Where do these monies live?

Fifteen percent (15%) is allocated to an undefined “State Fund” and explicitly excluded from the 70% Opioid Abatement Special Fund.[1]

What can this share be spent on?

With limited exceptions,[2] this share may be spent either on reimbursements for past abatement expenditures or for forward-looking abatement.[3] Communications from the Vermont Attorney General refer to the national settlement agreement’s (non-exhaustive) Exhibit E,[4] which includes prevention, harm reduction, treatment, recovery, and other strategies, as the state’s list of approved uses.

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

The “State” decides. The “state,” which Vermont’s governing documents do not define, ultimately decides specific expenditures for this share.[5]

Is this share attached to an explicit bar against supplantation?

No, supplantation is not prohibited. Vermont does not explicitly prohibit supplantation uses of funds from its 15% state share. This means that the state share may be spent 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?

Not applicable.

Citations

1. Vermont Attorney General’s Executive Summary of Opioid Distributors and J&J Settlements (AG Executive Summary) I. September 14, 2021. Accessed August 28, 2024 (“15% to states to remediate for past expenses of the opioid crisis or for future abatement”). 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 “15% [of these settlement funds go] to the State”). Attorney General 2023 Memo. March 23, 2023. Accessed August 28, 2024. See also 18 V.S.A. Sec. 4771 (“While an opioid litigation settlement may designate a portion of the monies for local or State use, this subchapter applies to only monies from abatement accounts funds”). ↑

2. See AG Executive Summary IV (“[A]pproved purposes can be found 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”). ↑

3. AG Executive Summary I (“15% to states to remediate for past expenses of the opioid crisis or for future abatement (the ‘State Fund’)”). ↑

4. AG Executive Summary IV (“[A]pproved purposes can be found at Exhibit E to the SAs, which is attached to this memo”). See also Opioid Settlements. Vermont Attorney General website. Accessed August 28, 2024 (linking to “Exhibit E - List of Opioid Remediation Uses”). ↑

5. AG Executive Summary I (“15% to states to remediate for past expenses of the opioid crisis or for future abatement (the ‘State Fund’)”). ↑

This Community Guide will describe how Vermont is spending its opioid settlements and whether Vermont is working to ensure community access to opioid settlement funds. Last revised September 1, 2024.

Where do these monies live?

The 15% local share is allocated to participating counties, cities, and towns according to of the national settlement agreements.[1]

Non-participating subdivisions’ amounts are reallocated to the Abatement Fund,[2] and Vermont’s counties may also redirect their shares to the Fund.[3]

What can this share be spent on?

With limited exceptions,[4] this share must be spent on the uses described in the national settlement agreement’s (non-exhaustive) ,[5] which includes prevention, harm reduction, treatment, recovery, and other strategies.

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

Local governments decide autonomously. Decisionmakers for the participating counties, cities, and towns will ultimately decide for themselves how to spend their monies on Exhibit E uses.[6]

Is this share attached to an explicit bar against supplantation?

No, supplantation is not prohibited. Vermont does not explicitly prohibit supplantation uses of funds from its 15% local share. This means that the local share may be spent in ways that replace (or “supplant”) — rather than supplement — existing resources.

Can I see how this share has been spent?

Up to each locality (neither public nor intrastate reporting required). Opioid settlement expenditures are not officially published in a centralized location for this share.

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

What else should I know?

Not applicable.

Citations

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) ,[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 substantially mirror those in the national settlement agreements’ .[6]

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

Opioid Settlement Advisory Committee and Department of Health recommend, state legislature decides. The ultimately decides expenditures for the Fund after consulting the recommendations of the Vermont (DOH) and its .[7]

The Committee was created to advise the state’s , DOH, and on spending priorities for the Fund.[8] In making its recommendations, the Committee is required to consult those with lived experience,[9] the , 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 that includes budgeted amounts for activities funded by the Opioid Abatement Special Fund.[16]

Visit OpioidSettlementTracker.com’s 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

4. 18 V.S.A. Sec. 4774(b)(1)-(13). ↑

5. 18 V.S.A. Sec. 4774(c)(2) and (c)(8). ↑

8. 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”). ↑

9. 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). ↑

11. 18 V.S.A. Sec. 4772(c)(1)-(3). ↑

13. 18 V.S.A. Sec. 4774(a)(2). ↑

15. 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”) ↑

Can I provide input on spending?

• 70% Opioid Abatement Special Fund share: Yes (required). The Opioid Settlement Advisory Committee is subject to the state’s open meetings law, which requires an opportunity for public comment.[1] The Committee includes a dedicated public comment period at the end of each of its meetings, typically at the end of each agenda.[2] Visit the Advisory Committee’s website to find meeting dates and agendas and note future meeting dates, which are generally listed at the end of the “Meeting Minutes” for the most recent meeting. The Advisory Committee is required to meet at least quarterly but “not more” than six times per year.[3]

• 15% local share: Generally, yes. Though local governments are not required to seek public input as to opioid settlement spending specifically, the Vermont Open Meeting Law requires that they accept public comments during their public meetings.[4] Take advantage of this requirement by showing up to meetings of your local governing body and offering comments on local settlement spending.[5]

• 15% state share: No opportunities available. The state has not established recurring opportunities for the public to provide input on uses of its 15% share.[6]

Can I apply for grants?

Yes. The state has made grant funding available in the past and any current opportunities can be found here.[7] Local governments may create grant programs to distribute their share of funds. The existence, parameters, and processes for local settlement grant programs will vary by locality, so stay alert for new opportunities. Visit the Opioid Settlement Community Grants Portal (OpioidSettlementTracker.com and Legal Action Center) for the most up-to-date information on settlement grant opportunities for community organizations.

Where do I go for updates?

• For updates on the Opioid Abatement Special Fund share, visit the Opioid Settlement Advisory Committee’s website, which links to the Department of Health’s Opioid Settlement Activity Status Report.

• To find updates on the local share, a good starting point is to check the websites for your county executive, city council, or local health department.

• A single resource containing updates specific to the state’s 15% share could not be found.[8] See the AG’s general Opioid Settlements page.

What else should I know?

Not applicable.

Citations

1. 18 V.S.A. Sec. 4772(f)(4) (providing that “All meetings of the Advisory Committee shall be consistent with Vermont’s Open Meeting Law”); 1 V.S.A. Sec. 312(h) (“At an open meeting, the public shall be given a reasonable opportunity to express its opinion on matters considered by the public body during the meeting, as long as order is maintained. Public comment shall be subject to reasonable rules established by the chairperson. This subsection shall not apply to quasi-judicial proceedings.”) ↑

2. See, e.g., Opioid Settlement Advisory Committee June 28, 2024 agenda. Vermont Department of Health (DOH) website. Accessed September 1, 2024. ↑

3. 18 V.S.A. Sec. 4772(f)(2). ↑

4. 1 V.S.A. Sec. 312(h) (“At an open meeting, the public shall be given a reasonable opportunity to express its opinion on matters considered by the public body during the meeting, as long as order is maintained. Public comment shall be subject to reasonable rules established by the chairperson. This subsection shall not apply to quasi-judicial proceedings”). See also 1 V.S.A. Sec. 310(6) (defining “public body” to include political subdivisions). ↑

5. Note that this may only be possible when settlement spending is related to “matters considered by the public body during the meeting.” 1 V.S.A. Sec. 312(h). ↑

6. If you see this change, email tips@opioidsettlementtracker.com. ↑

7. Requests for Proposals, Information and Applications. Vermont DOH website. Accessed September 1, 2024. ↑

8. If you see this change, email tips@opioidsettlementtracker.com. ↑

Vermont Attorney General’s Office

Opioid Settlements

Executive Summary of Opioid Distributors and J&J Settlements (September 14, 2021)

Vermont Department of Health

Opioid Settlement Advisory Committee

Opioid Settlement Status Activity Report

Vermont General Assembly

Opioid Settlement Advisory Committee

VT Helplink (free and confidential support and referral service)

Harm Reduction / Safer use services

Here are the entities that ultimately decide how each of Vermont’s opioid settlement shares are spent:

• 70% Opioid Abatement Special Fund share: Vermont state legislature

• 15% local share: local officials for counties, cities, and towns

• 15% state share: the “State” (not further specified)

Has the state established an advisory body for settlement funds?

Yes. The Opioid Settlement Advisory Committee was created by state law to provide advice and recommendations on spending priorities for the state’s 70% Opioid Abatement Special Fund share.[1] The Advisory Committee must consult people with lived experience,[2] the Substance Misuse Oversight Prevention and Advisory Council, frontline support professionals, and other stakeholders.[3] Additionally, in making its spending recommendations, the Advisory Committee must consider the:[4]

• “[I]mpact of the opioid crisis on communities throughout Vermont, including communities’ abatement needs and proposals for abatement strategies and responses”

• “[P]erspectives of and proposals from opioid use disorder prevention coalitions, recovery centers, and medication-assisted treatment providers”

• “[O]ngoing challenges of the opioid crisis on marginalized populations, including individuals who have a lived experience of opioid use disorder”

The Advisory Committee must meet at least quarterly but no more than six times per calendar year.[5] and its meetings are subject to Vermont’s open meetings law.[6]

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

Yes. The Opioid Settlement Advisory Committee is required by state law to include “two individuals with lived experience of opioid use disorder, including at least one of whom is in recovery.”[7] The Advisory Committee is also required to “ensure inclusion of individuals with lived experience of opioid use disorder and their family members whenever possible.”[8]

What is the overall membership of the state advisory body?

The Advisory Committee has 16 members, including:[9]

• The Commissioner of Health or their designee, who serves as a nonvoting chair

• The state’s Chief Prevention Officer

• One current member of the Vermont House of Representatives, appointed by the Speaker of the House

• One current member of the Vermont Senate, appointed by the state Senate’s Committee on Committees

• A primary care doctor associated with the Blueprint for Health and who has experience providing medications for opioid use disorder, appointed by Blueprint for Health’s executive director

• An academic researcher appointed by the University of Vermont

• An assistant judge appointed by the Vermont Association of County Judges

• Seven people employed by (or an agent of) Vermont’s cities and towns and reflecting their geographic and population diversity, appointed by the Vermont League of Cities and Towns

• Two people with lived experience of opioid use disorder, at least one of whom is in recovery, with one member each appointed by the Howard Center’s Safe Recovery program and the Vermont Association of Mental Health and Addiction Recovery

Members must reflect Vermont’s gender, race, age, ethnicity, sexual orientation, gender identity, disability status, and socioeconomic diversity, and “ensure the inclusion of individuals with lived experience of opioid use disorder and their families whenever possible.”[10] You can view a list of current Advisory Committee members and their contact information here.

Terms: Advisory Committee members serve four-year terms and are eligible for reappointment.[11] Members may be removed from the Advisory Committee by their appointing entity for cause.[12]

Are local governments required to establish a settlement advisory body? If so, are local advisory bodies required to include member(s) with lived and/or living experience?

No (up to each locality). Local governments in Vermont 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.

What else should I know?

Vermont state law requires that spending recommendations supported by an affirmative majority vote of the Advisory Committee be submitted to the Department of Health, the Vermont House Committees on Appropriations and on Human Services, and the Vermont Senate Committees on Appropriations and on Health and Welfare.[13] This process has not been without controversy. In February 2024, ACLU of Vermont sent a letter to Vermont Commissioner of Health Mark Levine accusing the Commissioner and Vermont Governor Phil Scott of unlawfully modifying the Advisory Committee’s recommendations by excluding a recommendation to fund overdose prevention centers.[14] On June 17, 2024, the Vermont Legislature overrode Governor Scott’s veto of House Bill 72, which authorizes a pilot overdose prevention center in the city of Burlington and allocates $1.1 million in opioid settlement funds to support the pilot and conduct a study of its impact.[15]

Citations

1. 18 V.S.A. Sec. 4772(a). These recommendations are provided to the Governor, the Department of Health, and the General Assembly. 18 V.S.A. Sec. 4772(c). ↑

2. More 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). ↑

3. 18 V.S.A. Sec. 4772(c). ↑

4. 18 V.S.A. Sec. 4772(c)(1)-(3). ↑

5. 18 V.S.A. Sec. 4772(f)(2). ↑

6. 18 V.S.A. Sec. 4772(f)(4). ↑

7. 18 V.S.A. Sec. 4772(b)(1)(G). ↑

8. 18 V.S.A. Sec. 4772(b)(1). ↑

9. 18 V.S.A. Sec. 4772(b)(1). ↑

10. 18 V.S.A. Sec. 4772(b)(1). ↑

11. 18 V.S.A. Sec. 4772(b)(2)(A) (“Members shall hold office for the term of their appointments and until their successors have been appointed.”) ↑

12. 18 V.S.A. Sec. 4772(b)(2)(B) (cause “includes only neglect of duty, gross misconduct, conviction of a crime, or inability to perform the responsibilities of the office.”) ↑

13. 18 V.S.A. Sec. 4772(e). ↑

14. Harrison Stark (ACLU of Vermont) Letter to Dr. Mark Levine (Commissioner of Health, Vermont Department of Health). “Open Meeting Law Violation re: Opioid Settlement Advisory Committee Funding Recommendations, FY ’25.” February 15, 2024. Accessed June 18, 2024. ↑

15. 2023-2024 Vermont House Bill 72. The bill also expresses that “[i]t is the intent of the General Assembly to continue to appropriate funds from the Opioid Abatement Special Fund through fiscal year 2028 for the purpose of awarding grants to the City of Burlington for the operation of the pilot program.” Id. at Sec. 2. See also Peter D'Auria. Lawmakers override Phil Scott’s veto of overdose prevention center bill. VTDigger. June 17, 2024. Accessed June 18, 2024. ↑