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

• 72.5% West Virginia First Foundation share: and regions decide

• 24.5% local share: local officials for counties, cities, towns, and villages

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

West Virginia First Foundation

• About the Foundation

• Notice of Questions and Responses Regarding RFPs (January 19, 2024)

• Contact us

West Virginia Attorney General

• and Guidance Regarding Accounting for Opioid Settlement Funds

• (December 20, 2023)

Can I provide input on spending?

• 72.5% West Virginia First Foundation share: Not… yet? (required) The Foundation’s Public Access Policy requires its Board of Directors to provide an opportunity for public comments and questions at each of its regular quarterly meetings, with each speaker being given no more than 5 minutes.[1] However, as of September 1, 2024, the Foundation’s Board meetings have not yet included any dedicated public comment periods.[2] Upcoming meeting dates of the Board and information to attend virtually are available on the Foundation’s website.

  • Regional expert panels. Expert panels, established to provide input and recommendations on spending and review grant proposals from their designated region, are also required to “engage with the public of their Region quarterly to identify concerns and funding priorities.”[3]

• 24.5% local share: Up to each locality (not required). Local governments are not required to seek public input on uses of their shares. However, each may choose to seek such input.[4] Watch for opportunities to weigh in on city and county spending decisions, such as city council meetings and town halls.

Yes. Visit the West Virginia First Foundation’s “Requests for Proposals” to view current opportunities for grants from the 72.5% Foundation 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.

• For updates on the Foundation share, visit the West Virginia First Foundation’s , which includes , a list of , and links to that govern its activities.

• To find updates on the local share, a good starting point is to check the websites for your county commission, city council, or local health department. See, e.g., the opioid settlement-specific websites maintained by , , .

• You can also check for updates on Community Education Group’s which tracks information about the 13 states of Appalachia.

The Foundation’s website includes a .

1. . West Virginia First Foundation, Inc. Feb. 2, 2024. ↑

2. See, e.g., . Accessed September 1, 2024. ↑

3. . West Virginia First Foundation, Inc. Accessed September 1, 2024. These “identified needs” are “vetted by the Regional Panel and … submitted to the State Panel.” Id. Regional Panels also must “conduct a needs assessment in their Region every fiscal year to aid the

   Board in formulating the annual budgeted amount of disbursements,”

The is a non-profit organization created to hold 72.5% of the state’s opioid settlement funds.[1] The Foundation’s share is subdivided as follows:

• 80% Board share (58% of total funds statewide). Most of the Foundation share is disbursed by the Foundation’s .[2]

• 20% regional share (14.5% of total funds statewide). During the first seven years of the Foundation’s funding (through approximately 2030),[3] 20% of its annual budget will be spent on and disbursed using fixed Regional Share Calculations.[4]

Has the state established an advisory body for settlement funds?

Yes. The West Virginia First Memorandum of Understanding requires the creation of the West Virginia First Foundation, which is assisted in its duties by a “governing board,” expert panel, and “regional entities.”[1] The Foundation’s policies and bylaws describe its State Expert Panel and six Regional Expert Panels, which are required to provide non-binding input and guidance regarding expenditures from the 72.5% Foundation share.[2]

The State Expert Panel must:

• Consult with each region prior to the disbursement of the region’s Regional Share Allocation[3]

• Create a process for regions to submit proposals on uses of non-discretionary distributions[4]

• Provide recommendations to regions on projects, services, or expenses to fund.[5]

• Review grant applications received from the Regional Expert Panels to ensure compliance with approved purposes[6]

• Determine strategies and funding recommendations for submission to the Foundation’s Board of Directors after reviewing and evaluating recommendations and information from the Regional Expert Panels[7]

• Assist the Foundation’s Board of Directors “in making decisions about strategies for abating the opioid epidemic in West Virginia.”[8]

The six Regional Expert Panels are required to:

• Engage with members of the public in their regions at least quarterly to “identify concerns and funding priorities,” then vet and submit “[a]ll identified needs” to the State Expert Panel.[9]

• Conduct a needs assessment for their region every fiscal year[10]

• Review applications received by a region to “ensure that the proposals meet the stated need, are [for] approved purpose(s) … and are submitted by reputable and capable entities.”[11]

Yes. The West Virginia First Foundation’s provides that the State Expert Panel and each Regional Expert Panel must include a member with expertise on “recovery / lived experience.”[13]

Additionally, the requires the Foundation’s Board to consider certain types of qualifications and experience when appointing its Expert Panel members,[14] including “personal lived experience in addiction,” which it describes as “highly preferred.”[15]

The State Expert Panel and each of the Regional Expert Panels have six members representing each of the following areas of expertise:

• Treatment (including mental health and pharmacology)

• Prevention

• Recovery / lived experience

• Systems of care, health policy, and management (including finance)

Selection process: Members of the Regional Expert Panels are nominated by the Foundation Board member representing the applicable region and approved by the greater Foundation Board.[17] Members of the State Expert Panel are nominated by members of the Regional Expert Panels representing each area of expertise and approved by the greater Foundation Board.[18]

Selection criteria: Panel members must be “experts and leaders in their respective fields,”[19] with “multiple years of work experience or an advanced degree in their respective fields.”[20] They should also be “representative … of the characteristics, demographics, and individualized needs of each region.”[21] The Expert Panel Policy includes a non-exhaustive list of that must be considered when making appointments.[22]

Terms: Members are typically appointed for 3-year terms.[23] None may simultaneously serve on the State Expert Panel and a Regional Expert Panel.[24]

No (up to each locality). Local governments in West Virginia 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.

The Foundation’s Board of Directors expanded the required areas of expertise for members of the State Expert Panel and Regional Expert Panels. As originally contemplated by the and the Foundation’s , the expert panel was to include “experts in the fields of substance abuse treatment, mental health, law enforcement, pharmacology, finance, and healthcare policy and management.”[25] The Foundation has since expanded the areas of expertise required by its to include prevention, first responders, and “recovery / lived experience.”[26]

1. (MOU). Accessed September 1, 2024 (“The Parties shall create a private … Foundation … with a governing board … , a panel of experts …, and such other regional entities”). ↑

2. . West Virginia First Foundation, Inc. Accessed June 3, 2024. Neither the State Expert Panel nor the Regional Expert Panels have the authority to bind (require) the Foundation’s Board of Directors to a particular action. . See also . Accessed September 1, 2024 (“The Board shall appoint the Expert Panel. … The purpose of the Expert Panel is to assist the Board in making decisions about strategies for abating the opioid epidemic in local communities around the state”); . Oct. 31, 2023. ↑

3. . West Virginia First Foundation, Inc. Accessed June 3, 2024. ↑

Where do these monies live?

This 24.5% local share is distributed directly to participating counties, cities, villages, and towns according to the default allocations in Exhibit C of West Virginia’s MOU.[1] Counties and their municipalities can agree to allocate the funds differently than according to the default in Exhibit C.[2] Each county and municipality receiving funds is required to set up a separate account to hold their opioid settlement proceeds separate from their general coffers.[3]

What can this share be spent on?

In general,[4] this share must be spent on the approved purposes described in Exhibit A of West Virginia’s MOU,[5] which mirrors much of the national settlement agreements’ Exhibit E but differs from it in key respects, including but not limited to its omission of syringe service programs from its “Core Strategies” list and the inclusion of an extra law enforcement category of funding to curtail the oversupply of “licit and illicit opioids.”[6]

Localities may use up to one-half of their settlements funds to reimburse for past abatement expenditures (including past “law enforcement and regional jail fees”), provided that these uses are recorded via resolution or similar government action.[7]

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

Local governments decide autonomously. Local officials in the counties, cities, villages, and towns will ultimately decide for themselves how to spend their monies on approved purposes but must report its uses to the West Virginia First Foundation.[8]

Are supplantation uses prohibited for this share?

No, supplantation is not prohibited. Like most states, West Virginia does not explicitly prohibit supplantation uses of its opioid settlement funds. This means that the local share may be spent in ways that replace (or “supplant”) — rather than supplement — existing resources.

Eventually (public reporting required). Expenditures from this share will likely be published on the Foundation’s . State law and the MOU require local governments to submit an annual report to the West Virginia First Foundation specifying their expenditures on approved purposes.[9] The Foundation is then required to publish a consolidated report of opioid settlement expenditures.[10]

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

Not applicable.

1. (“24.5% of the Net Opioid Funds shall be allocated as LG Shares. These LG Shares shall be allocated amongst the Local Governments using the default percentages set forth in Exhibit C”) and W. Va. Code Sec. 5-31-1(d) (legislature finding that “[a]ll 55 counties and virtually all participating municipalities, representing 99.6 percent of the population of West Virginia, have executed the memorandum of understanding”). See also (defining “Local Government(s)” to mean “all counties, cities, villages, and towns located within the geographic boundaries of the State”) and (“If a Local Government for any reason is excluded from a specific Settlement or Judgment, the allocation percentage for that Local Government shall be redistributed among the participating Local Governments for that Settlement or Judgment”). ↑

2. . ↑