Noble County Commissioner Allen Fraley says the opioid epidemic threatened the fabric of his rural eastern Ohio community.
“You couldn't go to a football game. You just couldn't go to church. You couldn't go to an ice cream social without knowing somebody's whole family was hurting,” Fraley said.
Through various lawsuits against opioid manufacturers, Noble County has received a little over $100,000 over the last three years to tackle the issue. It’s not enough money to build a brand new jail diversion center, like Cleveland did. Or to hire an addiction coordinator, like they’re doing in Cincinnati. Still, Fraley sees it as a once in a lifetime opportunity to repair some of the damage.
“We really need any money we get to be as impactful as possible,” Fraley said. “How can we pull this off?”
It’s a question many of Ohio’s small cities and counties are asking themselves. Over the course of 18 years, Ohio and its communities are receiving about $2 billion from pharmaceutical companies to compensate for harm caused by opioids.
For smaller Ohio communities, the payouts don’t come close to the millions heading to the state’s major metros. So, Ohio’s rural areas are strategizing on how they can make the most out of what they have.
Leveraging what’s already there
There are plenty of opportunities to aid Ohioans with substance use disorders that don’t require a lot of money, according to Kristen Pendergrass. She works with Shatterproof, a national nonprofit that’s working alongside John Hopkins University to help communities spend their opioid settlement money on evidence-based practices.
Pendergrass said small areas, like Noble County, should focus on strengthening local programs that already work, instead of starting from scratch.
“If you know that you already have an organization that's doing good work, that you want them to do more of that good work, then that could be a way to just tap into what's already happening,” Pendergrass advised.
To figure out what’s actually working in the community and where the biggest needs are, Pendergrass said communities have to ask. She suggested putting some money toward conducting a comprehensive community needs assessment.
Some places, like Knox County in north central Ohio, have formed focus groups of schools, law enforcement and healthcare providers to ensure every dollar of settlement money goes to addressing a real problem.
“Before we even had any idea of what our focus would be, we had group meetings [where we asked] in an ideal world, what would we have for the jails, what would we have for the schools? What would we have for the community?” said Lisa Lloyd, who helped lead Knox County’s settlement advisory board.
Working together
Still, not every community has the infrastructure in place to manage these funds on their own. Lima mayor Sharetta Smith said the small northwest Ohio city lacked the capacity to divvy out their dollars independently.
"The need is always greater than the resources that you have."Sharetta Smith, mayor of Lima
“I don't have a health department or a direct department that can provide the direct services that these dollars were calling for,” Smith said. “And so rather than looking to build that infrastructure, we looked to collaborate with another entity.”
Lima pooled resources with Allen County, which hosts the area’s public health department. Combined, they’ll be receiving more than a million dollars over nearly two decades to spend on programming that benefits them both.
Plus, they’re being careful that the projects they do fund will be sustainable in the long-term.
“These are one-time dollars,” said Allen County commissioner Beth Siebert. “We cannot build a program off of this because if we did, we would have to sustain it with our general funds.”
Making the most of the money
It doesn’t take a large investment to make an impact, Pendergrass said. Even small purchases, like buying fentanyl testing strips or creating care packages for Ohioans in recovery, can go far.
“Those things are not expensive, but they can make a big difference in just making someone's life a little easier and reducing the stress so that they don't return to use,” she said.
In Noble County, Fraley said they’ve already started spending what they can. Some of it has gone toward increasing prevention programming at their schools. Some has gone toward improving the court system. The rest is being placed in a rainy day fund to save for something bigger.
Places like Noble County have at least one advantage, Fraley said. They’re practiced in making ends meet.
“We're doing our best with what we have,” Fraley said. “It just may not be the Taj Mahal.”
