Michigan disbands racial equity group as tension mounts over opioid settlement money

KFF Health NewsJan 19 2024

An advisory group formed to help Michigan tackle high rates of opioid overdoses in communities of color has been disbanded by Democratic Gov. Gretchen Whitmer's administration, leading to hard feelings among some members who say their work is being buried.

The Whitmer administration is "trying to … silence in a systematic way the voices of the Racial Equity Workgroup," said Native American activist Banashee "Joe" Cadreau, a member of the work group. "For two years, we put our blood, sweat, tears, thoughts, time, to …. [come] up with these recommendations."

The frustration comes at a critical time as state and local governments debate how to spend $1.5 billion over 18 years to address an opioid crisis that kills thousands of Michiganders a year and destroys countless other lives.

The dissolution of a work group made up primarily of racial and ethnic minorities struck a nerve among some members, because the opioid epidemic has hit those communities hard in the state. In 2021, for instance, non-Hispanic Black men in Michigan died of overdoses connected to opioids at more than twice the rate of non-Hispanic white men. Another study showed racial and ethnic minorities are prescribed opioids for pain relief at lower rates than white patients.

A major point of contention, some members say, is the state Department of Health and Human Services' insistence that the work group's recommendations on combating the opioid crisis — as well as plans to hold public hearings — be reviewed by state officials before being made public.

That is "beyond frustrating and disingenuous," Sheyonna Watson, a work group member, told state health department officials at a December meeting, according to an audio recording of the meeting obtained by Bridge Michigan.

"What’s been brought [to us] as questions or recommendations or feedback feels like directives, feels like silencing, feels like censoring, feels like bottlenecking," said Watson, an African American minister and health consultant in Ann Arbor.

State officials deny they are trying to erase the work group's proposals, which include recommendations that are likely to be controversial, such as drug decriminalization, a ban on pre-employment drug testing in the workplace, "mandatory racial equity and cultural humility training" for state health staffers, and "racial equity training on bias on opioid prescribing [for] all prescribers of opioids."

Although the work group is finished, the state will "focus on embedding equity … in every action we take" going forward, rather than through the work of a single group, the state health department said in an email to Bridge Michigan on the evening of Jan. 15.

"Given our reorganized structure and focus on embedding equity in all of our efforts, we will be working more closely with our local regional partners to help us design and deploy engagement efforts best suited for their regions," health department spokesperson Lynn Sutfin wrote in the email.

Sutfin added that work group members can continue to have a voice by participating in subcommittee work linked to a Whitmer-appointed task force advising on opioid settlement funds.

Whitmer's office said the health department's statement represented its position as well on work group complaints.

Mounting frustrations

The complaints are the latest example of tensions that have played out mostly behind the scenes as the state works to distribute $1.5 billion in national opioid settlement funds earmarked for Michigan.

Last fall, the state Opioid Advisory Commission, created by the legislature, told lawmakers that it had struggled to get details from the health department on how opioid money was to be spent.

In December, Racial Equity Workgroup members had a heated meeting with the state's chief medical executive, Natasha Bagdasarian, in which they accused the health department of attempting to censor their proposals, according to the audio recording.

Then, last week, a scheduled meeting of the work group was canceled with just a few hours' notice, and a consulting group hired by the state to run the meeting was issued a work stop order by the health department.

Work group members were stunned largely because there was no explanation, Watson said.

More troublesome, she said, is the uncertainty over the future of the group's recommendations.

“There’s frustration. There is concern. There is a lot of skepticism that the work that we’ve done is actually going to be integrated” into state efforts.

Impact on diverse communities

The money comes from settlements of lawsuits against drugmakers, pharmaceutical distributors, and retail pharmacies accused of downplaying the risks and ignoring the perils of prescription painkillers, fueling today's opioid crisis. By agreement, half of Michigan's funds go to the state to finance efforts to curb drug use, and half to counties, townships, and cities across the state.

The first settlement checks arrived in early 2023. How well those funds address Michigan's crisis depends largely on understanding and meeting the needs of minority communities. And advocates say spending in the first years sets the tone for future spending.

State health officials recognized from the beginning the outsize impact opioid addiction has had on minority communities. Michigan Department of Health and Human Services officials are part of the state's Opioids Task Force, which Whitmer created in 2019 to advise the governor's office on how to best address the opioid crisis.

It was the task force that created the Racial Equity Workgroup two years ago, to "hear from people with lived experience" and represent voices in the Black, Indigenous, and people of color (BIPOC) communities, according to a state webpage. A state document shows more than $148,000 has been spent on the work group.

The work group, originally 15 members, was composed primarily of harm reduction and overdose prevention experts of color. It was meant to ensure "all the relevant stakeholders are at the table," said Jonathan Stoltman, director of the Grand Rapids-based Opioid Policy Institute, a national nonprofit. "To disband this group — I just don't understand it."

In the past week, Bridge Michigan and our reporting partners at KFF Health News spoke with 10 people who were either in the work group or familiar with the group's frustrations. Many wished to remain anonymous, some because they have financial ties to state government or because they hope to take part in future discussions on opioid-related spending.

Two said on the record they were frustrated that the Whitmer administration appeared to be ignoring their recommendations, which also included calls to expand drug recovery housing, include minority voices in the creation of drug prevention materials, and make the work group a permanent part of the advisory structure for settlement funds.

You can read the group's draft report here.

The work group had recommendations to share at community meetings for feedback, but Jared Welehodsky, a senior policy analyst for the state health department, told the group the department would need to review recommendations first. Members told Bridge they understood that the department would also need to preapprove the group's notices of public meetings.

At the December meeting, Bagdasarian, who chairs the governor's opioid task force, addressed frustration about the rules. She told the work group it's standard practice for communications staff members to review recommendations before they go public, according to the recording. And she said there were legitimate requests for more data to support some recommendations and measure outcomes.

Bagdasarian insisted the state was not trying to "tokenize" the group.

"I will move mountains to get things done," she said. "Tell me what to do and how to do it and how it will save lives, and I will do it."

But early last week, a work group meeting was abruptly canceled through an email from Welehodsky. The next day, the consulting firm that managed the work group received the stop work order.

A day after that — on Jan. 10 — work group members received another email, this one signed by Bagdasarian and Tommy Stallworth, a senior adviser to Whitmer, saying the state "will be restructuring our approach."

While disbanding the group, the email asked for its members' "continued commitment and support," and invited them to stay on as volunteers in the work.

With feelings so raw, it's unclear if that will happen.

Teresa Springer, director of operations at Wellness AIDS Services in Flint, accused state officials at the December meeting of "gaslighting" the group.

"We’re stuck in this space with more white people telling us that we need more proof that this has happened, and it just is so frustrating," she said on the recording.

Bagdasarian, who was born in India, noted that she, too, is a "woman of color."

When it comes to sorting out how to spend the settlement funds, she said, the state's intention is to "make sure that racial equity is part of everything we do. We want to make sure that the right folks are at the table in all of these conversations moving forward."

KFF Health News senior correspondent Aneri Pattani contributed to this report.