Jax City Council greenlights opioid treatment pilot program - Florida Politics

Jax City Council greenlights opioid treatment pilot program

The skinny: A bill that got pilloried while making its way through committees — $1.5M for a six-month opioid treatment program — passed the Jacksonville City Council Tuesday night.

The vote: 16-1, with Danny Becton as the no vote … after a lot of noise and drama, documented below.

But as in committees, discussion was robust at times. And surreal at others. And — underneath it all — intensely personal against the sponsor, with a cadre of Councilors pulling out every procedural trick imaginable to kill the bill and to frustrate said sponsor.

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Specifics of the bill: Councilman Bill Gulliford‘s bill, intended to address the mounting body count from fentanyl and derivatives, would see a local emergency room used as a feeder for two in-patient treatment programs, which would (at least in theory) help some of Jacksonville’s addicts beat the habit.

Gateway and River Region would be the in-patient facilities; UF Health will be involved to aggregate data, and a competitive process will determine the ER facility that would feed them (likely, St. Vincent’s in Riverside).

The program includes the following: residential treatment; outpatient services; medication costs, physician fees; access to medical and psychiatric treatment; and urine fentanyl test strips.

The Jacksonville Fire and Rescue Department was going to coordinate with the Florida Department of Health to identify participants, but a floor amendment struck that condition.

Factors such as reduction of recidivism, relapse, and other indicators will be metrics of success — key, given that one of the pervasive impacts is repeated emergency calls involving the same users, sometimes multiple times in a day.

Drug testing, early and often, will be a hallmark of the program — covering all substances of abuse and analogues thereof, including fentanyl and carfentanil.

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Weirdness started early: Discussion Tuesday night got weird. Because of course.

A speaker discussed her expectations of getting funding from the program for her non-profit, which confused Council members, and got Councilman Garrett Dennis to ask why she thought she would be getting funds.

The explanation was perplexing, and Dennis wanted to ask Gulliford about why she thought she was getting money, but had to wait to reprise the committee contretemps from a week prior.

Gulliford instead discussed the crisis — mentioning drug dealers, unscrupulous doctors, and the people dying, at a rate of two a day, in the streets and elsewhere.

“Some have asked what is the rush … ask someone close to” one of the victims, Gulliford said.

“Doing nothing and continuing to repeat this folly is not an option,” Gulliford added.

Councilman Jim Love spoke up in favor of the program.

“If this works, we may see the 700 [overdose victims projected for 2017] drop,” Love said.

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Floor Amendment Gets Pulled: Dennis, a co-sponsor of the bill, offered a floor amendment to appropriate half of the $1.5M for a three month period; the other half would be dropped into a contingency pending a report on “exactly where the program is and how much progress it made.”

Dennis will be Finance Chair starting in July.

This met with “hesitance” from the administering doctor, Dr. Raymond Pomm, given his intention to review the program regularly anyway.

“The $1.4M is fully budgeted for,” Pomm protested. “Every single penny.”

Dennis compared the allocation to a $25,000 allocation for swimming lessons in last September’s budget, damning the program as a “work in progress.”

“The nineteen of us, we have to be very good stewards of the taxpayers’ dollars,” Dennis said. “I do feel like they need to come back to make sure there is return on investment.”

Gulliford urged that his colleagues vote against the floor amendment, saying that “trouble” could ensue if funding got held up, and that most of the commitments have been finalized with service providers.

Other issues brought up: the need to standardize outpatient and in-patient treatment among the providers, and the need to make sure the pilot program works efficaciously, serving 100 people a month.

Councilman Reggie Brown reiterated claims made in committee about the perceived lack of specifics in the program.

“I’d like to see the plan … I’d like to see the contract … I don’t oppose the bill … what I oppose is the process,” Brown said in support of the Dennis floor amendment.

Eventually, Dennis dangled the possibility of withdrawing his floor amendment — but said that more “dialogue” and “information” needed to be provided about the program that Gulliford discussed in committees last week.

Jacksonville CFO Mike Weinstein noted, in response to a question, that the bill came out of an emergency in Council; the administration supports the bill, but has no guarantees as to how the program will work out.

With the floor amendment dead, Dennis continued thundering into the mike about “$1.4M of taxpayers’ money,” before the discussion moved on.

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Re-referral Motion: The discussion continued, with a rift between Gulliford and those who hadn’t paid attention to the plan as it was laid out in recent weeks.

For Gulliford, the $1.4M pales in comparison to rescue transport hard costs, and other soft costs related to the overdose epidemic — including taxing the resources of city personnel.

In a different time, with a different power dynamic on Council, Gulliford would have an easier time making his case.

But, marginalized on Council, the moral authority he brought to the discussion — and the months he spent raising awareness of the problem, and attempting to figure out a way forward — was rendered moot in discussion with a few councilors … even though he likely had the votes, as none of the 17 people in attendance were willing or able to just call the question and put the circular discussion out of its misery.

A representative of JFRD noted that there were checks and balances in the program, and Gulliford tried to close.

“We can keep kicking this dead horse,” Gulliford said, “but it’s pretty obvious what we need to do.”

It wasn’t obvious to Danny Becton, who said that Gulliford was trying to “guilt council members to death over people dying.”

“I’m not going to be guilted into pressing the green button,” Becton vowed. “Where’s your business plan? I don’t see it. I see a white paper about a 10,000 foot view of what you want to do here.”

“You can look at other colleagues,” Becton said, ” and say help me here.”

However, Becton predicted that the program had a 90 percent chance of flopping, and that the documentation provided didn’t meet his muster.

“I’m not comfortable sitting here and making a $1.4M decision … people are dying every day … we can’t solve everything,” Becton said, wanting the bill re-referred to Finance — where he would be Vice-Chair, and where the most strenuous objectors would be able to vote it down.

Gulliford found the re-referral “questionable,” given the fact that the bill cleared committees — with only one no vote. And questionable, given Narcan costs are spiking, and estimated transportation costs are approaching $5M this year.

Councilman Brown (who will also be on Finance starting next month) backed Becton’s play, saying the bill was “like a guilt thing,” without clear parameters.

“I support the bill — I do. We just need to make sure we ensure the taxpayers’ money was well spent,” Brown said, urging a one-cycle deferral.

Councilman Dennis — again, the next Finance Chair — urged a deferral.

“Dr. Pomm says St. Vincent’s is on board, but I don’t see St. Vincent’s on here … we’re going to push $1.4M on a guilt trip … I support fighting opioids, but I don’t want to be guilted into voting for this emergency tonight,” Dennis thundered, hitting his stride in demagogic high dudgeon.

And Councilwoman Brown spoke up again, as most of her colleagues slumped over, exhausted from the circular debate.

Brown, who has refused comment for a year on a failed economic development deal her family business had with the city, which now includes a $210,000 lawsuit against her shell companies, castigated Dr. Pomm for a lack of transparency.

“Death is death,” Brown said.

Mercifully, Councilman Greg Anderson called the question on re-referral. The re-referral motion failed.

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Bill discussion resumed, proof that if there is a God, he is a vengeful one, with particular punishment for those following city government for some masochistic reason.

The same points that were made for the last week in committee — made again.

Councilman Reggie Brown chastised locals (as he did in committee last week) for not applying for a portion of the $27M of state funds that filtered down from the Trump Administration.

“It’s obvious that folks are behind this,” Brown said, “for whatever reason.”

Gulliford fired back to Councilman Brown’s objection that the bill didn’t conform to “process,” noting that a four-week delay would coincide with 58 more overdose deaths — the human toll of the “crisis in front of us.”

For Becton, that was just a “guilt trip … a wing and a prayer” — and he vowed to push the red button, voting against a key bill from the man who beat him in a 2011 election for City Council.

Dennis then introduced another amendment, asking for the money to be moved “under the purview of the Mayor” for “oversight.”

Gulliford noted that Fire and Rescue was part of the administration; that wasn’t good enough for Dennis. He wanted CFO Mike Weinstein to handle it.

Of course, Gulliford added, the program could simply be shifted to administration by JFRD — with Weinstein’s green light.

The amendment carried by a show of hands.

And the question was called.

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