Where do these monies live?

This share is distributed directly to Idaho’s participating cities and counties according the percentages listed in the Exhibit B of Idaho’s opioid settlement allocation agreement.[1] A county and its incorporated cities may agree amongst themselves to modify their intra-county allocation.[2] Non-participating local governments’ allocations are redirected to Idaho’s public health districts.[3]

What can this share be spent on?

With limited exceptions,[4] this share must be spent on the uses described in Exhibit A of Idaho’s opioid settlement allocation agreement,[5] which is identical to the national settlement agreements’ (non-exhaustive) Exhibit E, Schedule B (“Approved Uses”) and includes prevention, harm reduction, treatment, recovery, and other strategies.[6]

Idaho’s agreement reiterates the national settlement agreements’ requirement that at least 70% of the state’s opioid settlement funds overall be spent on prospective abatement purposes but does not assign specific abatement thresholds to each share.[7]

Who ultimately decides how to spend this share (and how)?

Localities decide autonomously (but must report spending). Decisionmakers for cities and counties will ultimately decide for themselves how to spend their monies on Exhibit A uses. Participating local governments may choose to redirect their shares to their public health districts,[8] and all spend is subject to auditing and oversight by the state.[9]

Prior to spending their share of settlement funds, a local government’s governing body (i.e., board of county commissioners or city council) must pass a resolution or include in its budget an authorization of funds for specific approved purposes.[10]

Are supplantation uses prohibited for this share?

No, supplantation is not prohibited. Like most states, Idaho does not explicitly prohibit supplantation uses of its opioid settlement funds. This means that the 40% local government share may be spent in ways that replace (or “supplant”) — rather than supplement — existing resources.

Can I see how this share has been spent?

Yes (public reporting required). Limited details on expenditures are included in local governments’ annual financial reports. Local governments that receive settlement funds must submit to the state Attorney General “an annual financial report specifying the activities and amounts it has funded,” and the state Attorney General must make these reports publicly accessible on its website.[11]

Visit OpioidSettlementTracker.com’s Expenditure Report Tracker for an updated collection of states’ and localities’ available expenditure reports.

What else should I know?

In an August 2023 legal opinion, the Idaho Attorney General noted that settlement funds “be spent [only] on ‘persons with OUD and any co-occurring [substance use disorder/mental health (SUD/MH) conditions,” and that “if a person suffers from SUD, but it is a non-opioid addiction, then funding for that person’s care does not qualify.”[12]

Citations

1. Idaho Opioid Settlement Intrastate Allocation Agreement Between the State of Idaho, Health Districts, and Eligible Local Governments, Secs. B.1, B.4, A.13 (“‘Participating Local Government’ shall mean a county or city within the geographic boundaries of the State who participates in this Agreement and who participates in the National Settlement Agreements and/or Future Resolutions” and includes (1) all counties within the State of Idaho; and (2) cities within the State of Idaho who are either involved in Opioid Litigation or who have a population of over 10,000”). ↑

2. Idaho Opioid Settlement Intrastate Allocation Agreement Between the State of Idaho, Health Districts, and Eligible Local Governments, Sec. B.4. ↑

3. Idaho Opioid Settlement Intrastate Allocation Agreement Between the State of Idaho, Health Districts, and Eligible Local Governments, Sec. B.4. See also Idaho Opioid Settlement Intrastate Allocation Agreement Between the State of Idaho, Health Districts, and Eligible Local Governments, Secs. A.5 (defining “Litigating Participating Local Governments” as “Participating Local Governments that filed an initial complaint in the Opioid Litigation by September 1, 2020”), A.10 (defining “Non-Participating Local Government” as “a city or county who is not a Participating Local Government”), A.13 (defining “Participating Local Government”). ↑

4. Idaho Opioid Settlement Intrastate Allocation Agreement Between the State of Idaho, Health Districts, and Eligible Local Governments, Secs. B.4 (share is deposited “after payment of funds into the Idaho Attorney Fee Back-Stop Fund as provided in Section C.5”), C.5(a) (establishing “a supplemental Idaho Attorney Fee Back-Stop Fund”), C.5(b) (“The Idaho Attorney Fee Back-Stop Fund shall be funded by ten percent (10%) of the LG Share from the National Settlement Agreements and Future Resolutions not exempt under Section C.7. …. If some or all of the Participating Local Governments believe that ten percent (10%) will not be sufficient to cover a deficiency in attorney’s fees those Participating Local Governments can enter into an agreement to hold back an additional amount of up to two and one-half percent (2.5%) of the LG Share allocated to those Participating Local Governments under Exhibit B to be put into the Idaho Attorney Fee Back-Stop Fund. For the avoidance of doubt, … in no circumstance may the overall amount withheld exceed twelve and one-half percent (12.5%)”), C.5(e) (reverting excess funds in Back-Stop Fund to local share), C.7 (providing that Section C’s attorneys’ fees and costs provisions do not apply to monies obtained from Purdue, Mallinckrodt, or “other future resolutions”). ↑

5. Idaho Opioid Settlement Intrastate Allocation Agreement Between the State of Idaho, Health Districts, and Eligible Local Governments, Secs. B.2 (“All Opioid Funds, regardless of allocation, shall only be utilized for Approved Purposes”), A.2 (“‘Approved Purpose(s)’ shall mean those uses identified in the agreed Opioid Abatement Strategies attached as Exhibit A”). ↑

6. The national settlement agreement’s “Approved Uses” list is Schedule B of its Exhibit E, a document that “provides a non-exhaustive list of expenditures that qualify as being paid for Opioid Remediation. Qualifying expenditures may include reasonable related administrative expenses.” Distributor Settlement Agreement, Sec. I.SS. ↑

7. Idaho Opioid Settlement Intrastate Allocation Agreement Between the State of Idaho, Health Districts, and Eligible Local Governments, Sec. B.2 (“no less than eighty-five percent (85%) of the funds must be used for Opioid Remediation with at least seventy percent (70%) of funds used solely for future Opioid Remediation”). Note that other settlement agreements require a higher percentage of funds be spent on opioid remediation. See, e.g., CVS Settlement Agreement, Sec. V(B)(1) (minimum 95.5% opioid remediation spending); Walgreens Settlement Agreement, Sec. V(B)(1) (minimum 95% opioid remediation spending); Walmart Settlement Agreement, Sec. V(B)(1) (minimum 85% opioid remediation spending). ↑

8. Idaho Opioid Settlement Intrastate Allocation Agreement Between the State of Idaho, Health Districts, and Eligible Local Governments, Sec. B.4. ↑

9. Idaho Opioid Settlement Intrastate Allocation Agreement Between the State of Idaho, Health Districts, and Eligible Local Governments, Secs. D.3 (“Opioid Funds are subject to the financial audit requirements for Participating Local Governments and Participating Health Districts as provided under Idaho Law, and shall be separately accounted for in any such audit”), D.6-8 (describing State’s power to reduce payments to participating local governments and health districts that misspend their funds). ↑

10. Idaho Opioid Settlement Intrastate Allocation Agreement Between the State of Idaho, Health Districts, and Eligible Local Governments, Secs. D.2 (“The budget or resolution should: (1) indicate that it is an authorization for expenditure of Opioid Funds, (2) state the specific Approved Purpose the governing body intends to fund as identified in Exhibit A, and (3) state the amount dedicated to each Approved Purpose for a stated period of time”), A.3 (“‘Governing Body’ means (1) for a county, the board of county commissioners; (2) for a municipality, the city council; and (3) for a health district, the district board of health”). See also Idaho Opioid Settlement Intrastate Allocation Agreement Between the State of Idaho, Health Districts, and Eligible Local Governments, Sec. B.6 (providing that state, participating local governments, and participating health districts may also coordinate spending to collect data and best practices on effective uses of funds). ↑

11. Idaho Opioid Settlement Intrastate Allocation Agreement Between the State of Idaho, Health Districts, and Eligible Local Governments, Sec. D.4 (“Each annual financial report must include the following information: (1) the amount of Opioid Funds available at the beginning of the fiscal year; (2) the amount of Opioid Funds received during the fiscal year; (3) the amount of Opioid Funds disbursed or applied during the fiscal year, broken down by Approved Purposes set forth in Exhibit A; (4) the amount of Opioid Funds available at the end of the fiscal year”) ↑

12. Stephanie N. Guyon. “Re: State Opioid Settlement Fund Spending Guidance.” Idaho Office of the Attorney General. August 31, 2023. Accessed August 21, 2024. Note that while the Idaho Attorney General’s legal opinion is based, in part, on state laws that do not apply to the 40% local share, it’s underlying reasoning as to the uses permitted by Exhibit A of Idaho’s opioid settlement allocation agreement would apply equally to funds from this share. ↑

Here are the entities that ultimately decide how each of Idaho’s opioid settlement shares are spent:

• 40% state share: Idaho state legislature and governor

• 40% local share: decisionmakers for cities and counties

• 20% Health Districts share: Public Health Districts’ Boards of Health

Where do these monies live?

The State-Directed Opioid Settlement Fund (“State Fund”) holds the state’s 40% share of opioid settlement funds.[1]

What can this share be spent on?

With limited exceptions,[2] this share must be spent on the uses described in Exhibit A of Idaho’s opioid settlement allocation agreement,[3] which is identical to the national settlement agreements’ (non-exhaustive) Exhibit E, Schedule B (“Approved Uses”) and includes prevention, harm reduction, treatment, recovery, and other strategies.[4]

Idaho’s agreement reiterates the national settlement agreements’ requirement that at least 70% of the state’s opioid settlement funds overall be spent on prospective abatement purposes but does not assign specific abatement thresholds to each share.[5]

Who ultimately decides how to spend this share (and how)?

Idaho Behavioral Health Council guides, state legislature and governor decide. Idaho’s State Fund is appropriated by its state legislature to state agencies based on requests from the governor.[6]

The Idaho Behavioral Health Council (IBHC) describes a multi-step decision-making process:

• IBHC solicits input from state agencies and the public.[7]

• IBHC votes on priority recommendations and submits them to the governor (these recommendations are available on IBHC’s website).[8]

• The governor then incorporates the IBHC’s recommendations into state agencies’ budgets,[9] which the legislature then approves and appropriates.[10]

The state may also coordinate with participating local governments and public health districts to collect information about successful programs and share best practices.[11]

Are supplantation uses prohibited for this share?

No, supplantation is not prohibited. Like most states, Idaho does not explicitly prohibit supplantation uses of its opioid settlement funds. This means that the 40% state share may be spent in ways that replace (or “supplant”) — rather than supplement — existing resources.

Can I see how this share has been spent?

Yes (public reporting required). View the “Funded by the Legislature” resource for each fiscal year on the Idaho Behavioral Health Council’s website. You can also view annual financial reports and non-remediation use reports on the Idaho Attorney General’s website. Idaho’s opioid settlement allocation agreement requires the Idaho Attorney General to post on its website an annual report of expenditures from the 40% state share.[12]

Visit OpioidSettlementTracker.com’s Expenditure Report Tracker for an updated collection of states’ and localities’ available expenditure reports.

What else should I know?

• The IBHC’s recommendations inform more than just settlement spend. For example, based on the IBHC’s recommendations for Fiscal year 2024, “[t]he Legislature funded almost $90 million in behavioral health initiatives,” with only “approximately $2 million provided annually by the state-directed opioid settlement fund.”[13]

• In an August 2023 legal opinion, the Idaho Attorney General noted that settlement funds “be spent [only] on ‘persons with OUD and any co-occurring [substance use disorder/mental health (SUD/MH) conditions,” and that “if a person suffers from SUD, but it is a non-opioid addiction, then funding for that person’s care does not qualify.”[14]

Citations

1. Idaho Opioid Settlement Intrastate Allocation Agreement Between the State of Idaho, Health Districts, and Eligible Local Governments, Secs. B.1, B.3; and Idaho Code Secs. 57-825(1) (“There is hereby established in the state treasury the state-directed opioid settlement fund, to be managed by the state treasurer, Moneys in the fund shall consist of:”), (1)(a) (“Moneys received by the state of Idaho pursuant to settlements and judgments obtained by the state relating to opioids”). ↑

2. Idaho Opioid Settlement Intrastate Allocation Agreement Between the State of Idaho, Health Districts, and Eligible Local Governments, Secs. B.3 (share is deposited “after payment of attorney’s fees and costs to the State’s outside counsel as provided in Section C”), C.4(a) (“As a means of covering any deficiencies in payment for outside counsel retained by the State specifically for Opioid Litigation, five percent (5%) of the State Share and five percent (5%) of the HD Share from the National Settlements and Future Resolutions not exempt under Section C.7 shall be sent to outside counsel prior to payment to the State-Directed Opioid Settlement Fund and the Public Health District Fund. No funds from the LG Share shall be used to pay attorney’s fees for outside counsel for the State”), C.4(c) (“Any remaining funds in the account in excess of the amounts needed to cover the deficiency in attorney’s fees as provided in this Section shall revert back to the State Share and HD Share”), C.7 (providing that Section C’s attorneys’ fees and costs provisions do not apply to monies obtained from Purdue, Mallinckrodt, or “other future resolutions”). ↑

3. Idaho Opioid Settlement Intrastate Allocation Agreement Between the State of Idaho, Health Districts, and Eligible Local Governments, Secs. B.2 (“All Opioid Funds, regardless of allocation, shall only be utilized for Approved Purposes”), A.2 (“‘Approved Purpose(s)’ shall mean those uses identified in the agreed Opioid Abatement Strategies attached as Exhibit A”); Idaho Code Sec. 57-825(2) (“must be used only in accordance with the terms of the applicable settlement or judgment and for purposes relating to opioid abuse prevention and recovery programs”). ↑

4. The national settlement agreement’s “Approved Uses” list is Schedule B of its Exhibit E, a document that “provides a non-exhaustive list of expenditures that qualify as being paid for Opioid Remediation. Qualifying expenditures may include reasonable related administrative expenses.” Distributor Settlement Agreement, Sec. I.SS. ↑

5. Idaho Opioid Settlement Intrastate Allocation Agreement Between the State of Idaho, Health Districts, and Eligible Local Governments, Sec. B.2 (“no less than eighty-five percent (85%) of the funds must be used for Opioid Remediation with at least seventy percent (70%) of funds used solely for future Opioid Remediation”). Note that other settlement agreements require a higher percentage of funds be spent on opioid remediation. See, e.g., CVS Settlement Agreement, Sec. V(B)(1) (minimum 95.5% opioid remediation spending); Walgreens Settlement Agreement, Sec. V(B)(1) (minimum 95% opioid remediation spending); Walmart Settlement Agreement, Sec. V(B)(1) (minimum 85% opioid remediation spending). ↑

6. Idaho Code Sec. 57-825(2) (“Moneys in the state-directed opioid settlement fund shall be used as determined by legislative appropriation, provided that such moneys must be used only in accordance with the terms of the applicable settlement or judgment and for purposes relating to opioid abuse prevention and recovery programs”). See also Idaho Opioid Settlement Fund (“IBHC Opioid Recommendation Process“). Idaho Behavioral Health Council (IBHC) website. Accessed August 21, 2024 (“The IBHC has no spending authority itself. Priorities from the IBHC are submitted to the Governor for incorporation into the state budget process. During this process, the Governor’s Office and the Division of Financial Management work with various state agencies to include suitable recommendations in the Governor’s budget. Final appropriation authority rests with the Legislature. The Joint Financial Appropriations Committee (JFAC) and the Legislative budget staff also review each state agency’s budget and determine how the IBHC recommendations are funded”). ↑

7. See Idaho Opioid Settlement Fund (“IBHC Opioid Recommendation Process“). Idaho Behavioral Health Council (IBHC) website. Accessed August 21, 2024 (for example, For FY 2025, IBHC accepted submissions via email until May 25, 2024). ↑

8. Idaho Code Sec. 57-825(3) (requiring the IBHC to recommend uses of State Fund monies to the Governor and Joint Finance-Appropriations Committee). ↑

9. Idaho Code Sec. 57-825(3) (“Such recommendations must be submitted to the governor on or before September 1 in the year before the legislative session in which the Idaho behavioral health council recommendations are presented to the joint finance-appropriations committee”). ↑

10. Idaho Code Sec. 57-825(2) (“Moneys in the state-directed opioid settlement fund shall be used as determined by legislative appropriation”). See also Idaho Opioid Settlement Fund (“IBHC Opioid Recommendation Process“). Idaho Behavioral Health Council (IBHC) website. Accessed August 21, 2024 (“Final appropriation authority rests with the Legislature. The Joint Financial Appropriations Committee (JFAC) and the Legislative budget staff also review each state agency’s budget and determine how the IBHC recommendations are funded. Due to the variability of funding from the opioid settlement fund and flexibility of the state budgeting process, the IBHC submits its recommendations as priority requests rather than specific budget items”). ↑

11. Idaho Opioid Settlement Intrastate Allocation Agreement Between the State of Idaho, Health Districts, and Eligible Local Governments, Sec. B.6. ↑

12. Idaho Opioid Settlement Intrastate Allocation Agreement Between the State of Idaho, Health Districts, and Eligible Local Governments, Sec. D.3. ↑

13. Idaho Opioid Settlement Fund (“IBHC Opioid Recommendation Process“). Idaho Behavioral Health Council (IBHC) website. Accessed August 21, 2024. ↑

14. Stephanie N. Guyon. “Re: State Opioid Settlement Fund Spending Guidance.” Idaho Office of the Attorney General. August 31, 2023. Accessed August 21, 2024. ↑

Can I provide input on spending?

• 40% state share: Yes (required). The Idaho Behavioral Health Council (IBHC) was required by executive order to develop a statewide strategic plan that “[d]etermine[d] Idaho citizen’s unique needs via broad stakeholder input and known best practices.”[1] The IBHC opioid recommendation process invites “[m]embers of the public and Idaho state agencies … to submit proposals and make recommendations to the Idaho Behavioral Health Council,”[2] and the IBHC’s website also instructs members of the public to email the IBHC with any questions or concerns at IdahoBHC@idcourts.net.

  • IBHC’s fiscal year 2026 recommendations process included a public input period held from April through May 2024,[3] an August deadline by which IBHC must vote on “priority recommendations” and submit its ultimate recommendations to the Governor, and legislative appropriations in spring 2025 for eventual inclusion into agencies’ budgets by July 2026.[4] Public proposals and recommendations for FY2025 and FY2026 are accessible here.

• 40% local share: Up to each locality (not required). Local governments are not required to seek public input on uses of their shares. However, each may choose to seek such input. Watch for opportunities to weigh in on city and county spending decisions, such as city council meetings and town halls.

• 20% health districts share: Up to each health district (not required). Though the state’s seven health districts are not required to seek public input on uses of their opioid settlements specifically, Idaho’s Open Meeting Law requires district boards of health to hold its meetings publicly.[5] While this state law does not explicitly require the district health boards to accept public comments,[6] they may independently choose to do so.[7]

Can I apply for grants?

It depends. As of September 1, 2024, Idaho has not established any settlement-funded grant opportunities for which community organizations are eligible to apply. Local governments and health districts may create grant programs to distribute their share of funds. The existence, parameters, and processes for local settlement grant programs will vary by locality, so stay alert for new opportunities. Visit the Opioid Settlement Community Grants Portals (OpioidSettlementTracker.com and Legal Action Center) for the most up-to-date information on settlement grant opportunities for community organizations.

Where do I go for updates?

• State share: For updates on the Idaho Behavioral Health Council, visit its website and bookmark the IBHC Meetings page, which includes meeting materials for the IBHC and its workgroups. See also the Idaho Attorney General’s Opioid Settlement page.

• Local share: To find updates on the local share, a good starting point is to check the websites for your county board of commissioners, city council, or local health department.

• Health districts share: To find updates on the health districts share, a good starting point is to check the websites for public health districts’ opioid settlement websites (e.g., District 1: Panhandle Health District and District 7: Eastern Idaho Public Health).

What else should I know?

Not applicable.

Citations

1. Idaho Executive Order No. 2020-04 “Creating the Idaho Behavioral Health Council”, Sec. 2(c) (February 19, 2020). ↑

2. IBHC does not, however, appear to offer regular public comment periods at its meetings. (The agendas for those held in January, April, June, and July 2024 did not expressly include a public comment period.) ↑

3. Idaho Opioid Settlement Fund (see “Fiscal Year 2026 Opioid Recommendation Process”). Idaho Behavioral Health Council (IBHC) website. Accessed September 1, 2024 (“April 15 – May 15, 2024”: “IBHC solicits agency proposals and public input”). ↑

4. Idaho Opioid Settlement Fund (see “Fiscal Year 2026 Opioid Recommendation Process”). Idaho Behavioral Health Council (IBHC) website. Accessed September 1, 2024. ↑

5. Idaho Code Secs. 74-202(4)(b) (defining “public agency” to mean “[a]ny regional board, commission, department or authority created by or pursuant to statute”), 39-408 (establishing seven public health districts by statute), 74-203(1) (“all meetings of a governing body of a public agency shall be open to the public and all persons shall be permitted to attend any meeting except as otherwise provided by this act. No decision at a meeting of a governing body of a public agency shall be made by secret ballot”). ↑

6. Idaho Open Meeting Law Manual (see “Question No. 19”). Idaho Office of the Attorney General. January 2023 (“Does the Open Meeting Law require the governing body of a public agency to accept public comments and testimony during meetings? Answer: No. While other statutes, such as the Local Planning Act, may require the solicitation of public comments, the Open Meeting Law does not expressly require the opportunity for public comment”). ↑

7. But see Board of Health – Meeting Agenda and Minute. Public Health Idaho North Central District website. Accessed September 1, 2024 (“No verbal public comments or questions will be accepted during the meeting”). ↑

This Community Guide will describe how Idaho is spending its opioid settlements and whether Idaho is working to ensure community access to opioid settlement funds. Last revised September 1, 2024.

Idaho Attorney General’s Office

(IBHC)

• and

• (“up-to-date action items and prioritized work for the IBHC’s nine priority recommendations”)

Idaho Association of Counties

Idaho Department of Health & Welfare

Has the state established an advisory body for settlement funds?

Yes. The (IBHC) was established by to oversee the development of a statewide strategic plan that “ensure[s] an effective, efficient, recovery-oriented behavioral healthcare system for all Idahoans in need of those services.”[1]

Specifically, the IBHC is required by state law to meet “as necessary” to “make recommendations to the governor and the joint finance-appropriations committee as to how moneys from the state-directed opioid settlement fund should be used.”[2] The is hosted on IBHC’s .

• Public documents. The IBHC maintains online, including its funding recommendations, results of its stakeholder outreach activities, and meeting materials.

• Advisory board. also required the IBHC to create an advisory board to “assist and advise” the IBHC.[3] However, as of September 1, 2024, the advisory board’s display meeting materials for 2020 and 2021 only, making it unclear whether the advisory board remains active.

Is the state advisory body required to include member(s) with lived and/or living experience?

No. The (IBHC) is not required to include member(s) with lived and/or living experience. However, recommends that the IBHC consider the inclusion of “[a]n adult consumer of behavioral health services” and “the [f]amily of a child consumer of behavioral health services” in its advisory board.[4] Current members of the IBHC’s advisory board are listed .[5]

What is the overall membership of the state advisory body?

There are 13 members of the (IBHC), about a quarter of whom represent the criminal legal system. Current IBHC members are listed . describes the composition and appointment of the IBHC’s following ex officio and appointed members (but does not address their term limits, if any):[6]

• Four (4) ex officio members, whose designees may serve in their place:[7]

  • Administrative Director of the State Courts

  • Director of the Idaho Department of Correction

  • Director of the Idaho Department of Health and Welfare

  • Director of the Idaho Department of Juvenile Corrections

• Three (3) governor appointees, including a representative from the Idaho Department of Education, a county elected official, and a member of the public[8]

• Two (2) appointees by the Chief Justice of the Idaho Supreme Court, including a presiding judge of a treatment court and a member of the public[9]

• Four (4) legislative representatives appointed by the majority and minority leadership of each chamber of the state legislature[10]

Are local governments required to establish a settlement advisory body? If so, are local advisory bodies required to include member(s) with lived and/or living experience?

No (up to each locality). Local governments in Idaho are not required to establish opioid settlement advisory bodies. However, local governments may independently choose to establish such bodies to inform opioid settlement spending. For example, the city of Nampa approved a resolution to form an Opioid Settlement Advisory Group to “review proposed allocations of funds and provide feedback on important aspects to ensure prevention, education, and support to the citizens in the community.”[11]

What else should I know?

Citations

2. Idaho Code Sec. 57-825(3). ↑

Where do these monies live?

This share is distributed directly to the Public Health District Fund, which sits in the state treasury and divides itself across the state’s seven regional public health districts.[1] Settlement funds are allocated to each regional health district according to the percentages listed in Exhibit C of Idaho’s opioid settlement allocation agreement.[2] District boards of health are appointed by majority vote of all county commissioners of counties located within the public health district.[3]

Non-participating local governments’ allocations are redirected to Idaho’s public health districts.[4]

What can this share be spent on?

With limited exceptions,[5] this share must be spent on the uses described in Exhibit A of Idaho’s opioid settlement allocation agreement,[6] which is identical to the national settlement agreements’ (non-exhaustive) Exhibit E, Schedule B (“Approved Uses”) and includes prevention, harm reduction, treatment, recovery, and other strategies.[7]

Idaho’s agreement reiterates the national settlement agreements’ requirement that at least 70% of the state’s opioid settlement funds overall be spent on prospective abatement purposes but does not assign specific abatement thresholds to each share.[8]

Who ultimately decides how to spend this share (and how)?

District boards of health decide (but must report spending). The district boards of health for each of the state’s seven regional public health districts will ultimately decide specific expenditures for their district’s opioid settlement-funded “divisions” of the greater Public Health District Fund.[9] These districts work with but are not part of any state agency,[10] and all district expenditures of opioid settlement funds are subject to auditing and oversight by the state.[11]

Prior to spending their share of settlement funds, a participating public health district’s board of health must pass a resolution or include in its budget an authorization of funds for specific approved purposes.[12]

Are supplantation uses prohibited for this share?

No, supplantation is not prohibited. Like most states, Idaho does not explicitly prohibit supplantation uses of its opioid settlement funds. This means that the 20% health districts share may be spent in ways that replace (or “supplant”) — rather than supplement — existing resources.

Can I see how this share has been spent?

Yes (public reporting required). Limited details on expenditures are included in public health districts’ annual financial reports. Public health districts that receive settlement funds must submit to the state Attorney General “an annual financial report specifying the activities and amounts it has funded,” and the state Attorney General must make these reports publicly accessible on its website.[13]

Visit OpioidSettlementTracker.com’s Expenditure Report Tracker for an updated collection of states’ and localities’ available expenditure reports.

What else should I know?

In an August 2023 legal opinion, the Idaho Attorney General noted that settlement funds “be spent [only] on ‘persons with OUD and any co-occurring [substance use disorder/mental health (SUD/MH) conditions,” and that “if a person suffers from SUD, but it is a non-opioid addiction, then funding for that person’s care does not qualify.”[14]

Citations

1. Idaho Opioid Settlement Intrastate Allocation Agreement Between the State of Idaho, Health Districts, and Eligible Local Governments, Secs. A.18, B.1, B.5; Idaho Code Sec. 39-422(1). ↑

2. Idaho Opioid Settlement Intrastate Allocation Agreement Between the State of Idaho, Health Districts, and Eligible Local Governments, Secs. B.1, B.5. See also Idaho Opioid Settlement Intrastate Allocation Agreement Between the State of Idaho, Health Districts, and Eligible Local Governments, Secs. A.4 (“‘Health Districts’ shall mean the seven regional public health districts created pursuant to Title 39, Chapter 4, Idaho Code”), A.14 (“‘Participating Health District’ shall mean a Health District who agrees to participate in this Agreement and in the National Settlement Agreements and/or Future Resolutions”). ↑

3. Idaho Code Sec. 39-411(3). ↑

4. Idaho Opioid Settlement Intrastate Allocation Agreement Between the State of Idaho, Health Districts, and Eligible Local Governments, Sec. B.4. See also Idaho Opioid Settlement Intrastate Allocation Agreement Between the State of Idaho, Health Districts, and Eligible Local Governments, Secs. A.5 (defining “Litigating Participating Local Governments” as “Participating Local Governments that filed an initial complaint in the Opioid Litigation by September 1, 2020”), A.10 (defining “Non-Participating Local Government” as “a city or county who is not a Participating Local Government”), A.13 (defining “Participating Local Government”). ↑

5. Idaho Opioid Settlement Intrastate Allocation Agreement Between the State of Idaho, Health Districts, and Eligible Local Governments, Secs. B.5 (“The HD Share shall be paid directly to the Public Health District Fund after payment of attorney’s fees and costs to the State’s outside counsel as provided in Section C”), C.4(a) (“As a means of covering any deficiencies in payment for outside counsel retained by the State specifically for Opioid Litigation, five percent (5%) of the State Share and five percent (5%) of the HD Share from the National Settlements and Future Resolutions not exempt under Section C.7 shall be sent to outside counsel prior to payment to the State-Directed Opioid Settlement Fund and the Public Health District Fund”), C.4(c) (“Any remaining funds in the account in excess of the amounts needed to cover the deficiency in attorney’s fees as provided in this Section shall revert back to the State Share and HD Share”), C.7 (providing that Section C’s attorneys’ fees and costs provisions do not apply to monies obtained from Purdue, Mallinckrodt, or “other future resolutions”). ↑

6. Idaho Opioid Settlement Intrastate Allocation Agreement Between the State of Idaho, Health Districts, and Eligible Local Governments, Secs. B.2 (“All Opioid Funds, regardless of allocation, shall only be utilized for Approved Purposes”), A.2 (“‘Approved Purpose(s)’ shall mean those uses identified in the agreed Opioid Abatement Strategies attached as Exhibit A”). ↑

7. The national settlement agreement’s “Approved Uses” list is Schedule B of its Exhibit E, a document that “provides a non-exhaustive list of expenditures that qualify as being paid for Opioid Remediation. Qualifying expenditures may include reasonable related administrative expenses.” Distributor Settlement Agreement, Sec. I.SS. ↑

8. Idaho Opioid Settlement Intrastate Allocation Agreement Between the State of Idaho, Health Districts, and Eligible Local Governments, Sec. B.2 (“no less than eighty-five percent (85%) of the funds must be used for Opioid Remediation with at least seventy percent (70%) of funds used solely for future Opioid Remediation”). Note that other settlement agreements require a higher percentage of funds be spent on opioid remediation. See, e.g., CVS Settlement Agreement, Sec. V(B)(1) (minimum 95.5% opioid remediation spending); Walgreens Settlement Agreement, Sec. V(B)(1) (minimum 95% opioid remediation spending); Walmart Settlement Agreement, Sec. V(B)(1) (minimum 85% opioid remediation spending). ↑

9. Idaho Code Sec. 39.422(1) (“Each division within the fund will be under the exclusive control of its respective district board of health and no moneys shall be withdrawn from such division of the fund unless authorized by the district board of health or its authorized agent”). ↑

10. Public Health Districts. Idaho Department of Health & Welfare website. Accessed August 21, 2024 (“Idaho public health districts work closely with Health and Welfare and other state and local agencies. Each district has a board of health appointed by county commissioners within that region. The districts are not part of any state agency”). ↑

11. Idaho Opioid Settlement Intrastate Allocation Agreement Between the State of Idaho, Health Districts, and Eligible Local Governments, Secs. D.3 (“Opioid Funds are subject to the financial audit requirements for Participating Local Governments and Participating Health Districts as provided under Idaho Law, and shall be separately accounted for in any such audit”), D.6-8 (describing State’s power to reduce payments to participating local governments and health districts that misspend their funds). ↑

12. Idaho Opioid Settlement Intrastate Allocation Agreement Between the State of Idaho, Health Districts, and Eligible Local Governments, Secs. D.2 (“The budget or resolution should: (1) indicate that it is an authorization for expenditure of Opioid Funds, (2) state the specific Approved Purpose the governing body intends to fund as identified in Exhibit A, and (3) state the amount dedicated to each Approved Purpose for a stated period of time”), A.3 (“‘Governing Body’ means (1) for a county, the board of county commissioners; (2) for a municipality, the city council; and (3) for a health district, the district board of health”). See also Idaho Code Sec. 39.422(1) (“Each division within the fund will be under the exclusive control of its respective district board of health and no moneys shall be withdrawn from such division of the fund unless authorized by the district board of health or its authorized agent”); Idaho Opioid Settlement Intrastate Allocation Agreement Between the State of Idaho, Health Districts, and Eligible Local Governments, Sec. B.6 (providing that state, participating local governments, and participating health districts may also coordinate spending to collect data and best practices on effective uses of funds). ↑

13. Idaho Opioid Settlement Intrastate Allocation Agreement Between the State of Idaho, Health Districts, and Eligible Local Governments, Sec. D.4 (“Each annual financial report must include the following information: (1) the amount of Opioid Funds available at the beginning of the fiscal year; (2) the amount of Opioid Funds received during the fiscal year; (3) the amount of Opioid Funds disbursed or applied during the fiscal year, broken down by Approved Purposes set forth in Exhibit A; (4) the amount of Opioid Funds available at the end of the fiscal year”) ↑

14. Stephanie N. Guyon. “Re: State Opioid Settlement Fund Spending Guidance.” Idaho Office of the Attorney General. August 31, 2023. Accessed August 21, 2024. Note that while the Idaho Attorney General’s legal opinion is based, in part, on state laws that do not apply to the 20% health district share, it’s underlying reasoning as to the uses permitted by Exhibit A of Idaho’s opioid settlement allocation agreement would apply equally to funds from this share. ↑