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

• 55% Remediation Trust Fund share: Governor’s Opioid Overdose Prevention and Recovery Steering Committee

• 25-33% local government share: decisionmakers for counties, cities, and other municipalities

• 12-20% state share: the “State” (not further specified)

Where do these monies live?

Fifty-five percent (55%) of Illinois’ settlement monies are directed to the Illinois Opioid Remediation Fund (Remediation Fund) administered by the Illinois Department of Human Services (IDHS).[1]

What can this share be spent on?

With limited exceptions,[2] this share must be spent on the abatement uses described in Exhibit B of the Illinois Opioid Allocation Agreement,[3] which is identical to the national settlement agreements’ (non-exhaustive) Exhibit E and includes prevention, harm reduction, treatment, recovery, and other strategies.[4]

Remediation Fund monies must be spent on forward-looking abatement uses and in ways that “equitabl[y]” support abatement services in the seven service regions listed in Exhibit C of the Illinois Opioid Allocation Agreement.[5]

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

Opioid Remediation Advisory Board guides, Governor’s Opioid Overdose Prevention and Recovery Steering Committee decides, Office of Opioid Settlement Administration administers. The Illinois Opioid Remediation Advisory Board (Advisory Board or “IORAB”) and the Governor’s Opioid Overdose Prevention and Recovery Steering Committee (Steering Committee) both play a role in determining Remediation Fund expenditures.

• The Advisory Board, a sub-committee of the Steering Committee,[6] provides non-binding recommendations for forward-looking abatement expenditures to the Steering Committee.[7] The Advisory Board’s working groups help it develop recommendations,[8] as does the Illinois Office of Opioid Settlement Administration within IDHS.[9]

• The Governor’s Steering Committee, which oversees implementation of the State Overdose Action Plan (SOAP),[10] then makes the final determination on how to spend Remediation Fund monies.[11]

The Advisory Board’s January 2024 meeting minutes describe this decision-making and implementation process for Remediation Fund expenditures:[12]

1. The Illinois Department of Human Services Division of Substance Use Prevention and Recovery (IDHS/SUPR) “reviews pending recommendations to determine if they are an existing recommendation, duplicate existing efforts, or can be funded by existing resources.”

2. If the Advisory Board “votes to approve a recommendation, the recommendation moves to the Steering Committee and the Attorney General's (AG) Office for certification of the recommendations.”[13]

3. After the AG’s Office certifies the recommendation, how the strategy is implemented (e.g., “a NOFO, intergovernmental agreement or funding expansion”) is determined by the Illinois Grant Accountability and Transparency Act (GATA) and procurement rules.

4. “SUPR experts develop the statement of work (SOW) that describes grant requirements,” the Regional Care Coordination Agency (RCCA) develops a notice of funding opportunity, and the RCCA selects grantees.

Are supplantation uses prohibited for this share?

No, supplantation is not prohibited. Like most states, Illinois does not explicitly prohibit supplantation uses of its opioid settlement funds. This means that the 55% Remediation Fund 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 (neither public nor intrastate reporting required). Visit the Illinois Opioid Settlements Initiative’s Settlements Information page to see approved recommendations and expenditures.

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

What else should I know?

Not applicable.

Citations

1. Illinois Opioid Allocation Agreement, Sec. 3.A(c); 30 Ill. Comp. Stat. Ann. 105/6z-133(b). ↑

2. 30 Ill. Comp. Stat. Ann. 105/6z-133(e) (“The Attorney General may use a portion of the proceeds in the Illinois Opioid Remediation State Trust Fund for administrative costs associated with opioid-related litigation, demands, or settlements”). ↑

3. Illinois Opioid Allocation Agreement, Sec. 3.A(c); 30 Ill. Comp. Stat. Ann. 105/6z-133(a)(1), (d). ↑

4. See also Illinois Opioid Remediation Advisory Board (“About the IORAB”). Illinois Department of Human Services website. Accessed August 21, 2024 (“These opioid core abatement strategies align with recommendations in the State Overdose Action Plan (SOAP) [] a comprehensive, equity-centric outline for combatting the opioid epidemic”). ↑

5. Illinois Opioid Allocation Agreement, Sec. 3.A(c) (“funds disbursed from the Remediation Fund shall go to support abatement uses that provide services in each of the seven regions identified in Exhibit C, with the allocation of resources being equitable across regions, taking into consideration population as well as other factors relevant to opioid abatement, including rates of Opioid Use Disorder, Overdose Deaths, and amounts of opioids shipped into each region as measured in Morphine Milligram Equivalents”); Illinois Exec. Order No. 2022-19, Recitals (“55% of these proceeds are allocated to the Illinois Opioid Remediation State Trust Fund … and must be used for forward-looking opioid abatement purposes”) and Agreement 3.A(c) (describing Remediation Fund uses). ↑

6. Illinois Exec. Order No. 2022-19, Sec. 4. ↑

7. Illinois. Exec. Order No. 2022-19, Sec. 4 (“The Board shall make advisory recommendations to the Committee regarding the forward-looking Approved Abatement Program uses of monies in the Fund as set out in the Agreement”); Illinois Opioid Allocation Agreement, Sec. 3.A(c) (“A Remediation Fund Advisory Board shall be appointed to provide nonbinding recommendations regarding the administration and distribution of the Illinois Remediation Fund”) ↑

8. Illinois Exec. Order No. 2022-19, Sec. 7 (describing the Advisory Board’s ability to create working groups). See also Build, Amplify, Support, Empower (BASE): Notice of Funding Opportunity Technical Assistance Session, Slide 4. Illinois Opioid Settlements Initiative presentation. February 29, 2024. Accessed August 22, 2024 (illustrating hierarchy between Steering Committee, IORAB, and “Working Groups”). ↑

9. Illinois Exec. Order No. 2022-19, Sec. 1 (establishing the Office of Opioid Settlement Administration within IDHS); Illinois Opioid Settlements Initiative website (“About OOSA“). Accessed August 22, 2024 (“The [Office] is led by the Statewide Opioid Settlement Administrator, who works collaboratively with the Illinois Opioid Remediation Advisory Board … to develop non-binding funding recommendations to present to the Illinois Opioid Prevention and Recovery Steering Committee”). More specifically, the Office of Opioid Settlement Administration resides within IDHS’ Division of Substance Use, Prevention and Recovery (“SUPR”). Illinois Exec. Order No. 2022-19, Sec. 2. ↑

10. Illinois Exec. Order No. 2020-02, Sec. II (“The purpose of the Steering Committee is to … oversee[] the ongoing implementation of the SOAP”). See also Illinois Opioid Crisis Response Advisory Council. Illinois Department of Human Services website. Accessed August 22, 2024 ("The Illinois Opioid Crisis Response Advisory Council is convened by the Illinois Department of Human Services/Division of Substance Use Prevention and Recovery (IDHS/SUPR). … The purpose of the Illinois Opioid Crisis Response Advisory Council is to inform the ongoing implementation of the State Opioid Action Plan (SOAP)”). ↑

11. Illinois Exec. Order No. 2022-19, Sec. 4 (“The Committee shall consider the Board’s advisory recommendations and make the final determination as to the uses of Fund monies”). ↑

12. IORAB Minutes 01.18.24. Illinois Opioid Remediation Advisory Board website. January 18, 2024. Accessed August 22, 2024. See also IORAB Minutes 1.12.2023 (“Discussion of IORAB Structure and Process”). Illinois Opioid Remediation Advisory Board website. January 12, 2023. Accessed August 22, 2024. ↑

13. See Illinois Exec. Order No. 2022-19, Sec. 4 (“The Attorney General or their designee will certify compliance with the terms of the Agreement, the Settlements, and any court order prior to expenditure”) ↑

Where do these monies live?

Twenty-five percent (25%) of Illinois’ opioid settlement funds is paid to local governments in two distributions:[1]

• 10% is allocated directly to counties according to of the Illinois Opioid Allocation Agreement.[2]

• 15% is allocated to municipalities and townships according to of the Illinois Opioid Allocation Agreement.[3]

Additionally, a between the state and city of Chicago directs 40% of the state’s share of the Distributor and Janssen settlements — 8% of Illinois’ total monies from these settlements — to the city.[4] This means that a total of 33% of Illinois’ funds from the Distributor and Janssen settlements are allocated to local governments.

What can this share be spent on?

Illinois’ Opioid Allocation Agreement requires at least 70% of its settlement proceeds to be used on “specified” opioid remediation or abatement programs,[5] and local governments’ spending restrictions depend on their sources of funds:

• The 10% allocated to counties according to must be spent on uses “to support opioid remediation programs in their community.”[6]

• The 15% allocated to municipalities and townships according to from the Distributor and Janssen settlements are not restricted for use on approved abatement programs.[7] For other settlements (e.g., CVS, Walgreens), at least a portion of monies in this allocation must be spent on abatement uses because these settlement agreements require a higher percentage of funds be spent on opioid remediation.[8]

• The 8% of the state share from the Distributor and Janssen settlements allocated to Chicago must be spent by the city on approved abatement programs.[9]

The state’s is identical to the national settlement agreements’ and includes prevention, harm reduction, treatment, recovery, and other strategies.

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

Localities decide autonomously (but some must report spend). Decisionmakers for counties, municipalities, and townships, including the city of Chicago, will ultimately decide for themselves how to spend their funds from this share.[10] Counties must report their spending to the state,[11] and the city of Chicago must likewise report spending of the 8% of the state share from the Distributor and Janssen settlements allocated to it.[12] No such reporting obligations apply to other municipalities and townships.

Are supplantation uses prohibited for this share?

No, supplantation is not prohibited. Like most states, Illinois 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.

Can I see how this share has been spent?

Up to each locality (no public reporting required, only some intrastate). Opioid settlement expenditures are not officially published in a centralized location for this share. Additionally, while counties and the city of Chicago must report some or all their settlement spending to the state,[13] there is no requirement that these reports be published in a publicly accessible location. There are no reporting requirements applicable to funds from this share allocated to municipalities and townships.[14]

What else should I know?

Not applicable.

Citations

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

Has the state established an advisory body for settlement funds?

Yes. There are two state-level advisory bodies:

• . Illinois’ required the creation of the (IORAB),[1] and the IORAB was formally established by in 2022.[2] The IORAB is a sub-committee of the (Steering Committee),[3] and its role is to provide “non-binding recommendations regarding the administration and distribution of the Illinois Remediation Fund.”[4] These recommendations are presented to the greater Steering Committee, which is ultimately responsible for making “the final determination as to the uses of Fund monies.”[5]

  • “Equitable allocation.” When recommending expenditures, the IORAB is required to work toward “ensur[ing] an equitable allocation of resources to all parts of the State” by taking rates of overdose death, opioid use disorder (OUD) rates, and other factors into account.[6]

  • Working groups. The IORAB may establish working groups to support its efforts.[7] Working groups are chaired by IORAB members and may contain both IORAB members and other individuals appointed by the Secretary of the Illinois Department of Human Services “in consultation with” the Illinois Attorney General.[8] As of September 1, 2024, the IORAB has three working groups: the ,[9] the ,[10] and the .[11] Details on prior and upcoming meetings of these workgroups are available on their respective websites, and all provide space for public participation.

  • OOSA. The Office of Opioid Settlement Administration (OOSA), housed within the Department of Human Services (DHS) Division of Substance Use, Prevention and Recovery, supports the IORAB with its duties.[12] The OOSA is responsible for presenting to the IORAB an “integrated and complementary approach to opioid use disorder and reduce and address trauma within [Illinois’] communities,” and to use technical assistance providers to engage “individuals with lived expertise, subject-matter experts, and other interested parties to develop a comprehensive [opioid abatement] plan for [IORAB’s] consideration.”[13]

  • Term limits. Excepting certain initial appointments, terms for IORAB members are generally four years.[14]

• . The (Steering Committee) was established by in 2020 in order to guide the work of the (Council), to liaise between Council stakeholders and the governor’s office, and to oversee the implementation of the Statewide Opioid Action Plan (SOAP).[15] The Steering Committee receives non-binding recommendations from the IORAB and makes the ultimate decisions on expenditures from the 55% Remediation Fund Share.[16]

  • Duties beyond opioid settlements. More broadly, the Steering Committee’s duties include working with state agencies and other stakeholders to establish local recovery-oriented systems of care (ROSC) councils in communities disproportionately impacted by the overdose crisis, evaluating existing and recommending new harm reduction strategies for inclusion in subsequent SOAPs, working with the Council’s to address social and racial disparities, and creating a comprehensive website that consolidates state agencies’ OUD resources, among other duties.[17]

  • Term limits. Steering Committee members are not subject to explicit term limits.

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

It varies.

• The : No. The IORAB is not required to include a member with lived and/or living experience.[18]

• : Yes. The Steering Committee must include “[a] person with lived experience of OUD, to be appointed by the Governor and compensated appropriately for their time devoted to the work of the Steering Committee.”[19]

What is the overall membership of the state advisory body?

• The 11 non-voting members are directors of state agencies or appointees of legislative leadership.[21]

• Lieutenant Governor or their designee[23]

• Secretary of the Illinois Department of Human Services or their designee[24]

• Directors of the Illinois Department of Public Health, Illinois Department of Healthcare and Family Services, and Illinois State Police or their designees[25]

• A person with lived experience of OUD who is appointed by the Governor[27]

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 Illinois are not required to establish opioid settlement advisory bodies to recommend uses of their combined 25-33% share. However, localities may independently choose to establish advisory councils that include members with lived and/or living experience to help ensure that settlement spending reflects community priorities.

What else should I know?

Not applicable.

Citations

Can I provide input on spending?

• 55% Remediation Fund share: Yes (required). The Illinois Opioid Remediation Advisory Board (IORAB) and the Opioid Overdose Prevention and Recovery Steering Committee (Steering Committee) work together to determine uses for this 55% share.[1] Both entities are subject to Illinois’ Open Meetings Act — which states that the public “shall be permitted an opportunity to address public officials under the rules established and recorded by the public body”[2] — and have included dedicated public comment periods in their meetings.[3]

  • The IORAB meets quarterly, and minutes from its prior meetings and upcoming meeting details can be found here.

  • The Steering Committee is required to meet at least quarterly,[4] and minutes from its prior meetings and upcoming meeting details can be found here.

• 25-33% local government share: Generally, yes. Though local governments are not required to seek public input as to opioid settlement spending specifically, Illinois’ Open Meetings Act states that the public “shall be permitted an opportunity to address public officials under the rules established and recorded by the public body.”[5] Local governments each may choose to seek additional input too. Watch for opportunities to weigh in on city and county spending decisions, such as city council meetings and town halls.

• 12-20% state share: No opportunities available (not required). The state has not established recurring opportunities for the public to provide input on uses of its 12% share.[6] The state is only required to spend a portion of this share on approved abatement programs.[7]

Can I apply for grants?

Yes. Illinois has established settlement-funded grant opportunities for which community organizations are eligible to apply. Visit the Illinois Opioid Settlements Initiative’s Funding Opportunities website to view current and past grant opportunities. Local governments also 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?

• For updates on the Remediation Fund share, visit the Illinois Opioid Settlement Initiative, Illinois Opioid Remediation Advisory Board, and Governor’s Opioid Prevention and Recovery Steering Committee websites, and sign up for email updates from the Regional Care Coordination Agency here.

• To find updates on the local share, a good starting point is to check the websites for your county commission, city council, or local health department. See also Illinois Opioid Settlement Initiative’s Settlements Information page.

• For updates on the state share, visit the Illinois Opioid Settlement Initiative’s Settlements Information page.

What else should I know?

Not applicable.

Citations

1. The IORAB provides non-binding spending recommendations to the Steering Committee, which then makes the final decision on use of the funds. Illinois Exec. Order No. 2022-19, Sec. 4. See also Illinois Opioid Allocation Agreement, Sec. 3.A(c). ↑

2. Illinois Exec. Order No. 2022-19, Sec. 16 (“The Board and any Working Groups created by the Board shall be subject to the provisions of applicable law, including without limitation the Illinois Open Meetings Act, 5 ILCS 120”); Illinois Exec. Order No. 2020-02, Sec. V (the steering committee was set to expire in 2023 but was renewed by Illinois Exec. Order No. 2023-08) (“In addition to whatever policies or procedures it may adopt, the Steering Committee shall be subject to the provisions of the … Open Meetings Act (5 ILCS 120)”); 5 Ill. Comp. Stat. Ann. 120/2.06(g) (“Any person shall be permitted an opportunity to address public officials under the rules established and recorded by the public body”); 5 Ill. Comp. Stat. Ann. 120/1.02 (defining “[p]ublic body” to mean “all legislative, executive, administrative or advisory bodies of the State, counties, townships, cities, villages, incorporated towns, school districts and all other municipal corporations, boards, bureaus, committees or commissions of this State, and any subsidiary bodies of any of the foregoing including but not limited to committees and subcommittees which are supported in whole or in part by tax revenue, or which expend tax revenue, except the General Assembly and committees or commissions thereof”). For more background on the requirements of Illinois’ Open Meetings Act, check out this resource. ↑

3. See, e.g., 07.18.2024 Agenda. Illinois Opioid Remediation Advisory Board. Accessed September 1, 2024; Opioid Steering Committee Agenda 08.23.24. Governor's Opioid Overdose Prevention and Recovery Steering Committee. Accessed September 1, 2024. ↑

4. Illinois Exec. Order No. 2020-02, Sec. IV(3), subsequently renewed by Illinois Exec. Order No. 2023-08. ↑

5. 5 Ill. Comp. Stat. Ann. 120/2.06(g) (“Any person shall be permitted an opportunity to address public officials under the rules established and recorded by the public body”); 5 Ill. Comp. Stat. Ann. 120/1.02 (defining “[p]ublic body” to mean “all legislative, executive, administrative or advisory bodies of the State, counties, townships, cities, villages, incorporated towns, school districts and all other municipal corporations, boards, bureaus, committees or commissions of this State, and any subsidiary bodies of any of the foregoing including but not limited to committees and subcommittees which are supported in whole or in part by tax revenue, or which expend tax revenue, except the General Assembly and committees or commissions thereof”). For more background on the requirements of Illinois’ Open Meetings Act, check out this resource. ↑

6. If you see this change, email tips@opioidsettlementtracker.com. There is no legal requirement for decision-makers to seek public input on uses of this share. ↑

7. Illinois Opioid Allocation Agreement, Sec. 3.A(a). ↑

Where do these monies live?

Twenty percent (20%) of Illinois’ opioid settlement monies are allocated to the state.[1] A separate agreement between the state and city of Chicago directs 40% of the state’s share of the Distributor and Janssen settlements — 8% of Illinois’ total monies from these settlements — to the city.[2] This leaves the state’s share at 12% for the Distributor and Janssen settlements (and at 20% for all other settlements).

What can this share be spent on?

The Illinois Opioid Allocation Agreement requires the state to spend at least a quarter of its original 20% share — just 5% — on the approved abatement programs listed in Exhibit B,[3] which is identical to the national settlement agreements’ (non-exhaustive) Exhibit E and includes prevention, harm reduction, treatment, recovery, and other strategies.[4]

For settlement agreements entered after the Distributor and Janssen settlements (e.g., CVS, Walgreens), the state will need to spend a greater percentage of this share on abatement uses to meet the minimum remediation spending requirements in those agreements.[5]

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

“State” decides (and reports partial spend). Beyond requiring that “the State” track and report only the monies from this share spent “to support opioid remediation programs,”[6] neither state law nor the state’s allocation agreement otherwise outline how or for what this share is used.[7]

Are supplantation uses prohibited for this share?

No, supplantation is not prohibited. Like most states, Illinois does not explicitly prohibit supplantation uses of its opioid settlement funds. This means that the 12-20% 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?

No (no public reporting required, only some intrastate). Opioid settlement expenditures are not officially published in a centralized location for this share. While the state is required to “track and report all spending used to support opioid remediation programs,”[8] there is no requirement that these reports be published in a publicly accessible location.

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

What else should I know?

Not applicable.

Citations

1. Illinois Opioid Allocation Agreement, Sec. 3.A(a). Neither state law nor the state’s allocation agreement define “the state” to mean a specific entity, agency, department, or otherwise. ↑

2. Agreement Relating to the Distributor and J&J Opioid Settlements (“State-Chicago Agreement”), Sec. (c) (entered by the State of Illinois and City of Chicago on January 26, 2022). ↑

3. Illinois Opioid Allocation Agreement, Sec. 3.A(a). ↑

4. Distributor Settlement Agreement 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”). ↑

5. 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). would be impossible, for example, for Illinois to satisfy the 95% opioid remediation spending requirement in the Walgreens settlement unless at least ¾ of the state share (i.e., 15% of Illinois’ total funds from the settlement) were spent on abatement uses. ↑

6. Illinois Opioid Allocation Agreement, Sec. 3.A(a). The Allocation Agreement does not further define “the State.” ↑

7. See, e.g., 30 Ill. Comp. Stat. Ann. 105/6z-133 (“In addition to proceeds directed by the Attorney General into the Illinois Opioid Remediation State Trust Fund, the Attorney General may, at his or her discretion, direct additional funds received from any opioid-related settlement into the DHS State Projects Fund”). ↑

8. Illinois Opioid Allocation Agreement, Sec. 3.A(a). ↑

Illinois Opioid Settlements Initiative

• Settlements Information

Illinois Department of Human Services

• Illinois Opioid Remediation Advisory Board

• Governor’s Opioid Prevention and Recovery Steering Committee