In November 2023, Wheeler Clinic CEO Sabrina Trocchi sent in several funding proposals to the Opioid Settlement Advisory Committee, or OSAC, an entity charged with determining how best to distribute hundreds of millions of dollars the state has reaped from opioid litigation settlements. Trocchi was optimistic that some of that money might end up funding new services at the Wheeler Clinic, a nonprofit community health group that treats clients with substance abuse disorder at five locations across the state. She was particularly hopeful about funding for two new positions at Wheeler’s Bristol location to do community outreach and support patients in recovery. But Trocchi says she still hasn’t heard anything about that proposal, or the five others she submitted to the committee, more than a year later. Several organizations contacted by The Connecticut Mirror, including the Cornell Scott-Hill Health Corporation, the Hartford Public Library, and the Connecticut Chapter of Labor Assistance Professionals, say they also haven’t heard back from the committee. Some are confused by OSAC’s methods for distributing the funds and believe the pace of putting that money to work is worrisomely slow, given the lives at stake.  “The fact that we are at the year point and we have not received any communication on any of the proposals that were submitted is rather concerning,” Trocchi said. “The longer we wait to hear on next steps and how long until funds will be allocated, the longer we are not delivering these critical services to our communities.” According to a representative for OSAC, these groups are fundamentally misunderstanding how the committee is considering the plans they submitted. While Trocchi and others believed they were submitting applications and anticipated budgets for specific funding asks, like a peer support specialist or a van, OSAC was instead seeking a wish-list of ideas from nonprofits and private individuals for how the settlement money should be spent. That list is still being reviewed by subcommittees from OSAC and the Alcohol Policy Drug Council to guide funding decisions. Nancy Navarretta, the commissioner of the Department of Mental Health and Addiction Services and the co-chair of OSAC, expressed empathy when asked about the frustration some groups say they are feeling. “It’s not a reflection of the quality of the provider making the recommendations. Of course, people are invested and would love to be funded in whatever organization that they represent, and I can appreciate that,” Navarretta said. But, she added, part of the committee’s mandate is to draw from data and expertise to determine how the money can be best spent to save as many lives as possible, not to fund a laundry list of asks. So far, OSAC has designated $21 million for spending on 13 different projects since the committee began to meet in March 2023. That is a small fraction of the overall pot of money, which is enormous — $600 million the state will get over an 18-year period, and likely much more once additional lawsuits are settled. As of the group’s November meeting, the state had already received more than $158 million in funds paid by pharmacies and manufacturers of opioids in litigation settlements. The Drop, located at 557 Albany Ave. in Hartford, is one of Connecticut Harm Reduction Alliance’s physical storefront locations. Credit: Shahrzad Rasekh / CT Mirror In 2023, 1,338 people died in Connecticut of a drug overdose, according to the state Department of Public Health. Complete data is not yet available for 2024, though numbers were trending slightly below 2023’s figures during the first eight months of this year.  For providers, frustration stems from the reality that people are continuing to die of drug overdoses in Connecticut and that an intense demand for services remains, even as a large pot of money sits in the bank. At Wheeler, Trocchi said she understood the submissions she made back in 2023 to be applications with concrete requests for funding. But, “at the end of the day, if the department’s understanding was that those were recommendations, the question I still have is, what have they done with those recommendations in the last year?” Chris McClure, the chief of staff at the Department of Mental Health and Addiction Services, helped create the committee and the submission process. “We had to create something from nothing — the bylaws, the subcommittee to write the bylaws, how funding recommendations go in and move through the system, then go out the door,” McClure said. “We didn’t have a great way to keep people updated, and I’ll take ownership of that.” Spending has been slow due to a variety of factors. First, it took time to actually create the committee, which McClure said had no analog in state government. The committee is large — its 53 members include state and local officials, public health experts, treatment providers, and people who have lost family and friends to opioid use. Ambassadors pack condoms into plastic bags to pass out to clients of the The Drop harm reduction center in the Clay Arsenal neighborhood of Hartford. Credit: Shahrzad Rasekh / CT Mirror The concepts for harm reduction, prevention, treatment and recovery support systems must first get vetted and approved by subcommittees. The full committee convenes every two months, though subcommittees meet in between. Then, after those projects are approved by the main committee, the Office of Policy and Management and the Attorney General’s Office must determine whether there is sufficient funding, and whether that proposed use — like buying a van to get medication assisted treatment to more people, or the purchase of harm reduction supplies — falls into one of the uses permitted under the terms of the settlement agreement and state statute. In some cases, a bidding process follows.  [RELATED: Many struggle with addiction during, after incarceration. Will CT use opioid settlement funds to help?] Many projects never make it past OSAC because of concerns about the dangers of using the settlement funds to create a series of “benefit cliffs,” whereby new projects are launched or positions are temporarily funded, only to see funds dry up, leaving patients and providers in the lurch.  OSAC’s funding priorities were outlined in a March 2024 report. They include increasing access to medication like methadone used to treat opioid use disorder; harm reduction programs that provide medication to treat overdose and supplies like clean syringes; improved data collection; and training for personnel to create more workers in the addiction and recovery field. Recommendations continue to be reviewed and transformed by the subcommittees into project proposals. McClure said he expects around $17 million in spending to be approved in January. Ultimately, Navarretta said, the proposals that rise to the top use proven methods to provide life saving care. That’s why proposals to provide Medication Assisted Treatment, or to buy naloxone — the medication that be used in the event of an overdose — and other harm reduction supplies have been successful. Michelle Melendez, who sent in a recommendation on behalf of United Community and Health Services in Norwich, said she understood that OSAC was compiling a wish list of ideas for spending from various stakeholders across the state. She knew that her proposal — to hire a recovery coach and purchase a van — was unlikely to get a simple “yes” from OSAC. Rather, by submitting the request, OSAC would see the need for coaches and transportation in the Norwich area and consider creating a funding stream to address those needs. McClure said that some of the recommendations have served as inspiration for projects that are currently being funded. For example, the Hartford Public Library made a request to the committee for naloxone, also known as Narcan, a medication that can be used to save a person’s life in the event of an overdose. A representative from the Hartford Public Library said that OSAC has not funded their request. However, OSAC did fund a robust supply of naloxone for use across the state in a program called “naloxone saturation,” which put more than $2 million toward the purchase and distribution of 60,000 naloxone kits. That supply is being distributed by DMHAS to hospital emergency departments, municipalities, treatment and recovery support providers and harm reduction organizations, free of charge. So while the Hartford Public Library’s individual request for naloxone was not approved, a larger push to supply naloxone across the state was given the green light. McClure said it’s a supply the library can draw from. Program ambassador and The Drop outpost supervisor Andrea McKnight picks out produce for a client. Credit: Shahrzad Rasekh / CT Mirror But while those groups can technically benefit from the naloxone supply, the lack of communication from OSAC has still been a roadblock. Jason Bannon, the chairman of the Connecticut Chapter of Labor Assistance Professionals, said the group asked for funding for naloxone from OSAC, and, after receiving a confirmation that their submission was received by the committee, never heard anything else. Bannon said he was not aware that the committee had funded a naloxone saturation program. In Hartford, Mark Jenkins, the founder and CEO of the Connecticut Harm Reduction Alliance, has seen close-up what OSAC funds can do. He runs one of the few nonprofits that has already received a chunk of the settlement funds. On Albany Avenue, a syringe exchange program run through the Alliance has been buoyed by OSAC funding since June. OSAC gave $260,000 to the group to purchase syringes, sterile water packets — to reduce the possibility of infection during injection — and alcohol wipes. While the group had offered the syringe exchange program for some time, funding had dried up. The money from OSAC has allowed clients to continue to walk into the group’s locations and exchange used syringes for clean ones, keeping them safe from HIV and Hepatitis C.  In early December, clients at the alliance walked in with used syringes and dropped them into a medical waste container. A staff member wrote down the number of used syringes, how many clean ones each client took, and what other harm reduction supplies they received, from condoms to antibiotic ointment. Larger sharps containers in a nearby closet were filled with used syringes, ready to be shipped off to a medical waste company. A wall in the center is lined with photos of community members. Many of them have passed since. Credit: Shahrzad Rasekh / CT Mirror Jenkins, too, is frustrated with the pace at which the money is being distributed, precisely because he sees the life and death stakes every day. One wall of the small front room was covered in more than a hundred photos, the faces of people the alliance has served — young, old, housed, unhoused, Black, white, brown — since the group was founded 10 years ago. Jenkins, a recovered addict, was standing next to them in many of the images. Jenkins’ finger traveled from face to face, remembering nicknames.  “God bless Buster,” Jenkins said, his voice booming, then laughing at some mental image of Buster. The iconoclast who slept in his truck. A street artist who bristled against society’s rules. Then he pointed to Walter, who improbably retained a joyful disposition despite years of struggling to get clean. Walter and Buster — and half of the other faces on that wall — are dead now. “I could double this wall,” Jenkins said. Once the clients had their supply of clean syringes, some of them grabbed a fruit cup and a sandwich and walked into the winter morning. Maybe, with these supplies in hand, Jenkins would see them again. Jenkins turned his face from the wall of photos and pushed the tears away. When the words came they were quiet. “It takes a toll,” he said.