Narcan nasal spray in a harm reduction vending machine. Photo taken Aug. 12, 2024 by Graham Kilmer A proposal that could have curtailed the City of Milwaukee’s primary opioid response initiative instead exposed deep divisions among Common Council members over how — and whether — to evaluate the effort before continuing to fund it. During a tense Friday meeting of the Public Safety & Health Committee, Fire Chief Aaron Lipski and others warned that the city’s Milwaukee Overdose Response Initiative (MORI) could run out of funding without council action, even as some members pushed for a broader review of how millions in opioid settlement funds are being spent. An initial proposal would have let the MORI funding lapse, at least temporarily, but a new proposal introduced Friday restored $1.6 million in settlement funding through the end of 2026 and floated the idea of spending $250,000 on an outside audit. “I think many of us in the community are interested to see how this has an impact in our communities and how we work together,” said Council President José G. Pérez, a cosponsor of the measure. “There were some concerns among members about whether we were scaling up before we looked back and evaluated,” said Ald. Scott Spiker. Ald. DiAndre Jackson, the other sponsor, said the outside audit would allow an “independent third party” to review the expenditures to date. The program, staffed by the Milwaukee Fire Department (MFD), was created in 2019 and has expanded with funding from the city’s large opioid settlement. MFD members meet with individuals who have experienced an overdose to attempt to get them treatment. The Milwaukee Health Department also uses opioid settlement money to support additional substance abuse and harm reduction measures. “I continue to have questions about intervention,” said Pérez, in whose district the MORI program was first housed. But the audit proposal quickly became a flashpoint. Commissioner Michael Totoraitis called it a “waste” and said it would be a study of things that had already been studied. The council previously unanimously approved a three-year plan to spend $17 million in settlement funds on MORI and harm reduction strategies, he said. “Since that day, it seems that all we do is argue with the same council,” said Lipski. “Every time any words related to this program come up, here we are.” Dr. Ben Weston, director of medical services for Milwaukee County, said “tens of millions” of dollars have already been spent studying harm intervention responses. “It’s sort of like if we want to spend money to know if antibiotics work against infections. We can do that, but we kind of know the answer,” he said. He said the county has momentum now, reducing overdose deaths by more than 50% from a 2022 high of 674. “I’m not sure how the evaluation works at this point, to be honest with you,” said Pérez. “But you’re putting forth an evaluation that you don’t understand?” asked Totoraitis, before Spiker admonished him for “decorum.” “That’s what he just said,” said the health commissioner. “What you will presently be evaluating is a program that has been stitched together,” said Lipski. He accused the council of blocking a “coherent path” that would build on initial successes. “We’re saving lives out here … We would love to have an open dialogue, but can it be in two directions?” The immediate concern, he added, is financial. “The short answer is yes, I will run out of money,” Lipski said when asked whether MORI could continue without action. He said MFD has $20,000 remaining for the program. That warning appeared to shift the committee’s direction, despite Pérez’s plea for more time to discuss the issue further. Ald. Milele A. Coggs suggested stripping the audit provision from the amendment to avoid disrupting services while city officials debated its merits. The committee, with Jackson’s support, endorsed her idea on a 3-1 vote. Ald. Peter Burgelis, a leading MFD supporter, voted against it. The full council will review it on April 21. “I am very fearful of interrupting the Health Department’s efforts on the opioid crisis,” Burgelis said. The broader debate remains unresolved. Pérez said he has “questions that I need answers to,” particularly around the roles of city and county agencies in intervention efforts. “I do want to see something move forward,” Pérez said, while adding that he needs “a cycle to figure some stuff out.” He said things have been “brought to his attention in recent days,” but did not respond to a request for comment on what those things are. “We’ll see you in three weeks,” said Spiker to Lipski and Totoraitis. For more on MORI, see a March 30 profile from Isiah Holmes.
