So, technically, then I can say. Are they county juvenile on that 1? I can just copy and paste. Copy. Hello, everybody. Good morning. Hi. I'd like to welcome you all to today's event. We are gathering together today. Sorry, that's a little, I don't know, it's kind of loud. My name is Sherry Watkins, and I'm with the Opioid Response Network, and I want to welcome you all today to the Kansas Municipalities Fight Addiction Regional Summit. I know how busy you all are in your busy workday lives, and I want to thank you sincerely for taking time out of your schedule to come today and be with us and learn about effective approaches to ending the opioid crisis, because that's really what we're going to be talking about today. It's really easy to get caught up in, you know, interventions and ideas and processes, but at the end of the day, the opioid settlement funds really represent our best hope at ending the opioid crisis in our state and in our nation. So I want to thank you all for being a part of that effort and for joining us here today. I'd also like to thank our participants who are joining us today via Zoom. Great to have you all here virtually. Thanks for joining us, and we'll be sure to include you in our last session today where we'll be going into breakout rooms, so be ready for that later this afternoon. As I said, my name is Sherry Watkins, and I'm with the Opioid Response Network, and before we go any further, I'd like to welcome my colleague to the microphone, Chris Teeters, with the Kansas Attorney General's Office, to welcome you all. Well, hello, everybody. As Sherry indicated, my name is Chris Teeters, and I'm with the Kansas Attorney General's Office, and on behalf of the Kansas Attorney General's Office and Sunflower Foundation, we wanted to thank you very much for participating today. The goal for today is really twofold. One is for you all to gain a lot of education about new and maybe a step deeper level of ideas and strategies that you can use to deploy these opioid dollars, but the second strategy, and the reason we're so happy to see so many of you here in person but also on Zoom, is so that you can all start talking to each other, because it's really easy to get siloed into your particular local community on how you're going to approach the use of these dollars, and so we're encouraging you to communicate with each other, sit at your nice round tables to have cross-table conversations about what you all are doing with your opioid dollars and share ideas on how to do things going forward. So I'll turn it back over to Sherry, but I just want to say thank you very much for being here. Thank you, Chris, so much. Really appreciate that. Now I'd like to give brief introductions to the members of our planning team who've really been working together since October to make today's event possible. First is Krista Machado, M.S., Director of Sunflower Foundation and Kansas Fights Addiction. Krista, I want to say hi, and you can hold your applause for this amazing group of people until the end. That's Krista. You already met Chris. Dr. J.K. Costello, M.D., M.P.H., Principal and Director of Behavioral Health at the Steadman Group and ORN Consultant. Thank you, J.K., great to see you. His colleague, Brianna Robles, is flying in mid-morning, so we'll see her here in a little bit. She has an M.P.H. and she's an Associate Consultant at the Steadman Group and an ORN Consultant. Then my team, Jill Erickson, M.B.A., ORN Technology Transfer Specialist. My colleague, Jenny Ho, is one of the folks that probably signed you in when you arrived today, Bachelor's of Arts and ORN Technology Transfer Specialist. And Rory McKeown, M.P.H., ORN Regional Outreach and Engagement Coordinator. And then we have a whole host of speakers who are going to be sharing their amazing expertise with you today, so I just want to call them out as well, though each one will be introduced before their sessions. Seth Dewey is the Newton Regional Area Director for Mirror, Inc. and ORN Consultant and is our keynote speaker today. Silke von Eiswein, Ph.D., is an Associate Researcher Senior at the University of Kansas Center for Public Partnerships and Research. Janine Heron, M.A., Associate Director, University of Kansas Center for Public Partnerships and Research. I wanted to be sure I got everybody's names right. Alyssa Nava, M.P.H. and Project Manager with the Sunflower Foundation, Kansas Fights Addiction. And then finally, our panelists, who are here really out of the generosity of their own hearts to come here and share the information with you that they'll be sharing. That's Erica Garcia-Reyes, M.P.A. She's with United Community Services of Johnson County. Dante Martin is the Assistant City Manager in Wichita. Sheriff Jeff Easter is with Sedgwick County. Mike Smith is a Court Administrator in Ellis County. Chief Michael Holton is with the City of Eldorado. And then Candace Davidson is a Health Promotion Supervisor at Reno County. So again, I just want to give a round of applause to this group of people who've been working so hard to make today happen. Okay. I guess I need to forward my slides. Okay. So just a couple of details I want to make sure you guys were aware of. We did offer registrants $100 stipend to help offset some of the cost of attending in person today. And so when you checked in, you should have gotten a little half sheet piece of paper with some instructions on it. Hope that's helpful to you. And if you do have any questions, Jenny and I will be here for the entire event. And you can ask us if you have any questions. If you need to use the Wi-Fi, there is Wi-Fi. I think it's literally called Overland Park Convention Center. You should be able to find it easily on your devices. If you need to connect to the internet, there are restrooms right outside the store and to the right, there's women's restrooms and men's restrooms. And there's a water fountain out there, although we also have lemon water and ice cold water at the kind of forward area here on the other side of where the food is laid out. There's an elevator just over here to the left and there's an AED device just on the other side of that should we experience any medical crisis. And the emergency exits are to the front and to the back. If you take this exit here, you'll have to round the corner to get out. If you go out to the front and to the right or straight ahead, you can access the outdoors that way if needed. If you have any questions, we want to encourage you to ask them. There are microphones at either side of our room today, but if you're feeling a little shy or hesitant about asking a question in front of a room full of people, you can always use your Post-it notes on your table and your markers to write a question and place them on one of our two kind of sticky notes over here on the wall. One is for questions, which obviously is any questions that you have. The other one is kind of we're calling a parking lot. This is for questions that you might have that are kind of adjacent to this topic, but maybe not directly related to what we're here to talk about today. But we do have a room full of experts, so if you do have questions that you're wondering about, please feel free to put them in the parking lot, write them down on a Post-it note, or just approach any member of the team that I've already introduced and share your questions. We want to be sure that you leave here with your questions answered, so please let us know how we can do that. Also, I wanted to encourage the folks who are joining us from Zoom that if you have any questions, we have a technician who is watching the chat closely and will be happy to call out your questions to the folks in the room. So, I appreciate you doing that and keeping that chat going and making it be lively with your questions. We'd love to hear from you. And if you do have a question you want to call out, please do approach one of the microphones rather than projecting from where you're seated. Our Zoom participants won't be able to hear you unless you're on a microphone, so I really appreciate your attention to that matter. Next, you're going to see a list, a listing of QR codes on your table. It's two-sided, and I just wanted to share some of the resources that we have for you there. The first is we're going to spend some time talking about the Opioid Response Network today, and there's a QR code that will take you directly to our website if you want to submit a request or learn more about what we do. There's an evaluation survey. It's the second one down. We're going to ask everybody in this room to please take this evaluation survey. I put it out here early. I hope you'll wait until it's further along in the event to complete your evaluation, but we really need your feedback. The Opioid Response Network is funded by SAMHSA, and this is one of the ways that they measure us for success. So, it will help us to learn and grow if you do take a moment to complete the brief evaluation survey, and we want to thank you for doing that. Next is a link to the Opioid Settlement Funds Exhibit E. This is a wonderful tool. It can be a little overwhelming to look at. It's 15 pages long, but it does represent all the approved uses of opioid settlement funds. So, you can go to that website and learn about all of the strategies that are allowable for the use of the funds. And then finally, the last QR code will take you to a link for copies of today's slides. So, you can download them now and follow along, or they'll be available to you after the event for your reference when you're gone from this room. Okay. So, you will see on your table, or you should have gotten when you checked in, an agenda. So, we're going to try to hold the times as well as we can, but we've got a lot of information to share with you today. If a presenter or speaker goes over, let's extend some grace, and then we'll catch up the time either during the break or for lunch. We want to be sure that everybody has time to share the important information that they'll be sharing. I would like to take a moment now, too, to really sincerely thank the Sunflower Foundation for their support of this event and collaboration. They funded the Steadman Group to provide lunch today and to provide breakfast and snacks. SAMHSA does not allow the Opioid Response Network to spend any money on any refreshments, including water. So, I don't know about y'all, but we're here in the heartland. We feed each other when we come together. And so, I asked if they would consider this, and they graciously accepted. So, I want to sincerely thank them for doing that. Let's give Sunflower Foundation a little round of applause. Thank you, you guys. Sorry, the folks on Zoom won't be joining us for lunch, but for those of you who are before, and I'll remind you again, but you'll see on the back of your lanyard, on the back of your badge, which meal you signed up for when you registered. Because I don't know about you guys, I might have forgotten. But this will help you remember which box lunch to pick up. It's on the back of your badge. And if you have any questions, you can always reach out to me or Jenny about that. So, okay. Well, now I just need to spend a few minutes talking to you all about the Opioid Response Network, who we are, and what we do. So, as I've already mentioned, we are funded by the Substance Abuse and Mental Health Services Administration for now. I don't know if you all have been following national news, but some of the federal agencies are, shall we say, in a state of play. But we continue to be funded to do this important work, and we're grateful to SAMHSA for the funding that they allocate to us. What we do is we assist anybody, states, organizations, big and small, counties, faith-based communities, individuals, anybody who wants to know more information about evidence-based approaches in prevention, treatment, recovery, and harm reduction. We provide technical assistance and training, and technical assistance really just means tools, resources, and consultation related to implementing these approaches. We provide that to everybody who asks us at our website for absolutely no cost. So, our services are completely free for our users, and we want to encourage you all, as you're thinking about what you're learning today, if there are some strategies or approaches that you think, wow, I really wish that we had capacity to do that in our community, or wish we knew someone who knew how to implement something like that, never fear. If you have ready partners who are interested, we can provide them the technical assistance and training and the tools that they need to be able to implement these community-based approaches in prevention, treatment, recovery, and harm reduction. And as the slide reminds me, we provide information and education around evidence-based approaches. So, if it's not science-backed, if science hasn't shown that it's effective, then we don't, in general, provide technical assistance around those topics. So, how do we do our work? Well, we do our work through the experience, wisdom, and knowledge of a large directory of subject matter expert consultants. These folks have great education, experience, and wisdom in the areas of prevention, treatment, recovery, and harm reduction, and they are the ones who really support our requesters to get the technical assistance that they need. Every state and territory in the nation has a team that's led by someone like me. So, wherever you go in any of our states or territories, there's a team that is ready to assist you with your technical assistance needs related to opioids and stimulants. We can also provide education and training, really, on any substance of misuse, but our focus is on opioids and stimulants, and we do accept requests for education and training, as I've mentioned. The last part of our day together, I'll give you a quick tour of our website so you can see what I'm talking about. There are many public-facing resources there as well, so it's a great website for you to spend a little time with, and if you feel like you need assistance or would benefit from technical support, reach out to us by submitting a request. We'd love to work with anybody in this room and help you with these approaches. So, our goal, really, is to provide training and technical assistance related to prevention, treatment, recovery, and harm reduction, and when we talk about treatment, we really focus on medications for opioid use disorder. These medications are the gold standard for treating people with opioid addiction, and they are profoundly effective. So, we spend a lot of time educating people on the use of medications like buprenorphine, naltrexone, and methadone. Our approach is to build on existing efforts and to enhance and refine gaps where needed, but we avoid duplication. We are a network of community-based and national-based partners, so when we have a request that requires expertise that might be a little bit outside of what I might be able to assist with or someone else on my team, we can turn to one of our 45 national partner organizations. So, here is a quick video that I wanted to show, and I'll ask our AV support to see if they can get that going for us. Communities across the nation are mobilizing to address opioid and stimulant use and the overdose crisis. We can't overcome this alone, but we can, together, and we are. We are the Opioid Response Network, a coalition of 40 national organizations representing more than two million people. We serve all 50 states and nine territories locally through our network of nearly 1,000 professionals working across prevention, treatment, and recovery. For state agencies, organizations big and small, and individuals working to address local needs, we bring training and education to bear on your efforts. We're here to help you help others through evidence-based support, all at no cost to you. For instance, the Opioid Response Network helped a tribal college in New Mexico join forces with local organizations to develop a culturally appropriate prevention, treatment, and recovery training series for its students. In Rhode Island, we convened corrections staff from 34 states to share how a program had reduced post-incarceration overdose deaths by more than 60% and supported them in their efforts to build similar programs in their home states. In West Virginia, we mobilized to help a clinic incorporate substance use disorder services into their practice, serving a faith-based community. We helped health care providers in South Dakota address barriers they faced providing treatment services for their patients. We're here to help those on the front lines, so what are your needs and how can we help? Visit theopioidresponsenetwork.org to learn more and to submit a request for support. The Opioid Response Network, funded by the Substance Abuse and Mental Health Services Administration. Thanks. Okay, so the last slide that I have to share with you all is our contact information. Really, Google is your friend. If you just Googled Opioid Response Network, this is going to be the first hit that comes up on a Google search, but that's our website address. We also go old school with phones and email, so anytime that you want to reach out to us, there is no wrong door. You can use any of these ways to reach out to us, and once you do, once we receive a request, our team has 24 hours, one business day to respond. That's the whole response part of the ORN, and as I said, we would be absolutely delighted to work with anybody in this room. So now, if you'll give me just one moment, I'm going to switch our slides over, and then I'm going to introduce Seth, so let me do that. Okay, I've got my laptop up and ready. There it is, okay. All right, y'all. I'd like to welcome Seth Dewey to the stage. Seth has been a dedicated advocate for public health, harm reduction, and recovery efforts since 2017. Seth is known for his impactful work in substance misuse prevention and education. He previously worked at Reno County Health Department where he played a pivotal role in community prevention efforts, overdose prevention, including the state's first overdose fatality review team and other legislative initiatives like the decriminalization of fentanyl test strips. Seth also co-founded a grassroots nonprofit harm reduction coalition, the Kansas Recovery Network. His contributions were recognized in 2022 at the Kansas Prevention Community Leader Award. And in 2023, he was appointed to the Governor's Behavioral Health Services Planning Council. Recently, Seth transitioned to a new role as the Regional Area Director for Residential and Outpatient Services at Mirror, Inc. in Newton, Kansas. He is also a student at Fort Hayes State University, pursuing his BS in organizational leadership with minors in sociology and criminal justice. Seth, I'm really glad to have you here, welcome. Let's give him a round of applause. All right, it's good to see everybody here today. I'll be honest, when I first pulled up and saw how big the conference center was, I was like, how big is this thing? I was like, oh boy, you know. But it's funny, when I was thinking about coming here to talk about the topic and how important it is, I was thinking about a conversation, well, several conversations I have with my six-year-old boy. And for those of you that know Colton, he's very active and he's constantly thinking. And one of the things that he always says, and I'm sure a lot of you parents in here can relate, is whenever I tell him anything, he always follows it up with why, but why? And I really appreciate that about him because I think that sometimes we get to a point where we stop asking why and it makes me wonder how much that is to our detriment, right? And so as we sit here today, everybody has to see a lot of law enforcement here. I don't know why I had to raise that up right now, but because I'm really awkward, right? And you'll understand some of the reasons why I bring that up as you go through my story. So we're all here from different perspectives, but I think it's super important for us to all remember the why, why we're here. And I think it's been touched on a little bit by everyone who's spoken so far. Sherry, you brought it up. We have a chance, an opportunity here. And when I look around, I don't really see the sectors, except for sometimes I do see guns and badges, right? I don't really notice the sectors too much, but what I do see is a lot of people here who are concerned, right? I see a lot of people here whose faces are filled with purpose, mission-driven. And I think that's all of us, right? No matter what sector we're in, we're here to try to pick up some ideas and see what we can do with this opportunity. See, we're gathered here not by chance, but by shared urgency and a profound responsibility. And I think that's the thing to keep in mind too with our why, right? One of my favorite books is called Start With Why by Simon Sinek. And in the process of my life and my journey, leadership has been something that's just really stood out to me because I think it's an opportunity for everybody to stand up and exercise leadership no matter what role they play, whether that's in your home, in your community, in your job, there's always that opportunity to stand up and exercise leadership. See, we stand at this pivotal moment, a crossroads forged in this crucible of a national crisis, right? For far too long, the opioid and stimulant crisis has cast this shadow across our communities and across our states, and it's left behind a trail of strained resources and a deep ache in our nation and in our communities. And I think it's important that we talk about that, the strained resources, right? Because how many times do we continue to ask certain sectors, well, why don't we do this? Well, why don't we do this? Or what if we added on this? And a lot of us in the various sectors that we're in are like, you want me to add something else? How are we supposed to do this? So today, as we stand here, and I get the opportunity to kick it off, I'm so excited, this is cool. But today we're not here simply to just talk about the devastation because we're all familiar with the devastation. We see the statistics, right? We see the statistics. We have been at record numbers of overdose fatalities for some time now, right? And then we saw a recent decline in overdose deaths, right? And there's a lot of factors to that, including the fact that a lot of the individuals who were most susceptible, well, guess what? They're already dead. And that is a stark reality when we think of that being a potential to the reason that we've lost or that our overdose deaths have declined. I mean, that's mind blowing, right? So all of us are here to hopefully seize an unprecedented opportunity, an opportunity though that is born from accountability because I think the awareness is there, right? The awareness is there. We have raised awareness. We have done a good job of awareness. I have seen a lot of cross-sector collaboration where people in recovery and law enforcement are coming together, which is, that's pretty, that's rare, right? And we're seeing it though. And that's cool because we're coming together to do something, but the awareness is there. Awareness without action is complicity. So hopefully we're here to take it to the next step and think about that this opportunity right now is born from accountability. It's a chance for us to turn the tide to build a healthier future for our communities because these settlements reached with the opioid manufacturers and distributors represent more than just financial recompense, right? It's a potential game changer. It's a game changer if we use them appropriately. So it's not just money, it is raw potential. But just like all things with potential, we have to realize it and then we have to utilize it. So this is potential to expand lifesaving access to treatment, to bolster youth prevention efforts, to support recovery services in our communities, things like peer services, which I'll get more into. This funding holds the remarkable advantage of allowing us to move beyond these piecemeal solutions. Just something here and something here, something here. Let's hope this works, right? It's kind of like playing darts blindfolded, right? It's not always the most effective, but sometimes it feels like that's what we're doing, right? But this offers us the chance to implement some comprehensive, innovative, yet evidence-based strategies. An advantage that if guided wisely by principles of action can truly transform our collective response. Collective response. I like that word collective. I like collaboration, cross-sector, because that's what we got here. And that's cool. That is exciting. And I'll get more into why it's so exciting to me in a few minutes, because this means so much to me on so much more of a personal level. And it's with these principles in mind, principles championed by institutions like Johns Hopkins, that the task becomes ever clearer, right? So we have these five principles that I want you to keep in mind as we go through our whole day, but also while I'm talking for the next 20 minutes. Oh, I'm going way too long on my introduction. The timer guy's gonna be getting after me. So yeah, I tend to get really excited about this topic. So we have to spend the money to save lives, right? We have to prioritize evidence-based interventions that have been proven effective. We must use the evidence to guide every single spending decision. Evidence, the data, ensuring that our investments are rooted in the data and the research, not just good intentions. What do they say about good intentions? I won't say it. But we know, we know the saying, we all know it. We have a profound obligation also to invest in the youth prevention, planting the seeds of resilience and healthy choices for future generations. And we do, like Johns Hopkins says, focus on racial equity. Now, while we can't go into it too deeply because of some recent changes, we just want to keep in mind that we have communities that are more disproportionately affected by this particular issue than others. So once again, let the data drive us to focus on these things. And finally, underpinning all of our efforts, we must develop a fair and transparent process for deciding where and how these crucial funds are allocated ensuring accountability and community trust. The community trust is key, right? I think all of us can relate to the need for there being that, especially when it comes to spending, right? This advantage is not a guarantee, it's a challenge. A challenge to be wise, to be strategic, to be fiercely collaborative in how we steward these funds guided by these very principles. The decisions that we make in the coming days, weeks and months will determine whether this historic opportunity becomes a turning point or just merely another chapter of missed potential, which is something that I think we can all relate to in strategies we have taken in the past, funding opportunities that have appeared in the past and also a lot of times our drug policy in the past. So that's the rousing introduction. Now I get to go into a really fun part. Well, it's fun for me. It's kind of also uncomfortable, but I think it's important, right? Turning principle to practice. So when we think, it's funny, because my major is in organizational leadership, and so I can learn all the concept and theory, but putting it into practice is something different, right? And so I think it's the truth about this information too. It's like, yeah, we can have it up here, but how do we do that practically in our communities? And we could sit there and show you all a bunch of data and a bunch of charts and a bunch of numbers, right? We could do that. But I'm gonna use a story, and I'm gonna use a story to tell stories. And I was actually asked if I could incorporate my personal story into today's meeting, and that's really exciting for me. An individual that some of you might know, DJ Gehring, he told me something very early on in my public health journey. He said, Seth, the data tells, but the stories sell. So we're gonna get into some stories. That's me, okay? So aside from all those things that Sherry read in my introduction, the reason I've been a passionate advocate for recovery since 2017 is because I'm a person in recovery, meaning that I ended my journey with chaotic substance use July 23rd of 2017. And so that's why I'm so passionate about recovery, right? Because it's important to me. And I think that it's important that we talk about these stories of recovery and how we lift that up in the information we're talking about. And also sharing pictures like this, because look at that. I mean, I was such a cute little guy, right? Wearing a suit at 18 months old, though. What's up with that? Oh God, 15 minutes. Oh no. Okay, we're gonna have to speed it up. So that's me, right? Looks normal and everything. Well, unfortunately for me and like so many others, right? This looks normal, but that's not what was going on at home, okay? It was really not a good thing. I was raised in an extremely toxic religious extremist environment, right? And there was an instance not too long from here where there was sexual abuse that happened in the church that I was raised in and nothing was done. And I could not talk about that. I wasn't gonna talk about that. I was already scared. My relationship and the way that I was raised was you're afraid of anything, any authority. So I already had the disdain for any type of authority figure. So that's part of why I was like, oh man, there's a lot of law enforcement here, right? But yeah, so that's where it started out. And then that continued, right? Because I kept it down here. I buried it and I buried it and I buried it. And I never fit anywhere. I was looking for someplace to belong because it sure as heck wasn't at home and I didn't have a spiritual relationship. In fact, that made me feel more fear. So I was driven from a place of fear and a place of hiding. And then, well, that's me a little older. And see, at the age of 12 years old, I was sent to stay with my grandparents because I was born in Nebraska, but sent to stay with my grandparents at the age of 12 for a while down in Branson, Missouri. And there I saw my uncle and my cousin who were, they were different. These guys were not going to church. They were not in suits. They were in black leather jackets. They were riding around on motorcycles and they called each other brother. And I was like, wow, that's cool. And that's where I was introduced to methamphetamine at 12 years old. And I hate to say this, guys, but with all those things that I was keeping down and buried down, that first time that I did methamphetamine, I felt normal. There was something that was, that didn't bother me anymore. I wasn't thinking about all that stuff that I had to hide and it was different for me. It was different for me. At the age of 17, or well, 16, I graduated high school early because I was doing well in school, even with using drugs sporadically in between there, because I wasn't using it every day. I didn't have that ability yet, right? Because I was still living a double life. I was putting on masks, right? When I could, I would use substances. And when I wasn't, I was around my parents and this other religious organization. Well, 16, I graduated. I asked, I begged my dad. I'm like, dad, let me go to the military. This is not going to end good for me. I could tell it was on a trajectory. And since I was a minor, he would have had to sign. And he said, no, that was part of their beliefs. No college, no military service, nothing like that. Right on my 18th birthday, guess what happened? Before I could go to the military, I caught my first charge or earned it, however you want to say. And that's where eventually that led me to Nebraska Department of Corrections. So the whole time that I was in the Nebraska Department of Corrections though for this drug related offense, my first time, there was nothing about recovery. I never heard about it. There was nothing about substance use prevention, anything like that. That was back in 2001. I was definitely given opportunity for work release. I got to go out on the road crew, which I enjoyed thoroughly definitely being in the cells. But there was nothing about recovery and there was nothing about re-entry or what I was gonna do when I released. And there was definitely nothing, no opportunities for me to explore why I use substances the way that I did. What was I pushing down? Why was I putting on these masks? Never that opportunity. And so like with so many of us, we go back to the things that we know. And for me, when I got released from prison, it wasn't going back to substances right away. It was going back to my family and that religious thing. Cause I knew that, hey, at least I wasn't doing drugs then, right? Unfortunately for me, one of the things I did not learn was this, it's more than substances, right? And like this states from NIDA, if you've experienced the effects of past trauma, a vicious cycle gets created. Once you stop using the substances, the trauma symptoms such as anxiety, emotional triggers and upsetting memory surface again, and often trigger recurrence of use. Time. So with that triggering a potential recurrence of use, that's what happened, right? I went back to the organization. I never, I figured that everything got handled. What happened to me was a one-time thing. It got handled, justice was served. Unfortunately, as I climbed my way through this organization and started speaking around the country for them briefly, even got married, right? I was living a normal life, but I never addressed any of those things. And when something resurfaced and I found out that the individual who abused me had actually been doing this since 1982, 82 is the year that I was born. And these individuals, these men in this organization knew about it and I wanted justice and I wasn't getting justice and I didn't know how to seek justice. And what happened? Well, I relocated. I went to Hutchinson, Kansas. And one night when I was in Hutchinson, Kansas, there was an individual that I ran into that I hadn't seen since I was incarcerated in Nebraska. And guess what this individual had? He had methamphetamine and I had a reoccurrence of use, right? And when we talk about substance use disorder being a chronic and recurring and progressive illness, right? It's true. Once it happened again, man, it sent me down a path. And that's where I started getting very knowledgeable about Reno County Correctional Facility and there in Hutchinson and Reno. But it was also one of the things that I started realizing when I was in Reno County Jail, because they had, the last time I was there, they had a program and the sheriff there, he's like, Seth, you keep coming in for the dumbest stuff. He's like, what's going on with you, man? And I'd never had a law enforcement officer just have the conversation with me. Like, what's wrong? What's going on? And I was like, is this a trap? And he said, I want you to be in this program. And there was a peer that came in who had a similar life experience as me. And I was like, how does this guy who's got the same background as me get to go out the front door and I got to go back to my cell? Whatever he's doing, I want to listen to, right? And he started talking to me about the trauma. He started talking to me about how we don't ask why the addiction, we ask why the pain, something that Dr. Gabor Matei said. And I said, well, I don't want to talk about the pain. That's not very manly. And he said, Seth, but that's why we use drugs differently than other people. And I said, well, what did you do? He's like, well, I started looking at those things. And I stopped repeating the cycle. I didn't go back to the same places I went to when I got out of jail. And that's when he said, Seth, you need to start thinking about not just what happened to you, but all the other things. And then you need to start looking about what else is going on in your circles. That's where I started learning about, reading about adverse childhood experiences when I was in jail and started getting an understanding of these things like, oh my goodness. And it wasn't because it was an excuse, right? But it gave me a better understanding of myself. What that did was it armed me to do something different. So when I got released from jail that time, I went over to an Oxford house because I heard about it from a peer. And that was the Oxford house. I tell you what, the first thing, when I got out of there, I go, this cannot be the place where a bunch of people on recovery are living. I knock on the door and the guys come in and they're covered in tattoos, just like me. And they, but they got smiles on their faces and it's a nice house. Like I can't be in the right place. They invited me in, they took me in and they said, hey man, we're gonna help you out. If you really want this thing, we're gonna help you out. And that was it for me, man. I started having community. I started having support. It's not just not using drugs, right? So the opposite of addiction is not sobriety. The opposite of addiction is connection. Johann Hari says that in the book called Chasing the Scream. This was something when I was in Oxford house, I said, man, I really wanna play a softball match against the sheriffs. I think this would be really fun for those of us in recovery to play the sheriffs. Well, they beat us. They beat us real bad, but it was fun, right? It was a fun thing. And it was, I really don't like that picture cause I look like a goofball, but that was the guy who was doing programs at the time, Mike Hill, and that's the former sheriff, Randy Henderson over there giving us hugs. We were like, hey, we're on the same page here. Let's do this thing. Then in 2018, we had a rash of overdose deaths in Reno County. We had some rallies to bring awareness to access of naloxone. Started a little group called Addicts Against Overdose. Then we changed it to the Kansas Recovery Network. That right there is my son. Yeah, that's my son up there with the free Narcan sign because you know what? We were all involved in this. These are people in recovery down there passing out naloxone and educating their friends. Educating their friends on what they can do to stay alive, stay healthy, and then get plugged into other supports, okay? I'm trying to fly. So in late 2019, Sheriff Randy Henderson called me and he said, hey, Seth, there's a job opportunity that I think you might want to apply for. I'm like, what's that? He's like, it's at the health department. I go, bro, that is a county job. What am I supposed to put on my resume, my felonies? And he said, well, in this case, I think so. He's like, we're wanting someone who's understanding of the substance use world, who's lived it to be able to come in and offer some of the, he's like, we got the law enforcement perspective. We got the epidemiological perspective. We got the other criminal justice components. What we don't always have is the individual who's lived it. And I was like, oh, this is, well, once again, I said, is this a trap? I walked through the fear, applied, and was hired to the Reno County Health Department where we started using real-time data to drive our work because I got, man, I'm way past time, aren't I? So this is my favorite, right? Because when I got hired, I said, guys, we know there's overdoses going on. And DJ Gehring over at the health department, he said, but show me, Seth. And I said, well, why do I need to show you? We know what's happening. We're hearing it on the street. And he's like, well, but where's the data? And I was like, this is bull, you know? I'm like, we know what's happening. He's like, but think about how much more powerful your story will be and what you're telling people when you're trying to seek funding and trying to do these initiatives, new initiatives will be if we have the data to show us. And so we started using ODMAP with our law enforcement and our EMS entering in not only fatal, but non-fatal overdoses. And when the coroner got on board, we could add even more of a richer component to this. So that's what you see. It's been going on since 2020 and is still ongoing. And it's really nice because we're also able to, we're able to listen to the data. We're able to see that right now, fentanyl isn't, yes, we need fentanyl awareness, whatever, right? It's always gonna be something though, right? We know this. The way that we react to things in our drug policy and our response is always so reactionary. And what we need to remember is the roots like that picture was earlier. What's in the roots of our soil? What's in the roots of our community? Why is it we're seeking out these substances? What is it culturally and societally that is happening to where we seek out substances? And what can we do to intervene with that? So this is cool because it helps us to see like, like, as you can see there, methamphetamine, 25% of the overdoses is meth, which I mean, law enforcement, you guys know, meth is never left, right? But what we're starting to see is more meth toxicity, even in the fatalities, more than fentanyl, more than opioids. So what are we doing to prepare for that? What are we doing to prepare for that? Then we started things like this, our spike alert framework. We were featured by ODMAP and their national website when we were at the health department, creating our response. When we had a certain amount of overdoses in a 24 hour period, we would respond immediately. We would send peers, well, first of all, we would send the information out to all of our partners, law enforcement, EMS. And so we were all pumping out the same information. It was cool. It wasn't like, oh, this is just a health department thing. No, this is a community thing. Here's the information. Here's how you can tell the individuals that you love that might still be using substances how to be safe. And here's what we know about the substances. It was really awesome to see that kind of collaboration and communication between our law enforcement, hospital, EMS, and people in recovery. And then we could get people out on the streets in those hotspots with Naloxone and offering peer services. Hey, you ready to go? You want something different? Hey, let me tell you how I did that. That's where we can get some really cool, cool progress. So the takeaways. Sorry, I had to fly through that. I get so excited. Every single one of us, we have stories of struggle, right, in our communities. We've been rocked. And something that doesn't always get talked about is the disproportionate ways that rural communities are being affected by it as well. So we need to keep that into mind when we're talking about utilizing these opioid settlement funds. How can we make a difference in our rural communities as well? Keep that in mind. Our communities are full of stories of struggle, resilience, of the enduring human spirit in the face of the devastating impact. And these settlement dollars represent a once-in-a-generation opportunity. But like we know, the money's not enough. The money alone is not enough. It's how we use it that will define this time that we're in. Our legacy, if we will. I'm so dramatic. My girlfriend tells me all the time, she's like, you have got a flair for the dramatic, boy. I'm like, I can't help it. So hopefully what we can do is commit to spend the money to save the lives. Every dollar must be directed towards interventions that work. Expanding access to medicated-assisted treatment. Hopefully also exploring contingency management with what we know about methamphetamine, right? Let's get creative. It's not just opioids. Let's not get so laser-focused that we're just like, ah, it's fentanyl. Well, fentanyl's already declining. What's coming up next? This is the mistake we make in drug policy in the United States of America. We focus on the substance. And when we focus on one substance, what happens? We're so focused on that that something else is coming up right behind it. That's more lethal usually, okay? Expand access to those things. Provide overdose reversal medications. Fund harm reduction services. And harm reduction is not just a naloxone in the fentanyl test strips. It's community. It's community. Peers. Get people out on the streets that can relate. How powerful it is when we see co-responder projects. And, sorry, the sign said end. Let us pledge to use evidence to guide our spending. No more wasting resources on programs that sound good, that lack scientific backing. We got to invest in what works. Proven strategies that deliver results and offer the best possible outcomes for individuals and communities. Incorporate people who've lived it. Don't just give these individuals, oh yeah. Don't just give these individuals a seat at the table. Give them a voice. Let them drive the work. When we couple our lived experience with what you guys know, that's power. Man, when I got hired on at the health department, I learned so much about data and so much about epidemiological things. I've met so many cool people that I know in this room. And I get to work with you guys. It's phenomenal. And we get to share that information and that is power. That's how we build power in our communities. We use the data to determine community needs and drive the work. Always reevaluate it. And don't be afraid to say we gave it a good shot, but it's not working. Stop. Redirect it. Redirect it. Sometimes we get so married to an idea that we just keep going with it. And it's like, it's done. It's not working. Redirect. Be firm with a goal, but flexible with how we get there. And always be judicious, fair, and innovative with these opioid settlement funds. And with that, I will stop. I want to thank Seth for really setting the tone for today and sharing his story, which is really personal. And so thank you, Seth, for being vulnerable with us and sharing your amazing story. Let's take a quick break. We can convene back here at 10 o'clock. And then we're going to listen in to some data from the University of Kansas. So check your emails, check your emails, and we'll see you back here at 10 o'clock. From the University of Kansas. So check your emails, take a bio break, get yourself some more food, and meet back in here at 10 o'clock. Thanks. Okay everybody, I'd like to invite you to go ahead and come into the room and take your seats. Our break is ended and now we're going to hear from some folks who have done a lot of work across our state to try to determine what the needs are in Kansas related to substance misuse. So it's my pleasure to invite two staff members who've been working with United to Transform. United to Transform performed a comprehensive statewide needs assessment of substance use disorder systems and related work in Kansas and so they have some excellent information to share with us today. So I'd like to invite Dr. Silke von Eisswein, PhD, Associate Researcher Senior at the University of Kansas Center for Public Partnerships and Research, and Janine Haran, MA, Associate Director, University of Kansas Center for Public Partnerships and Research, to the podium. Let's listen closely to what they have to say. Thanks. Thank you, Sherry. It's really nice. My name is Janine Haran and as Sherry mentioned, Silke and I work at KU and we have had the good fortune over this last 15 months to be working on a study that we are excited to share in in an overview kind of a format with you today. Every day we all share the challenges associated with SUD and that's what this project has really been about, about understanding the dynamics of substance use in Kansas and and learning about the opportunities that there can be for us in Kansas. This segment is titled KFA Needs Assessment Findings and what I need to tell you is that there are hundreds of pages of findings and it's organized in three ways. One is a macro view for a quick big-picture takeaway including priorities and strategies that are indicated by the research. The second, there are 11 sections related to details of specific topics and then there are multiple appendices that provide specific supporting data tables for those who like data and as well as the resources for active decision-making consistent with the assessment findings and really focusing on putting what is in the data to work in our communities. The timing of this meeting is actually a little head ahead of the delivery of the full report which is occurring at the end of this month and the KFA board will need a little bit of time to take that in and then I understand that it is intended that this will be offered in a very publicly accessible way along with all those guidance and tools for our collective everyday work. So coming soon on the whole on the whole thing but for today I'll provide a little bit of background on a brief structural overview of our processes in the needs assessment and then Zilke will speak to sampling of the data in the research findings and share some inspiration of specific tactics that are working for others that you might might consider and we've left 10 to 15 minutes at the end for questions. So today is today is the preview. We set out I think I'm on the wrong slide yeah all right there we go we set out to see the whole system and we approached it using a pretty wide-angle lens in support of a big picture but a big picture that we can then turn to action. So we sought and listened to as many voices as possible by connecting with those who are addressing SUD challenges every day as well as by reaching out to others who currently see themselves on the sidelines. We connected directly with over 2,000 people across all 105 counties in the state and incorporated more than 70 quantitative data sources. Some of you I see have been with us for that journey and we thank you for your participation in some of those meetings. I want to talk about some specific groups to help you to understand the methodology a little bit further. One is the accountability cohort. This is a group of eight people with lived experience who have participated throughout the entire 15 months as consultants to the process and both the broad concepts and the strategic topics as well as very specific issues. This group was remarkably quick to respond to any questions and contributed both their technical expertise and understanding as well as their personal views and ideas about advocacy, about empowerment, about peer connection, and practical solutions. There was a series of 11 community sessions that we called the community futures tour and that took place in March of 2024. We're seeking to garner statewide awareness for the for the project when we got going and we were focused on discussing perspectives regarding both the current state, what was happening in their communities right now, as well as their future aspirations. The question was if we do our work well what will it look like in 2040? And that was the beginning of the development and the articulation of a common vision for the state. We used sense-making in the early stages as well as in the latter part of the process. This is a strategy that you we use to understand how people make sense of their personal experiences as well as their experiences in context to what's happening throughout their community. It supports the search for the things that we may not know to ask for so we like to get into that early in the process and it also involves collaborative groups to construct the meaning about their collective experiences and specific areas that we're seeking to explore. So the people attending the in-person sessions, the sense-making sessions, focused particularly on processing manifestations of stigma, on the navigation of substance use disorder resources, on workforce concerns, and a discussion of potential solutions to some of the identified challenges. There was also early on a sense-making survey that was completed by 437 Kansas residents which provided confidential indication of personal and family experiences related to SUD. Zilka and her team engaged over 150 people in confidential interviews and focus groups. Those conversations were protected by the policies of the KU Institutional Review Board providing a safe way for people to participate in discussions and accurately and openly share sensitive information without fear. Our quantitative team benefited from a generous group of 36 specialists who not only helped and provided data but clarified and advised along the way and this again involves some of you so we thank you. There were multiple topic specific surveys focused in a targeted kind of a way as well as internet discussion strategies where additional people provided focused input to the surveys and ultimately on the recommendation and the strategies and then we also used six lunchtime webinars and requested listserv access for very topical messages and again this was for building awareness and participation in the actual needs assessment process but also to provide opportunity for people across the state to share and discuss their work with each other. We also used and learned a lot by mapping substance use disorder organizations within the domains prevention, harm, harm reduction, treatment, recovery, as well as related to the adjacent systems at work within the overall substance use ecosystem. So there are eight of those maps. They helped us to understand who is out there, the relationships between the players, and the overall infrastructure currently in place in the state. There is one thing that all those maps have in common and it is the exceptional fragmentation. The picture of those maps is worth a thousand words and and I don't have it today. I'm very sorry and we will put that out there but what it did help us to understand is that there is a remarkable splintering in our programmatic coordination. There's inconsistent referral pathways that are impeding some of our connection and our work and siloed information and data systems. You know those things, right? You know on the day-to-day that that translates to confusion for individuals and their families who may be seeking to understand what their resource options may be. It's also difficult for professional to professional kinds of interaction both for care coordination and systems level business exchanges and it makes it difficult for funders to braid resources in a coordinated kind of a way. So with that in mind let's consider the experience of the individuals. We started with our accountability cohort and we asked them to help us understand what is that individual story all about and each person laid out their journey and were unique in the things that they chose to highlight and the words they chose to use. Those words or phrases became the signposts that you see on this particular slide. Entry points or initial recollections centered around trauma. Seth helped us to understand that and sometimes that's in the past and sometimes that is ongoing acute and chronic and at some point there was a realization I've got a problem I don't like this direction whatever is that realization and that's that tipping point. It's most often not a singular moment but rather a gradual experience and people used a range of descriptions to describe then the interactions that followed once that that tipping point occurred for them the first time. That fell into three groups. You see here the intense stigma that's marked an experience of overwhelming shame and isolation particularly isolation and the comment that gave me great pause was when when one of our individuals declared we are the new Jim Crow caught in the ugly ways of thinking about people who use illegal substances. The treatment approaches also were described and and they were described in ways that mimicked or perpetuated that judgment. So here they described the oversized societal dependence on and outsized reliance on law enforcement and corrections to be the interveners to provide the treatment right. One person described that as a betrayal. They said gosh they lied to us. All the training and things we did all day were just to keep us busy while we were in prison and the day you leave is the day you realize that there really aren't any jobs and you're back to square one and this time with a felony record. And then there is the persistence and the strength of the root cause and and Seth spoke to that as well. It doesn't go away right and it was cited as being like gravity and and that pull that holds you down. So the time that a person remains in that in that cycle can be long and it can take one clear takeaway there is that the systems level solution needs to address all three of those factors simultaneously or at a minimum acknowledge that all of those factors exist because otherwise what they described was that the situation spirals into ultimately a very low point that was characterized as lack of mattering. And that lack of mattering you can see on the slide there is that orange washes over the experiences that are going on was described differently or experienced differently but consistently present and sometimes that was an accelerant for the stigma treatment root cause cycle or sometimes it served as traditional what we think of as rock-bottom role where the next step begins to be recovery. The most important note really is that this isn't a linear process it's not cyclical it's not any of that it's it's individual and it addresses if we address only one category we leave people in a really vulnerable state. Also shared as much if not more was the connection points relating to the recovery and the process of change. This group really acknowledged and embraced the SAMHSA definition of recovery and that definition is a process of change through which individuals improve their health and wellness, live direct, self-directed lives, and strive to reach their full potential. And that experience elements here are once again, different for every person, but the same in the concepts, right? So we're recognizing, first of all, you have to recognize that there are processes for change. There are options. And then comes the importance of an accurate diagnosis and the simultaneous treatment for mental health and substance use disorders. That's validated study after study. The lack of connection between mental health and substance use disorder is consistently voiced by people in the field and people with lived experience throughout the state. And misdiagnosis was a really common theme. Recognition of the nuances of SUD, which was reflected in the elusive criteria for what is SUD recovery, which in discussions with multiple groups was different for every person. And it really underscored the importance of the individualized response and the ability to offer an array of resources in support of individuals who are working to realize better health. The connection to others leading to feelings of community belonging and purpose. This was by far across the board, the most consistent, most pervasive outcome as people described how they regained their personal strength. These are the needs assessment components. The vision represents aspirations expressed by people across the state. The hallmark attributes of the vision are compassion and understanding. The understanding is that this is a preventable and treatable chronic condition that requires ongoing community involvement and support for healthy functioning. And it also recognizes that collaborative system players are essential to achieving integrated and cohesive support. The vision is defined by tenants that describe what that vision looks like on the day-to-day on the ground. And the vision and the tenants create the foundation for the overall recommendation, which is formed and informed through the key priorities that were identified in the research. And then we've also identified strategies and tactics that can be used to actualize the desired outcome expressed in the priorities. This is just a simple slide where we express the recommendation to strengthen the hope and the connection via emphasis on a public health approach is our overall objective. And we also share a visual here of the relationship between those tenants. So you see the individual in the middle as the central focus, where we emphasize each person's values and strengths and where their access to substance use systems resources is understood to be a universal right. Those interventions are flexible with the individual defining their desired outcomes. And then you can see that green ring that surrounds the people. And that's the community environment that anticipates and responds to the needs of its residents and particularly the health of children and young people. And then in the blue for the benefit of individuals and communities is the coordinated and ongoing support of substance use disorder with emphasis on community measures of health rather than reinforcing the burden of illness on individual residents. Priorities and strategies. This is where the action is. And we hope will become a practical tool and trusted reference for people in this room and throughout the state. It can help us to hold together a really important dynamic in these times of unexpectedness in our day-to-day world. There are six priorities in the plan. They have created a flexible structure. Three of those support systems level action that those would be actions that require centralized organization and implementation supports. They are the first priority, which is to develop structured relationships that foster community-driven health and wellbeing. The second priority, which is to reduce stigma and expand statewide public knowledge and engagement. And the sixth priority, which is to ensure long-term programmatic and financial sustainability. The other three priorities are best actualized by leveraging the strengths and the interests at the community and the regional level. And we're gonna speak to those a little more clearly today. Those include priority three, which is the prevention of drug use and drug-related overdoses and deaths. Expanding consistent statewide access to high quality SUD services and normalizing continuous care models that sustain progress beyond initial treatment. For each of those priorities, there are four to five facilitating strategies defined in the assessment identified through the data. These are investments and actions that based on the research and the experiences of others would have high probability for noticeable impact, addressing both near-term challenges and or long-term objectives and creating initial momentum for a long-term strategic plan. There are also numerous tactical options, hundreds of tactical options that are in the plan appendices and also there for inspiration and to be a guide for those in the field. So with this, I'm going to turn the reins to Zilke to share some specific and actionable insights from the research itself. Thank you. Good morning. I'm going to start this presentation with kind of a startling number. And it might be a little bit of a surprise to you, but based on actual survey data, about one in five adults in Kansas, and that's over 395,000 people, actually meet the criteria for substance use disorder. If you go to young adult ages 18 to 25, it's actually one in three. It's the highest of any age group. Now the substance that is the big elephant in the room for Kansas is alcohol. So alcohol most certainly drives most of the substance use in Kansas. Meth, like Seth pointed out, is still a major driver, especially in rural communities and communities that don't have a lot of access to the substance. In communities that don't have a lot of access to care, which 5% of adults over 26 years of age qualifying for substance use disorder for meth. Opioids may be smaller share, but we know how deadly it is, but it's between two and 3% of Kansans. And then about the same number are about for non-medical use of prescription painkillers. We're also seeing early signs of new emerging substances like xylosines and other synthetic opioids in our communities. And this is a troubling trend, but it's really critical to point out that this is why it's important to strengthen our prevention efforts and to strengthen our response system. So we're not always just reacting to a crisis, but we're also staying ahead of the next wave. I also want to point out that while overall youth while overall youth under 18 have a lower substance use disorder rate, they're sitting at 9%, right? That underscores the importance of early intervention in schools, family support systems, and community health settings. While the types of substances may be evolving, the geography of overdose risk also tells an important story. This slide looks at non-fatal overdose incidents across different counties in Kansas proved by how urban, how rural they are. The data shows that urban counties like Shawnee, Wyandotte, and Sedgwick have the highest incidence rates. That's not a surprise to anybody here. We know these population centers have high frequent high overdose frequencies and they're more visible. But I really want to point out here that the non-urban counties are also clearly impacted. Counties like Pawnee, Atchison, and Elk classified as rural or even frontier still show significant overdose rates. Elk County, for instance, has one of the highest rates per capita in the state. Even though the total number of cases is obviously smaller. And this challenges the assumption that substance use is mostly an urban issue. In reality, the crisis is everywhere and communities of all sizes need tailored response systems and prevention strategies. Middle-aged adults, especially those between 35 and 54 now have the highest overdose death rates in Kansas. That's nearly 40 deaths per 100,000. But the burden is not shared equally. Black Hansons experience the highest overdose death rates in the state and they're more than double than those of white Hansons. These data points underscore how often individuals with substance use disorders and cancer interacting with the system during moments of acute care. So across the state, over 20% of all patients receiving SUD services require emergency or crisis care indicating that a lot of them don't intersect with any kind of treatment system until they're already in crisis. And among those that die, only about 5% of them have any kind of formal SUD treatment history in their records. That means 95% of those who died had never connected with a formal care system. And these patterns point to critical missed opportunities for earlier intervention stabilization. Suggesting that a stronger focus on outreach, low barrier entry points and continuity of care could prevent crisis and save lives. And for our overdose deaths, even when help was physically there, it wasn't enough. When nearly half of fatal overdoses, a bystander was present. But fewer than 10% of those that were there stepped in. That's far below the national average where intervention happens about 30% of the time. So what keeps people from stepping in here in Kansas or from seeking help in the first place? It's not just lack of tools or training, often it's fear, fear of legal consequences. In Kansas, not everybody knows about the Good Samaritan Law which is relatively new. And even those who do may hesitate. And why is that? Because the law doesn't protect everyone. People on probation or parole, for example, are still at risk of legal penalties if they call for help. That fear rooted in real gaps in protection can be paralyzing and it's deeply connected to the stigma that surrounds substance use. This slide illustrates how widespread and embedded stigma can be. And it doesn't come from one place, but from many systems around a person and from the person themselves. In the center, you see the individual, someone navigating substance use. Around them are 12 sectors where stigma often shows up either directly or indirectly. One important sector is healthcare and behavioral health where people may be judged, dismissed, or denied care. Employment or housing, where substance use history can limit access. Education, this is especially true for youth and families affected by substance use. Public safety in courts, where substance use is often punished instead of treated. Faith communities, community leaders, and even peers, where negative attitudes can reinforce shame. This impact is more than just emotional. Research, including from the National Service on Drug Use and Health, we saw the numbers of earlier, show that 95% of people meet clinical criteria for a substance use disorder don't think they need treatment. So when we talked about this 395,000 Kansans that meet the criteria, over 370,000 don't think they need any help. That gap is driven in part by stigma. If someone's internalized the message that needing help is a weakness or failure, they're much less likely to seek it. So while policy, prevention, and care systems are critical, none of them will work if people don't feel safe using them or if they don't think they need it. For many individuals and families, stigma takes a torm of silence, judgment, and isolation. This quote from a parent says it plainly. When their child was struggling with substance use, they felt invisible, unsupported, like they're being quietly written off. No food train for them, right? And the kind of exclusion doesn't just hurt emotionally, it limits opportunities for connection, treatment, and recovery. But here's the good news. People with lived experience are powerful agents of change. We make space for their leadership, visibility, and stories. We help dismantle stigma from the inside out. Whether through peer support, advocacy, or simply being visible in recovery, people with lived experience remind us that recovery is possible and that everyone deserves to be seen, supported, and included. So what does this mean for people with lived experience? So to address substance use effectively, we also have to look at the bigger picture, not just what happens during treatment or crisis, but what leads people there in the first place. I think we've heard that today. And I also wouldn't be a biologist if I didn't point out that research shows that 40 to 60 percent of persons risk for developing a substance use disorder is linked to genetics and other biological factors. That includes things like brain chemistry, family history, and how a person's body responds to substances. But biology doesn't happen in isolation. The environments people live in, their housing, relationships, opportunities, and supports, all influence how biological risk plays out in real life. These conditions can either buffer that risk or make it harder to manage. To better understand the environment that substance use happens in Kansas, we built on the vulnerability index originally developed by KDHE. Their framework was a strong foundation, but we've recognized the opportunity to build on it by adding additional dimensions, especially those related to social determinants of health. So in our version, we expanded the index to over 20 factors that include measures like food security, overall health risk indicators, access to child care, and community environment. These additions help capture a fuller picture of the conditions that shape people's health, stability, and risk for substance use. I'm going to talk you through three slides of examples of what this actually looks like county to county and what that means in practice. So the first slide is an example of three counties that fall into the high vulnerability kind of section of the state. So that's Cedric, Selene, and Wyandotte. But as you see, even though they're the same vulnerability, what's called vulnerability cluster, they're actually not the same when you look at actually the data underneath it. To the right, you see what's called a radar chart that helps visualize these differences. Each colored line represents a county. Orange is for Cedric, blue is for Selene, gray is for Wyandotte. Each point on the chart corresponds to public health or behavioral risk indicator, including EMS overdose incidence, HIV and STD prevalence, homelessness, liquor store density, lack of physical activity or leisure time. The farther point is from the center, the higher the rate for that issue in that county. So if you look at the graph, you see Cedric spikes on overdose and STDs, so indicates high levels of acute need around both substance use and infectious disease. Selene shows elevated rates of homelessness and high alcohol access, paired with limited physical activity, pointing to community conditions that may erode protective factors. Wyandotte trends high nearly across all indicators, particularly HIV, inactivity, and overdose, suggesting more systemic layered risk. So these differences illustrate a crucial point. Even when counties fall into the same overall vulnerability category, the specific risks and needs beneath that label can vary widely. So the solutions need to vary too. Cedric, for instance, may benefit from expanded harm reduction and stronger preventive care infrastructure. Selene might require housing investment, alcohol zoning reforms, or wellness programming. And then Wyandotte, like in these more comprehensive wraparound supports, grounded in public health and community outreach. So the next slide is actually examples of a cluster of counties that falls into the medium vulnerability, and that's Pratt, Thomas, and Johnson. Orange is Pratt, blue is Thomas, and gray is Johnson County. So just like the slide before, each axis corresponds to a key risk indicator, and the farther point is from the center, the greater the level of concern in that area. So let's take a look. So Johnson County faces public health challenges like homelessness, HIV, and high STD rates. But protective factors like relatively low inactivity, low liquor store density, and moderate overdose rates are working for it in its favor. So possible strategies here could include strengthening housing stability and wraparound support services, integrating HIV and STD prevention into routine care, expanding its partnerships with schools and community orgs for prevention outreach. Now Pratt County shows elevated overdose rates, but otherwise tracks closely to state averages. This points to a need for earlier intervention and crisis response. So some strategies here could include expanding naloxone distribution and bystander training, offering low barrier outpatient and medication-based treatment, or increasing public awareness around overdose signs and the Good Samaritan Law. And finally, Thomas County is fairly close to the state average across all indicators. This makes it a great candidate for proactive prevention and early intervention. So some strategies here could be investing in youth programming and protective factor development, supporting primary care providers in screening and referral for STD, or training trusted community leaders to recognize early signs of substance use and connect people to help. And finally, we wanted to also show you examples from the low vulnerability cluster because we really want to make sure you see that this is not all about risk factors. This is also about protective factors and bolstering those. So here are Greenwood, Harper, and Lynn. White is Greenwood County, blue is Harper County, and orange is Lynn County. Greenwood County shows high concentrations of physical inactivity and alcohol access. And so some strategies there that could work is investing in community wellness and prevention programs, such as walking groups, fitness incentives, and youth recreational spaces. Maybe some zoning or licensing reforms to limit alcohol outlet saturation, or partnering with local organizations to promote protective factors early, especially before risks escalate. Now in contrast, Harper County shows high rates of NICT and moderate overdose, but is low in homelessness. This suggests a more dispersed population with limited engagement in health promotion activity. So some health strategies might include bringing services to where people are through mobile outreach or telehealth, integrating substance use screening and Loxone distribution into primary care pharmacy settings, or supporting employer and school-based wellness programs to promote early engagement. Lynn County shows relatively low rates of homelessness and inactivity, but higher than expected overdose rates for a low-vulnerability area. So this could indicate that maybe missing some warning signs and we have insufficient early intervention. So strategies here could include boosting community Loxone access and training, promoting awareness of early SUD symptoms and how to get help, and strengthening connections between first responders and treatment providers to ensure follow-up care after a crisis. And I hope that the takeaway is very clear now, but these vulnerability scores are a starting point, not the whole story. With a closer look at county-level data, communities can target resources more efficiently, matching investments to the specific conditions that put their residents at risk. And we're already seeing that momentum. Communities across Kansas are using their settlement funds to support housing, harm reduction, school case prevention and peer support. These local investments are making a difference, but we also know that the needs are complex and that the funding won't last forever. That's why it's so important to be strategic, focusing on solutions that meet immediate needs and build towards long-term impact. This slide shows a few examples of how Kansas communities are already using opioid settlement funds to meet local needs and build stronger systems of care. Let's start with prevention. On the left, you'll see an example of Chenute Public School, where funds are supporting students' well-being and resilience. Schools are using local dollars to strengthen mental health education, peer support and prevention programming. And we know that we invest early. We reduce the likelihood that people will reach crisis in the first place. Prevention works best when it's local, consistent, and connected to trusted relationships and uses evidence-based interventions. Next, harm reduction. There's a lot of law enforcement, Latino-Locuston distribution initiatives that have been funded already. So, departments like the one in Allen County are helping to put life-saving tools into more hands, whether that's through officers, first responders, or community events. By increasing access to naloxone and fentanyl test strips, communities are helping people keep people alive long enough to reach treatment. And they're showing that they value every life, even in moments of crisis. And then there's treatment. You can see here, an example is Lorraine House, where residential treatment recovery facilities for women in southeast Kansas is happening. This is a powerful example of funds being used to expand access to safe, stable, and gender-responsive treatment. These kinds of investments are helping fill critical gaps, especially in rural areas. By increasing the availability of providers and strengthening ties between emergency services, behavioral health, and long-term recovery. And finally, recovery and integration. Programs like InCircle and Topeka are using local funds to support people after treatment through housing assistance, peer mentorship, and job readiness training. These supports are what make recovery sustainable. When people have safe housing, meaningful work, and a sense of belonging, they're much more likely to stay engaged in care and avoid returning to crisis. So again, the message here is that practice is already happening across Kansas. These communities didn't wait for a perfect plan. They built on what they already had and focused on what mattered most. The opportunity now is to continue supporting those efforts, share what's working, and make sure every county has a chance to put these funds to work in a way that reflects their unique needs and strengths. Like we said, Kansas communities are already making smart, community-driven choices with their settlement dollars, and we're starting to see the impact. Prevention education continue to be top priorities. These early wins are helping raise awareness, promote mental wellness, and connect people to support before a crisis happens. As we look ahead, there's a chance to expand the reach and depth of strength-based prevention programs, approaches that build on skills, resiliency, and protective factors rather than just focusing on risk. There's also strong potential to expand access to treatment and recovery, especially peer supports, medications for substance use disorder, and services that help people rebuild their lives. That includes investing in housing, employment pathways, and recovery-friendly environments. And importantly, we encourage communities to focus on building systems that last so that the solutions funded today continue to serve Kansas well into the future. This slide serves as your reminder and your encouragement that you don't have to start from scratch. Like I said, communities are working on this already, but you can build on what you already have and everybody has already something going on in their county. Whether that's an existing program, a trusted partner organization, or a bit of infrastructure that needs a new use, there's already something in place that you can grow from. The keys would begin with the end in mind. What are the outcomes you want to see in your community? What's the next small, tangible step you can take towards that goal? And this path forward doesn't require inventing a brand new solution, although there are many really exciting new things you can implement. It's often about recognizing, investing in what's already working, and finding opportunities to collaborate. Our report and the data tools that come with it have hundreds of actionable ideas. That could mean joining forces with school districts, health departments, law enforcement, recovery groups, or even more creative partners like the funeral home that distributed drug deactivation kits to grieving families in southeast Kansas, or the Uber drivers that run their stock knock-in in their cars. And remember, progress doesn't require perfection. It requires momentum, and there's a lot of momentum right now. And every action counts. Every connection matters. And the work is challenging, but you're not in it alone. So in closing, this is the journey. And we've talked about it from the perspective of the individual, but we are also considering these same dynamics from the perspective of communities and how we bring people together and keep people together, reinforcing those connections to others and creating community and purpose, recalling that those were the most important elements of keeping people healthy. Particularly during these times when predictability of so many essential day-to-day structures are shifting or being eliminated, we are strongest together. And we have geared this plan to make it very usable. You'll be able to see your county, any county, and what are those factors and what does that map look like for you, which can be a guide for how you participate and how we participate at both the systems level. We talked about those three systems priorities, as well as at the local and community level and how those things work together. We are fortunate in Kansas to have a Kansas Fights Addiction board that is taking that long-term and holistic approach and is asking for this kind of information. That is good leadership. We are very fortunate to have the expertise and the energy that comes with the Sunflower Foundation staff supporting that board. I would venture to say that we are also very fortunate to have one another and what that takes and how we stick together. If there's any big takeaway from the needs assessment, it is we've got this. We can do this together and believe that we now have additional information that will help to guide us to do that in a cohesive kind of a way. And with that, I would open for questions. Wow, did you guys hear that? They've actually done all the work for you. You can use this needs assessment to really identify not only what's happening in your local community, but suggested strategies to turn the tide for any challenges that you might be facing. I didn't realize that it was at that depth. This is an amazing tool. If I was sitting in your seat, I would be so excited to learn more about it. But now, we do have time for some questions. You have two amazing experts in this room. So if you do have a question, just make your way to either of the two microphones that you see on either side of the room. We need you to use the microphone so folks on Zoom can hear you. So if you do have a question, now's the time to make your way to a microphone. So we'd love to hear any questions that you all might have. So thank you. Thanks. Hi. Hi. So mine's just kind of a data question. Julie Brewer. I'm a county commissioner here in Johnson County. So if you go back to your map slide, you used about 20, and you don't need to, but I'm just going to reference it, used about 20 risk factors to kind of determine in your mapping. But the slides, a few slides before that, you indicated where data shows highest use. So take an elk county. You had it as a low risk factor on the mapping, but 20% of that very low population had had an interaction or fatality from substance use. So when I think of data, I think of using that filter of the risk factors to set a level set, then looking at anomalies and reconstituting that map. So it's a merged of risk factors and real time data to maybe highlight those things where the risk factors in the real time data do not mesh well, and then have special attention to that. Do you plan to do something like that with your data analysis? If not, I'm not elk county, but from elk county, I would want to know that disconnect between the two. Right. So that's why the radar charts are only five things. Right. That would be just some help. That would be some input, because I know you're still finalizing the report, and I know there's a lot of data sets. And I used to be in that work and did a lot of that heavy lifting around data. So that's just an observation. And then when Alcohol Tax Fund and the Opioid Settlement Funds, when there was an original analysis of how those statutes read, Alcohol Tax Fund, where it left opportunity on the table was really around recovery. Right. And where OSF really came in is offering us to be more intentional and more broad in recovery. Right. And those other self-sufficiency supports that support recovery. And so I didn't know if the report identifies more opportunity space for those recovery. And I know it's not as, that question's not going to be as germane to some counties, because in order to get your Alcohol Tax Funds directly to you, there's different population thresholds. But for those of us who are in those population thresholds, that braiding of those dollars in a very intentional way, I think is vitally important. And I didn't know if any of that is contemplated in the product that you're finalizing. Can I answer the first question? So yes. So one of the things that happens when you do these vulnerability maps, right? Some of these individual differences from counties get washed out because compared to the other counties, they're not that high, right? And that's why it's so important to look at the individual counties and then say, well, they might look at low vulnerability when compared to everybody else. But if you look at their data, all of their factors, you can actually see, oh, their overdose risk is actually quite high, or their usage risk is really high, right? And so that's why it's important to not just take the, you know, we debated, should we even put the vulnerability county map up? Because it washes these differences out, right? And if it's really the important part is that you have to take a deeper dive into your county and then look at the vulnerability factors, maybe not in comparison with the rest of the other counties in Kansas, but just by itself and say, might look good on paper, but what's really happening here is not so good. So we need to focus on that. So yes, I hear that. I can speak to recovery too, I don't know what, but we have actually focused a great deal on recovery. We really want to get out of this, you know, mindset of we sent you to, you know, we sent you to treatment, you come out and then good luck to you, kind of, this just keeps people feeding back into the same. This is not an effective system. It's not working for anybody, right? And so we spent actually a fair amount on the report on how can we break out of this traditional one and done, you're coming back six times, you know, without any success. So we have a heavy emphasis on these recovery supports. And back on those anomalies, is part of the work that you're doing for the Sunflower Foundation and for Kansas Fights Addiction is to, after the report is put out, is if you have various communities who need some additional data support analysis support that you provide that to them in a fashion to help them disseminate the information and to highlight those anomalies and figure out why. Not that specifically. So we have a couple of sessions where we're actually going to talk to board through how to use the data that they can use, but it's definitely something. So there's no field component to the agreement that you guys have? Noted. Okay. Thank you. I will also detail for you that the sections, as I mentioned early on, we've started with a very introductory approach and the overview and a macro view for people. And then there are these 11 sections that go into much greater detail, particularly for people to do, Julie, the kinds of things that you are talking about to tailor the broad data. It gets narrower and then it gets narrower again, so that you have three different levels of access within the document itself. Those additional chapters include, well, an overview of substance use in Kansas, specific factors that are contributing to that, and that has localization associated with it. Then there's a whole section on stigma, the manifestations of stigma and how that is feeding to this problem. Then we have a very detailed section with regard to ecosystem players and actors. And that includes those who are in the throws day to day, as well as the adjacent kinds of ecosystems, our healthcare systems, our law enforcement, our education systems that are so a part of our work as well. There are coverage factors influencing treatment access. There is a detailed section on funding. Where is it coming from? Where is it going? How are we spending it now? What does that look like? Then we get to what I consider more the common way of thinking of these things by domain. Primary prevention, follow-up care, harm reduction, workforce needs for a model like this, a public health model. Within the appendices are all of the methods in detail, the data tables, the resources, and tactics as may be used for inspiration or to pick up and use, community sensemaking and futures findings, and then the detail of the quantitative work. It does go really quite detailed for those particularly like you who have had a lot of background and are working at that level. I don't see any lines at the microphone, so I don't think you all probably have any other questions. I want to thank Janine and Silke for presenting this information. It's only the second time that they've shared this publicly, and I'm so grateful that they had the opportunity to do that here, and really want to encourage you all to use this data in your own communities to make the decisions that you need to make around the opioid settlement funds. And anytime you heard of a suggested strategy that might be able to benefit your community based on data, the Opioid Response Network can provide you with free consultation and training related to implementing those approaches. We've done everything from helping the state of Iowa set up a recovery housing affiliate network through NAR, helping Nebraska with a peer run warm handoff programs based on a model that's out of Missouri and Rhode Island. Whatever strategy you're thinking would be beneficial to your community, the work of the Opioid Response Network and our partners can be brought to bear to support you in implementing those strategies and approaches. So just bringing that back around to ORN and how we are always here to help with those kinds of needs. So I hope you'll think about that as you consider your planning. We've got about 15 minutes now until our next presentation. We're going to start at 11.15, so if you'd like, we tried to build in lots of little breaks so you can check your email and take care of yourself. So let's meet back in this room at 11.15. This is a really pretty good turnout. We had about 16 people. So good. We have a lot of great people in the room. All right, let's get started. Okay, everybody, I'd like to welcome you back from our break. I hope you had time to get some water or coffee or return a phone call or an email to help make your workday a little easier today. After this session, we will be breaking for lunch. And again, on the back of your badge is your choice that you made. So just keep that in mind as you go to get your lunch when we're done with this session. So I want to thank you all again for being here and welcome back folks on Zoom. It is my absolute pleasure to welcome J.K. Costello with the Opioid Response Network. He's a consultant for the ORN, and also he's the principal and director of behavioral health consulting at the Steadman Group. And Brianna Robles, opioid response network consultant and associate consultant also with the Steadman Group. They have been doing work across many states in our region, Colorado, Kansas, and Oklahoma, just to name a few. And they have some really great information, I think, that's going to help you in the decisions that lay ahead of you. They're going to share information about how to use and leverage data and return on investment research to inform the settlement decisions. So I'd like to welcome them both to the podium. All right. Thanks, Sherry. It's close. I need a little extender that puts it up to my height. All right. I'm J.K. and I'm chicken. And just to give you an idea of the structure of the day, we got great information about statewide. We got some inspiration, reasons why the opioid settlement's here. And we're going to start to narrow the funnel and get more specific about spending and then get some examples in the afternoon. And then last thing you're going to hear from the attorney general's office. So we hope you stay all day. Today, Brianna and I are going to talk about evidence-based ways to spend your opioid settlement funds, what's allowed. And then we'll move into what is evidence-based, what's good. And then give some examples of how people spent money in these ways previously in some of the regions we've worked. So a little bit about our background. We both work for a consulting firm called the Sedman Group based out of Denver. But we also help Sedgwick County and Wichita do their opioid settlement strategic plan. So we've done some work here in Kansas and, as Sherry said, in some other states as well. So we've got a broad overview of how people go about making decisions and go about spending funds all the way down to procurement and evaluation. And then iterating that into the next version of spending. So today we're going to talk about return on investment. Like I said, what's allowable and what's a great way to spend your funds and then how you might go about doing that. So what's allowable? Bottom line, most things are allowable. I think I counted 106 one time in Exhibit E or Exhibit A, whatever your state calls it. You know, E, Exhibit E. And is there an Exhibit A through D? I don't know. But Exhibit E has all you need to know about how you can spend funds. And it breaks it down into several different categories that you'll see. Things that you would expect, like prevention, treatment, recovery. And then some others that seem kind of random to me, like first responders and training and research. Bottom line, I've never seen a use of funds that was really directed at opioids that was earnestly arrived at by the community that was not allowable. So people have asked us, oh, what about transitional housing? What about this type of treatment program? What about a faith-based program? All of those things are definitely allowable under Exhibit E. I actually see a question that I will leave to Chris to answer about canines. And so there are definitely some, like, good questions about this. But the vast majority of uses are found somewhere on that list. So everything from improving data systems to evaluation to helping to decide how you're going to decide, all of those are allowed uses. So rest assured, when something comes out of your community, it's probably A, allowable use funds. So you've got allowable use funds. What would be a good use of funds? And that's a loaded question because you want to align, preferably the evidence base, with what you can do with what's going to look valid and look good to your stakeholders, which are the citizens of your city or county. And so that's a little bit more difficult. It's trying to align all those things and figure out what you can do. Because I think Silke said it. Trusted organizations. We've seen a lot of gaps analyses that don't recognize rural areas or just what people already have because it's really hard to bring in something totally new. Like, if you don't have a methadone clinic, maybe there's a reason for that. And so bringing in a methadone clinic could be really difficult, whereas working with a group organization that runs recovery homes could be really easy. So we want to try to align all three of those things. And we won't do that totally in this talk, but we want to start thinking about that. And so you see some examples here of approved uses and the different categories. We're going to go through each of those categories and give more specific ideas of how you could spend and some specific evidence, cost-benefit analyses, cost-effectiveness analyses on what works well within those realms. And I'm going to hand it off to Brianna to go through prevention and risk reduction. I'm going to move this way down. I'm used to standing on my tippy toes next to JK when we present together. All right. So just as JK said, we're going to go through each of the categories outlined in Exhibit E and talk about return on investment analysis, what works, and how to identify what may be useful in your community. So starting with prevention, SAMHSA defines prevention as activities that work to educate and support individuals and communities to prevent the use and misuse of drugs and the development of substance use disorders. Prevention is often youth-focused. It's most often in the community and school-based. It can be universal prevention. So prevention is for everyone. It's rarely billable, and prevention is almost always education-based. So what does the evidence say about what works for prevention programming? When we look at the general population, evidence points towards robust PDMPs, prescription drug monitoring programs, and also clinical pain management interventions. When looking at youth, again, another big aspect of prevention is focusing on youth and our young folks, specifically children whose parents misuse opioids. Evidence points to programs such as these as being effective, so integrated SUD treatment, home visitation programs, family skills trainings, and family drug treatment courts. When looking at the youth population specifically, school-based programs to build social resistance and normative education. Some examples of these are general life skills trainings and family matters trainings. Getting the family involved is also proven to be really effective in prevention, especially with young people. Looking at the data, prevention return on investments. This is a chart showing from 2017, a research analysis in 2017, the benefits of different prevention programming. So on the left side, you have the program, whether a life skills training, a screening intervention, or a teen intervention. And then you have the benefit-cost ratio all around in the first column, taxpayers and other societal benefits. Other societal benefits includes reductions to healthcare costs, reductions to crime, and improving the value of statistical life. So you can see here that there was high return on investment for both the life skills trainings program and an alcohol screening program. So again, really, really effective. Another study from 2013 showed that the average effective school-based program would save an estimated $18 per $1 invested. And that's a SAMHSA study. All right, moving right into the next category of that Exhibit E approved uses, which is risk reduction and overdose prevention. What is risk reduction? Risk reduction are strategies aimed at reducing negative consequences associated with drug use. So meeting people where they are. It often overlaps with tertiary prevention. And it's usually provided in community settings, also rarely billable, just like prevention. And as we've heard before in other presentations, it's really important to include folks with lived experience with substance use disorder in the decision making. So what works? What is the evidence behind risk reduction practices? A common risk reduction practice is naloxone distribution, getting naloxone out into the community widely and making it available to everyone in your community. So naloxone distribution is well supported. We'll talk a little bit more about return on investment for naloxone. Also hepatitis C and HIV education and prevention and syringe service programs. So these risk reduction practices might not directly address opioid use disorder symptoms or opioid use. However, they greatly reduce the risk of the negative outcomes associated with opioid use disorder, such as HIV transmission and overdose. So looking specifically at naloxone, intranasal naloxone, this study was done. Let me tell you when. In 2015, to see the savings of a... Oops, sorry, I'm on the wrong page right here. To see the cost savings of a intranasal naloxone program. So you can see that collectively, all the studies concluded that community distribution of naloxone was very cost effective, with cost savings ratio between $111,000 and all the way up to $58,000 per quality adjusted life year gained. So you can see ICER, this is basically just the dollars saved per quality life year. So high savings all around from different research studies there. And I'm going to pass it back to JK, because he's the treatment guy. I'm going to move it back up. Thank you. All right, and I just want to illustrate a story on that risk reduction. I had a friend, so I'm in recovery, and when I was not in recovery, I had a friend who used needles, I did not, he did. And I got this insight because I was a physician and he told me stories, and he had gotten hepatitis. And it was interesting because that kept him like in shame and guilt. And so just having hepatitis really kept him using. And the other interesting part was how simple it could be to prevent something like that, because I asked him how he got it. And he said, Oh, I left a needle out one time in the air, and hepatitis landed on it. And in my head, I was like, that's, that's not how it works. But like, I mean, I get it's a simple thing. We all know that, right? It's a bloodborne disease and sharing needles is what causes that probably somebody used it when he was not there. But just that knowledge that reusing needles is really the only way to get hepatitis C could have ostensibly prevented this. That's a very easy intervention. I realized like getting it to the right person is not easy. But simple switch in knowledge that could have prevented him from having hepatitis C. So risk reduction programs aren't just syringe access. It's also a lot of knowledge around how to use drugs more safely, and how to prevent easily preventable infections like hepatitis and HIV. Next, I'm going to talk about treatment. And we you saw some of the graphs on cost effectiveness around prevention. One of the things I think is a pitfall of opioid settlement spending is that we spend all the money on treatment, because it seems easy to measure like, oh, there's a person in front of us who needs treatment, we should give them treatment, we've got money to pay for it. The pitfall what I mean is not that that's not effective, but that there's already a lot of money that flows into treatment. Even in states that don't have Medicaid expansion, treatment is still by far the largest expenditure on substance use in Kansas and every other state. The other thing is, many of the population based interventions like prevention are more effective, more cost effective than treatment itself. So I know it's easy to say, oh, gosh, we can measure this really well. And there are good outcomes for treatment because there are. But there are also a lot of ways that are underfunded like recovery and prevention to spend opioid settlement money. So with that caveat, I'm going to talk about treatment, what it is, and what are the most cost effective cost beneficial ways to spend money within it. So treatment's probably the most, the easiest to define of these five boxes that we're going to talk about, because it's largely delivered by people with lots of letters behind their names. I recently saw a record, I think somebody had 12 sets of letters after their name. Counselors are like so guilty of this, they just stack up credentials. And so those are people that do treatment. And so they are often also in an office that you could recognize as someplace people get treatment. And that's broken down a little bit with telehealth. There's a lot more treatment going on outside of clinic walls. But still, a lot of substance use treatment is in counseling centers and residential treatment and detox in places like methadone clinics. So this is pretty easy to define and measure. And I think that, again, leads to that pitfall of, oh, we should fund this because we have good metrics about what happens and what the outcomes are and what we're paying for. There are gatekeepers in treatment much more than in recovery or prevention. Insurance companies usually are those gatekeepers. And you can see here, this is a great thing about treatment, actually, is that there is a very well-defined continuum of care within treatment that is actually starting to incorporate some things outside of treatment, like recovery. So you see here, for the first time, the new ASAM criteria includes recovery residences or sober living. So this is a new step that treatment is now acknowledging that there are things outside of treatment that are effective and even some things like long-term remission monitoring. I would call that recovery, but this is giving it a medicalized point of view. So some of these that you're most familiar with would be the higher levels. Those are the residential levels of care, also known, well, residential and inpatient. Those are your 28-day stays, three-month stays. And then there is intensive outpatient, which has gotten a lot more attention because often people will live, say, in a sober living, and they'll attend treatment every day, keeping them busy, but also in the community and not such a high, expensive level of care. And then at level one here, you've got your outpatient, once-a-week therapy, and that also now includes medication-based therapy, like methadone or buprenorphine, which are really, really well-supported. And I'm going to talk about that on this slide. I want to recognize that in treatment and in recovery and in prevention, we know what works, and it's a common misconception that, like, substance use is just this crazy world where we don't know what works and nobody's successful. People are successful, and they're more successful when they do the things that we know works. I'm a great example. I went to treatment twice. The first time was kind of a spin-dry. They didn't use medications for opioid use disorder. It was really lacking in structure. And the second time was this really evidence-based program at the University of Colorado. I love it. It's called CDER. And I went through levels of care all the way from the highest to the lowest, and it worked. They incorporated things like exercise, which is actually a very underrated but important part of treatment and recovery. And that worked, and it's been almost 11 years now. And so I think it's a really good, like, that's an N of two, but one worked and one didn't. And I think there's a lot of validity just in my personal experience there. But you'd see that if you extrapolated that to a million people, I think you'd see the same things, higher rates of recovery for people who go to more evidence-based treatment. So within that, there's a big debate about medications, a crutch. It's trading one thing for another. Is it better to do counseling or medication? Treatment and recovery are not a this or that. Things have an additive effect, and there's no doubt that counseling along with medication is better for people long-term than one or the other. But if I had to choose one, in the short term, it would be medications because they help people alleviate withdrawal. And withdrawal is the number one thing in the short term that keeps people using. So medications help with that, especially really only those top two, methadone and buprenorphine, which is also suboxone. But there are a lot of behavioral therapies that work. And one of those I want to highlight, cognitive behavioral therapy is just talk therapy, like many of you probably experienced or are familiar with. Contingency management is actually paying people not to use drugs, and it's really effective for stimulant use. And that is actually something that we have a lot less effective therapies in. So that's something that is very effective, hard to implement, but effective. And then you've got a couple other models here, and there are lots of other models that work in treatment. This is contingency management, and we've done a lot of work and research on this. It's a different treatment model because most treatment models, as I said, are a licensed clinician talking to someone and either talking to someone or prescribing something for them or keeping them in a place that helps them be safe. Contingency management is a totally different model. It is really almost bypassing the clinician and providing incentives directly to a person for achieving some behavior, which is usually short-term abstinence, at least. So you pass the drug test, you get $10. And the funny thing is there are many sayings that the cheapest way to get something is to pay for it directly. This is one of those things that you pay for abstinence and you get it because people respond to rewards. Often the only thing people respond to when they're using substances are rewards, and money is a very tangible one. So there are a lot of regulatory hoops, but you can see here that it's actually a very low-cost program because treatment's expensive. Giving people $10 every week or so is not expensive. And there's a lot of benefits to this because people use less substances, especially stimulants, over time. This is a return on investment for medications. And it's really extremely positive. People are 50% less likely to overdose when they're on medications. And they generally stay in treatment for up to six months, even longer. Six months is the median duration of therapy for buprenorphine or methadone, which I know sounds like it's not that long. But that's actually pretty good, given that the average quit attempt for opioids lasts a few hours to a few days. And so keeping people in treatment for six months with medications is a big success. These also reduce people's, not only keep them in treatment, reduce their use of opioids. And some studies have shown that they keep people out of jail, in prison too, and in jobs. Next, we're going to talk about recovery. And I think this is one of the harder to define buckets because recovery, I think long-term recovery, just looks like a good life. Like anybody else's life. And I started to realize my problems, I'm a person in recovery, and now my problems are just the same as yours and yours and yours. Which is kind of mundane and boring. But also, that's life. That's a good life. And so recovery is really easy to define at the beginning, because I think a lot of it is 12-step recovery. It's very substance-use-focused recovery. But long-term, it's having a job, having a stable mortgage. It's just life. And so I think it's easier to find things to fund earlier. Things like sober living. I mean, that's very easy to define as recovery-related. We have a gym called The Phoenix, and it is sports and activity, specifically for people who have been absent for 48 hours or more. And some people do it for years. But it's really specific to recovery. So in sorting through proposals, I have kind of learned that at some point you have to cut this off and say, this isn't recovery, this is just life. And we need to find another funding source for it. But things like peer recovery coaches, like I said, sober living are really easy to fund because they are so substance use specific and often acute for people. So you heard SAMHSA's definition. That's the great thing is even though you don't necessarily know it when you see it, there's a really well accepted definition and pillars for recovery. And you see those there, definition and pillars. I would say 90% of people in the field would recognize SAMHSA's pillars of recovery and be able to slot different types of programs into one of those fields, like universally accepted. And so you see there, the hard part, there's a good definition, but it's hard to say, to quantify this because so often for a long time, it was just, you had to be abstinent for X amount of time to be in recovery. And that definition is really broken down where there are people who maybe use occasionally or they use one thing, they drink normally, but they don't use substances and they're still in recovery. So I think that lack of, or difficulty in defining someone's recovery shouldn't prevent us from funding it. Recovery is almost always community-based and there is this like tendency for treatment centers to call themselves recovery centers, but we should not let that, again, prevent funding. So this is something that happens in the community, can be a coffee shop, often they're in church basements, they're in much less defined locations than you'd see treatment. And they weren't billable. I made this slide like five years ago when recovery wasn't billable. There are more billing codes now for recovery, especially in Medicaid expansion states. So that's really good that there's a more sustainable funding line for recovery, peer recovery support specifically. And of course, if you're gonna fund recovery, talk to people in recovery, talk to their families, talk to people who are still using. That's kind of, it can be difficult to get longitudinal engagement, but attempting it's really important too. And there are evidence-based practices in recovery. Absolutely. A lot of sober living, Oxford House has been studied extensively, like extensively, extensively, and it has great outcomes at a really low price. So recovery residence is one of my favorites to fund because there aren't a lot of other funding sources. So grants and opioid settlements, we've done a lot of recovery residence funding because often it's really cheap to run and the capital is what's needed. And so grants are really useful for that kind of project where, hey, we need $100,000 to renovate this house and then we can run it for a long time. That's great use of funds. I mean, there are mutual support groups that don't take money. And so it's actually more difficult to fund, but there are non 12-step support groups that do accept funding. So peer recovery organizations, recovery community organizations that offer peers, not just sponsors, will have grant applications sometimes. And you see a lot of enabling services here, access to housing, case management, that kind of overlaps with other navigation type services. But one that's been utilized recently is having people in recovery on even co-responder teams or on follow-up teams. And I find that really cool. It's definitely a cutting edge to have people in recovery out there on the front lines or following up with people after an overdose because that's a sensitive period. Like after someone overdoses, after they leave prison, you would think this would be a good time to get people into treatment. Peer to four, it has not been a high fidelity linkage. Like people's follow-up after an overdose is very, very low. People's follow-up after leaving prison is very, very low. And having peers in those settings is a promising practice to improve follow-up. You see recovery return on investment here. And... Oh, so this is like peer recovery outreach. And it shows that there's a good benefit cost ratio for peer recovery. It is, as I said earlier, like one-on-one interactions generally tend to be more expensive, but peer recovery is a good use of funds, absolutely. And especially because there are so few other sources of funding for it. All right, last one I'm gonna talk about is criminal justice. And this one's a... This one's really easy to find, right? It's like usually in a jail or prison or in parole or probation settings. That's kind of how we define criminal justice, but it also usually consists of something else, something prevention, something treatment, something recovery. And so it often is like a peer recovery coach who goes into a jail or methadone treatment in a jail. And so it's not, I don't really think of it as a totally separate funding line, but it is well-defined as far as where it happens. And obviously in public health, you want a high prevalence of a disease. You don't want, actually, you want a low prevalence of disease, but like to intervene, you want to find people who have this condition, substance use, and you wanna find them all in one place. So what describes that better than our jails and prisons? I mean, there are lots of people with substance use issues in jail and prison. So this is a really good place to intervene. And I think historically there've been issues because it is a much more controlled setting than the community or residential treatment even. One of the most, I mean, I wouldn't say famous, but one of the biggest success stories in substance use treatment in the last 30 years has been implementation of medication into jails and prisons. You actually saw ORN did a project in Rhode Island I got to attend like eight years ago where Rhode Island's Department of Corrections implemented a comprehensive methadone and buprenorphine program. And the year after they did that, their overdoses for people who left their prison system dropped by 60%. And that like blew my mind. Changes of three or 5% are really, really significant in this field and other fields. So to see overdoses drop just like that in a really convincing study by 60% just convinced me like we need to do this. And so I actually got to help do this in Colorado and get laws passed and get funding. So now all our jails and prisons do that seven years later, but still. So that's one that's really a pet project of mine. And I think is a great example of how to use evidence-based interventions in a, we call it a target-rich environment to help people, especially to help people as they go back into the community during a sensitive time. Hits a lot of public health principles. So outside of medication, there are also peer programs that can start in jail or start as people transition back into the community. And those are actually becoming pretty popular in lots of jails and prisons through telehealth. And one of the barriers is having people in early, even middle recovery, coming into jails and prisons can be difficult. So as county law enforcement, I think one thing we've tried to do is standardize. Like, so I did this for a 12-step group and every county had a different requirement for what you needed to go in there. So like I could go into Broomfield County, but I couldn't go into Douglas County. And that actually made it really difficult. And it made it more difficult in employment settings because they were hiring people to be peers in a jail and they'd hire somebody and then they couldn't actually go into the jail. And so it was not only demoralizing for the employee, it was a waste of money that they'd hired this person and also prevented this effective programming in the jail. And this is just, this is another cost-benefit ratio for substance use treatment in jail and prison. It's really effective as everyone would expect. And there's usually a waiting list in many jails and prisons for it. With that, I'm gonna hand it off to Brianna to talk about using data. There we go. All right. We talked about different types of programs in each of the categories under Exhibit E that are effective what the research supports is effective in many different communities. Now we're gonna talk about how you can show your programs are effective and how you can show the impact of your community's programs. How do you know that the programs that you're funding are impactful and evidence-based? And how do you know that your programs are impactful and evidence-based? Well, you use data. So data matters because it can show transparency, accountability, and impact tracking. So with opioid settlement funds, all of the above are really important. You must be transparent with your community and others about your spending, and then also be accountable and impactful with your funds. So an approach to using data efficiently for opioid settlement spending is to collaborate and define clear metrics. So work with the programs that you're funding. What's feasible for them to collect? What are they already collecting? And what would be maybe efficient for them to collect? So work with them, collaborate and define clear metrics together. Align with evidence-based practices. So we just showed you some evidence of what works, what the research shows works. Align your programming with these evidence-based practices, and then utilize data dashboards. Data dashboards are really helpful to show real-time tracking of spending and outcomes. Visual insights can be helpful for policymakers and stakeholders, and better decision-making through data-driven adjustments. So example uses can be to monitor overdose trends by different regions, compare program spending versus impact. So program spending versus people served, or program spending versus MAT doses delivered, program spending versus number of peers hired, to show impact, and then also identify gaps in service delivery. There's a really great resource by Johns Hopkins called OSPRI. I cannot remember the acronym off the top of my head, Opioid Settlement Spending Something, that helps define evidence-based metrics for different types of opioid settlement funding. It's a really great resource. It's a website. You go on there, you put in the type of the program that you're interested in funding, or that you are funding, and it will spit out some evidence-based metrics that maybe the organization is already collecting, or may be feasible for them to collect, that will show impact of your programming. So highly recommend checking out that Johns Hopkins resource. So defining and tracking key programmatic metrics. How do you choose metrics? Process metrics are more of the short-term metrics, as well as equity metrics, so who receives services, and then outcome metrics are more of those long-term metrics related to overdoses and increased treatment access. We at Steadman Group utilize a framework called RE-AIM. There are many different evaluation frameworks you can use, but utilizing a framework keeps you consistent across the board when you're evaluating programs, and it also keeps you aligned to those short-term and long-term outcomes so that you can be sure you're measuring everything from the process and equity metrics all the way to the outcome metrics. So be sure to align data collection with contractual requirements, whether it be quarterly or biannual. Make sure the programs that you are funding know when they are supposed to report the data. Be really clear about that. Be really clear about the metrics that they are to report to as well. And then again, work with those partners. Collaborate to ensure meaningful but standardized data collection. You want to make it not a big burden for your partners to collect their data. So what's feasible for them, what are they already collecting, and what's going to show an impact? Here's an example of that framework I mentioned. Again, there are many different frameworks. We utilize logic models and RE-AIM models along with some other different evaluation frameworks. We really like the RE-AIM framework because it does show everything from those short-term outcomes to the long-term outcome process measures. So everything from reach to effectiveness to adoption to implementation to maintenance. And you can see some examples on this slide for different metrics for either a treatment program, an MAT program, and then a youth prevention program. So everything from the demographics of the people served to the number of trainings developed or the number of patients receiving MAT all the way down to maintenance, which is how will the program be sustained long-term. And I'm going to pass it back to JK to close us off. Thanks. All right. So in closing, I hope we've dispelled any concerns you have, not any concerns, but some concerns about deciding what you want to spend money on, that there are a lot of things you can't go wrong on and finding something that's going to work in your community because I know we've got some really small counties and towns out there is really crucial. And something that's generated by your community is going to help. I have a big bias toward more preventative measures because I think like recovery is a great story. Treatment and recovery are great stories. And I think we heard like the story sells and there's less of a story in prevention. And I'll give you like two brief stories. You heard mine a little bit, twice in treatment, now cool story, 11 years in recovery, like great, great. My girlfriend, her dad died when she was young. She started drinking a lot and she recognized that, that she was really missing out on life because she was drinking too much and never went to treatment. She went to a program called Celebrate Recovery, which is an awesome faith-based 12-step program and didn't drink heavily after that. It didn't cost a thing and her life's a lot better. And I get there's not, she doesn't identify as being in recovery. She doesn't have this like amount of time. She doesn't get these cool like chips that you get, but what's a better story for public health than a lot of people doing something community-based and really cheap, almost free and avoiding that whole, like my story doesn't get into all the bad stuff that happened, right? And she avoided all that, not all of it, but some of it. And so I think looking at how we can just not cut out treatment, but maximize the number of people. I think I heard 375,000 people don't know or aren't ready for treatment yet. How could some of those people get into, reduce their use, right? We don't even need to use words like recovery. That's the big win. And where I think opioid settlements can be so powerful is we can re-envision what it means for someone to go from unhealthy relationship with substances to healthy relationship with substances and not spend a bundle in the meantime and create a system that's gonna work forever. And I know that's kind of idealistic, but I think it's just a little different than how we usually think about substance use, which is like this person needs to hit rock bottom and they need to go to a 30-day treatment and be taught how to live. And that's just not the case. Like a lot of people know how to live and they just need some minor adjustments. And those are a lot better than the big fixes. So a little bit about Opioid Response Network. You heard about it. It is free. We're here, courtesy of Opioid Response Network and Sunflower Foundation and the Attorney General's Office, so thank you. It's really easy to submit a request and they do get back to you the same day. In fact, sometimes they get to me the same day and we get this request dealt with really quickly. So if you are a county, city, provider organization, and you have a question, they'll help you. We will also help you. If you have questions, feel free to email us. And, oh, did we move the QR code? Okay, awesome. Well, thanks everyone, I appreciate your time. Oh, let's see. Yeah, that's okay. Okay, so we just have a few minutes here, but there were a couple of questions over there and now seems like a good time to try to get them answered succinctly and briefly since we only have five minutes. Huh? I don't know if you guys will be able to answer it, but maybe somebody else in the audience can. I have an opinion about one of them. Can we use these funds to purchase a canine for detection enforcement and outreach purposes? Chris, would you like to comment on that? So I think I've probably talked to a number of you about questions like this. What we use in Kansas is a pretty general bright line, and it is, the question you ask yourself is, who is the expenditure for? If the expenditure is for an individual or a group or working in your community to do prevention work, treatment work, harm reduction work, then it's probably going to be acceptable. But if the expenditure is for traditional law enforcement purposes, so you think like criminal prosecution, those sorts of things, and that's gonna be distinct from the criminal justice piece that we just talked about. That's likely gonna be excluded. So I heard you say, can it be used for detection purposes? Yeah, it was a canine for detection enforcement and education. So that's gonna be a complicated answer. But generally speaking, for detection purposes, no. That's generally outside the scope of what these dollars are really used for. For community engagement, it really is gonna be dependent on what are you doing with that particular dog? That's, again, we go to the question, what is the purpose for the expenditure? Is it for prevention, treatment, recovery, harm reduction, those sorts of things? Then that's likely gonna be acceptable. But if it's really purchasing that unit for traditional law enforcement, those sorts of things, that's generally where it's gonna be outside of the bounds of this particular approach. I don't wanna say you can't use a dog for treatment purposes or for community engagement and things like that, it's really gonna be a very close line on that particular question. I'm gonna hang out here for a second. And I would say that don't worry about these kinds of approaches being funded because the executive branch of our federal government has made their drug policies pretty clear. They have five of them and three of them are enforcement related. So there is going to be an increase in the funding available for detection and enforcement coming from the federal government. And that's a really great reason not to use the opioid settlement funds. Like don't use them for things that you can find other funding for or use it to leverage things that are already funded to bring them to scale or expand them because there are gonna be more funding available for these types of law enforcement activities. Okay, and so the next question is, and I'm a worst case scenario person. So this question has my heart. I better put on my glasses. In the worst case scenario, let's say a local government spends funds, the opioid settlement funds in an unapproved manner, what legal consequences could result? So I'm not gonna start at the worst case but we'll work our way down there. So in an instance in which a local government used dollars in an inappropriate way and in a manner that was just wildly outside the scope, I'll use my classic example here of say you were a local government and you purchased guns and flash suppressors. Our first step here would be to have a contact with you to discuss that particular expenditure. What was the purpose for those expenditures? Is there a defensible purpose for those expenditures within the limited scope of the particular opioid settlements? If there was not a permissible use there, our next step is to work with you to determine if you can reassign your budget, so those expenditures to a different fund within your particular unit of government. If you can reassign those, our expectation is that you will then assign those dollars that you expended for that impermissible purpose back to the opioids fund. If you remember, each of your units of government is supposed to have a separate fund, either account or separate fund for these opioids dollars, and this is for this purpose. So if there was an impermissible use of those dollars, then you can reassign money back to that fund so that we're back essentially to where you had not used these dollars for an impermissible purpose. If we go to the worst case scenario and there is some situation where you are unable to do that, I don't want to say that there would be litigation, but we would probably work into a situation which a clawback or something like that, there are terms in the MOU on how we would go about that particular process. The reason I'm hesitant to tell you exactly what we would do is because we really do not wanna get into that situation, we really wanna work in this in a collaborative way. So what I would tell you here is don't be super concerned if there is a situation where we have to have that conversation, just be willing to work with us to correct the issue going forward so that we can make certain that these dollars are not used in an impermissible way. Our approach here at the AG's office and at the state level is to make this not super burdensome on you, to make sure we're all playing within the guidelines, staying within the lines, but we want to be very collaborative as a partner here, not as the strict enforcer coming down to audit your dollars and claw dollars out of your accounts. I hope that almost answered your question without directly answering it. If you did have that question, feel free to reach out to myself at the AG's office, we can have a more detailed conversation with your city or county attorney. Thank you, Chris. Everybody, it's lunchtime. Please remember to look on the back of your badges for the meal that you chose when you registered and make your way out and enjoy a delicious lunch. We will reconvene in here at 1245. So we'll see you back here at that time. Thank you. I'd like to welcome the panelists up to the table. So if you're serving on a panel, come on up. Oh, hello? Oh, it's on. Alrighty, I am going to kick us off here. We're going to start with introductions. Are you Erica? Hi. All right. Welcome back for lunch, everyone. I hope your sandwich was delicious. The little salad bowl with the spoon, that was really nifty. I've never seen that before. All right, this is going to be a community spotlights panel. I have some awesome panelists up here, and they're going to introduce themselves and where they're from, and then we'll dive into some details on how are they spending their dollars, challenges, successes, and that sort of thing. So here are our panelists' names and contact information on the slide. I am just going to let the panelists introduce yourself, including a high level summary of your community and how you're involved in opioid settlement spending there. And I'll start with you, Sheriff. Got it. Is it on? Is it on? It's on. Well, good afternoon. I'm Jeff Easter. I work at the Sedgwick County Sheriff's office. I've been in law enforcement 36 years. I started at the Wichita Police Department back in 1989. I got to know Dante back then when he was in probation. So we've known each other for a long time. Our community, well, you saw the stats on it. So, you know, you have the city of Wichita, which is where the most of the population is. We patrol out in the rural areas. We got the same problem in the rural areas of Sedgwick County as we have in the city, just not as many people. And so it's a deal where the city and the county came together, and we'll be discussing that today. Thank you for being here. Yeah, thank you. Good afternoon, everyone. Dante Martin, city of Wichita. I am currently assistant city manager, city of Wichita, where I work with our public safety departments, police, fire, municipal court, and also our administrative department. So HRIT finance and law prior to that. And as Jeff was mentioning, I spent 12 years working in our court system. Part of that is the municipal court administrator. In terms of our community, Jeff laid it out for you. Wichita, largest city within the community. Long history of partnering with Sedgwick County, city county working together to tackle local issues. Recognize that the issue we're facing now doesn't recognize jurisdictional boundaries. So it makes sense. And I look forward to continuing to work with Jeff, assistant county manager, Rusty leads in the room also. So long held partnership that we hope to leverage going forward with our settlement funds. Hello. I'm Mike Smith. I'm the district court administrator for the 23rd judicial district, which is Ellis go Brooks and Frigo County out in Western Kansas. I. In 2018 Ellis County developed a. Recovery court. Through the national association of drug court providers and. Our county administrator decided. That he wanted to. Get these opioid funds to. Our drug court. It happened. That we had been accepted for a federal grant. So we had. A lot of fun for our drug court. And I looked and saw that a lot of these funds were. We're going to be beneficial to a lot of different people. So. I. Kind of created a program there in Ellis county that we use to. Distribute some of the funds. So. I was going to say good morning. It's already afternoon. Erica Garcia. Yes. I'm the director of resource allocation that United community services of Johnson County. We use the acronym UCS. And we are a nonprofit organization that provides data analysis. We lead collaborative planning and mobilize resources. To enhance the availability and delivery of health and human services. We currently have a structure. That has been in existence since 1980. That is to manage the alcohol tax funds. That come for a couple of jurisdictions. And so when the opioid settlement fund became available, we talked to some of those jurisdictions. To pull those resources together as well. And being able to kind of. Provide those grants that way. So we'll talk a little bit more about that in a little. Yeah. Thank you all. Thank you all for being here and for being a part of this panel. We're really glad to have you and to hear some different ideas. My next question is how is your community spending opioid settlement dollars so far? You can just popcorn or go down the line again, whatever you. I guess best. Hello. So city of Wichita. And what I really appreciate about the approach, the city and county have taken over the last 12, 15 months is recognizing that together, if we pull our money, we can accomplish more. I think we're expected to receive short of $60 million over the next 14 years. As far as the city of Wichita, we've had small purchases. We've purchased Naloxone for first responders. Recognizing there was an immediate need. So small amount. We've also funded some community agencies and certain parts of activities conducted by community agencies, namely the mental health and substance abuse coalition. And sheriff Easter can tell you much more about that. But as I was mentioning earlier. Recognizing an opportunity to have a greater impact. If we work closely with our partners at the county. And building on relationships that have been in existence for, for decades, we have shared departments. We have shared offices or services. We've participated in joint and shared strategic planning processes. So this process wasn't new to us. It was just the recognition that together we can accomplish more and making a commitment to work with stepping group or bring in a professional that could help facilitate the conversation. Also recognizing and knowing our limitations. Fortunately, Sedgwick county, we were able to leverage or take advantage of the services that calm care provides, but calm care faces many of the same challenges that all local government agencies face. And so wanting to use our resources strategically and Jeff, I think you probably have more experience with the mental health and substance abuse coalition and how that kind of feeds into this work. Yeah. So the county hasn't spent any money yet. The mental health substance abuse coalition was formed six years ago to, to tackle the issues that we were having with mental illness and substance abuse and the lack of funding, the lack of services, and those types of things. And so through that particular group, we were able to form partnerships with a ton of nonprofits. And I'm not, I think one of the questions later on is challenges. Nonprofits are always competing for the same money and the same donors. So getting them all into the room and having open discussions was a little bit of a problem in the beginning. And so, but because of those relationships that were built through the mental health substance abuse coalition, when we started down this path for opioid settlement monies, we already had the entities that needed to be there. Plus folks that have lived experiences. And so when we formed the group for the Stedman group that was formed, it included a lot of those nonprofits that deal specifically with substance abuse, recovery, harm reduction, those types of things that dealt with, you know, we had law enforcement in the room, the DA's office in the room. So we had some government entities in the room and then people with shared life experiences. And then we can get into that more later, but that's, that's the group that was formed to build the strategic plan for the plan for our elected officials to see and hopefully implement. So in Ellis County, started off that after I saw what these funds were for, I kind of got in touch with some of the stakeholders that we had with our local drug court being sheriff's department, the substance abuse providers, the city, well, not the city cause they had their own funds, but the schools, just a lot of different people, our community corrections agency and put together a committee because this wasn't, they put me in charge of managing these funds, but I always felt like this is not my money to deal with. This is the County commissioner's money to deal with. So I went to our County commission and I had them put together a panel or a committee. And that's made up of me, my sheriff, and our County administrator. So, and then I created a fund or a form that if anybody had a request for an opioid settlement fund, that they would just submit that form to me that I would take it to the committee. We would all look that over. If it's approved, then we would take it to the commission for them to approve because ultimately it is their money. It's their decision. And we wanted to include them and make sure that they were involved in that. So we had some requests. One of the requests that we had at the end of the year, we did some reporting and it was, you know, Chris talked a little bit about it earlier. And one of the questions was what if it's not right in line? And we didn't do a really good job on our documentation as to look, turning that back to how it affected opioids. So Chris got back to us and said, you know, how did this affect your opioid stuff? So we were able to tweak that and got it taken care of. We have used stuff for community corrections, purchased an app for their phones that tracked substance abuse offenders or people that are in a recovery court right now that actually acts as a GPS. It acts as a notification, gives them notification reminders called Repath. It's a really good app that they've used for their supervision tool. We've also used it for training for law enforcement is using it for a detective from Las Vegas, got his fees paid for and he's coming out to give training to local law enforcement on fentanyl abuse. We've used it for sweat patch testing for substance abuse for our drug court team. They have had times where they weren't available to do, their staff wasn't available to do drug testing as often as they wanted to. And the sweat patch testing is good for two weeks. So they have requested that a time or two. We've also used it for AED devices for our sheriff's vehicles that came about because we had an overdose death or overdose that they use the AEDs in the jail facility where they were able to bring somebody back to life at the jail facility because they had overdosed prior to going into the jail. Once they got there, they overdosed and our sheriff said, you know, this is something we need in all of our vehicles because we come up on this stuff out in the field and it's, you know, several minutes before an ambulance can get there at times in rural areas. And so that's something that we've also used it for, but we've had no requests that we've really turned down. We have scaled some back, but for the most part, if they had a request and it fit within the abatement strategies, then we were approving most of those. And in Johnson County, we have the drug and alcoholism council, which is a committee composed of 11 jurisdiction representatives, a couple of school district representatives, some individuals that are very interested in the topic, as well as nurses and attorneys and even some judges. And so they help us come up with the recommendations that they were able to go ahead and submit to those funding jurisdictions. And then they basically kind of go through that cycle again and again. And so, so far we've been able to not only provide funding for new programs, but also the expansion of programs. So they, I was glad that they were highlighted today, but in circle is one of our amazing programs. They work with the department of corrections and trying to really provide those supports of after what happens after treatment, what happens after you're done with this small cycle in your life and making sure that there is actual recovery after. And then also making sure that there is a reduction in the relapse. Another program that we're very proud. So we are able to provide those funds in three categories. So we provide funding to school districts, what we call programs of Johnson County and then also nonprofits. And so within the school districts, only the school district, one of three of the largest school districts here in Johnson County was able to hire on a specific individual to come and implement fentanyl and substance education. And so far she has been a huge success. If you search up for Olathe school district, she has come on news like about five or six times already. And she's only been at the school district for about six to eight months at this point. So that you can kind of see the impact that she's had within the school district. And I think that the other component of that is making sure that we were expanding the access to Naloxone. So we have a school districts like blue Valley, another of our largest school district here that we're able to expand the access, not just in the school nurses offices, but throughout all of their buildings and even within the fields so that if anything was ever to occur, there was always Naloxone available for them to use. So, so far we've been able to grant about 12 programs. And a few of them were new and a couple of them were expansion programs. Thank you. What makes you most excited or proud related to your community's opioid settlement spending plan? I would say on mine. I'm proud of the fact that we have created a way that includes everybody in the County. The form that I created has all the abatement strategies that you find in the approved uses. So the, the form identifies who the stakeholder is, gives a brief description of the plan as to what they're wanting to use the funds for. And then we put the abatement strategies in there and let them choose which one they think it fits into when it goes to the committee. Then initially it was just me. They put me in charge of watching over these opioid funds and I didn't think that was right. So I wanted this to be in front of the committee. and then for those that provided the question earlier as to what are the what are the consequences of doing something that's not out that's outside of that i think this helps in taking away that because it's not just me looking at it me deciding it's going to a committee and we all look at that and say and we debate whether or not this fits within that abatement strategy if it does great if it doesn't then we talk about it we decide whether or not that's something that fits or not so i'm really proud of the process that we have in putting that all together and the fact that most of the stuff that we've had come through i think has been a real beneficial to to our area so just going back in history here a little bit when in in the 90s crack cocaine was a huge issue especially in wichita it devastated some communities our purpose back then in law enforcement was whether you're selling using or whatever that's the law i'm taking you to jail and then i go out and arrest somebody else for it we've been doing the war on drugs since 1985 does anybody in this room think we're winning that because we're not and so what i'm most excited about is the fact and i know i got some law enforcement partners in here so i hope i don't offend you here but i don't think any of this money should go to law enforcement we have other grants we have other types of things that we can do for the law enforcement side of it we do not have enough treatment we don't have enough recovery we don't have enough resources for the amount of people that suffer from this and so what i'm most excited about is that this money from what we are planning in wichita cedar county area is going towards that there's five buckets that we've allocated money towards and that's treatment recovery prevention education and harm reduction you don't see law enforcement on that and so it's a deal where bringing all the folks that we brought together and really listening and sometimes disagreeing but really listening to what's needed in our community our community suffers from the fact that we have a lot of people without insurance we're on a medicaid expansion state so if you don't have insurance and you have mental illness we can still get you to calm care if you have a addiction problem or a substance abuse problem there's nothing other than about two entities that can do it because they're funded through private funding and to get into them especially the folks coming out of jail and 74 percent of our inmates have substance use problems it's three to four months do you think that they're going to go out on the streets for three or four months and not use again because they do and it's a cycle they just keep coming back and so that's probably what i'm most excited about is the fact that money is actually going towards helping these folks um hopefully live better lives jeff mentioned just briefly some of the local drug history we've experienced in wichita cedar county and we've had a drug court in existence since the mid-1990s and i was looking at the stats in preparation for today's meeting we've seen a shift from crack cocaine alcohol has been consistent we also saw a rise in meth 20 some odd years ago we're seeing a rise in fentanyl use opioid use over the last five years and so we've had tools and systems in place that we've been able to leverage and adapt to meet changing needs if you will and that partnership between city of wichita and cedar county and comcare has been very helpful um one of the things i'm proud of over the last several weeks so rusty leads who's an assistant county manager tom stoltz uh county manager bob layton and i got on the phone and started thinking about a governance model one of the things that stedman group pointed out during a strategic planning exercise is that if we're going to pool funding we need a governance model within a matter of and rusty you can correct me if i'm wrong within a matter of 30 35 minutes we were able to point to a model that we believe would work and namely what that model is in the early 2000s we created a coalition for distribution of special alcohol tax funds um local tax liquor tax coalition is what we call it locally and so it's adopting that model and in a complementary way i think you heard a commissioner say earlier today there are some limitations in terms of what the statute allows you to use liquor tax funding for that limitation namely recovery may not exist as far as where we are with opioid settlement funds so if we can design a governance model that's complementary we can use this funds for these things and use this fund for these things we now have a more i guess holistic approach that i'm excited about and i think for me it's definitely making sure that we have low or no cost for the services that we're able to provide through the non-profits that we are able to fund because even though our medium income for johnson county is about a hundred and three thousand dollars there's also a huge amount of need within our community about 14.6 percent of johnson county residents are at or below the 200 federal poverty level and we're able to provide those services um medically assistant treatment to make sure that they're able to recover and have long-lasting impacts i also think that we've been very successful with engaging our school districts and we know as we heard all throughout today that prevention is definitely very difficult to be able to track but it definitely has a longer impact the other thing with that is making sure that within those school districts that we're we're able to encourage them and lend them a help to make sure that they know what kind of strategies are successful so that they can also implement it within their school districts thank you we've talked a little bit about your processes around opioid settlement spending but can you talk a little bit more about how you involve the community how you involve folks with lived experience how you involve subject matter experts and decision makers in the in the whole process to make decisions on opioid settlement spending i'm happy to start on that one uh so we have a three to five year alcohol tax fund priority report that helps us identify the needs and so what could be funded and so this process was last done for 2023-2028 and so through that we're able to similarly to what was done for the entire state collect survey data as well as have conversations with all of the organizations that are already providing the services to be able to identify the needs and then also being able to talk to the jurisdictions and what they're seeing so there's definitely a lot of conversation we've also had a strong relationship with the attorney general's office to make sure that we're also in line with that we're very proud to also have created a provider network so all of our grantees meet on a quarterly basis and are able to share best practices with each other but then also we have that we call our grant process the substance use continuum of care fund and so we can definitely see kind of that referral process i was very excited to also have our first meeting when we were able to implement and have those kind of newer grantees with opioid settlement funds because you could see the excitement in the room you could see those traditional alcohol tax prevention programs but then now bringing on that additional layer everyone was kind of on top of the new programs and making sure that they all knew what they were but then also how can they collaborate and work together to make sure that we're really tackling the problem again i mentioned the drug and alcoholism council meets on a year-round basis in fact we had a meeting today and we have about two members here who weren't able to meet today but also being able to have those experts that are able to also help us identify in the field and then also again the jurisdictions making sure that we understand what their priorities are as well as we're trying to allocate the funding for me getting out to the stakeholders was reaching out to our contacts we had with our local drug court that we had implemented on top of that we have executive team meetings with our local county department heads a lot of these funds are available to ems they're available to the health department the sheriff's department and it depends on you know who where you want to allocate this fund we're a small community we don't have millions of dollars to deal with we have we have to be a little bit more careful and make sure that we're putting those for the best use and we try and reach out to the to the stakeholders and like i said through drug court we have stakeholders of substance abuse providers i've gone to the school i have reached out to oxford houses know that we have availability our community correction agencies know that we have availability of funds for those that that may may be in drug court they may not be in drug court that have the same needs that those that are in drug court have that are just not receiving those services our drug courts are heavily funded with uh justice grant through the bureau of justice assistance so these funds really weren't needed for drug court stuff but we have stuff that is not funded through drug or drug court grant that we look to use these on as a contingency and like jeff said if when it gets out there that funds are available those people are all reaching all those non-profit organizations are coming for the same money and it's a competitive competitive world out there and they're going to be coming for those and you got to decide which ones are the best use of these resources jeff mentioned how the mental health and substance abuse coalition kind of flowed into the work we've done over the last year with the stedman group i look at the report that step in group provided and there's a group photo and you look in that photo and you see folks that touch every aspect of our community i believe i see my chief judge our chief probation officer alongside assistant county manager alongside the sheriff alongside providers alongside those with lived experience but it's important to us that that work not get lost in this strategic planning exercise that occurred over 15 months so the draft a resolution that we're presenting in an en banc meeting a joint city council county commission meeting next week i believe on the 29th codifies the makeup of what we want that coalition to look like including providers those that know a lot more about this than we do we don't want we it's our job to provide information for elected officials to make decisions as a part of that recommendation you want people at the table who operate and live in this space who know much more about it than we ever will and so look forward to moving that forward in the presentation that rusty is going to make next week and hopefully it'll be adopted by the council and commission i would just echo what dante said if you're in a community that's starting this process make sure and reach out to the folks and give them a voice in this process if not you're not going to get their cooperation later on and there's going to be hurt feelings so you have to you have to involve the people that do this for a living and that's where i'd leave it at thank you all all right we're going to get to that challenges question next so in what ways or what were some of the most difficult aspects of this process and how did you overcome them i think for us was definitely making sure that jurisdictions understood the bigger impact that they could have if they were going to elect to continue to pull funding and then have that longer impact my understanding is that education was definitely a key concept making sure that they understood if you know you're definitely just getting this funds from now to 2040 what's the actual amount that you're going to be able to receive is that something can you actually do something solid with that amount of funding or would it be better invested if you were to pull this funding together and then have have gone through the same process as you've done with the alcohol tax fund so for us it was also making sure that we went and located all of those jurisdictions that were actually part of the signed settlement agreement and making sure that they understood not just that right now yes i'm getting a lot of money but no long term you can't just establish a program and then take it away from the community so how do you have a plan actually to continue to fund that but then also making sure that we were kind of taking the burden of the jurisdiction so currently UCS manages the funds and then we're able to go ahead and distribute that out to the grantees as mentioned before we have a competitive process but also we have a lot of accountability so we have semi-annual reports that those grantees are able to submit so then that way we can also show impact not just as a county but also by jurisdiction and so we're able to kind of get through that and really show the impact that they've been able to do and just in 2024 about 15,000 individuals were impacted with osf funds in johnson county so for me we've been pretty lucky in ellis county we haven't had a lot of issues one of the the one things that i see coming is stakeholders wanting to push the boundaries of what the use is for so they see that you know there's what they consider free money out there and they think oh well i've been wanting to do this and they said well i just have to ask them for it and they'll give it to me well it has to fit within those abatement strategies you can't just throw it in there and say you know this is an opioid problem when it has nothing to do with opioids so i'm kind of a broken record but that committee that we put together has really helped with that that there's not it it goes into a group everybody looks at it everybody decides and you have a debate a friendly debate as to whether or not these fit in there and if they do fine then the amount then the decision comes to whether or not you approve those or if you fully approve them if you partially fund them you can also do that and give them partial money but we've done that the committee approach has really helped so that one person isn't telling somebody no all the time so that has been our biggest issue but it really hasn't been that big of an issue but I see it being an issue at some point I think one of the biggest challenges for us was taking a step back being deliberate being strategic in terms of how we wanted to spend our funds if I remember correctly funds started coming in 2023 we really released an RFP that same year looked at a handful of proposals including some proposals that within 30 days we could have you plan you could get going and other proposals I think the Stedman proposal was nine months to a year and really appreciated how Stedman laid out their approach to the work so the challenge for us as we have money in our pockets is not to spend it is to commit to a process be deliberate and try to develop a strategic plan that will be more impactful over time we're looking at 14 years what are we going to do over 14 years built into that plan is the understanding that circumstances change so this is our plan this is where we are in 2025 where will we be five years from now what would be ten years from now so that being deliberate in terms of strategically allocating and spending funds as opposed to funding some projects that may not be evidence-based that may not be best practice they may address an immediate need or may address an immediate want but long term it may not be how you necessarily want to spend your funds I think also there was probably threefold things that we saw going through the 15 months that we were doing this and Stedman group did a great job of keeping us on task because you have to understand that there's a lot of different voices in the room a lot of different opinions those type of things and probably one of the things that I saw is you had some really strong voices from different groups in the community that were were very strong in their opinions in the beginning of this and so as we kept going down that path of developing a strategic agenda a vision what these buckets of money is going to look like those voices left the room and so trying to get people to stay in touch with this as we move through for some of that it became a little bit more difficult so at the end the day did we have every voice in the room when the plan was finalized no so that was kind of the first issue the second issue was the debate on how much money should be allocated to those five five buckets it wasn't there was no arguing or anything like that but just opinions on how much of this 15 16 million should be allocated to each one of those buckets the other issue with that is is that we had you know some folks that were like well it all needs to go to treatment or it all needs to go to recovery this is a finite amount of money and at the end of the day we had to have those discussions to how do we sustain this afterwards and that's still a big issue when this money runs out how do we sustain this and the third and for some of you in this room you're probably not gonna like what I got to say but I understand the needle exchange program if we want to catch that cut down on HIV and those type of things not a supporter I've talked to several people that have been in and out of jail heroin addicts over the years and they tell me yeah all it is facilitate my drug habit it didn't keep me from doing drugs I've also toured some of the different conferences some of the cities that have needle exchange programs and it's it can be a mess too so there's good sides to some of this but there's also a problem with some of this and when you have the homeless population that we have the mental illness that we have that became a point of contention with me and a couple other people on there that supported what I was saying what they were saying about the needle exchange program at the end of the day that's going to be up to the elected officials if they want to fund that particular program I think getting people in the room getting the right people in the room figuring out the allocations are universal opioid settlement challenges so that all is aligned with what we see in the opioid settlement world I've got one more question for you all and then we'll move on to questions from the audience if there are any but if you had to give other communities in Kansas one piece of advice on how to it's how to spend their opioid settlement dollars what would it be so looking around the room our communities are different I come largest County in Kansas largest city in Kansas and the challenges we face may be different than the challenges you know your communities better than we do it's taking a step back and I really appreciate the information that was shared earlier understanding what problems you have locally and what evidence-based practice are best suited for your local community as the data shows in Wichita we face a huge challenge related to homelessness with that comes challenges related to substance use disorder and so on behavioral health mental health issues those are challenges that we have an opportunity to address with each of our communities being different it's knowing your community and then also knowing the strength and the capacity of your community once again it's not a problem there we're going to solve on our own as far as government so partnerships not only cross governmental partnerships or partnerships with community would be one recommendation I'd have I would say my recommendation to everybody would be make sure you reach out to those stakeholders there's a lot of lot of uses for this money it's like Dante said they have 15 million we might have I'm not even sure how much Ellis County's slated to get but at this point we have roughly $60,000 to work with it left over so it's not a lot of money but you've got to spend that money for it to make a difference so make sure you're reaching out to the people that need it doesn't do any good if it just sits there in a fund and doesn't ever get used but make sure that you're using it for the right purposes that's like said I created that form so that we could go through make sure it fit into the abatement strategies but we also Ellis County got these funds City of Hayes got these funds our neighboring counties got these funds and you can go and collaborate with any of those and make that smaller pool of money a much bigger pool of money our police chief and Hayes came to our office and said hey we have all these opioid funds we haven't spent any of it what are you guys using it for does anybody need it so there's a lot of they don't know what to use it for and you know we're we have a process that we use it for but we can combine those funds if there are projects out there that are bigger that we can actually use so I would I would encourage you to reach out to other stakeholders reach out to two other people who are receiving these funds and collaborate and work together with them I would definitely agree with that so collaboration is super helpful not only with older jurisdictions but also are there any trusted organizations already providing some level of services similar to the allowable expenses that maybe they might be interested in expanding their program or maybe they know of someone else that is also starting you know something or that has been under the radar and so we definitely find a lot of that here so yeah I agree with everything that Dante and Mike and Erica had to say the only other thing that I would suggest and we had these conversations with our consortium as well if anybody remembers weed and seed money from years ago that came down from the federal government and it was a lot of grant money that was being put into neighborhoods to weed out the criminals and seed back with programs and stuff for youth and drug programs those type of things one of the issues that popped up it wasn't governed very well in the beginning and so you had a lot of folks that just kind of threw together 501 c3 set out we're gonna do this and then say it's a Oxford house type didn't have those back then but type deal and they'd have one person in there but claiming they had five as they were pocketing the rest of money and so we had to come in redo how we were allocating money and stuff I would say and if with this funding and especially since the Attorney General's office is here you need to have some type of mechanism to ensure that the money that you're giving to any other entities or groups that they're you've vetted those groups and that you're following up on what they're doing and that there's measurements that's one of the things that we built into our program was those kind of kind of aspects to ensure that the money is being allocated and used properly that's a great point utilizing data to show impact and also deter using the data to determine to determine the continuation of existing programs and as Erica said meeting programs where they are starting with what's already existing which was mentioned in the previous presentation so I think this is a full good circle moment thank you all for being a part of this panel I'm gonna open it up to questions now from the room any questions for our panelists here anybody have any question I did I had a question so in talking sheriff Easter about vetting of your entities I know the sunflower foundation does that and I'm wondering if Krista would tell just briefly how you vet your grantees maybe folks in the room could you know take a lesson from what you've done sure so we also have our CFO that's heavily involved in in that piece because she does the financial due diligence but we require specifically for nonprofits it was what we're currently funding expanding to for profits as a statute has opened is still in the works of figuring out what that looks like but for nonprofits we request a 990 we request any audits ideally that are less than two years old and financial statements that are at least newer than the past six months and so that's what our CFO looks like to do a kind of financial check of each organization to determine any kind of level of risk and then of course we have questions in our application to try to figure out what kind of organization it is if we're not familiar with it the work that they do and the experience they also have in working in this area to try to get that kind of feel for the organization itself Chris anything you can think of that I'm missing the only thing I would say is I don't think we turn away anybody who's had lived experiences with those organizations if they have feedback either positive or negative that they want to share about those organizations so this is going to be the theme of the afternoon of talking to your stakeholders and talking to folks who know what's going on so yeah that's that's part of our diligence process thanks are there any other questions from the room for our lovely panelists who've done such an amazing job y'all have done an amazing job you really are pioneering the actual use of these funds and it seems that each one of you have taken a very measured and practical approach to deciding how to use these funds I did have one more question I wondered if you'd experienced any community either like excitement or support around the things you're using the funds on or if you've experienced any community push back around how you've decided to use the funds and how you help how you dealt with both of those things a little bit of both and keep in mind we're in the very early stages City of Wichita has allocated just a small amount of money the locks on and supporting community agency so the excitement is the opportunity so community agencies recognize that money is flowing into the community how do I get my hands on it the frustration is we have money in our community why don't I have my hands on it and so I truly feel we've done the right thing and taking a more deliberate approach and I look forward to the conversation we're gonna have with City Council and the Board of County Commissioners here in a couple of weeks and starting to see programs and a process that that our partners can look forward to to make an impact in our community but I truly has been a good process in my opinion that we've gone through I think Jeff would agree the best is yet to come when you actually see the impact of putting resources at the hands of professionals that know what they're doing I look forward to what's gonna come out of this I would say for us there hasn't been a lot of pushback or anything every every expense that we've put through for opioid funds has been in an open open meeting through the County Commission those have all been approved to the County Commission the media is there not one thing has ever been said about any of them I think the people that come up and present and make the request because when they make a request I don't come up and do the request for them we have whoever's doing the request come up to the County Commission and actually put in their request we just act as a committee to push it through to the County Commission so they actually come up do their own request and they do a really good job of explaining it or have so far and it's never never had any pushback whatsoever I would definitely say maybe I wouldn't categorize it as pushback but more as a frustration of why aren't we reducing the amount of need that there is out there the amount of individuals that have a substance use disorder and will we if even if we had all the money in the world could we ever get you know to a lesser percentage in that portion so there's definitely frustration other questions okay well we are running a little bit ahead of schedule if y'all give us just about three minutes to invite this panel to go back to their seats and invite the new panel to come up then I invite JK to come up to the front and help the panelists on our collaboration focus panel answer some questions and while they are making that change I will say I have been asked the question before like sustainability what will we do after these funds leave leave and what I want to say is that what if in 10 years we're no longer in a crisis and we don't need the things that we funded because the crisis has you know abated so I want to encourage you guys to think about that think about giving a decade to turn the tide on this crisis and as far as sustainability other things will come but perhaps the need will go down as people's overdose deaths decline as addiction declines and as prevention approaches really support people in healthy lifestyles so anyways give us just a few minutes to turn the panel over Let's talk to them. Oh, OK, good to know, good to know. I have been told I talk a little bit, but it's fine. started before more people leave, because I know a void at the front of the room invites people to their cars. So this panel, a little bit similar to the last panel, but a little bit different. We're going to really focus on collaboration between cities, between city and county. You heard a lot of that with Wichita and Sedgwick, which I will identify as a stellar example of city-county collaboration, not just because we're involved there, but we see so many counties that lack that with their big cities. And I get that there are a lot of barriers to collaboration between governments, but it really is for the best. So many times we try to individualize everything, but honestly the thing that works in Sedgwick County, honestly probably works in Ellis County, probably works in Wyandotte County. And that's not to say not to individualize things, but we also have to look at the commonalities too. And so collaboration can really make best use of funds. So we're going to talk about that specifically during this panel. And I've got three folks. I'm going to ask you to introduce yourselves, your position, and we'll hold off on questions. So just an introduction to yourselves and what role you play. Good afternoon. My name is Mike Holton. I'm the chief of police at the Eldorado Police Department. Candace Davidson. I'm with the Wyandotte County Health Department. I'm the health education supervisor. My role with Opioid Settlement Funds is I'm the Opioid Settlement Funds Advisory Committee chairperson. And you already met me, but I'll just emphasize that the cities that are pulling their OSF funding, to give them a shout out, our Johnson County government, the City of Leawood, Lenexa, Olathe, Overland Park, which we have a preference since here too, Prayer Village, and Shawnee. And we also have some Johnson County government representation. So thank you. All right. Thanks. We'll move right into the first question, which is, how have you worked effectively with other cities or counties on your opioid settlement spending? Let's just go down the line. In Eldorado, we have joined together. We partnered with numerous different organizations, both inside the City of Eldorado, along with Butler County. We have members of the Butler County Health Department that are a part of our coalition, along with service providers in Eldorado from mental health, from the hospital, all over Eldorado. Anybody that provides any type of mental health or substance abuse service in Eldorado has come together and we collaborate monthly on this issue, on the issue of opioid abuse specifically right now. Are there other cities in Butler County that collaborate on this, or are you the only city getting funds within the county? Every city in Butler County receives these funds. We have had conversation with other cities. However, that collaboration has not gone very far at this point. Thanks, Wayne. So I'm a Reno County employee, obviously. Reno County gets money, and then our biggest city in Reno County, which is Hutchinson, is the only other city that receives opioid funds from the Kansas Fights Addiction Fund. We work together pretty well as a county and city, being that Reno County offices are housed within Hutchinson, so that's an easy collaboration for us. As far as the opioid settlement funds go, we wanted to really make sure that we had all of the right people at the table. So we have representatives from the Hutch police department, the city attorney for the city of Hutchinson, Reno County counselor, sheriff's department, our county administrator. We also obviously have the health department administrator, and then myself and court services. But then we also brought in obviously treatment facilities, people with lived experiences, super important to us, as you heard with the keynote speaker. Seth is an amazing part of what we started with all of this. Then we also have the Hutchinson Community Foundation, which is a great foundation. They do a lot of work within Reno County. We also have a representative from our churches, so we have a pastor that comes. He's also, all of you are from Kansas, so hopefully you've heard of the Kansas Leadership Center. They have a lot of great trainings, and he's a big part of the KLC life, and so he brings a really interesting dynamic to our roundtable. And then we also have our director of strategic growth from Hutchinson at the table as well. Thank you. All right, so as a small non-profit, we're very fortunate to have the trust of those seven jurisdictions that I mentioned before, and really it allows them to have a maximum impact in our community. For example, we also are very fortunate to have Johnson County government always kind of be the leader in saying yes, because once they are able to contribute, then the other jurisdictions can see this as a possibility. And so really being able to have those strong partnerships with those jurisdictions, it goes a long way. And then also, I will say this is now going into our third year of trying to pull the funding together. We always get the question of what are other jurisdictions doing for the next year? Are they increasing? Are they decreasing? And also understanding what they're actually using their funds for, if they are keeping any of the portion that they're getting, and we'll talk about that in a minute. Thank you. Some things I want to note there are your work with your community foundation. A lot of counties across the country either work closely with their community foundation or just pass funds through their community foundation to ease the process and take some of the administrative burden off themselves. And I also heard faith and schools having buy-in from your faith community is really cool, and I could say there's been a lot of emphasis nationally on substance use working more closely with faith community, and I would say largely it has not been a huge success. There's just been a lot of barriers, so to hear that you've got that, and you with your schools, that's another type of group where we've seen that schools aren't always at the table. So you both have that, and that's really amazing to get everybody on the same page. All right, our next question is, was there anything about your collaboration that seemed improbable but eventually came true? I guess I will say, the one thing that we have always had a challenge is as a public health department, I don't know if you all know the political climate as it stands, but we are not always a trusted source after COVID, but I'll just own it. We are who we are, and we are trying to make the community health the most important thing on the block, and so we have worked really hard to really become the trusted source for all things community health based. You've heard actually everyone come up here and talk about public health in some form or fashion. People don't understand what public health is, but we are, we're seatbelts, right? We are, the reason we don't have a communal cup at water fountains anymore, all of those things are public health, and so that has always been our kind of barrier is that this is getting led by public health. So we have worked really hard to make sure that our stakeholders and our community knows that we are the trusted source, and I think that we've worked well within our community. Having Seth as a champion when we first started this process was also a nod in our favor. So, not so much the collaboration, but what seemed improbable when we first got started was actually getting all of these stakeholders at the same table. For a long time, especially after COVID, people just kind of went and did their own thing. You know, if you provided a resource in your community, that's what you did. You didn't talk to everybody else that provided a resource in your community. You just kind of went down your own path, and I have found that through collaboration, that has been the most important piece of what we do is collaborating with each other, talking to each other, because when that one person walks through your door and they ask you for a certain service and you have to tell them, I'm sorry, we don't provide that service, nine times out of ten before, they were just sent out the door and expected to figure it out. Today, through the collaboration of our coalition, I'm very proud to say that when somebody walks into a service provider's organization and asks for help and they can't help them, they can now look at them and say, I'm sorry, we don't provide that service, but here's where I want to send you. These people can help you. And I think for Johnson County jurisdictions, it was more about logistics. It was more about can you actually manage these funds? What kind of problems would we get into with the attorney general if we don't report this information? And so it was definitely giving them that trust that we would not be a burden, but that if they were to trust us, that we could also help manage that process. And to this date, I still get jurisdictions calling me all the time. Can you please help us? Which is great, because then we know that they're trusting us in that level. So definitely making sure that they were complying and not getting in trouble. Thank you. And I'm going to go off script, actually. I was thinking about how you've all collaborated, and you've got city and county, you've got more city and county, you've got intercities with the county. Any of you worked across county lines with some of your neighboring or not neighboring counties on projects? So as far as law enforcement agencies, we talk all the time. But one example that I will give you is Seventh Direction. Seventh Direction has just recently moved to El Dorado. But prior to the coalition's existence, they were in Wichita. Once the coalition started, they heard about us. And they began coming to our meetings monthly. So I would consider that a cross over there. We've had other organizations out of Wichita and as far as Mound Ridge that are now attending our meetings. Okay. Yeah. So as far as opioid settlement funds go, we were able to fund a, it's called Reno Connections, and it's based out of the United Way, and it's kind of a no-wrong-door model. They're helping people get driver's license, get into housing, do all of the things that you need to be able to do that you aren't necessarily able to do if there's any sort of barrier. And so they are mostly based out of Reno County, however, they do move around our state. So as far as opioid funds, that's... I would say we have definitely a few grantees that serve in both state lines, actually. So Kansas and Missouri, and then also Johnson County, and even 11th or so Douglas County. So there's definitely kind of that collaboration. But I also think it definitely gives them a little bit more power because they're able to say, this is what's working over there, or this is what's working here. And so they're able to kind of not only compare outcomes and the impact, but then also really being able to help us identify how big is the problem, what are the differences between the counties, and then how can we address them better. So they definitely are more boots on the ground. Thank you. And I wanted to take that opportunity to highlight some differences between other states. So most states have done what Kansas has done, which is delegate funds to counties. Our state, Colorado, mostly big counties get their own money, but little counties were grouped together. So there weren't counties that had, say, $5,000. All of our groups have a significant six figures into the millions amount of money. But it also means that they have to work together. So it wasn't a choice. The counties can't just take their money and run. They have to work together on their planning. And I think there are pluses and minuses to that, in that some of the lines were not natural groupings of counties. They did a pretty good job. Most of them, like there's not mountain passes between them for us, which is a big deal. It's a big deal. But it's different, whereas you have more autonomy, but less collective volume. So there are some counties with, I don't know, what's the smallest amount of counties got? The smallest county that's getting money is, I think, 1,800, 1,900 people. Okay. So they've got what? About 20,000 bucks. Yeah. Like the smallest check, I think it's like 12 bucks a check. So you can see that would be problematic to create a program or even think about funding a program with that small money. So working together between counties is something that is available, but maybe doesn't come to mind initially. And so with that, I would ask a question, follow up to that. Have you balanced, through your collaborations, the autonomy of your jurisdiction, counties, with the greater needs of other municipalities and the county itself? So we were very strategic in who we brought to the table, as well as then. So our process is we have this Opioid Settlement Funds Advisory Committee, who meets, well, at the beginning, we met quite a bit, because we needed to educate, we needed to bring the data to the table, we needed to make sure that we knew what and why and who we were funding, and how we were going to do that as well. So that was the group that decided how we were going to move forward. They decided on an RFP, Request for Proposals, that we send out yearly, and it's narrowed down to the specific needs from those strategies, which, instead of reading the 200-page document that has Appendix E on it, I recommend the John Hopskins super easy one-pager. That was a lifesaver. And that's how our community, so that group decided what our community needs kind of were and narrowed it down to five, but then also said, if something fits within the other scope, we'll look at it. So they sent out this RFP to just anybody and everybody. We put it out on news media. We put it out to our partners. We put it out to whoever we thought could utilize the funds, and then those came back. We sat and went through our little checklist of, is this part of the abatement strategies? Is it evidence-based? Because that is also important. We had a few that we had to toss because they weren't evidence-based, and a few that we had to toss because they weren't a part of the abatement strategies. It was free money that people thought they could just get. And so we made sure that we really went through that process, talked through all of the RFPs, and were able to award money out that way. And so that way, we really made sure to hone in on, that was that balance between what we thought we needed and what the community is actually seeing, and so that we could really spread the wealth throughout the community and wherever it needed to go. Thanks. I'll actually go back a little bit further by saying that United Community Services doesn't get all of the opioid settlement fund from all of the jurisdictions. So for example, Overland Park will give us $100,000, while they keep a much larger portion to be able to determine how they want to use that. Johnson County government does the same thing. And so we help kind of elevate the impact, but they're also already determining how they can use it within their local jurisdiction as well. So I kind of mentioned earlier that we have that priority report that we definitely go back into and make sure that whatever we're allocating funding for, we've already determined that that was the need. So I mentioned before that naloxone was a huge deal for the drug and alcoholism to make sure that we weren't just making it available, but then there was also training. And so that training was very impactful over the last year or so, that the work supports were actually work support. So the N-Circle organization that I talked about not only provides kind of the work training, but then N-Certification in partnership with Johnson County Community College. But then also once the person is out and ready to go to work, if they don't have the money to buy the boots that they need for their job, they'll actually help them make sure that they have the attire that they need, at least to get through a couple of weeks and make sure that they get the first paycheck. And so really, really emphasizing on those kind of elements. And then another one that I'll just highlight is helping the homeless. And they have, you know, a 90% more than success rate. And so making sure that not only are you providing housing, but there's also that peer support. And in fact, that organization, most of their staff has been through the program. And so you're able to kind of see and show that success of what your life could be once you've gone through all of this program. So coming from a much smaller community, our target was very focused. And when the opioid settlement funds came out, we obviously knew that we had an opioid crisis in our own community. So as we put together our coalition, we knew who our stakeholders were, the Substance Abuse Center of Kansas, Second Chance Ministries, and resources or people like that. So we were able to get them in and start talking about what direction we wanted to go with our opioid funds. And we came up with the idea of creating a voucher program that we would utilize at our town hall meetings. Through the voucher program, what we did was we were able to pass out vouchers at our town hall meeting, and these vouchers were redeemable at a local pharmacy that we had partnered with. And as people took those, they were a... Let me back up. Through the town hall meetings, we provided training and education on the identification of a drug overdose and what to do when you did see that. Through that, people were taught how to utilize naloxone, and after the town hall meeting, they could pick up a voucher, redeem that voucher at our local pharmacy. And I can tell you to this day that although we do still have overdoses, our overdose deaths have reduced dramatically. It's remarkable because we've really had a hard time working naloxone, trying to take advantage of pharmacy benefits. most people just buy it and they give it out to people. So that's a pretty ingenious solution to getting people trained for your town hall meeting. And when you're talking about getting the biggest bang for your buck, so to speak, there's nothing bigger than being able to arm your community with the tools that they need to save a life. Wow, cool. Those are some great examples. I really appreciated that. Next question. What are the key barriers to effective collaboration between cities and counties around opioid settlements? I can laugh on this one all day long because the biggest thing that I get asked is who's contributing? Are we all contributing our fair share? So who has the largest problem or who's using the most of the services provided by the grantees? And we talked about this earlier, but in reality, individuals move from town to city to county to state especially. We're part of the metro area in Missouri all the time and come back and all of that. So it definitely makes me laugh because substance use disorder doesn't really know a geographical boundary. And so we should all feel responsible for kind of putting a little bit to help either decline it or at least provide the services that individuals need. All I can do is concur with that. So we had a little bit of a different way about going about it to start with. We just went to both the city and the county as the health department and said, you're getting this money. We can help you figure out how to spend it and then you don't actually have to spend any of your time or resources doing that. And they said, oh, yes, please. Thank you. And they said, oh, yes, please. Thank you. Here you go. And so we were able to just kind of nip that in the bud and they just trust us to make decisions as a group and go forward, which is nice. Yeah, we've had a similar experience. Most of the municipalities have delegated the money. Some of them held onto it and I think they thought they would do something and they realized we invited them to see what was going on and see that it was a transparent process. And most of them after a couple of meetings just said, take it. And we have had one interesting exception to the rule. So Aurora is actually a big suburb of Denver and it's in three counties. So there's a little bit, there's about 5,000 people in one county, it's about 30,000 people in another county, and then there's 250,000 people in one county. So they've actually kept their funds and that's caused a lot of consternation with those counties because they still participate in the county decision-making process. And frankly, a lot of the funding goes to Aurora because it's a big town and we've spent much more time than is useful, people trying to figure out how to punish them for not putting their money in. And ultimately that's why I asked the question, it's like, it is their money and they have to make decisions delegated to the county. But generally we found that there is a lot of decision-making that goes into this and you know, county stakeholders, nonprofits, I say it's $50 an hour for each person, it's an expensive process when you think about all the labor that goes into it. And so for smaller counties, the returns become smaller and also smaller counties have less people who are generally already involved in more things. So we found it to be, I think, a benefit to, especially in rural areas, to have a unified and even multi-county decision-making group. And one place actually, picking on Aurora, but we have two big counties and they're both building detoxes and they're right next to each other. And we've talked about them working together, but I think they're both too proud. Like they want a photo op, they want a name on the facility and really right now there's plenty of money, but in five or 10 years there won't be. And it's been a little frustrating to see this process happen in parallel in two counties with pretty similar needs and not be able to collaborate because they've collaborated on their crime lab and so I don't understand why this one couldn't work, but there's a lot of bureaucracy. All right, last question I've got are, any takeaway from today's discussion or any of the earlier sessions about how to collaborate more effectively on opioid settlement spending? So I've written down a few things today, but one of the big ones is making sure that we're sending that RFP, because we do have this process in place, to those 12 sectors. Making sure that we're really hitting all of the walks of life and making sure that we get that word out to everyone and not just we're pretty sure we got it out to everyone, but really make sure that it's going out to those 12 sectors in a meaningful way. I think for me has definitely been a tag along with whatever is being created. So for Johnson County government, with some of the funding that they decided to keep, they helped fund a campaign called You Never Know and you can search for it, but it's definitely bringing a lot of awareness to that youth population. And so for me to be able to elevate to all the school districts to, hey, we've seen the success of all of this. This is all the data that was collected during the first year. Help us push this out. You don't have to recreate it even if you're not part of, you know, the grantee pool. And then also elevating the work that is happening already in your community. So for us, one of the school districts, DeSoto, was able to put together this community event that actually was highlighted in another discussion of like, why didn't we all know about this? And as you can imagine, DeSoto inviting all of the, you know, 600,000 Johnson County residents would have been probably chaotic, but just really being able to then highlight this is the type of curriculum or presentation that they had. And then for them to be able to say, this is our contact here and you can use this to be able to provide it at your school or at a night event. But that one is called Hidden in Plain View and it was really impactful. Thank you. I go back to what Dante said earlier, and that was bringing the right professionals to the table and empowering them to go out and do what it is that they do. Short and sweet. A couple of things I heard there that really resonated with me is one, if you're going to go the RFP route, you have to publicize it. If you don't, you essentially get the worst of both worlds that you have to go through this big bureaucracy and you don't get what you want. And we, sadly, we did that once. We thought, oh, we'll put it out to, you know, trusted folks. And we got like six proposals and some areas got none. And we ended up having to redo this detox proposal and it took years. So there are like public bidding websites. I put it out through my LinkedIn and the last time we got, I think, 48 in one county, which is almost too much. But I realized it is much better to err on the side of having a county website for your opioid settlement spending if you're able to, even if it's just a brief landing page. It's really helpful. Putting minutes, RFPs up on that will get a lot more bidders and a lot more interest and people feel a lot more heard in that process. And then other one I heard is great. Don't reinvent the wheel. We've had so many things where we thought, gosh, we want to fund scholarships and we'll talk to the schools and we'll talk to the treatment providers. And we actually found out our state funds scholarships for clinicians already. And so we just contacted the agency and said, hey, could we give the money to you? And you just double up your scholarships. And they said, oh yeah, no problem. And so instead of having a full-time person that managed that, we just handed the money off. And there've been a couple of examples like that. Publicity campaigns also, lots of them out there. And it costs a couple hundred thousand bucks to make a campaign. So we just said, hey, could we compromise and choose a campaign that's good enough and just put money into that? And it saved lots of money. So absolutely. A lot of things are out there and don't need to be redone. With that, questions from the audience. Sweet. Be happy to bring a microphone to you if you have a question, but in the meantime. So I get a lot of questions to the Opioid Response Network that start like this. Well, we've heard this today from Silke and Janine. Opioids aren't our main issue. We're suffering from people's addiction to alcohol or methamphetamine or other stimulants. JK, what are your thoughts about how you can utilize opioid settlement funds to address other addiction? Yeah, great question. So we're often in the role of facilitating and we hear this a lot and people say, oh, we need to do something alcohol focused. We say, well, that falls afoul of the rules. And so sometimes we say, like, no, no, like this is way outside of what you can do. Sometimes it's really well intended, but the spin is a little bit wrong. Like we've seen proposals strictly for suicide prevention. You know, does suicide overlap with substance use? Absolutely. Could we plausibly fund a suicide prevention initiative through opioid settlements? So sometimes we'll work with them to reframe their ask and highlight the overlap between opioids and substance use and suicide or alcohol use and other substances, co-occurring mental illnesses, just so it's frankly optically a little more viable. Other times we ask them to look at what works across different substances. So we talked earlier about sustaining things past the opioid crisis because alcohol will be around, methamphetamine will be around, there'll be new things. So there are programs like peer recovery. It doesn't, you know, peer recovery coaches work with people who use alcohol, marijuana, whatever it is. And so for those programs highlighting the polysubstance nature makes everything okay. Detox, great. I mean, there's no detox that just does opioid treatment or just does alcohol treatment. They treat all substances. So we try to look both for legal reasons and also utility reasons, try to ask people to broadly apply their thinking to substance use and co-occurring mental health disorders in general. But there are programs that get very specific and obviously then there's some that are more experimental. Like we had somebody pitching Ibogaine, which was like a psychedelic research. And we're like, no, no, that's just out. But then there are others that we've been able to kind of reframe and bring back into fundability by highlighting the true nature of the problem, which is that people usually use multiple substances and they often have mental health issues. So just make that part of your proposal. Other questions? All right. Well, you formulate a question. I have one thing I wanted to highlight that we have not yet highlighted. It's that we've talked a lot about collaboration between city and county, adding your money, working with the county next to you. That is wonderful. But opioid settlements are, I don't want to overstate how much funding is out there because it seems to be dwindling every day, but there is even more funding outside of the opioid settlement world. There are HRSA grants and SAMHSA grants. And again, they're still there, still funding Sherry. And I suspect many of those will still, BJA grants, we heard Bureau of Justice Assistance grants, a lot of discretionary grants and other programs out there to fund substance use initiatives. So using this, using your funds to develop a governance process, data, things that are kind of mundane, but help legitimize and professionalize the process, can leverage far larger amounts of money. So a couple of good examples. We work in Northwest Colorado. I think they will get about two or $3 million over 18 years. So a big amount of money in a rural area. They've gotten HRSA grants worth almost $10 million. And a lot of that was using this coalition and their structure and all their data into bigger ideas. And so they've used a little bit opioid settlement funding to reap much larger amounts. And my favorite, this is my favorite. We're working in Durango, which is rural Southwest Colorado. So they're going to take a million dollars in settlement funding, leverage low-income housing tax credits. Is there anybody out there in the housing world? Leverage about 15 million in low-income housing tax credits and another 3 million that we have for like modular construction, which I didn't even know was a thing. But you can construct housing. And if you do it modularly, you can get state tax credits. And they're going to build a hundred bed recovery residence, which kind of looks like a treatment center. So for about a million dollars, they're going to get like a $20 million facility through all the planning they did, all the data they've gathered, getting everyone in the community together and building will for this is going to leverage 20 to one opioid settlement fund. So that's the kind of thinking that I love to see because it's sustainable. And this program is sustainably funded. So by funding the capital, they're going to have this big, rare a hundred bed facility in this rural area, probably for 20, 30, 40 years, maybe forever. And I'm really proud of that work. And it just goes to show that urban areas don't have a monopoly on the good ideas. I mean, this is a really frontier area and they're doing something almost nobody else is doing. So by working together, we can leverage those things. And I want to thank our panelists. I appreciate you. Hey everybody, we're running a little ahead of our agenda, which is good news for us on a Friday afternoon right. I would like to go ahead and move into our next session which has Chris teeters kind of leading us in a discussion about how you can operationalize your funding. It's going to involve a lot of you sitting at your tables to talk to your neighbors, or to move tables and talk to other people, the folks on zoom crystal have some instructions for you as well for breakout rooms that we're going to do. So we're going to do kind of three rounds of breakouts a small group discussions around this topic. And then there'll be a chance at the end for anybody who wants to to report out or share any, you know, big revelations that they had or anything that you decide while you're doing this work. And then we'll have another afternoon break about 245 so I'm imagining we might get through one or two breakouts then have a quick break, we do have some yummy snacks, and then come back and finish up our day so where it looks like we might be getting out of here a little ahead of four o'clock and I don't see anybody upset about that so let's just move forward that plan and I'll change out the slides here for Christmas presentation. Well, hello, everybody. I am going to ask at the start of this that if you can, if you are at a table where you are the only city or county that is a representative of that, or if you only got about two people, if you could consolidate down into some of these other tables, bring chairs if you need to bring chairs. But let's take a second to do that. And while you all are doing that, I will tell us what the objective of this particular session is. This is the dreaded public participation, audience participation section of any session. So my name, as you all probably know, I'm Chris Cedars with the AG's office. And I wanted to let you know, what are we doing here? Well, the point of what we're gonna do here is we are going to try to have you all incorporate the knowledge that we've learned today, the kind of high level knowledge of the goals that we're doing and kind of the lower level, more strategic planning kind of steps. And we're gonna try to identify knowns, unknowns and unknown unknowns, not to quote Donald Rumsfeld out of turn, about OUD and SUD in your community, about the strategies that already exist in your community and what you could do going forward. We've learned about resources today. I'm gonna highlight a few more and tell you where you can find those resources. And then we're gonna have some conversations amongst ourselves so that we can start opening the door on that kind of collaboration process. Open that door so that we can find the areas where we are similar in Kansas and the areas where each of our communities are a little different. And the important point here is I want you all to ask questions, to know that you can ask each other questions, that you can ask us at the AG's office questions, that you can ask Sunflower questions, OR, and there's a lot of people here who wanna answer your questions. That's what we're here for. For the people on Zoom, when we get into the actual conversation point, we're gonna break you out into a couple breakout rooms. I'm not entirely certain how many people are on Zoom right now. Is it over 20? 33 people on Zoom, so that's gonna be about three breakout rooms. You're gonna be randomly assigned. There's gonna be three topic areas, so you should be able to see different people in each of those particular conversations. The point we want you to do here is you don't need to take a lot of notes, but we will kinda wanna hear about how your conversations go. So hopefully one or two people in the room will be ready to share. If not, I am not afraid to call on people and just do the old law school lightning bolt technique. All right, so let's move forward. We have quite a few resources that are available for you already in the state as a subdivision participating in this process. First and foremost, I'd point you to the Kansas Sunflower Foundation, not only the wonderful people at the foundation, but the website itself under the Kansas Fights Addiction page has a lot of resources available for you to know how other cities or counties are using their dollars. We've reported on 2022, or 2023 and, excuse me, 2022 and 2023 expenditures, and we are getting ready to report on 2024 expenditures. So you can see what everybody else in the state is doing with their dollars. But we also have some additional guidance. We've talked about Exhibit E quite a bit today. Sunflower and the AG's office put together a, and mostly Sunflower, fantastic. It's about a 45 page document. So if you need some light reading before bed, there is a long extended detailed guidance document, primarily focusing on what are called the Schedule A strategies, but those are the high priority strategies, about ways you can implement that. But the other thing that's in that document is a method. So you've all gotten kind of this method about how to think about your substance use and opioid use disorders in your community and how to strategize using those dollars. That all is articulated as well in the written document, if you need a little bit more guidance, or if you wanna share that with other people in your community. The other things though, that I want you to know, and this is also in the detailed guidance, there's a lot of data out there, right? If you don't know exactly what's going on with substance use in your community, I bet you, you can find some data that'll help you get a better picture. I've listed four resources here. The extended guidance gives you quite a few more, but the KDHE Overdose Data Dashboard, I believe they are in the process of updating to 2023 data, hopefully soon. But it can provide some county level data to explain what's going on in your particular community. The Kansas Communities that Care Student Survey can really focus on what youth are going through, what the youth experience of substance use. Similarly focus the Kansas Young Adult Survey, as well as the Kansas Behavioral Health Indicators Dashboard. These are a couple of just really quick Kansas focused resources to let you know what is going on in your community. Not everybody is going to be in the position of some of our bigger cities and counties who have really extensive local data available. And you don't necessarily need to be in that position. The point is that data is out there and available for you. And if you need help finding it or interpreting it, I can tell you real quick, we got lots of people who'd be glad to help you interpret that. The other thing though I want to highlight about data is some data is really dependent on federal collection. And due to, as we mentioned earlier, a lot of things being kind of in play, we don't know what the environment will look like for federal data collection. So really realize that you got a lot of good state resources. And if you need more data, we can help you articulate a process for collecting that data in your community. And the other thing I wanted to point out, so there's a lot of treatment resources that are available for you. SAMHSA's got a treatment locator. When we get to the needs assessment, there will be some additional data in the needs assessment about where can you find treatment in your community, if there's treatment available in your community at all. And we'll be able to help you kind of articulate those sorts of positions, or excuse me, sorts of services that are available. There's also the Kansas Prevention Collaborative Coalition Directory. I need to slow down a little bit. But I want you to just know that there are resources available to you. Those are in that extended guidance. And please use those resources. You do not have to, as you've heard, reinvent the wheel. You don't have to go in with absolutely no clear picture. We can help you develop that clear picture with the data resources that are available. So we have a pretty simple method here for how to operationalize your dollars. So you've heard a lot of information about why it's important to go through this strategic process. You've heard success stories about how that process worked for a variety of communities in Kansas, how it worked to collaborate with folks. But how do you do it for yourself? We have a four-step process. This is just one model. There's plenty of models that can work for other folks. There's a four-step process here. First is identify. Identify what the problem is in your community. If opioids are the highest problem in your community, your approaches might be a little different than if, say, methamphetamine or other substances are the primary issue in your community. If you've got a lot of different issues in your community, you need to be able to know what those are. So using this kind of identify step is really important. But it's not just identifying the issues. It's identifying people and resources that are already available in your community. It's really hard to solve a problem if you don't know what tools you have available to solve the problem. And so using this first identify step will be really important. Second, once you've kind of gathered the tools together, it's really important to start planning out your solution. This is where we talk about getting those stakeholders together, getting people across the community. I've talked to a number of cities and counties across the state on a regular basis. And what I've heard from a lot of medium and smaller size communities is they don't know who to talk to. So they just give their money to their law enforcement officers or law enforcement agency, and then they stop thinking about it and just kind of put everything on law enforcement. And law enforcement can do a lot of things. Law enforcement aren't typically mental health professionals for your community. There may be other folks that can do treatment services in your community, and law enforcement is just one of many other resources available. So being able to identify who in your community can help is important in that identify step, and getting them to the table is important for the planning step. I wanna say, you heard from Seth Dewey earlier, unless you are Reno, you need to find your own Seth Deweys so that you can get people at the table who have had experiences in your communities. And the reason I say this is I had a conversation with a family from North Central Kansas, and it was a dad and his son was going through opioid use disorder. And the kid came to the dad and said, hey, I wanna get help. I need to get help. And the dad didn't know the first thing. So they went to what a lot of families do. They go to their general practitioner. And the GP said, I don't touch junkies. And that was it. They didn't know where to go. They didn't know who to ask. And that's a person who has a story in your community about a problem your community is experiencing that you may never find out if you don't go find your Seth Dewey. You need to find somebody who can be at that table for this planning process. Finally, once you've done some planning, you gotta actually implement your ideas. Figure out if you're gonna do targeted versus comprehensive approaches, and then actually go and do it. And finally, one of the things that I really wanna highlight, and we've talked about it a bit, but we've used the phrase transparency or community buy-in or really get your folks invested. You've gotta be able to communicate what you're doing with your community. A lot of times, we will talk to people in communities. People will call us and say, hey, I heard about those opioid settlements. What's happening with those? It's like, well, what city are you in? Well, I'm in this city. Well, that city's getting this much money. Really, I'd never heard anything about it. They don't say anything to us. Talk to your community in whatever means you have available to let them know what you're doing because that's one way to get community buy-in. But it's not only just important for community buy-in, it's important for accountability and transparency purposes. We want folks to feel like we are using these dollars in the most impactful ways possible. And in order for that to happen, we need folks to know what's actually happening with the dollars. Finally, the final step of this is review and revise. As you've heard, one solution may not be the best solution in five years or 10 years. What works today may not be the only thing that you need to be doing as the process goes along. So review and revise your approach and keep going through that identification, planning, and implementation process so that you are making certain that you're capturing the most that you can and being the most effective with your dollars. So what are we doing with that, excuse me? It's been a long day and I apparently can't say operationalize anymore. What are we doing with this process? Today, we're gonna go through those first three steps just at a high level. We only have so much time and we're not gonna solve all the problems of the world today, but we are gonna have you all talk with each other about identifying what's going on in your community. If you don't know, talk to each other to figure out how you can find out. Each table is gonna discuss this. As Sherry mentioned, we'll go through probably two of these topics and that'll likely get us to the break unless I vamp for a very long time. And we will go through. And what we're gonna do for the folks in Zoom is that you will each, once you do each of these breakout rooms, we'll get you the topics, the questions that you can work through. And we wanna hear back both from the folks on Zoom, if you can put your answers in chat, and from the folks in the room about what to do talk about. And that way we can all gain from this conversation. One of the reasons that we wanted to have this conference was not just because we were getting a lot of calls and emails and sorts of conversations from folks saying, what do I do? What to do with these dollars? I've never done anything public health in our community before. We wanted to address those questions, but one of the other things we wanted was for you all to know that you are all not alone. Every single community that is represented in this room and on Zoom is working on this issue together, using these same resources, operating under these same rules. If you have questions, reach out to the folks that you're sitting with, that you've met today, because now you know that you are all working on this problem together using these same resources. And that was one of the other major goals that we wanted for today. So now after much introduction, let's get into the first topic, identifying. How do we do this identification step? Wow, that is a lot tinier than I was hoping it would be. So why don't we read through some of these questions and then you all can start discussing. A lot of these questions are about identifying the problem and resources in your community. So do you have a substance use disorder problem in your community? I can tell you the answer to that question. Who do you talk to when examining the size and scope of substance use disorder in your community? A lot of folks will talk to public health individuals if you have a public health body in your community. If you don't, one of the first places you go is to law enforcement, because law enforcement are gonna be typically your first responders responding to opioid and substance use disorders in your community. So who do you talk to? Who has the information about what's going on in your community? Who are we currently serving in our community? Who are we not serving? And who currently needs help? The reason I ask you this question is because we all kind of have some built in assumptions about what is going on in the substance use world, in the treatment recovery world. But unless we examine those assumptions, we may not realize that there are gaps in who we're serving and who we're not. Next important step on this, do we have any resources to provide help? Really like just ask yourselves, do you have resources in your community? Not just dollars from the opioids funds, but as we've talked about other grant opportunities and not just dollars, but people. People are a fantastic resource to use. Faith communities, service communities. Do you have a United Way in your community? Or a key club? Or an optimist group? Folks who are just in the community doing service in the work. What do you have in your community? Couple of these other topics and then we'll turn it over to you. Are we talking to enough people? Are we taking enough steps to be able to identify the problem? Is this kind of an iterative process of like, all right, now we've got this much information, what else do we wanna know? All right, now we've got this much information, what else do we wanna know? And at some point, you'll decide, we've probably got enough to move forward. And I think the last step of this kind of identifying process is, do you have resources that are permanent or temporary? These opioids dollars are temporary. What other kind of resources do you have? Are they permanent? Are they temporary? Do they need to be permanent? If we're doing this project well, hopefully, as Sherry pointed out, this won't need to be permanent. This can be temporary, at least some of these dollars. So what I'd like to do is take, let's say eight to 10 minutes and have you all talk with each other and see if you can answer some of these questions. And I don't expect you to have answers for all of these, but I hope you can use this process to start asking questions about how do I go about answering these questions? Remember, we've got known knowns, we have some known unknowns, and this process will hopefully help us identify our unknown unknowns so we can try to start getting those resolved. So please talk amongst yourselves. thousand dollars a year for the next three years, and that they would hire a mental health co-responder that would go with us out on calls for service, and then do mental health follow-up in the days after that, facilitate commitments to, you know, facilities, that sort of thing, teach CIT, and so it's worked exceedingly well. She does quite a bit of work for us, and so what we did is I, you know, kind of pitched that to the group over here when we talked about it. The difficulty we have with it is, as anything, the amount of money that we're getting is sporadic. We've gotten $3,000, $8,000, $88,000, and so it's very difficult to project and, you know, budget for that, but I can say we're going to be able to do this for a while. The good thing is our city commission, recognizing the difficulties we've had about mental health in our community, committed that if at some point we're not able to continue to do that, they at least, you know, on paper said that they would be willing to fund that, you know, moving forward at least at a different rate, so, and we just kind of vetted that out and talked about it, and it's worked very well for us. Very good. Thank you. Just so everybody knows, if you do need assistance in projecting out how much money you're going to get, we do have projections on that, and feel free to reach out to Nancy or myself in the office. We have projections out through the entire life of the settlement program for each of our participating cities and counties. What I will tell you is that they are very conservative, and I can almost guarantee you it is not the number that you will receive because we've taken 10% off of our projections so that we don't promise you more money than you will actually receive, largely for concern that, you know, somebody may prepay the exact dollar amount that we will get is a little contingent going forward, so just know we do have that available for you. It is used for projection and modeling purposes. Do not treat it as the exact dollar amount subject to other terms that you will get in the email. Yes. 2038 is the last year that we're currently projected. You can use the microphone. Yes, the second part. So the first question just was what is the life of the settlement, and it will be through 2038. Okay, and the second part of my question is, as long as it's spent by the final thing or is there There is no spend down element. Our procedure, our policy on this is that we will track what you receive and what you spend, and if we see a couple of years that spending isn't happening, we'll have a conversation just to see if we can assist you with identifying programs, things like that. Okay, thank you. Well, now that you've subjected your table to next questions, I want to ask, what kind of resources are available in your communities? What do you have currently? Are you able to identify what you've got in your community? Yeah, Mike Holton. Very good. Most of us, for the most part, are in Butler County. We do meet the chiefs meet monthly, as well as Sedgwick County. We meet with those guys. Some of this is the unknown, as it was thrown in law enforcement's lap. We agree with Chief Easter 100%. Gosh, why did you give us this money? It shouldn't have been ours. It has nothing to do with, very little, I should say, to do with us compared to who should control it. But yet, at the same time, it's there, so now we've got to figure it out and work together as teams. We should be a part of it. I think it's important. But yet, now we know Mike's got a lot of things already established. He's going to help with this, as well. I did have South Central Mental Health that was in my neighborhood. Today's one of the ladies' last days. We were already working on some projects. It's like, well, goodness gracious. Having those teams established, like we just talked about as well, bringing his chief to the table, and already things that are in place. Don't reinvent the wheel and just try to figure out what people are doing. We did spend some of ours. The first time I got it, I'm like, I don't know what the frickin' to do with this money. We bought the TrueNarc, not for criminal justice purposes, but for the safety of the people that may have an overdose or fire EMS-touching substances. It's like, what are they dealing with? How can they treat a person if we don't know what we're touching here? We ended up getting that to say, okay, we're dealing with cocaine or fentanyl or whatever it is. That one we felt good about, but it's like, okay, well, you can only do so much. What else is out there to really try to help the prevention side of this? Very good. Well, thank you. This table over here, because you just happened to come into my line of sight, so sorry. Are there any groups that are, I noticed a lot of Johnson County, Cedric County here. Are there any groups in your community that you're not able to serve or have identified that you would like to serve more, but currently don't have the resources for? You heard from the sheriff and from Dante. One thing that they didn't emphasize was that going through the strategic planning process with Stedman, working with the community partners, we have, obviously, we have resources in Cedric County. We have a robust ComCare program, and then we have private and non-profits that do substance use treatments. The problem we have, the sheriff pointed out, is there's only a couple that receive funding so that they're able to serve those who are uninsured or underinsured. If they don't have a pay source, they don't get treatment. Medically-assisted treatment is scarce, and again, if you have no pay source, then you don't get it. And so the intent of the strategic planning process was to get the partners to identify the gaps in the community. We have these services. Here are where the gaps are. Here's where this money should go so that we fill those gaps and specifically serve the populations that are not being served, which are generally those who don't have the resources. So that was kind of the goal that was, that came out of, or that's kind of the ultimate, what came out of that process was to fill the gaps and serve who isn't being served. And most of those providers in the county can probably fill in those gaps. We'll have to see. But first, have you had to figure out what those gaps were in order to be able to fill them? That was the first thing, was to ensure that we understood what the gaps were. And then as we put this coalition together that will push out requests for proposal, that's what we'll be focused on is filling those gaps, whether it's in recovery or treatment or harm reduction or whatever that is. Very good. Thank you. I'm going to turn it over to Zoom. Oh, very good. Yeah. And I just wanted to share, we were actually going down a different path because we hadn't met in a while. But something that counties might want to think about who are a little bit more strapped for pulling together a team and looking at their resources and doing their environmental survey of what they have available, is if you're a county that's a part of the Balance Estate Continuum of Care on Homelessness, don't forget those partners because there's a lot of folks at that table who are working on that issue of homelessness, right? In the faith community, school community, agency communities that are serving populations that have complicated histories that can include substance use. So they might be a nice entry point of discussion if you're scratching your head or thinking it's only courts and it's only law enforcement I'm able to work with. No, I think you would find some unique partners going down that route as well. Yeah, I absolutely agree. One of the things that I flagged for everybody is if you've looked at Exhibit E but not in a while, do take a look at the Schedule B, the kind of later part of that document because there's a lot of things that are covered and can be covered that are things like housing and some specific job training programs, child care programs. A lot of this can be captured under or used with these dollars. And for one thing I want to flag, and this may be a difference between Colorado and Kansas, we specifically keep this broad for substance use disorder, not just specifically opioid use. So if you're in a community where methamphetamine is the bigger issue, especially with the fourth wave of methamphetamine, or excuse me, fourth wave of the opioid crisis being characterized by poly drug use, we would really say that you can do programs that are targeting different substances because of that co-occurrence or the potential for co-occurrence. with opioid use disorders. So think about that, I know we talk about these as opioid settlement dollars, but it is a very broad project that we're working on here. Let's toss it to Zoom, see do we have any questions? Zoom is very quiet today, we're gonna. We just got one. Can anyone talk about identifying the stakeholders or community board generating energy for participation and community slash council approval for use? So I can give you at least a couple ideas. You know, if your community has a public health entity, that's a great one. I'll talk about, I'm gonna come over to this table I spent some time with. I would like you all to tell me a little bit about how you kind of identified a couple of the folks, specifically the one person who was working in your community on the Oxford houses. Yeah, Brittenstein, City of Junction City. So we had a gentleman a couple of years ago, he bought a few homes, the idea of making them into Oxford homes, but they were in the middle of a unsafe, uninhabitable blight tear down demolition process. So we've been working through it, he said he has limited resources to do it, so we've been kept getting extension after extension. So kind of I got the whole thing clicked today is okay, we can use this for homes, maybe. So this might be a thing that we might use our first monies for is looking at doing that. And how did you first identify? Did he come to you? He came in and said, please don't tear down these homes I'm trying to buy. So one of the ways you can identify stakeholders is they will come to you if they know that you've got money. I have found that out very quickly that if somebody knows that you've got money that's available, they will find you and they will come talk to you. But other ways, talk to your public health folks, talk to local law enforcement. As we heard from this table over here, you may have local law enforcements may have people in their neighborhoods that they know that they can identify that as potential stakeholders. As for generating energy, I think that really comes from having a focused goal and making certain that you're all working towards the same goal. I'm gonna say that that's probably good for a break now. Sherry, you've got a microphone. Yes, I would say so. But before we do leave for break, I wanted to say that I was really grateful to hear all y'all talking about partnering with your community mental health centers. I worked at Wyandotte Center for about, well, I worked there four times, total of 25 years. That's a long story. But I think mental health centers were partially responsible for fueling the silos that occur between substance use disorder treatment providers and behavioral health, like creating these artificial barriers. But there's a new movement. It's called the Certified Community Behavioral Health Center, or CCBHC or CCBHH, if you've heard of those terms. And now mental health centers are now required to provide substance use disorder services. So if you are partnering with your mental health center, chances are really good that you'll be working with a partner that's not only very savvy around behavioral health issues in your community, but also should be having their finger on the pulse and services to provide to people who are struggling with addiction. So you don't just have to go to the typical substance use disorder treatment facilities that we have in our state, of which there are not very many. So continue those partnerships. That's a great idea. Sherry, how can I find out if there's a CCBHC in my community? I think that there is a national repository for understanding who is a CCBHC and who isn't. But I'm pretty sure Kansas is mandating that all their mental health centers become CCBHCs. That is correct. And I believe KDADS also has a list of CCBHCs. How could I forget KDADS? Thank you for that. Yes, and we are gonna have a break for a snack now. We are gonna go ahead and pull down our exhibiting materials out there. So if there are any cool ORN things you wanted to grab before our end today, do that now. And while we're meeting, Rory's gonna take that down. But we still have more to come after the break, but not much more. So please return after the break. We'd really love to see your faces back in the room for just a few more exercises and then a closing. So thank you guys so much. Thank you. Everybody, as we come back from break, I just want to remind folks, now's the time to take your evaluation survey. So, if you see these QR codes on your table, please use that one to give us an evaluation. We'd really appreciate it. to Bonner Springs about that. All right, everybody, I think we can go ahead and move along. So before we send all of our Zoom folks off into the breakout room again, let's talk a little bit about what our second topic is. And that's gonna be about planning the second phase of our operationalization strategy. I am certain I'm gonna get that word right once. So the questions I'm asking or wanting you to think about is how much money will you receive in dollars from this particular program each year? I think we've come to the realization that not everyone has received their projections for how much money you'll receive over the life of the program. So to answer this question just for you, if you don't know, Nancy Deaver is right over here and she'll be very happy to give you that particular information. What are the short-term goals for substance use disorder in your community? And what I mean by that is, are your goals harm reduction related? Is it purely just harm reduction? We just wanna get overdoses down or overdose deaths down. We'll worry about the rest once we get that particular problem solved. Is it that you want in-community treatment? And what I mean by that is, do you want treatment facilities in your community, inpatient, outpatient, therapy providers? Is that what you're looking for? Or are you simply looking to connect people to providers, even if that's not in your community? And those approaches can look quite different. What are your long-term goals? So we think about short-term goals, we think about long-term goals. What are your long-term goals? Is that prevention? And how are you wanting to do prevention? Is it job training? Is it housing? Is it childcare? Is it education? Is it long-term education plans? So these are kind of the approaches that I want you to think about and talk about within your groups. What are these strategies that you wanna look at? And finally, are we talking about a comprehensive or a targeted approach? And what do I mean by that? Are we targeting one specific aspect of our community, one region of our community, one demographic in the community? Or are we trying to target all SUD, people experiencing SUD within the community? Those are very different approaches. And so I want you to think about what is our goal? Or how would we go about articulating a goal? And finally, on this planning phase, are there opportunities to collaborate? I'm gonna expand that. Are there opportunities to collaborate or braid funding? And Kate, if you're not familiar with the phrase braiding funding, don't worry, I learned about it about six months ago. Thank you, Krista and Sunflower Foundation. But the idea being that are there opportunities for you to use your funding on the opioid settlement dollars with other funding programs? You heard it from JK earlier about whether or not there's going to be other grant opportunities available, and maybe you can use these dollars with those dollars. You can collaborate with amongst groups. You can collaborate city and county or across county lines with different cities together working on a regional approach. One of the ideas that went into this particular Kansas Fights Addiction approach was to give autonomy to the municipalities. And that is a trade-off, right? That's a huge trade-off when we didn't dictate what your regions were going to be. And part of that is because Kansas has tried regional approaches and different structures before and it didn't work particularly well. Part of it is because Kansas is fairly sparsely populated in quite large parts of the state. And part of it is because you in your community know what other communities you work best with. And it's probably not best for the state to dictate, you will work with this other community. It's a lot better if you can engage with those communities yourselves. And so we're going to encourage you to work towards collaboration and work towards braiding. But as part of this discussion stage, they want to ask you, are there opportunities? Have you thought about opportunities? Or how would you go find opportunities for these types of braiding approaches? So I'm going to give a minute for the folks to get into their breakout rooms in Zoom. And then we will have you all talk and we'll do a much shorter conversation period since I noticed that it's getting a little thin in the room. So we will go ahead and have you start your conversations. We'll give it, let's say eight minutes to talk amongst yourselves about what are your planning goals? How do you develop these strategies? And those steps like that. All right, why don't we come back to the center so we can wrap this topic up. But I would like to hear from, if you could grab the microphone there, this table, talk to me about your planning ideas. What are your longterm, it is unfortunately you made eye contact. So now it's, I know it's been a minute from school for all of us, but you got to remember the rules. So what I was expressing to my group is I am actually here for these reasons to get answers for these questions. What would a plan be for my community and law enforcement and how is it going to look there? I was tasked with that and just reaching out to others and making those collaborations to figure out how to get to this level and what is it that we can, who is it that we can collaborate with? How is that going to look at what resources are out there? Right. Kansas, South central Kansas. There's, there's not a whole lot of resources. They, they kind of say they stop at the Wichita and West. We kind of don't exist. We do, but it's, it's not, it's not a really a perfect point. So we're trying to adapt what we can with the resources that we have and the settlement funds that we have gotten, it has basically just been on training and now how are we going to use those at the local level? Who am I going to get with and what that may look? Well, for the education piece, and I'm going to maybe toss this open to other folks, I know there are a lot of prepackaged curricula that you can purchase to deploy in your education setting for a different type of targeted approaches. And these are evidence-backed curricula that, that can be effective at different age groups. So I would tell you, I encourage you to I'm looking at my sunflower folks to see if they have any idea what I'm talking about, but yes, good. So I'm not talking a crazy talk, but there is a evidence-based curricula approaches and they are usually not super expensive to purchase. I don't believe so that it would be a way to use your resources there. The other thing, and I'd ask this, both of you and other folks, have you considered any the approaches that are very either cheap or free, which is collaborating with other community members, right? Interfacing with service organizations that are in a lot of communities. I know campus is pretty big on, you know, like Lions and Rotary and those types of groups, interfacing with those types of groups can be a great way to interface with other folks who can also assist in deploying some of these education resources. So I tell you to consider that as well. I am part of a lot of those groups that you've mentioned. That is also a challenge because of how they may look at the situation. And again, in our community, they want to say that it doesn't exist when they know it does, but it doesn't in their, literally in their backyard until something criminal happens and why is there no preventative measure before me when there is, but they just don't want to hear that until it's gone. So I might see if JK might have a thought or two on how to do stigma education or de-stigmatizing education. I have, I have a, I have an idea. So the opioid response network will give you free training on, we do lots of trainings on stigma and really what I, how I talk about it is we spend a lot of time winning over people's hearts and minds that addiction is a chronic and persistent disease for which there are treatments and that people struggling with addiction deserve our compassion and empathy. And we have experts, physicians, people with lived experience, social workers who are really great at getting that message across. And that's a really easy thing for the ORN to do to support you. As well, I've received many requests from our region around, well, what are the evidence-based school-based prevention programs? And more than once I have curated all kinds of, you know, prepackaged programs that are evidence-based that school members. So like your social worker, a school nurse, a counselor can literally like pull off the shelf and implement in the K through 12 setting. There's a ton of them. And some of them are, you know, they cost, but you have funds to pay for those things. So just two ways, as you were talking that I thought that the ORN could really help. So if there is anything we can do related to those two things, that's perfect reason to submit a request to us and let us meet with you and talk about what you need and then deliver it. So as if, if part of your short-term goals is developing, you know, a plan to deploy education, long-term goals, getting that education into your institutions it sounds like we've got some resources that can assist you with trying to get that. And that'd be for everybody, not just for Pratt, Kansas. Yeah, that would be great. We, we developed the hard part is done. I was able to get a school resource officer and have that position. So the big funding part of it, it's already been that challenge. Those parts are great as well, but I will definitely be reaching out with that information. So I appreciate it. Very good. And you are no longer in the hot seat. All right. So I want to hear from other tables. Can I pick on this middle table again for ideas on, on long-term, short-term planning goals, things like that. And thank you, Sherry, for running a microphone. No, no, no. Do you want to say anything? Um, do you want me to what I, yeah, absolutely. So I'm sorry, guys, I'm going to stand over here. So it's easier to see people. So I introduced myself before, um, I'm accounting commissioner here in Johnson County, but before that, I actually led United community services of Johnson County. So, um, and, uh, so I'm going to put on my nonprofit hat for a moment. A few counties I was talking with through the course of the day, um, are smaller counties, right? Where not only do where one of your barriers may be, do I even have any resources to choose from to fund if raise your hand, if you fall into that area, anybody left who falls into that? Okay. Awesome. So one of the things that we, if, if you're, um, fall into that, or you're more of a mid range County and you have limited resources, right. Is to look at this funding as how do I want to put this? I took some notes. So let me just is look at this funding as an opportunity to stand something up. Um, in the, in Johnson County, we've taken an approach where we've looked at the money that we're going to have throughout the whole course of the period. And then we've divided it by the number of years, right. To kind of have the same amount to deploy every year. Well, you might do that only. Maybe you do it over 10 years instead of the 17 years. So you have a little bit more front load of money. Then you say, I may need to create a program or I may need to create a position. Maybe I can house it in law enforcement. Maybe it can house it in a County or city building, but I need to create a position in a program. So you kind of front load your money to get the program up and running. To collect your data, to have some outcome, and then to use that information of what you learn, to then go out and apply for other types of, be it, you know, healthcare foundation dollars, federal dollars. Also when we think about federal dollars, and I know that's scary and bumpy right now, but a lot of large healthcare funders and a lot of federal grants require some level of local match. Well, this becomes part of that local match, right? So now I'm, I'm doing what Chris talked about, what you learned about six months ago is the braiding of the funding, right? And so look at this because otherwise we'll have a tendency to play small ball. I'm going to buy equipment. I'm going to do things that don't obligate me to ongoing funding when my funding goes away. If you look at this as an investment to create that thing you could never create before, and if it's successful, you'll garner dollars that makes it sustainable. The other thing is if you're in a part of the state where it's not just you, but your fellow counties are all in a similar situation, then you could collaborate those dollars and bring in a service or program that has a certain level of mobility to it so that it could do a circuit, right? And now you're braiding those resources together. You're all identifying maybe a key need around a program, a service or an agency. And you're creating that seed money, standing it up, meeting the needs today and building the case for continued funding. So that's just a thought is when you think about this money of how it can still be transformational. Thank you so much. All right. I think we can move on. JK's table. Don't think you get away from it for round three. You will be on the hot seat. So have a good discussion, but we'll have one last topic here and then we'll wrap things up. So for topic three, this is really now thinking about the implementation phase. And what I want you to be thinking about is who do you need to be involved? Who do you need to involve in your decision-making? We've heard a lot about advisory groups. We've heard a lot about involving your elected board. One of the things that we really want to talk about, and we've, we've discussed at length here is finding your Seth Dewey, finding somebody with lived experience, because they will tell you things about your community. You have not heard from other folks. And that's really important. But also like what governmental units are going to be involved? What administrative units are going to be involved? Who all can be involved in this particular advisory committee? And they don't necessarily need to be involved in every decision because sometimes you just need to go talk to maybe a state agency to ask a couple of questions about how to do something. So think about who is available to you. And if you don't know, again, going back to identify, how do you find out what units are available to you? Finally, how frequently will you distribute money? Well, not finally, but how frequently will you distribute money? One of the things that we've heard is a couple of different models of distributing funds. Johnson County, not to pick on you, has a annual grant program through the UCS program, but that's not the only way they distribute funds. Some folks are just doing specific targeted projects. We heard that from Mike and his court administration role of targeting specific projects as requests come in. Or are you going to do a multi-year project with the funding that comes in year over year over year? So think about how would you want to do that? And maybe you want to do different approaches for different projects. So I'd like you to talk through kind of those different ideas. And finally, and this is a point that I'm really starting to hammer on for this year, is how are you going to inform the public about what you're doing? Is it just going to be that we talk about it during the city or county commission meeting, or is it just going to be a post on the website somewhere, 14 links down and it's difficult to find, or is there going to be a press release? Is there going to be a, are you going to invite the media to talk about it? Are you going to put it on your Facebook page or whatever other kind of means of public communication? Is it going to be talked about more than once a year? And the reason I say that specifically is for a lot of funding sources, a number of communities I know we'll talk about it at their budget meeting in June, and then never, ever, ever talk about that funding source again for the rest of the year. So it's important to know what is your method for communicating what you are doing, in part because you want your community to be buying in, but in part because you're going to report it to us, Nancy and I are going to find out what you're doing, and then we're going to make it public. And I think that a strategic point is you don't want the public to come asking you based on a report they got from the AG's office about what you're doing with your dollars. So let's take a couple of minutes, have the conversation about these particular issues. And let's wrap up in about five ish minutes for this conversation. Sound good? All right. Zoom folks. I'm going to give you the minute to get into the breakout rooms and vamp for a hot second while the rest of you continue talking. I take just a couple more minutes on this subject and then we'll get wrapped up. All right, JK's table, I told you you were on the hot seat. So what all did you talk about? I was waiting for that knock. Yeah, sorry, you guys get to hear me again. So we you already know how we do things. We do an RFP, we do it one time a year. We're actually in our second iteration of that. So really, informing the public is probably our biggest what we need to work on doing. So not just doing the press release, but also getting out into the community, doing those 12 sectors, really making sure that we're hitting all of the different groups, making sure that it's out on our website and JK just reminded me that I need to put up our agendas for our meetings on that said website. So all of those things, just making sure that we're out and about and in the community, with the variety of stakeholders, making sure that they all know that this money is available. Yeah, something we found helpful at the state level is a mailing list, literally just an emailing list that keeps people appraised of what's happening. It's a dead simple tool and really helps make certain folks are engaged. It's not got super high membership nor click through, but it is at least a stage that's easy to implement, is free to implement if you don't have, you know, 1000 people and is a really easy way, especially for smaller communities to keep people involved should folks want to keep posted that way. I'm going to pick on the table in the far back corner because you all have been free for far too long. So let me get you a microphone, or actually could one of you come up to that microphone and let us know what you talked about. Our table is a little bit lighter than it was half an hour ago. So it's just me and the chief of Osawatomie holding down the fort. So we talked about getting the word out. One of the challenges that I think both of our communities have, we will talk about things in city council meetings, but unless people are really angry about something, 99% of our residents don't really follow city council meetings. So that's kind of one of the challenges we talked about. We spoke about doing press releases. We spoke about putting things on the Facebook page. We spoke about putting things in our city's newsletters, things like that to get the word out. But we kind of talked about the pros and cons of how we get the word out to our community. Yeah, no, I think that makes sense. Multi-channel communication is important and repeated communication is important because otherwise folks will just miss it. It's like when a city puts a road under construction and they put it up under like two or three places and then you get angry messages on Nextdoor about, why didn't the city tell anybody about this? You got to try as many different ways as you possibly can and say it more than once, unfortunately. But that is, I think, the approach that works the best. One thing, though, I think you mentioned about just talking and talking about things. I do think it's really helpful for each of you to find one or two people who are motivated to work on this project as part of the implementing step. You can't just have a committee of a bunch of people who meet once a month to make decisions and really hope that everything gets done well. You need one or two dedicated people to stay on top of these types of projects. It's not easy to do the work of, if you're going to do big grants, vetting people. That's not easy work. It's not easy getting data for accountability purposes. So having somebody who is dedicated, even if it's part-time dedicated, that is helpful in making certain that you are actually being impactful with your dollars. Last one we'll go to is, is there any questions or comments on the Zoom? I'm seeing a big no. Zoom, you're too quiet today. All right, we'll wrap this up. So just kind of final points here. You are, like I said earlier, you're all basically working on the same set of questions, right? How badly is my community impacted? What is it impacted with? Who do I need to talk to? How do I design these particular programs? How do I best use these dollars? How do I be accountable? And your approaches are going to potentially vary, but a lot of your approaches, as J.K. said, are going to probably be about the same as other places. One of the things we saw a lot in 2024 for the communities that spent money was they spent it on Narcan and Naloxone, because that is an easy, tangible, and immediate impact in their communities. But we don't expect that's going to be the case in 28, 29, 30. As we get deeper into this project, you're going to have other ideas, other approaches, other things that are going to need expenditures. And so talking amongst yourselves is going to be a really valuable tool. You know, I keep saying this because I've talked to a number of cities who feel like they're alone, right? They feel like I'm one person who I get to spend two days a month working on this, and I don't know who to talk to or how to talk to anybody, and I'm afraid to bother somebody, where Kansans were a little bit afraid to bother somebody. So just know you're not bothering anybody when you reach out to people who are also working on these things. And when you're all working on it together, it can make it feel, A, like a community, and B, like you're actually making progress on things. The other thing I just really want to emphasize, you are not bothering me when you email me or call me. Yes, I do get a lot of emails, yes, I do get a lot of calls, and sometimes I am not as fast as I want to respond. So number one, if you have questions, you are free to reach out to me or Nancy. Probably me. Actually, if you ever contact the AG's office at all and mention the word drugs, it just comes to me. They kind of just automatically filter it. Don't worry about it. You'll eventually get to the right person. Two, if you do not hear back from me in a timely fashion, it is not offensive to me to poke me one or two times. Sometimes I'm out of the office, sometimes I've got a lot of other projects. So please, please, please do contact me. But one last thing I wanted to mention, and it's not on these slides, and this is really more for law enforcement folks, and it's going to take me a second to pull this back up. There are other trainings that are available going on constantly. Not just ORN trainings, not just trainings from the AG's office or Sunflower. One of the ones I wanted to just flag for you is that Kansas Department of Health Midwest HIDTA is doing a training in a couple of weeks for law enforcement on deflection and diversion strategies for addressing substance use. This is just another approach for law enforcement. We know that in Kansas, a lot of the municipal dollars are going to law enforcement, just because that is the first responder organization that a lot of our cities and counties think of. So I just wanted to flag that these trainings are available. If you have questions, guess what? Ask me. Ask Nancy. We will answer your questions to the best of our ability. Last thing I do want to say on this is that we are incredibly grateful for all of you spending a very long Friday. I know that I technically had a day off today. I'm sure a bunch of you technically had a day off today. So I very much appreciate you spending your time on this. We will fight the opioids crisis, but it is going to take each and every one of us working on these projects together, and not any of us working in individual silos. So thank you, and have a safe trip back for the folks who are going to be driving away. I am going to turn this back over to Sherry. Thank you. Wow, Chris. Thank you, Chris. Okay. I thought I had my QR code here on this presentation, but it is not. So, on your tables, you will see this sheet of paper with the QR codes on them. The first code right here is to link to the Opioid Response Network. It's the second one on the page. I'd really like you to take a moment to use your camera on your phone to navigate to our evaluation survey. This is how SAMHSA judges whether or not we're doing a good job. And if you thought we did a good job today, great. If you thought there were areas we could improve, we want to hear that, too. So please complete that evaluation survey. And then, just finally, I wanted to show you all really quickly, because we are at the end of our time. This is the information about the Opioid Response Network. If you go to our website, you will see tons of amazing resources, information about our network, and the ability to submit a request. You just click on that button. It takes you to a Google form that isn't very long, just asks the kinds of questions that you're going to know the answers to. Once you submit that to us, we will respond to you within one business day. So I hope that if we can help you, you will consider submitting a request. We also talked a minute about the Kansas Sunflower Foundation and their website for Kansas Fights Addiction. This website blows me away, you guys. Compared to other states in my region, Kansas is doing such a great job. Kansas is doing such a fantastic, transparent job with this funding to educate people about the resources available. So please don't end your opioid settlement funds planning without visiting this website. I also wanted to point out that on the QR code page, there's also a link to Exhibit E, Schedule A and B. This is a wonderful document to just make sure that the strategies you're planning on are indeed approved strategies. NACO, the National Association of County Organizations, also has an amazing opioid solutions center for counties or really anybody. Tons of really great guidance and tools available there. And then finally, I know we had several speakers reference the Johns Hopkins website, their opioid solutions page. It starts with the principles for the use of the funds, but they have lots of other resources there too. And you learned about a ton of resources here today. The Kansas Fights Addiction Needs Assessment, the Opioid Response Network, all of those things are available here to help you guys in the important work you'll be doing. Thank you so much for spending your day with us, and we hope that you learned something. And we look forward to seeing you again in the future, either through a request or an email. And safe travels home, everybody. Thank you so much.

Kansas Municipalities

Addiction Summit

Opioid Crisis

Sherry Watkins

Opioid Response Network

Seth Dewey

Substance Use Disorder

Community Change

Opioid Settlement Funds

Treatment Strategies

Janine Haran

Dr. Silke von Eisswein

Needs Assessment

J.K. Costello

Brianna Robles