Twelve states pledged to open the books on their opioid settlement funds. We checked them. • Minnesota reformer

To learn how millions in opioid settlement funds are being spent in Idaho, visit the Attorney General’s websitewhich contains 91 documents from state and local entities receiving the money.

What you will find is a lot of bureaucracy.

Almost three years agothese jurisdictions signed an agreement promising annual reports “indicating the activities and amounts” they have funded.

But many of those reports remain difficult, if not impossible, for the average person to decipher.

It’s a scenario that’s playing out across a large number of states. As state and local governments begin spending billions in opioid settlement fundsis one of the loudest and most frequently asked questions from the public: 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 use these funds, which many consider “blood money.”

Last year, KFF Health News published an analysis by Christine Minhee, founder of OpioidSettlementTracker.comwhich showed that twelve states – including Idaho – had made written commitments to publicly report spending on 100% of their resources in a way that an average person could find and understand. (The other 38 states pledged less.)

But there is a gap between those promises and their implementation.

This year, KFF Health News and Minhee revisited these twelve states: Arizona, Colorado, Delaware, Idaho, Massachusetts, Minnesota, Missouri, New Hampshire, New Jersey, Oregon, South Carolina and Utah. Their reports made it clear that some were not keeping their promises. And some just got by, meeting the letter of the law, but falling far short of communicating with the public in a clear and meaningful way.

Take Idaho, for example. Jurisdictions there filled out a standard form showing how much money they had spent and how it fell under the approved use of the settlement. Sounds great. But in reality it reads as follows: In fiscal year 2023, the City of Chubbuck spent about $39,000 on Section G, Subdivision 9. Public Health District No. 6 spent more than $26,000 on Section B, Subsection 2.

To crack that code is one separate document. And even that only gives broad outlines.

G-9 refers to “school-based or youth-oriented programs or strategies that have demonstrated effectiveness in preventing substance abuse.” B-2 refers to “the full continuum of care of treatment and recovery services for OUD and any co-occurring SUD/MH conditions,” referring to opioid use disorders and substance abuse disorders or mental health conditions.

“What does that mean? How exactly do you do that?” asked Corey Davisproject director at the Network for Public Health Law when he first saw the Idaho reports.

Does a school program involve hiring spiritual counselors or holding a one-time meeting? Do treatment and recovery services involve paying for someone’s rehabilitation or building a new recovery home?

Without details about the organizations receiving the money or descriptions of the projects they are undertaking, it is impossible to know where the money is going. It would be like saying that 20% of your monthly salary goes to food. But does that also mean grocery bills, eating out at restaurants or hiring a chef?

The Idaho attorney general’s office, which oversees reports on the state’s opioid settlement, did not respond to requests for comment.

Although Idaho and the other states in this analysis do better than most states in making reports publicly available, Davis says that doesn’t mean they automatically get a gold star.

“I don’t think we should judge them on a curve,” he said. It is not a “high bar to show the public at a reasonably detailed level where their money is going.”

It is fair to say that 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 spending in a way that is easy for the public to find and understand. The Minnesota Dashboard and a downloadable spreadsheet clearly mention projects such as Renville County’s use of $100,000 to “install a body scanner in our jail to help staff identify and address hidden drugs in inmates.” New Jersey Annual Reports contain details on how provinces allocate funds and how they track success.

There are also states like Indiana who did not originally promise 100% transparency, but now publish detailed accounts of their spending.

However, there are no national requirements for jurisdictions to report money spent on opioid remediation. In states that have not adopted stricter requirements on their own, the public is left in the dark or forced to rely on ad hoc efforts Through advocates And journalists Unpleasant fill the hole.

Browse reports

When jurisdictions do not publicly report their spending — or publish reports without meaningful detail — the public is deprived of the opportunity to hold elected officials accountable, said Robert Pakco-director of the Addiction Science Center at East Tennessee State University and a national expert on addiction issues.

He added: People need to see the names of organizations receiving the money and descriptions of their work to ensure projects are not duplicative efforts or duplication. replacement of existing financing flows to save money.

“We don’t want to burden the whole thing with too much reporting,” Pack said, acknowledging that small governments have to run on lean budgets and staff. But organizations typically submit a proposal or project description before the government gives them money. “If the information is all out there, why wouldn’t they share it?”

Norman Litchfielda psychiatrist and director of addiction medicine at St. Luke’s Health System in Idaho, said sharing the information could also promote hope.

“Many people are simply not aware that these funds exist and that these funds are currently being used in ways that are helping,” he said. Greater transparency could “spread the message that treatment works and that treatment is available.”

Other states that lacked details in some of their spending reports said further descriptions are available to the public and can be found in other state documents.

For example, in South Carolina, more information can be found in the minutes of the meeting of the Opioid Recovery Fund Board, said board chairman Eric Bedingfield. He also wrote that, following KFF Health News’ investigation, staff will prepare an additional report with more detailed information about the board’s allocations to “discretionary sub-funds.”

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 email the departmentshe said.

Bottom line: The details are technically publicly available, but finding them can take hours of research and wading through budget jargon—not exactly a system that’s friendly to the average person.

Click ctrl+F

New Hampshire’s efforts to report its spending follow a similar pattern.

Local governments control 15% of state funds and report their expenditures in annual letters posted online. The remainder of the state’s settlement funds are overseen by the Department of Health and Human Services, along with an advisory committee on opioid control and the governor and executive council.

Majority grant recipients explain their projects and the populations they serve in the state Opioid Control Website. But the reports miss an important detail: how much money each organization received.

To find those dollar figures, people have to search the Opioid Control Advisory Commission meeting minutes, which go back several years, or search the governor’s and executive council’s records. meeting agendas for the proposed contracts. Typing the search term “opioid settlement” will return no results, so you should try “opioid settlement” instead, which will bring up results about opioid settlements and federal opioid subsidies. The only way to determine which results are relevant is to open the links one by one.

Davis, of the Network for Public Health Law, called the situation an example of “technical compliance.” He said people in recovery, parents who have lost their children to an overdose and others interested in the money “don’t have to click through the meeting minutes and then hit Control-F and search for opioids.”

James Boffetti, New Hampshire’s deputy attorney general, who oversees funds for the opioid settlement, agreed that “there are probably better ways” to share the various documents in one place.

“That doesn’t mean they’re not publicly available and that we’re not being transparent in some way,” he said. “We have certainly been more than transparent.”

The New Hampshire Department of Health and Human Services said it will produce its first comprehensive report on the opioid settlement funds by the end of the year. laid down in the articles of association.

Where’s the incentive?

With opioid settlement funds set to continue flowing for at least a decade, some jurisdictions are still hoping to improve their public reporting.

In Michigan, the state uses some of it his opioid settlement money to encourage local governments to report on their shares. Counties were offered $1,000 to complete a survey about their settlement spending this year, said Laina Stebbins, spokesperson for the Michigan Department of Health and Human Services. Sixty-four provinces participated – more than double last year, when there was no financial incentive.

In Maryland, lawmakers took a different approach. They introduced a bill requiring each county to publish an annual report detailing the use of the settlement funds, and imposed specific timelines for the Department of Health to publish decisions on the state’s share of the funds.

But after the provinces concerns expressed on excessive administrative burdens, the provisions were knocked outsaid Samuel Rosenberga Democrat who represented Baltimore and sponsored the House bill.

Lawmakers have now asked the Health Ministry to come up with a new plan by December 1 to make local government spending public.

Toni Torsch, a Maryland resident whose son Dan died of an overdose at 24, she said she will ensure the public gets a clear picture of settlement spending.

“This is money we’ve been given because people’s lives have been destroyed,” she said. “I don’t want money to be misused or fill a budget gap.”

This story first appeared in KFF Health News.