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

• 70% abatement share: Mississippi state legislature

• 15% state share: Mississippi state legislature

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

Has the state established an advisory body for settlement funds?

No. Mississippi has not established an advisory body to inform opioid settlement spending.

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?

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

What else should I know?

In July 2024, Mississippi Attorney General Lynn Fitch referred to a “two-prong proposal” to allocate this 70% abatement share differently.[1] As proposed by the AG, only half of this 70% abatement share would be directed to CAM as per the MOU, and the other half “would become an annual grant program through which a committee established by the Legislature would distribute funds to [abatement] projects.”[2] Both advocates and leaders within the state await finalization of Mississippi’s opioid settlement spending scheme, including the creation of any advisory committees.[3]

Citations

1. “[W]e created a two-prong proposal to meet the abatement requirements in these settlements.” Lynn Fitch. . . July 13, 2024. Accessed September 1, 2024. ↑

2. “Ensuring Mississippi got its full funding due was our top priority, so we proposed that the Legislature divide the abatement funds from these eight settlements roughly in half. The first half of the funds would go to the University of Mississippi Medical Center to create and run the Center for Addiction Medicine – a project that clearly checks the boxes for these settlements. The other half would become an annual grant program through which a committee established by the Legislature would distribute funds to projects that also meet the abatement requirements around the State.” Lynn Fitch. . . July 13, 2024. Accessed September 1, 2024. ↑

3. See “What else should I know?” (below) for more. See also Violet Jira and Henry Larweh. . KFF Health News and Mississippi Today. August 14, 2024. Accessed September 1, 2024 ("According to Leah Smith, deputy chief of staff for Lt. Gov. Delbert Hosemann, his office intends to meet with Mississippi state leaders and advocates ‘to establish a plan to be adopted by the Legislature when it next meets in January,’ although the timeline is uncertain”). ↑

Where do these monies live?

According to Mississippi’s MOU, seventy percent (70%) of Mississippi’s opioid settlement funds are directed to the University of Mississippi Medical Center’s (UMMC) Center for Addiction Medicine (CAM) “to establish a new multidisciplinary program … dedicated to both short-term and long-term opioid abatement.”[1]

In July 2024, Mississippi Attorney General Lynn Fitch referred to a “two-prong proposal” to allocate this 70% abatement share differently.[2] As proposed by the AG, only half of this 70% abatement share would be directed to CAM as per the MOU, and the other half “would become an annual grant program through which a committee established by the Legislature would distribute funds to [abatement] projects.”[3] There is some indication that this share must pass through the state’s newly created Opioid Settlement Fund prior to its use by UMMC as well.[4] Both advocates and leaders within the state await finalization of Mississippi’s opioid settlement spending scheme.[5]

What can this share be spent on?

The national Distributor and Janssen settlement agreements require states to spend at least 70% of their proceeds on prospective abatement uses (i.e., “future Opioid Remediation”), as illustrated by the (non-exhaustive) , which includes prevention, harm reduction, treatment, recovery, and other strategies.[6] According to , Mississippi has opted to satisfy this abatement requirement by directing this amount to the creation of a new multidisciplinary program at the University of Mississippi Medical Center (UMMC),[7] described as “Mississippi’s only academic medical center dedicated to both short-term and long-term opioid abatement.”[8]

This means that this share must only be spent on prospective abatement and may not be used as reimbursement,[9] whether by UMMC or otherwise.[10]

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

State legislature decides. The will decide how this 70% abatement share is ultimately spent,[11] whether exclusively by UMMC’s new multidisciplinary program, as grants administered via committee, or otherwise.[12]

Are supplantation uses prohibited for this share?

No, supplantation is not prohibited. Like most states, Mississippi does not prohibit supplantation uses of its opioid settlement funds. This means that the University of Mississippi Medical Center can spend its share 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 for an updated collection of states’ and localities’ available expenditure reports.

What else should I know?

Mississippi has been slower than most states in finalizing its allocation and decision-making scheme.

• The state’s allocates Mississippi’s 70% abatement share to the Center for Addiction Medicine (CAM). Our 2023 Community Guides referred to UMMC’s (CIDA) as a possible alternate recipient of this share,[13] given that evidence of CAM’s existence — beyond its initial MOU mention — could not at the time be identified.

• In July 2024, the state’s Attorney General penned a column for the Daily Journal that described CAM’s existence as an unfinalized but likely eventuality.[14] The AG proposed to further subdivide the state’s 70% abatement share 50/50 between CAM and “an annual grant program through which a committee established by the Legislature would distribute funds.”[15]

• In August 2024, KFF Health News reported on the continued uncertainty surrounding the state’s opioid settlement abatement planning and linked to a provided by the state Attorney General’s office that “explains why [CAM] should receive millions in settlement funds.” This document is described by

Citations

1. Mississippi State-Local Government Opioid Litigation Memorandum of Understanding, (“The [University of Mississippi Medical Center’s Center for Addiction Medicine (CAM)] will receive 70% of all Opioid Funds to establish a new multidisciplinary program through Mississippi’s only academic medical center dedicated to both short-term and long-term opioid abatement”). See also (paraphrasing the national settlement agreements’ 70% “future Opioid Remediation” requirement and announcing that the AGO will work with UMMC to create a program to meet this requirement). ↑

2. “[W]e created a two-prong proposal to meet the abatement requirements in these settlements.” Lynn Fitch. . . July 13, 2024. Accessed September 1, 2024. ↑

3. “Ensuring Mississippi got its full funding due was our top priority, so we proposed that the Legislature divide the abatement funds from these eight settlements roughly in half. The first half of the funds would go to the University of Mississippi Medical Center to create and run the Center for Addiction Medicine – a project that clearly checks the boxes for these settlements. The other half would become an annual grant program through which a committee established by the Legislature would distribute funds to projects that also meet the abatement requirements around the State.” Lynn Fitch.

Can I provide input on spending?

• 70% abatement share: No opportunities available (not required). The Mississippi state legislature has not established recurring opportunities for the public to provide input on uses of the 70% abatement share.[1]

• 15% state share: No opportunities available (not required). The state has not established recurring opportunities for the public to provide input on uses of its 15% share.[2]

• 15% local share: Up to each locality (not required). Local governments are not required to seek public input on uses of their collective 15% share. However, each may choose to seek such input. Watch for other opportunities to weigh in on city and county spending decisions, such as city council meetings and town halls.

Can I apply for grants?

It depends. As of September 1, 2024, Mississippi 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.

Where do I go for updates?

• A single resource containing opioid settlement-related updates on the 70% abatement share could not be found.[3]

• A single resource containing state share updates could not be found.[4] The state Attorney General’s website contains information related to the litigation only.

• For updates on the local share, a good starting point is to check the website for your county board of supervisors, city council, or local health department.

• You can also

What else should I know?

Not applicable.

Citations

1. If you see this change, email . ↑

2. If you see this change, email . ↑

3. If you see this change, email . ↑

4. If you see this change, email . ↑

University of Mississippi Medical Center

• Center for Innovation and Discovery in Addictions (CIDA)

Mississippi Attorney General

Community Education Group

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

Where do these monies live?

This share is paid to Mississippi’s Attorney General, who deposits the funds into the state’s Opioid Settlement Fund created in 2024.[1]

What can this share be spent on?

Where do these monies live?

This share is distributed directly to 146 participating counties, cities, towns, and villages according to the percentages listed here­­­.[1]

What can this share be spent on?

Mississippi’s settlement memorandum of understanding provides that localities “may” spend funds from this share “for opioid abatement, or any purpose deemed appropriate by [a] County or Municipality,” with no more than half used for certain local governments’ attorneys’ fees.[2] However, at least a portion of monies in this share must be spent on abatement uses (as illustrated the non-exhaustive , which includes prevention, harm reduction, treatment, recovery, and other strategies) to ensure the state meets the minimum opioid remediation spending requirements in later settlement agreements.[3]

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

Local governments decide autonomously. Decisionmakers for counties, cities, towns, and villages will decide for themselves how to spend their monies from this share.[4]

Are supplantation uses prohibited for this share?

No, supplantation is not prohibited. Like most states, Mississippi does not prohibit supplantation uses of its opioid settlement funds. This means that its 15% 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

1. Mississippi State-Local Government Opioid Litigation Memorandum of Understanding, (“The County/Municipality fund will receive 15% of all Settlement funds for the direct benefit of Mississippi Counties and Municipalities. The amounts to be distributed to each County and Municipality shall be determined by the Negotiation Class Metrics”). Non-litigating cities and towns with populations under 10,000 will have their amounts reallocated to their counties. Mississippi State-Local Government Opioid Litigation Memorandum of Understanding, . See also Mississippi State-Local Government Opioid Litigation Memorandum of Understanding, (defining “County” to mean “one of the 82 governmental subdivisions in the State recognized and/or established under the Mississippi Constitution of 1890 that filed a lawsuit against settling Pharmaceutical Supply Chain Participants as of August 1, 2021, or has a population greater than 10,000 individuals”), (defining “Municipalities” to mean “cities, towns, or villages within the State with a population greater than 10,000 individuals and shall also include all cities and towns that filed a lawsuit against settling Pharmaceutical Supply Chain Participants as of August 1, 2021”). Note that all Opioid Settlement Funds are deposited into the Attorney General Contingency Fund before being allocated into the respective shares. Mississippi State-Local Government Opioid Litigation Memorandum of Understanding, . ↑

2. Mississippi State-Local Government Opioid Litigation Memorandum of Understanding, . A maximum of 7.5% may be spent for certain local governments’ attorneys’ fees.