Spending ‘blood money’ in secret: OneOhio seeks political cover

The proposed budget would allow the foundation responsible for distributing a bulk of Ohio’s opioid settlement money to operate in darkness. Jamie Decker and others want to shine light on the process.
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It's blood money, Jamie Decker said. The opioid settlement is compensation for the deaths of his friends and loved ones. It belongs to people like him. 

Decker has lived in Findlay, Ohio, about 90 miles northwest of Columbus, his whole life. He started using opioids there in 1994 and quit about nine years ago. Today, he feels privileged to be alive. And more than most, he said he knows what could help keep people who use drugs in Findlay and elsewhere safe and healthy.

But if it's up to the OneOhio Foundation – the body responsible for dispensing 55 percent of Ohio's opioid settlement money – how that settlement money gets distributed will remain a secret.

The Ohio Senate's proposed state budget includes language that would ensure that the OneOhio Recovery Foundation (including its 19 regional boards) is not considered a public entity and would no longer have to follow state open records, bribery, or ethics laws. If that language remains, the foundation could operate in secret despite Ohio Supreme Court rulings stating it should do the opposite. 

This push for secrecy is especially upsetting to folks like Decker. He's a frontline harm reduction worker for Hancock County Public Health, working alongside colleague Sharona Bishop to distribute safe use supplies such as new syringes, naloxone and testing strips to folks whose shoes he once stood in. Across Ohio, people like Decker save our neighbors every day. And if OneOhio and the regional boards can operate in secret, Decker said he's not sure if they'll use it to address the crisis, or if the money will end up in the hands of law enforcement or shady treatment providers. 

Policy choices like this are a matter of life and death. 

In an emailed statement, OneOhio told me: "Along with the recent decision by the IRS to grant the foundation 510c3 status,[sic] the proposed budget language confirms the OneOhio Recovery Foundation is a private, nonprofit organization. The Foundation supports a broader public mission and will continue to operate as arguably the most transparent organization in the state of Ohio."

A few counterpoints: Transparent organizations allow public records requests. They hold space for public comment. And they are not threatened by journalists sitting in on meetings. (I'm reminded of the moment in The Princess Bride when Inigo Montoyo says to Vizzini, "You keep using that word. I do not think it means what you think it means.")

This is public money, and the board members were appointed by public officials. And yet Ohio, along with 16 other states, has yet to commit to publicly reporting anything at all. 

Dennis Cauchon, president of advocacy organization Harm Reduction Ohio, said that he thinks they're doing this because they would like to be able to control how the funding is being used. It's that simple. "It's an ideal political situation,” he said. “If there's openness, then there might be other ways of seeing what they did." 

We've been down this road before. In 1998, the $246 billion tobacco settlement flooded states with mostly unrestricted money that was spent on everything from literacy programs and golf carts to Ohio school construction. At this point, less than 3 percent of those dollars go toward tobacco cessation and smoking prevention. 

Technically, 85 percent of opioid settlement funds must be used toward opioid use disorder and prevention. But how that's interpreted depends on who's sitting at the table. It's not hard to imagine the money being deposited in law enforcement coffers (which we need less of) rather than on overdose prevention and harm reduction (which we need more of). To wit: At the OneOhio meeting on February 8 (at approx. 1 hr. 23 min), a board member suggested putting something in bread products that stops opioid cravings. 

Representation matters. Many of the state board's 29 members are elected officials who have been appointed by the governor, attorney general, legislators, and local officials. Decker is the kind of person who should be on the OneOhio Board. Listening to people who use drugs, or who are in recovery, or who work on the ground in harm reduction matters because they’ve seen first-hand the effects of the drug war. (Decker applied alongside more than 90 others to be on the OneOhio board of experts, but every source I know who did the same has not heard back.)

When he was using, Decker said, "Nobody ever treated me like an adult." But he learned from other people who used drugs how to keep his rigs clean, how to watch out for others, how to go slow when taking stimulants. When he stopped using, Jamie said he thought a lot about how others made using safer for him, and how others gave him Narcan when he overdosed. And he realized, with gratitude, that harm reduction had kept him alive. He researched best practices and connected with harm reduction advocates from across Ohio. 

But he also learned that not everyone supports this approach to substance use. He faced resistance at 12-step meetings when he passed out naloxone. In other circles, people have told him that handing out naloxone is okay, but syringes is taking things too far. 

"In my mind, there is no 'too far,'" Decker said. "They're humans." One time, at a public meeting in Findlay, a harm reduction advocate from Dayton spoke about the need to teach people how to use more safely. As she was talking, he said, a row of probation and law enforcement officers responded with laughter. He called them out on it. 

"I don't really have anything to lose," Decker said. "I survived all kinds of stuff. I'm not going to sit back and be quiet. … The only thing I really have are my principles and integrity, and I’m not going to compromise either one of those ever again."

I hope those responsible for distributing the opioid settlement money will follow his lead.

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