(The Center Square) — As some of Pennsylvania’s $2 billion opioid crisis settlement begins flowing into counties over the next two decades, a few spending plans have emerged as popular among officials.

It’s still unclear, however, which will be identified as the best approach. 

Counties will dictate how the majority of the money – about 70% – gets spent. So far, some concentrate the dollars into a singular focus, while others dole out grants on a bunch of different ideas, and some more are trying a hybrid approach.

The Pennsylvania Opioid Trust uses a number of reporting requirements to track where the money goes. Though members of the trust have been worried about a lack of transparency for how the board operates, Brant was less concerned at the county level.

“While there’s a lot of discretion here, it seems like there’s also a decent amount of oversight,” she said. “That’s helping push counties from doing something that really doesn’t fall within the spirit of what the funds are for.”

The trust’s December meeting highlighted one example when board members discussed whether buying a drug-sniffing dog at a county jail would be a legitimate use of the funds. Board members ultimately decided that it would not be legitimate spending.

However, the board discussion also showed that county officials don’t have as much clarity as they’d like on how they could spend the settlement money. Early results from interviews with officials from a half-dozen counties by Elevate PA highlighted the problem.

“We did hear a good amount of anxiety and confusion about how to best use the funds,” Brant said. “Both commissioners and the people that these responsibilities had been devolved to were really concerned about making the right decisions.”

Sometimes, that’s encouraged a lead-by-committee design instead of having a few people make decisions to spread the pressure. It’s also meant that counties haven’t embraced some types of spending, like using the money for fentanyl test strips or syringe exchanges, Brant noted. More common programs like sending out the overdose-reversal drug naloxone have been boosted.

Housing demands and in-jail treatment programs have also expanded, Brant said. Those approaches continue a trend of counties focusing more on recovery services to help people returning to society after medical treatment or incarceration.

“A lot of this has to do with ‘let’s throw a lot of darts and see what sticks, then evaluate for future years,’” Brant said.