Funding Delay Stalls Bexar County’s Efforts to Aid Opioid Abusers

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A hypodermic needle lays on the ground near a cleanup site. Photo by Scott Ball.

Scott Ball / Rivard Report

A hypodermic needle lies on the ground near downtown San Antonio.

State and federal officials, including President Donald Trump, have called fighting opioid abuse and addiction a national priority, yet Bexar County is still waiting to receive $3 million in state funding to fight the epidemic on the ground.

Funding awarded in October 2017 will be used to train first responders to administer naloxone, a drug used to reverse opioid overdoses, and increase access to the life-saving drug throughout the city. But bureaucratic delays have left local officials waiting for the money to be released.

San Antonio Metropolitan Health District Director Colleen Bridger said members of the Joint Opioid Task Force are “frustrated that it has taken so long to actually see that money.”

The task force is a collaborative effort between the City and County to combat the opioid epidemic, which Trump declared a public health emergency on Oct. 26, 2017.

“The longer that local governments have to wait for the distribution of funds for opioid-related grants, the more difficult it is to implement strategies on the local level,” said TJ Mayes, chief of staff for Bexar County Judge Nelson Wolff.

More than 42,000 Americans died from a drug overdose in 2016 alone, according to the Centers for Disease Control and Prevention (CDC). For the first time, deaths linked to opioids have surpassed gun homicides, according to CDC data.

Bexar County has the third-highest per-capita rate of overdoses in Texas and leads the state in the number of infants born with opioid withdrawal symptoms.

The task force’s four-year grant was made possible through the Comprehensive Addiction and Recovery Act (CARA), signed into law in July 2016 by President Barack Obama to expand access to drug addiction treatment and overdose reversal drugs. It also includes related reforms in criminal justice and law enforcement. CARA provides $181 million each year in new funding to fight the opioid epidemic.

Bridger said that the 30-plus members of the opioid task force remain “optimistic that eventually [they will] be able to start the work of the grant.” She added that training and planning already are underway so officials can implement the initiatives once “all the barriers to accessing those funds have been removed.”

UT Health San Antonio Professor Lisa Cleveland, who will administer the grant, told the Rivard Report that while Bexar County has received a verbal commitment from the Texas Health and Human Services Commission to deliver the funds, there’s no contract yet for release of the $3 million.

The Texas Health and Human Services Commission receives addiction and recovery act funding from an agency within the U.S. Department of Health and Human Services (HHS); the state agency then distributes the money to recipients at the local level.

“They’ve been slow getting it out of their contracts department,” Cleveland said, noting that such delays are common. “[As] soon as we have a contract we can begin spending the money.”

But without funding, the task force’s efforts are a standstill. Members can continue planning, Cleveland said, but cannot begin purchasing training materials and equipment, including supplies of naloxone, until they receive a contract.

“So far we are on the right track [with planning], but the State does need to get the contract executed soon,” Cleveland said.

State HHS officials said they were unable to comment on why the grant funding has been delayed.

While funding for already-existing grants to combat the opioid epidemic are stalled, on March 1 the Trump administration announced a funding proposal that included $13 billion to be distributed by HHS for programs and media campaigns aimed at those at risk of opioid abuse and addiction. Of the funding, $3 billion would be distributed in 2018, and $10 billion in 2019.

Mayes explained that delays in receiving federal grant funding could be minimized by allowing local governments to apply directly for federal money instead of having to go through the State.

He said that making changes in the funding procurement process to allow a quicker turnaround in receiving funding is a “key federal legislative priority for the [opioid] task force.”

“As we enter the upcoming legislative session, we hope that the Legislature will look at this process,” Mayes said, noting that the process as it stands now is “lengthy.”

The opioid task force is made up of more than 30 public health experts, medical and pharmaceutical professionals, first responders, policymakers, public school district representatives, and social services agencies.


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