Each week, staff at The Keene Serenity Center provide about 80 rides to people recovering from substance abuse through its Road to Recovery transportation program.
Recently, those trips have included taking someone to Boston for eye surgery, delivering groceries to someone who has health challenges and helping someone who hasn’t held a job in 10 years get to work every day, Sam said Lake, Serenity. The centre’s managing director.
Staying in recovery requires a lot of support, and “the transportation program is really a champion of that,” he said.
Demand for the Serenity Center’s transportation program has been increasing over the past few years, and it is currently at maximum capacity. Lake would like to expand it, but said the nonprofit has “a big funding hole for it.”
Now a $20,000 grant from Cheshire County will support the program. The money is part of opioid settlement funds being distributed across New Hampshire after state, county and local governments sued opioid manufacturers whose prescription and marketing tactics contributed to a widespread opioid use disorder in the state. New Hampshire has been one of the states hardest hit by the opioid epidemic, with 416 confirmed opioid-related deaths in both 2020 and 2021.
Eighty-five percent of the settlement funds go to the NH Opioid Abatement Trust Fund, a fund established in 2020 to distribute the settlement money throughout the state. Money from the fund is distributed through grants. The first round of grant funding has been awarded but not yet announced, said state Sen. Cindy Rosenwald, D-Nashua, chair of the Opioid Abatement Advisory Commission, which oversees the trust fund.
The other 15 percent of the funding goes directly to the 23 cities and counties, including the city of Keene and Cheshire County, which also joined the lawsuits. The money is allocated to each claimant based on its population.
To date, New Hampshire has received $46 million in settlement funds, according to NH Deputy Attorney General James Boffetti. Many settlements, including opioid manufacturers’ bankruptcies, are still pending, but Boffetti expects the state to receive about $310 million over the next 18 years. So far, Cheshire County has received $267,699 in settlement funding, while the city of Keene has received $115,729.
Although officials say the settlement amounts pale in comparison to the impact of the opioid crisis New Hampshire has faced, they provide much-needed money to address the decades-long crisis. In the Monadnock region, the impact of funds can be “subtle,” according to Cheshire County Administrator Christopher Coates.
“Ultimately, I think over time you’ll see we have a better-run system,” Coates said. “This additional revenue allows us to be much more proactive than we would be without the funding in place.”
Cheshire County provides five grants
Cheshire County will award five $20,000 grants to help address opioid use in the county, according to Coates. Three of the grants will go to county-run programs through the Cheshire County Department of Corrections, the Cheshire County Treatment Court and the Cheshire County Sheriff’s Office. The remaining two will go to the Serenity Center and Reality Check, a Jaffrey-based nonprofit that provides recovery and prevention services.
Sheriff Eli Rivera said he plans to use those funds for training for county law enforcement.
While there is existing training for law enforcement responding to opioid-related emergencies ranging from overdoses to people facing withdrawal, Rivera said the training often does not address the unique challenges rural law enforcement faces, such as the fact , that officers usually work individually. rather than in a team.
Additionally, many small police departments cannot afford to send officers to top-notch training that requires travel. Rivera said he plans to bring nationally recognized trainers to the county to alleviate that problem and make training more accessible to local departments. He is still figuring out the exact details of the workouts, he noted.
At Cheshire County Treatment Court, the $20,000 grant will be used for incentives and transportation for participants, according to program coordinator Alison Welsh. The court serves Cheshire County residents with a diagnosed substance use disorder who are facing legal charges related to their addiction. The participants plead guilty, but are not sentenced to prison. Instead, they are required to follow an individual treatment program established by the drug court. Gift cards, rental assistance and dental care are needed incentives that don’t have other funding sources, Welsh added.
“They encourage positive behaviors that work toward [participants’] recovery goals, such as completing levels of treatment and periods of sobriety,” Welsh said in an email.
To the Cheshire County Department of Corrections, grant funds will support an Opioid Use Disorder (MOUD) medication program at the county jail In Keene. This protocol, also called medication-assisted treatment, is clinically proven to help people enter and maintain recovery. The jail started the program in 2017, and today about half of the inmates participate in it, said Douglas Iosue, superintendent of the Cheshire County Department of Corrections. As of April 4, 49 of 102 inmates were in medication-assisted treatment, Iosue said.
MOUD comes with huge costs
In 2022 alone, the cost of medicine increased by about $10,000 because more inmates were on MOUD. In addition, administering the program cost the jail an additional $124,186 in personnel costs annually in 2021 and 2022, according to Iosue. The jail is considering hiring additional staff to run the program, he added.
Because of these high costs of medication-assisted treatment, the jail is applying for more grants, Iosue said. Along with other county departments of corrections, the Cheshire County DOC is preparing a grant application directly to the Opioid Reduction Fund, independent of the $20,000 in county funding.
The Opioid Abatement Advisory Commission voted in March to approve a round of grants to help offset the costs of medication-assisted treatment, according to Sen. Rosenwald. However, the detailed specifications for the grants, including how much DOC will be able to apply for, have not yet been finalised.
“It will help us fairly reimburse our costs, not only for the medication itself, but our additional staff time and travel time,” Iosue said.
Although the jail will not introduce any new programs with the funding, Iosue said the money will allow the DOC to “catch up” on the costs it incurs due to the ongoing opioid epidemic.
“The impact and the costs have increased gradually, and I think the fund will be helpful in reimbursing and helping to provide services and treatment related to that,” Iosue said.
2 nonprofit organizations looking forward to funding
While Coates said county funding will always be prioritized for internal county programs, the funding is also used to support local nonprofits.
“There are nonprofits hanging on by a thread,” Coates said. “We will do what we can to get the money out as quickly as possible.”
The county also deliberately keeps the administrative costs of these grants down. Tracking deliveries and accounting for every bit of money spent can typically eat up to a third of a grant, according to the Lake of the Serenity Center. But the county is only asking for a simple update on how the money was spent, allowing more of the dollars to be targeted to the programs they are meant to support.
At Reality Check, founder and CEO Mary Drew said funding will be used to strengthen the recovery coach program. These are professionals who meet with people in prison or in the community to help support and guide them through the challenges of early sobriety.
In addition, Reality Check will use some of the funds to provide employer training to help businesses retain and assist people with active opioid use disorder or who are in recovery. This initiative was particularly appealing to the county, Coates said, because of its widespread impact on the local economy.
“It intrigued us,” Coates said. “They work with businesses that have people who are employed but struggling with addiction, to keep them employed and work them through this moment in time.”
Zero-tolerance policies around substance abuse are ineffective, Drew said. Policies such as allowing people to attend recovery sessions during their workday can help retain employees and ultimately provide much-needed support for people with opioid use disorders and lower hiring or training costs for employers.
Keene is looking to hire a social worker for the police force
As a litigant in the cases, the City of Keene will receive a portion of the settlement funds directly. Like the DOC, the city also plans to apply for additional grants from the Opioid Confrontation Fund, City Manager Elizabeth Dragon said.
“The idea is to be able to combine with the state program to create a much larger impact, rather than using it when we get the smaller amounts,” Dragon said.
Recently, Dragon announced that Keene would like to use funds to add a social worker to the city’s police department. The social worker could follow up on calls involving opioid-related emergencies to connect people with resources and treatment.
“It’s really necessary,” she said. “There is a tremendous opportunity to integrate these services into the police department for the future.”
Still, planning for a new position is difficult given the uncertainty surrounding total settlement amounts and the one-time nature of mitigation fund grants, Dragon said. Although Keene does not receive state funding, Dragon said she plans to add a social worker position to the city’s fiscal year 2025 budget.
Dragon’s concerns about the availability and predictability of funding are shared.
“It’s one-time funding,” said Drew of Reality Check. “When we talk about one-off funding, it’s inadequate in the sense that we’re trying to sustain what we’re building, and it’s hard to sustain services without ongoing funding.”
For immediate substance abuse help, Cheshire County residents can visit The Doorway, a referral center at 24 Railroad St. in Keene. The door opening is open Monday to Friday at 8:00 a.m. to 5:00 p.m. Support through the state’s 24-hour hotline is available at 211.