Can I provide input on spending?

• 50% state share: Yes (not required). Members of the public can attend the State Opioid and Overdose Response Plan (SOORP) learning community meetings and provide input on opioid settlement spending recommendations by contacting the SOORP workgroup leads. Visit the SOORP website to find the dates, times, and attendance information for each SOORP learning community meeting, plus information about past SOORP workgroup meetings. You can find the names and email addresses of lead contacts for each SOORP workgroup on page 39 of the state’s Opioid and Overdose Response Plan,[1] and general questions may be emailed to Kris Shera, Washington’s State Opioid Coordinator, at [email protected].

• 50% local share: Yes (required). Local governments are required to gather community input on settlement funding priorities as a condition of receiving direct settlement payments.[2] See, e.g., (announcing County’s October 2023 public input survey, launched for the public “to share suggestions, ideas and concerns with Spokane County Leadership to support decision making on the use of Opioid Settlement Funding”).[3]

  • Some regional opioid abatement councils have established regular meeting schedules with opportunities to provide public comment.[4] For example, both the and publish meeting schedules on their respective websites and include a dedicated public comment period on each meeting agenda.

Can I apply for grants?

It depends. As of September 1, 2024, the state has not yet established any grant opportunities for the 50% state share. 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 (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 state share, visit the Department of Health’s website and refer to the State Opioid and Overdose Response Plan’s for meeting updates. Sign up to receive email updates and reminders from the state opioid response workgroup .

• To find updates on the local share, a good starting point is to check the websites for your regional opioid abatement council (see, e.g., the and regional OACs), city or county council, or local health department (see, e.g., the settlement-specific webpages of , , and the City of ).[7]

What else should I know?

The (SURSAC), a legislatively created body required to include people with lived experience, is responsible for recommending policies to the state legislature and working with the Washington State Health Care Authority to implement the state’s substance use recovery services plan.[8] The SURSAC meets monthly and encourages public comments.[9]

Visit the SURSAC’s to find the dates, times, and attendance information for upcoming SURSAC meetings and instructions on how to submit public comments during meetings. The website also includes materials and recordings from previous meetings, information about the SURSAC’s Safe Supply Work Group, and an email address to submit written feedback ().

Citations

1. See Washington opioid settlement frequently asked questions (FAQ), (“How can I participate in developing the recommendations for how to use the settlement funds?” “Anyone can provide comments to a SOORP workgroup by contacting the workgroup leads listed in the plan. These workgroups provide input on work from a variety of funding sources, including opioid settlement funds”). Washington State Health Care Authority. January 6, 2023. Accessed September 1, 2024. ↑

2. One Washington Memorandum of Understanding Between Washington Municipalities (Municipalities MOU) Sec. (“As a condition of receiving a direct payment, each Participating Local Government that receives a direct payment agrees to undertake the following actions: ii. Ensuring there is opportunity for community-based input on priorities for Opioid Fund programs and services”). Accessed September 1, 2024. ↑

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

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

• 50% state share: Washington state legislature

• 50% local share: local officials for counties, cities, and towns

Washington State Health Care Authority

• State Opioid and Overdose Response plan

• State Opioid and Overdose Response learning community meetings

• (January 2023)

Where do these monies live?

The Opioid Abatement Settlement Account holds the state government’s 50% share of Washington State’s opioid settlement funds.[1] Starting July 2025, 20% of this share’s receipts (or $7,750,000, whichever is greater) will be annually transferred from this Account to the newly created Tribal Opioid Prevention and Treatment Account.[2]

What can this share be spent on?

In general, and with limited exceptions,[3] this share must be spent only on the forward-looking opioid remediation uses described in the national settlement agreement’s (non-exhaustive) ,[4] which includes prevention, harm reduction, treatment, and other strategies.

The Attorney General has expressed that this share will be spent consistently with Washington’s ,[5] which focuses on the following priority goals:[6]

1. Prevent opioid misuse

2. Identify and treat substance use disorder

3. Ensure and improve the health and wellness of individuals that use drugs

4. Use data to detect opioid misuse/abuse, monitor illness, injury and death, and evaluate interventions

The 20% of this share that is annually transferred to the Tribal Opioid Prevention and Treatment Account (beginning July 2025) must be spent to “address[] the impact of the opioid epidemic in tribal communities” by funding “[p]revention and recovery services,” “treatment programs[,] including medication-assisted treatment,” “peer services,” “awareness campaigns and education,” and “support for first responders.”[7]

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

Workgroups and governor provide input, state legislature decides. The ultimately decides specific expenditures for this share,[8] inclusive of the 20% allocated to the Tribal Opioid Prevention and Treatment Account.[9]

According to authored by the ,[10] the legislature is informed by input from a chain of key stakeholders:

1. The (SOORP) provides recommendations to the SOORP “executive sponsors” (representatives from key state agencies and academia).[11]

2. The SOORP executive sponsors use the workgroup’s recommendations to develop their own funding recommendations, which are then provided to the Governor’s office.[12]

3. The SOORP executive sponsors’ recommendations may be integrated into the Governor’s budget, which contains funding proposals for the legislature’s consideration.[13]

Is this share attached to an explicit bar against supplantation?

No, supplantation is not prohibited. Like most states, Washington does not explicitly prohibit supplantation uses of its opioid settlement funds. This means that the 50% 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?

Yes (neither public nor intrastate reporting required). The Attorney General has published a one-time for the state legislature’s 2023-25 biennium.

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

What else should I know?

Not applicable.

Citations

1. and Wash. Rev. Code Sec. Sec. 43.79.483(1) (“The opioid abatement settlement account is created in the state treasury. All settlement receipts and moneys that are designated to be used by the state of Washington to abate the opioid epidemic for state use must be deposited into the account”). ↑

2. (Tribal Opioid Prevention and Treatment Account) (“A new section is added to chapter 43.79 RCW to read as follows: The tribal opioid prevention and treatment account is created in the state treasury. All receipts from the transfer directed in RCW 3.79.483(3) must be deposited in the account”) and Wash. Rev. Code Sec.43.79.483(3) (“Beginning July 1, 2025, and each fiscal year thereafter through June 30, 2031, the state treasurer shall transfer into the tribal opioid prevention and treatment account created in section 3 of this act from the opioid abatement settlement account an amount equal to the greater of $7,750,000 or 20 percent of the settlement receipts and moneys deposited into the opioid abatement settlement account during the prior fiscal year”). ↑

Has the state established an advisory body for settlement funds?

No. Washington has not established an advisory body specifically to inform spending of funds from the 50% state share.[1] However, those involved with Washington’s State Opioid and Overdose Response Plan (SOORP) provide recommendations across numerous funding streams, including opioid settlement funds.[2]

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

Not applicable.

What is the overall membership of the state advisory body?

Not applicable.

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?

Yes, but regional only. Local governments in Washington are not required to establish their own opioid settlement advisory bodies, but local governments within each of are required by the to establish a regional opioid abatement council (regional OACs) (see, e.g., King County’s ).[3]

A regional OAC, which may be a new or preexisting regional body,[4] must be composed of representatives from participating counties, cities, and towns within the region that have “work or educational experience pertaining to one or more Approved Uses.”[5] Regional OACs are not required to include any member(s) with lived and/or living experience.

Each regional OAC must:

• Oversee the distribution of settlement funds by participating local governments within the region,[6] including reviewing annual expenditure reports to ensure funds were used for approved purposes[7]

• Report and make publicly available opioid settlement fund distributions and expenditures by the region’s OAC and/or its participating local governments,[8] including via a centralized public dashboard that must be updated at least annually[9]

• Hear participating local governments’ complaints regarding misuse of settlement funds within the region or noncompliance with reporting requirements[10]

Regional OACs are also empowered to take “remedial action” against participating local governments determined to be misusing opioid settlement funds or otherwise failing to comply with the terms of the .[13] This includes withholding future settlement funds or requiring the repayment of misspent funds.[14]

What else should I know?

Not applicable.

Citations

1. The state has established a “National Opioid Abatement Trust Subcommittee” of the State Opioid & Overdose Response Plan, but it appears the subcommittee was created solely to satisfy requirements related to the Mallinckrodt bankruptcy. See . August 12, 2022. Only one independent meeting of the subcommittee is listed on the Washington Healthcare Authority’s . See (includes list of committee members, presentation on the committee). Accessed September 1, 2024. ↑

2. See Washington opioid settlement frequently asked questions (FAQ), and . Washington State Health Care Authority. January 6, 2023. Accessed September 1, 2024. ↑

Where do these monies live?

This share is distributed to 125 participating local governments by county according to Exhibit B of the MOU between Washington municipalities.[1] Non-participating local governments’ amounts are reallocated to those participating.[2]

Intra-county allocations are determined by regional agreements and decision-making structures for each of the nine predefined Washington State Accountable Communities of Health Regions (Allocation Regions).[3] Each region can either determine its own sub-allocation of funds among its counties, cities, and towns or use the MOU’s default intra-region allocation formula.[4] Regions are also free to also pool their shares for joint uses, and local governments may reallocate their shares to their regional Opioid Abatement Councils (OACs).[5]

What can this share be spent on?

With limited exceptions,[6] this share must be spent only on the opioid remediation uses described in the national settlement agreement’s (non-exhaustive) ,[7] which includes prevention, harm reduction, treatment, and other strategies.

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

Local governments decide autonomously (with regional council oversight). Decisionmakers for the local governments may ultimately decide for themselves how to spend their monies on Exhibit E approved uses.[8]

Each region must establish an Opioid Abatement Council (OAC) to oversee regional distributions, review the expenditures of participating local governments in the region, and publish its activities to a dashboard.[9] To receive their monies directly, local governments are required to create a process for receiving, reviewing, and approving or denying funding proposals; ensure opportunities for community input; and report its expenditures to its regional OAC and the public.[10] Regional OACs may suspend participating local governments’ direct payments if they use funds for non-approved uses, fail to satisfy the MOU’s reporting requirements, or fail to meet the conditions for direct payment described above.[11]

If participating local governments forego their shares, regional OACs are responsible for directing and administering the distribution of those funds based on proposals from community groups or localities.[12]

Is this share attached to an explicit bar against supplantation?

No, supplantation is not prohibited. Like most states, Washington does not explicitly prohibit supplantation uses of its opioid settlement funds. This means that the 50% 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?

Eventually (public reporting required). Opioid settlement expenditures are not officially published in a centralized location for this share. Expenditure data will likely be published by the Regional Opioid Abatement Councils (OACs), given that each are required to “[d]evelop[] and maintain[] a centralized public dashboard or other repository for the publication of expenditure data.”[13]

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

What else should I know?

Not applicable.

Citations

1. , , (“All Opioid Funds shall be held in a [Qualified Settlement Account] and distributed by the Trustee, for the benefit of the Participating Local Governments, only in a manner consistent with this MOU”) and (referring to Exhibit B). See also and Para. 3.A-3.D (defining “Participating Local Governments” to mean those participating in Washington’s opioid settlement agreements) and . HCA. Updated January 6, 2023. Accessed September 1, 2024 (“The 125 eligible cities and counties that signed onto the distributors settlement are covered by a memorandum of understanding (MOU),” and “[a]ll 125 of these cities and counties signed onto the MOU as of 10/3/22”). ↑

2. (“In the event any county does not participate in this MOU, that county’s percentage share shall be reallocated proportionally amongst the Participating Counties by applying this same methodology to only the Participating Counties”), (“Cities and towns with a population of less than 10,000 shall be excluded from the allocation, with the exception of cities and towns that are Litigating Participating Local Governments) and (“A Local Government that chooses not to become a Participating Local Government will not receive a direct allocation of Opioid Funds. The portion of the Opioid Funds that would have been allocated to a Local Government that is not a Participating Local Government shall be redistributed to Participating Counties in the manner directed in C.4.a above”). ↑