Where do these monies live?
It depends:
The Georgia Opioid Crisis Abatement Trust holds the state’s 75% share of settlement funds from the distributor and Janssen settlements,[1] and 30% of the state’s total funds from settlements with Allergan, CVS, Teva, Walgreens, and Walmart.[2] This constitutes most funds in this share.
Sixty percent (60%) of the state’s share of funds from settlements with Allergan, CVS, Teva, Walgreens, and Walmart – 45% of funds from these settlements – are held by the State Treasury.[3]
At least 30% of Georgia’s total opioid settlement funds — 40% of this 75% state share — is “earmarked” for regional uses across the state’s 11 regions:
The six regions of the Georgia Department of Behavioral Health and Developmental Disabilities.[4]
The five Qualifying Block Grantees (QBGs), i.e., the City of Atlanta, Cobb County, DeKalb County, Fulton County, and Gwinnett County.[5]
Only QBG regions receive their monies directly; to do so, each had to certify that they have sufficient infrastructure to provide opioid abatement services.[6]
With limited exceptions,[7] this share must be spent on the uses described in the national settlement agreements’ (non-exhaustive) Exhibit E,[8] which includes prevention, harm reduction, treatment, recovery, and other strategies.
Georgia’s settlement MOUs require at least 70% of the state’s opioid settlement funds overall to be spent on prospective abatement purposes but does not assign specific abatement thresholds to each share.[9]
In January 2024, the Georgia Department of Behavioral Health and Developmental Disabilities published “Continuum of Care” gap analysis reports “to inform the public and potential applicants of current resources, missing provisions of service, and the extent of overdose prevalence in certain areas.”
Trustee of the Georgia Opioid Abatement Trust decides majority; Georgia General Assembly and local officials for the city of Atlanta and Cobb, DeKalb, Fulton, and Gwinnett Counties decide remaining.[10]
The Trustee for the Georgia Opioid Crisis Abatement Trust — currently the Commissioner of the Georgia Department of Behavioral Health and Developmental Disabilities[11] — ultimately approves specific expenditures for the majority of share after consulting the Georgia Opioid Settlement Advisory Commission and Regional Advisory Councils.[12] This share includes 75% of the state’s total funds from the distributor and Janssen settlements and 30% of the state’s total funds from settlements with Allergan, CVS, Teva, Walgreens, and Walmart.
The Georgia Opioid Settlement Advisory Commission was established in 2023 to provide recommendations to the Trustee on the Trust’s overall expenditures.[13]
The Georgia General Assembly ultimately decides via appropriations how to spend 45% of the state’s total funds from settlements with Allergan, CVS, Teva, Walgreens, and Walmart.[14]
For the 30% of funds that must be spent regionally:
The local governments of the six regions of the Georgia Department of Behavioral Health and Developmental Disabilities are required to create Regional Advisory Councils, who are each responsible for consulting local governments and the Advisory Commission on best uses of funds within the region.[15] However, “the Trustee … retain[s] final authority over disbursement” of this “RAC Funding” sub-share.[16]
Qualifying Block Grantees — the City of Atlanta, Cobb County, DeKalb County, Fulton County, and Gwinnett County — are ultimately responsible for “approv[ing] opportunities in their community for opioid abatement” for this “QBG Funding” sub-share according to the terms of their own decision-making processes.[17]
No, supplantation is not prohibited. Like most states, Georgia does not explicitly prohibit supplantation uses of its opioid settlement funds. This means that the 75% state share may be spent in ways that replace (or “supplant”) — rather than supplement — existing resources.
Eventually (public reporting required). Expenditure data will eventually be available on the Georgia Opioid Crisis Abatement Trust’s website. The state must publish on its website an annual report detailing expenditures from this share, including individual expenditure reports from each Regional Advisory Council.[18]
Visit OpioidSettlementTracker.com’s Expenditure Report Tracker for an updated collection of states’ and localities’ available expenditure reports.
Not applicable.
State of Georgia and Local Governments: Memorandum of Understanding Concerning National Settlements with Teva Pharmaceutical Industries Ltd., Allergan Finance, LLC, Walmart Inc., CVS Health Corporation and CVS Pharmacy, Inc., and Walgreen Co. (“Georgia Subsequent Settlement MOU”), Secs. II.b-c. More specifically, the Trust receives 40% of the state’s 75% share from these settlements. ↑
Georgia Subsequent Settlement MOU, Secs. II.b-c. ↑
Presentation of Grant Thomas, Director of Georgia Governor’s Office of Health Strategy and Coordination, Slide 10. October 26, 2022. Accessed August 19, 2024. See also Regional Field Offices. Georgia Department of Behavioral Health and Developmental Disabilities website. Accessed August 19, 2024. ↑
Georgia Distributor and J&J MOU, Secs. III.c, III.c(i) (“Each county with a population of at least 400,000 persons (‘Qualifying Block Grantee’) shall be counted as a separate Region”), III.c(iii); Georgia Subsequent Settlement MOU, Sec. II.c. See also Qualifying Block Grantees (QBGs). Georgia Opioid Crisis Abatement Trust website. Accessed August 19, 2024 (“Each QBG is a region”). ↑
Georgia Distributor and J&J MOU, Secs. III.c(ii)-(iii); Georgia Subsequent Settlement MOU, Sec. II.c(ii). ↑
Georgia Distributor and J&J MOU, Sec. II.d (providing that “[t]he Trustee shall make disbursements of State Opioid Funds for (1) Approved Purposes … (2) for administrative expenses …. and (3) for attorneys’ fees and costs”); Georgia Subsequent Settlement MOU, Sec. III.a (providing that State Opioid Funds must be used for Approved Purposes and administrative expenses). See also Georgia Distributor and J&J MOU, Secs. V.c (“The State shall endeavor to keep such Trustee expenses reasonable in order to maximize the funding available for Opioid Abatement”), VII.g (“State outside counsel shall be compensated pursuant to separate agreement between the State and its outside counsel”), IV.a (summarizing exceptions); Georgia Subsequent Settlement MOU, Secs. IV.c (“The Trustee and the State shall endeavor to keep such expenses reasonable in order to maximize the funding available for opioid abatement”), VI.a (providing that Section VII of the 2022 MOU applies for purposes of attorney’s fees, costs, and expenses). ↑
Note that McKinsey settlement monies were allocated by the governor to the Department of Law, Department of Behavioral Health and Developmental Disabilities, and Department of Public Health and spent according to the recommendations listed here. Gov. Kemp Awards $13M in Settlement Funds to Help Fight Opioid Crisis. Georgia Office of the Governor press release. February 17, 2022. Accessed August 26, 2024. ↑
Georgia Distributor and J&J MOU, Sec. II.b (providing that “[t]he Commissioner of an agency of the Executive Branch of the State, or his or her designee or other designee of the Executive Branch of the State, shall act as Trustee” and that “[t]he agency or department shall be selected by the Governor, after consultation with the Attorney General”); Governor Appointed Trustee. Georgia Opioid Crisis Abatement Trust website. Accessed August 26, 2024 (noting that Kevin Tanner, Commissioner of the Georgia Department of Behavioral Health and Developmental Disabilities, serves as the Trustee). ↑
Georgia Distributor and J&J MOU, Sec. II.d (“The Trustee shall retain final decision-making authority over expenditures of State Opioid Funds for Approved Purposes”), III.c(vi) (“The Regional Advisory Councils shall be available to consult with the Government Participation Mechanism … to best determine how funds will be spent for opioid remediation within the established Regions”); Georgia Subsequent Settlement MOU, Secs. II.c (“The remaining 40% after payment of fees and costs shall be transferred to the Trust by the receiving state agency and shall be expended by the Trustee on a regional basis”), II.c(iv) (“The Regional Advisory Councils established pursuant to the 2022 MOU shall have the same duties and responsibilities in connection with the funds allocated to the Trust pursuant to this 2023 MOU as under the 2022 MOU, including … making themselves available to consult with
the Government Participation Mechanism” and “[i]n every instance the Trustee shall retain final authority over Regional Distributions”). See also About Us. Georgia Opioid Crisis Abatement Trust website. Accessed August 26, 2024 (“The Georgia Opioid Crisis Abatement Trust is a Qualified Settlement Fund established under the Memorandum of Understanding and administered by the Trustee and the Georgia Opioid Settlement Advisory Commission … in coordination with the Regional Advisory Councils (‘RACs’)”). ↑
266 Ga. Gov’t Reg. 10 (LexisNexis June 2023) (an Executive Order signed by Georgia’s Governor on May 18, 2023 that established the Georgia Opioid Settlement Advisory Commission as the “Government Participation Mechanism” described in the state’s opioid settlement memoranda of understanding). See also Georgia Distributor and J&J MOU, Secs. I.b (defining “Government Participation Mechanism”), II.c (providing for establishment of a Government Participation Mechanism), II.d(1) (providing that the Trustee make disbursements of state settlement monies “after consultation with the Government Participation Mechanism”). ↑
Georgia Subsequent Settlement MOU, Sec. II.c (“Of the State’s 75% share, after the payment of litigation fees and costs owed to the State’s outside counsel pursuant to the agreement entered into on September 10, 2018 or as may be amended, 60% of the remaining funds shall be transferred by the receiving state agency through the Office of Planning and Budget to the State Treasury and spent at the direction of the State Legislature for Approved Purposes by appropriation and in compliance with the terms of the Opioid Settlements and this Memorandum”) (emphasis added). ↑
Georgia Distributor and J&J MOU, Secs. III.c(v)-(vi); Georgia Subsequent Settlement MOU, Sec. II.c(iv). See also Regional Advisory Councils (RACs). Georgia Opioid Crisis Abatement Trust website. Accessed August 26, 2024. ↑
Georgia Distributor and J&J MOU, Sec. III.c(vi); Georgia Subsequent Settlement MOU, Sec. II.c(iv). See also Notice of Funding Opportunity, Sec. 1.2.2 RAC Funding. Georgia Opioid Crisis Abatement Trust. April 26, 2024. Accessed August 26, 2024. ↑
Georgia Distributor and J&J MOU, Secs. III.c(ii)-(iii); Georgia Subsequent Settlement MOU, Sec. II.c(ii). See also Qualifying Block Grantees. Georgia Opioid Crisis Abatement Trust website. Accessed August 26, 2024 (“Each QBG is a region and will receive its allocation directly from the Trust so long as it certifies that it has sufficient infrastructure to provide opioid abatement services. Each QBG will develop a process for funds to be requested and approved. If the QBG wants State Opioid Funding, the funding request must be reviewed by the Commission and approved by the Trustee”). See also Notice of Funding Opportunity, Sec. 1.2.3 QBG FUNDING. Georgia Opioid Crisis Abatement Trust. April 26, 2024. Accessed August 26, 2024 (“QBGs have a level of autonomy in approving and overseeing the expenditure of their allocated funds, albeit within the guidelines and core strategies and approved uses described in the settlements. QBG funding is allocated for local initiatives within the specified jurisdictions. As such, each QBG has established its own application procedures; therefore, applicants must engage directly with their respective QBG for guidance, as the application steps will differ from those outlined in this NOFO. If your project area is within a QBG, please contact the appropriate county or city for further information regarding the specific application requirements"). ↑
Georgia Distributor and J&J MOU, Secs. V.a (“The State, through the Trustee, shall provide an annual report detailing: (1) the amounts received by the Trust; (2) the allocation of any awards approved, listing the recipient, amount awarded, programs funded, and disbursement terms; and (3) the amounts actually disbursed. The Trustee shall also include an assessment of how well resources have been used by the State and the Local Governments and Regions to abate opioid addiction, overdose deaths, and the other consequences of the Opioid Crisis. The State shall publish its annual report and all Regional Advisory Council annual reports on its website”), V.d (requiring each Regional Advisory Council to “provide a report annually to the Trustee and [Georgia Opioid Settlement Advisory Commission] detailing: (1) the amount received by each local government within the Region; (2) the allocation of any awards approved, listing the recipient, amount awarded, programs funded, and disbursement terms; and (3) the amounts actually disbursed and approved allocations. Each Participating Local Government within each Region shall provide any information necessary to facilitate such reporting to a single Regional Delegate selected by the Region to provide its annual report”); Georgia Subsequent Settlement MOU, Secs. IV.a (the same requirements except inclusive of funds remitted to the State Treasury and appropriated by the Georgia General Assembly), IV.d (same requirements for Regional Advisory Councils and Participating Local Governments). ↑
See also Notice of Funding Opportunity. Georgia Opioid Crisis Abatement Trust. April 26, 2024. Accessed August 26, 2024 (but noting that “applicants must engage directly with their respective QBG for guidance [on applying for QBG funds], as the application steps will differ from those outlined in this NOFO”). See also Jill Nolin. Georgia to distribute $638M settlement through grant program to combat deadly opioid epidemic. Georgia Recorder. April 9, 2024. Accessed August 26, 2024 (“A total of $638 million will flow into Georgia, with three-fourths of the funds being distributed through the grant process unveiled Monday. Another 25%, or $159 million, will be shared among the city of Atlanta and the state’s largest counties. ... Of the money coming to Georgia, $479 million will be distributed through Georgia Opioid Crisis Abatement Trust using the grant process announced Monday. Groups can either apply for a regional grant or a state level grant if they can show the proposed project has broader impact. ... Each application will go through a multi-layered review process that will land before what’s called the Georgia Opioid Settlement Advisory Commission”). ↑
This share is distributed to Georgia’s local governments:[1]
For certain counties, at least 9.45% of their funds is allocated to the county’s sheriff.[2]
For certain counties, at least 2% of their funds is allocated to the county’s public hospital(s).[3]
For certain counties, at least 1% of their funds is allocated to the county’s school district.[4]
Excepting a 15% set-aside for attorneys’ fees,[5] this share must be spent on the uses described in the national settlement agreement’s (non-exhaustive) Exhibit E, which includes prevention, harm reduction, treatment, recovery, and other strategies.[6]
Georgia’s MOU requires at least 70% of the state’s opioid settlement funds overall to be spent on prospective abatement purposes but does not assign specific abatement thresholds to each share.[7]
Localities decide autonomously (with regional advisory council guidance). Decisionmakers for the counties and municipalities will ultimately decide for themselves how to spend their monies on Exhibit E uses.[8] For example, Cobb County established an Opioid Abatement Advisory Commission to recommend strategies to the county’s board of commissioners.[9]
The local governments of the six regions of the Georgia Department of Behavioral Health and Developmental Disabilities are required to create regional advisory councils, who are each responsible for consulting local governments and the Advisory Commission on best uses of funds within the region.[10]
No, supplantation is not prohibited. Like most states, Georgia does not explicitly prohibit supplantation uses of its opioid settlement funds. This means that the 25% local government share may be spent in ways that replace (or “supplant”) — rather than supplement — existing resources.
Up to each locality (neither public nor intrastate reporting required). Opioid settlement expenditures are not officially published in a centralized location for this share.
Visit OpioidSettlementTracker.com’s Expenditure Report Tracker for an updated collection of states’ and localities’ available expenditure reports.
Not applicable.
State of Georgia and Local Governments: Memorandum of Understanding Concerning National Distributor and Johnson & Johnson Opioid Settlements (“Georgia Distributor and J&J MOU”), Sec. III.a; State of Georgia and Local Governments: Memorandum of Understanding Concerning National Settlements with Teva Pharmaceutical Industries Ltd., Allergan Finance, LLC, Walmart Inc., CVS Health Corporation and CVS Pharmacy, Inc., and Walgreen Co. (“Georgia Subsequent Settlement MOU”), Sec. II.a. ↑
Georgia Distributor and J&J MOU, Sec. III.a(i) (“If a county who is a Participating Local Government under this Memorandum has a sheriff who is a Litigating Subdivision listed in Exhibit C of the National Distributor Settlement”); Georgia Subsequent Settlement MOU, Sec. II.a(i) (substantively the same). ↑
Georgia Distributor and J&J MOU, Sec. III.a(iii) (“If a county who is a Participating Local Government under this Memorandum has a school district which is a Litigating Subdivision listed in Exhibit C”); Georgia Subsequent Settlement MOU, Sec. II.a(iii) (substantively the same). ↑
Georgia Distributor and J&J MOU, Sec. VII.c (setting aside 15% of local governments’ 25% share to fund the Local Government Cost and Fee Fund (attorneys’ fees)); Georgia Subsequent Settlement MOU, Sec. VI.a. See also Georgia Distributor and J&J MOU, Sec. IV.a (summarizing exceptions); Georgia Subsequent Settlement MOU, Sec. III.a (summarizing exceptions); Distributor Settlement Agreement, Sec. I.SS (“Exhibit E provides a non-exhaustive list of expenditures that qualify as being paid for Opioid Remediation. Qualifying expenditures may include reasonable related administrative expenses”). ↑
Georgia Distributor and J&J MOU, Secs. I.a, IV.a; Georgia Subsequent Settlement MOU, Sec. III.a. See also Distributor Settlement Agreement, Sec. I.SS (“Exhibit E provides a non-exhaustive list of expenditures that qualify as being paid for Opioid Remediation. Qualifying expenditures may include reasonable related administrative expenses”). ↑
Resolution No. 21702. Cobb County Board of Commissioners. April 23, 2024. Accessed August 26, 2024. See also Larry Felton Johnson. Cobb’s Opioid Abatement Advisory Council held its first meeting. Cobb Courier. June 16, 2024. Accessed August 26, 2024. ↑
Georgia Distributor and J&J MOU, Secs. III.c(v)-(vi); Georgia Subsequent Settlement MOU, Sec. II.c(iv). See also Regional Advisory Councils (RACs). Georgia Opioid Crisis Abatement Trust website. Accessed August 26, 2024. ↑
Here are the entities that ultimately decide how each of Georgia’s opioid settlement shares are spent:
75% state share: Trustee of the Georgia Opioid Abatement Trust decides majority; Georgia General Assembly and local officials for the city of Atlanta and Cobb, DeKalb, Fulton, and Gwinnett Counties decide remaining
25% local share: decisionmakers for cities and counties