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Committee approves Public Health budget shift as officials detail jail MAT costs and falling overdoses
Summary
The Human Services Committee approved a budget-neutral transfer of $540,000 to cover Public Health overspending. Officials described higher jail medical costs tied to opioid treatment, operational risks of switching MAT delivery, and a local decline in overdose deaths attributed to coordinated county efforts.
The Chautauqua County Human Services Committee voted to amend the 2025 Public Health budget through budget-neutral transfers totaling $540,000 to cover accounts with higher-than-expected expenditures. Diana Songer, deputy director of finance for human services, presented the resolution and said the transfers move appropriations from surplus accounts to those over budget.
Public health leaders told the committee that several divisions recorded surpluses because of efficiency gains, reduced transport and contract costs, and vacancy savings. Dr. Mike Falk, the county's chief medical officer, and Lacey Wilson, public health director, said the jail clinic has incurred higher medical expenses after an increase in jail census and more individuals entering custody with opioid withdrawal or dependence.
Wilson said the county is spending “800 plus thousand dollars for just medications for assisted medication assisted treatment within the county jail,” and described the trade-offs between long-acting injectable medications and oral alternatives. She said the long-acting injectable costs about $1,500 per person per month, while oral medications typically run $20–$50 per person per month but are more cumbersome to administer and raise diversion and security concerns in the jail setting.
Officials said the county has been using opioid settlement funds to offset MAT costs and that $750,000 is included in the 2026 budget for MAT medications; they cautioned those funds will taper over the next decade. Staff said operational changes—potentially including a jail redesign and different medication administration workflows—could yield substantial savings but may require added nursing or corrections staff to implement safely.
The public health team also reported an encouraging decline in overdose deaths, describing roughly a 50% reduction from 2024 to 2025 compared with prior annual counts near 60. They credited a multi‑pronged approach that includes harm-reduction programs, local treatment partners, outreach, and active local law enforcement work.
The committee voted 'Aye' and carried the resolution. Officials said they will continue planning operational steps carefully to avoid security or diversion risks if the county moves toward more oral MAT dosing.
The committee did not set a specific implementation date for operational changes; the budget amendment takes effect for 2025 as a transfer of appropriations.
