Illustration of a gavel made of pills and coins. (Credit: Daniel Fishel / Spotlight PA)
Pennsylvania expects to receive more than $1 billion in opioid settlement money. Decisions made by a powerful and secretive oversight board could set a precedent for years to come.
A review of hundreds of decisions made by a powerful state oversight board sheds light on how Pennsylvania counties will be allowed to spend hundreds of millions of dollars from opioid settlements.
Money for coroner offices? Yes. The board in June reversed its earlier rejection of Lawrence County’s decision to spend $25,000 to support its coroner’s office.
Funds for Kensington residents? No. Members rejected using $7.5 million for a plan focused on improving the quality of life in an area that Philadelphia city government described as “widely known as the epicenter of the nation’s overdose crisis.”
Syringe services? Yes, at least in Allegheny County.
Probation and parole? No, in at least some cases.
The Pennsylvania Opioid Misuse and Addiction Abatement Trust has the power to withhold and reduce funding if it decides counties spent money inappropriately. The secretive actions of the 13-member oversight board have made it more difficult for the public to influence the process or understand the rationale and legal justification behind many of the trust’s decisions.
But these early decisions could have an influence for years to come, which trust member Kevin Boozel acknowledged.
“We’re being looked at as we’re setting a precedent,” Boozel, a Butler County commissioner, told Spotlight PA.
A review of the trust’s most recent actions, as well as its statements and practices going back more than a year, helps show what the precedent is.
Some programs are still awaiting a final decision from the trust, and counties with rejected strategies have options. They can appeal to a newly approved dispute resolution committee of the trust. The chair of the trust, Tom VanKirk, says that committee will have public meetings, unlike the groups that reviewed spending reports and created recommendations for the full board.
Counties can also appeal to Commonwealth Court, VanKirk said. He declined to answer questions after the June meeting.
Here’s what you need to know about some of the more controversial, scrutinized, and debated spending issues.
Kensington residents
The trust in June voted to reject Philadelphia’s use of $7.5 million to support residents of the Kensington area.
Philadelphia dedicated money for home repairs, rental assistance, park and school improvements to ensure children and families can safely access those spaces, and other initiatives. It argued that residents “live in a state of constant, compounding trauma due to the intense concentration of open-air drug markets that operate 24/7,” which could lead to long-term health problems.
Multiple trust members expressed support for the programs, but said funding them didn’t align with Exhibit E, a legal document that broadly outlines what spending is permitted.
“Nobody doubts the fact that … Kensington needs these things, and we’d love to see Philadelphia be able to fund it,” VanKirk said. “But we just can’t feel we’re fulfilling our responsibilities and allow these kind of things to be paid for out of opioid funds.”
Tumar Alexander, a member of the trust and senior adviser to Philadelphia Mayor Cherelle Parker, told people listening to the meeting from Kensington not to be discouraged, adding that there are “pathways for us to sort of dispute and appeal.”
“But there’s also conversations around how we want to fund this — and our commitment, and Mayor Parker’s commitment to continue to fund this,” he added.
Alexander and a spokesperson for the mayor declined further comment after the meeting.
Exhibit E does not specifically mention funding resident support in neighborhoods impacted by the opioid epidemic.
The trust also is still considering dozens of specific initiatives in Philadelphia that are part of a $3.5 million portion of an overdose prevention and “community healing” program.
Coroners
In May, a trust vote deemed Lawrence County’s use of $25,000 in opioid settlement funds to support its coroner’s office as noncompliant. In June, members reversed that decision.
Some advocates for people with substance use disorder told Spotlight PA they were concerned funding for coroners’ offices would ultimately help district attorneys prosecute people accused of providing drugs.
People charged with drug delivery resulting in death can face up to 40 years in prison. Over the most recent five-year period, there were more than 1,100 such offenses filed on criminal cases statewide, state court data show.
During a discussion of coroner spending, VanKirk said “it was pointed out that the tests really were being used not for law enforcement purposes, not for use in a court setting,” and instead to identify exactly what was causing the drug overdoses and ultimately save lives.
But in a funding request obtained by Spotlight PA, Lawrence County’s coroner said the information would be valuable to “law enforcement and key stakeholders.” Officials in other counties using opioid settlement money for coroner offices acknowledged the variety of ways information can be used, including for prosecution. The trust also approved coroner programs in Lehigh and Mercer counties.
A working group recommended the trust continue evaluating a Chester County coroner program. Latika Davis-Jones, a trust member and secretary for the Department of Drug and Alcohol Programs, suggested the final recommendation will likely “be consistent with” the other counties.
Exhibit E does not specifically mention funding coroners’ offices.
Probation and parole
The trust rejected at least two programs related to probation and parole: nearly $323,000 for a Blair County drug court program and $200,000 for a Bucks County drug court probation officer program. Some other programs await a final decision.
A “probation officer strikes us as a police-related use of the money,” VanKirk said during the June meeting.
The trust did approve $250,000 for an expanded drug testing program that Chester County said was managed by its adult probation office.
Exhibit E does list funding services for people on probation or parole as allowed, but it does not specifically address salaries for probation officers or drug testing people under court supervision.
Policing and prosecutors
The trust’s public guidance warned against funding “policing activity.” In May, it rejected Lawrence County’s use of the funds for a district attorney office program and for a local police department.
Lancaster County recently withdrew its plan to use nearly $85,000 for a community prosecutor program.
Exhibit E lists addressing the needs of people involved in the criminal justice system as allowable, but it does not specifically mention funding prosecutors.
Public defense
The trust last year publicly warned against using opioid settlement money for an assistant public defender.
Following reporting by Spotlight PA, the Public Defender Association of Pennsylvania’s executive director — who was concerned the trust’s guidance might prevent spending on both public defenders and related office needs, such as social workers — said the group reached out to the trust requesting it reconsider and clarify the issue.
At a trust meeting in May, VanKirk reiterated that funding a public defender would not be allowed. But he suggested social workers and certain programs of public defender offices might be.
In the reports that required trust approval, counties did not describe spending money on public defender positions, a review by Spotlight PA of available information found. That meant the trust wasn’t forced to vote on formally approving or rejecting that use during its May and June review of spending reports.
Sara Jacobson, the association’s executive director, told Spotlight PA she thought parts of VanKirk’s comments were unclear, and if the trust will allow counties to fund public defender social workers with settlement money, it should clarify the public guidance on its website. She also still believes the trust should reconsider its guidance against funding public defenders with settlement money.
Exhibit E lists addressing the needs of people involved in the criminal justice system as allowable, but it does not specifically mention funding public defenders.
A recent lawsuit from the ACLU of Pennsylvania cited Spotlight PA’s reporting on opioid settlement money, as the organization described how indigent defense is often excluded from state and federal funding.
“For example, while district attorneys offices have received millions of dollars from the state’s opioid settlement fund, public defenders in counties ravaged by the opioid crisis have had their requests for funds denied,” the lawsuit said.
Syringe services
The trust in May approved Allegheny County’s use of $325,000 to support access to sterile syringes and other supplies for safer drug use — despite objections from state Sen. Greg Rothman (R., Cumberland), a trust member.
Exhibit E does list expanding syringe services as one of the core strategies for settlement money and the programs have support from leading medical groups. But the services are widely considered illegal in most of the state because of Pennsylvania’s definition of drug paraphernalia.
“While I agree that that’s allowable, I don’t think it’s good public policy,” Rothman said.
VanKirk described syringe services as “a difficult question,” saying trust members “are not encouraging anything that would violate state law.” But he acknowledged actions by officials in Philadelphia and Allegheny County, citing their own public health powers, to allow these programs.
Media campaigns
The trust in June approved multiple media and public education campaigns, after first requiring more information about them. The list includes $300,000 Allegheny County dedicated for a public education campaign.
“While anyone in Allegheny County can be exposed to elements of this media campaign, 100%
of the content is related to opioid use,” the county wrote in a response to follow-up questions from the trust.
Exhibit E does specifically allow funding for media campaigns to prevent opioid use and misuse.
What wasn’t reviewed?
Many decisions — involving millions of dollars — are currently not receiving public oversight and scrutiny by the trust.
As Spotlight PA and WESA reported last year, the section of the court order creating the trust that specifies that counties must file annual reports doesn’t mention other local government agencies that are receiving funds based on their role in litigation, including 10 district attorneys offices. But another section of the order says counties and those other local agencies can be penalized if they misspend money or don’t file an annual report.
A spokesperson for the state attorney general’s office in February told Spotlight PA and WESA the office intended to amend the order and clarify the requirement for local agencies.
But for the most recent reporting period, the trust encouraged, but did not require, those places to file the spending reports. The trust did not publicly review the reports that were voluntarily submitted. Records obtained by Spotlight PA and WESA show some county district attorneys offices chose to use settlement funds for deputy or assistant district attorney positions.
Under the order creating the trust, money controlled by the legislature and governor is not covered by the type of annual reporting requirement that counties have.
Kate Giammarise of WESA contributed to this article.
