Based on the best available evidence, all of Hawai’i's opioid settlement funds, including the 15% local government share, is held in a trust jointly administered by the Hawai’i Department of the Attorney General and Hawai’i State Department of Health (DOH).[1] Apart from Kalawao County’s de minimis share,[2] these monies are transferred to Hawai’i’s counties via intergovernmental agreements between DOH and each county according to the following percentages:[3]
Hawai’I County, 18.2671692501%
Kaua’i County, 5.7006273580%
Maui County, 13.9979969296%
City and County of Honolulu, 62.0307563109%
This share must be spent on the uses described in Exhibit A of Hawai’i’s State-Local Agreement,[4] which is largely identical to the national settlement agreements’ Exhibit E, Schedule B (“Approved Uses”) and includes prevention, harm reduction, treatment, recovery, and other strategies.[5]
Uniquely, Hawai’i’s State-Local Agreement requires spending to address non-opioid substance use: 85% of funds must be spent on “opioid-related remediation,” while 15% of funds must be spent on “other substances” (specifically, “treatment and prevention, consistent with Exhibit A, except not limited to opioids”).[6]
Localities decide. Decisionmakers for Hawai’i, Kaua’i, Maui, Honolulu counties will ultimately decide specific expenditures for their shares, while Kalawao County’s 0.00345% will be spent by the state.[7]
The City and County of Honolulu, for example, entered into a separate memorandum of agreement (Honolulu MOA) with the state’s Department of Health (DOH) to direct its share for fiscal year 2022-2023 to its emergency services department. The Honolulu MOA’s Exhibit 2 describes the county’s planned expenditures, which fall into staffing, equipment purchasing, public education campaigns, lab training, and other categories.[8]
Hawai’i County directed its share to the Hawaiʻi Island Fentanyl Task Force, a cross-sector coalition “dedicated to reducing overdose deaths and the negative impacts of fentanyl on Hawaiʻi Island,”[9] and the Big Island Substance Abuse Council, a longstanding non-profit treatment provider and the Taskforce’s fiscal sponsor.[10]
No, supplantation is not prohibited. Like most states, Hawai‛i does not explicitly prohibit supplantation uses of its opioid settlement funds. This means that counties, cities, and towns may spend their shares 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.
Although a November 2023 presentation by the state Department of Health emphasized county autonomy, local government press and media reports suggest that expenditures from this share are still subject to the state government’s spending processes.[11]
Memorandum of Agreement Between the State of Hawai’i and Local Governments on Proceedings Relating to the Settlement of Opioid Litigation (“Hawai’i State-Local Agreement”), Sec. B.2(b) (“Each year, 15% of the Total Opioid Settlement Funds shall be spent by the State at the local government level”); Addendum to Memorandum of Agreement Between the State of Hawai’i and Local Governments on Proceedings Relating to the Settlement of Opioid Litigation (“Addendum to Hawai’i State-Local Agreement”), Sec. B (providing that “[t]he MOA shall apply to Phase 2 National Settlements in all respects”); Memorandum of Agreement Between Department of Health and Honolulu Emergency Services Department (“State-Honolulu Settlement MOA”), Recitals Sec. C (describing state’s opioid settlement funds as “held in a trust and jointly administered by the Department of the Attorney General and the Department of Health”). ↑
Hawai’i State-Local Agreement, Sec. B.2(b) (“15% of the Total Opioid Settlement Funds shall be spent by the State at the local government level according to the following percentages: … With respect to these funds, the County of Hawai'i, the County of Kaua'i, the County of Maui, and the City and County of Honolulu may each direct and determine how their respective share is spent”); Addendum to Hawai’i State-Local Agreement, Sec. B (applying terms to Phase 2 settlements). See, e.g., State-Honolulu Settlement MOA (describes transfer of Honolulu County’s share for fiscal year 2022-2023); October 17, 2023 Meeting Minutes. Council of the County of Maui’s Government Relations, Ethics, and Transparency Committee. Accessed August 28, 2024 (“I’m requesting approval of this intergovernmental agreement between the County of Maui and the State of Hawai‘i. This agreement basically will release the settlement funds arising out of the national opioid litigation against several pharmaceutical companies that are named in the memorandum of agreement that was attached. The total share of Maui County’s recovery at this time is estimated to be $1,245,720. Those monies are earmarked for remediation programs for the treatment primarily of opioid addictions. The recovery is based on our percentage of the population of 13.99. The State is…was the party to the national settlement agreement. The money is earmarked to be spent between 3 and 15 years. 1,058,000 is for the remediation specifically of opioid addiction, and the remainder 186,858 is for treatment of other addictions. The monies are scheduled to be funneled through the Department of Health, but it will be spent entirely at Maui County’s discretion”); County of Hawai’i Resolution No. 402-24. January 24, 2024. Accessed August 28, 2024 (authorizing the county mayor to enter into an agreement with the State of Hawai’i Department of Health for funds “derived from Opioid Settlement Funds”). See also Matthew Leonard. Hawaii’s Opioid Settlement Fund Is Growing And, After Delays, Starting To Be Spent. Honolulu Civil Beat. May 28, 2024. Accessed August 28, 2024 (reporting on “appointment of a full-time project coordinator to manage Hawaii’s opioid settlement trust fund,” which “has set the process of allocating money to the counties for drug treatment efforts on a faster track”). ↑
Hawai’i State-Local Agreement, Secs. A (defining “Opioid Remediation” to mean Exhibit A), B.1 (“All Opioid Settlement Funds shall be spent to address substance abuse in the State subject to the following conditions: (i) 85% shall be spent on opioid-related remediation, consistent with Exhibit A; and (ii) 15% shall be spent on remediation regarding other substances (i.e., treatment and prevention, consistent with Exhibit A, except not limited to opioids”); Addendum to Hawai’i State-Local Agreement, Sec. B (applying terms to Phase 2 settlements). ↑
The national settlement agreement’s “Approved Uses” list is Schedule B of its Exhibit E. ↑
Hawai’i State-Local Agreement, Sec. B.2(b) (“15% of the Total Opioid Settlement Funds shall be spent by the State at the local government level according to the following percentages: … With respect to these funds, the County of Hawai'i, the County of Kaua'i, the County of Maui, and the City and County of Honolulu may each direct and determine how their respective share is spent. … The Local Governments’ authority to direct and determine how their respective shares are spent is a material term of this Agreement”); Addendum to Hawai’i State-Local Agreement, Sec. B (applying terms to Phase 2 settlements). See also Hawai’i Opioid Settlement Advisory Committee, Slide 13 (presentation for Committee of Health & Homelessness Informational Briefing). Hawai’i State Department of Health. November 15, 2023. Accessed August 28, 2024 (noting “Autonomy of Counties”). See generally Ashley Mizuo. State works to spend millions of dollars to address opioid addiction. Hawai’i Public Radio. June 4, 2024. Accessed August 28, 2024 (“Michael Miranda, leader of the Kauaʻi task force and a representative on the Opioid Settlement Advisory Committee, explained that Kauaʻi had its first meeting two weeks after the workshop and has already pulled together treatment providers, prosecutors, police, fire department and community members. ‘We're trying to recruit people from different sectors and it's slowly growing with every meeting that we've had,’ Miranda said. ‘We're focusing on prevention, harm reduction and treatment — trying to get people into treatment and manage their substance misuse’”). ↑
State-Honolulu Settlement MOA, Exhibit 2 (“Utilization of County Share”). ↑
Hawai‘i County formalizes support for Hawai‘i Island Fentanyl Task Force and BISAC. County of Hawai‘i press release. July 15, 2024. Accessed September 1, 2024. ↑
History. BISAC website. Accessed September 1, 2024 (describing the council’s establishment in 1964) and Our Mo‘olelo. Hawai‘i Island Fentanyl Task Force website. Accessed September 1, 2024 ("In July 2023, the Big Island Substance Abuse Council (BISAC) became our 501(c)(3) fiscal sponsor. With their financial vitality, BISAC entered into an MOA with the County to receive $460,900.00 of Opioid Settlement funds over the next two fiscal years. This funding will allow us to expand our efforts in all areas of our operation drastically”). ↑
See Matthew Leonard. Hawaii’s Opioid Settlement Fund Is Growing And, After Delays, Starting To Be Spent. Honolulu Civil Beat. May 28, 2024. Accessed August 28, 2024 (“That memorandum, however, cedes all the spending power to the state, even at the local level, and that formula has fueled Hansen’s frustration at the small amount of money released so far. Hansen is one of eight state and county representatives on the Opioid Settlement Advisory Committee. … In the case of Hawaii, 85% of the money is allocated to the state. But the remaining 15% for the counties still needs to go through the state spending process at the direction of the county, creating the logjams, Hansen said”). See also Hawai‘i County formalizes support for Hawai‘i Island Fentanyl Task Force and BISAC. County of Hawai‘i press release. July 15, 2024. Accessed September 1, 2024. ↑