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County amends public‑health budget as jail demand for medication‑assisted treatment rises
Summary
Chautauqua County approved a $540,000 internal reallocation in the public‑health budget. Officials said about 65 jail inmates are on medication‑assisted treatment, many receiving long‑acting injectables that cost roughly $1,500 per person per month; opioid settlement funds will partially offset 2026 costs.
The Audit & Control Committee on Nov. 13 approved a budget‑neutral amendment shifting $540,000 within the 2025 public health budget to account for program overages and surpluses.
Deputy finance official Diana Songer said the amendment rebalances appropriations across public‑health programs. Chief Medical Officer Mike Falk told the committee the county has seen a sharp increase in demand for medication‑assisted treatment (MAT) in the county jail: "We have 65 individuals on medication assisted treatment... probably 50 or 55 of those probably are on long acting injectable medications every month," he said. Falk said some injectable medications cost about $1,500 per person per month.
Falk and Public Health Director Lacey Wilson said state policy mandated certain services and that the county has improved operational efficiency to get people on treatment more quickly. They said 2026 budgeting anticipates roughly $800,000 for MAT medications and that the county expects to use about $750,000 of opioid settlement funds in 2026 to offset those costs. Staff cautioned those settlement distributions are front‑loaded and will decline: one finance speaker estimated annual payments could be about $200,000 in later years.
Committee discussion focused on operational challenges, diversion risk with injectable medications, and initiatives to move toward oral administration where clinically appropriate. Members asked about continuity of care after release; Falk described bridge prescriptions, coordination with pharmacies, and referrals to statewide resources (a toll‑free number) to help people continue treatment after release.
Next steps: Public Health will work with the sheriff’s office to develop operational plans to safely administer alternate MAT regimens and report back on cost management and outcomes for 2026 budgeting.
