The Opioid Restitution Fund (Fund) holds 75% of Maryland’s opioid settlement funds,[1] including the 45% of funds allocated for Targeted Abatement Grants.[2]
Monies from this share must be spent on the forward-looking abatement uses specified in state law and in a manner that’s consistent with the national settlement agreements’ (non-exhaustive) Exhibit E.[3] The permitted uses specified in Maryland state law include:
Eleven (11) evidence-based programs, services, supports, and resources for substance use disorder (SUD) prevention, harm reduction, treatment, or recovery.[4]
“[S]upporting community-based nonprofit recovery organizations that provide nonclinical substance use recovery support services.”[5]
Evidence-informed SUD prevention, harm reduction, treatment, or recovery pilot programs or demonstration studies that are not evidence-based, if approved by the Maryland Opioid Restitution Fund Advisory Council.[6]
Evaluations of the effectiveness and impact of Fund expenditures.[7]
Qualifying charter counties decide autonomously; other localities decide with Maryland Department of Health approval. Targeted Abatement Grants (45% of Maryland’s total opioid settlement funds) are non-competitive grants made to two types of local governments:
Qualifying Charter Counties — Baltimore City and Anne Arundel, Baltimore, Frederick, Harford, Howard, Montgomery, and Prince George — receive their monies automatically.[8] Importantly, Baltimore City receives funds only from the statewide settlement with Walmart, as it declined to participate in the other statewide settlement agreements.[9]
The remaining 51 subdivisions each receive their monies through a Maryland Department of Health (MDOH) grant program after approval of their Local Abatement Plans.[10] Approval of Local Abatement Plans is limited to MDOH ensuring funds are used for permitted uses that constitute future opioid remediation and that the subdivision “has the capability of carrying out the specific program for which the grant is to be made.”[11] Subdivisions that do not participate in this process will have their funds reabsorbed by their respective county.[12]
Yes, supplantation is prohibited. State law provides that monies expended from Opioid Restitution Fund — which houses this share — are “supplemental to and not intended to take the place of funding that otherwise would be appropriated for programs and services.”[13] This means that this share must only be used in ways that supplement — rather than replace (or “supplant”) — existing resources.
Yes (public reporting required). View annual public reports here. Maryland state law requires the governor to annually report to the Maryland General Assembly all expenditures from the Opioid Remediation Fund, including Targeted Abatement Grants.[14]
Visit OpioidSettlementTracker.com’s Expenditure Report Tracker for an updated collection of states’ and localities’ available expenditure reports.
Not applicable.
Md. State Finance and Procurement Code Ann. Secs. 7-331(b) (establishing the Opioid Restitution Fund), (e) (providing that the fund includes all opioid settlement revenues received by the state); State-Subdivision Agreement Between the State of Maryland and Local Governments on Proceeds Relating to the Settlement of Opioids Litigation (“2022 Maryland State-Subdivision Agreement”), Secs. II(h) (requiring the state to maintain a Targeted Abatement Subfund in the Opioids Restitution Fund), IV(a)(1) (directing 15% state share to the Opioid Restitution Fund), IV(a)(2) (directing 60% of the state’s annual settlement payments to the Targeted Abatement Subfund). See also State-Subdivision Agreement Between the State of Maryland and Participating Local Governments on Proceeds from Settlement of Opioids Litigation Against Teva, Allergan, Walmart, and Walgreens (“2023 Maryland State-Subdivision Agreement”), Sec. I (providing that except as otherwise specified, the terms of the 2022 Maryland State-Subdivision Agreement apply to the settlements with Teva, Allergan, Walmart, and Walgreens). ↑
2022 Maryland State-Subdivision Agreement, Secs. IV(a)(2), IV(a)(2)(B); 2023 Maryland State-Subdivision Agreement, Sec. I (applying terms to later settlements). ↑
Md. State Finance and Procurement Code Ann. Secs. 7-331(f) (listing permitted uses of monies in the Opioid Restitution Fund), (i)(2) (prohibiting use of Fund monies for administrative expenses except as specified in subsection (f)); 2022 Maryland State-Subdivision Agreement, Secs. I(h) (defining “Permitted Use” to “mean any use permitted by the National Settlement Agreement and Section 7-331(f) of the State Finance and Procurement Article, as amended from time to time. Except as specifically provided otherwise by this Agreement, Permitted Uses shall be limited to Future Opioid Remediation”) (emphasis added), III(a) (requiring all settlement funds be used for “Permitted Uses that serve the purpose of Future Opioid Remediation” unless otherwise authorized), III(b) (authorizing reimbursement uses for only a portion of the 25% local share); IV(a)(2)(B) (requiring Targeted Abatement Grants be used for “Permitted Uses”); 2023 Maryland State-Subdivision Agreement, Sec. I (applying terms to later settlements). See also Distributor Settlement Agreement, Sec. 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”). See also Emily Keller. “Re: State Finance and Procurement Article § 7–331 (Chapter 537 of the Acts of 2019)—Opioid Restitution Fund Expenditure Report (MSAR # 14240).” Maryland Opioid Operational Command Center. November 1, 2023. Accessed August 27, 2024 (“to determine whether expenditures are approved and to identify the procedural and allocation requirements that apply to particular funds deposited in the ORF, the Maryland Department of Health must examine the requirements of Section 7-331, of the particular settlement agreement or judgment from which funds were derived, and of any applicable state-subdivision agreement entered by the Attorney General with one or more of the State’s subdivisions”). ↑
Md. State Finance and Procurement Code Ann. Sec. 7-331(f)(1). Note that administrative expenses are specifically authorized for four of the eleven enumerated uses: (1) “expanding the Heroin Coordinator Program”; (2) “organizing primary and secondary school education campaigns to prevent opioid use”; (3) “enforcing the laws regarding opioid prescriptions and sales”; and (4) “research regarding and training for substance use treatment and overdose prevention.” Md. State Finance and Procurement Code Ann. Secs. 7-331(f)(1)(iv), (f)(1)(vii)-(x). ↑
Md. State Finance and Procurement Code Ann. Sec. 7-331(f)(2). ↑
Md. State Finance and Procurement Code Ann. Sec. 7-331(f)(3) (providing that the Opioid Restitution Fund Advisory Council must both “determine[] that emerging evidence supports the distribution of money for the pilot program or that there is a reasonable basis for funding the demonstration study with the expectation of creating an evidence-based program” and “approve[] the use of money for the pilot program or demonstration study”). ↑
Md. State Finance and Procurement Code Ann. Sec. 7-331(f)(4) (“evaluations of the effectiveness and outcomes reporting for substance use disorder abatement infrastructure, programs, services, supports, and resources for which money from the Fund was used, including evaluations of the impact on access to harm reduction services or treatment for substance use disorders and the reduction in drug-related mortality”). ↑
2022 Maryland State-Subdivision Agreement, Secs. I(k) (defining “Qualifying Charter Counties”), IV(a)(2)(B) (“These non-competitive grants shall be made … to the Local Abatement Funds of participating Qualifying Charter Counties within 30 days of the later of the deposit of Annual Payments in the Targeted Abatement Subfund or a Qualifying Charter County’s establishment of a Local Abatement Fund pursuant to this Agreement”); 2023 Maryland State-Subdivision Agreement, Sec. I (applying terms to later settlements). ↑
See City of Baltimore Joins Settlement in Walmart Opioid Suits. Baltimore City Mayor press release. February 29, 2024. Accessed August 27, 2024; Baltimore City Executive Order – Administration of Baltimore City Opioid Restitution Funds. August 29, 2024. Accessed September 4, 2024. See also Settlement Overview. Maryland’s Office of Overdose Response website. Accessed August 27, 2024 (“Baltimore City is pursuing independent litigation against Johnson & Johnson and is not eligible to receive funding through Maryland’s settlement agreement. However, non-government organizations that operate in Baltimore City will be eligible to receive discretionary abatement funds for eligible uses through the Janssen settlement, which will be distributed through a competitive process”). ↑
2022 Maryland State-Subdivision Agreement, Secs. I(j) (defining “Qualifying Exhibit G Subdivision” to mean “a subdivision listed on Exhibit G of the National Settlement Agreement that is not a Special District”), IV(a)(2)(B) (“These non-competitive grants shall be made … to other participating Qualifying Exhibit G Subdivisions upon the Secretary’s approval of a grant application demonstrating that a Local Abatement Fund for deposit of Settlement Proceeds has been established, that the Settlement Proceeds will be used under a Local Abatement Plan that ensures the use of funds for Future Opioids Remediation through a Permitted Use, and that the Qualifying Exhibit G Subdivision has the capability of carrying out the specific program for which the grant is to be made. … A Subdivision receiving a grant under this subparagraph … must renew it every five years”); 2023 Maryland State-Subdivision Agreement, Sec. I (applying terms to later settlements). See also Settlement Overview. Maryland’s Office of Overdose Response website. Accessed August 27, 2024 (“The remaining 51 subdivisions must submit “Local Abatement Plans” and participate in a block grant program administered by the Maryland Department of Health to receive their portion of these funds”). ↑
2022 Maryland State-Subdivision Agreement, Sec. IV(a)(2)(B) (“A grant application under this subparagraph (ii) that meets these requirements must be approved by the Secretary”) (emphasis added); 2023 Maryland State-Subdivision Agreement, Sec. I (applying terms to later settlements). ↑
2022 Maryland State-Subdivision Agreement, Sec. IV(a)(2)(B) (“The Settlement Proceeds of any Qualifying Exhibit G Municipal Subdivision that does not apply for a grant shall revert to the County in which the Subdivision is located”); 2023 Maryland State-Subdivision Agreement, Sec. I (applying terms to later settlements). ↑
Md. State Finance and Procurement Code Ann. Sec. 7-331(i)(1). Vital Strategies and OpioidSettlementTracker.com have confirmed with the Maryland Office of Overdose Response that this provision operates as a substantive prohibition on supplantation uses rather than a mere expression of intent. ↑
Md. State Finance and Procurement Code Ann. Sec. 7-331(j)(3). ↑