70% Opioid Abatement Special Fund Share
Where do these monies live?
The Opioid Abatement Special Fund holds 70% of Vermont’s opioid settlement funds.[1]
What can this share be spent on?
In general, and with limited exceptions,[2] Vermont’s opioid settlements must be spent on the uses described in the national settlement agreement’s (non-exhaustive) Exhibit E,[3] which includes prevention, harm reduction, treatment, recovery, and other strategies.
State law further defines approved uses of the Opioid Abatement Special Fund with a 13-item list of “opioid prevention, intervention, treatment, recovery, harm reduction, and evaluation activities,”[4] and Fund expenditures must prioritize reducing overdose deaths according to a 9-item list that includes activities such as “increasing access to medication-assisted treatment” and expanding syringe service programs.”[5] Taken together, the approved uses in Vermont state law substantially mirror those in the national settlement agreements’ Exhibit E.[6]
Who ultimately decides how to spend this share (and how)?
Opioid Settlement Advisory Committee and Department of Health recommend, state legislature decides. The Vermont state legislature ultimately decides expenditures for the Fund after consulting the recommendations of the Vermont Department of Health (DOH) and its Opioid Settlement Advisory Committee.[7]
The Committee was created to advise the state’s Governor, DOH, and General Assembly on spending priorities for the Fund.[8] In making its recommendations, the Committee is required to consult those with lived experience,[9] the Substance Misuse Prevention Oversight and Advisory Council, frontline support professionals, and “other stakeholders.”[10] It must also consider community abatement needs, provider perspectives, and the “ongoing challenges of the opioid crisis on marginalized populations, including individuals who have a lived experience of opioid use disorder.”[11] It must then annually present its recommendations to DOH and legislative leaders.[12]
Vermont’s statutory scheme requires DOH to submit a spending plan “informed by the recommendations of the Opioid Settlement Advisory Committee.” [13] But according to a press release from the Governor earlier this year, “the law does not limit [the DOH Commissioner’s] discretion in making … final recommendations to the Governor for [the Governor’s] budget proposal or to the Legislature.”[14]
Is this share attached to an explicit bar against supplantation?
Yes, supplantation is prohibited. Vermont state law explicitly prohibits supplantation uses of funds from the Opioid Abatement Special Fund.[15] This means that funds from Vermont’s 70% Opioid Abatement Special Fund share must be spent in ways that supplement – rather than replace (or “supplant”) – existing state or local government resources.
Can I see how this share has been spent?
Yes (neither public nor intrastate reporting required). DOH publishes a Summary and Status Report that includes budgeted amounts for activities funded by the Opioid Abatement Special Fund.[16]
Visit OpioidSettlementTracker.com’s Expenditure Report Tracker for an updated collection of states’ and localities’ available expenditure reports.
What else should I know?
In July 2024, the ACLU of Vermont sued DOH asserting violations of Vermont’s Open Meetings Law and its Public Records Law based on allegations that the DOH Commissioner (as non-voting Chair) “unilaterally” changed the Advisory Committee’s recommendations to remove funding for overdose prevention centers (OPCs) before presenting those recommendations to the legislature.[17]
Citations
18 V.S.A. Sec. 4774(a)(1) (“There is created the Opioid Abatement Special Fund”). See also 32 V.S.A. Sec. 585(a)(2) (defining a special fund). Vermont Attorney General’s Executive Summary of Opioid Distributors and J&J Settlements (AG Executive Summary) I. September 14, 2021. Accessed August 28, 2024 (describing Vermont’s adoption of default allocation scheme: 70% to Abatement Fund, 15% to State Fund, and 15% to Subdivision Fund). The September 2021 executive summary from the AG applies only to the Distributor and Janssen settlements. A subsequent memo from the AG in March 2023 addressed “second wave” settlements (Teva, Allergan, CVS, Walmart, and Walgrens) and confirmed that “70% [of these settlement funds go] to the statewide Opioid Abatement Fund”). Attorney General 2023 Memo. March 23, 2023. Accessed August 28, 2024. ↑
18 V.S.A. Sec. 4774(b)(13) (describing “the cost of the administrative, technical, and legal assistance provided to the [Opioid Settlement] Advisory Committee by the Department of Health” as a valid use of Fund monies). See also AG Executive Summary IV (“[A]pproved purposes can be fund at Exhibit E to the [Settlement Agreements], which is attached to this memo.) and 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”). ↑
18 V.S.A. Sec. 4774(a)(1) (“The Opioid Abatement Special Fund shall consist of all abatement account fund monies … that must be utilized exclusively for opioid prevention, intervention, treatment, recovery, and harm reduction services”) and also AG Executive Summary IV (“The [Settlement Agreements] provides a default mechanism for distributing the Abatement Fund that comprises 70% of the settlement monies. The default mechanism requires the State to designate an agency that will request the monies for approved purposes. Those approved purposes can be found at Exhibit E”). 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”). ↑
18 V.S.A. Sec. 4774(b)(1)-(13). ↑
18 V.S.A. Sec. 4774(c)(2) and (c)(8). ↑
18 V.S.A. Sec. 4774(b)(1)-(13) (largely corresponding to Exhibit E’s Schedule B, Approved Uses) and 18 V.S.A. Sec. 4774(c)(1)-(9) (largely corresponding to Exhibit E’s Schedule A, Core Strategies). Compare, e.g., 18 V.S.A Sec. 4774(c)(1) (“promoting the appropriate use of naloxone and other U.S. Food and Drug Administration-approved drugs to reverse opioid overdoses”) with Exhibit E, Schedule A (item) A (“NALOXONE OR OTHER FDA-APPROVED DRUG TO REVERSE OPIOID OVERDOSES”) and ↑
See, e.g., 2024 Vermont Pub. Acts 113, Sec. B.1100(d)(1)-(7) (making numerous appropriations from the Opioid Abatement Special Fund, including $800,000 “for grants to providers for ongoing support for contingency management” and $150,000 “for a grant to Johnson Health Center to established a managed medical response partnership”). See also 18 V.S.A Sec. 4774(a)(1) (Fund is “administered” by DOH), Sec. 4774(a)(2) (“DOH] shall submit a spending plan to the General Assembly, informed by the recommendations of the Opioid Settlement Advisory Committee” and “[DOH] shall disburse monies from the Opioid Abatement Special Fund pursuant to 32 V.S.A. chapter 7, subchapter 3”) and Sec. 4772(e) (“[T]he Advisory Committee shall present its recommendations for expenditures from the Opioid Abatement Special Fund …to the Department of Health”). ↑
18 V.S.A Sec. 4772(c) (describing one of the Advisory Committee’s duties as “providing recommendations to the Governor, the Department of Health, and the General Assembly on prioritizing spending from the Opioid Abatement Special Fund”). ↑
Specifically, the Advisory Committee must “demonstrate broad ongoing consultation with individuals living with opioid use disorder about their direct experience with related systems, including medication-assisted treatment, residential treatment, recovery services, harm reduction services, overdose, supervision by the Department of Corrections, and involvement with the Department for Children and Families’ Family Services Division.” 18 V.S.A Sec. 4772(c). ↑
18 V.S.A. Sec. 4772(c) (“[T]he Advisory Committee shall demonstrate consultation with individuals with direct lived experience of opioid use disorder, frontline support professionals, the Substance Misuse Oversight Prevention and Advisory Council, and other stakeholders to identify spending priorities as related to opioid use disorder prevention, intervention, treatment, and recovery services and harm reduction strategies for the purpose of providing recommendations”). The Substance Misuse Prevention Oversight and Advisory Council advises the Governor and the General Assembly on improvements to Vermont’s substance use prevention policies and programs. See Council’s website for more. Accessed August 28, 2024. ↑
18 V.S.A. Sec. 4772(c)(1)-(3). ↑
18 V.S.A. Sec. 4772(e) (“Annually, the Advisory Committee shall present its recommendations for expenditures from the Opioid Abatement Special Fund established pursuant to this subchapter to the Department of Health and concurrently submit its recommendations in writing to the House Committees on Appropriations and on Human Services and the Senate Committees on Appropriations and on Health and Welfare”). See, e.g., Advisory Committee Recommendation Memo submitted by DOH Commissioner. January 16, 2024. Accessed August 28, 2024 (“I am pleased to provide the recommendations of the Opioid Settlement Committee to the VT General Assembly for fiscal year 2025…”). ↑
18 V.S.A. Sec. 4774(a)(2). ↑
Facts Matter: Health Commissioner Mark Levine, MD, Makes Opioid Settlement Recommendations within Legal, Statutory Authority. State of Vermont, Governor’s press release. February 16, 2024. Accessed August 28, 2024. ↑
18 V.S.A. Sec. 4774(a)(3) (“Disbursements from the Opioid Abatement Special Fund shall supplement and not supplant or replace any existing or future local, State, or federal government funding for infrastructure, programs, supports, and resources, including health insurance benefits, federal grant funding, and Medicaid and Medicare funds”) ↑
Summary and Status Report for activities funded by Opioid Settlement Funds created by the Vermont Department of Health and updated regularly. DOH. Last updated August 21, 2024. Accessed August 28, 2024. ↑
ACLU of Vermont Sues Scott Administration for Withholding Opioid Settlement Records, Open Meeting Violations. ACLU of Vermont press release. July 17, 2024. Accessed August 28, 2024. Read the complaint in full here. ↑
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