Wake County Health & Human Services Committee members received an update on April 7 on the countyopioid-settlement program, including how settlement funds have been used to expand treatment, naloxone distribution, recovery housing and peer-support services.

Elizabeth Kittliff, who oversees the countyopioid-settlement program in the Behavioral Health Department, told commissioners that Wake County began receiving settlement payments in April 2022 and that the county currently expects to receive more than $67 million over the life of the settlements. Kittliff said the county has funded 23 projects and plans roughly $6.5 million in expenditures through the current plan year.

Kittliff highlighted several program areas and recent awards: support for youth-focused early-intervention trainings (youth mental-health first aid) through partnerships with Boys & Girls Club, Communities In Schools and the Post Center; funded mobile opioid-treatment units by Morse Clinic and Southlight Healthcare to take medication-based opioid treatment into communities; recovery-housing expansions through several local providers; expanded medication-assisted treatment in the Wake County Detention Center; peer-support and care-navigation projects; naloxone distribution efforts including low-barrier access points; and workforce-development investments such as peer-specialist training and apprenticeships.

She said a one-time $322,000 settlement from McKinsey expands allowable strategies into primary prevention and education that were not covered under the North Carolina memorandum of agreement (NCMOA) guiding most settlement funds. Kittliff said the McKinsey payment will be included in the FY26 budget process.

Kittliff emphasized evaluation and reporting, saying the North Carolina Association of County Commissioners has provided evaluation guidance and county staff collect quarterly process and outcome metrics from funded programs. "We're tracking metrics from every program," she said, including process indicators and measures of whether participants are better off.

Commissioners commented that Wake County appears to be moving faster than many peers in distributing funds. Commissioner Adamson said some neighboring counties had yet to spend settlement dollars; Kittliff said Wake County has prioritized getting funds to community partners and building technical assistance and peer-learning opportunities for small organizations.

Examples cited in the presentation included: mobile opioid-treatment programs that reduce transportation barriers; expanded peer-based rapid-responder services with transportation added to link people to medication dosing and care; recovery housing supports including security-deposit and utility assistance; and low-barrier naloxone distribution through community placements and outreach.

Kittliff told the committee the county expects to publish a draft plan update and include settlement-related budget items in the countybudget process; final materials and an item for the full board are expected in June.

Why it matters: county officials said early investment in a range of interventions aims to reduce overdose deaths and emergency-department visits, improve treatment access and build capacity among community providers. Kittliff noted recent declines in county overdose counts but stressed continued attention to racial and age-group disparities in emergency visits.

Provenance: quotations and program details in this article come from Elizabeth Kittliffpresentation to the Health & Human Services Committee at the April 7 meeting.