Luzerne County Panel Advances $1.2 Million in Opioid Earmarks

Luzerne County's Commission on Opioid Misuse and Addiction Abatement voted Wednesday to send three spending requests to County Council, including $570,000 to keep medication-assisted treatment available to uninsured and underinsured residents in 2027, and turned down two others. The recommendations total $1,247,436, nearly all of it for the county Drug and Alcohol department, and council is scheduled to vote on them Oct. 27.

The money comes from Luzerne County's share of Pennsylvania's settlement with opioid manufacturers and wholesale distributors. Council has the final say, and every allocation must fit the settlement's eligibility rules — a constraint that has shaped how counties across the state spend the first years of the payouts.

What the department asked for

The largest single request, $570,000, would mainly support continued access to medication-assisted treatment for people who cannot pay, covering both oral medication and long-acting injectable products such as Brixadi and Sublocade. The county has funded this work with opioid money in previous rounds, and providers serving eligible clients file reimbursement claims rather than receiving a block of cash up front.

A second request of $676,936 would replenish and sustain prevention, intervention and provider services that three earlier settlement earmarks had paid for. Together the two department allocations come to $1.2 million.

"Consistent access to medication-assisted treatment and recovery support services helps individuals maintain treatment, decreases the likelihood of relapse, and reduces the risk of overdose and other negative consequences associated with ongoing opioid use," the department wrote in its application, which also cites housing instability and difficulty reaching services as barriers to care.

Two thousand dollars a month, per patient

The case for the injectable line rests on arithmetic the county has now stated publicly. Michael Gagliardi, the Drug and Alcohol administrator and a commission member, told the panel that injectable treatments cost $2,000 to $3,000 a month but have been very effective for "people serious about recovery." Long-acting injectables such as Sublocade are given monthly and remove the daily decision to take a pill, which is the property that makes them attractive for people leaving residential care or jail — and the property that makes them expensive enough to need a subsidy.

Jeffrey Loftus, the department's fiscal officer, told the commission the supplemental funding will ensure residents have access to needed care. Megan Stone, the county's Human Services division head and a commission member, said opioid funding has gone to the department for this purpose before, with reimbursement requests from providers as the mechanism.

The third recommendation was $500 to Wyoming Seminary for its IMPACT substance use prevention program — a sum small enough to be administrative, but one the commission still had to process as a settlement-funded earmark.

What the panel turned down

The commission denied two requests from the Susquehanna Warrior Reserve totaling $398,772 for support services aimed at homeless people and public safety personnel. Members raised concerns that some of the proposed services are already being provided elsewhere in the county, while praising the organization's work, and the commission did not rule out future partnerships after further discussion with county human services administrators.

That denial is the part of Wednesday's meeting that says most about how these panels operate in practice. Settlement money is not a general fund for anything addiction-adjacent; it has to be tied to an eligible use and, increasingly, defended against duplication.

The decision still ahead

Council Chairman Jimmy Sabatino, who sits on the commission, said the three earmarks will come before council at its Oct. 27 meeting. Approval would lock in 2027 treatment capacity for the county's uninsured residents at a moment when the injectable products have become a larger share of the local medication budget; rejection, or a reduced allocation, would leave the department to decide which patients continue on injectables and which return to daily oral doses.

What the county has not published is how many patients the $570,000 covers, what the department's total annual medication bill is, or how it would sequence patients if the request is trimmed. Until those numbers surface, the earmark is a budget line rather than a measure of how many people in Luzerne County can start buprenorphine next year.