Opioid settlement dollars will strengthen community mental health response to opioid use disorders

Medication-assisted treatment, Narcan, and recovery housing are some of the programs that could be funded through a nationwide opioid settlement agreement.
SUDs were a topic of discussion at the June 2023 CMHAM conference.If she had been offered a medication blocker such as Vivitrol when in jail, Ashley Markovich says she most certainly would have taken it. Vivitrol can help prevent relapses in alcohol and drug abuse disorders.
Ashley Markovich, Summit Pointe recovery coach.
“When I was in jail, most times that's when I wanted to change,” says Markovich, who is now a recovery coach for Summit Pointe, Calhoun County’s community mental health agency. “That's when my mind was the most clear. I didn't have the distractions of the world. That was when I was ready.” 

Medication-assisted treatment programs, Narcan kits, and recovery housing are just some of the programs that could be funded through a nationwide opioid settlement agreement. The State of Michigan is set to receive nearly $800 million over an 18-year period with the funds being split 50-50 between the state and county and local governments. 

“What I liked about what Michigan has done is it had a strategy before the opioid settlement money came,” says Robert Sheehan, executive director of Community Mental Health Association of Michigan. He noted  Michigan has been providing methadone since the 1970s and suboxone the past couple of years. Both of these medications are used to treat opioid use disorder.

CMHAM executive director Robert Sheehan addresses conference attendees. Increasing Accessibility

In 2022, Michigan created the Opioid Advisory Commission focused on substance abuse disorders and co-occurring mental health conditions. The commission has put together a detailed plan for the use of the state’s portion of the settlement funds following the guidelines established in the settlement, according to Jared Welehodsky, senior analyst, Policy and Strategic Initiatives Policy and Planning Administration, Michigan Department of Health and Human Services
Jared Welehodsky, senior analyst, Policy and Strategic Initiatives Policy and Planning Administration MDHHS.
“Our state has a statewide strategy that we're focusing on prevention, treatment, harm reduction, retaining, and recovery,” Welehodsky says. He adds that these are the guidelines set forth in settlement. “The guidelines are not all encompassing, because if it’s not in there, it does not mean you can’t spend the money on it. But it gives communities pretty strong guidelines as to what type of programs are part of the expectations for how these dollars can be used.”

For the 2023 fiscal year, Welehodsky says that the state’s biggest expense will be on naloxone (brand name, Narcan). Other state initiatives include increasing staffing, expanding facilities, and improving transportation for better access to clinics and treatments. There are also plans to partner with the Michigan State Housing Development Authority on recovery housing programs and the Michigan Department of Corrections to expand treatment capacities in the jails.

Welehodsky says because of litigation with Ottawa County – the county questioned how much money it was receiving, and the case was dismissed earlier this year – some things were delayed, but funding is starting to roll out and communities will begin to see the impact from the state funding.

The litigation also delayed the funding to county and local governments, which are making plans for their 2024 fiscal year. To help with that planning, The Michigan Association of Counties has put together a template designed to aid county leaders in thinking through what would be best for their community. 

Another key asset to county governments are the prepaid inpatient health plans, which manage Medicaid mental health, developmental disabilities, and substance abuse services in Michigan.

“We've been urging the counties to work with them, because those organizations have been purchasing substance abuse treatment — well they have been the predecessors for 50 years,” Sheehan says. “They really know treatment and prevention, and they know the opioid world.”

Robert Sheehan, CMHAM executive director, addresses conference attendees.Filling gaps, breaking down barriers

About 18 months ago, Summit Pointe started a jail initiative funded through MDHHS Boundary Spanner grant. The program fills the gap for people with mental health and/or substance abuse disorder needs who end up in jail by connecting them to services after they are released. 

While still new, the jail program has seen success. From April 1 - June 16, 2023, the program screened 774 inmates, contacted 178, and connected 128 of them to services. Taneisha Pointer is clinical advisor and boundary spanner for Summit Pointe’s jail initiative. 
Taneisha Pointer, Summit Pointe clinical advisor.
“Summit Pointe has been super innovative with coming up with ideas on how we can remove barriers for people to access treatment and access it right here, right now. right away,” Pointer, says. “Having that availability and being able to touch the specialty courts, the jails, the shelters, and all of the different areas along with going to people's homes is helping to remove some of those barriers and lets people know that there is access to care.”

Community mental health organizations such as Summit Pointe offer a range of substance abuse disorder programs. Along with its intensive outpatient program (IOP), Summit Pointe has Opioid Home Health, which connects a person with a recovery coach who can help the individual through the barriers they are facing.

To help fill gaps in services, Summit Pointe started an overdose response program partnering with LifeCare Ambulance for the Marshall and Albion areas. Markovich receives a list from LifeCare with staff going out into the community to work with those needing support.. 

Continuing to remove barriers to access is the goal, Pointer notes, Both she and Markovich state that they would like to see expanded medication-assisted treatment programs and more recovery homes.

“If you can get into a sober living environment from jail that would be like a 10-stars score in helping to keep you in or engaged in recovery and engaged in service,” Pointer says.

St. Clair Community Mental Health reception area. Linking  people to services

Research has shown that medication-assisted treatment “significantly increases a patient’s adherence to treatment and reduces illicit opioid use compared with non-drug approaches.” To help increase access to medication-assisted treatment, St. Clair County Community Mental Health (CMH) added a substance abuse disorder program about five years ago to complement its co-occurring disorders programs. The SUD program offers individual and group therapy, case management, a medication-assisted treatment program, and most recently started a recovery court — a diversion program with the 72nd District Court

Marocco says that they have seen a lot of success in the recovery court program. It has helped divert people from jail to treatment along with offering medication-assisted treatment programs and connections to community partners who have worked hard to provide easy access to Narcan kits. Because of the increased number of Narcan kits in the community, the Portland Police Department recently reported having seen fewer overdoses than this time last year. 
Kathleen Gallagher, St. Clair CMH program director.
St. Clair County has allocated some of its opioid settlement money to a Mobile Overdose Response Program, overseen by Odyssey House. St. Clair County CMH program director Kathleen Gallagher is part of a community committee made up of organizations that, like St. Clair County CMH, have been working on substance abuse issues and will make recommendations to the St. Clair County Commission.

More recovering housing for rural St. Clair County is on Jason Marocco’s bucket list. Marocco, is the assistant division director for adult services at St. Clair County CMH

“The closest one to us is Sacred Heart,” he says. “It is on the border of our county and Macomb County and is about 30 miles away.”

Distance is not the only barrier. Due to a shortage of these residential facilities, people in need of services have a wait time of three to seven days. Gallagher notes that this can be a critical period as a person has a high potential to overdose during that time frame.

“Trying to patch people through until they get treatment is always a race for us,” Gallagher says. “Getting people linked quickly to services is always a key to success.”

Joanne Bailey-Boorsma has 30-plus years of writing experience having served as a reporter and editor for several West Michigan publications, covering a variety of topics from local news to arts and entertainment. 

Photos of Community Mental Health Association of Michigan and Robert Sheehan by John Russell.
Photo of naxolone by Steve Koss.
Photos of Kathleen Gallagher, Taneisha Pointer, and Ashley Markovich courtesy Summit Pointe. Photo of Jared Welehodsky courtesy Michigan Department of Health and Human Services. Photo of St. Clair Community Mental Health courtesy St. Clair Community Mental Health.

The MI Mental Health series highlights the opportunities that Michigan's children, teens, and adults of all ages have to find the mental health help they need, when and where they need it. It is made possible with funding from the Community Mental Health Association of MichiganCenter for Health and Research TransformationGenesee Health SystemMental Health Foundation of West MichiganNorth Country CMHNorthern Lakes CMH AuthorityOnPointSanilac County CMHSt. Clair County CMHSummit Pointe, and Washtenaw County CMH.
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