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What advice does Providence have for other cities?

November 1, 2022

Rhode Island has begun getting money from the opioid litigation out the door, including to cities across the state. In order to better understand the process that localities are using to decide how to spend the money, we spoke to Laurie Moïse Sears, the Director of Providence’s Healthy Communities Office. She gave her perspective on the current state of the opioid epidemic in Providence, the process the city is using to decide how to spend the money, and advice for other cities.

The nature of the opioid epidemic has been rapidly shifting across the country, with an increase in fentanyl in the drug supply and more polydrug use. What can you tell us about the current nature of the opioid epidemic in Providence?

Like the rest of the country, Providence has seen an uptick in overdoses. We know that trauma-associated use, as well as mental health issues, have been heightened because of pandemic-related stressors, which were unbearable for many of our community members. The increase in fentanyl in the drug supply has resulted in more overdoses – even for individuals for whom opiates may not be the drug of choice. In 2021, 30% of overdoses in the state of Rhode Island happened in Providence. Providence has the most disproportionate rate of overdose, even when compared to our “high burden” municipality counterparts.

The City of Providence is actively looking at ways to increase care and treatment for those experiencing substance use disorder and co-occurring illnesses. We have expanded our public safety response to include more mental health professionals, worked with local organizations to increase harm reduction efforts, and are actively engaged in establishing a Harm Reduction Center to serve our community members – all with the hope that we can meet folks where they are and provide the care they need.

Rhode Island will be sending 20% of the money coming to the state to cities. How are you deciding which programmatic areas are in need of more funding?

In preparation for receiving opioid settlement funds, the Healthy Communities Office reviewed all funding sources within our office and categorized them by levels of care, including prevention, harm reduction, treatment, and recovery. We then identified where there are funding gaps and looked at ways to meet those needs.

We also lead the Mayor’s Coalition on Behavioral Health, which is a coalition of experts that we call on monthly to help drive our policy and program functions in Providence. This group helps immensely by sharing what they see on the ground while working to address the opioid epidemic, which has driven many of the programmatic decisions the Healthy Communities Office has made thus far.

Tell us about your process for engaging community members and service providers in the discussion around how to spend the money. What are effective ways that you’ve found to get their input?

The Healthy Communities Office hosts the monthly Mayor’s Coalition on Behavioral Health meeting where we discuss the current needs of our community. About 25 members that represent behavioral health programs and community members are part of this coalition, which gives us direct access to the issues on the ground.

I am also a member of the Rhode Island Opioid Settlement Committee. This committee has been leading statewide efforts on spending settlement funds. This gives us an opportunity to support and influence the statewide funding plan, while also ensuring that our work on the municipal level is complementary. This committee also gives us access to community members that we may not already interact with through our Mayor’s Coalition on Behavioral Health meetings.

How is the state helping cities make decisions around how to spend the money they’ll be getting from the opioid litigation?

The state has held monthly Opioid Settlement Fund Commission meetings, during which stakeholders come together to discuss how funding should be allocated. The state has also been transparent on how state dollars are being allocated for annual funding. This has allowed municipalities to think of ways to complement the efforts of the various state departments that are funding services, housing, etc. The state has also been a great thought partner in thinking through programming ideas.

What advice would you have for other cities that are early in the process of deciding how to spend the money?

I suggest starting by identifying and analyzing the funding gaps that may exist in your city. Overcoming this epidemic will require increases in support on all levels of service. With every decision, it is essential to keep prevention, harm reduction, treatment and recovery in mind – we need to combat this crisis on all levels. It is also important to find equitable practices that engage individuals from all walks of life, representing diverse races, genders, languages, etc. We have a unique opportunity to fund gaps in service, and we shouldn’t take this time and funding for granted. We have the ability to make a large impact in the lives of those who are suffering.