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43.86% Fund for a Resilient Nevada Share

Where do these monies live?

The state’s 43.86% share of opioid settlement funds is held in the Fund for a Resilient Nevada and appropriated to the Department of Health and Human Services (DHHS),[1] which administers the fund.[2]

What can this share be spent on?

Excepting several set-asides for litigation costs, attorneys’ fees, and administrative expenses,[3] the state’s share of opioid settlements must be spent on approved purposes,[4] which the state defines to mean uses that are consistent with state law,[5] plus the national settlement agreement’s (non-exhaustive) Exhibit E,[6] which includes prevention, harm reduction, treatment, recovery, and other strategies.

State law requires that expenditures from the Fund be guided by a statewide plan based on a needs assessment that is developed by DHHS in consultation with its Office of Minority Heath and Equity.[7] State law also provides a non-exhaustive list of projects and uses that the statewide plan “may” include, such as expanding prevention, treatment, and recovery initiatives; programs to reduce the incidence and severity of neonatal abstinence syndrome; preventing and mitigating the harms of adverse childhood experiences; harm reduction services; housing for people with or in recovery from substance use disorder; substance use disorder provider workforce development; data collection; and capital projects, including construction costs, related to substance use.[8]

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

Department of Health and Human Services decides (in consultation with its Office of Minority Health and Equity). DHHS, in consultation with its Office of Minority Health and Equity, ultimately decides specific expenditures from this share based on a statewide needs assessment and plan.[9]

When conducting the statewide needs assessment and developing the statewide plan, DHHS and the Office of Minority health and Equity are required to consider recommendations submitted by the Advisory Committee for a Resilient Nevada (ACRN),[10] in addition to the recommendations of “state, regional, local and tribal governmental entities in this State whose work relates to opioid use disorder and other substance use disorders.”[11]

  • Statewide needs assessment. The Department of Health and Human Services (DHHS), in consultation with its Office of Minority Health and Equity, must conduct a statewide needs assessment at least once every four years.[12]

  • Statewide plan. The statewide plan, established by DHHS in consultation with its Office of Minority Health and Equity, prioritizes actions identified by the statewide needs assessment.[13] The plan must allocate funds to approved purposes,[14] whether to statewide projects or as grants to organizations or regional, local, or tribal agencies.[15] Recommendations made in the 2022 Statewide Plan are divided into categories: Data, Prevention, Treatment, and Social Determinants of Health and Recovery Supports. Each section categorizes recommendations according to the approved purposes identified by state law. Proposed budget allocations across the plan’s goals can be found here.

  • ACRN recommendations. The ACRN must submit a recommendations report to the DHHS Director in each even-numbered year “concerning” the statewide needs assessment and statewide plan.[16] When developing its recommendations, the ACRN must consider health equity and racial, ethnic, geographic, and other disparities across the state,[17] as well as the need to prevent overdose, address disparities in healthcare access, and prevent youth substance use.[18]

Is this share attached to an explicit bar against supplantation?

Yes, supplantation is prohibited. Nevada state law explicitly prohibits monies from the Fund for a Resilient Nevada from being used to “supplant existing methods of funding that are available to state, regional, local or tribal agencies.”[19] This means that this 43.86% share must only be spent in ways that supplement — rather than replace (or “supplant”) — existing resources.

Can I see how this share has been spent?

Yes (no public reporting required, only intrastate). View DHHS’ annual reports on its Fund for a Resilient Nevada website.[20] DHHS must report details on expenditures to the Governor, legislative leadership, the Commission on Behavioral Health, and other entities each year.[21]

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

What else should I know?

State law requires applications for funding submitted by government entities (regional, county, local, or tribal) and private-sector organizations to contain a needs assessment and grant plan that meet specific requirements in state law.[22]

Citations

  1. One Nevada Agreement on Allocation of Opioid Recoveries (Agreement) B.2(1). (“State of Nevada Allocation: 43.86% to the State of Nevada”) and B.11 (“The State of Nevada’s share of Recoveries, after deduction of any remaining costs and attorney fees, shall be deposited in the Fund for Resilient Nevada through Senate Bill 390 (2021)”). Nev. Rev. Stat. Sec. 433.732(1) (“The Fund for a Resilient Nevada is hereby created in the State Treasury”), and Sec. 433.732(6) (“all money that is deposited or paid into the Fund is hereby appropriated to the Department to be used, subject to the provisions of chapter 353 of NRS, to carry out the provisions of NRS 433.734 to 433.740, inclusive”). ↑

  2. Nev. Rev. Stat. Sec. 433.732(2). ↑

  3. See Nev. Rev. Stat. Sec. 433.732(1) (“[T]he Attorney General shall, after deducting any fees and costs imposed pursuant to an applicable contingent fee contract as described in NRS 228.111, deposit in the Fund all money received by this State pursuant to any [opioid] settlement”). Sec. 433.732(4) and Agreement B.1 (capping administrative costs at 8%); Agreement A.9 and B.2 (describing litigation costs); Agreement B.6-7 (describing attorneys’ fees); and A.10 and B.2 (defining "Federal Government CMS Medicaid Costs" to mean “22.52% of any Recovery after deduction of the Lead Litigator Costs that may be asserted, and only if determined to be recoverable, against the State of Nevada's Federal Government Centers for Medicaid Services costs for claims” and describing the deduction of these costs as part of allocation). ↑

  4. Agreement B.1 (“all Recoveries must be used for Approved Purposes”) and A.12 (defining “Recoveries” to mean monies from the settlements in Exhibit C of Nevada’s agreement, which ostensibly lists all possible defendants in the opioid litigation at large). ↑

  5. Agreement A.13 (defining “Approved Purposes” to mean “only uses to remediate the harms, impact, and risks caused by the opioid epidemic to the State of Nevada and its residents, and are consistent with those uses required by Senate Bill 390 (SB 390) as enrolled by the 81st (2021) Nevada Legislative Session and signed into law by the Nevada Governor, or uses that are listed as an approved use for abatement purposes in any plan approved by a bankruptcy court that are not otherwise inconsistent with SB 390”). ↑

  6. Fund for a Resilient Nevada. Nevada Department of Health and Human Services (DHHS), (see “Opioids Recoveries Approved Uses,” which links to each settlement agreement’s Exhibit E or equivalent of Exhibit E [Exhibit A for bankruptcies]). Accessed August 8, 2024. See also 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”). ↑

  7. Nev. Rev. Stat. Secs. 433.738(1) (requirement for statewide plan) and 433.734 (requirement for statewide needs assessment). See Fund for a Resilient Nevada. DHHS (“FRN … funding is guided by the required Opioid Statewide Needs Assessment Plan: Nevada Opioid Needs assessment and Statewide Plan 2022” and that “[f]unding will not be available for any activities not specifically identified in the Plan”). Accessed August 8, 2024. ↑

  8. Nev. Rev. Stat. Secs. 433.738(2)(a)(1)-(4), (7), (11)-(13). This list of allowable statewide projects is non-exclusive. Nev. Rev. Stat. Sec. 433.738(2)(a) (“Statewide projects, which may include, without limitation”) (emphasis added). ↑

  9. Nev. Rev. Stat. Sec. 433.734(1)(a)-(b) (“At least once every 4 years, the Department, in consultation with the Office, shall … [c]onduct a statewide needs assessment in accordance with NRS 433.736; and … [b]ased on the statewide needs assessment, develop or revise, as applicable, a statewide plan to allocate the money in the Fund in accordance with NRS 433.738”); Sec. 433.738(1) (describing requirements of statewide plan). See also DHHS: Fund for a Resilient Nevada (“FRN … funding is guided by the required Opioid Statewide Needs Assessment Plan: Nevada Opioid Needs assessment and Statewide Plan 2022” and that “[f]unding will not be available for any activities not specifically identified in the Plan”). Accessed August 8, 2024. ↑

  10. Nev. Rev. Stat. Sec. 433.734(2)(a) (“When performing the duties described in subsection 1, the Department and the Office shall consider: … [t]he recommendations provided by the Advisory Committee in the report submitted pursuant to NRS 433.730”). Subsection 1 refers to DHHS’ and the Office of Minority Health and Equity’s statewide needs assessment and planning responsibilities. ↑

  11. Nev. Rev. Stat. Sec. 433.734(2)(a)-(b) (“When performing the duties described in subsection 1, the Department and the Office shall consider: … [t]he recommendations of state, regional, local and tribal governmental entities in this State whose work relates to opioid use disorder and other substance use disorders”). Subsection 1 refers to DHHS’ and the Office of Minority Health and Equity’s statewide needs assessment and planning responsibilities.

    Nev. Rev. Stat. Secs. 433.730(1)(a)-(b) (requirement for ACRN to submit a report to DHHS “concerning” the needs assessment and statewide plan required by state law for the allocation of funds from this share) and 433.064 (defining “Department” as the Department of Health and Human Services). See also Nevada Opioid Needs Assessment and Statewide Plan 2022. Mercer Government Human Services Consulting. December 1, 2022. Accessed September 1, 2024 (“The state’s Advisory Committee will prioritize recommendations from the Needs Assessment to submit to the DHHS, including feedback from the public and other stakeholder groups”). ↑

  12. Nev. Rev. Stat. Secs. 433.734(1)(a)-(b) and 433.720 (defining “Office” to mean “the Office of Minority Health and Equity). ↑

  13. Nev. Rev. Stat. Sec. 433.734(1)(a)-(b). See also Attorney General Ford Announces Nevada Will Join Settlement with Opioid Manufacturer Allergan. Nevada Attorney General press release. February 22, 2023. Accessed August 8, 2024 (“The law requires the state to create a State Needs Assessment which identifies the critical needs for attacking the impacts and effects of opioids throughout the entire state, and a State Plan for prioritizing funding for the needs identified in said assessment. The law also creates a mechanism for the state, counties and cities to work together in developing county needs assessments and county plans that complement the State Needs Assessment and State Plan, therefore maximizing the use of the money from recoveries”). ↑

  14. Nev. Rev. Stat. Sec. 433.738(1)(b). See also Agreement B.2 and A.13. ↑

  15. Nev. Rev. Stat. Sec. 433.738(2)(a)(1)-(14), (2)(b). ↑

  16. Nev. Rev. Stat. Secs. 433.730(1)(a)-(b), 433.734(1)-(2), and 433.738(1). ↑

  17. Nev. Rev. Stat. Sec. 433.730(2)(a). ↑

  18. Nev. Rev. Stat. Sec. 433.730(2)(b). ↑

  19. Nev. Rev. Stat. Ann. Sec. 433.732(7) (“Money expended from the Fund must not be used to supplant existing methods of funding that are available to state, regional, local or tribal agencies”). ↑

  20. Nev. Rev. Stat. Sec. 433.734(3)(a)-(f) (requirement that DHHS submit an annual report that describes “recommendations made and money expended” to the governor, various legislative stakeholders, the attorney general, and others). ↑

  21. Nev. Rev. Stat. Secs. 433.740(1)(a)(1)-(2), 433.742, and 433.744. ↑

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