{"id":1791,"date":"2024-11-07T10:00:00","date_gmt":"2024-11-07T10:00:00","guid":{"rendered":"https:\/\/medical-article.com\/?p=1791"},"modified":"2024-11-07T10:00:00","modified_gmt":"2024-11-07T10:00:00","slug":"12-states-promised-to-open-the-books-on-their-opioid-settlement-funds-we-checked-up-on-them","status":"publish","type":"post","link":"https:\/\/medical-article.com\/?p=1791","title":{"rendered":"12 States Promised To Open the Books on Their Opioid Settlement Funds. We Checked Up on Them."},"content":{"rendered":"

To discover how millions in opioid settlement funds are being spent in Idaho, you can visit the state attorney general\u2019s website<\/a>, which hosts 91 documents from state and local entities getting the money.<\/p>\n

What you\u2019ll find is a lot of bureaucratese.<\/p>\n

Nearly three years ago<\/a>, these jurisdictions signed an agreement<\/a> promising annual reports \u201cspecifying the activities and amounts\u201d they have funded.<\/p>\n

But many of those reports remain difficult, if not impossible, for the average person to decipher.<\/p>\n

It\u2019s a scenario playing out in a host of states. As state and local governments begin spending billions in opioid settlement funds<\/a>, one of the loudest and most frequent questions from the public has been: Where are the dollars going? Victims of the crisis, along with their advocates and public policy experts, have repeatedly called on governments to transparently report how they\u2019re using these funds, which many consider \u201cblood money.\u201d<\/p>\n

Last year, KFF Health News published an analysis<\/a> by Christine Minhee, founder of OpioidSettlementTracker.com<\/a>, that found 12 states \u2014 including Idaho \u2014 had made written commitments to publicly report expenditures on 100% of their funds in a way an average person could find and understand. (The other 38 states promised less.)<\/p>\n

But there\u2019s a gap between those promises and the follow-through.<\/p>\n

This year, KFF Health News and Minhee revisited those 12 states: Arizona, Colorado, Delaware, Idaho, Massachusetts, Minnesota, Missouri, New Hampshire, New Jersey, Oregon, South Carolina, and Utah. From their reports, it became clear that some did not fulfill their promises. And several just squeaked by, meeting the letter of the law but falling far short of communicating to the public in a clear and meaningful manner.<\/p>\n

Take Idaho, for instance. Jurisdictions there completed a standard form showing how much money they spent and how it fell under approved uses of the settlement. Sounds great. But in reality, it reads like this: In fiscal year 2023, the city of Chubbuck spent about $39,000<\/a> on Section G, Subsection 9. Public Health District No. 6 spent more than $26,000<\/a> on Section B, Subsection 2.<\/p>\n

Cracking that code requires a separate document<\/a>. And even that provides only broad outlines.<\/p>\n

G-9 refers to \u201cschool-based or youth-focused programs or strategies that have demonstrated effectiveness in preventing drug misuse.\u201d B-2 refers to \u201cthe full continuum of care of treatment and recovery services for OUD and any co-occurring SUD\/MH conditions,\u201d referring to opioid use disorder and substance use disorder or mental health conditions.<\/p>\n

\u201cWhat does that mean? How exactly are you doing that?\u201d asked Corey Davis<\/a>, a project director at the Network for Public Health Law, when he first saw the Idaho reports.<\/p>\n

Does a school-based program involve hiring mental health counselors or holding a one-time assembly? Does treatment and recovery services mean paying for someone\u2019s rehab or building a new recovery house?<\/p>\n

Without details on the organizations receiving the money or descriptions of the projects they\u2019re enacting, it\u2019s impossible to know where the funds are going. It would be similar to saying 20% of your monthly salary goes to food. But does that mean grocery bills, eating out at restaurants, or hiring a cook?<\/p>\n

The Idaho attorney general\u2019s office, which oversees the state\u2019s opioid settlement reports, did not respond to requests for comment.<\/p>\n

Although Idaho and the other states in this analysis do better than most in having any reports publicly available, Davis said that doesn\u2019t mean they get an automatic gold star.<\/p>\n

\u201cI don\u2019t think we should grade them on a curve,\u201d he said. It\u2019s not \u201ca high bar to let the public see at some reasonable level of granularity where their money is going.\u201d<\/p>\n

To be sure, many state and local governments are making concerted efforts to be transparent. In fact, seven of the states in this analysis reported 100% of their expenditures in a way that is easy for the public to find and understand. Minnesota\u2019s dashboard<\/a> and downloadable spreadsheet clearly list projects, such as Renville County\u2019s use of $100,000 to install \u201ca body scanner in our jail to help staff identify and address hidden drugs inside of inmates.\u201d New Jersey\u2019s annual reports include details<\/a> on how counties awarded funds and how they\u2019re tracking success.<\/p>\n

There are also states such as Indiana<\/a> that didn\u2019t originally promise 100% transparency but are now publishing detailed accounts of their expenditures.<\/p>\n

However, there are no national requirements for jurisdictions to report money spent on opioid remediation. In states that have not enacted stricter requirements on their own, the public is left in the dark or forced to rely on ad hoc efforts<\/a> by advocates<\/a> and journalists<\/a> to fill the gap<\/a>.<\/p>\n

Wading Through Reports<\/strong><\/p>\n

When jurisdictions don\u2019t publicly report their spending \u2014 or publish reports without meaningful details \u2014 the public is robbed of an opportunity to hold elected officials accountable, said Robert Pack<\/a>, a co-director of East Tennessee State University\u2019s Addiction Science Center and a national expert on addiction issues.<\/p>\n

He added: People need to see the names of organizations receiving the money and descriptions of their work to ensure projects are not duplicating efforts or replacing existing funding streams<\/a> to save money.<\/p>\n

\u201cWe don\u2019t want to burden the whole thing with too much reporting,\u201d Pack said, acknowledging that small governments run on lean budgets and staff. But organizations typically submit a proposal or project description before governments give them money. \u201cIf the information is all in hand, why wouldn\u2019t they share it?\u201d<\/p>\n

Norman Litchfield<\/a>, a psychiatrist and the director of addiction medicine at St. Luke\u2019s Health System in Idaho, said sharing the information could also foster hope.<\/p>\n

\u201cA lot of people simply are just not aware that these funds exist and that these funds are currently being utilized in ways that are helping,\u201d he said. Greater transparency could \u201chelp get the message out that treatment works and treatment is available.\u201d<\/p>\n

Other states that lacked detail in some of their expenditure reports said further descriptions are available to the public and can be found in other state documents.<\/p>\n

In South Carolina, for instance, more information can be found in the meeting minutes<\/a> of the Opioid Recovery Fund Board, said board chair Eric Bedingfield. He also wrote that, following KFF Health News\u2019 inquiry, staff will create an additional report showing more granular information about the board\u2019s \u201cdiscretionary subfund\u201d awards.<\/p>\n

In Missouri, Department of Mental Health spokesperson Debra Walker said, further project descriptions are available through the state budget process. Anyone with questions is welcome to email the department<\/a>, she said.<\/p>\n

Bottom line: The details are technically publicly available, but finding them could require hours of research and wading through budgetary jargon \u2014 not exactly a system friendly to the average person.<\/p>\n

Click Ctrl+F<\/strong><\/p>\n

New Hampshire\u2019s efforts to report its expenditures follow a similar pattern.<\/p>\n

Local governments control 15% of the state\u2019s funds and report their expenditures in yearly letters posted online<\/a>. The rest of the state\u2019s settlement funds are controlled by the Department of Health and Human Services, along with an opioid abatement advisory commission and the governor and executive council<\/a>.<\/p>\n

<\/a>Grant recipients from the larger share explain their projects and the populations they serve on the state\u2019s opioid abatement website<\/a>. But the reports lack a key detail: how much money each organization received.<\/p>\n

To find those dollar figures, people must search through the opioid abatement advisory commission\u2019s meeting minutes, which date back several years, or search the governor and executive council\u2019s meeting agendas<\/a> for the proposed contracts. Typing in the search term \u201copioid settlement\u201d brings up no results, so one must try \u201copioid\u201d instead, surfacing results about opioid settlements as well as federal opioid grants. The only way to tell which results are relevant is by opening the links one by one.<\/p>\n

Davis, from the Network for Public Health Law, called the situation an example of \u201ctechnical compliance.\u201d He said people in recovery, parents who lost their kids to overdose, and others interested in the money \u201cshouldn\u2019t have to go click through the meeting notes and then control-F and look for opioids.\u201d<\/p>\n

James Boffetti, New Hampshire\u2019s deputy attorney general, who helps oversee the opioid settlement funds, agreed that \u201cthere\u2019s probably better ways\u201d to share the various documents in one place.<\/p>\n

\u201cThat doesn\u2019t mean they aren\u2019t publicly available and we\u2019re somehow not being transparent,\u201d he said. \u201cWe\u2019ve certainly been more than transparent.\u201d<\/p>\n

The New Hampshire Department of Health and Human Services said it will be compiling its first comprehensive report on the opioid settlement funds by the end of the year, as laid out in statute<\/a>.<\/p>\n

Where\u2019s the Incentive?<\/strong><\/p>\n

With opioid settlement funds set to flow for another decade-plus, some jurisdictions are still hoping to improve their public reporting.<\/p>\n

In Michigan, the state is using some of its opioid settlement money<\/a> to incentivize local governments to report on their shares. Counties were offered $1,000 to complete a survey<\/a> about their settlement spending this year, said Laina Stebbins, a spokesperson for the Michigan Department of Health and Human Services. Sixty-four counties participated \u2014 more than double the number from last year, when there was no financial incentive.<\/p>\n

In Maryland, lawmakers took a different approach. They introduced a bill that required each county to post an annual report detailing the use of its settlement funds and imposed specific timelines for the health department to publish decisions on the state\u2019s share of funds.<\/p>\n

But after counties raised concerns<\/a> about undue administrative burden, the provisions were struck out<\/a>, said Samuel Rosenberg<\/a>, a Democrat representing Baltimore who sponsored the House bill.<\/p>\n

Lawmakers have now asked the health department to devise a new plan by Dec. 1 to make local governments\u2019 expenditures public.<\/p>\n

Toni Torsch, a Maryland resident whose son Dan died of an overdose<\/a> at age 24, said she\u2019ll be watching to ensure the public gets a clear picture of settlement spending.<\/p>\n

\u201cThis is money we got because people\u2019s lives have been destroyed,\u201d she said. \u201cI don\u2019t want to see that money be misused or fill a budget hole.\u201d<\/p>\n

Methodology<\/h4>\n

In March 2023, KFF Health News published an analysis<\/a> by Christine Minhee, founder of OpioidSettlementTracker.com<\/a>, assessing states\u2019 written commitments to report how they use opioid settlement dollars. That analysis<\/a> determined that 12 states had promised to publicly report expenditures on 100% of their funds in a way an average person could track.More than a year later, KFF Health News senior correspondent Aneri Pattani and Minhee revisited those 12 states\u2019 reporting practices to determine if they had fulfilled their promises and to assess how useful the resulting expenditure reports were to the public.Expenditure reports were gathered via state and local government websites, Google searches, and Minhee\u2019s Expenditure Report Tracker<\/a>. If Minhee and Pattani were unable to find public reports, they contacted state governments directly.For expenditures to be considered \u201cpublicly reported,\u201d they had to meet the following criteria:1. Expenditures had to be expressed as specific dollar amounts. Descriptions of how the money was used without a dollar figure would not qualify.2. The report passes the \u201cGoogleability test\u201d: Could a typical member of the public reasonably be expected to find expenditure information by keyword-searching online? If people had to file a public records request, navigate lengthy budget or appropriations documents, or rifle through meeting minutes for the information, it would not qualify.For an expenditure report to be considered \u201cpublicly reported with clarity,\u201d it had to meet one additional criterion:3. Reports had to contain some combination of vendor name (e.g., an individual or organization) that received the money and a description of the money\u2019s use such that a typical member of the public could understand the specific service, product, or effort the money supported.Each state divides opioid settlement funds into shares controlled by different entities. The majority of expenditures in each share were required to meet the above-listed criteria in order for that share to be classified as \u201cpublicly reported\u201d or \u201cpublicly reported with clarity.\u201dFor example, in Utah, 50% of opioid settlement funds are controlled by county governments. As of Oct. 9, less than half of all counties had reported expenditures in a manner that was easily accessible to the public. As such, that 50% share was not counted as \u201cpublicly reported.\u201dThis analysis was conducted by Pattani and Minhee from July to October. Classifications were made based on states\u2019 expenditure reports as of Oct. 9.<\/p>\n

KFF Health News<\/a> is a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at KFF\u2014an independent source of health policy research, polling, and journalism. Learn more about KFF<\/a>.<\/p>\n

USE OUR CONTENT<\/h3>\n

This story can be republished for free (details<\/a>).<\/p>","protected":false},"excerpt":{"rendered":"

To discover how millions in opioid settlement funds are being spent in Idaho, you can visit the state attorney general\u2019s website, which hosts 91 documents from state and local entities getting the money. What you\u2019ll find is a lot of bureaucratese. Nearly three years ago, these jurisdictions signed an agreement promising annual reports \u201cspecifying the…<\/p>\n","protected":false},"author":0,"featured_media":1792,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[2],"tags":[],"class_list":["post-1791","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-articles"],"_links":{"self":[{"href":"https:\/\/medical-article.com\/index.php?rest_route=\/wp\/v2\/posts\/1791"}],"collection":[{"href":"https:\/\/medical-article.com\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/medical-article.com\/index.php?rest_route=\/wp\/v2\/types\/post"}],"replies":[{"embeddable":true,"href":"https:\/\/medical-article.com\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=1791"}],"version-history":[{"count":0,"href":"https:\/\/medical-article.com\/index.php?rest_route=\/wp\/v2\/posts\/1791\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/medical-article.com\/index.php?rest_route=\/wp\/v2\/media\/1792"}],"wp:attachment":[{"href":"https:\/\/medical-article.com\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=1791"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/medical-article.com\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=1791"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/medical-article.com\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=1791"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}