Butler County mental-health levy funds to expand services; officials flag syringe-exchange gap

Butler County public-health officials told county commissioners on May 14 that revenue from a voter-approved levy will expand local mental-health and addiction services but will not be collected and paid out until next year.

Scott Rasmus, executive director of the Butler County Mental Health Addiction Recovery Services Board, said the board expects the levy to allow it to target about 42,500 county residents and to operate on an annual budget of roughly $18 million. "We will probably target 42,500 Butler County residents," Rasmus said. "Our actual budget's around $18,000,000 spent."

Why it matters: Commissioners were briefed on how levy funds will be used to address rising suicide and overdose deaths, extend services for five priority populations (people at risk of suicide, people at risk of overdose, veterans, youth and families, and senior citizens) and to shore up prevention, crisis response and treatment capacity across the county.

Key points from the presentation - Suicide and overdose trends: Rasmus said county suicide deaths have run at about 57 and are projected at 62 this year; overdose deaths fell to about 80 last year but are projected to rise to roughly 120 this year. He also said veteran suicide deaths are up: eight so far this year and, if trends continue, could reach about 23. "This year we're projected for 62," Rasmus said of suicide deaths. "Overdose deaths ... looks like we're projecting about 120 overdose deaths this year." - Timing and budget flow: Rasmus cautioned there is roughly a one-year gap between levy approval and the time new levy revenues are collected and distributed. He said the new levy will bring in about $4.2 million in additional funding starting next year; until then the board continues to operate on the prior levy. "They are not collected and paid out until next year," he said. "So there's sort of a year, a gap here." - Veterans and fatality review: The board plans to expand a fatality-review process and dedicate staff to analyze veteran deaths and identify prevention targets. Rasmus said the board is coordinating with local veteran services and the Butler County Veterans Administration to design interventions and staff training. - Syringe-exchange site loss in Middletown: Rasmus told commissioners the county lost the largest syringe-exchange and bloodborne-pathogen testing site in the southwestern part of Ohio when that program at Access Counseling in Middletown closed about 18 months ago. He said that loss likely contributed to later increases in overdoses and infectious-disease risks and that the board is seeking a replacement site. "We lost the Middletown Syringe Exchange and bloodborne pathogen program a year and a half ago," Rasmus said. "That's one of the reasons I think there was a little bit of a delay that overdose deaths are going up now." - Youth, families and detention settings: Rasmus said juvenile-detention and jail populations show higher rates of mental illness and substance use; the board is discussing a family-therapy model and in-place services at the juvenile center to reduce emergency transports and improve outcomes. - Senior services: The board aims to expand an evidence-based senior program called Uplift/PEARLS by about 10%. Rasmus said the program serves roughly 225 seniors annually and reported sustained reductions in depressive symptoms after treatment.

Commissioner questions and next steps Commissioners pressed for detail on prevention and earlier intervention. Commissioner Dixon asked where prevention programs would be deployed and how the board planned to reduce rising veteran suicides. Rasmus said the board intends to expand emergency-department and field crisis staffing, invest in training, and work with local partners to reach schools and community groups.

Several commissioners and Rasmus discussed forming or joining broader coalitions that include cities and health partners to coordinate syringe-exchange services and homeless-support efforts. Rasmus said he was pursuing hospital and stakeholder partners but described outreach as ongoing and not yet finalized.

What commissioners decided No formal policy change or appropriation was adopted at the meeting; Rasmus said he would return with updates, and commissioners asked the board to continue coordinating with local hospitals, the Butler County Health District and jurisdictions to place services where they are needed.

Ending: Rasmus thanked the commissioners and offered to return with implementation updates. "Please feel free. I'm happy to come back and address the outcomes," he said.