The conversation wasn\u2019t sounding good for Kensington residents on June 20.<\/p>\n
The Philadelphia neighborhood is a critical center<\/a> of the nation\u2019s opioid crisis, and the city had decided to spend $7.5 million in opioid settlement money to improve the quality of life<\/a> there. But on that day, a Pennsylvania oversight board was about to vote on whether to reject the city\u2019s decision.<\/p>\n It was a thorny issue with major implications \u2014 both for Kensington residents and people across the state, as the decision could set a precedent for what kind of spending the board would allow for years to come.<\/p>\n But a lot of people were shut out of the discussion.<\/p>\n Pennsylvania\u2019s board doesn\u2019t allow members of the public to speak at its meetings, a rule that sets it apart from about two dozen similar opioid councils nationwide.<\/p>\n \u201cIt\u2019s another moment where folks not connected to this community are making decisions for this community, and I think that\u2019s inappropriate,\u201d said Bill McKinney, a Kensington resident whose nonprofit<\/a> is involved in some of the city\u2019s settlement-funded initiatives. \u201cThose that are sort of most affected are not at the table.\u201d<\/p>\n It\u2019s one example of how the public, including people who have lost loved ones to the opioid crisis or are dealing with it daily, are routinely shut out of having a meaningful say in how this windfall can be best used to address the damage. They are eager to suggest solutions for dollars that many of them consider blood money<\/a>. But a first-of-its-kind survey conducted by KFF Health News and Spotlight PA found that, in many places, their voices are systematically dismissed.<\/p>\n In at least 39 states and Washington, D.C., councils consisting<\/a> of government officials, clinicians, law enforcement officers, and others guide decisions about how to spend settlement dollars. These powerful groups are influencing addiction policy and funding at a time when more than 100,000 Americans<\/a> are dying of overdoses annually.<\/p>\n At least 14 of these councils \u2014 including Pennsylvania\u2019s \u2014 routinely block members of the public from speaking at their meetings. Four of those typically conduct their meetings in secret, barring the public from even attending or observing.<\/p>\n The survey also found:<\/p>\n The majority of councils do not make video recordings of their meetings readily available online for those who cannot attend live. Although some councils said recordings can be accessed through public records requests, at least one \u2014 Minnesota\u2019s Opioid Epidemic Response Advisory Council \u2014 deletes its recordings after using them to create meeting minutes. (Minnesota law does not require the council to record its open meetings or post recordings online.)<\/p>\n At least five states have used committees or work groups that meet in private, or have a policy for allowing such private meetings. In Pennsylvania, such work groups have become a point of contention, with victims, advocates, and even one member of the council questioning their legality<\/a>. (The Pennsylvania Opioid Misuse and Addiction Abatement Trust\u2019s administrative director said the work groups\u2019 meetings are not required to be public. They make recommendations that the full council decides on.)<\/p>\n Practices that close the public out of settlement spending discussions are \u201cunconscionable,\u201d said Stephen Loyd<\/a>, chair of Tennessee\u2019s Opioid Abatement Council, which regularly allows public attendance and comment at its meetings. \u201cThis is the population we\u2019re there to serve. They have to have a voice in this process.\u201d<\/p>\n Different Stances on Public Comment<\/strong><\/p>\n People directly affected by the issue are a staple of the Tennessee council\u2019s meetings. This year, commenters have included several parents<\/a> holding photos of their deceased children and choking back tears, and at least one frustrated community member.<\/p>\n At the June meeting<\/a> in Memphis, Peter Hossler, an associate professor at Rhodes College, said he was \u201cvery angry\u201d about how the council\u2019s recent grant awards of $81 million<\/a> seemed to shortchange the western part of the state.<\/p>\n Loyd called such critique \u201cinvaluable,\u201d comparing it to the feedback he received from loved ones during his recovery journey.<\/p>\n \u201cWe have to be held accountable,\u201d he told KFF Health News and Spotlight PA. \u201cAnd then we have to fix it.\u201d Hossler\u2019s comments are changing the council\u2019s conversation about its next round of grants, Loyd added.<\/p>\n Loyd believes people who have been failed by the current system know what needs to be improved \u201cbetter than anybody.\u201d<\/p>\n \u201cI want to talk to the people who had medication stopped in jail and laid there and withdrew,\u201d he said. \u201cI want to talk to the people who got out of jail with no money, a couple of felonies hanging over their heads, three meetings they had to make that week or they’re going to be in violation of their probation, and they ain’t got a car or driver’s license.\u201d<\/p>\n States cited a variety of reasons for limiting public involvement. In some, state law does not require councils to take public comment at meetings<\/a>. Several officials said they\u2019ve sought feedback in other ways. An official in New Jersey said its council held public listening sessions<\/a>, but that its monthly meetings are not public.<\/p>\n Some officials may worry<\/a> that public comment would add to meetings that already run multiple hours, but several states manage that by limiting each person\u2019s comment to a few minutes.<\/p>\n For communities of color, being shut out of opioid settlement discussions can compound the negative effects not just from today\u2019s overdose crisis but from the earlier crack cocaine epidemic. Many people considered the government\u2019s response at that time to be ineffective and harmful<\/a>.<\/p>\n If settlement money is used only to \u201cbuild on what’s already in place, you’ve already failed,\u201d said Philip Rutherford<\/a>, an expert on substance use disorder at the National Council for Mental Wellbeing.<\/p>\n At a July 2023 meeting<\/a> of Illinois\u2019 settlement council, Fanya Burford-Berry<\/a> said the current system doesn\u2019t work for women of color with substance use disorder \u2014 they can risk losing custody of their children<\/a>. Burford-Berry, director of the West Side Heroin\/Opioid Task Force in Chicago, hopes comments like hers will prompt the council to support solutions tailored to women of color, including bringing together more organizations that already work in those communities.<\/p>\n \u201cWhen you allow more people to be involved, and then they have an idea, and they get excited about it, then they get more people involved and the circle of healing can become larger,\u201d she said.<\/p>\n \t\t\t\t\t<\/p>\n \t\t\t\t\t<\/p>\n \u2018A Retraumatizing Moment\u2019<\/strong><\/p>\n In Pennsylvania, the state\u2019s 13-member opioid settlement board<\/a> has the power to withhold future funding if it decides local governments spent their money inappropriately. At its June meeting, the board \u2014 which includes a state senator representing part of Kensington \u2014 voted to disapprove<\/a> of Philadelphia\u2019s use of $7.5 million<\/a> for park improvements, home repairs, rent relief, and other initiatives in Kensington. (Philadelphia later appealed the rejection<\/a>; the issue is pending.)<\/p>\n McKinney, the Kensington resident and executive director of the New Kensington Community Development Corporation, called the board\u2019s decision \u201ca retraumatizing moment\u201d for residents and criticized the way they were silenced.<\/p>\n \u201cI think it\u2019s unfortunate that things were chosen to be done that way,\u201d McKinney said.<\/p>\n Others have also been frustrated by Pennsylvania\u2019s settlement council.<\/p>\n Gail Groves Scott, a public health policy advocate who has a child in sustained recovery from an opioid use disorder, attended a board meeting in person last year. Not allowing the public to comment at meetings, she said, prevents them from offering feedback at critical times, such as when the board is considering county spending plans or contracts for its operations.<\/p>\n \u201cWe could be questioning those decisions or adding information they may not be aware of,\u201d Groves Scott said. \u201cIt\u2019s disappointing that, despite pushback from multiple people, they have not changed.\u201d<\/p>\n Some advocates say the closed sessions of work groups<\/a>, which make recommendations about which programs to approve, obscure why the full board takes certain action.<\/p>\n Pennsylvania trust officials have defended their practices.<\/p>\n Briana Anderson, the trust\u2019s administrative director, downplayed the group\u2019s role, saying it does not make specific spending decisions on settlement money but reviews choices made by local governments<\/a>. State law doesn\u2019t require the trust to offer public comment at its meetings but the public is encouraged to participate at the local level, Anderson added.<\/p>\n Pennsylvania\u2019s practices contrast sharply with the way councils operate in places like Illinois, Kentucky, and Oregon, which routinely allow public comment at both full council and smaller committee meetings. In Kentucky, the open process has allowed members of the public to weigh in on a fierce debate<\/a> over funding research into ibogaine, a psychedelic drug that has shown potential to treat addiction. At least eight people spoke in favor<\/a> of the drug at the council\u2019s January meeting.<\/p>\n Back in Tennessee, council chair Loyd said he hopes to increase public participation by creating an advisory panel that consists primarily of people who have personally experienced addiction or their loved ones.<\/p>\n He also encouraged other settlement councils to embrace opportunities to hear from people in their states.<\/p>\n \u201cYou\u2019ll make better decisions as a result. I can\u2019t be convinced otherwise,\u201d he said.<\/p>\n In June and July, reporters from KFF Health News and Spotlight PA surveyed opioid settlement councils in 39 states and Washington, D.C., to assess their general and standard practices for engaging with the public. The team also reviewed council websites, meeting minutes, agendas, and, in some cases, hours of meeting recordings. These councils have various roles, including directly deciding how to spend the money, making recommendations, or providing oversight. Although they go by different names, including advisory councils, boards, committees, and commissions, we refer to them as councils as a broad, encompassing term.<\/p>\n Spotlight PA<\/em><\/a> is an independent, nonpartisan, and nonprofit newsroom producing investigative and public-service journalism that holds power to account and drives positive change in Pennsylvania. <\/em>Sign up<\/em><\/a> for its free newsletters.<\/em><\/p>\n KFF Health News<\/a> is a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at KFF\u2014an independent source of health policy research, polling, and journalism. Learn more about KFF<\/a>.<\/p>\nMethodology<\/h4>\n
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