Broome County Puts $800,000 Behind Eight Addiction Programs

Broome County ended Recovery Month with a list: eight organizations, more than $800,000 in opioid settlement money, and a two-year contract window that runs through May 2028. The announcement landed as September closed, two days after local television covered the same awards, and it marks the third round of settlement grants the county health department has distributed since 2023.

The recipients cover most of what addiction care looks like on the ground in the Southern Tier. There is an outpatient clinic on Binghamton's West Side, a faith-based recovery home, a syringe exchange operating out of Johnson City, a rural health network, and, for the first time in this program, two college campuses.

The dollar figure is small next to the billions moving through New York from opioid litigation. What makes Broome worth watching is the machinery underneath it: which organizations get paid, what the money is legally allowed to buy, and whether the county that has posted some of the state's worst overdose numbers can keep the recent decline going.

Eight Organizations, One Round of Money

The third-round awardees are the Addiction Center of Broome County, which runs outpatient treatment from Binghamton and Endicott and also serves Tioga and Tompkins counties; Helio Health, which provides medically supervised withdrawal and stabilization services along with inpatient rehabilitation in the county; and the Hope Foundation of Binghamton, which operates faith-based recovery housing.

Binghamton University and SUNY Broome Community College join the list this round, alongside the Rural Health Network of South Central New York, the Southern Tier AIDS Program and its syringe exchange, and Truth Pharm, the Binghamton harm reduction group best known for its Trail of Truth memorial marches.

The county opened the competition in January, took proposals through March 16, and is writing contracts that begin June 1 and expire at the end of May 2028. Awards are open to nonprofits, municipalities, community groups and even privately owned businesses, provided the work happens inside Broome County and targets at least one of the uses approved under the state's Schedule C, a document that sets out what settlement money may legally pay for. In practice that means prevention and education, treatment, harm reduction, recovery support, and the staffing that holds those programs together.

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A County That Still Buries Too Many People

The county's own data tells a two-part story. In 2024, Broome recorded 49 suspected fatal overdoses and 219 suspected non-fatal ones. Measured per capita, state figures cited by local outlets put the county's 2024 rate at 35 overdose deaths per 100,000 residents, the second-highest in New York.

Then the curve bent. In 2025, suspected fatal overdoses fell 43 percent, from 49 to 28, and non-fatal overdoses dropped 29 percent. Naloxone distribution across the county rose 438 percent in a single year, work carried out by nine local agencies that train people and hand out the medication.

Marissa Knapp, who directs the county's Overdose Prevention Program and chairs the Broome Overdose Action Collaborative, credits the network rather than any single intervention. "I truly believe the reduction in overdoses can largely be attributed to all of the humans doing the work," she said when the 2025 numbers were released. She added a caveat that anyone working in this field repeats: "One life lost, is one too many."

County Executive Jason Garnar, who has staked part of his record on the overdose response, frames the settlement awards as a continuation rather than a victory lap. "While we're encouraged by these numbers and the impact of our work, we know our responsibility is to keep building on this momentum and saving more lives," he said.

A 28-death year in a county of roughly 195,000 people is progress, and it is still a death rate that most of New York would not accept. That gap between direction and level is exactly the space the settlement money is meant to occupy.

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Where the Settlement Money Comes From

New York's opioid settlements trace back to the lawsuit Attorney General Letitia James filed against pharmaceutical manufacturers in March 2019, and to the wave of distributor and pharmacy cases that followed. The state has secured more than $3 billion in total, paid out annually over as many as 18 years, starting in 2021.

The split matters more than the headline number. OASAS oversees roughly 40 percent of the state's settlement funding and committed all $454 million of its first five years to programs and initiatives. The rest goes directly to counties and cities, which is how a health department in Binghamton ends up running its own grant competition and signing its own contracts.

What Counties Are Allowed to Buy

Settlement payments come with strings, and the strings are the point. The national agreements require that money be spent on abatement of the opioid crisis, and New York encodes the specifics in Schedule C, the approved-uses list that every local award has to map back to. Naloxone, treatment capacity, recovery housing, peer support, workforce training and youth prevention all qualify. General budget relief does not, which is why counties publish rubrics and scoring sheets alongside their requests for proposals rather than distributing the money as they please.

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Three Rounds, Same Names

Broome's funding history is unusually easy to read because the health department keeps a project page listing every award. The first request for proposals went out in 2023 and selected seven agencies, with five programs running by September and $189,392.58 awarded by the end of that year. A second round in 2024 brought three more organizations into the program and pushed the total to ten, with $807,695.55 distributed. A partial list covering awards through May 1, 2025 itemizes another $274,015.79 across nine providers. The county describes the combined first two rounds as more than $2 million across ten organizations.

The same names recur every cycle. The Addiction Center of Broome County, Truth Pharm, the Rural Health Network, Helio Health and the Hope Foundation appear year after year, which in a county with a thin provider base is less a sign of favoritism than of arithmetic. When the number of organizations capable of running an evidence-based program in a metropolitan area of about 240,000 is small, repeat funding is the predictable result. It is also why the roster changes at the margins, with colleges entering this round and harm reduction groups that were once considered fringe now sitting permanently on the list.

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Harm Reduction Groups Are Still Getting Paid Here

Of the eight awardees, at least three work primarily in harm reduction rather than treatment: Truth Pharm, the Southern Tier AIDS Program's syringe exchange, and the Rural Health Network. That is a notable position for a county in upstate New York to hold in 2026, because the federal government moved the other way in April.

On April 24, SAMHSA sent grantees a funding guidance letter prohibiting federal dollars from paying for sterile syringes, smoking supplies, and fentanyl and xylazine test strips, reversing a policy the same agency had promoted five years earlier. The county's settlement dollars are not federal dollars, so they can still buy what federal grants no longer can. That distinction is quietly becoming one of the most consequential facts in American overdose prevention: where state and local settlement funds exist, harm reduction survives; where they do not, programs fold.

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The Oversight Conversation Is Getting Louder

Nationally, the criticism now aimed at settlement spending is not that the money is missing. It is that the money is hard to follow. A September analysis from the USC Schaeffer Center noted that while most settlements require at least 70 percent of funds to go to opioid recovery, treatment or prevention, the state entities overseeing the money are not required to report how it is used. Advocates in neighboring New Jersey made a similar argument on October 1, warning that spending there lacks oversight.

New York's answer has been transparency infrastructure rather than silence. OASAS publishes an annual opioid settlement report covering statewide initiatives and regional abatement funding, maintains a public tracker, and runs the Opioid Settlement Fund Advisory Board, created by statute in 2022 to recommend where the money should go.

The Next Public Meeting

That board meets October 7, from 10 a.m. to 3 p.m. Eastern, with sessions in Albany, New York City, Rochester and a virtual option for anyone who wants to listen in. The meeting notice is public, as are the minutes from previous sessions. For Southern Tier residents with opinions about how the next round of Broome County money should be spent, the January filing window is not the only way in.

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Where to Get Help in the Southern Tier

If you or someone you know needs treatment in Broome County or the surrounding counties, these are the numbers that answer:

• 988, the Suicide and Crisis Lifeline, staffed around the clock for substance use and mental health crises
• NYS HOPEline at 1-877-846-7369, an OASAS-run line for addiction and problem gambling that answers 24 hours a day
• Addiction Center of Broome County at 607-723-7308, for outpatient treatment across Broome, Tioga and Tompkins counties
• Helio Health at 607-296-3072, for withdrawal and stabilization services and inpatient rehabilitation
• Southern Tier AIDS Program's Fix Safe syringe exchange at 607-798-1706, for harm reduction and HIV and hepatitis C services
• Truth Pharm at truthpharm.org, for overdose prevention training, naloxone and family support in Binghamton

The third round's contracts expire in May 2028. By then, Broome County will have a clearer answer to the question that follows every settlement check: whether the money moved the number, or merely arrived.