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As expected, it didn’t take long for Democrats in New Hampshire to point out what proposals they didn’t like in Gov. Chris Sununu’s budget speech last week.

“I am encouraged by statements of Governor Sununu in support of full-day kindergarten and funding for the developmentally disabled, but as we all know, the devil is in the details,” said House Democratic Leader Steve Shurtleff in a statement. “The Governor’s budget address made no mention of the successful NH Health Protection Program, leaving serious unanswered questions for the 50,000 Granite Staters who rely on the program for their health care coverage.”

But the more divisive statements came from the Senate Democratic Caucus and New Hampshire Democratic Party (NHDP). While they applauded Sununu for keeping several initiatives put in place by former Gov. Maggie Hassan, they criticized him for not fully funding the Alcohol Fund to combat the opioid crisis.

“And in the midst of a substance abuse crisis, we need to find out why Governor Sununu chose not to fully fund the Alcohol Fund, which supports our effort to combat this crisis,” said Senate Minority Leader Jeff Woodburn in a statement.

NHDP Chairman Ray Buckley echoed Woodburn’s sentiments saying he was “disheartened to see that the governor did not fully fund the state’s alcohol fund, which would provide key resources to combat this epidemic.”

The Alcohol Abuse Prevention and Treatment Fund was created in 2000 by the Legislature, and it’s a mechanism that takes 5 percent of the gross profits from the sale of alcohol to support education, prevention, treatment, and recovery programs for alcohol and drugs. The fund has only been fully financed one time since its inception, which was in the 2003-2004 biennium — the first year it began. In his budget speech, Sununu proposed increasing the funds to 3.4 percent, double the 1.7 percent rate the previous budget had set.

In each budget after that, the governor or Legislature transferred the revenue to the general fund and only appropriated a small amount to the Alcohol Fund, which means Republican Gov. Craig Benson and Democratic Govs. John Lynch and Maggie Hassan suspended funding during their terms.

In the most recent budget, for the 2016-2017 budget biennium, Hassan and the House proposed suspending the funding formula. Hassan proposed giving the fund $9.6 million over the two-year period, but the Republican-controlled House dropped that figure to $3.6 million. Senators proposed bringing the formula back and lowering the cap to 1.7 percent, which would give the fund $6.7 million.

If the fund was fully financed for the whole biennium, it would have received approximately $19 million, still nearly $10 million less than what Hassan suggested. After the Senate put forward its recommendation for the budget, the NHDP called their budget “unbalanced and partisan” with “irresponsible gimmicks.”

It’s interesting that the NHDP would criticize Sununu for not fully funding the Alcohol Fund, when previous Democratic governors did not fully fund it either.

“We haven’t had a Democratic governor who has fought as hard as Sununu is fighting for it [the Alcohol Fund] right now,” said former state Rep. Joe Hannon, R-Lee, who made his mark in the Legislature by focusing on the opioid crisis.

“No one has taken the leadership on this, and the battle will be in the House and Senate Finance Committees,” he told NH Journal. “I’m always happy when the governor speaks about how he is addressing substance abuse treatment. He gets it, and that’s something I haven’t seen in awhile from leadership in the state.”

New Futures, a nonprofit group looking to curb substance abuse in the state, is a fervent supporter of fully funding the Alcohol Fund at 5 percent. They believe the money from the non-lapsing, flexible fund could be used for creative and innovative solutions to stop the opioid epidemic.

“We are encouraged by the fact that Gov. Sununu has increased the funding for the Alcohol Fund by doubling the current amount,” said Linda Paquette, president and CEO of New Futures. “However, we anxiously await the release of House Bill 2 in order to clarify the support in the budget for addressing New Hampshire’s substance abuse epidemic.”

Paquette said she was “very curious” what Sununu meant when he talked about “incentives” with the Alcohol Fund.

“First, I propose we double the Alcohol Fund, increasing these important resources by more than $3 million and creating incentives to ensure that those funds are truly spent,” he said in his Thursday speech.

Pacquette said she is hopeful that the Alcohol Fund will be a priority for the Republican-controlled State House because the funds are “not restricted.” New Hampshire is expected to receive federal money from grants and the 21st Century Cures Act, legislation approved by Congress and former President Barack Obama in December 2016, which gives $6.3 billion in funding to circumvent the opioid crisis and enhance medical research and development.

“The Alcohol Fund can be used to fill gaps where grant money and federal funds are restricted for certain uses,” Paquette told NH Journal. “It can be used for supporting recovery housing and investing in early childcare as a substance abuse prevention strategy. He [Sununu] clearly has made the opioid crisis a priority of his administration.”

Sununu presented his budget to the House and Senate Finance Committee in a Tuesday joint committee meeting. The House Finance Committee will take a look at his budget first and put forward recommendations to the full House later in the spring. After passage in the House, the Senate Finance Committee will review that budget and put it up for a vote to the full Senate, before returning to the governor’s desk for his signature or veto.

“We’re going to double that fund and get the money where we can have a lot of impact,” he said in the meeting. “Not just in the high-density areas, but really all across the state. None of our communities have been immune to that.”

The Senate Finance Committee recommended passage of Senate Bill 196 on Tuesday, which was amended to increase the Alcohol Fund to the 3.4 percent rate proposed by Sununu. If the House changes the formula or suspends it in its budget recommendations, this bill could override it and fund it at the rate Sununu proposed.

“This is a sound proposal that I and a majority of the Senate Finance Committee supported today by recommending a bill to do just that,” said Senate Finance Chair Gary Daniels, R-Milford, in a statement. “We have established a number of initiatives that serve to stem substance abuse, including the heroin crisis, and I know we can do more with the funding Governor Sununu has proposed as part of his budget.”

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Another year is gone and New Hampshire is still one of the states hit hardest by the opioid crisis. Now, a new legislature is again trying to figure out how to curb the rampant use of opioids.

Lawmakers might be hesitant to allocate more funds to the effort, since it can appear previous funding has had little effect. But advocacy groups, health experts, and recovering addicts say money is only part of the solution. According to them, the state needs to be more flexible with how the funds are spent and amenable to creative solutions.

That was one of the themes discussed at the State House on Tuesday, where advocates asked the Senate Finance Committee to approve a bill funding the state’s Alcohol Fund.

It’s a unique mechanism created by the legislature in 2000 that takes 5 percent of the gross profits from the sale of alcohol to support alcohol and drug education, abuse prevention, and treatment programs. In the past year, approximately $19 million would have gone to service providers and recovery centers that are dealing with the opioid crisis at a local level.

The Alcohol Fund has only been fully financed one time in its history. In previous biennium budgets, the governor or legislature have transferred the revenue to the general fund and only appropriated a small amount to the Alcohol Fund.

Supporters of the bill say the fund is a creative solution the state should use because it already exists in law and is designed to aid prevention and treatment of issues like the opioid epidemic.

“Two governors have called substance abuse the biggest problem in this state,” Keene Democrat Sen. Jay Kahn said, noting Gov. Chris Sununu called for putting more money into treatment, prevention, and recovery in his inauguration speech.

“I completely agree,” Kahn added. “This legislation provides an innovative solution to the real problems confronting the state.”

A similar proposal was introduced in the Boston City Council, where councilors tried to add a 2 percent tax on alcohol sold in Boston to help fund substance abuse prevention programs. The council eventually voted against the proposal.

New Hampshire’s Alcohol Fund is different. In the “Live Free or Die” state, voters wouldn’t be too happy about a tax on their alcohol (a major reason why Bay Staters cross the border). The Alcohol Fund uses revenue the state is already making from sales.

That’s the reason former state Sen. Ned Gordon, R-Bristol, authored that 2000 law establishing the fund. And while it’s focus back then was mostly on alcohol abuse and prevention, the language was broad enough to evolve over time to include other substance abuse.

“The state adopted a policy that if we are going to aggressively market alcohol, we are going to accept the consequences,” Gordon testified Tuesday. “You can’t be just committed to a treatment program. You have to be committed to a recovery, so we need more resources going to prevention and recovery. Unless you provide the funding to do it, you won’t have the capacity to do it.”

While the Alcohol Fund revenue goes to the Governor’s Commission on Alcohol and Drug Abuse Prevention, Intervention, and Treatment for their determination on what contracts, programs, and centers need the funds most, advocates said more funding could be used for New Hampshire’s Safe Station programs — another unique and creative approach to the opioid crisis.

Safe Station is the brainchild of Chris Hickey of the Manchester Fire Department. The program launched in May 2016, and anyone who is struggling with drug addiction can go to any one of the 10 fire stations in the Queen City any time and connect with recovery resources.

Anyone who visits the fire stations will go to Serenity Place, an outpatient program focusing on recovery work, or a similar center, and no one is turned away if they go through that method. Safe Station doesn’t receive any direct funding from the state, which can place limits on the program. Overall it’s seen as a success for the city, but it may still be too early to tell. Nashua also opened their first Safe Station in November.

From May to December 2016, there were 509 overdoses and 49 deaths — a slight drop from the same time period in 2015.

The American Medical Response group recently announced there was a slight increase in overdoses and deaths from 2015 to 2016 for Manchester and Nashua.

In 2015, Nashua saw 250 overdoses, with 19 fatalities. In 2016, the city’s total overdose number rose to 365 with 40 fatalities. For Manchester, there were 729 overdoses with 88 fatalities in 2015 and then 785 overdoses and 90 fatalities in 2016.

Traci Green, associate professor of emergency medicine at Boston University School of Medicine, is hopeful those numbers will decrease in 2017 as the Safe Station programs expand.

“I hope this is one new entree into an expanded hub for people to enter,” she told NH Journal. “There is great hope in trying to think about how public health and public safety can work together to get people to go to a place where it’s safe and connect with other peers in a time when they’re feeling extremely vulnerable. It seems like a great working relationship.”

Green called for states to be more creative in their thinking on how to address the opioid crisis, and make sure that it fits with the individual needs of their towns and cities. She applauded fire departments, law enforcement, and public health groups taking a role in prevention, treatment, and recovery rather than one entity trying to do everything.

“The entree into treatment and recovery seem to really work in Manchester, and people can have their clear roles and responsibilities,” she said. “I think that’s really important.”

It may be difficult to replicate Safe Station programs throughout New Hampshire, since fire stations must be staffed 24/7 and have access to a treatment center or emergency shelter nearby. It’s a problem the state will wrestle with as they decide how to disburse funding to all communities.

“Manchester has available resources that a place like Concord just certainly wouldn’t have,” James Vara, the state’s “drug czar,” said in September. “So, you have to look at them and temper that with the fact that these approaches may not all work. Safe Station is a great access point for people who are suffering, but they also have available resources like Serenity Place, which many of your districts wouldn’t have.”

It’s possible Sununu could address solutions like funding the Alcohol Fund and Safe Station programs throughout the state in his proposed 2018-2019 biennium budget, scheduled for released Thursday. Sununu said the opioid crisis was the state’s top priority, and funding to fix the crisis is expected to be a significant part of his budget proposal.

Combatting the epidemic is usually a bipartisan issue, though it may depend on how creative lawmakers in the State House can get.

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Despite several inches of snow in most parts of the state, substance abuse prevention advocates and recovering addicts made the trek to the State House to show support for a bill that would be able to fund more recovery programs in the Granite State.

“What are we waiting for?,” deputy director at New Futures Kate Frey asked at a Tuesday press conference. New Futures is a nonprofit advocacy organization looking to prevent and reduce substance abuse in the New Hampshire. According to her, the state is suffering a serious epidemic and needs creativity to get out of it.

One of those creative solutions unique to New Hampshire and endorsed by New Futures should be fully funding the state’s Alcohol Fund.

The New Hampshire Alcohol Fund was created in 2000 as a non-lapsing and continually appropriated fund to support alcohol and drug education, abuse prevention, and treatment programs. The law provides 5 percent of the gross profits from the sale of alcohol to support such programs. The funds would be allocated to the Governor’s Commission on Alcohol and Drug Abuse Prevention, Intervention, and Treatment to pay contracts for service providers in the communities hardest hit by opioid abuse.

The fund began during the 2003-2004 biennium and was fully funded in that budget. But every year since, the 5 percent funding has been suspended by either the governor or the legislature, and revenue transferred to the General Fund. In the subsequent years, the legislature appropriated only a small amount of general funds — significantly less than the 5 percent that was mandated by law for prevention and treatment.

The 2016-2017 state budget allocated only 1.7 percent to the Alcohol Fund. That total amount equated to about $6.6 million, instead of the $19 million had the fund received the total 5 percent. In the previous legislative session, lawmakers allocated an additional $2.5 million from the General Fund for prevention, treatment, and recovery in 2017, bringing the total to $9.1 million.

But a bill in the Senate would fully fund the Alcohol Fund for the 2017-2018 biennium at the 5 percent rate. At a hearing for Senate Bill 166 on Tuesday before the Senate Finance Committee, prime sponsor Sen. Jay Kahn, D-Kenne, said if the state is going to be serious about addressing the opioid crisis by focusing on prevention, intervention, treatment, and recovery, then legislators should be doing everything possible to get ahead of the problem.

“Where we invest our money is a direct reflection of our priorities, and our priorities ought to be with people in New Hampshire who need care,” he said. Kahn also called for creative ways to fight to crisis with “yankee ingenuity.”

But it might not be an easy task to convince the Legislature that this is a worthwhile endeavor.

In the last biennium budget, lawmakers approved $42 million in substance abuse funding. Former Gov. Maggie Hassan was criticized for originally vetoing the budget, delaying the appropriation of the funds by three months. The total amount was $14 million more than the 2014-2015 budget. During the legislative session, lawmakers approved at least $5 million in additional funding.

Some legislators on the Senate Finance Committee were concerned that the state has already spent a significant amount of money, yet didn’t seem to fix anything.

“If we just throw money at the problem, we don’t necessarily solve the problem,” Sen. Bob Giuda, R-Warren, said.

Gov. Chris Sununu is scheduled to release his budget proposal for the 2018-2019 biennium on Thursday, so it remains to be seen how much money he’s putting towards the opioid crisis or if he plans to fully fund the Alcohol Fund. During his bid for the corner office, Sununu and his Democratic challenger Colin van Ostern said they supported returning the Alcohol Fund to 5 percent.

In his inauguration speech, Sununu said getting the opioid crisis under control was the state’s top priority.

“I believe we need to start in the beginning in terms of our schools,” he said on January 5. “Aggressive prevention programs in our schools that start earlier, that are more aggressive. And I think we need to start bringing in the parents and the stakeholders into those programs. There is a different path for everybody and we need to be open to all the paths. We need to put resources behind our words and take real action.”

NH Journal previously reported fully funding the Alcohol Fund had bipartisan support among most of the gubernatorial candidates. And when the fund was first debated in 2000, it received widespread, bipartisan support in the House and Senate. Former Gov. Jeanne Shaheen vetoed the original legislation establishing the Alcohol Fund, but a two-thirds majority in the House and Senate overrode her veto, so it has the potential to appeal to lawmakers on both sides of the aisle.

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