Spending opioid settlement money in New York

ALBANY, N.Y. (NEXSTAR) — On August 14, a coalition of 200 advocacy organizations released a series of recommendations for reducing overdoses, using money won from settlements from those who profited off the opioid epidemic. It pushes for transparent funding to proven public health approaches across the country, rather than backing policies from the generations-long drug war.

Their roadmap argues that jailing drug addicts or alcoholics instead of treating addiction separates families, and that corporate money-grabs often pretend to be harm reduction. Their recommendations center on rehabilitation—they want needle exchange programs, employment initiatives, expunging of criminal records, more access to opioid-reversal drugs like naloxone, and focusing on kids from families damaged by substance abuse.

The broader aspects of their recommendations already appear in New York State law. Signed by the governor after the 2021 legislative session, S7194 / A6395B ceated a new “Opioid Settlement Fund” managed by the State Comptroller and the Commissioner of Taxation and Finance. An Opioid Settlement Advisory Board —made of 21 experts in public health, addiction, and related fields—would also help decide spending.

The Advisory Board last met in July. Beyond representing a broad range of expertise, they represent appointments from a broad range of state leadership:

1. A representative for the Commissioner of Addiction Services and Supports (Dr. Chinazo Cunningham)
2. A representative for the Commissioner of Mental Health (Dr. Ann Marie Sullivan)
3. A representative for the Commissioner of Health (Dr. James McDonald)
4. A representative for the Director of the Division of Budget (Blake Washington)
5. Two members appointed by the governor (Kathy Hochul)
6. Three members appointed by the temporary president of the senate (Majority Leader Steward Cousins)
7. Three members appointed by the Assembly Speaker (Carl Heastie)
8. One member appointed by the Attorney General (Letitia James)
9. One member appointed by the mayor of New York City (Eric Adams)
10. Seven members—nominated by an association representing 90% of counties and 90% of the population (roughly 56 counties numbering at least 17 million New Yorkers)—and then selected by:
    • Three more from the governor
    • One more from the Senate President
    • One more from the Speaker of the Assembly
    • One from the Senate Minority Leader (Rob Ortt)
    • One from the Assembly Minority Leader (William Barclay)

The fund must be separate from other state funds and used for new addiction prevention, treatment, and recovery programs. Those would include, for example, public health education, harm reduction initiatives, and housing for people in recovery. The law makes it clear that settlement money must be added on top of existing, ongoing funding for addiction services, not for maintaining current projects or filling budgetary holes.

When the state receives settlement money, it gets distributed in two ways. Some goes directly to counties, cities, and towns for local programs. There are different rules for different counties and New York’s Office of Addiction Services and Supports (OASAS) has formulas for how the money gets divided, but this bucket of funding would not be subject to Advisory Board recommendations.

The rest of the money gets channeled through OASAS for individual grant programs to nonprofits, healthcare systems, and individual programs. Their website has many open requests for proposals where organizations can apply for grants from settlement funds. The legislature can also pass measures directing how OASAS spends the money.

According to a spokesperson from OASAS, New York has offered over $335 to communities affected by the opioid crisis from settlement funds. They aim to fund local outpatient treatment programs and recovery centers, medication delivery, community outreach programs, training and recruitment for more addiction specialists, and handing out over half a million naloxone kits.

Although each settlement agreement with opioid profiteers differs in precise specifics , some share the general financial structure outlined broadly below:

• 46.11% to local governments
  • 6.68% to Nassau County
  • 8.63% to Suffolk County
  • 10.8% to all participating counties except Nassau and Suffolk
  • 20% to New York City for approved uses
• 36.99% to the Opioid Settlement Fund
  • 45% (16.39% of total) for regional spending
  • 55% (20% of the total) to lead state agency (OASAS) for discretionary spending on state projects that qualify as approved uses
• 17.5% to New York State

In the Assembly, Rep. Phil Steck chairs the Committee on Alcoholism and Drug Abuse, which is not the Opioid Settlement Advisory Board that’s empowered to make recommendations for spending settlement funds. He worries that settlements aren’t supplementing funding with new initiatives, but maintaining funding at existing levels, contrary to the 2021 law that Gov. Kathy Hochul signed.

“People are more concerned with a lot of other aspects of the budget like education, healthcare,” Steck said. “It’s not something that the typical voter has in the forefront of their mind despite the fact that they know someone [who is addicted to drugs or alcohol.]”

Steck, concerned with transparency, also highlighted the Opioid Stewardship Fund. Former Gov. Andrew Cuomo created that fund in 2018 from additional tax on opioids and controlled by the executive branch. Steck supported S9836 / A9100 in the previous legislative session to get greater transparency around that money.

OASAS maintains data breaking down substance use disorder and overdose deaths statewide . For example, they said that overdose deaths decreased in 2023, but that New Yorkers are likelier to use cocaine, ecstasy, molly, heroin, or meth than the average American.

The coalition that created the roadmap of recommendations included:

• The Center for Popular Democracy
• Community Education Group
• HEAL Ohio
• Legal Action Center
• National Council on Alcoholism and Drug Dependence-Maryland Chapter
• New Jersey Organizing Project & New Jersey Resource Project
• National Sea Change Coalition & Sea Change Recovery Community Organization & Harm Reduction Center (NJ)
• People’s Action
• VOCAL-US

International Overdose Awareness Day falls on August 31.

Related video: Grants helping local organizations fight opioid epidemic

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