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Codington County allocates $35,000 in opioid-settlement funds to Human Service Agency’s MAT buy-and-bill program
Summary
After a presentation from Carrie Johnston of the Human Service Agency, the Codington County Board of Commissioners approved a $35,000 allocation from opioid-settlement funds to establish a buy-and-bill inventory to maintain injectable medication-assisted treatment for uninsured clients.
Carrie Johnston, executive director of the Human Service Agency, told the Codington County Board of Commissioners that her agency is the only MAT (medication-assisted treatment) prescriber in Watertown and asked the board to authorize $35,000 from the county’s opioid-settlement allocation to start a buy-and-bill inventory for injectable medications.
Johnston said the county has been receiving settlement funds since 2022 and that the county dashboard projects further payments through 2038. “I think, I believe, since, 2022 … to date, maybe the county has received about $80,000,” she said, later noting a current available balance shown on the dashboard. She described the clinic’s model: screening by an addictions counselor, psychiatric prescriber assessments and weekly visits that taper with patient progress. “We are the only prescribing program in Watertown,” Johnston said, and she described injectable products by name: “The name of them is SUBLOCADE or VIVITROL. Brixadi is another 1.”
Johnston told commissioners that Medicaid’s reimbursement policy change effective June 1 will limit pharmacy distribution of injectables and that the buy-and-bill approach would let HSA purchase stock and bill Medicaid or use county funds for uninsured patients. She asked for $35,000 to cover initial purchases and cash flow while reimbursements are processed. “So we are asking for $35,000 from the county to help us get established with our buy and bill program,” she said.
Commissioners asked logistical and budget questions, including the county’s current opioid allocation balance; staff noted a balance of $88,086.32. Commissioner Gable moved to approve the request and Commissioner Johnston (the commissioner) seconded. After brief discussion about wholesalers, reimbursement rates and program tracking, the board voted in favor; the motion carried.
Why it matters: The allocation funnels settlement dollars into local treatment capacity, aiming to maintain access to injectable MAT for people without reliable pharmacy reimbursement. The county’s decision supports continuity of care at a clinic that officials say provides combined counseling and medical oversight rather than medication-only prescribing.
Next steps: County staff will coordinate with the Human Service Agency to implement the buy-and-bill process and monitor reimbursement flow and inventory costs.
