New Hampshireâs local government share is distributed to its litigating counties and political subdivisions, the latter of which are defined to include âany village district, school district, town, city, county or unincorporated place in the state.â[1] Each localityâs share is based on population.[2]
In general, and with limited exceptions,[3] New Hampshireâs local share must be spent on uses that align with the 19 project criteria listed in state law.[4]
Three of these criteria are reimbursement uses: for outpatient and residential treatment services for OUD and co-occurring disorders (inclusive of medications and âabstinence-based treatment,â in addition to treatment for people involved in the criminal legal system;[5] for law enforcement and emergency response services;[6] and for naloxone.[7]
Other approved uses in state law include supports for mobile services, âwithdrawal management,â[8] access to housing, transportation to treatment and other services, employment training, centralized call centers to connect people to supports, improved oversight of methadone treatment programs, scholarships for health providers to work in underserved areas, efforts to prevent over-prescribing, improvements to the prescription drug monitoring program, education for law enforcement on fentanyl, evidence-based âand/or evidence-informedâ prevention, school programs, secondary and tertiary prevention âthrough harm reduction programs,â and addressing the pain management needs of chronic pain patients and/or those in hospital or palliative care.[9]
The Opioid Abatement Advisory Commissionâs also contains a non-exhaustive list of strategies that are âin alignment with [state law] ⌠, NHâs SUD Action Plan[,] and the 10-Yr Mental Health Plan.â[10] The Commissionâs document refers to of the national settlements â which includes prevention, harm reduction, treatment, recovery, and other strategies â as providing a âfurther description of opioid remediation uses.â[11]
Local governments decide autonomously. Decisionmakers for the counties and political subdivisions will ultimately decide for themselves how to spend their monies on the 19 project criteria listed state law.[12]
No, supplantation is not prohibited. Like most states, New Hampshire does not explicitly prohibit supplantation uses of its opioid settlement funds. This means that the 15% local share may be spent in ways that replace (or âsupplantâ) â rather than supplement â existing resources.
Yes (public reporting required). View localitiesâ limited annual reporting under âDistribution of Fundsâ . State law requires localities to annually report to the Department of Health and Human Services and the Commission,[13] and the latter must publish funding awards and reports of funding by recipients online.[14]
Visit OpioidSettlementTracker.comâs for an updated collection of statesâ and localitiesâ available expenditure reports.
The New Hampshire Attorney General's office sent a letter to 47 New Hampshire subdivisions encouraging participation in the National Opioid Settlement. Of the 47 subdivisions, only 23 participated.[15]
N.H. Rev. Stat. Secs. 126-A:83(I) (âAll ⌠opioid-related settlement funds or judgments from New Hampshire counties and all political subdivisions shall, likewise, be placed in the trust fundâ),126-A:83(II) (âThe treasurer shall distribute 15 percent of all funds received prior to any deposit in the consumer escrow account or the opioid abatement trust fund to the counties and the political subdivisions that filed lawsuits, on or before September 1, 2019â), and 126-A:84(II)(a) (âFifteen percent of the funds each year shall be distributed to the counties and political subdivisions as identified in RSA 126-A:83, IIâ). See also N.H. Rev. Stat. Sec. 541-B:1(VI) (defining âpolitical subdivisionâ to mean âany village district, school district, town, city, county or unincorporated place in the stateâ). But see 70% regional, 30% non-regional apportionments of Mallinckrodt trust distributions. . National Opioid Abatement Trust II (NOAT II). January 13, 2023. Accessed August 9, 2024. â
N.H. Rev. Stat. Sec. 126-A:83(II) (âThe distribution of funds shall be based on the most recent decennial census population of each qualifying county and political subdivisions. The population of any political subdivision which receives funds under this section shall not be included in the population of the county for determining the distribution to that countyâ). â
See, e.g., . New Hampshire Attorney General news release. September 1, 2022. Accessed August 9, 2024. (âUnder the terms of the settlement agreement, Johnson & Johnson will make a single payment of $39.605 million to the State and pay approximately $900,000 in attorneysâ fees to counsel for the counties, cities and towns that filed opioid lawsuits against Johnson & Johnson prior to September 1, 2019â). See also N.H. Rev. Stat. Ann. Sec. 126-A:85(VII) (âThe department of health and human services shall provide administrative support to the advisory commissionâ). â
N.H. Rev. Stat. Sec. 126-A:83(I) (âAll ⌠opioid-related settlement funds or judgments from New Hampshire counties and all political subdivisions shall, likewise, be placed in the trust fund. The state treasurer shall disburse funds from the trust fund solely for the purposes and in the manner set forth in RSA 126-A:84â), Sec. 126-A:84(I) (âThe commissioner shall draw from the opioid abatement trust fund for qualifying opioid abatement projects under RSA 126-A:86, I(b)â), and Sec. 126-A:86(I)(b)(1)-(19) (listing acceptable project criteria). See also City of Nashua: (âFunds will be used in accordance with RSA 126-A:86(I)(b)(1) through (14) [ed. note: now likely âthrough (19)â] for the intervention, treatment, and recovery services related to opioid use disorderâ). September 8, 2021. Accessed August 9, 2024. â
N.H. Rev. Stat. Sec. 126-A:86(I)(b)(1). See, e.g., Belknap County Commissioners, (âThis initial check was received by the County and will be used to offset the costs of providing Medically Assisted Treatment (MAT) to inmates of our Corrections Departmentâ). August 25, 2021. Accessed August 9, 2024. â
N.H. Rev. Stat. Sec. 126-A:86(I)(b)(2). â
N.H. Rev. Stat. Sec. 126-A:86(I)(b)(5) (âFDA-approved opioid reversal agentsâ). â
The law originally referred to this as âdetoxification.â See 2020 NH . Legislation in 2023 replaced instances of âdetoxificationâ with âwithdrawal management.â 2023 NH . â
N.H. Rev. Stat. Ann. Sec.126-A:86(I)(b)(3)-(4), (6)-(19). The approved criteria regarding pain management were added by legislation enacted in 2024. See â
Opioid Abatement Advisory Commission (Commission), . February 2024. Accessed August 9, 2024. (âUse of these strategies should be determined within the broader context of statewide plans, community feedback, current efforts by non-governmental and governmental entities and anticipated funding reductions (State Opioid Response, COVID relief, etc). This is not an exhaustive list of applicable strategies, but rather, a guiding document to help establish a road map for funding, in alignment with NH statute and opioid settlement agreements (see for further description of opioid remediation usesâ). â
. Opioid Abatement Advisory Commission (Commission). February 2024. Accessed September 1, 2024. (â[The Guiding Strategies] is not an exhaustive list of applicable strategies, but rather, a guiding document to help establish a road map for funding, in alignment with NH statute and opioid settlement agreements (see Exhibit E for further description of opioid remediation uses)â). â
N.H. Rev. Stat. Ann. Secs. 126-A:83(I) (âAll ⌠opioid-related settlement funds or judgments from New Hampshire counties and all political subdivisions shall, likewise, be placed in the trust fund. The state treasurer shall disburse funds from the trust fund solely for the purposes and in the manner set forth in RSA 126-A:84â), 126-A:84(I) (âThe commissioner shall draw from the opioid abatement trust fund for qualifying opioid abatement projects under RSA 126-A:86, I(b)â), and 126-A:86(I)(b)(1)-(19) (listing acceptable project criteria). See also DHHS, generally (linking to documentation of funds distributed to localities, as well as some cities, counties, and townsâ annual spending reports as required by Sec. 126-A:84(IV). Accessed August 9, 2024. The City of Nashua offers an example of a locality applying these requirements. See (âFunds will be used in accordance with RSA 126-A:86(I)(b)(1) through (14) [ed. note: now likely âthrough (19)â] for the intervention, treatment, and recovery services related to opioid use disorderâ). September 8, 2021. Accessed August 9, 2024. â
N.H. Rev. Stat. Sec. 126-A:84(IV) (âOn or before September 1, 2020, each county, city, town or program that receives funds under paragraph II shall annually provide to the department of health and human services and the opioid abatement advisory commission a detailed account of all monies spent on approved uses, including, but limited to, an analysis and evaluation of the projects and programs it has fundedâ) (emphasis added). Note that paragraph II encompasses both the 85% state share and the 15% local share. For information about intrastate reporting submitted by DHHS, see N.H. Rev. Stat. Sec. 126-A:84(VI) (âOn or before November 1, 2020, the commissioner of the department of health and human services shall submit an annual report to the governor and fiscal committee of the general court detailing the activities of the advisory commission, the administration of the opioid abatement trust fund, the amount distributed in the past year, including available measures of success and corresponding data of programs funded, the amount remaining in the trust fund, a summary of how funds were used in the past year, and any recommendations for future legislationâ). Regulations adopted by the Commission make clear the relationship between the reports submitted by localities and DHHS reporting requirements. See N.H. Code R. He-C 1002(11)(f) (âThe department's reporting requirements are governed by RSA 126-A:84, subject to receipt of reporting information from the commission and from counties, cities, towns, or programs that receive funds from the trust fundâ). â
N.H. Rev. Stat. Sec. 126-A:86(III) (âThe [Opioid Abatement Advisory] [C]ommission shall create and maintain a website on which it shall publish its minutes, attendance rolls and votes, including records of all votes on funding requests, funding awards, and reports of funding by recipientsâ). â
. DHHS. Accessed September 1, 2024. â