• 50% Commonwealth share: the .

• 50% local share: decisionmakers for counties, consolidated local governments, urban-county governments, and cities

This Community Guide will describe how Kentucky is spending its opioid settlements and whether Kentucky is working to ensure community access to opioid settlement funds. Last revised September 21, 2026.

• 50% Commonwealth share: Yes (not required). Though the Commonwealth is not required to seek public input on uses of its share,[1] the in-person meetings of the (KYOAAC) and its subcommittees include dedicated public comment periods.[2] The KYOAAC is required by state law to meet at least twice each calendar year but has consistently met more frequently.[3]

  • KYOAAC has also occasionally held listening sessions across the state to provide an opportunity for community members to discuss the overdose crisis and recovery programming. Details for both KYOAAC’s regular meetings and listening sessions are available on the KYOAAC’s .

Where do these monies live?

The Opioid Abatement Trust Fund holds the state government’s 50% share of opioid settlement funds (i.e., the “Commonwealth Share”).[1]

What can this share be spent on?

With limited exceptions,[2] funds from the Commonwealth Share must be spent on the uses described in state law, KRS 15.291(5).[3] This state law outlines:

• 28 categories of permissible forward-looking abatement projects.[4] These categories vary widely and include, for example, projects to provide access to opioid-abatement-related housing (e.g., supportive housing) and “evidence-informed treatment, recovery support, harm reduction, or other appropriate services to individuals with OUD and co-occurring SUD/MH issues” who are justice-involved.

• 3 categories of permissible reimbursement expenses: outpatient and residential treatment services, emergency response, and naloxone administration.[5]

Funds may also be used for "[a]ny other project deemed appropriate for opioid-abatement purposes by the [Kentucky Opioid Abatement Advisory Commission].”[6]

Kentucky Opioid Abatement Advisory Commission decides. The (KYOAAC) ultimately decides specific expenditures for the Commonwealth Share and distributes the funds via grants.[7] Both non-governmental entities such as community-based and non-profit organizations and government agencies may apply for grants through KYOAAC’s .[8]

The application process is as follows:

• An application is submitted via the KYOAAC grant portal.

• KYOAAC reviews applications on a continuous basis according to a range of ,[9] such as:

  • Applicant’s record of effectively utilizing settlement funds previously.

  • Geographic reach and extent to which project would reach un(der)served. populations.

No, supplantation is not prohibited. Like most states, Kentucky does not explicitly prohibit supplantation uses of its opioid settlement funds. This means that the 50% Commonwealth share may be spent in ways that replace (or “supplant”) — rather than supplement — existing resources.

Yes (public reporting required). Visit the KYOAAC’s and , which provide information on expenditures of both state and local opioid settlement funds. The dashboards include grant amounts, recipients, county, funding source, and category of funding. Kentucky state law requires KYOAAC to maintain a website on which it publishes funding awards and reports of funding.[11]

Visit OpioidSettlementTracker.com’s for the most up-to-date information on states’ and localities’ available expenditure reports.

Not applicable.

1. Ky. Rev. Stat. Secs. 15.293(2), (3)(a). ↑

2. See Ky. Rev. Stat. Secs. 15.293(9)(a) (“The Department of Law may recover its reasonable costs of litigation from the moneys received under subsection (3)(a) of this section”), (9)(b) (“The Department of Law may recover any direct costs, including employee time, used to perform or administer the duties required by this section and KRS 15.291 from the moneys received under subsection (3)(a) of this section. The Department of Law shall report all such recovered costs to the commission no less than annually”). ↑

3. Ky. Rev. Stat. Secs. 15.291(5), 15.293(5). ↑

Where do these monies live?

Kentucky's local government share is distributed to its “counties, consolidated local governments, urban-county governments, and cities.”[1] Funds are distributed according to a pre-determined formula.[2] The Kentucky Association of Counties (KACo) recommends that local governments keep these monies in a separate special account/fund.

What can this share be spent on?

With limited exceptions,[3] each local government receiving funds from this share must spend at least 85% of the funds on the uses described in state law, KRS 15.291(5).[4] This state law outlines:

• 28 categories of permissible forward-looking abatement projects.[5] These categories vary widely and include, for example, projects to provide access to opioid-abatement-related housing (e.g., supportive housing) and “evidence-informed treatment, recovery support, harm reduction, or other appropriate services to individuals with OUD and co-occurring SUD/MH issues” who are justice-involved.

• 3 categories of permissible reimbursement expenses: outpatient and residential treatment services, emergency response, and naloxone administration.[6]

Funds may also be used for "[a]ny other project deemed appropriate for opioid-abatement purposes by the [Kentucky Opioid Abatement Advisory Commission].”[7]

Local governments decide autonomously (but must report on spending). Though decision-makers for the counties, consolidated local governments, urban-county governments, and cities decide for themselves how to spend their share,[8] they must submit annual certifications to the Kentucky Opioid Abatement Advisory Commission (KYOAAC) with detailed information on settlement spending.[9]

No, supplantation is not prohibited. Like most states, Kentucky does not explicitly prohibit supplantation uses of its opioid settlement funds. This means that counties, cities, and towns may spend their shares in ways that replace (or “supplant”) — rather than supplement — existing resources.

Yes (no public reporting required, only intrastate). Visit the Kentucky Opioid Abatement Advisory Commission’s and , which provide information on expenditures of both state and local opioid settlement funds. The dashboards include grant amounts, recipients, county, funding source, and category of funding. The KYOAAC requires that local governments submit an annual certification report that includes detailed information about local settlement spending.[13] KYOAAC compiles information from these reports for publication on its public dashboards, though this is not required.

Visit OpioidSettlementTracker.com’s for the most up-to-date information on states’ and localities’ available expenditure reports.

According to a from the Kentucky Center for Economic Policy, over 90% of opioid settlement funds received by local governments in Kentucky remained unspent at the end of fiscal year 2025.[15]

1. Ky. Rev. Stat. Secs. 15.293(4)(a) (“The [opioid abatement trust] fund shall not consist of the remaining fifty percent (50%) of all proceeds received by the Commonwealth, counties, consolidated local governments, urban-county governments, and cities of the Commonwealth”), (4)(b) (“To the extent that the negotiation class distribution metrics would result in a city receiving a total of less than $30,000 in any individual settlement, judgment, or bankruptcy proceeding, the payment is instead made to the county, consolidated local government, or urban-county government in which that city is located”). ↑

2. Ky. Rev. Stat. Sec. 15.293(4)(b) (“paid to counties, consolidated local governments, urban-county governments, and cities of the Commonwealth in accordance with the negotiation class distribution metrics established in In re National Prescription Opiate Litigation, MDL No. 2804, Case No. 1:17-md-02804, in the United States District Court for the Northern District of Ohio unless precluded by order of a court of competent jurisdiction in connection with any settlement, judgment, or bankruptcy proceeding”). This formula is based on factors such as population, amount of prescription opioid sales, number of people with pain reliever use disorder, and number of overdose deaths. ↑

Has the state established an advisory body for settlement funds?

Yes. The Kentucky Opioid Abatement Advisory Commission (KYOAAC) was created by state law.[1] The KYOAAC is responsible for awarding funds from the 50% Commonwealth share.[2]

In addition to its grantmaking role,[3] the KYOAAC is empowered to develop spending priorities,[4] work with state agencies and other stakeholders to develop project metrics,[5] recommend state or local policy changes,[6] and create regulations to carry out its duties.[7]

The KYOAAC is required to meet at least twice each calendar year,[9] though in practice it has met more frequently,[10] and its meetings must be conducted in accordance with Kentucky’s Open Meetings Law.[11]

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

Not necessarily. One appointee of the KYOAAC must represent “victims of the opioid crisis,”[12] but the law does not say that person must themselves have lived and/or living experience. A list of KYOAAC members may be found here.

What is the overall membership of the state advisory body?

The composition of KYOAAC’s nine (9) voting and two (2) non-voting members is defined by state law to include:[13]

• State Attorney General or their designee, who serves as chair[14]

• State Treasurer or their designee[15]

• Secretary of the Cabinet for Health and Family Services (CHFS) or their designee[16]

• Member appointed by the University of Kentucky from its HEALing Communities Study team[17]

• Member appointed by the state Attorney General representing “victims of the opioid crisis”[18]

• Member appointed by the state Attorney General representing “the drug treatment and prevention community”[19]

• Member appointed by the state Attorney General representing law enforcement[20]

• Two (2) citizens at large appointed by the state Attorney General[21]

• Two (2) non-voting members appointed by the Speaker of the Kentucky House of Representatives and President of the Kentucky Senate, respectively[22]

KYOAAC members’ terms are served concurrently with their respective offices (state Attorney General, Treasurer, and CHFS Secretary, or their designees), staggered two-year terms (the remaining six voting members), or at the pleasure of their appointing authorities (non-voting legislative appointees).[23] Current KYOAAC members are listed .

No (up to each locality). Local governments in Kentucky are not required to establish opioid settlement advisory bodies. However, localities may choose to establish advisory councils that include members with lived and/or living experience to help ensure that settlement spending reflects community priorities.

Vital Strategies and the Kentucky Center for Economic Policy developed that Kentucky counties can use to establish a county opioid abatement advisory council to advise and make recommendations on the allocation and use of local opioid settlement funds. The model ordinance recommends county advisory councils include multiple members with lived and/or living experience.

The Kentucky Attorney General (AG) exercises a notable level of influence over the KYOAAC’s composition. In addition to serving as a voting Chair, the AG appoints five of the remaining eight voting members.[24]

1. Ky. Rev. Stat. Sec. 15.291(1). ↑

2. Ky. Rev. Stat. Secs. 15.291(5). ↑

3. See , , and . ↑

4. Ky. Rev. Stat. Sec. 15.291(6)(b). ↑