Managing The Push And Pull On Fiscal Resources During The Opioid Crisis
Managing The Push And Pull On Fiscal Resources During The Opioid Crisis
By National Association of Counties
Challenging Fiscal Factors in Rural Counties
Rural counties in America are making progress on the ground level in the fight against opioid addiction, but the costs have been high and are mounting. Counties work on the frontlines to advocate for and protect the health and safety of residents affected by the opioid crisis. Counties directly experience the human toll and shoulder a large share of the costs required to respond to the crisis. They deliver key prevention, treatment, and recovery resources for SUDs through local agencies, as well as public safety resources and emergency first response teams. Due to the increased demand for services resulting from the opioid crisis, local governments are acutely feeling the strain on resources, from a shortage of hospital beds to overworked foster care systems and overcrowded jails.
As a result, local governments are struggling to contain the scope and costs of the opioid crisis in their jurisdictions and provide adequate addiction response and recovery support services. Not surprisingly, handling the different challenges that flow from the opioid crisis is straining county resources. The national opioid crisis has been playing out most markedly in remote, rural areas, which presents a challenge for healthcare providers already hindered by rising healthcare costs. In rural counties the costs can be attributed to services surrounding overdose deaths and burdens to the criminal justice system.
Reducing Costs in Rural Communities
Leaders in county and city governments are exploring innovative strategies to address the fiscal strain of dealing with the ongoing opioid crisis. In 2016, Boulder County established an Opioid Advisory Group in Colorado to improve the community-based response to the crisis through coordination across county medical providers and law enforcement officials, and in tandem with harm-reduction and faith-based organizations in the county. In the two years since the group’s creation, the county reported a 36 percent decrease in opioid prescribing at the county’s largest hospital and 191 lives saved by naloxone administered by community members and law enforcement.
Other locally-led programs are meeting patient needs on an individual level. In New Jersey, Ocean County launched the “Recovery Coach Program,” a voluntary initiative connecting individuals who are revived by naloxone with treatment options once they are stabilized in emergency rooms. In cooperation with local hospitals, the program matches overdose victims with recovery coaches. If the patients are willing, coaches provide mentoring for up to eight weeks and help guide them toward recovery. Treatment is free or partially subsidized for those willing to participate. Program coaches are often working through the recovery phase of addiction themselves and can add a valuable perspective to the individual’s recovery.
Local leaders are finding resourceful and impactful ways to confront the opioid crisis in their jurisdictions thereby helping to relieve the strain on local services. However, as the Nation seeks to bring an end to the crisis, cities and counties recognize that these efforts are more effective when carried out in, partnership with State, Tribal and Federal counterparts. The National Association of Counties has been working diligently toward this goal in recent years with intergovernmental partners to emphasize the importance of expanded prevention, treatment, and recovery resources. They are also identifying policy recommendations for Federal, State, and local officials that could maximize the intergovernmental response to opioid overdoses and deaths.