District officials were left scrambling this week to award millions of dollars in contracts for addiction services as the D.C. Council and Mayor Muriel E. Bowser allowed a public emergency declaration over the opioid crisis to expire, complicating efforts to reduce a record death toll.
While a top-ranking member of the administration said Bowser (D), plans to reinstitute the emergency soon, advocates and officials who pressed for the measure last year expressed disappointment that it had been allowed to sunset and implored the District to scale up its response to overdoses.
“The problem is moving faster than they are able to catch up with it,” said Ambrose Lane Jr., head of the DC Health Alliance Network, which advocates for better outcomes for communities of color.
Bowser declared the initial emergency in November, under pressure to take action as public scrutiny increased on the District’s strategies to combat serious substance abuse. She has the power to declare an emergency for 15 days, and the council can extend it.
Wayne Turnage, deputy mayor for Health and Human Services, did not say why Bowser waited to re-up the order until after it expired. Council Chairman Phil Mendelson (D) said the council had limited the extension to 90 days because some members were uneasy giving Bowser carte blanche to circumvent procurement rules and other extraordinary powers afforded under a public emergency.
Under the order, city officials fast-tracked $3.6 million in contracts for eight projects, including the Children’s National Hospital substance abuse clinic, housing for people in recovery and a radio and social media campaign, Turnage said. D.C. Fire and EMS Department and city agencies also began sharing nonfatal overdose data in real time.
Fatal opioid overdoses in the District have more than doubled since 2018 when the Bowser administration released a treatment and prevention plan known as Live. Long. DC., an update to which officials have been promising to release for three months. The surge is in keeping with a nationwide trend that emerged as the potent synthetic opioid fentanyl overtook the drug supply.
The emergency order was one prong in the city’s approach to combating substance abuse, which includes opening a stabilization center and convening the Opioid Abatement Advisory Commission to divvy up national opioid lawsuit settlement dollars. The commission, which is made up of agency leaders, providers and people in recovery, has held six two-hour public meetings since late October, spending much of the time debating procedural rules such as how to handle conflict of interest and seeking answers from city agencies about spending choices.
At-Large Council member Christina Henderson (I), chair of the council’s health committee and a member of the abatement commission, had pushed the council to keep the order in place for at least another month so the group would have more space to deliberate.
“It’s unfortunate because I believe there’s more we could have gotten done on the opioid side that we didn’t have time for,” Henderson said. “Everybody was giving warning that it wasn’t enough time.”
On Wednesday, the day before the emergency order expired, the opioid abatement commission directed the agency leading the city’s response to the opioid crisis, the Department of Behavioral Health, to spend up to $4.5 million on 13 prevention, harm reduction and treatment priorities drawn up in subcommittee sessions.
Chad Jackson, chairman of the commission, said he hoped the move would convince elected officials to extend the emergency.
“We put it in the mayor’s hands with the expectation that that’s what they were looking for in order to extend this emergency,” Jackson said Friday. “I wanted to move as quickly as possible to give the executive branch something to work with.”
Even with access to federal funding, District agencies and providers have struggled to effectively respond to the underlying needs of those in addiction, which often include housing, jobs and medication-assisted treatment.
Wednesday night — about 12 hours after the agency advanced top line priorities — Barbara Bazron, director of the Department of Behavioral Health, emailed Turnage at 11:29 p.m. with a list of contracts, including five grants of $100,000 for faith-based organizations, $490,000 for FEMS to hire more peer specialists and $350,000 for a new drop-in center for residents in need, Turnage said in a phone interview Friday evening. The list also includes $425,640 for sober and “abstinence not required” housing, he said.
The next night at 8:17 p.m., Bazron again emailed Turnage with two more contracts: $460,000 for Children’s National Hospital to treat young people with substance use disorder, particularly patients referred from the justice system, and $500,000 for the D.C.-based firm Octane Public Relations to create a prevention campaign that includes radio and social media marketing, Turnage said.
Turnage said Bowser plans to announce another 15-day emergency order next week to expedite the spending of the remaining $15 million in opioid lawsuit settlement dollars currently in city coffers.
The District has already received about $19 million of an estimated $80 million it stands to receive by 2024 from multistate settlement agreements with companies that prosecutors say profited from the manufacturing, distributing and marketing of opioids that fueled a crisis of addiction.
Turnage said much about opioid use disorder, including the manner in which people overdose, often alone, makes breaking the cycle of abuse difficult.
“We are operating with some urgency, but you also have to be mindful of the particular difficulty of this challenge,” he said. “The opioid death numbers that you see in D.C. sadly are mirrored across the country in many urban areas.”
The real-time data sharing between the D.C. fire department and city agencies outlined in the order will continue, said FEMS spokesman Noah Gray.
“The opioid crisis is a serious issue we work to combat and respond to every day,” FEMS Chief John A. Donnelly Sr. said in a statement. “Addressing substance abuse by our residents and visitors has been a priority for the District and will continue to be.”
