Three opioid projects forwarded to county board

FACILITATING HELP

I would argue that getting people connected to services is almost more important than the therapy itself. We’ve got people, literally, on the streets not accessing services.”

Ginger Knisley, Lee County Supervisor

LEE COUNTY – A panel that recommends spending of the county’s opioid settlement money is pushing three proposals that are part of the new Meller Family Health Center to supervisors.
The Lee County Opioid Committee reviewed three new applications at a meeting Wednesday afternoon in the Lee County Board of Supervisors' room in Fort Madison.
The applications considered were for an ADDS counselor on site for four hours a week, a counselor from Counseling Associates on site for six hours a week, and a $300,000 contribution to the MFHC to help pay for space the other two counselors would access at the new facility once it opens.
Revenue in that county’s fund comes from national settlements with opioid manufacturers, distributors, and marketers. The state of Iowa gets lump sum payments as part of the national opioid settlement trust and half of that money, minus a ‘backstop fund’ that compensates attorneys for work on behalf of the governmental agencies, goes to local governments.
Lee County gets about 1.48% of the local government share based on a formula that includes data sets from crime and prescription use in the county. All counties in the state, with the exception of Davis County, are participating in the settlements.
However, spending the money has proven to be a little tricky as the trust outlines some specific ways the funds can be spent limited to specific opioid abuse abatement to include medical assisted treatment, neonatal and pregnancy addictions, incarcerated populations,  and the programs that connect people to treatment, shelter, and transitional services.
The county has committed $155,000 in funding for the Talbot House in Keokuk as the only real spend out of the fund. The county had given $230,000 to the EMS department when a new structure was put in place in Keokuk for hiring and training, but that money was reimbursed to the opioid fund on a recommendation from the state auditor’s office.
The fund currently has $673,000 with $350,000 of that invested in CDs at the county’s direction.
On Wednesday, Dan Kenel, director of ADDS of Southeast Iowa, talked about his grant application that would not only put a counselor on site at MFHC one day a week, but would help keep an ADDS counselor involved in the adult drug court.
“We’ve done that for the past several years using a grant from the State of Iowa and that grant is set to go away next week. The funding we would apply for here would cover that counselor’s time to continue that on Thursday afternoon,” he said.
He would also be sending a peer recovery coach to the MFHC one day a week that would not cost the county any funding.
Lee County Health Department Administrator Michele Ross said that counseling and peer support services are something that was identified strongly in a recent community health needs assessment.
“It’s definitely needed. These kinds of services offered in the Fort Madison area came out very strongly when we did the opioid community health assessment. We surveyed lots of people with lived experience and they thought shortfalls were there was nothing in Fort Madison available,” Ross said.
The application from Counseling Associates would dedicate six hours per week to coordination of services and outreach to those struggling with opioid and co-occurring substance abuse issues.
Counseling Associates CEO and Executive Director Mike Maher said he envisioned the new partnership as a central point of coordination to reach those in the county who are looking for assistance. He said counseling wouldn’t be done on site, but the staffer dedicated to the hours would help get the message out about where help is and help coordinate the connection.
The final application is from Lee County for funding for a contribution to MFHC on a square footage basis for the space that would be shared with ADDS and Counseling Associates. That amount is based on a shared space of just over 650 square feet or about 4% of the 13,500 square foot
Maher said he wasn’t looking at providing treatment on site, but more to become a central point of coordination where people could get connected to resources.
“My thought is a couple things. One, that we have a person there a couple times a week that provides assessment, an information source, does education training, and can even be out and about making people aware of the resources,” he said.
“We will know it’s there, but someone out in the county may not know where this opioid resource is or how to access it.”
He said having the person on site at the health department also reduces the stigma of going into a counseling service center. He said a lot of people access the Health Department and people don’t have the same assumption there as they do a counseling center.
Donna Amandus, one of the committee members, questioned the amount of one-to-one service that the applications are asking for.
Maher said he can’t see his staff doing actual counseling there.
“Ok, so we’re not counseling. That’s my worry is that we’re going to put a whole bunch of money into this and people are going to feel, I mean we’ve got a lot of money,” she said.
“I assumed for this $300,000 that we were paying for a counselor, but we are not supplying any counseling services through the county. So to me, we’re renting a small office for $300,000. That seems a little exorbitant.”
She said her thought would be to hire more counselors. Maher said it would be difficult to counsel on site because then you would have two different entities and there could be concerns about HIPAA regs and protecting records.
Supervisor Ginger Knisley said the investment is a start and is a one-time investment into the building for a program that could go 15 years or more.
“I would argue that getting people connected to services is almost more important than the therapy itself,” she said. “We’ve got people, literally, on the streets not accessing services.”
Maher said the therapy itself will likely be paid for through insurance or private pay, but the key to the program is creating awareness about the connections the county is trying to provide in Fort Madison.
The panel approved all three applications as recommendations to the Lee County Board of Supervisors at the board’s next meeting Oct. 7.