Pennsylvania Families Push for Statewide Grief Support System Using Opioid Settlement Funds

When Susan Ousterman lost her son Tyler Cordeiro to a drug overdose in 2020, the location of his death proved unexpectedly important. Because Tyler died in Philadelphia, Ousterman became eligible for Philly HEALs—a free city-funded grief support program specifically designed for families experiencing drug-related losses.

"They were incredible," Ousterman said. "They absolutely changed the trajectory of my healing journey."

Now, she and other Pennsylvania parents who've buried children to the overdose crisis are calling on state leaders to replicate that model statewide. They're urging agencies to use hundreds of millions of dollars in opioid settlement funds to create a comprehensive support system accessible to all bereaved families across Pennsylvania, not just those fortunate enough to live near existing programs.

The advocacy campaign comes as counties throughout the state wrestle with how to allocate settlement money from lawsuits against pharmaceutical manufacturers and distributors. While most funding has targeted prevention, treatment, and harm reduction services, advocates argue the state has neglected an equally critical dimension of the crisis: supporting the thousands of Pennsylvanians left behind when someone dies.

A City Program That Works

Philadelphia launched Philly HEALs in 2019 after behavioral health providers recognized a growing need for specialized bereavement services. Since then, the program has served more than 4,000 people—making it one of the earliest and most comprehensive city-funded grief support initiatives in the country.

The program eliminates health insurance barriers by offering services completely free. Participants can access virtual and in-person peer support groups tailored to specific relationships and circumstances: groups for parents who've lost a child, for siblings, for partners. There's a writing group, a movement group, and a men's group.

Philly HEALs also provides one-on-one grief counseling with licensed therapists for at least 10 sessions, along with short-term services for children and teens ages 4 to 19.

About 90% of participants are identified through next-of-kin information from Philadelphia's Medical Examiner's Office, which confirms drug-related deaths. Others find the program through online searches or word of mouth.

Rachel Essy, program manager and licensed marriage and family therapist, said the initiative creates space for people who feel they can't grieve properly elsewhere—where judgment, stigma, or loneliness in their experience makes traditional support systems inadequate.

"Just having a place where there's no judgment, they don't have to feel like they're burdening somebody with their grief, and just have it recognized that you are grieving," Essy said. "This is a place to share about your loved one."

The Grief No One Talks About

For Ousterman, Philly HEALs validated not only her grief but the complex emotions she felt as a parent who had watched her son battle substance use disorder for years.

"When you're living with an adult child in chaotic use, it's really no different than being shot at in a war," she said. "Your nervous system is totally dysregulated. You're living on edge constantly."

Many of those feelings dissipated after Tyler's death, replaced by other types of deep pain—and a small measure of relief. That contradictory emotional landscape is something only other parents who've lost children to substance use can fully understand, Ousterman said.

"There is that relief. And it absolutely doesn't compare to the pain we feel, of course," she said. "But it's nice to be able to say that to someone, like, 'Yeah, I don't miss not sleeping because I'm waiting for the phone to ring.'"

This kind of disenfranchised grief—mourning that society doesn't readily validate—is exactly what specialized support programs address. Traditional grief counseling often lacks the framework to navigate the pre-death trauma of addiction, the chaos of active substance use, the cycles of hope and despair, and the stigma that follows overdose deaths.

Why Pennsylvania Needs More

Ousterman now coordinates virtual peer grief support groups through her nonprofit, the Vilomah Foundation, with help from a small grant sourced from Bucks County's opioid settlement allocation. But the funding isn't enough to serve everyone in the county who needs these services.

In fact, Bucks County had previously proposed establishing a larger network of grief support groups with up to $150,000 of opioid settlement money. The project didn't move forward, according to a county spokesperson. A smaller amount was ultimately allocated toward grief support services in the community—far short of what advocates say is needed.

That's emblematic of a broader challenge across Pennsylvania. While Philadelphia's city-funded model demonstrates what's possible, most counties lack the infrastructure, expertise, or political will to create similar programs from scratch. And even where local initiatives exist, they often struggle with sustainability, geographic reach, and awareness.

Advocates are pushing for a statewide program that would:

• Coordinate grief support services across all 67 counties
• Connect families to resources immediately through partnerships with medical examiners' offices and funeral homes
• Provide respite care opportunities for grieving loved ones
• Offer financial assistance for funeral costs, which can create devastating debt for families already facing economic instability
• Support grandparents and other relatives who suddenly become primary caregivers for children left behind when a parent dies

"That's what we hope to do in Pennsylvania, is be connected to medical examiner's offices, funeral homes, so we can reach people right when it happens," Ousterman said. "If people don't have that support, you can't authentically grieve."

Settlement Funds as an Opportunity

Pennsylvania is expected to receive hundreds of millions of dollars from national opioid settlements over the coming years. While counties have broad discretion over how to spend their portions, state leaders could direct a portion of the state's share toward establishing the kind of coordinated grief infrastructure advocates envision.

The funding opportunity is significant. Other states and counties have begun dedicating settlement dollars to grief services, recognizing that the crisis has left a wake of bereaved family members whose suffering often goes unaddressed.

In Fort Wayne, Indiana, for example, the city allocated $25,000 from its first settlement round to Stillwater Hospice to expand grief counseling for people who've lost loved ones to substance use. Massachusetts recently launched a public dashboard tracking how the state and municipalities spend nearly $1 billion in expected settlement funds, part of a broader push for transparency and accountability in how those dollars are deployed.

Pennsylvania has no similar statewide coordination or transparency mechanism, advocates note. Without one, there's risk that settlement money will be deployed unevenly—leaving some communities with robust services while others receive nothing at all.

The Long Shadow of Loss

The scale of need is staggering. More than 1,300 people died from opioid-related overdoses in Massachusetts in 2024 alone. Pennsylvania's toll is similarly devastating, with thousands of families navigating grief each year.

Many of those deaths occur in counties with no specialized bereavement support, no peer groups, no counselors trained in the specific traumas of substance-related loss. Families are left to navigate their grief in isolation, often while managing the practical chaos that follows a sudden death: estate issues, custody battles, financial ruin, and the stigma that still clings to addiction in many communities.

The emotional toll extends beyond immediate family. Siblings, grandparents, partners, close friends, coworkers—each experiences their own version of the loss, often without language or support to process it.

Children left behind face particularly complex challenges. Some are suddenly being raised by grandparents who are themselves grieving the loss of a son or daughter while trying to provide stability for young children. Financial strain compounds the emotional burden.

"It impacts the whole family," Ousterman said. "It's very intricate. And we need this more."

What Comes Next

The push for statewide grief support in Pennsylvania is part of a broader reckoning with how society responds to the overdose crisis. For decades, policy focused almost exclusively on prevention and treatment—critical interventions, but ones that implicitly assume the goal is stopping deaths before they happen.

The reality is that despite those efforts, tens of thousands of Americans continue to die each year. And when they do, their families are often left with nowhere to turn.

Philly HEALs demonstrates that publicly funded, specialized grief support can work. The program has created a replicable model: city funding eliminates insurance barriers, partnerships with the medical examiner's office ensure outreach happens quickly, and tailored support groups address the specific contours of substance-related loss.

Scaling that model statewide would require political will and sustained funding. But advocates argue the investment is essential—not just as a compassionate response to suffering, but as a public health intervention in its own right.

Unprocessed grief can lead to prolonged mental health struggles, substance use, and social isolation. Supporting families through their loss may help prevent the intergenerational trauma that often follows when a parent dies from overdose and children are left without adequate support.

For Ousterman and others who've lost loved ones, the urgency is personal. Every day that passes without a statewide system means more families navigating their darkest moments alone.

"If people don't have that support, you can't authentically grieve," she said.

And without authentic grief, healing never truly begins.