County gigged by auditor on opioid transfer

OPIOID FUNDS

We just didn’t act quick enough on these plans. We had a hospital close, the ambulance department was still in its infancy, and it didn’t get done. But I still believe those plans need to be done because we need to address this issue here.”

Garry Seyb, Lee County Supervisor Chairman

LEE COUNTY – The Iowa state auditor’s report for Lee County was made public Thursday and the county had 12 reported findings, seven of which are recurring from previous years.
The audit summary indicated there were no issues of non-compliance material to financial statements, and no material weaknesses in internal control over major programs.
The audit also disclosed no findings which were required to be reported under Uniform Code guidance.
One recommendation included in the auditor’s report was a direction to reimburse the county’s opioid fund $230,000 that was transferred to Lee County EMS in 2023 to pay salaries and benefits.
The money was transferred from the county’s Opioid Settlement Fund to the EMS according to guidelines put forth in settlement agreements with companies tied to the distribution of opioid medications.
Per those agreements, 75% of all opioid funds are required to be spent on core abatement strategies such as drugs to reverse overdoses, medication assisted treatment, treatment for pregnant women and neonatal treatment, hand-off programs, treatment of those incarcerated, and prevention programs.
Up to 25% can be spent on support treatment; recovery; connections to care; preventing over prescribing opioids; first responder support including, leadership, planning and coordination of care; first responder training; and research.
The county used the $230,000, which will be less than the 25% of the amount the county has already signed agreements to receive, to offset payroll and benefits for additional staff that was brought on in the wake of the Keokuk Blessing hospital closure.
County Attorney Ross Braden issued an opinion on the usage of the funds saying the county needed to go beyond just payroll and include brochures and education for patients who suffered injuries that could require opioid pain management. He also recommended bi-annual trainings and a campaign for Lee County’s Operation Against Opioid Use.
Braden issued that opinion and recommendation in February of 2023.
Supervisor Chairman Garry Seyb said he saw the recommendations from the auditor’s office and signed off on them and the county we’ll be taking the auditor's recommendation and reimbursing the opioid fund.
“There is no money lost to the county taxpayers. This is a recommendation from the auditor’s office and we are going to go at their direction,” Seyb said.
“We just didn’t act quick enough on these plans. We had a hospital close, the ambulance department was still in its infancy, and it didn’t get done. But I still believe those plans need to be done because we need to address this issue here,” Seyb said.
Lee County Grant Writer Chuck Vandenberg said he has been handling the compliance requirements on the opioid funding, including reports to the National Opioid Settlement Trust and the Iowa Attorney General’s office, and has to date received no reports of violations or recommended actions from those settlement monitoring agencies. The latest report was submitted on Nov. 29, 2023.
The Lee County Board of Supervisors will be voting on a budget amendment at its next meeting that includes transferring the funds back to the opioid settlement fund. The opioid fund currently has $291,048 and, with the transfer, will have $521,048 in an interest bearing account.
An opioid fund committee is currently completing an application process for organizations and agencies to apply for funds from the account. Currently the county has settlement agreements that will total close to $2 million over the next 15 years. Over the 15 years current agreements, the $230,000 would represent about 11.5% of the county’s disbursements.
Other notes on the audit include: a recommendation to remit property tax on farmland the county owns and leases; independent contractor pay, including clothing as part of taxable fringe benefits; handling outstanding checks of more than two years; one repeated travel reimbursement, minutes submitted for publication from Lee County PSAP, use of debit cards vs credit cards; and segregation of duties notes.