Concerns about opioid funding decisions discussed at Stanly health board meeting

Concerns about how opioid funding is spent and who decides where the money goes came up at this month’s meeting of the Stanly County Consolidated Health Services (CHS) board.

County Commissioner Peter Asciutto mentioned local funding of Gateway to Hope, an opioid addiction recovery facility, to illustrate from where the health department’s frustrations have been coming.

“My concerns were twofold. The first concern was that, as county commissioners, we were not getting the proper information that the health department staff had concerns about recommending the funding,” Asciutto said. “The second concern is the pressure and frustrations of the health department staff who are doing the best they can to make decisions for us to follow opioid guidelines. I feel the staff is getting pressure from the county manager to make decisions he is in favor of making, which he wants to present to the Board of Commissioners.”

Gateway to Hope was scheduled in August to receive $63,600 from the county’s opioid settlement special use fund. Asciutto said he asked County Manager Andy Lucas about who made the recommendation to approve the funds.

According to Asciutto, Lucas told him health department staff had made the recommendation. Asciutto further asked if they had objections to the recommendation, which Lucas said they did.

The commissioner said it was Lucas who made the recommendation for the August meeting for the contract to be approved.

However, the board tabled the recommendation to the September commissioner meeting, two days before the CHS meeting. In the minutes of the August meeting, the motion passed to pull the item from that agenda 4-3. The minutes note Asciutto made the motion to table the item to allow the CHS Board to review the request.

“When you think about it, you have your boss coming in all the time not sharing the recommendations that you give,” Asciutto said. “At some point, it puts pressure on (staff) to come up with a solution he wants to talk about.”

Asciutto mentioned a suggestion from Health Department Director David Jenkins to bring in a third party to decide which organizations should qualify for opioid funding.

“It’s gotten to a point now with us in the driver’s seat,” Jenkins said, referring to staff making recommendations, “that we come across as adversarial if we don’t make a recommendation.”

Jenkins said a process needs to be set up for a third party to evaluate requests for funding, “somebody that’s unbiased that can help facilitate some strategic planning and look for gaps.”

Jenkins said the department needs assistance “because I can not express the amount of stress it’s caused on my staff and I. It’s a political nightmare…there’s no reason we should be making these decisions being caught up in this.”

Regarding the health department staff, he also said their morale was “fairly low when we’re trying to deal with these issues.”

Commissioner Brandon King, in attendance at the meeting but not a member of the health board, said since the CHS board could not have a special meeting, the contract with Gateway to Hope was set to expire.

“Therefore, their funding was going to stop on that day,” King said, referring to Aug. 31. “So we wanted to move forward if it was something worth moving forward.”

Referring to a visit from North Carolina Attorney General Josh Stein, King said, “He was specifically asked in that meeting, ‘Could this money be used for a process that was not MAT?’ ” (MAT stands for medication assisted treatment with FDA approved drugs such as buprenorphine, methadone and naltrexone.) At the meeting, King said, he was assured non-MAT treatments could be funded.

“We’ve invested a bunch of money as taxpayer,” King said. “We can’t just shut it down for a month until you have your next meeting. It still has to move on.”

King said it is like any business.

“If the CEO gets locked up today, we can’t shut the business down tomorrow. Someone’s got to step up. (Gateway To Hope) has a new CEO, new director, new chair,” King said.

Referring to the arrest of former Gateway of Hope director Larry Wilkins, King said all of his files and computers were seized, which was why the files were not available for review for compliance for the opioid funding.

Asciutto said if that was true, then the letter Gateway sent to the county was false.

“They said he departed unexpectedly and did not leave records,” Asciutto said. “It said Larry Wilkins did not leave the records; it did not say the police seized them.”

Jenkins said he and staff member Wendy Growcock had been talking with Gateway three months before the contract’s expiration date of Aug. 31.

He said the point regarding Gateway is not an issue now because commissioners approved the funding with a 6-1 vote at the September meeting, with Asciutto voting against approval. He said the issue was how to deal with requests in the future.

Jenkins said he had spoken with the previous director of Gateway about finding funding so the facility would “stop being so dependent on Stanly County Health Department funding.”

Asciutto eventually moved to have the county get a contract in place for a third-party evaluator for future requests. The motion passed unanimously.