Travis County outlines the next year of opioid overdose prevention strategy

Even as the Trump administration attempts to gut every kind of federal grant bolstering local services, from transportation to public health and beyond, Travis County is still managing to continue its long-term investments in opioid recovery services and harm reduction. It’s largely aided by a national settlement with the producers of opioids, from which the county has received multiple payouts over the last few years, with another expected this spring. On Tuesday, the Commissioners Court received an update on its FY 2024-25 plans to continue supporting harm reduction work – and some warnings that funding may soon run out.

In November, the county extended its opioid overdose public health crisis declaration to October 2026, as overdose deaths continue to be the leading cause of accidental death in the county, ahead of falls and car accidents. However, a recent optimistic trend has surfaced according to the Travis County medical examiner: For the first six months of 2024, there was a 19 percent decrease in accidental drug deaths overall and a 26 percent decrease in those involving fentanyl.

“That was the first time we’ve seen a decline. So we’re hopeful that that will have continued the last six months of last year, but we’ll find that out officially in April,” County Judge Andy Brown said, as the medical examiner will release data from the end of 2024. That optimism has informed commissioners’ urging of Travis County Health and Human Services to invest more money urgently, instead of focusing on the sustainability of the investments.

The county currently has three two-year contracts funded using the opiate abatement funds, which began in Fiscal Year 2024, and are currently set to expire at the end of this fiscal year. Two are for methadone services, one with addiction and psychotherapy services and the other with community medical services. Both provide gap funding for people who don’t qualify for Central Health’s Medical Access Program (MAP), or for whom insurance doesn’t cover methadone – “a niche group of individuals who aren’t going to be served by other funding sources,” said Courtney Bissonnet Lucas, the interim strategic advisor for Travis County HHS. The third contract is with Communities for Recovery, which provides peer support for people in recovery at the Other Ones Foundation, Esperanza Community and Sunrise Resource Center. They focus on unhoused people who are at higher risk of an overdose. 

The county also recently contracted with Santa Maria Hostel, which is set to serve 100 people needing treatment for substance use disorder – focused on pregnant women and women with children within Austin who had to leave previously to the nearest facilities in Houston or Dallas to access services while still caring for their children. That will open in fall 2025 and start with serving 35 people with the goal of 100 eventual residents. 

One of the cornerstones of the county’s approach to harm reduction is distribution of the overdose-reversal drug naloxone (also known by the brand name Narcan). On Nov. 12, the court authorized up to $100,000 for that, but HHS reported Tuesday that the county has received all of its supply of naloxone through the opioid settlement at the state level.

“It’s working very well, so we see having some additional surplus in that particular area, funding that was previously identified for naloxone” Bissonnet Lucas said.

On the federal side, Travis County has accepted two grants to address opioid remediation. The first is the OJP Byrne award of $932,000, secured by U.S. Rep. Lloyd Doggett last year. One part of the funding will go to the Sobering Center to collaborate with Dell Seton to provide harm reduction services in the ER, and the other will fund court-mandated recovery programs for people navigating the carceral system, specifically in the civil court focusing on SUD in the child welfare system. 

The second federal grant is the BJA Cossup grant the county received in December, for $1.6 million over three years. It funds support services for people reentering the community from the local jail. Importantly, the program will offer methadone. “Injectables, if they so choose to participate, will allow them to have the medication in their system, and it will be over an extended period of time, allowing us enough time to get them to local community resources for medication assisted treatment.”

These targeted services are essential for ensuring the continuation of the downward trend of overdose deaths in the county, but as Commissioner Jeff Travillion pointed out, “it’s a scary time” for reliance on federal money. Both of the grants have been awarded, but the county will need to seek reimbursement by documenting costs expended in the future. “It seems to me that everything that is vaccine-oriented, everything that’s remediation strategy, (the current administration) is going to have a problem with, say it’s not necessary and try to recapture the dollars,” warned Travillion, who urged that “as we go forward, we (should) build a process that allows us to say that the actions that we’re taking are best practices, the actions that we’re taking are peer-reviewed, and make sure that we’re documenting things in such a way that that if there are federal funding opportunities, we aren’t automatically eliminated.”

In addition to the two federal grants, HHS expects the county to receive another disbursement of opioid abatement funds this spring, and to up the usage of its current funds in response to the court’s pushback on Nov. 12. During the budget process last summer, the court had already allocated $325,000 from the opioid abatement budget for peer recovery and methadone programs – and in November it directed HHS to invest $400,000 more. HHS is now increasing that to $450,000, using the surplus naloxone funding. Two-year contracts for $150,000 each will be awarded to three vendors that HHS selects for these services – and these entities must have specialized expertise in offering harm reduction services to three distinct populations: Transition-age youth 16-26; people who use drugs and are at high risk of overdose; and people with co-occurring STIs. 

The city is also continuing this work. Austin Public Health expects to allocate $1.2 million from the opioid abatement funds during FY 25 as its federal earmark ends, and $850,000 to continue contracts for expansion of peer support, education and harm reduction services. Central Health expects to invest over $4.95 million in these services this year. And Travis County HHS, APH and Central Health staff are meeting monthly: “We’re reducing duplication, we’re reporting out on new initiatives and best practices and discussing future funding opportunities,” said Laura Peveto with Travis County HHS. 

However, in addition to federal grant anxiety, HHS told the county in November and repeated this past week that unless the opioid abatement disbursements are larger than projected, the county will be unable to sustain the services it wants to offer in FY 2026 – including peer support, methadone and new harm reduction services – into FY 2027. If the county’s plan is to make an urgent investment now, however, Peveto said, “we feel like this investment plan allows for a timely response to the crisis and ensures breadth and depth of services throughout the entirety of the public health crisis declaration, which is set to expire Oct. 1, 2026.”

Photo made available through a Creative Commons license.

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