Travis County details opioid abatement spending, grants and new harm-reduction contracts plan

Travis County Health and Human Services (HHS) told the Commissioners Court on Feb. 25 that the county has accepted two federal grants and is expanding local harm-reduction services using opioid settlement funds while continuing existing contracts for methadone and peer recovery support.

Courtney Bissnet Lucas, interim strategic advisor for Travis County HHS, told the court that "in calendar year 2024, there were 1,102 EMS calls and 878 emergency-department visits for overdoses," and said the county is tracking additional overdose and death data via Austin Public Health and the Travis County Medical Examiner, whose 2024 fatal-overdose report is expected in mid-to-late April.

The update answered a court directive from Nov. 12, 2024, that required biannual reports under the county's public-health-crisis declaration on overdose prevention. HHS reported three major funding and program items:

- Grants: Travis County has accepted two federal grants: a $932,000 Office of Justice Programs (OJP) Burn grant to support sobering‑center collaborations and wound care and peer services, and a Bureau of Justice Assistance (BJA) COSIP grant of $1.6 million over three years to provide evidence‑based SUD treatment, medication-assisted treatment and reentry supports for people leaving the county jail. HHS said both grants are active and the county can now seek reimbursement for eligible expenditures.

- Local investments and contracts: County-funded contracts include two 2-year gap‑funding agreements for methadone services (providers not specified in the court backup text) that began in FY2024 and are scheduled to expire at the end of FY2025, plus a peer recovery support contract with Communities for Recovery serving unhoused populations at on-site community locations. HHS reported the county's current funding fills coverage gaps for people who do not qualify for Medicaid Assistance Programs or whose insurance is inadequate.

- New harm‑reduction contracting plan: At the court's earlier direction, HHS proposed using $400,000 in opioid-abatement settlement funds for harm‑reduction services. HHS said it will directly negotiate up to three FY25 contracts of $150,000 each (one per target population): transition‑age youth (roughly ages 16'26), people who use drugs at high overdose risk, and people receiving treatment for co-occurring HIV/STI and substance use. HHS said it will require vendors to follow SAMHSA guidance as allowable in Texas and to provide community-based outreach and low‑barrier services. Staff plans to return to court with contract documents for approval.

HHS also briefed the court on operational elements already in place or rolling out:

- Naloxone distribution: County staff reported 20,180 doses of naloxone distributed to date through MOUs with community providers and county partners. HHS said the court-authorized line item of up to $100,000 for naloxone purchase (approved Nov. 12) has not yet been spent because the county has been receiving supply via the state's settlement-supported program (referred to in materials as the "Be Well" program).

- Overdose training and low‑barrier access: HHS said 424 people have been trained in overdose recognition and naloxone administration through certified staff; the county is piloting low‑barrier naloxone access in some county buildings (initially airport office and the CFCF courthouse), placing naloxone plus guidance cards in public restrooms.

- Sharps-collection kiosks: Four kiosks were procured and delivered to community partners; three are installed (Texas Harm Reduction Alliance, Vivint Health, Urban Alchemy) and the fourth at the Sobering Center is pending installation. HHS said site staff will collect and ship sharps for safe disposal and the kiosks provide an online dashboard to monitor utilization.

- Santa Maria House: HHS reported closing on a contract for a multi‑building turnkey site (former private residential treatment facility) that will focus on women, including pregnant women and parents seeking reunification. HHS described initial capacity estimates of about 30'35 people at opening, expanding toward roughly 100 residents depending on funding and licensing; licensing and HHSC provider approvals were described as in process and HHS projected a fall 2025 opening.

Court discussion focused on continuity of care, documentation and performance measurement. Commissioner concerns included documenting use of funds to withstand potential federal scrutiny and demonstrating program performance in case of future funding changes; HHS said it is working with IGR, DASHEL and partners on performance metrics and asset mapping.

HHS also described two active federal grant projects in more detail: the OJP-funded sobering-center subaward for on-site harm-reduction and follow-up recovery coaching, and the COSIP-funded reentry support model embedding a case manager in the Travis County Sheriff's Office to link people to medication-assisted treatment and peer supports upon release; the COSIP grant will also pilot injectable medications as an option in the jail under a limited pilot.

HHS said it will return with updates tied to the Medical Examiner's 2024 report (expected in April) and with the formal contract documents for the three proposed harm‑reduction awards. The next statutorily required court update is scheduled for August, but staff offered to present earlier if the court prefers.

Why this matters: The briefing lays out how county staff are spending settlement and federal funds on immediate harm‑reduction (naloxone, sharps disposal, peer outreach) and on continuity of care strategies that bridge jail, hospital and community settings. Commissioners emphasized the need for rigorous performance documentation so the county can show the results of these investments if state or federal funding priorities shift.

Ending: HHS asked the court to note the planned next steps: finalizing the three FY25 harm‑reduction contracts, continuing to draw down federal grant reimbursements, and providing data to the court after the Medical Examiner's April report. HHS said it will continue cross‑jurisdiction coordination with Austin Public Health and Central Health on investments and avoid duplicative services.