Less than 4% of Long Island's opioid lawsuit settlement millions spent as overdose deaths continue

Only a fraction of the millions of dollars available for drug abuse prevention, treatment and education on Long Island has been spent in the more than three years since a landmark settlement against opioid manufacturers and distributors — even with hundreds of local overdose deaths annually. 

A Newsday investigation showed that out of $213.5 million in settlement money available on Long Island to date, Nassau and Suffolk counties have issued a collective $97.2 million in contracts and grants since 2022, but only $8.1 million has been distributed.

That adds up to about 3.8% of the funds and less than the combined $13.4 million the counties have earned in interest as most of the money sits idle.

A lack of urgency to get opioid settlement funds to vendors, bureaucratic red tape and a cumbersome grant reimbursement process appear to have slowed the pace of distribution in both Nassau and Suffolk, according to some county legislative leaders and a budget watchdog.

The funds were part of the more than $2.6 billion that court records show entities in New York State have received so far after 2021 settlements in a lawsuit over the opioid epidemic that 46 states and municipalities brought against pharmaceutical distributors McKesson, Cardinal Health and AmerisourceBergen, along with drug manufacturer Janssen Pharmaceuticals and its parent company Johnson & Johnson.

In 2022, settlements also were announced with three pharmacy chains — CVS, Walgreens and Walmart — and drug manufacturers Allergan and Teva. 

Records show Nassau has distributed 3.15% of its funds and Suffolk's rate of spending is slightly higher at 4.32%, both through reimbursement grants where recipients are repaid for spending their money after submitting documentation.

At the same time, the opioid crisis, while showing signs of slowing, has claimed thousands of lives on Long Island since the 1990s, with more than 650 people dying of overdoses last year, according to government figures.

Bennett Allen, an assistant professor of epidemiology at the NYU Grossman School of Medicine, where he is affiliated with the school's Center for Opioid Epidemiology and Policy, said there's a need for rapid investments in drug treatment and prevention.

"I would implore public authorities to recognize the urgency of the crisis and think about ways that they can — within processes ... set up to safeguard against fraud and things like this — to work within the system, to spend the money as efficiently as possible," Allen said.

'Our blood money'

There were 463 fatal overdoses in Suffolk County last year, a more than 11% drop from the 523 reported in 2022, the county medical examiner’s office confirmed. State figures show 210 people in Nassau died from overdoses in 2023, down 16% from 250 deaths a year earlier.

Old Field resident Carole Trottere, whose son, Alex Sutton, died in 2018 of a fentanyl overdose at age 30, said she's disappointed the opioid settlement money has moved out the door so slowly.

She stood with Nassau County Executive Bruce Blakeman at a September 2022 news conference when he announced the first disbursements from the county's opioid settlement fund while speaking of plans to spend $60 million over four years to fight the epidemic.

The county now has received a total of $95.5 million in settlement funds, with Blakeman — who publicly has announced awards totaling $14.4 million — saying Nassau could get up to $180 million. 

"This is our blood money that we've lost our children and loved ones for," said Trottere, 68, who worked for years in Nassau as a communications director for a host of elected Democrats.

"I don't see how that is helping this crisis," she said of Nassau's spending rate. "Every day someone is dying from an overdose. Who knows if the money had been dispensed a year ago, if some of those lives could have been saved?"

Blakeman's administration has awarded 24 contracts — including eight multiyear commitments — to vendors totaling $39.5 million, according to county legislative officials.

But Nassau has spent just $3.01 million, distributing the money to 14 vendors, and has encumbered — or guaranteed — another $12.7 million to 18 vendors, according to county financial documents. An additional $9,482 was transferred to the county Health Department. 

While a vendor may receive a contract to begin work, money is often distributed piecemeal for specific projects. Encumbrances are the portion of a contract appropriated for a designated purpose but not yet spent or distributed.

A spokesman for Blakeman, a first-term Republican up for reelection next year, declined to directly address why just over 3% of opioid settlement money has been distributed.

Blakeman said in May 2023, as Newsday previously reported, that his administration has been "deliberate" in its spending.

"We have received communications from people who wanted us to speed up the process and I think we're going at a very good pace. We want to make sure that the money is used well," he added.

In a recent statement, Nassau Health Department Commissioner Dr. Irina Gelman said Blakeman "is taking a methodical approach to distributing opioid funds." 

Nassau Legis. Howard Kopel (R-Lawrence), the legislature’s presiding officer, defended the pace of the county's opioid settlement spending, saying in a statement the "funding has already contributed to a reduction in opioid-related deaths."

As a measure of progress, Kopel pointed to the planned construction of an Intensive Crisis Stabilization Center in Hicksville that will provide emergency care, observation and treatment for Long Islanders with mental health conditions or substance use disorders — a project that will be funded with $12 million in opioid settlement funds. 

Central Nassau Guidance & Counseling Services broke ground on the center on Nov. 14. 

'A real disconnect'

Critics concerned about Nassau's slow distribution of funds include the county's Democratic minority leader.

"Nassau University Medical Center is in financial ruin. We could put in $30 million and make it the best opioid treatment center in the nation. But the Blakeman administration doesn’t want that. There’s a real disconnect," Legis. Delia DeRiggi-Whitton (D-Glen Cove) said.

Blakeman has publicly announced $12.9 million in funding for NUMC, the county's only public hospital. County records show $660,000 of that money has been distributed. 

To look at Nassau fund spending, Newsday analyzed figures from the Nassau County Comptroller’s Office, the legislative majority and data from the county’s internal finance system — the latter of which Democratic county legislators provided.

Newsday also filed Freedom of Information Law requests with the Blakeman administration in June and October seeking details of its opioid fund distribution, including spending to date through contracts, grants and account transfers.

County officials responded twice with one page that appeared to detail $37.3 million in expected spending over four years but didn’t show how much had been spent. Newsday's legal team appealed the records production for being unresponsive. Then on Nov. 12, the county sent the same document again, along with copies of most vendor contracts and a list of organizations that have applied for funding. 

Newsday's analysis showed Nassau's opioid settlement fund has earned $3.9 million in interest — helping to balance the county's budget.

The county legislature recently passed the Blakeman administration's $4.2 billion fiscal budget for 2025, but the Nassau Interim Finance Authority, a financial oversight board that has been critical of the administration's budgeting practices rejected the spending plan.  

Records show Nassau's 2025 projected budget includes spending $15 million from the fund in 2025, the same amount as was budgeted in 2024.

NIFA officials declined to comment on the county's handling of opioid settlement fund money.

There are benefits to not rapidly spending from the fund, according to a budgetary watchdog.

Ken Girardin, research director of the Empire Center for Public Policy, a fiscally conservative Albany think tank, said having more than $90 million in fund reserves is looked upon favorably by credit rating agencies and can help with the cost of borrowing for long-term projects. He added that given Nassau's precarious finances, caution with its fund spending makes sense. 

"If this were almost any other county you could make the case for spending the money faster," Girardin said. "But this is a county that was holding its finances together by its fingernails before COVID."

However, he said fiscal prudence comes at a price.

"You won’t be seeing the county executive standing in front of a ‘Mission Accomplished’ banner on opioids any time soon," Girardin said. 

Audit ongoing

Suffolk has received $118 million to date in opioid settlement funds and issued $57.7 million in contracts. But less than $5.1 million, or 4.32% of the total funding, has gone to vendors, according to county data, and $11 million has been encumbered.

The county expects to receive a total of $264 million in opioid funding over the next two decades, according to Michael Martino, a spokesman for Suffolk County Executive Edward P. Romaine.

Newsday obtained the data from Romaine's office and the County Comptroller's Office. The comptroller's figures show more than $110 million in undistributed funds has earned more than $9.5 million in interest since 2022.

The administration of former Suffolk County Executive Steve Bellone, a Democrat, awarded the bulk of the funding that's been spent, according to county records. Romaine, a Republican who took office this year, has been managing the reimbursement. 

Some of the groups receiving funding got six months of up-front money — highly unusual in county procurement — to begin hiring staff, leasing space and purchasing equipment, according to Presiding Officer Kevin McCaffrey (R-Lindenhurst).

At the request of county and state lawmakers, Suffolk Comptroller John M. Kennedy Jr., a Republican, launched an audit of all opioid settlement spending from the fund's origins through June, Newsday reported in April.

The audit began after Newsday reported in March that Bellone took a position at Northwell Health, which was awarded more than $3.4 million in opioid funding, while his former chief of staff, Ryan Attard, was named chief operating officer at the Family & Children’s Association in Garden City, which was awarded more than $1.8 million in settlement funds. 

Bellone has denied any conflict of interest, arguing he was "not personally or directly dealing with Northwell Health or personally involved in any of their business dealings as a county official at the time." Kim Como, a Family & Children’s Association spokeswoman, has said Attard was appointed to the position nearly a year after a Suffolk committee decided on its initial opioid award recipients. 

Newsday also has reported the Suffolk committee making decisions on disbursing opioid funds during the Bellone administration didn't keep minutes of meetings or records of members’ votes, and the meetings weren't public.

Romaine pledged in April to reform Suffolk's process for disbursing opioid money to increase transparency. 

In a recent interview, Kennedy said he attributes the slow pace of fund distribution, in part, to vendors who "seem to be uninformed, unaware or have had difficulty compiling and submitting" reimbursement documentation.

The comptroller pointed to one group in Riverhead that received funds to provide housing for recovering addicts but failed to submit claims on a monthly basis as required — an example, he said, of some contracted vendors being unable to follow the process because of their lack of financial structure. 

"Municipal claiming is a very routine, boring process that should not be controversial," Kennedy said. "It only becomes problematic when somebody either can't or won't provide the sufficient proofs to get the money."

In a statement, Martino said the administration "is working closely with the Suffolk County Legislature as we review the process that is currently in place for the disbursement of opioid settlement funds."

'Obviously not working'

There are strict limitations on how municipalities such as Nassau and Suffolk can spend opioid settlement fund dollars, but there is no deadline for localities to distribute the money — and, in fact, no regulation mandating county officials ever utilize the money.

In addition, Nassau, Suffolk and New York City are exempt from oversight by the New York State Office of Addiction Services and Supports, unlike the majority of counties statewide, because they reached direct settlements with drug manufacturers and distributors. But they still have to give a detailed accounting of the yearly spending of such funds to the state.

McCaffrey said he's "frustrated" and "truly concerned" about the slow pace of fund distribution, which he attributes to "government red tape."

The Suffolk Department of Health Services and comptroller's office have rejected some funding reimbursement requests, arguing the money isn't being spent appropriately, McCaffrey said.

For example, he said one organization that paid for the car insurance and footwear of people in drug treatment so they could rejoin the workforce had its reimbursements rejected. The same happened with a group that went to a suicide prevention conference, in that case because auditors found a lower available hotel rate than what the group booked.

McCaffrey said some organizations told him they're planning to close because of the lack of timely reimbursement while others have told him they won't apply for future funding, arguing Suffolk's scrutiny exceeds what state or federal agencies have required for previous contracts and grants.

"We have an obligation to make sure that the money that we're giving out is being spent properly," McCaffrey said. "But there should have been more training and a greater level of scrutiny ... There has to be a middle ground here. It's obviously not working and the numbers don't lie. "

Suffolk Legis. Jason Richberg (D-West Babylon), the minority leader, said he's "disheartened" about the slow pace of opioid fund spending.

"It's our responsibility to adapt to the changing needs to ensure that we're doing what we're supposed to with these funds," he said. "Everything should be on the table so we can get this money out."

'We're frustrated'

Shelly Weizman, an addiction policy expert at the Center on Addiction and Public Policy at the O’Neill Institute at the Georgetown Law Center, said counties around the country "are in different places" with opioid fund settlement spending.

"Some are very sophisticated, have a plan, and are getting money out the door. Others have no idea where to start," she said.  

 Blakeman administration officials have said all of Nassau's contract awards have gone to vendors with preexisting county contracts, and records show 13 organizations that never applied for settlement funding got awards.

The Blakeman administration said a nine-member committee, comprised predominantly of law enforcement officials, along with budget, human services, minority affairs and health officials, has been involved in evaluating and choosing vendors for opioid funding.

Suffolk's 18-member committee, set up during the Bellone administration, was made up of top county health, education, law enforcement, legislative and administration officials, Martino said.

Guidance from Johns Hopkins University on the use of the opioid settlement funds adopted by governments across the country recommends municipalities also fill their committees with drug treatment providers, recovery and social service organizations and family advocates.

Sara Whaley, a senior practice associate for Johns Hopkins School of Public Health in Maryland, who studies opioid policies, said it's critical to ensure "there's representation of people with lived and living experience with the opioid and overdose crisis in this decision making."

Such inclusion "is really going to help maximize the impact of the investment of these dollars," she added.

Some applicants who were denied funding said the process has left them dejected.

Gary Butchen, executive director of the Bridge Back to Life Center in Bethpage, which operates drug treatment programs but never has previously received grant money from Nassau County, is among them.

"We're frustrated," Butchen said of the process.

Cindy Wolff, executive director of Tempo Group Counseling Services, which provides drug treatment services from Woodmere, North Merrick and Syosset offices, said it's "unclear" to her "exactly what the plan is for all of the money that has been earmarked through the settlement fund."

Others who have lived through the opioid epidemic's tragic results agreed.

Corinne Kaufman, 75, who has advocated for Nassau legislation aimed at distributing fentanyl test strips to prevent overdoses, said she's frustrated by the county's lack of opioid fund settlement spending.

The Glen Cove resident's late granddaughter, Paige Gibbons, 19, died in 2022 when she took what she thought was a Percocet pill but later was found to be fentanyl.

"I was joyful to learn that he was pledging $15 million a year for the next four years," Kaufman said of Blakeman's announcement on opioid settlement funding in 2022. "But not much of that has been distributed yet ... That's incredibly disappointing."