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DHSS uses federal grants to address rural opioid treatment gaps, but western Sussex left out

Milton Pratt
Delaware Public Media

Delaware’s Department of Health and Social Services has received hundreds of thousands of dollars in federal grants to address the state’s rural opioid crisis, but federal rules restrict those dollars to eastern Sussex County — leaving out hard-hit areas of western Sussex.

Two DHSS divisions received funds from the federal Health Resources and Service Administration's (HRSA) Rural Communities Opioid Response Program over the past year-and-a-half — an opportunity to address critical gaps in the treatment and outreach network in an area of eastern Sussex County from Milford to Selbyville.

Division of Substance Abuse and Mental Health Director Joanna Champney recently told a stakeholders’ meeting that one critical gap is the handoff from emergency rooms to substance use treatment facilities, which often fails in rural Delaware for lack of transportation.

“We’ve talked at length, especially in light of transportation gaps in rural areas of the state," she said, "about the need for robust transportation options, which is often one of the reasons why we see people drifting away and not maintaining their treatment appointments.”

The Division of Public Health is using some grant funding to cover transportation directly from emergency departments to treatment appointments. Director of the DPH Office of Health Crisis Response
Kate Brookins says the healthcare providers will be responsible for arranging the transportation.

And the Division of Substance Abuse and Mental Health (DSAMH) is using a portion of its grant dollars to launch outreach efforts at poultry plants in eastern Sussex county, prioritizing Spanish- and Haitian Kreyol-speaking workers previously underserved by treatment services.

"It's only a portion of what we're using this grant for," said DSAMH Director of Executive Programs and Grant Administration Brent Waninger, "but our federal partners are especially interested in it — it's something they haven't seen before."

DSAMH has already reached an agreement with Mountaire Farms to conduct outreach through the poultry processors' health and wellness centers; the agency is pursuing similar agreements with other poultry companies, including Perdue Farms.

Brookins notes that the Department of Public Health launched a similar outreach program focused on Delaware's construction industry in 2021. Previous DPH surveys found that a disproportionate share of Delawareans who die from overdoses work in the construction industry — 23 percent of the total in 2017, according to a 2019 DPH study.

DSAMH will also use grant dollars to place behavioral health specialists inside local hospitals to help them better-serve overdose survivors and other patients with substance abuse disorders.

But when both the Division of Public Health and DSAMH applied for the grants, HRSA's definition of rural excluded the western half of Sussex County — an high-priority area for the state's opioid crisis response, given the disproportionate concentration of overdoses in the Seaford area.

“We’ve petitioned them to include western Sussex County previously, but their formula for calculating what constitutes a rural census track – that’s what we have to abide by," said Waninger, "and we weren’t successful in changing their mind.”

Brookins adds that HRSA has since amended its definition of rural. "Unfortunately, that doesn't apply to grants that have already been awarded, so we will have to wait to apply again."

DSAMH is less than a year into its four-year grant; DPH is a year-and-a-half into its three-year grant.

Paul Kiefer comes to Delaware from Seattle, where he covered policing, prisons and public safety for the local news site PubliCola.