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National Coordination

SAFE Takes analyzes and assesses the federal recommendations and proposals made by the White House and National Governors Association.

SAFE Takes reflects our analysis and assessment of the progress made in each of the recommendations made by the President’s Commission (Commission) on Combatting Drug Addiction and the Opioid Crisis (November 2017) and the National Governors Association’s (NGA) Recommendations for Federal Action to End the Nation’s Opioid Crisis (January 2018). The following SAFE Takes focuses on government action pertaining to national coordination.


Commission #1:  Congress and the Administration should increase block grant funding for opioid-related and substance use disorder (SUD)-related activities in the states.



Some Considerations


Increased funding to states and communities is a great first step and has been realized through several initiatives such as through the HHS Five-Point Opioid Strategy. However, any funding initiatives should be paired with a national strategy focusing on bold ideas, promising practices, and evidence-based youth prevention efforts.

Commission #2: The Office of National Drug Control Policy (ONDCP), through support from Health & Human Services and the Department of Justice, should establish a coordinated system for tracking all federally-funded initiatives.

NGA: Congress and the Administration should increase federal funding to states for SUD related activities, streamline the grant process (extend duration), and increase flexibility in grants/funding.


Warning, Caution Ahead


Tracking the effectiveness of grants made by the Federal Government is an important accountability measure. While there has been an increase in funding and grant measures, an increase should go along with an effort to make grants more flexible. States and individual recipients still struggle to meet overburdensome reporting requirements, while new actors in the field struggle to understand the grant-making process. There is an influx of money, but efficacy, coordination and tracking are to still be determined.
Commission #3: Congress should fund implementation of ONDCP review for every federal program and mandate federal and state cooperation.



Some Coordination


Inter-agency task forces are a great way to accelerate progress on initiatives important to the Administration, but must be paired with the resources and accountability to drive action. ONDCP is a natural office to lead an inter-agency task force and should receive the resources and legitimacy to facilitate a review process. While ONDCP does coordinate federal agency actions, it does not have the funding and resources to do reviews at the suggested level. Reviews of federal programs should be based on measures appropriate to the program area; prevention and treatment programs must be evaluated by different criteria.

In March 2019, the Bipartisan Policy Center released a report: Tracking Federal Funding to Combat the Opioid Crisis. They included the same recommendation that ONDCP should should enhance federal coordination, indicating a lack of progress. However, all of the states included in the report had coordinating bodies that improved communication and data-sharing.

Additionally, The Comprehensive Opioid Abuse Grant Program (COAP) administered by the DOJ. In FY2018, they included funding to improve the SUD response to those in the criminal justice system. It was intended to enhance coordination between criminal justice agencies and the single-state agency responsible for administering SUD grants. While this initiative shows some interest in increasing coordination, it falls short of meeting the national level discussed in the NGA and President’s Commission.