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NACo stands up new effort to help counties

August 9, 2022

We recently spoke Ashleigh Holand, Director of the Counties Futures Lab at the National Association of Counties (NACo), the home of educational programming and original research on and for America’s counties. In this role, Ashleigh facilitates partnerships with researchers, think tanks, federal agencies and charitable foundations and designs and oversees NACo programs that are responsive to county needs, grounded in evidence and elevate county innovation to solve our most pressing challenges.

Tell us about NACo’s new Opioid Solutions Center: What is it, and how can the Center help counties invest the money to save the most lives?

NACo’s Opioid Solutions Center is a comprehensive information hub on that empowers local leaders to invest resources in effective treatment, recovery, prevention and other public health practices that can save lives and address the underlying causes of substance use disorders.

Opioids are not the only substance issue counties are confronting. Our residents in crisis are dealing with addiction and misuse of multiple substances and behavioral health issues. The recent opioid settlements were written broadly to enable counties to use those funds to address all manner of co-occurring behavioral health issues.

Our goal is to provide guidance and support and to elevate county solutions. We are publishing briefs on approved opioid settlement expenses, helping county leaders disentangle different funding streams to maximize available resources and amplifying how counties are working to save lives.

What are some of the challenges faced by counties as they start receiving money from the opioid litigation?

The first challenge is related to when counties and political subdivisions will receive the first payments as there has been some confusion on when they will be released. Once funds are received, county leaders will identify top local priorities that are the best use cases for the settlement funds—things that Medicaid won’t reimburse or where state and federal grants can’t be used. Counties will also navigate their states’ spending and reporting requirements, which is one of the many ways their state associations are key partners. Another challenge will be to develop long-term budgets that consider when future payments will be disbursed.

Despite any challenges, counties are up to the task. We are conveners and problem-solvers and well-positioned to bring communities together to find local solutions.

Counties vary in size, resources, and existing substance use disorder programs. How are you designing the programming at the Center to meet the different levels of readiness and need across counties?

No two counties are exactly the same, but we can all learn from one another and share resources to overcome common challenges. The Opioid Solutions Center is part of NACo’s broader opioid and substance use disorder efforts designed to meet a wide range of county capabilities and needs.  Our portfolio of actionable resources includes:

  1. Opioids Solutions Center: NACo’s web-based hub that provides shortform, downloadable written resources – like strategy briefs and case studies – to help counties plan and invest available funds in high impact solutions
  2. Connections to Technical Assistance: NACo has partnered with SAMHSA’s Opioid Response Network to promote the direct line for county leaders to receive free technical assistance on areas of the greatest need, from on-site or virtual trainings, to short or long-term consultation, to a specific implementation plan that takes local circumstances into account
  3. National Learning Series: A public e-learning series that will bring all this information to life and feature county leaders and experts who can speak to their substance use disorder prevention and treatment strategies
  4. Opioid Solutions Leadership Network: Launching in early 2023, this leadership network of counties will study substance use disorder, share planning strategies and see first-hand how these resources are making an impact in local communities

Two years from now, how will you know that the Initiative has been successful?

Our focus is connecting counties to peer networks, resources and data. We will be successful when we see counties adopting, customizing and implementing strategies to meet their priorities and needs. By harnessing a nationwide network of county leadership and innovation, we can move the needle on the substance use disorder and behavioral health crisis.

If the tools and expertise we provide can help save one life, it will be a success. We want to strengthen county efforts to help individuals find pathways to treatment and sustainable recovery.

What are the three things that county leaders should be doing right now to prepare for the dollars?

Because every county is unique, there are no cookie-cutter approaches; however, there are a few actions counties could consider:

  • Create a dedicated fund set apart from county general funds.
  • Coordinate across agencies, with community input, to review the current behavioral health continuum of care and identify gaps these resources can help fill.
  • Explore regional approaches that meet residents’ needs across jurisdictional lines and maximize efficient use of resources.

Where can folks find you and how can counties get more information?

The Opioid Solutions Center website, made possible with support from our partners at Arnold Ventures and The Pew Charitable Trusts, is located at Samantha Karon, NACo senior program manager for substance use disorder, leads the initiative and can be reached at