60% Opioid Addiction Treatment and Recovery Fund Share

Where do these monies live?

The Opioid Addiction Treatment and Recovery Fund holds the state’s share of opioid settlement funds.[1] The Fund holds monies from the local share that local governments can choose to direct to the Fund.[2]

Note: This 60% allocation to the state applies to the grand majority, but not all, of Missouri’s opioid settlements.[3]

What can this share be spent on?

In general, and with limited exceptions, the state must spend its share on the uses described in the national settlement agreement’s (non-exhaustive) Exhibit E, Schedule B (“Approved Uses”),[4] which includes prevention, harm reduction, treatment, recovery, and other strategies.

The Fund must also be specifically spent only to “pay for opioid addiction treatment and prevention services,” including their related “health care and law enforcement costs.”[5]

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

General Assembly decides. The Missouri General Assembly appropriates Fund monies to state agencies and departments for uses on opioid use disorder treatment and prevention:[6]

In 2022-23, the legislature appropriated Fund monies to DMH, DOH, and the Office of Administration.[14] In 2024, the Department of Mental Health continued to be a major recipient of Fund appropriations.[15] As in many other states, the Missouri Governor has line-item veto authority over specific appropriations.

Is this share attached to an explicit bar against supplantation?

No, supplantation is not prohibited. Like most states, Missouri does not explicitly prohibit supplantation uses of its opioid settlement funds. This means that the 60% Opioid Addiction Treatment and Recovery Fund 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 (public reporting required). View annual reports on the Department of Mental Health’s Opioid Settlement Reporting Website.[16] DMH is required to annually report to the legislature, and this report must be published online.[17] The drop-down feature here also links to expenditure reports for specific categories of recipients.

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

What else should I know?

Missouri’s non-litigating subdivisions’ amounts are distributed directly to them from the state’s share of funds, not the local share, and according to Exhibit G of the national settlements.[18]

Citations

  1. Mo. Rev. Stat. Sec. 196.1050(2)(1) (establishing the Opioid Addiction Treatment and Recovery Fund); Memorandum of Understanding Between the State of Missouri and its Political Subdivisions on Proceeds Relating to the Settlement of Opioid Litigation (MOU) C.25 (“60% [Opioid Settlement Funds (applying to funds from the Janssen and Distributor settlements only)] to the State Share”); and MOU C.28 and D.32 (“All Opioid Settlement Funds [and all Bankruptcy Settlement Funds] allocated to the State Share shall be deposited into the Opioid Addiction Treatment and Recovery Fund”). ↑

  2. MOU C.29 (“Any Political Subdivision that cannot use its Opioid Settlement Funds for Approved Uses as required by this MOU may remit their allocated share of Opioid Settlement Funds to the State to be deposited in the Opioid Addiction Treatment and Recovery Fund”). See also Summary of Missouri Recipients. Missouri Department of Mental Health (DMH). Accessed September 1, 2024 (describing the state’s share of funds as also containing “[r]estitution payments (state only) to compensate states that did not use outside counsel”). ↑

  3. Bankruptcy-related winnings, e.g., Purdue and Mallinckrodt, are allocated differently: 85% to the state and 15% to litigating subdivisions. MOU D.30. Missouri’s MOU differentiates its intrastate opioid settlement allocation between “Opioid Settlement Funds” (Distributor and Janssen settlements) and “Bankruptcy Settlement Funds” (Purdue and Mallinckrodt). MOU B.12 and B.15 (“Settlement Fund Definitions”); see also MOU D.31 (describing Purdue/Sackler appeal contingency), MOU G.48 (“The provisions relating to the Bankruptcy Settlement Funds in this MOU shall become binding upon the Effective Date in the Purdue Bankruptcy Settlement and/or the Mallinckrodt Bankruptcy Settlement”), and MOU G.50 (“This MOU does not automatically apply to future national settlements with opioid manufacturers, distributors, or other opioid-related Defendants not named herein. It will only apply to such settlements if the State and Political Subdivisions agree in a separate written MOU or other Agreement executed by the applicable parties”). Given that the Distributor and Janssen settlements combined provide the largest monetary award in any state, including Missouri, the headers in this Community Guide describe Missouri’s intrastate shares according to the 60%-40% allocation attached to those settlements. The complete breakdown of Missouri’s entitlements under these awards may be found using OpioidSettlementTracker.com’s Global Settlement Tracker. ↑

  4. MOU C.28, D.32 (“All Opioid Settlement Funds [and all Bankruptcy Settlement Funds] allocated to the State Share shall be deposited into the Opioid Addiction Treatment and Recovery Fund and used only for Approved Uses consistent with the provisions of Mo. Stat. Ann. Sec. 196.1050”) and MOU B.24 (defining “Approved Uses” to mean “those uses identified in the J&J National Settlement and the Distributor National Settlement”). ↑

  5. Mo. Stat. Ann. Sec. 196.1050(1) (funds “shall only be utilized to pay for opioid addiction treatment and prevention services and health care and law enforcement costs related to opioid addiction treatment and prevention. Under no circumstances shall such settlement moneys be utilized to fund other services, programs, or expenses not reasonably related to opioid addiction treatment and prevention”). ↑

  6. Mo. Stat. Ann. Sec. 196.1050(2)(1) (describing the state treasurer as the “custodian” of funds who “may” approve the legislature’s disbursements). See Suzanne King. KC-area politicians pick between war on drugs or treatment when spending opioid settlement. Missouri Independent. April 17, 2024. Accessed September 1, 2024 (“In Missouri, the legislature makes the spending choices about the state’s share of the settlement. Of the $71.5 million Missouri received so far, $14.3 million went to the departments of mental health, health and senior services, social services, corrections and the office of administration”). ↑

  7. Mo. Stat. Ann Sec. 196.1050(2)(1). See First Annual Report to the Missouri General Assembly on Opioid Settlement Funds. DMH. March 1, 2024. Accessed September 1, 2024 (describing DMH as receiving the bulk of appropriations in both 2022 and 2023). ↑

  8. Sec. 196.1050(2)(1); referred to as “Department of Health” by DMH’s First Annual Report to the Missouri General Assembly on Opioid Settlement Funds (March 1, 2024) (describing DOH as receiving appropriations in 2023 but not 2022). ↑

  9. Mo. Stat. Ann. Sec. 196.1050(2)(1). ↑

  10. Mo. Stat. Ann. Sec. 196.1050(2)(1). ↑

  11. Mo. Stat. Ann. Sec. 196.1050(2)(1), as amended by 2022 MO HB 2162 (added the Department of Corrections, the Office of Administration, and the judiciary). ↑

  12. Mo. Stat. Ann. Sec. 196.1050(2)(1). ↑

  13. Mo. Stat. Ann. Sec. 196.1050(2)(1). ↑

  14. First Annual Report to the Missouri General Assembly on Opioid Settlement Funds. DMH. March 1, 2024. Accessed September 1, 2024. ↑

  15. 2024 MO HB 2010. For example, DMH received $6,044,000 for “community grants to local governments impacted by the opioid epidemic” (Sec. 10.105), $8 million for “statewide distribution of opioid antagonists to . . . law enforcement agencies and first responders” (Sec. 10.110), and $5 million for “competitive grants to research universities for opioid related research and its (sic) ability to treat opioid addiction” (Sec. 10.114). ↑

  16. MOU F.42 (describing reporting requirements); Missouri Department of Mental Health, Missouri Opioid Settlements. Accessed August 7, 2024 (“As long as the State of Missouri and its local governments are receiving payments, the Department of Mental Health will continue to coordinate reporting through this website”). ↑

  17. MOU B.18-19 (defining “Non-Litigating Subdivisions” to mean “Political Subdivisions with a population of 10,000 or more individuals … that did not initiate opioid-related litigation on or before January 1, 2021” and “Political subdivisions” to mean “all political subdivisions of the State of Missouri”) and MOU C.27 (“The Non-Litigating Subdivisions Share of the Opioid Settlement Funds shall be deducted from the State Share; it shall not be deducted from the Litigating Subdivisions Share. The Non-Litigating Subdivisions Share shall be paid directly to them by the national administrator and shall not be deposited into accounts for the State of Missouri”). See also MOU C.26 (“Thus, Non-Litigating Subdivisions shall receive the same amount under Exhibit G they would have received as if 15% of the Opioid Settlement Funds had been allocated to all Political Subdivisions”). ↑

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