Hawai’i State Department of Health

• Hawai'i Opioid Settlement Project

  • Opioid Settlement Fund Data Dashboard

• Hawai’i Opioid Initiative

• Committee of Health & Homelessness Informational Briefing: "" (November 15, 2023)

Where do these monies live?

Based on the best available evidence, all of Hawai’i's opioid settlement funds, including the state’s 85% share of settlement funds, is held in a trust jointly administered by the Hawai’i Department of the Attorney General and Hawai’i State Department of Health.[1] Some materials have referred to this as the “Hawaii Opioid Settlement Trust Fund.”[2]

What can this share be spent on?

With limited exceptions,[3] this share must be spent on the remediation activities described in Exhibit A of Hawai’i’s State-Local Agreement,[4] which is largely identical to the national settlement agreements’ Exhibit E, Schedule B (“Approved Uses”) and includes prevention, harm reduction, treatment, recovery, and other strategies.[5] One of these activities must be a statewide needs assessment.[6]

Uniquely, Hawai’i’s State-Local Agreement requires spending to address non-opioid substance use: 85% of funds must be spent on “opioid-related remediation,” while 15% of funds must be spent on “other substances” (specifically, “treatment and prevention, consistent with Exhibit A, except not limited to opioids”).[7]

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

Hawai’i Opioid Settlement Advisory Council guides, Hawai’i State Department of Health decides. The Hawai’i State Department of Health ultimately decides specific expenditures for this share after consulting the Hawai’i Opioid Settlement Advisory Committee.[8] The state is required to conduct a statewide needs assessment that includes input from local governments.[9]

Are supplantation uses prohibited for this share?

No, supplantation is not prohibited. Like most states, Hawai‛i does not explicitly prohibit supplantation uses of its opioid settlement funds. This means that the 85% State Share may be spent in ways that replace (or “supplant”) — rather than supplement — existing resources.

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 for an updated collection of states’ and localities’ available expenditure reports.

Not applicable.

1. Memorandum of Agreement Between the State of Hawai’i and Local Governments on Proceedings Relating to the Settlement of Opioid Litigation (“Hawai’i State-Local Agreement”), Sec. (“85% of the Total Opioid Settlement Funds shall be spent by the State”); Addendum to Memorandum of Agreement Between the State of Hawai’i and Local Governments on Proceedings Relating to the Settlement of Opioid Litigation (“Addendum to Hawai’i State-Local Agreement”), Sec. (providing that “[t]he MOA shall apply to Phase 2 National Settlements in all respects”); Memorandum of Agreement Between Department of Health and Honolulu Emergency Services Department (“State-Honolulu Settlement MOA”), (describing state’s opioid settlement funds as “held in a trust and jointly administered by the Department of the Attorney General and the Department of Health”). ↑

2. See, e.g., Hawai’i Opioid Settlement Advisory Committee, (presentation for Committee of Health & Homelessness Informational Briefing). Hawai’i State Department of Health. November 15, 2023. Accessed August 28, 2024; Matthew Leonard. . Honolulu Civil Beat. May 28, 2024. Accessed August 28, 2024 (reporting on “appointment of a full-time project coordinator to manage Hawaii’s opioid settlement trust fund”). ↑

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

• 85% state share:

• 15% local share: decisionmakers for Hawai’i County, Kaua’i County, Maui County, and the City and County of Honolulu

Has the state established an advisory body for settlement funds?

Yes. The Hawai‛i Settlement MOA established an Hawai‛i Opioid Settlement Advisory Committee (HOSAC) to consultat with the state on uses of its 85% share.[1] Other than providing that the HOSAC may “seek guidance from experts in addiction, pain management, opioid remediation, and public health,”[2] the MOA provides no detail on the HOSAC’s role or operations.

• Testimony regarding legislation proposed in 2024 has offered slightly more information on HOSAC’s activities, revealing that it has the power to establish its own meetings procedures and hire staff, and that it has both “[r]esearched best practices to distribute the funds in a community driven[,] transparen[t] manner” and “[i]dentified over $13 million in planned spending on county and state-wide projects” since its formation.[3]

• According to its recent meetings materials, HOSAC meets virtually every month.[4]

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

No. The HOSAC is not required to include a member with lived and/or living experience.

The HOSAC’s membership is established by the and includes the following eight representatives:[5]

• The mayors or their designees from the city and county of Honolulu and counties of Hawai'i, Kaua’i, and Maui (4 members total)

• Designee of the Director of the Department of Health

• Director of the Department of Public Safety or their designee

• Superintendent of the Department of Education or their designee

Members are appointed to two-year terms.[6] A roster of HOSAC members may be found .

No (up to each locality). Local governments in Hawai‛i are not required to establish opioid settlement advisory bodies. However, localities may independently choose to establish advisory councils that include members with lived and/or living experience to help ensure that settlement spending reflects community priorities.

Not applicable.

1. Memorandum of Agreement Between the State of Hawai’i and Local Governments on Proceedings Relating to the Settlement of Opioid Litigation (“Hawai’i State-Local Agreement”), Sec. ; Addendum to Memorandum of Agreement Between the State of Hawai’i and Local Governments on Proceedings Relating to the Settlement of Opioid Litigation (“Addendum to Hawai’i State-Local Agreement”), Sec. (providing that “[t]he MOA shall apply to Phase 2 National Settlements in all respects”). ↑

2. Hawai’i State-Local Agreement, Sec. . ↑

3. . Hawai’i State Department of Health Alcohol and Drug Abuse Division. February 14, 2024. Note: did not pass. ↑

Can I provide input on spending?

• State share: No opportunities available (not required). The state has not established recurring opportunities for the public to provide input on uses of its 85% share.[1] Members of the public are instructed to email doh.adad.opioidsettlement@doh.hawaii.gov for information on how to virtually attend meetings of the Hawai‛i Opioid Settlement Advisory Committee (HOSAC).[2]

  • A November 2023 presentation by the Hawai‛i State Department of Health describes an interest in requests for information as one means of “[g]athering public input,” with “public feedback portal” and “listening sessions” listed as “TBD,” without describing a commitment to their certain delivery.

• Local share: Generally, yes. Though local governments are not required to seek public input as to opioid settlement spending specifically, Hawai‛i’s open meetings law requires the opportunity for public comments at the meeting of any board.[3] Watch also for opportunities to weigh in on city and county spending decisions, such as city council meetings and town halls.

It depends. As of September 1, 2024, Hawai’i has not established any settlement-funded grant opportunities for which community organizations are eligible to apply. 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 state share, keep an eye out for a website from the Hawai‛i State Department of Health, which in late 2023 stated that it will contract with one of its existing vendors to develop a website that will serve as a “one-stop shop” for information on opioid settlements in the state.[4]

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

Not applicable.

1. If you see this change, email . There is no legal requirement for decision-makers to seek public input on uses of this share. Though Hawai‛i’s open meetings law requires the opportunity for public comments at the meeting of any board, Haw. Rev. Stat. Ann. Sec. 92-3, the HOSAC may not meet the definition of a board, Haw. Rev. Stat. Ann. Sec. 92-2 (“A ‘board’ is an agency, board, commission, authority, or committee of the State or its political subdivisions which is created by constitution, statute, rule, or executive order”). See Memorandum of Agreement Between the State of Hawai’i and Local Governments on Proceedings Relating to the Settlement of Opioid Litigation (“Hawai’i State-Local Agreement”), Sec. (outlining Advisory Committee's creation by the MOU – not by constitution, statute, rule, or executive order); Addendum to Memorandum of Agreement Between the State of Hawai’i and Local Governments on Proceedings Relating to the Settlement of Opioid Litigation (“Addendum to Hawai’i State-Local Agreement”), Sec. (providing that “[t]he MOA shall apply to Phase 2 National Settlements in all respects”). ↑

2. Hawai’i State Department of Health: . ↑

Where do these monies live?

Based on the best available evidence, all of Hawai’i's opioid settlement funds, including the 15% local government share, is held in a trust jointly administered by the Hawai’i Department of the Attorney General and Hawai’i State Department of Health (DOH).[1] Apart from Kalawao County’s de minimis share,[2] these monies are transferred to Hawai’i’s counties via intergovernmental agreements between DOH and each county according to the following percentages:[3]

• Hawai’I County, 18.2671692501%

• Kaua’i County, 5.7006273580%

• Maui County, 13.9979969296%

• City and County of Honolulu, 62.0307563109%

This share must be spent on the uses described in of Hawai’i’s State-Local Agreement,[4] which is largely identical to the national settlement agreements’ Exhibit E, (“Approved Uses”) and includes prevention, harm reduction, treatment, recovery, and other strategies.[5]

Uniquely, Hawai’i’s State-Local Agreement requires spending to address non-opioid substance use: 85% of funds must be spent on “opioid-related remediation,” while 15% of funds must be spent on “other substances” (specifically, “treatment and prevention, consistent with Exhibit A, except not limited to opioids”).[6]

Localities decide. Decisionmakers for Hawai’i, Kaua’i, Maui, Honolulu counties will ultimately decide specific expenditures for their shares, while Kalawao County’s 0.00345% will be spent by the state.[7]

The City and County of Honolulu, for example, entered into a (Honolulu MOA) with the state’s Department of Health (DOH) to direct its share for fiscal year 2022-2023 to its emergency services department. The Honolulu MOA’s describes the county’s planned expenditures, which fall into staffing, equipment purchasing, public education campaigns, lab training, and other categories.[8]

Hawai’i County directed its share to the , a cross-sector coalition “dedicated to reducing overdose deaths and the negative impacts of fentanyl on Hawaiʻi Island,”[9] and the , a longstanding non-profit treatment provider and the Taskforce’s fiscal sponsor.[10]

No, supplantation is not prohibited. Like most states, Hawai‛i does not explicitly prohibit supplantation uses of its opioid settlement funds. This means that counties, cities, and towns may spend their shares ways that replace (or “supplant”) — rather than supplement — existing resources.

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.

Although a by the state Department of Health emphasized county autonomy, local government press and media reports suggest that expenditures from this share are still subject to the state government’s spending processes.[11]

1. Memorandum of Agreement Between the State of Hawai’i and Local Governments on Proceedings Relating to the Settlement of Opioid Litigation (“Hawai’i State-Local Agreement”), Sec. (“Each year, 15% of the Total Opioid Settlement Funds shall be spent by the State at the local government level”); Addendum to Memorandum of Agreement Between the State of Hawai’i and Local Governments on Proceedings Relating to the Settlement of Opioid Litigation (“Addendum to Hawai’i State-Local Agreement”), Sec. (providing that “[t]he MOA shall apply to Phase 2 National Settlements in all respects”); Memorandum of Agreement Between Department of Health and Honolulu Emergency Services Department (“State-Honolulu Settlement MOA”), (describing state’s opioid settlement funds as “held in a trust and jointly administered by the Department of the Attorney General and the Department of Health”). ↑

2. Hawai’i State-Local Agreement, Sec. (“H12 Kalawao County, Hawaii 0.0034501514%”); Addendum to Hawai’i State-Local Agreement, Sec. (applying terms to Phase 2 settlements). ↑

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