70% Abatement Share
Where do these monies live?
According to Mississippi’s MOU, seventy percent (70%) of Mississippi’s opioid settlement funds are directed to the University of Mississippi Medical Center’s (UMMC) Center for Addiction Medicine (CAM) “to establish a new multidisciplinary program … dedicated to both short-term and long-term opioid abatement.”[1]
In July 2024, Mississippi Attorney General Lynn Fitch referred to a “two-prong proposal” to allocate this 70% abatement share differently.[2] As proposed by the AG, only half of this 70% abatement share would be directed to CAM as per the MOU, and the other half “would become an annual grant program through which a committee established by the Legislature would distribute funds to [abatement] projects.”[3] There is some indication that this share must pass through the state’s newly created Opioid Settlement Fund prior to its use by UMMC as well.[4] Both advocates and leaders within the state await finalization of Mississippi’s opioid settlement spending scheme.[5]
What can this share be spent on?
The national Distributor and Janssen settlement agreements require states to spend at least 70% of their proceeds on prospective abatement uses (i.e., “future Opioid Remediation”), as illustrated by the (non-exhaustive) Exhibit E, which includes prevention, harm reduction, treatment, recovery, and other strategies.[6] According to Mississippi’s MOU, Mississippi has opted to satisfy this abatement requirement by directing this amount to the creation of a new multidisciplinary program at the University of Mississippi Medical Center (UMMC),[7] described as “Mississippi’s only academic medical center dedicated to both short-term and long-term opioid abatement.”[8]
This means that this share must only be spent on prospective abatement and may not be used as reimbursement,[9] whether by UMMC or otherwise.[10]
Who ultimately decides how to spend this share (and how)?
State legislature decides. The Mississippi state legislature will decide how this 70% abatement share is ultimately spent,[11] whether exclusively by UMMC’s new multidisciplinary program, as grants administered via committee, or otherwise.[12]
Are supplantation uses prohibited for this share?
No, supplantation is not prohibited. Like most states, Mississippi does not prohibit supplantation uses of its opioid settlement funds. This means that the University of Mississippi Medical Center can spend its share in ways that replace (or “supplant”) — rather than supplement — existing resources.
Can I see how this share has been spent?
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.
What else should I know?
Mississippi has been slower than most states in finalizing its allocation and decision-making scheme.
The state’s MOU allocates Mississippi’s 70% abatement share to the Center for Addiction Medicine (CAM). Our 2023 Community Guides referred to UMMC’s Center for Innovations and Discovery in Addictions (CIDA) as a possible alternate recipient of this share,[13] given that evidence of CAM’s existence — beyond its initial MOU mention — could not at the time be identified.
In July 2024, the state’s Attorney General penned a column for the Daily Journal that described CAM’s existence as an unfinalized but likely eventuality.[14] The AG proposed to further subdivide the state’s 70% abatement share 50/50 between CAM and “an annual grant program through which a committee established by the Legislature would distribute funds.”[15]
In August 2024, KFF Health News reported on the continued uncertainty surrounding the state’s opioid settlement abatement planning and linked to a document provided by the state Attorney General’s office that “explains why [CAM] should receive millions in settlement funds.” This document is described by KFF as the last point of “cohesion” in the state’s planning, as UMMC “declined to confirm any communication with the attorney general’s office about the idea of a new center or answer any questions about the proposal.” The coverage refers to the Mississippi governor’s estimation January 2025 was mentioned as the next likely opportunity for the legislature to discuss its settlement spending scheme.[16]
Citations
Mississippi State-Local Government Opioid Litigation Memorandum of Understanding, Sec. B.1(c) (“The [University of Mississippi Medical Center’s Center for Addiction Medicine (CAM)] will receive 70% of all Opioid Funds to establish a new multidisciplinary program through Mississippi’s only academic medical center dedicated to both short-term and long-term opioid abatement”). See also Mississippi Attorney General’s November 5, 2021 letter to localities (paraphrasing the national settlement agreements’ 70% “future Opioid Remediation” requirement and announcing that the AGO will work with UMMC to create a program to meet this requirement). ↑
“[W]e created a two-prong proposal to meet the abatement requirements in these settlements.” Lynn Fitch. Demanding Accountability for the Opioid Crisis. Daily Journal. July 13, 2024. Accessed September 1, 2024. ↑
“Ensuring Mississippi got its full funding due was our top priority, so we proposed that the Legislature divide the abatement funds from these eight settlements roughly in half. The first half of the funds would go to the University of Mississippi Medical Center to create and run the Center for Addiction Medicine – a project that clearly checks the boxes for these settlements. The other half would become an annual grant program through which a committee established by the Legislature would distribute funds to projects that also meet the abatement requirements around the State.” Lynn Fitch. Demanding Accountability for the Opioid Crisis. Daily Journal. July 13, 2024. Accessed September 1, 2024. ↑
2024 MS House Bill 1705, Sec. 2(1) (“There is created in the State Treasury a special fund to be known as the Opioid Settlement Fund. The fund shall consist of monies received by the Attorney General on behalf of the State of Mississippi from settlements of opioid litigation”); Lynn Fitch. Demanding Accountability for the Opioid Crisis. Daily Journal. July 13, 2024. Accessed September 1, 2024 (describing the AG’s request that the “Legislature … at the very least start the transfer of funds for the Center for Addiction Medicine’s endowment” and referring to the creation of the Opioid Settlement Fund as a “first small step,” but that “the Legislature did not authorize [the AG’s office] to transfer any of the settlement dollars to that Fund, so the seeds for the Center for Addiction Medicine and other abatement projects will wait another year to be planted”). ↑
See “What else should I know?” (below) for more. See also Violet Jira and Henry Larweh. Opioid Settlements Promise Mississippi a Windfall. What Happens Next?. KFF Health News and Mississippi Today. August 14, 2024. Accessed September 1, 2024 ("According to Leah Smith, deputy chief of staff for Lt. Gov. Delbert Hosemann, his office intends to meet with Mississippi state leaders and advocates ‘to establish a plan to be adopted by the Legislature when it next meets in January,’ although the timeline is uncertain”). ↑
See, e.g., Mississippi Executed Judgment, June 30, 2022 – Distributor pg. 3 and Janssen settlement agreement Sec. I.47. ↑
Mississippi Attorney General’s November 5, 2021 letter to localities (“we worked with the University of Mississippi Medical Center to create a program that meets the opioid abatement requirements (that “the vast majority of the funds be used specifically for the treatment and abatement of opioids”) for the State. This will free local governments up to use your funds as you see fit without a national fund administrator micromanaging their use”). ↑
Mississippi State-Local Government Opioid Litigation Memorandum of Understanding, Sec. B.1(c) (“In the short-term, CAM will provide a patient-centered treatment program for patients of all ages and across the State through a continuum of inpatient, outpatient, and chronic care settings. This will include leveraging UMMC’s Center for Telehealth and utilizing existing and new collaborative community partnerships to address healthcare disparities in rural Mississippi. In the long-term, CAM will become a hub for training medical professionals, including those in pharmacy, nursing, and emergency medicine, to screen, diagnose, and treat individuals with addiction disorders. CAM will make Mississippi a nationally recognized leader in addiction research and treatment”). ↑
See, e.g., Mississippi Attorney General’s November 5, 2021 letter to localities (paraphrasing the national settlement agreements’ 70% “future Opioid Remediation” requirement and announcing that the AGO will work with UMMC to create a program to meet this requirement). See also Violet Jira and Henry Larweh. Opioid Settlements Promise Mississippi a Windfall. What Happens Next?. KFF Health News and Mississippi Today. August 14, 2024. Accessed September 1, 2024 (“The 70% opioid abatement share must be spent on programs and services to address addiction. The state and local government shares may be spent on anything”). ↑
Lynn Fitch. Demanding Accountability for the Opioid Crisis. Daily Journal. July 13, 2024. Accessed September 1, 2024 (referring to AG’s proposal to the Legislature to split the state’s 70% abatement share 50/50 between UMMC’s Center for Addiction Medicine and an “annual grant program through which a committee established by the Legislature would distribute funds to projects”). See also UMMC Center for Addiction Medicine Fact Sheet. Accessed September 1, 2024 (“The money allocated to CAM from the opioid litigation settlement will be used for certain one-time expenses (capital and initial operating investment) with the majority of the funds comprising an endowment. The interest income generated by the endowment would be used for ongoing operating expenses of the center. Expense categories are dependent on program prioritization and design”). ↑
2024 MS House Bill 1705, Sec. 2(1) (“There is created in the State Treasury a special fund to be known as the Opioid Settlement Fund. The fund shall consist of monies received by the Attorney General on behalf of the State of Mississippi from settlements of opioid litigation”); Id. At Sec. 2(2) (providing that “Monies in the fund shall be expended upon appropriation by the Legislature in accordance with the requirements of the opioid litigation settlements”); Lynn Fitch. Demanding Accountability for the Opioid Crisis. Daily Journal. July 13, 2024. Accessed September 1, 2024 (describing the AG’s “two-prong[ed] proposal” as having been made to the “Legislature”; referring to AG’s request that the “Legislature … at the very least start the transfer of funds for the Center for Addiction Medicine’s endowment” and the creation of the Opioid Settlement Fund as a “first small step”). See also Violet Jira and Henry Larweh. Opioid Settlements Promise Mississippi a Windfall. What Happens Next?. KFF Health News and Mississippi Today. August 14, 2024. Accessed September 1, 2024 (“Both the state government’s share and the abatement fund will be under the direct control of the state legislature, which will ultimately decide how that money gets spent. The legislature, through an appropriations act, has set up a special account for all of the funds it controls”). ↑
In July 2024, the AG referred to a proposal that would devote “half” of this 70% abatement share to UMMC, and that the other half to “an annual grant program through which a committee established by the Legislature would distribute funds to projects.” Lynn Fitch. Demanding Accountability for the Opioid Crisis. Daily Journal. July 13, 2024. Accessed September 1, 2024 (“The grant program would be administered by a committee of individuals who have a part in addressing opioids, including sheriffs; police chiefs; fire chiefs; local government leaders; the Departments of Mental Health and Health; and representatives appointed by the Governor, Lieutenant Governor, and Speaker of the House”) (emphasis added to emphasize lack of finality). There is some indication that the state legislature will consider this proposal in January 2025. Violet Jira and Henry Larweh. Opioid Settlements Promise Mississippi a Windfall. What Happens Next?. KFF Health News and Mississippi Today. August 14, 2024. Accessed September 1, 2024 (“According to Leah Smith, deputy chief of staff for Lt. Gov. Delbert Hosemann, his office intends to meet with Mississippi state leaders and advocates ‘to establish a plan to be adopted by the Legislature when it next meets in January,’ although the timeline is uncertain”). ↑
CIDA, which is the “umbrella” for addiction medicine across the University, aims to discover and implement innovative substance use disorder treatments through support for research, education, and healthcare. See UMMC Opens New Center. The University of Mississippi Foundation Website. January 10, 2022. Accessed September 1, 2025; About Us (“About CIDA”). The University of Mississippi Medical Center website. Accessed September 1, 2024. ↑
“This year, we asked the Legislature to at the very least start the transfer of funds for the Center for Addiction Medicine’s endowment, and they did take the first small step toward implementing this plan and distributing these funds by creating the Opioid Settlement Fund in the State budget. However, the Legislature did not authorize my office to transfer any of the settlement dollars to that Fund, so the seeds for the Center for Addiction Medicine and other abatement projects will wait another year to be planted.” Lynn Fitch. Demanding Accountability for the Opioid Crisis. Daily Journal. July 13, 2024. Accessed September 1, 2024. ↑
Lynn Fitch. Demanding Accountability for the Opioid Crisis. Daily Journal. July 13, 2024. Accessed September 1, 2024. ↑
Violet Jira and Henry Larweh. Opioid Settlements Promise Mississippi a Windfall. What Happens Next?. KFF Health News and Mississippi Today. August 14, 2024. Accessed September 1, 2024. ↑
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