CLEVELAND, Ohio – Cuyahoga County Executive Armond Budish’s second request to use $10 million in opioid settlement money to help develop innovative ideas for addressing addiction again met resistance on Tuesday.
Council’s Budget and Finance Committee liked the idea in theory and seemed eager to try new strategies to combat opioid addiction amid the county’s ever-rising drug deaths, but members struggled to overcome the price tag with virtually no guarantee of returns.
When the initiative seemed likely to fail, Budish asked to speak privately with the committee, which returned with an amendment to cut county’s investment in half. Ultimately, the committee unanimously approved appropriating $5 million for the innovation fund, with hopes that private investors will partner with the county to match it.
The county must do something to stop the opioid crisis, Budish urged, because traditional methods haven’t proven as effective as hoped. He agreed with Councilman Jack Schron, who has been the plan’s primary supporter, that Cuyahoga County has an opportunity to lead real change.
“Jack has put it best. He said we’ve been the center of the opioid crisis, we should now be the center of the opioid solution, and the solution is not just continuing to treat people,” Budish said. “(Treatment is) critical, we’re putting $100 million into that, but to put $10 million into trying to come up with an answer so that we don’t have to keep putting hundreds of millions of more dollars into beds and treatment is, I think, a very wise approach.”
If approved by the full council, next week, the money will be pulled from the county’s opioid mitigation fund and placed into a new account to be managed by an outside agency at the direction of an independent governing board made up of industry experts.
Officials have repeatedly used the Cleveland Foundation as an example of who could manage the funds, but transferring the money would require a contract and a separate stamp of approval from council. Members indicated Tuesday that the county still has a high bar to clear before that happens.
The goal of the initiative is to invest in promising technology or systems for preventing or treating opioid addiction. Budish had John Nottingham, co-president of Nottingham Spirk, and Michael Gibbons, founder and managing director of investment firm Browns Gibbons Lang and Company, attend the meeting and give two examples of what those new technologies might look like.
Nottingham is investing in what he described as a medication dropbox developed by MIDAS Healthcare Solutions that would destroy any unused medication to prevent it from getting back into the community. Jeff Wahl, president and cofounder of MIDAS, gave numerous examples of drugs being stolen or abused by medical health professionals, and said his technology could help prevent that.
Gibbons said he funded an addiction clinic that used a treatment method “generally regarded as safe” to help eliminate addiction cravings. The venture ultimately failed because of trouble finding patients for a practice not yet approved by the U.S. Food and Drug Administration, he said, although the treatment method was working.
Budish spoke of two other innovations in the works that use hypnosis or virtual reality goggles to prevent addiction and treat pain without opiates.
He asked council not to get hung up on the potential projects presented, noting they’re meant to be examples of the types of innovation underway. The actual projects to be funded would be decided by the advisory board — but Councilwoman Nan Baker, in particular, was unimpressed. She rejected using any funding for enforcement efforts such as MIDAS’ drug diversion prevention machines in hospitals, which she said is the industry’s responsibility and should already be occurring.
Other councilmembers had their own concerns.
Councilman Michael Gallagher said he will need a commitment from the private sector to partner with the county on funding these projects before he approves them, fearing it might take away from funding for recovery beds he said were proven to work when he was battling an unidentified addiction himself.
“I’ve lived it. I survived it.” Gallagher said, later becoming emotional as he recalled some of his own experiences.
Councilwoman Cheryl Stephens agreed with the need for private investment, but added she’s also interested in knowing if the investments might be able to generate income for the county down the road.
Councilman Scott Tuma wants to know how the county plans to track the success of the programs and who would be selected for the advisory board governing them. The county has said that the board will be comprised of experts from the medical field, community representatives and those with personal experience with addiction, either themselves or through a family member, but has not suggested who that might be.
“I know you’re asking us to put a little faith into what we’re voting on, I would just like more concreteness in the plan,” he said.
Council was just as skeptical of the idea when Budish first proposed the fund in June, but members are becoming increasingly aware that they need to decide how to spend the county’s $117.5 million in opioid settlement funds, about $98 million of which remained at the end of August.
Schron said he’s confident that the county’s investment will attract more funding and partners, but members need to believe in the idea first. Every year, the county gives tens of millions of dollars to the Alcohol, Drug Addiction and Mental Health Services Board for treatment efforts, he said, yet addiction rates and deaths continue to climb.
If the county doesn’t attempt to break the cycle on the front end, through prevention strategies, then Schron predicts the county will drain its settlement dollars and “have nothing to show for it.” The innovation fund accounts for a small portion of the overall dollars, and he believes it could end up having the biggest impact.
“There’s no question that this is something different,” Schron said, “but are we getting any closer, with spending the $110 million on treatment, than where we are today? I don’t think so.”