The Iowa Abatement Fund holds 50% of the state’s opioid settlement funds.[1]
With limited exceptions,[2] this share must be spent on the uses described in the national settlement agreements’ (non-exhaustive) Exhibit E[3] — which includes prevention, harm reduction, treatment, recovery, and other strategies. Additionally, at least 75% of this share must be spent on Exhibit E Schedule A’s “core strategies.”[4]
State law specifically provides that Iowa Abatement Fund monies may be used to support the opioid antagonist medication fund,[5] which funds the purchase, maintenance, and replacement of opioid antagonist medications for first responders.[6]
State legislature decides. The Iowa state legislature ultimately decides specific expenditures for this share.[7]
No, supplantation is not prohibited. Like most states, Iowa does not explicitly prohibit supplantation uses of its opioid settlement funds. This means that the 50% state share may be spent in ways that replace (or “supplant”) — rather than supplement — existing resources.
No (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.
Decisionmakers for both the state and local shares have been slow to spend: lawmakers have struggled for years to pass plans to spend the 50% state share,[8] and much of the 50% local share remained unspent in fiscal year 2023 as well.[9]
Iowa Opioid Allocation Memorandum of Understanding, Sec. B.1 (“50% to the Iowa Abatement Fund”); Iowa Code Sec. 12.51(1) (“An opioid settlement fund is created in the office of the treasurer of state. … The state portion of any moneys paid to the state as a result of a national settlement of litigation with entities that manufactured, marketed, sold, distributed, dispensed, or promoted opioids, made in connection with claims arising from the manufacturing, marketing, selling, distributing, dispensing, or promoting of opioids, shall be deposited in the fund. This subsection does not apply to such moneys paid to the state that are earmarked for or otherwise required to be transferred or distributed to counties, cities, or other local governmental entities”). ↑
Iowa Opioid Allocation Memorandum of Understanding, Sec. B.9 (“The Parties may use up to 2.5% of the Iowa Abatement Share and the LG Abatement Share for administrative costs for Opioid Related Expenditures”). ↑
Iowa Opioid Allocation Memorandum of Understanding, Secs. A.3 (defining “Opioid Related Expenditure” to mean the national settlement agreements’ Exhibit E), B.8 (“Except as provided herein, 100% of the Iowa Abatement Share and the LG Abatement Share, regardless of allocation, shall be utilized only for Opioid Related Expenditures incurred after the Effective Date of this MOU”). See also Iowa Opioid Allocation Memorandum of Understanding, Exhibit 1 (incorporating the entirety of Exhibit E). ↑
Iowa Opioid Allocation Memorandum of Understanding, Sec. B.8 (“The Parties agree that at least 75% of the Iowa Abatement Share and the LG Abatement Share shall be utilized for only the ‘Core Strategies’ listed in Schedule A of Exhibit 1 to this MOU,” i.e., Schedule A of the national settlement agreements’ Exhibit E). Schedule A of Exhibit E provides 9 categories of opioid remediation interventions. See Exhibit E E-1 through E-3. ↑
Iowa Code Sec. 12.51(2) (“Moneys in the fund shall only be used pursuant to appropriations from the fund by the general assembly for purposes of abating the opioid crisis in this state, which may include but are not limited to the purposes specified in section 135.190A for moneys in the opioid antagonist medication fund”). ↑
Iowa Code Sec. 135.190A(2). ↑
Iowa Code Sec. 12.51(2) (“Moneys in the fund shall only be used pursuant to appropriations from the fund by the general assembly for purposes of abating the opioid crisis in this state, which may include but are not limited to the purposes specified in section 135.190A for moneys in the opioid antagonist medication fund”). See also the many, many news articles reporting on Iowa’s legislative gridlock as preventing expenditures of settlement funds, e.g., Caleb McCullough. Iowa’s opioid settlement funds unspent after legislators fail to agree. The Gazette. April 27, 2024. Accessed August 8, 2024 (“The central disagreement, lawmakers said, was over the need for an advisory council to administer the treatment funding. House lawmakers said that was an important piece of the proposal — to ensure oversight over how the funds are spent”); Opioid settlement failure will be costly. The Gazette. May 3, 2024. Accessed August 8, 2024 (“the advisory council concept became a point of contention between the Senate and House. The Senate took out the advisory council, but an agreement was not reached before adjournment. So Iowa continues to lack treatment beds and adequate programs addressing drug addiction. The money will remain unspent until lawmakers take another crack in January”); Gov. Reynolds announces $17.5 million investment in opioid prevention and recovery programs. Iowa Governor press release. May 16, 2024. Accessed August 8, 2024 (“’I’m disappointed that a bill to spend a portion of Iowa’s opioid settlement money never reached my desk this session. As a result, $47.5 million remain unused in the fund,’ said Governor Reynolds. ‘Since legislation was not passed, I’m leveraging federal funds to make this investment in the health and well-being of Iowans’”). ↑
Caleb McCullough. Iowa’s opioid settlement funds unspent after legislators fail to agree. The Gazette. April 27, 2024. Accessed September 1, 2024 (“[F]or two years, lawmakers have not passed a plan to fund treatment and recovery operations,” and “[t]he central disagreement, lawmakers said, was over the need for an advisory council to administer the treatment funding”). ↑
Natalie Krebs. Iowa opioid settlement dollars are starting to come in, but most remain unspent. Iowa Public Radio. July 2, 2024. Accessed September 1, 2024 (“Seventy-two of Iowa’s [99] counties didn’t spend a dime in fiscal year 2023, according to records from the Attorney General’s office”). ↑
This share is distributed directly to Iowa’s counties according to Exhibit 2,[1] and each are required to set up separate funds to hold their opioid settlement proceeds separate from other local monies.[2]
Counties may agree to sub-allocate their funds to their cities or to the state’s Iowa Abatement Fund, provided that sub-allocated amounts are also spent on opioid-related expenditures.[3] Cities and counties may also combine their amounts.[4]
Excepting administrative costs and attorneys’ fees,[5] this share must be spent on the uses described in the national settlement agreement’s (non-exhaustive) Exhibit E,[6] which includes prevention, harm reduction, treatment, recovery, and other strategies. Additionally, at least 75% spent on Exhibit E Schedule A’s “core strategies.”[7] Localities may not use monies from this share to reimburse costs incurred prior to the settlements.[8]
Localities decide autonomously (but must report expenditures and are subject to audit). Decisionmakers for Iowa’s local governments will ultimately decide for themselves how to spend their monies on Exhibit E uses.[9] Each local fund is subject to audit.[10]
No, supplantation is not prohibited. Like most states, Iowa does not explicitly prohibit supplantation uses of its opioid settlement funds. This means that the 50% local share may be spent in ways that replace (or “supplant”) — rather than supplement — existing resources.
Eventually (public reporting required). Localities that receive settlement funds from the local share “must prepare and file a public annual report describing [its settlement] expenditures.”[11] As of publication,[12] these annual reports have not yet been made publicly available, either on the Iowa Attorney General’s Opioid Settlement Information website or otherwise.
Visit OpioidSettlementTracker.com’s Expenditure Report Tracker for an updated collection of states’ and localities’ available expenditure reports.
Iowa’s Opioid Allocation Memorandum of Understanding allows localities to securitize their share of opioid settlement funds.[13] This means that a locality may choose to sell its right to future settlement payments in exchange for a smaller sum provided up front.
Iowa Opioid Allocation Memorandum of Understanding, Secs. A.1 (defining “Local Government” to mean “all Iowa Counties (regardless of population) and cities, villages, and towns located within the geographic boundaries of the State of Iowa with a population exceeding 10,000”), A.6 (defining “Participating Local Government” to mean “any Local Government that agrees to be bound by a Settlement by Participation Agreement necessary to effectuate that Settlement”), B.1 (“50% to Participating Local Governments … (‘LG Abatement Share’)”), B.4 (“The LG Abatement Share shall be distributed in direct payments to the Counties that are Participating Local Governments”). County allocations for some of the settlements may be found here. ↑
Iowa Opioid Allocation Memorandum of Understanding, Sec. C.1 (“Every Participating Local Government that receives a Direct Distribution Amount shall create a separate fund on its financial books and records that is designated for the receipt and expenditure of the entity’s Direct Distribution Amount, called the ‘LG Abatement Fund’”). ↑
Iowa Opioid Allocation Memorandum of Understanding, Secs. B.6, B.7. Any suballocation must be made “according to an agreement between the County and the City requiring the use of the suballocated funds for an Opioid Related Expenditure and further providing that a use of funds inconsistent with an Opioid Related Expenditure shall make the funds subject to recoupment and otherwise disqualify the City from a future sub-allocation.” Iowa Opioid Allocation Memorandum of Understanding, Sec. B.7. ↑
Iowa Opioid Allocation Memorandum of Understanding, Sec. C.5. ↑
Iowa Opioid Allocation Memorandum of Understanding, Secs. B.1 (“50% to Participating Local Governments, less fees and costs allocated to the Iowa Backstop Fund as set forth in Section D”), B.9 (“The Parties may use up to 2.5% of the Iowa Abatement Share and the LG Abatement Share for administrative costs for Opioid Related Expenditures”), D.1 (regarding attorneys’ fees), D.3 (establishing the Iowa Backstop Fund for attorneys’ fees), D.7 (providing for 15% of total Net Direct Distribution Amount for all Litigating Local Governments to be deposited into the Iowa Backstop Fund and prohibiting monies from the Iowa Abatement Share from being used to pay attorneys’ fees). ↑
Iowa Opioid Allocation Memorandum of Understanding, Secs. A.3 (defining “Opioid Related Expenditure” to mean the national settlement agreements’ Exhibit E), B.8 (“Except as provided herein, 100% of the Iowa Abatement Share and the LG Abatement Share, regardless of allocation, shall be utilized only for Opioid Related Expenditures incurred after the Effective Date of this MOU”), C.2 (“Funds in a LG Abatement Fund may be expended by a Participating Local Government only for Opioid Related Expenditures”). See also Iowa Opioid Allocation Memorandum of Understanding, Exhibit 1 (incorporating the entirety Exhibit E). ↑
Iowa Opioid Allocation Memorandum of Understanding, Sec. B.8 (“The Parties agree that at least 75% of the Iowa Abatement Share and the LG Abatement Share shall be utilized for only the ‘Core Strategies’ listed in Schedule A of Exhibit 1 to this MOU,” i.e., Schedule A of the national settlement agreement’s Exhibit E). Schedule A of Exhibit E provides nine (9) categories of opioid remediation interventions. See Exhibit E E-1 through E-3. ↑
Iowa Opioid Allocation Memorandum of Understanding, Sec. C.2 (“For avoidance of doubt, funds in a LG Abatement Fund may not be expended for costs, disbursements or payments made or incurred prior to the Settlement”). ↑
Iowa Opioid Allocation Memorandum of Understanding, Secs. B.4 (describing “direct payments” to counties), B.5-7 (describing counties’ powers to forego their shares or enter into agreements to redistribute funds, further implying their fiscal autonomy). See also Iowa Opioid Allocation Memorandum of Understanding, Secs. B.6-7 (providing for optional sub-allocation of counties’ amounts to cities, thereby requiring us to expand the reference to localities here to “local governments” [rather than merely “counties”]). See, e.g., Lee County (reporting debate over board of supervisors’ uses of funds), Greene County (reporting on board of supervisors’ vote to spend settlement funds). ↑
Iowa Opioid Allocation Memorandum of Understanding, Sec. C.3 (“If any such audit reveals an expenditure inconsistent with the terms of this MOU, the Participating Local Government shall immediately redirect the funds associated with the inconsistent expenditure to an Opioid Related Expenditure”). ↑
Iowa Opioid Allocation Memorandum of Understanding, Sec. C.4.a (“The report shall include, though is not limited to, a narrative description of the funded programs; the dollar amount provided; and progress and/or outcomes of funded programs”). See also Iowa Opioid Allocation Memorandum of Understanding, Sec. C.4.c (“The State may utilize the reports in order to report to the public on the use and effectiveness of the Opioid Funds in addressing the opioid crisis in Iowa”). ↑
September 1, 2024. ↑
Iowa Opioid Allocation Memorandum of Understanding, Sec. C.6. ↑
Here are the entities that ultimately decide how each of Iowa’s opioid settlement shares are spent:
50% state share:
50% local share: decisionmakers for counties (and potentially cities)