jeppesen: And Logan, I was just going to say that on the Behavioral Health Council website that we actually have a link directly to that settlement agreement, so people can reference that as they think about ideas.

IR: That’s very helpful, thank you. So it sounds like there’s a lot here in Exhibit A, in this list of possible uses for this money. Is the Behavioral Health Council looking for mainly just some help with prioritization and ranking of those priorities?

Omundson: So the approach that we’ve taken is that we really want to help the governor and JFAC to understand sort of those broad categories of where people are seeing the most need. For example, last year, one of the things that we looked at is we had a number of folks weigh in and say, look, we’re having trouble with housing people who have been struggling with addiction and are on the path to recovery, are struggling with housing. And so we looked at that and the number one recommendation that we had for the governor and for the legislature was please invest in housing.

We don’t get into recommending specific programs or specific dollar amounts. We’re really looking to provide that high-level guidance, that as a system, here’s where we see that there is a gap that needs to be filled. And so what we’re really looking for from the public in part is tell us what the highest need is. Help us understand, what is the highest need in your community? What is it that you think your community is missing that the state could invest in, that could rise everyone, the whole community up and work towards the remediation?

IR: All right. Well, if our listeners are interested in looking at these lists and submitting their own comments, they can visit BehavioralHealthCouncil.Idaho.Gov or send those comments to IBHC@dhw.idaho.gov – and Stephanie, the Attorney General’s Office has some information as well, don’t you?

Guyon: On the Attorney General’s page, it’s www.ag.idaho.gov and people can go there to see how much money has come into the state of Idaho. And if for some macabre reason, they want to read the actual settlements – which are hundreds of pages – they can. It’s available there, and then of course Exhibit A is available too.

IR: Court Administrator Sara Omundson, Director of Health and Welfare Dave Jefferson, and Deputy Attorney General Stephanie Guyon, thank you all so much for joining us this week.

All: Thank you.