Yes. Nevada state law establishes the (ACRN) within the (NDHHS) to provide recommendations for statewide needs assessments, spending priorities for monies from the Fund for a Resilient Nevada (Fund), and the statewide plan for allocating monies from the Fund.[1]
The ACRN is required to meet at least twice annually but has met more frequently during certain years.[2] The ACRN is required by its bylaws to comply with Nevada’s .[3]
Yes. Nevada state law requires the ACRN to include at least one member “who has survived an opioid overdose.”[4] Three additional members of the ACRN must have “experience having a substance use disorder or having a family member who has a substance use disorder.”[5]
The composition of the 17-member Advisory Committee for a Resilient Nevada is defined by state law:[6]
Nevada’s Opioid Settlements
This Community Guide will describe how Nevada is spending its opioid settlements, and whether Nevada is working to ensure community access to opioid settlement funds. Last revised September 1, 2024.
Three (3) members appointed by the state attorney general who possess knowledge, skills, and experience working with youth in the juvenile justice system, working with persons in the criminal justice system, and in the surveillance of overdoses, respectively.
Three (3) members with experience having a substance use disorder or having a family member who has a substance use disorder. These members must include residents of Clark County, Washoe County, and a county other than Clark or Washoe County, and are appointed by the NDHHS Office of Minority Health and Equity, the director of NDHHS, and the state attorney general, respectively.
One member who is the director of an agency that provides child welfare services or designee, appointed by the NDHHS Office of Minority Health and Equity.[7]
One member who represents a program specializing in youth substance use prevention, appointed by the NDHHS Office of Minority Health and Equity.
One member who represents a faith-based organization specializing in recovery from SUD, appointed by the NDHHS Office of Minority Health and Equity.
One member who represents a state-certified SUD program operated by a nonprofit organization, appointed by the NDHHS Office of Minority Health and Equity.
An addiction medicine physician certified by the American Board of Addiction Medicine or its successor organization, appointed by the director of NDHHS.
A member who represents a nonprofit, community-oriented organization specializing in peer-led SUD recovery, appointed by the director of NDHHS.
A member who has survived an opioid overdose, appointed by the director of NDHHS.
A member who represents a program to prevent overdoses or otherwise reduce the harm caused by using substances, appointed by the director of NDHHS.
A member who represents an organization specializing in housing, appointed by the director of NDHHS.
A member with “knowledge, skills, and experience” in K-12 education, appointed by the director of NDHHS.
Nevada state law requires appointing authorities to coordinate “when practicable” to ensure ACRN members reflect the diversity of the state and “communities within this State that are disproportionately affected by opioid use disorder and disparities in access to care and health outcomes.”[8] The list of current ACRN members is available here.
Terms: ACRN members are appointed to two-year terms and may be reappointed for an additional term.[9]
No (up to each locality). Local governments in Nevada 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.
Not applicable.
Nev. Rev. Stat. Ann. Secs. 433.726(1), 433.730(1)-(4). See also Advisory Committee for a Resilient Nevada Bylaws, Article II Sec. 2. October 14, 2021. ↑
Nev. Rev. Stat. Ann. Sec. 433.728(2) See also Advisory Committee for a Resilient Nevada Bylaws, Article V Sec. 3. October 14, 2021. The ACRN met twice in 2021; nine times in 2022; twice in 2023; and as of June, five times in 2024. Accessed September 1, 2024. ↑
Advisory Committee for a Resilient Nevada Bylaws, Article V Sec. 1. October 14, 2021. ↑
Nev. Rev. Stat. Ann. Sec. 433.726(4)(d). ↑
Nev. Rev. Stat. Ann. Secs. 433.726(2)(d)(2), (3)(a)(2), (4)(a)(2). ↑
Nev. Rev. Stat. Ann. Secs. 433.726(2)-(4). See also Advisory Committee for a Resilient Nevada Bylaws, . October 14, 2021. ↑
An “‘[a]gency which provides child welfare services’ means: 1. In a county whose population is less than 100,000, the local office of the Division of Child and Family Services; or 2. In a county whose population is 100,000 or more, the agency of the county, which provides or arranges for necessary child welfare services.” Nev. Rev. Stat. Ann. Secs. 432B.030, 433.716. ↑
Nev. Rev. Stat. Ann. Sec. 433.726(5). ↑
Nev. Rev. Stat. Ann. Sec. 433.726(6). See also Advisory Committee for a Resilient Nevada Bylaws, . October 14, 2021. ↑
Has the state established an advisory body for settlement funds?
Is the state advisory body required to include member(s) with lived and/or living experience?
What is the overall membership of the state advisory body?
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?
What else should I know?
Citations
Local officials for counties and cities
Decision-making Process
Localities decide autonomously
In consultation with its , the Nevada Department of Health and Human Services develops a spending plan for uses of this share based on a needs assessment and recommendations submitted by the .
Supplantation
Not prohibited
Prohibited
Grant Funding
Up to each locality (availability and processes will vary)
Yes. See .
Public Input
Generally, yes (public comments required at public meetings)
Yes (Advisory Committee is required to accept public comments at its meetings and solicit public input on its recommendations at an annual public meeting; see also statewide needs assessments)
Advisory Body
Up to each locality (not required)
Yes (required). See the (ACRN).
The ACRN is required to include member(s) with lived and/or living experience.
Expenditures
No public reporting required (only intrastate)
No public reporting required (only intrastate), but see the Fund for a Resilient Nevada’s (e.g., and ).
Updates
To find updates on the local share, a good starting point is to check the websites for your board of county commissioners, city council, or local health department.
For updates on the Fund for a Resilient Nevada share, visit the Fund’s , which includes updates regarding the (including ), funding opportunities, and . You can also sign up for the Fund for a Resilient Nevada (FRN) listserv .
56.14% Local Share
43.86% Fund for a Resilient Nevada (FRN) Share
$1.03 billion[1]
[1] Total is rounded. See . Accessed September 1, 2024.
56.14% to local governments and 43.86% to the state
State-Local Agreement (); Legislation ()
Ultimate Decisionmaker
Community Access
Can I provide input on spending?
56.14% local share: Generally, yes. Though local governments are not requiredto seek public input as to opioid settlement spending specifically, they must accept public comments during their public meetings, including comments that may be unrelated to a particular meeting’s agenda.[1] Take advantage of this requirement by showing up to meetings of your local city council or board of county commissioners and offering comments on local settlement spending, and watch for other opportunities to weigh in on city and county spending decisions, such as city council meetings and town halls.
43.86% Fund for a Resilient Nevada share: Yes (required). The Advisory Committee for a Resilient Nevada (ACRN) is required by its bylaws to include the opportunity for public comment during its meetings,[2] and the ACRN is required by state law to hold a least one public meeting to solicit community input prior to finalizing its biennial recommendations report.[3] Visit the ACRN’s website to find upcoming meeting dates and its 2024 ACRN Public Meetings calendar, which links to agendas that show that the ACRN typically invites public comment at the beginning and end of each meeting.[4] The ACRN is required to meet at least twice each year,[5] but has met more frequently during certain years.[6] Look out for opportunities to participate in the various needs assessments required by state law as well:
Statewide needs assessment. The Nevada Department of Health and Human Services (NDHHS) is required by state law to conduct a statewide needs assessment at least once every four years.[7] When conducting the needs assessment, NDDHS is required to “use community-based participatory research methods or similar methods to conduct outreach to groups impacted by the use of opioids, opioid use disorder and other substance use disorders,”[8] including “persons and families impacted by the use of opioids and other substances” and “communities of persons in recovery from [OUD] and other [SUDs].”[9]
Regional, local, and tribal needs assessments. Entities that apply for monies from the Fund for a Resilient Nevada must conduct their own needs assessments that also use community-based participatory research or similar methods.[10] See, e.g., and community needs assessments.
Yes. Visit the Fund for a Resilient Nevada’s webpage to view current opportunities.[11] 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.
To find updates on the local share, a good starting point is to check the websites for your board of county commissioners, city council, or local health department.
For updates on the Fund for a Resilient Nevada share, visit the Fund’s , which includes updates regarding the (including ), funding opportunities, and . You can also sign up for the Fund for a Resilient Nevada (FRN) Listserv and contact the FRN by emailing .
Not applicable.
Nev. Rev. Stat. Ann. Sec. 241.021(1)-(2). ↑
The Advisory Committee for a Resilient Nevada’s requires it to operate in accordance with Nevada’s open meetings law, which legally requires public bodies to accept public comments at their meetings. Advisory Committee for a Resilient Nevada Bylaws, . October 14, 2021; Nev. Rev. Stat. Ann. Sec. 241.021. This includes allowing public comments unrelated to matters on a specific meeting’s agenda. Nev. Rev. Stat. Ann. Sec. 241.021(2) (adding that "[n]o action may be taken upon a matter raised during a period devoted to comments by the general public until the matter itself has been specifically included on an agenda as an item upon which action may be taken”). ↑
Nev. Rev. Stat. Ann. Sec. 433.730(4) (“Before finalizing a report of recommendations pursuant to subsection 1, the Advisory Committee must hold at least one public meeting to solicit comments from the public concerning the recommendations and make any revisions to the recommendations determined, as a result of the public comment received, to be necessary”). ↑
Nev. Rev. Stat. Ann. Sec. 433.728(2). See also Advisory Committee for a Resilient Nevada Bylaws, Article V Sec. 3. October 14, 2021. ↑
The ACRN met twice in 2021; nine times in 2022; twice in 2023; and as of June, five times in 2024. Accessed September 1, 2024. ↑
Nev. Rev. Stat. Ann. Sec. 433.734(1)(a). ↑
Nev. Rev. Stat. Ann. Sec. 433.736(2)(a). ↑
Nev. Rev. Stat. Ann. Secs. 433.736(2)(a)(1), (4). ↑
Nev. Rev. Stat. Ann. Secs. 433.740(1)(a) ("An application submitted by a regional, local or tribal governmental entity must include … [t]he results of a needs assessment that meets the requirements of NRS 433.742”), 433.742(2)(a). Regional, local, and/or tribal needs assessments must be conducted at least once every four years, or more frequently if required by Nevada Department of Health and Human Services regulations. Nev. Rev. Stat. Ann. Sec. 433.740(5). ↑
The combined 56.14% local share is distributed to cities and counties in two ways:
38.77% Local Governments. These monies are allocated to cities and counties according to Exhibit D of Nevada’s state-local allocation agreement.[1] 25% of non-litigating counties’ amounts are reallocated to the litigating counties outlined in Exhibit F of Nevada’s agreement.[2]
17.37% Medicaid Match. These monies are distributed to counties: 65% to Clark County, 14% to Washoe County, and 21% to the remaining litigating and non-litigating counties by population (according to Exhibit E of Nevada’s agreement).[3]
What can this share be spent on?
Excepting several set-asides for litigation costs, attorneys’ fees, and administrative expenses,[4] this share must be spent on approved purposes,[5] which the state defines to mean uses that are consistent with ,[6] in addition to the national settlement agreement’s (non-exhaustive) ,[7] which includes prevention, harm reduction, treatment, recovery, and other strategies.
Local governments decide autonomously. Decisionmakers for the cities and counties will ultimately decide for themselves how to spend their monies on approved purposes.[8]
No, supplantation is not prohibited. Nevada does not explicitly prohibit supplantation uses of opioid settlement funds from the 56.14% local share. This means that the local share may be spent in ways that replace (or “supplant”) — rather than supplement — existing resources.
Up to each locality (no public reporting required, only intrastate). Local governments must annually report information about their past and intended spending to the Attorney General “to ensure funds are being used for approved purposes only.”[9] Nevada’s does not require publication of this information online.
Visit OpioidSettlementTracker.com’s for an updated collection of states’ and localities’ available expenditure reports.
Not applicable.
. ↑
(described as a “deduct[ion]”). ↑
. ↑
See (capping administrative costs at 8%);
,
(describing litigation costs);
(describing attorneys’ fees); and
(defining "Federal Government CMS Medicaid Costs" to mean “22.52% of any Recovery after deduction of the Lead Litigator Costs that may be asserted, and only if determined to be recoverable, against the State of Nevada's Federal Government Centers for Medicaid Services costs for claims”). ↑
(“all Recoveries must be used for Approved Purposes”) and (defining “Recoveries” to mean monies from settlements in the agreement’s , which ostensibly lists all possible defendants in the opioid litigation at large). ↑
(defining “Approved Purposes” to mean “only uses to remediate the harms, impact, and risks caused by the opioid epidemic to the State of Nevada and its residents, and are consistent with those uses required by Senate Bill 390 (SB 390) as enrolled by the 81st (2021) Nevada Legislative Session and signed into law by the Nevada Governor, or uses that are listed as an approved use for abatement purposes in any plan approved by a bankruptcy court that are not otherwise inconsistent with SB 390”). ↑
. Nevada Department of Health and Human Services (DHHS) (see “Opioids Recoveries Approved Uses,” which links to each settlement agreement’s Exhibit E or equivalent of Exhibit E [Exhibit A for bankruptcies]). Accessed August 8, 2024. See also I.SS (“Exhibit E provides a non-exhaustive list of expenditures that qualify as being paid for Opioid Remediation. Qualifying expenditures may include reasonable related administrative expenses”). ↑
, (describing allocations to local governments for approved purposes). ↑
(“Prior to July 1st of each year, or as otherwise required by any Court Order, each of the Local Governments shall provide information to the State, to the attention of Mark J. Krueger, Chief Deputy Attorney General at mkrueger@ag.nv.gov, about how they intend to expend, and how they did expend, their allocated shares of any Recovery/Recoveries to ensure such Recoveries are being used for Approved Purposes only”). ↑
Who ultimately decides how to spend this share (and how)?
Is this share attached to an explicit bar against supplantation?
The state’s 43.86% share of opioid settlement funds is held in the Fund for a Resilient Nevada and appropriated to the Department of Health and Human Services (DHHS),[1] which administers the fund.[2]
What can this share be spent on?
Excepting several set-asides for litigation costs, attorneys’ fees, and administrative expenses,[3] the state’s share of opioid settlements must be spent on approved purposes,[4] which the state defines to mean uses that are consistent with state law,[5] plus the national settlement agreement’s (non-exhaustive) Exhibit E,[6] which includes prevention, harm reduction, treatment, recovery, and other strategies.
State law requires that expenditures from the Fund be guided by a statewide plan based on a needs assessment that is developed by DHHS in consultation with its Office of Minority Heath and Equity.[7] State law also provides a non-exhaustive list of projects and uses that the statewide plan “may” include, such as expanding prevention, treatment, and recovery initiatives; programs to reduce the incidence and severity of neonatal abstinence syndrome; preventing and mitigating the harms of adverse childhood experiences; harm reduction services; housing for people with or in recovery from substance use disorder; substance use disorder provider workforce development; data collection; and capital projects, including construction costs, related to substance use.[8]
Who ultimately decides how to spend this share (and how)?
Department of Health and Human Services decides(in consultation with its Office of Minority Health and Equity). , in consultation with its , ultimately decides specific expenditures from this share based on a statewide needs assessment and plan.[9]
When conducting the statewide needs assessment and developing the statewide plan, DHHS and the Office of Minority health and Equity are required to consider recommendations submitted by the (ACRN),[10] in addition to the recommendations of “state, regional, local and tribal governmental entities in this State whose work relates to opioid use disorder and other substance use disorders.”[11]
Statewide needs assessment. The Department of Health and Human Services (DHHS), in consultation with its Office of Minority Health and Equity, must conduct a statewide needs assessment at least once every four years.[12]
Statewide plan. The , established by DHHS in consultation with its Office of Minority Health and Equity, prioritizes actions identified by the statewide needs assessment.[13] The plan must allocate funds to approved purposes,[14] whether to statewide projects or as grants to organizations or regional, local, or tribal agencies.[15] Recommendations made in the are divided into categories: Data, Prevention, Treatment, and Social Determinants of Health and Recovery Supports. Each section categorizes recommendations according to the approved purposes identified by state law. Proposed budget allocations across the plan’s goals can be found .
Yes, supplantation is prohibited. Nevada state law explicitly prohibits monies from the Fund for a Resilient Nevada from being used to “supplant existing methods of funding that are available to state, regional, local or tribal agencies.”[19] This means that this 43.86% share must only be spent in ways that supplement — rather than replace (or “supplant”) — existing resources.
Yes (no public reporting required, only intrastate). View DHHS’ annual reports on its website.[20] DHHS must report details on expenditures to the Governor, legislative leadership, the Commission on Behavioral Health, and other entities each year.[21]
Visit OpioidSettlementTracker.com’s for an updated collection of states’ and localities’ available expenditure reports.
State law requires applications for funding submitted by government entities (regional, county, local, or tribal) and private-sector organizations to contain a needs assessment and grant plan that meet specific requirements in state law.[22]
. (“State of Nevada Allocation: 43.86% to the State of Nevada”) and (“The State of Nevada’s share of Recoveries, after deduction of any remaining costs and attorney fees, shall be deposited in the Fund for Resilient Nevada through Senate Bill 390 (2021)”). Nev. Rev. Stat. Sec. 433.732(1) (“The Fund for a Resilient Nevada is hereby created in the State Treasury”), and Sec. 433.732(6) (“all money that is deposited or paid into the Fund is hereby appropriated to the Department to be used, subject to the provisions of of NRS, to carry out the provisions of to , inclusive”). ↑
Nev. Rev. Stat. Sec. 433.732(2). ↑
See Nev. Rev. Stat. Sec. 433.732(1) (“[T]he Attorney General shall, after deducting any fees and costs imposed pursuant to an applicable contingent fee contract as described in
ACRN recommendations. The ACRN must submit a recommendations report to the DHHS Director in each even-numbered year “concerning” the statewide needs assessment and statewide plan.[16] When developing its recommendations, the ACRN must consider health equity and racial, ethnic, geographic, and other disparities across the state,[17] as well as the need to prevent overdose, address disparities in healthcare access, and prevent youth substance use.[18]
, deposit in the Fund all money received by this State pursuant to any [opioid] settlement”). Sec. 433.732(4) and
(capping administrative costs at 8%); Agreement
and
(describing litigation costs);
(describing attorneys’ fees); and
and
(defining "Federal Government CMS Medicaid Costs" to mean “22.52% of any Recovery after deduction of the Lead Litigator Costs that may be asserted, and only if determined to be recoverable, against the State of Nevada's Federal Government Centers for Medicaid Services costs for claims” and describing the deduction of these costs as part of allocation). ↑
(“all Recoveries must be used for Approved Purposes”) and (defining “Recoveries” to mean monies from the settlements in of Nevada’s agreement, which ostensibly lists all possible defendants in the opioid litigation at large). ↑
(defining “Approved Purposes” to mean “only uses to remediate the harms, impact, and risks caused by the opioid epidemic to the State of Nevada and its residents, and are consistent with those uses required by Senate Bill 390 (SB 390) as enrolled by the 81st (2021) Nevada Legislative Session and signed into law by the Nevada Governor, or uses that are listed as an approved use for abatement purposes in any plan approved by a bankruptcy court that are not otherwise inconsistent with SB 390”). ↑
. Nevada Department of Health and Human Services (DHHS), (see “Opioids Recoveries Approved Uses,” which links to each settlement agreement’s Exhibit E or equivalent of Exhibit E [Exhibit A for bankruptcies]). Accessed August 8, 2024. See also I.SS (“Exhibit E provides a non-exhaustive list of expenditures that qualify as being paid for Opioid Remediation. Qualifying expenditures may include reasonable related administrative expenses”). ↑
Nev. Rev. Stat. Secs. 433.738(1) (requirement for statewide plan) and 433.734 (requirement for statewide needs assessment). See . DHHS (“FRN … funding is guided by the required Opioid Statewide Needs Assessment Plan: ” and that “[f]unding will not be available for any activities not specifically identified in the Plan”). Accessed August 8, 2024. ↑
Nev. Rev. Stat. Secs. 433.738(2)(a)(1)-(4), (7), (11)-(13). This list of allowable statewide projects is non-exclusive. Nev. Rev. Stat. Sec. 433.738(2)(a) (“Statewide projects, which may include, without limitation”) (emphasis added). ↑
Nev. Rev. Stat. Sec. 433.734(1)(a)-(b) (“At least once every 4 years, the Department, in consultation with the Office, shall … [c]onduct a statewide needs assessment in accordance with ; and … [b]ased on the statewide needs assessment, develop or revise, as applicable, a statewide plan to allocate the money in the Fund in accordance with ”); Sec. 433.738(1) (describing requirements of statewide plan). See also DHHS: (“FRN … funding is guided by the required Opioid Statewide Needs Assessment Plan: ” and that “[f]unding will not be available for any activities not specifically identified in the Plan”). Accessed August 8, 2024. ↑
Nev. Rev. Stat. Sec. 433.734(2)(a) (“When performing the duties described in subsection 1, the Department and the Office shall consider: … [t]he recommendations provided by the Advisory Committee in the report submitted pursuant to ”). Subsection 1 refers to DHHS’ and the Office of Minority Health and Equity’s statewide needs assessment and planning responsibilities. ↑
Nev. Rev. Stat. Sec. 433.734(2)(a)-(b) (“When performing the duties described in subsection 1, the Department and the Office shall consider: … [t]he recommendations of state, regional, local and tribal governmental entities in this State whose work relates to opioid use disorder and other substance use disorders”). Subsection 1 refers to DHHS’ and the Office of Minority Health and Equity’s statewide needs assessment and planning responsibilities.
Nev. Rev. Stat. Secs. 433.730(1)(a)-(b) (requirement for ACRN to submit a report to DHHS “concerning” the needs assessment and statewide plan required by state law for the allocation of funds from this share) and 433.064 (defining “Department” as the Department of Health and Human Services). See also . Mercer Government Human Services Consulting. December 1, 2022. Accessed September 1, 2024 (“The state’s Advisory Committee will prioritize recommendations from the Needs Assessment to submit to the DHHS, including feedback from the public and other stakeholder groups”). ↑
Nev. Rev. Stat. Secs. 433.734(1)(a)-(b) and 433.720 (defining “Office” to mean “the Office of Minority Health and Equity). ↑
Nev. Rev. Stat. Sec. 433.734(1)(a)-(b). See also . Nevada Attorney General press release. February 22, 2023. Accessed August 8, 2024 (“The law requires the state to create a State Needs Assessment which identifies the critical needs for attacking the impacts and effects of opioids throughout the entire state, and a State Plan for prioritizing funding for the needs identified in said assessment. The law also creates a mechanism for the state, counties and cities to work together in developing county needs assessments and county plans that complement the State Needs Assessment and State Plan, therefore maximizing the use of the money from recoveries”). ↑
Nev. Rev. Stat. Sec. 433.738(1)(b). See also and . ↑
Nev. Rev. Stat. Sec. 433.738(2)(a)(1)-(14), (2)(b). ↑
Nev. Rev. Stat. Secs. 433.730(1)(a)-(b), 433.734(1)-(2), and 433.738(1). ↑
Nev. Rev. Stat. Sec. 433.730(2)(a). ↑
Nev. Rev. Stat. Sec. 433.730(2)(b). ↑
Nev. Rev. Stat. Ann. Sec. 433.732(7) (“Money expended from the Fund must not be used to supplant existing methods of funding that are available to state, regional, local or tribal agencies”). ↑
See, e.g., . ↑
Nev. Rev. Stat. Sec. 433.734(3)(a)-(f) (requirement that DHHS submit an annual report that describes “recommendations made and money expended” to the governor, various legislative stakeholders, the attorney general, and others). ↑
Nev. Rev. Stat. Secs. 433.740(1)(a)(1)-(2), 433.742, and 433.744. ↑
Is this share attached to an explicit bar against supplantation?
