While opioid lawsuits are pending, is there an immediate role for philanthropy?

Public Health's Guide to Pivots & Possibilities

While over 400 municipalities are jointly battling the makers, distributors, and sellers of opioids, there are other large cities independently taking on the opioid crisis by legal battles in their own jurisdictions. Regardless of how the legal battle is fought, I’m going to remain optimistic that at least in some of these cases authorities will win financial settlements.

Unfortunately, even when money is provided, there are barriers to spending that money at both the state and local level. In late 2016, over $375 million of available opioid funding was left untouched. These funds came with some challenging restrictions, such as:

  • Limited duration creating challenges for jurisdictions to create long-term (> 2 year) programs with provider organizations and limiting the ability to hire quality staff;
  • Restrictions on fund usage making contract negotiations difficult; and
  • Uncertainty about if funding would be provided in the second year of the program, and if so, how much.

So, how can philanthropy enable and support municipalities as they prepare for (and get) funding from lawsuits and from the government? Philanthropy can enable preparedness: when settlements get awarded, jurisdictions can act in the fastest and most effective way possible. Enabling rapid readiness will lead to quicker action, and more lives saved. Ideas for this pre-work include:

  1. Go local: Support local organizations, so they can partner with local jurisdictions to create sustainable solutions.
  2. Take risks: Invest in exploration, unexpected partnerships, testing of new concepts, start-up organizations, and bold leaders.
  3. Brainstorm/hack/innovate: Support or host events within communities, engaging those who are battling the opioid crisis directly. Bring together groups who otherwise wouldn’t be in the same room (civil society, private sector, medical organizations) for a free lunch with a speed-networking or pitch structure. Launch convenings that enable local jurisdictions who have tried different approaches to mingle and share what they have learned directly with other jurisdictions.
  4. Share what you learn: Evaluate the investments (#2 & #3), and then widely spread learnings so governments can scale what worked and not waste money on what didn’t.
  5. Create resources: Trade publications are writing about programs that are being launched, but that tends to be ad hoc. The Federal government used to keep a list of evidence-based practices. So, how can an organization find out what has been tried (either successfully or not), and what people are thinking about? Is there a system where practitioners can look at ratings and reviews of what others have tried (like we have for most consumer services today)?
  6. Think upstream: While government organizations are often restricted by what types of programs can be supported with different types of funding, philanthropy organizations can look with a systemic lens and fund efforts that cut across sectors. Programs can look at social determinants of health
  7. Be realistic: The Nonprofit Starvation Cycle is real, and if nonprofits at the local or regional level are doing amazing work, philanthropists can support the organizations by supporting the core operational costs.

If philanthropy made a big push to work with communities to figure out what works, what doesn’t, and what ideas still need to be tested, the settlement money that jurisdictions get can be invested in proven solutions as soon as that money hits the town council bank account.