Visit the Attorney General’s websitewhich hosts 91 documents from state and local entities that receive the money.

What you will find is a lot of bureaucrats.

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

But many of these reports are still difficult, if not impossible, for the average person to decipher.

It’s a scenario that plays out in a multitude of states. When state and local governments start spending billions in opioid decommissioning fundsone of the loudest and most frequent questions from the public has been: Where does the dollar go? Victims of the crisis, advocates and public policy experts have repeatedly called on governments to openly report how they spend these funds, which many consider “blood money”.

Last year KFF Hälsonytt published an analysis by Christine Minhee, founder of OpioidSettlementTracker.comwhich found that 12 states – including Idaho – had made written commitments to publicly report spending of 100% of their funds in a way that the average person could find and understand. (The other 38 states pledged less.)

But there is a gap between these promises and the follow-up.

This year, KFF Health News and Minhee visited the 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 whizzed by, fulfilling the letter of the law but falling far short of communicating to the public in a clear and meaningful way.

Take Idaho, for example. Jurisdictions there filled out a standard form showing how much money they spent and how it fell under approved uses of the settlement. Sounds good. But in reality it reads like this: In fiscal year 2023, the City of Chubbuck spent about $39,000 on section G, subsection 9 Public health district no. 6 spent more than $26,000 on § B, subsection 2

Cracking that code requires one separate document. And even that only makes big moves.

G-9 refers to “school-based or youth-focused programs or strategies that have demonstrated effectiveness in preventing substance abuse.” B-2 refers to “the entire 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 do you actually do it?” asked Corey Davisa project director at the Network for Public Health Law, when he first saw the Idaho reports.

Does a school-based program involve hiring mental health counselors or holding a one-time meeting? Does treatment and recovery services mean paying for someone’s rehab or building a new recovery house?

Without details of the organizations that receive the money or descriptions of the projects they carry out, it is impossible to know where the funds are going. That would be like saying 20% ​​of your monthly salary goes to food. But does that mean grocery bills, eating out or hiring a chef?

The Idaho Attorney General’s Office, which oversees the state’s opioid settlement reports, did not respond to requests for comment.

Although Idaho and the other states in this analysis do better than most by having some public reports, Davis said that doesn’t mean they get an automatic gold star.

“I don’t think we should grade them on a curve,” he said. It is not “a high level to allow the public to see at a reasonable level of granularity where their money is going.”

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 spending in a way that is easy for the public to find and understand. Minnesota dashboard and downloadable spreadsheets clearly show 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 inside inmates.” New Jersey Annual Reports include details about how counties allocated funds and how they track success.

There are also states like Indiana which did not originally promise 100% transparency but now publishes detailed accounts of its spending.

However, there are no national requirements for jurisdictions to report money spent on opioid remediation. In states that have not imposed stricter requirements on their own, the public is left in the dark or forced to rely ad hoc interventions of advocate and journalists to fill the gap.

Wading through reports

When jurisdictions don’t publicly report their spending — or publish reports without meaningful details — the public is deprived of the opportunity to hold elected officials accountable, said Robert Packa co-director of East Tennessee State University’s Addiction Science Center 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 do not duplicate efforts or replace existing funding streams to save money.

“We don’t want to burden the whole thing with too much reporting,” Pack said, acknowledging that small governments run on tight budgets and staff. But organizations usually submit a proposal or project description before governments give them money. “If all the information is in hand, 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 can also foster hope.

“A lot of people are just not aware that these funds exist and that these funds are currently being used in ways that help,” he said. Greater transparency can “help get the message out that treatment works and treatment is available.”

Other states that lacked details in some of their spending reports said additional descriptions are publicly available and can be found in other state documents.

In South Carolina, for example, more information can be found in meeting minutes from the Opioid Recovery Fund Board, said Board Chairman Eric Bedingfield. He also wrote that, following KFF Health News’ request, staff will create an additional report showing more detailed information about the board’s “discretionary sub-fund” awards.

In Missouri, Department of Mental Health spokeswoman Debra Walker said additional project descriptions are available through the state’s budget process. Anyone with questions is welcome email the departmentshe said.

Summary: The details are technically available to the public but finding them can require 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 authorities control 15% of central government funds and report their spending in annual letters posted online. The rest of the state’s settlement funds are overseen by the Department of Health and Human Services, along with an Advisory Commission on Opioid Reduction and Governor and Executive Council.

Beneficiaries from the larger share declare their projects and the population they serve on the state’s Opioid Reduction website. But the reports are missing a key detail: how much money each organization received.

To find those dollar figures, people have to search through the Opioid Reduction Advisory Commission meeting minutes, which go back several years, or search the Governor and Executive Council’s meeting agendas for the proposed contracts. Typing in the search term “opioid phase-out” returns no results, so one must try “opioid” instead, showing results on opioid phase-out as well as federal opioid grants. The only way to see 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 children to overdoses and others interested in the money “shouldn’t have to go through the meeting notes and then check-F and look for opioids.”

James Boffetti, New Hampshire’s deputy attorney general, who helps oversee the opioid settlement funds, 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 transparent in any way,” he said. “We’ve certainly been more than transparent.”

The New Hampshire Department of Health and Human Services said it will compile its first comprehensive report on the opioid settlement funds by the end of the year, which prescribed by law.

Where is the incentive?

With opioid decommissioning funds set to pour in for another decade, some jurisdictions are still hoping to improve their public reporting.

In Michigan, the state uses a portion of its opioid settlement money to encourage local authorities to report on their shares. County was offered $1,000 to complete an investigation about their settlement spending this year, said Laina Stebbins, spokeswoman for the Department of Health and Human Services. Sixty-four counties participated — more than double last year, when there were no financial incentives.

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 about the state’s share of the funds.

But by county caused concern on undue administrative burden, the regulations was knocked outsaid Samuel Rosenberga Democrat representing Baltimore who sponsored the House bill.

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

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

“This is money we got because people’s lives have been ruined,” she said. “I don’t want to see money misused or fill a budget hole.”

This article is produced by KFF Health newsa national newsroom that produces in-depth journalism on health issues and is one of the core operational programs on KFF — The independent source of health policy research, opinion polls and journalism. KFF Hälsonytt is the publisher of California Healthlinean editorially independent service of California Health Care Foundation.

Copyright 2024 KFF Health News