►
From YouTube: How States are Preparing for Opioid Settlement Funds
Description
This session will highlight actions states are taking and discuss ways policymakers can manage settlement funds to ensure they best serve communities affected by the opioid crisis.
A
Okay,
great
well,
we
will
get
started
here.
Thank
you
so
much
for
joining
us
today.
For
this
briefing
how
states
are
preparing
for
opioid
settlement
funds.
My
name
is
emily
mayer
and
I
am
a
policy
associate
in
the
fiscal
affairs
program
at
ncsl.
We're
glad
that
you're
able
to
join
us
at
this
time.
I'd,
welcome
you
to
write
your
name
and
stay
in
the
chat
and
encourage
you
to
turn
on
your
videos.
A
So
we
can
make
this
as
discussion
like
as
possible,
and
this
is
the
third
in
a
seven
part,
fiscal
briefing
series
and
the
programs
are
all
scheduled
for
wednesdays
at
the
same
time,
through
june
16th
covering
a
variety
of
topics,
including
state
and
local
fiscal
relationships,
corrections
costs
pensions
and
then
we'll
wrap
it
up
with
a
state
budget
update.
As
our
last
briefing,
my
colleague
laurel
will
be
posting
a
link
to
the
entire
schedule
in
the
chat.
A
Today,
we're
here
to
discuss
actions
states
are
taking
and
ways
policymakers
can
manage.
Opioid
settlement
funds,
but
before
we
discuss
today's
agenda,
I'd
like
to
ask
a
poll
question
here
and
laurel's
going
to
pull
it
up
in
just
a
moment
to
get
the
discussion
started
and
the
question
will
be:
does
your
state
have
a
clear
set
of
strategies
and
progress
metrics
for
addressing
opioid
use.
A
A
Great
okay,
so
it
looks
like
we
have
a
little
bit
of
a
mixed
bag
of
results,
but
the
majority
of
the
folks
on
the
line
here
answered
that
they
are
unsure.
So
we
hope
today's
presentations
and
discussion
provide
some
insight
for
your
states
on
on
taking
these
sort
of
actions,
and
I
am
going
to
pull
up
our
agenda.
A
A
So
today
we're
going
to
get
started
here
with
my
car
colleague,
charlie,
severance
medaris,
who
is
in
our
health
program
at
ncsl
and
charlie,
will
provide
an
overview
of
the
opioid
epidemic
in
states.
The
lawsuits
that
were
pending
and
occurring
and
how
state
legislatures
are
responding,
and
then
we'll
hear
from
three
legislators:
representative,
dave
baker,
assembly,
member,
john
mcdonald
and
senator
roger
thompson
on
the
challenges
and
lessons
that
they've
learned
in
their
states
and
then
lastly,
we'll
hear
from
sarah
dube
who
will
provide
some
insights
on
tools.
A
He
has
developed
to
help
lawmakers
think
strategically
in
the
budget
process
and
to
ensure
that
the
settlement
funds
are
being
distributed
to
address
the
epidemic.
And,
lastly,
this
session
is
being
recorded
and
will
be
posted
on
our
webpage
in
the
coming
days.
And
with
that
said,
I'm
going
to
turn
over
to
my
colleague,
charlie
thanks,
charlie.
B
B
B
I'd
like
to
go
ahead
and
thank
everyone
for
joining
us
today
and
thank
you
for
being
online.
We
know
you
have
lots
of
things
to
be
doing
on
a
wednesday
afternoon,
so
we
thank
you
for
spending
some
time
with
us
today.
I
will
be
moderating
the
remainder
of
the
webinar
today,
but
in
addition
to
moderating
the
remainder
of
the
webinar,
I
have
also
been
asked
to
sort
of
provide
just
a
quick
overview
of
the
epidemic,
some
level
setting
for
our
conversation
today.
B
My
intention
here
is
not
to
get
too
into
the
weeds,
but
to
cover
the
broader
narrative
of
how
we
got
here
by
highlighting
some
of
the
key
trends
patterns
and
ideas
that
are
really
shaping
the
conversation
around
the
current
litigation
from
there
I'll
sort
of
transition
into
direct
talking
directly
about
the
lawsuits
where
they
came
from.
What's
going
on
now,
what
the
legal
process
is
moving
forward
and
what
states
can
expect
from
that
legal
process?
B
And
then,
finally,
we
will
talk
a
little
bit
about
what
state
legislators
are
actually
doing
in
response
to
these
lawsuits,
and
when
I
say
that
I
will
do
that.
What
I
really
mean
is
that
I
have
a
few
examples
that
I'm
very
excited
to
share
with
you
all,
but
I'm
mostly
excited
and
grateful
to
be
able
to
connect
you
all
with
three
great
legislators.
So
we
have
representative
dave
baker
from
minnesota
assembly,
member
john
mcdonald
from
new
york
and
senator
roger
thompson
from
oklahoma,
representative
baker
and
assembly.
B
Member
mcdonald
are
former
ncsl
opioid
policy
fellows,
so
they
really
understand
this
issue
from
front
to
back
and
senator
thompson
from
oklahoma,
who
is
the
chair
of
their
appropriations
committee
in
a
state
that
has
actually
received
some
of
these
settlement
dollars?
I
think,
can
also
really
add
some
valuable
insights
as
you
all
move
forward
in
your
states
with
these
conversations,
but
to
get
this
kicked
off.
B
I
think
that
the
model
that's
most
helpful
to
understand
the
arc
of
the
opioid
epidemic
is
to
look
at
it
in
three
sort
of
waves
going
back
to
1999,
where
wave
one
began.
Three
things
sort
of
coalesced
in
this
time
frame.
One
is
that
we
sort
of
had
opioid
prescription
opioid
prescription
drugs
on
the
market
for
a
while,
so
we
had
sort
of
a
better
safety
profile
of
these
drugs,
at
least
in
terms
of
their
toxicity
and
sort
of
their
side
effects.
The
second
thing
was
availability.
B
They
began
to
prescribe
more
opioids,
and
you
can
see
based
on
that
purple
line
in
this
graph,
that
opioid
overdose
deaths
due
to
prescription
drugs
due
to
prescription
opioids
steadily
began
to
rise
during
this
time
frame,
wave
two
began
around
2010
being
driven
by
heroin.
This
is
about
the
same
time
that
we
started
seeing
more
national
news
coverage
of
this
epidemic
as
more
heroin
was
introduced
to
the
drug
market,
which
is
about
five
times
stronger
than
morphine.
B
Synthetic
opioids
are
not
naturally
derived
they
are
essentially
created
in
the
lab
and
are
much
more
powerful
than
traditional
opioids.
For
instance,
fentanyl,
which
was
sort
of
one
of
the
early
drivers
in
this
third
wave,
is
about
50
to
100
times
more
powerful
than
morphine
and
carfentanil,
which
came
onto
the
scene.
A
little
bit
later
is
about
10
000
times
more
powerful
than
morphine.
B
B
The
cdc
estimates
that
there
are
about
2
million
people
with
opioid
use
disorder
or
what
we
might
more
casually
call
opioid
addiction,
and
there
are
10
million
people
in
the
united
states
who
misuse
opioids
annually.
More
broadly
speaking,
there
are
about
20
million
people
who
have
a
substance
use
disorder
in
the
united
states.
B
We
can't
really
talk
about
anything
without
talking
about
the
impact
of
covid19
and,
unfortunately,
covet
19
has
had
a
dramatic
impact
on
the
opioid
epidemic,
so
opioid
overdose
deaths
were
already
rising
in
early
2019
and
coveted
like
covet
linked
stressors
likely
made
things
worse.
You
can
see
sort
of
by
that
demarcation
on
the
graph,
where
the
response
the
pandemic
in
the
u.s
sort
of
began
and
the
sharp
increase
in
deaths
due
to
total
overdose
deaths,
but
also
all
opioid
overdose
deaths.
During
that
time
frame.
B
Social
isolation
can
also
lead
to
increased
drug
use,
but
it
can
also
increase
the
chances
that
you're
using
drugs
alone.
So
if
you
do
get
into
a
situation
where
you're
experiencing
an
overdose,
there's
not
going
to
be
someone
around
to
either,
you
know
call
for
emergency
help
or
administer
naloxone,
which
is
the
opioid
reversal.
Medication.
B
Obviously,
states
have
taken
a
number
of
different
responses
to
this,
both
to
prevent
misuse
altogether
and
sort
of
implement
some
treatment
strategies
for
those
already
struggling
on
the
prevention
side
of
things.
States
have
tried
things
like
prescription,
drug
monitoring
programs.
These
are
essentially
databases
that
prescribers
can
check
before
prescribing
or
dispensing
an
opioid
to
make
sure
that
their
client
hasn't
already
received
a
drug
or
an
opioid
drug
from
another
provider.
B
In
the
area
prescribing
limits
I'll
get
into
sort
of
the
statistics
on
this
a
little
bit
later,
but
there
is
a
relationship
between
sort
of
the
duration
of
that
first
opioid,
prescription,
medication,
that
you're
administered
and
the
likelihood
that
you'll
still
be
using
opioids
a
year
later,
and
also
just
looking
at
things
like
alternative
pain
management.
Sometimes
opioids
aren't
necessarily
the
best
course
of
treatment
for
a
particular
patient's
pain
on
the
treatment
side.
B
This
has
really
been
expect
about
expanding
access
to
medication-assisted
treatment,
which
is
essentially
three
different
drugs
approved
by
the
fda,
to
treat
opioid
use
disorder.
The
way
states
have
done
this
has
been
through
medicaid,
making
sure
that
at
least
one
of
those
drugs
is
available
through
the
state's
medicaid
program,
but
also
looking
at
things
like
insurance
parity
between
mental
and
physical
health,
so
making
sure
that
folks,
on
private
insurance
can
access
these
services
through
their
private
health
insurance
states
have
also
looked
to
increase
the
number
of
providers
who
can
provide
this
kind
of
care.
B
But
all
this
is
to
say,
of
course,
that
all
of
these
treatment
and
prevention
measures
do
come
with
the
cost
about
two
and
a
half
trillion
from
2015
from
just
2015
to
2018.
According
to
one
estimate,
states
have
obviously
taken
on
quite
a
bit
of
that
expense,
medicaid
just
being
part
of
that
medicaid
covered
three
in
ten
people
with
opioid
use
disorder
in
2013
and
spending
on
people
with
opioid
use
disorder
through
state
medicaid
programs
increased
more
than
300
percent
between
1999
and
2013
totaling
9.4
billion
dollars
that
year.
B
So
as
we
sort
of
transition
now
into
the
conversation
about
the
lawsuits
in
particular,
states
really
have
three
main
questions
and
that's
what
responsibility
do
manufacturers
have?
Can
states
ensure
that
communities
most
affected
by
the
epidemic
or
the
ones
getting
the
resources
from
these
settlements
and
then
again
as
the
appropriations
branch
of
government?
What
is
the
legislative
role
here,
as
most
of
these
conversations
are
being
played
out
in
courtrooms
between
attorneys
general
and
the
defendants
and
judges?
B
B
This
does
not
necessarily
mean
that
these
individuals
had
a
prescription
for
an
opioid,
but
that
it
was
available
to
them
either
at
home
through
someone
else's
prescription,
or
they
had
easy
access
to
it
through
an
illicit
market.
Research
has
also
shown
that
prescriptions
for
opioids
for
pain
increased
significantly
since
1999,
but
the
statistics
of
americans
reporting
pain
haven't
changed
that
much
in
the
same
time
frame.
B
So
what
is
the
plaintiff
case
here?
With
that
in
mind?
Plaintiffs
in
these
cases
have
argued,
among
other
things,
that
opioid
manufacturers,
distributors
and
others
in
the
supply
chain.
Folks,
like
marketers
and
consultants,
downplayed
the
risks
associated
with
opioids
and
their
potential
for
abuse,
which
the
plaintiffs
would
argue,
these
groups
were
aware
of.
B
So,
where
are
we
now
so
based
on
those
arguments?
More
than
2
000
cases
have
been
brought
by
individuals,
local
and
state
governments
against
manufacturers,
distributors
and
those
other
groups
in
the
supply
chain.
Most
of
these
cases
have
been
aggregated
into
a
single
consolidated
case
called
the
national
prescription,
opiate
litigation,
and
that
is
being
heard
in
ohio.
B
Some
of
these
cases
will
eventually
get
remediated
back
to
their
original
court
of
origin,
and
we
have
seen
a
few
of
these
proceed
already,
but
a
lot
of
this
has
also
been
sort
of
backed
up
again
by
covit.
So
a
lot
of
these
have
been
sort
of
put
on
hold
for
the
time
being.
But,
as
I
mentioned,
we
do
have
a
number
of
settlements
already
distributed.
Both
the
states
and
local
governments,
and
I
won't
get
into
the
nitty-gritty
of
all
these
cases.
B
B
If
you
answer
that
you're
unsure
or
that
your
state
does
not
have
a
plan,
you
are
not
alone,
but
I
did
want
to
provide
a
few
examples
of
states
that
have
taken
legislative
action
to
address
these
lawsuits
and
the
potential
settlement
dollars
they
may
receive
from
them
and
I'm
not
going
to
go
through
each
of
these
individually.
But
you
will
get
the
powerpoint
from
today's
presentations
and
have
the
links
to
these
bills
and
you'll
also
get
to
hear
from
our
legislative
respondents
from
minnesota,
oklahoma
and
new
york.
B
Who
can
speak
to
some
of
the
specifics
from
those
states
much
better
than
I
could,
but
essentially
each
of
these
states
on
the
screen
have
made
some
effort
to
set
aside
some
of
the
money
they
may
receive
from
the
settlements
into
specific
funds
outside
of
the
general
fund.
This
has
allowed
them
to
sort
of
wall
off
unapproved
uses.
B
B
C
Hear
me:
okay,
we
can
hear
you
good
good,
good,
good,
hey,
listen!
This
is
really
great.
I
want
to
also
put
out
a
shout
out
to
ncsl
and
charlie
and
the
work
that
they
have
done
on
this
thing
has
been
really
remarkable.
I've
been
very
honored
to
call
myself
a
fellow
with
a
lot
of
other
great
people
that
have
gone
through
this
process
a
little
bit
of
background
again.
I
I
learned
this.
C
The
hard
way
I
lost
a
son
to
the
opioid
overdose
back
in
2011
became
a
legislator
in
2015,
not
just
because
of
this,
but
I
also
knew
there's
a
whole
lot
of
things
I
didn't
know
so
that
really
helped
drive
me
to
understand
this
better.
I'm
also
a
restaurant
operator,
and
I
serve
food
and
beer
and
liquor.
C
So
my
this
was
put
together
by
a
couple
of
folks,
myself
and
senator
chris
eaton,
who
also
lost
a
child
she's,
a
senator
who
has
been
serving
a
little
longer
than
I
have,
and
we
work
together
on
this
house
file
400
and
had
been
working
on
this
for
a
couple
of
years
and
really
had
the
thought
of.
We
have
to
do
some
kind
of
a
way
to
get
more
money
in
the
bank,
from
the
pharmaceutical
companies,
the
distributors
and
so
on.
Is
there
such
a
big
part
of
this
process
in
minnesota?
C
Anybody
who
sells
a
prescription?
A
pharmaceutical
item
pays
about
235
bucks
a
year
in
minnesota
for
for
a
thousand
units
or
dosages
or
a
gazillion.
It
doesn't
matter,
it's
all
the
same
price.
As
a
bar
operator,
I
spend
about
five
thousand
bucks
a
year
to
have
one
bar
in
minnesota
in
one
little
town,
and
I
think
the
part
of
that
reason
is
because
there's
some
problems
with
liquor,
if
you
don't
use
it
properly,
which
causes
societal
issues.
C
So
our
kind
of
our
two-fold
approach
was:
let's
reform,
that
so
that
if
you
sell
any
kind
of
prescriptions
in
minnesota,
whether
they're,
opioids
or
not,
you
should
have
a
minimum
fee
of
x
and
we
we
chose
five
thousand
bucks.
If
you
sell
opioids
in
minnesota,
it
should
be
a
minimum
of
fifty
thousand
dollars.
If
you're
a
super
super
seller,
we
have
a
different,
tiered
level
and
it
was
much
higher.
It
might
have
been
around
two
hundred
three
hundred
thousand
dollars.
C
If
you
want
to
sell
a
bunch
of
generics,
mel
and
crawl
would
be
a
good
example.
So
our
idea
was
to
try
to
raise
about
20
million
bucks
a
year
from
distributors
and
from
anybody
who's
in
that
system
through
the
board
of
pharmacy,
and
we
were
kind
of
the
first
in
the
country
to
design
that
it
finally
passed
about
three.
Four
years
later,
I
needed
a
republican.
C
I
needed
some
democrat
help
to
kind
of
get
this
over
the
finish
line
when
they
took
the
majority,
so
we
finally
got
it
over
the
finish
line
and
so
house
filed
400
was
was
created
along
with
that
writing
of
those
bills
that
bill
we.
We
also
made
sure
that
any
future
lawsuits
that
went
into
into
the
state
of
minnesota
would
go
into
what
we
call
a
stewardship
fund.
C
The
20
million
dollars
that
we
were
earmarking
for
this
ended
up
being
about
15
million
after
a
few
licensees
kind
of
decided
not
to
have
duplicate
license
in
minnesota,
and
so
we
just
kind
of
shuffled
through
it.
We
got
about
15
million
at
the
end,
so
any
future
lawsuits
now
also
part
of
legislation
are
going
to
go
into
that
same
opioid
stewardship
fund
and
that
fund
is
designed
to
be
used
for
local
grants.
C
Again
all
the
things
that
that
charlie
mentioned
today
was
really
about
prevention,
naloxone
support,
just
everything
that
you've
you've
heard
about
this
thing.
We
wanted
to
make
sure
we
put
together
this
very
complex
council.
We
call
it
the
orac
council,
it's
the
opioid
epidemic
response
council
here
in
minnesota.
C
Put
together
by
some
legislators,
I'm
on
the
council,
I'm
the
vice
chair,
but
we've
got
folks
that
are
in
pain,
recovery,
a
lot
of
providers.
We've
got
the
tribes
involved.
We
have
indigenous
we've
got
communities
of
color,
we've
got
about
20
people
on
this
group,
including
our
local
state
agencies,
and
we
sort
of
I've
been
referring
to
this
as
kind
of
our
motherboard,
to
try
to
really
get
our
hands
around.
C
So
again
because
of
that
business
model
that
I
have
as
a
restaurant
operator,
it
made
sense
to
us
to
treat
this
like
a
license
of
doing
something
that
if
you
sell
something
that
has
has
some
negative
impacts
on
our
communities
like
alcohol
like
prescription
drugs,
we
found
it
to
be
sort
of
a
very
good
argument
to
try
to
work
through
this
process.
We
are
still
cleaning
up
the
little
bit
of
language
that
has
to
be
tweaked
right
now.
C
B
B
We
will
have
a
specific
opportunity
after
the
legislators
have
finished
speaking
to
sort
of
ask
questions,
but,
as
those
questions
occur
to
you,
please
go
ahead
and
put
those
into
the
chat
box
and
we
will
address
those
in
just
a
bit,
but
otherwise
I
will
turn
it
over
to
assemblymember
mcdonald
who
I
will
give
really
just
the
same
introduction.
I
gave
representative
baker
a
former
opioid
policy,
fellow
someone
who
knows
this
stuff
from
you
know,
inside
out
and
there's
a
leader
of
the
leader
on
this
issue
in
new
york.
D
The
message
that
came
from
minnesota
in
regards
to
the
fees
was
that
everybody
had
their
hands
on
the
plane
one
way
or
the
other.
Everyone
had
a
responsibility.
Instead,
we
went
with
an
opioid
tax,
which
you
know.
The
challenges
is
that
our
legislature
just
loved
to
hate
pharma
for
lack
of
a
better
term,
so
that
was
their
way
of
thinking
or
getting
money
from
pharma,
and
we
put
this
two-level
opioid
tax
into
place.
D
The
problem
is
what
we
didn't
do
was
we
didn't
put
a
total
restriction
on
where
the
money
could
go,
so
we
had
budgeted
a
200
million
dollar
tax
that
we
were
going
to
collect,
which
I
advised
was
not
collectible,
because
you
know,
for
every
action
has
a
reaction
and,
as
data
alluded
to
a
little
bit
minnesota,
some
providers
decided
to
step
out.
Some
manufacturers
decided
to
stop
shipping
to
new
york
state.
D
That's
one
way
to
cut
down
on
opioid
dispensing,
but
you
also
have
to
be
mindful
the
fact
that
and
by
the
way,
I'm
a
licensed
pharmacist
as
well.
So
I
can
speak
to
this
from
a
couple
different
perspectives.
There
are
people
who
actually
truly
need
the
medication.
We
need
to
be
thoughtful
about
that
as
it
may.
The
biggest
issue
we
had
is
we
we
allocated
200
million
dollars
in
revenue
but
did
not
increase
one
iota
more
resources
for
opioid
use
disorder,
so
that
was
really
one
of
our
biggest
complaints
in
the
budget
process.
D
Unfortunately,
it
did
get
passed
and
true
to
form
we
only
collected
about
85
million
dollars.
We
keep
down
casting
each
subsequent
year.
We
are
in
year
three
now,
where
we're
down
to
about
50
million,
so
at
least
my
concept
of
going
back
at
the
licensing
component
might
actually
work,
because
we
have
a
lot
more
providers
in
new
york
state
and
a
lot
more
partners.
D
D
New
york
is
scheduled
to
receive
32
million
dollars
over
the
next
couple
years.
26.6
in
this
next
fiscal
year,
our
fiscal
year
started
april
1st,
and
we
just
passed
the
budget.
Surprisingly,
we
did
the
right
thing.
We
have
taken
a
portion
of
that
money
so
far
that
we're
scheduled
to
receive,
haven't,
received
yet
and
put
11
million
dollars
into
medicaid
assisted
treatment
in
the
state's
correction
facilities,
but
we're
also
going
to
be
allocating
another
eight,
nine
million
dollars
for
all
the
county
jails
as
well.
D
There
are
many
many
instances
of
substance
abuse
happening,
particularly
county
jails,
because
they're
usually
shorter
stays,
so
the
the
feeling
is
a
lot
of
individuals,
unfortunately
end
up
in
the
jails
because
of
either
the
mental
health
or
behavioral
health
or
substance
abuse
component.
While
we
got
them
there,
let's
do
something
constructive.
Let's
you
know
whether
they're
for
90
days
or
120
days,
let's
get
them
into
a
program,
let's
get
them
tip
top
shape
to
get
back
out
into
the
community
and
make
sure
they
have
the
resources
behind
them.
D
So
that's
a
good
sign
that
we're
actually
putting
the
money
where
it
is,
but
we
are
still
pushing
for
legislation
and
we've
got
until
june
10th
to
get
it
done
this
year,
so
stay
tuned
where
we
create
that
lock
box,
where
we
create
this
system,
where
settlement
money
goes
directly
into
this
lock
box
and
by
the
way
oasis,
which
is
our
office
of
well,
they
call
it
office
of
addiction
services.
I
think
we
should
ban
the
word
addiction
because
it
gives
a
criminal
justice
name.
It
really
should
be
more
of
support
services.
D
That
agency
would
be
directed
with
how
those
resources
should
be
spent
in
partnership
with
the
legislature,
new
york
state's
a
little
bit
more
of
a
combative
state
amongst
ourselves,
we're
all
in
the
same
party.
We
still
can't
get
along
for
some
reason,
but
when
it
comes
to
substance,
abuse
disorder,
whether
we
had
a
bifurcated
council
where
we
have
a
joint,
it's
we've
worked
well
together
for
the
most
part,
but
we
want
to
make
sure
that
oasis
is
using
tried
and
true
methods
to
dedicate
resources
all
focused
primarily
on
education,
treatment
and
recovery
services.
D
There
is
precedent
in
the
state
of
new
york
for
doing
this,
I'm
in
the
ways
and
means
committee
which
allocates
the
funding
and
develops
these
policies.
I've
talked
to
our
leadership
about
it,
we're
prone
to
get
this
through.
We
realize
that
it's
in
the
best
interest
of
really
getting
a
handle
on
substance,
abuse
disorder
in
new
york
state
and,
like
I
said,
we've
had
precedence
back
when
the
housing
and
foreclosure
crisis
was
happening
back
in
well.
B
Excellent,
thank
you
so
much
assemblymember
and
again
folks,
if
you
have
questions,
feel
free
to
jump,
though
drop
those
into
the
chat
function.
I
know
that
we've
received
a
few
of
those
just
directly
to
us,
but
senator
thompson
last
but
not
least,
share
a
little
bit
about
oklahoma's
experience
with
this
issue.
E
Thank
you
very
much,
and
certainly
an
honor
to
be
part
of
this
conference.
In
addition
to
being
the
appropriations
chair,
I
serve
on
the
opioid
commission
that
is
chaired
by
the
attorney.
General
oklahoma
certainly
has
had
its
struggles
with
the
opioid
addiction
in
2019.
We
had
645
overdose
deaths.
We
have
received
four
settlements.
E
Fifty
thousand
dollars
and
mckenzie
and
company
for
eight
million
nine
hundred
thousand
there
are
two
ongoing
cases
in
oklahoma.
One
of
those
major
cases
is
with
johnson
and
johnson
and
for
465
million
dollars.
That
case
is
on
appeal,
and
so
we've
not
received
any
of
the
money
and
we
have
a
case
against
distributors
of
mckenzie,
cardinal
and
amerisource
bergen
that
was
filed
in
bryan
county.
It's
presently
in
the
discovery
case,
and
so
we'll
have
an
update
on
that.
E
We
also
passed
two
other
pieces
of
legislation
that
created
the
oklahoma
opioid
abatement
board,
and
so
this
board
is
responsible
for
allocating
opioid
settlements,
to
the
political
subdivisions
and
for
approved
purposes,
and
we
have
about
19
of
those
in
legislation
I'll
not
go
through
all
19
of
those
today.
But
it's
made
up
of
nine
members.
E
It
is
something
that
we've
taken
very
seriously
in
oklahoma
this
year
and
our
budget
again
we
will
appropriate
another
29
million
dollars
that
will
come
out
of
the
the
tiva
380
fund
and
we'll
probably
go
back
into
many
of
those
same
areas.
We
have
a
board
meeting
that
is
coming
up
in
the
very
near
future.
B
Excellent,
thank
you
so
much
senator
for
that
overview
again.
As
a
reminder,
if
you
do
have
questions
go
ahead
and
just
drop
those
into
the
chat
function
and
we'll
go
ahead
and
start
addressing
a
few
of
these
that
are
coming
in
through
the
chat
right
now,
so
the
first
one
we've
got
is.
Maybe
I
missed
this
if
a
declarative
statement
was
made,
if
a
state
legislature
does
not
intervene,
who
at
the
state
level
decides
how
opioid
and
settlement
dollars
are
spent
and
really?
B
I
think
that
the
the
gist
of
this
question
is
that
it
gets
worked
out
between
the
attorneys
general
and
the
judicial
system
or
the
court
system.
Whoever
is
handling
that
particular
case
or,
however,
the
settlement
dollars
get
worked
out
between
you
know
the
defendant
and
the
plaintiff
in
that
case,
representative
baker.
It
looked
like
he
might
have
a
little
bit
to
say
here.
C
Yeah,
thanks
charlie,
I
think
I
think
you
answered
it
pretty
well,
I
think
mostly,
is
because
we've
been
had
some
experience
with
the
federal
sars
dollars
that
came
to
states.
A
lot
of
states
have
kind
of
built,
a
program
to
you
know
getting
some
grant
monies
out
to
communities
and
folks
and
things
so
that
was
kind
of
set
up.
B
Another
question
that
just
came
in
I'm
curious:
how
states
determine
allowable
expenses
for
these
funds?
Do
you
all
anticipate
using
any
of
these
funds
for
workforce
education,
training
as
a
component
of
rehabilitation,
and
I
hate
to
double
down
on
your
representative
baker,
but
I
do
know
that
there's
a
bit
of
a
process
there
in
your
bill
to
sort
of
decide
what
are
these
allowable
expenses.
C
C
It's
such
a
work
shortage
there,
but
we
have
programs
in
place
for
workforce
prevention
and
education
in
schools
again
getting
to
the
providers
with
more
information,
always
upgrading
our
prescription
monitoring
program
to
make
sure
that
it's
as
easy
as
possible
for
providers
to
check
in
on
the
website
to
make
sure
that
that's
a
smooth
process
and
quick
yeah.
So
workforce
is
definitely
a
part
of
this,
because
we've
gotta
direct
that
towards
those
professions
and
also
again,
there's
a
small
percentage
that
goes
to
the
agencies
to
kind
of
stand
up.
E
Certainly,
as
we
get
out
into
the
political
subdivisions
and
some
of
those
19
eligible
types,
our
workforce
is
involved
in
that
that
they're
going
to
be
able
to
use
to
encourage
people
to
get
involved
and
the
more
they
are
involved
in
a
job
and
working
forward,
but
also
that,
with
some
oversight
of
those
who
are
helping
them
to
get
back
on
their
feet,
you
know
what
are
they
going
to
do?
Making
sure
that
they're
not
just
put
in
a
workforce
program?
That's
job
related,
but
doesn't
really
abate.
The
problem
of
opioid
use
use.
D
I'll
just
reiterate
that
you
know
our
intention
is
to
focus
on
those
broad
areas
of
education,
treatment
and
recovery
and,
of
course,
included
with
that
is
workforce
development,
workforce
support.
You
know
many
of
the
individuals
are
making
below
a
living
wage
in
regards
to
providing
that
peer
recovery,
which
is
critical,
and
it's
it's
hard
to
recognize
the
fact
that
they
they
need
to
also
be
able
to
make
a
they
need
to
make
a
living,
because,
quite
frankly,
this
is
not
something
that
you
know
30
days
of
peer
recovery
and
it's
all
over.
B
C
I'm
pretty
sure
it's
available
online.
I
know
that
I
have
a
friend,
dana
farley
here
with
the
minnesota
department
of
health,
that
we
could
certainly
get
to
anybody
who's
requesting
that
I
assume
it's
maybe
under
the
board
of
pharmacy,
but
that
that
license
formula
is
online
for
kind
of
the
breaking
points
of
the
larger
manufacturers
and
larger
providers
of
these
of
these
opioids.
So
it's
it's
very
public
and
I'm
sure
that
it's
online
available
to
them.
If
anybody
needs
it,
we're
happy
to
get
it
to
them.
B
B
C
Again,
I
just
the
other
thing
I
wanted
to
mention
was
some
of
the
things
that
this
orac
group
we
took
pains
to
put
it
together
in
the
bill.
We've
got
corrections.
Folks,
we've
got
again.
I've
mentioned
communities
of
color
providers,
folks
in
recovery,
and
what
we
have
found
is
that
this
group
is
really
hitting
all
areas
in
the
state
of
minnesota
and
it's
a
slow,
painful
process
to
get
this
built
up,
and
I
think
what
I've
heard
from
our
friends
at
minnesota
department
of
health,
too
is.
C
But
this
is
a
voluntary
group
and
it's
really
done
a
good
job.
And
finally,
as
all
these,
other
counties
and
cities
have
joined
that
large
lawsuit
discussion
in
the
state
of
ohio
we've
actually
reached
out
to
them
under
the
attorney
general
here
in
minnesota,
we've
had
meetings
with
large
cities,
small
cities,
duluth
minneapolis
folks
that
have
have
jumped
onto
that
opioid,
larger
lawsuit
issue
and
we're
trying
to
help
them
determine
what's
the
best
way
for
us
to
actually
leverage
our
dollars
together.
C
C
But
if
a
city
like
rochester
or
duluth
wants
to
see
what
are
we
doing,
we
can
see
how
the
other
wheels
have
been
built
and
bikes
have
been
built
around
the
state
and
they
can
actually
kind
of
join
us
if
they
want
to
use
their
money
for
this
type
of
thing.
If
they
want
to
join
it
with
us,
we're
just
trying
to
create
a
very
kind
of
a
very
clean
and
open,
transparent
way
of
how
we're
not
just
all
in
these
silos
around
the
state
how
we
can
all
work
together.
B
Yeah,
thank
you
for
sharing
in
that
really
just
sort
of
conclusive
statement
about
the
the
way
that
minnesota
is
approaching
this
and
sort
of
the
struggles
that
everyone
else
is
having
around
the
country.
With
this
issue,
there
have
been
a
few
more
comments
that
have
come
in
through
the
chat,
and
I
promise
this
is
not
the
last
opportunity
we'll
get
to
answer
those,
but
I
do
want
to
quickly
bring
sarah
dube
from
the
jew,
the
truth,
the
pew
charitable
trust.
F
F
Clearly,
there
have
been
a
lot
of
great
examples
of
that
so
far
that
we've
heard
today,
but
it's
just
a
start,
we
would
say
so.
There's
there's
quite
a
bit
more
to
do,
but
before
I
get
started,
let's
go
ahead
and
do
our
third
and
final
polling
question
so
I'll
give
laurel
a
moment
to
bring
that
up.
So
this
one,
how
important
is
tracking
spending
on
opioid
programs
to
your
state
important,
somewhat
important,
not
important
or
unsure.
F
F
Results
well.
This
is
certainly
encouraging
to
folks
like
myself,
who,
like
tracking
everything,
so
it
looks
like
we've,
got
a
majority
saying
that
tracking
spending
on
opioid
programs
is
important,
so
a
little
mix
there.
But
that's
good
to
know,
because
that
is
one
of
the
the
strategies
that
I'll
be
talking
about
in
just
a
minute.
F
F
So
lots
of
money
that
we're
talking
about
across
the
country
and
to
help
ensure
that
those
funds
are
actually
used
to
make
the
progress
that
we're
all
looking
for
states
should
really
be
proactively
developing
plans
for
when
the
money
arrives,
establishing
a
dedicated
fund
for
the
money
that
we've
heard
about
a
lot
today
is
a
very
important
first
step.
It's
it's
and
I'm
sure
many
of
you
would
argue
not
the
first
step,
but
several
steps
down
the
road
incredibly
important.
But
I'd
also
say
that
that's
not
quite
enough.
F
There
is
more
to
be
done
there
and
that's
for
a
few
reasons
right.
We
know
that
future
legislatures
could
reallocate
the
money
to
other
uses
or
future
policymakers
could
try
to
offset
that
settlement
money
by
reducing
existing
spending
for
opioid
use,
disorder
and
and
slowing
that
progress
that
again
we're
all
looking
for.
F
There
are
a
lot
of
a
lot
of
states
as
again,
we've
heard
from
today
and
a
lot
of
organizations,
including
ncsl
and
many
others
who
are
looking
at
opioid
settlement
funds.
Looking
at
this
topic
through
a
health
lens,
including
a
coalition
that
developed
a
set
of
principles,
that
many
organizations,
including
pew,
have
endorsed
out
of
johns
hopkins
to
help
state
leaders
determine
the
best
use
of
those
funds
and
again,
we've
heard
some
great
examples
of
of
those
of
those
uses
today.
F
Pew
drafted
a
short
piece
that
ran
in
governing
last
week-
and,
I
believe,
was
in
your
meeting
prep
materials
from
ncsl
that
focuses
on
some
of
the
physical
strategies
that
are
also
important
to
consider
in
this
process.
So,
just
briefly,
we
recommend
three
guidelines.
First,
to
give
priority
to
evidence-based
programs
and
services
proven
to
work.
Many
of
them
have
been
mentioned
today,
mit,
for
example,
so,
first
and
foremost,
state
this
explicitly
and
rules
for
how
funds
can
be
used
so
that
there's
no
wiggle
room
there.
F
Also-
and
many
of
you
may
know
this-
but
there's
a
lot
of
existing
evidence
on
what
works
and
what
works
well.
So
there's
no
need
to
conduct
your
own
evaluations
to
know
what
to
invest
in
or
to
make
your
best
guess
about
what's
going
to
work.
So
the
idea
here
is
to
really
draw
heavily
on
the
existing
body
of
research
when
making
these
decisions
about
where
to
put
the
funds.
F
Second
develop
a
multi-year
budgeting
process
effectively
addressing
the
opioid
excuse
me
epidemic
will
clearly
require
sustained
funding
over
an
extended
period
of
time.
As
charlie
pointed
out,
this
has
been
going
on
for
for
quite
a
while.
There
are
many
waves
and
unfortunately,
we'll
probably
be
continuing
for
some
time
to
come.
Settlements
are
going
to
be
certainly
a
significant
source
of
the
of
the
funding
that
will
help,
but
they'll
be
temporary
and
they'll
be
a
cash
infusion,
as
opposed
to
ongoing
funding.
F
Ideally
can
do
a
few
things.
It
can
really
help
distinguish
between
those
one-time
expenses
and
ongoing
expenses.
So
you
can
actually
have
a
better
sense
of
where
to
focus
that
money.
It
can
also
help
you
coordinate
and
track
multiple
funding
streams
over
many
years,
including
your
state's
appropriations
for
this
to
help
determine,
if
you're,
actually
making
the
progress
that
you
want
to
make.
F
F
It's
also
important
to
understand
your
current
baseline
level
of
opioid
use
disorder
spending,
not
including
settlement
funds
for
the
states
that
haven't
received
them
yet
so
that
will
allow
you
to
track
whether
your
spending
is
actually
increasing
as
those
settlement
funds
become
available
and
then,
lastly,
make
expenditures
and
keep
progress,
metrics
easily
accessible
to
the
public
online
data,
dashboards
and
reports
are
a
great
way
to
disseminate
this.
I
know
many
of
you
already
do,
but
this
really
provides
context
and
also
enhances
public
accountability
around
your
spending
decisions,
particularly
around
the
settlement
funds.
F
B
B
The
pdf
of
today's
powerpoint
has
also
been
posted
into
the
chat
and
that
article
that
sarah
just
mentioned
has
also
been
linked
to
in
the
chat.
So
we
are
going
to
go
ahead
and
move
into
the
discussion
portion
of
today's
sort
of
web
conference,
and
our
first
question
here
is:
does
your
state
have
any
existing
statewide
task
forces
or
commissions
that
are
addressing
the
opioid
epidemic?
If
so,
what
is
their
role?
What
is
working
well
and
what
could
be
improved?
B
I'm
going
to
go
ahead
and
post
that
into
the
chat
as
well.
So
if
you
need
to
reference
sort
of
that
language,
you
have
it
and
we
will
go
ahead
and
open
up
the
floor
to
anyone
who
wants
to
share
from
their
state
about
a
commission
a
task
force.
How
are
you
addressing
the
opioid
epidemic
and
what
is
the
role
of
that
sort
of
body
and
sir,
I
don't
know
if
there's
anything
more,
you
wanted
to
say
about
this
particular
question.
F
B
And
I
wonder,
as
folks
sort
of
mull
this
over
I'd
I'd,
encourage
everyone
to
go
ahead
and
turn
on
their
cameras,
a
card
to
make
this
more
of
a
an
in-person
sort
of
meeting
as
much
as
possible.
So
if
you
are
able
to
turn
on
your
camera,
we
would
appreciate
that
just
so.
We
can
all
talk
to
you
individually,.
B
C
I'll
jump
in
here,
john,
you
can
go
in
after
I
guess,
if
you
want
to.
But
again,
our
agencies
are
super
critical
to
helping
us
actually
proceed
with
formal
meeting
settings.
Getting
the
agendas
helped
to
derived
every
month
kind
of
a
thing,
and
I
think
you
can't
do
without
those
efforts
and
all
the
things
that
they
have
been
doing
up
to
this
point,
with
federal
grants
with
state
dollars
that
we've
have
found
very
necessary.
C
We
felt
that
this
ulric
group
in
minnesota
was
critical
to
make
sure
the
agencies
can
listen
to
this
group
from
corrections
to
again
communities
of
color
and
we're
all
at
that
same
table
trying
to
figure
out
the
best
way
to
find
our
our
buckets
of
priorities
and
how
we
can
best
deploy
resources
to
those
areas
all
around
the
state
of
minnesota.
So
agencies
play
a
critical
role
in
getting
it
done
again.
C
We
don't
get
paid
for
this
as
as
volunteers
on
the
on
the
group,
but
the
agencies
have
to
make
sure
that
we
follow
the
right
process
when
dollars
start
to
be
granted
or
matched
or
something
we
want
to
make
sure
we
don't
miss
any
t's
or
eyes,
because
what
we
don't
want
is
to
you
know,
grant
money
to
something
that
was
really
not
set
up
appropriately.
Ahead
of
time
with
a
organization
that
really
had
no
right
to
being
asking
asking
us
for
money,
so
those
processes
are
really
important
for
us
in
our
work.
G
This
is
state
representative,
eisenhower
from
dubuque
I'd,
be
happy
to
elaborate
quickly
and
maybe
answer
my
own
question
I
see
representative
bergen
from
I
was
also
on
the
call,
and
maybe
he'd
want
to
chime
in
as
well
in
fact
represents
he's
district
just
north
of
me.
I
was
on
an
interim
committee
several
years
ago
when
iowa
first
tried
to
address
this
issue
of
the
opioid
epidemic,
and
our
committee
didn't
even
issue
formal
recommendations.
G
We
just
kind
of
regurgitated
the
input
we
received.
I
produced
some
of
my
own
personal
recommendations
and
I'd
like
to
say
that,
based
on
that,
we
made
some
progress,
but
I
can't
so.
This
has
really
been
a
back
burner
issue
at
best
as
a
legislative
matter
in
iowa
and,
I
would
say,
there's
also
a
political
barrier.
G
Our
attorney
general
is
from
one
party,
the
legislature
and
the
governor
is
from
another
party,
and
my
sense
is
that
there's
not
a
a
big
desire
to
engage
across
those
boundaries
for
fear
that
it'll
just
be
infected
by
political
disputes
about
how
to
proceed,
and
so
a
lot
of
this
is
just
happening.
I
would
say
behind
the
scenes,
the
discussions,
so
that's
kind
of,
I
guess
my
follow-up
question-
are
the
are
the
political
issues
that
seem
to
be
creating
barriers
to
progress
in
other
areas.
C
You
know
chuck
I'll,
take
a
swing
at
that,
and
thanks
for
that
question,
I
think
that
part
of
our
advisory
council
was.
We
methodically
took
the
time
to
kind
of
think
about
the
areas
in
our
state
that
should
be
having
a
seat
at
the
table.
We've
had
certainly
people
question.
You
know
why.
Why
isn't
there
more
people
of
color?
You
know,
as
you
know,
minnesota
is
going
through
an
enormous
change.
C
Yet
when
it
comes
to
this
issue,
I've
been
surprised
because
right
now
we're
about
as
divided
as
we
could
be
we're
the
only
state
legislature
that
has
a
house
that's
a
democrat
and
republicans
in
the
senate
and
we're
the
only
one
in
the
whole
country.
That's
that
that
is
set
up
this
way
right
now.
I
think
that
we
are
lucky
that
way.
I
think
this
this
council
has
made
sure
that
we
don't
let
it
get
political.
C
The
agencies
sometimes
don't
have
that
boots
on
the
ground,
working
knowledge
of
how
to
get
into
the
treatment
centers
and
how
to
get
people
clean
needles
and
all
those
things
they
touch
it
all,
but
they
aren't
on
it
they're,
not
in
it.
Every
day
like
like
dr
anne
pilkes,
our
chair,
who's,
a
who's,
an
addiction,
medicine
doctor
who
sees
people
homeless,
people
almost
every
day,
so
we
are,
we
are
having
those
kind
of
people
tell
us
where
the
money
needs
to
go
as
well,
so
but
you're
right.
We
we.
B
Excellent,
thank
you,
representative
baker.
So
our
third
conversation,
our
next
question,
is:
does
your
state
have
forward-looking
opioid
abatement
planning
and
budgeting
processes
that
can
help
you
understand
and
plan
for
long-term
funding
needs?
In
particular,
your
state's
recurring
and
non-recurring
funding
needs.
B
And
you
know
if
representative
baker
or
something
like
macdonald
want
to
address
that
question
first,
I
think
it
would
also
be
great
if
someone
maybe
from
a
state
that
we
haven't
heard
from
yet
from
the
participants,
maybe
wanted
to
share
a
little
bit
about
any
of
the
abatement
work.
That's
gone
on
in
their
states.
B
B
And
that's
all
right
if
we
don't
have
anyone
there,
because
we
do
still
have
a
few
questions
left
in
the
comments
that
we
can
get
to,
and
we
have
one
more
question
left
for
you
as
well
now
that
maybe
we
can
get
a
little
bit
more
discussion
going
for
what
are
the
barriers
to
collecting
track
to
collecting
tracking
and
comparing
data
on
spending
and
activities
across
all
sources.
Federal
grants,
state
local
funding
sources,
all
of
the
above.
B
B
Yet
so
we
did
get
one
question
on:
do
we
anticipate
that
all
states
getting
something
from
the
settlements,
or
did
some
not
opt
in
to
get
in
so
mr
franzen
41
states
are
involved
in
the
consolidated
case
that
I
mentioned
in
ohio.
So
not
all
states
are
part
of
sort
of
that
process,
but
there
isn't
necessarily
any
immediate
window
that
you
know
folks
had
to
sign
up
by
before.
B
I
think
that
part
of
the
concern
among
the
manufacturers
in
this
process
is
that
they
don't
want
sort
of.
You
know
some
lawsuits
coming
in
this
year,
some
more
coming
in
next
year
and
really
just
drag
out
this
legislation.
So
there
is
sort
of
an
effort
in
the
courts
to
sort
of
get
this
all
taken
care
of,
but
there
isn't
necessarily
a
requirement
that
all
states
get
something
if
they've
not
been
involved
in
the
process
so
far,
but
there
also
isn't
necessarily
anything.
That's
preventing
them
from
doing
that
if
that
makes
sense.
G
This
is
representative
gibbons
permanente
from
kentucky,
and
we
did
pass
house
bill
427,
creating
a
opioid
abatement
commission.
We
have
several
pharmacists
that
are
serving
now
in
the
legislature
who
understand
this
issue
very
well
and
and
that's
being
created.
You
know
post
session.
We
ended
up
in
april
or
march.
Excuse.
B
B
B
B
All
right,
it
does
feel
like
the
conversation
is
sort
of
coming
to
a
close
here,
so
we
won't
draw
this
out
any
longer,
but
we
do
appreciate
representative
baker,
assembly,
member
mcdonald.
Thank
you
so
much
for
sharing
your
perspective.
Today.
Senator
thompson
had
to
log
off.
He
had
a
budget
meeting
and
as
the
appropriations
chair,
he
couldn't
very
well
miss
that,
but
we
do
definitely
appreciate
his
participation
today,
as
well
as
everyone
who
has
asked,
questioned
or
take
taken
notes.
B
You
know
I
did
share
my
contact
information,
but
we'll
be
sure
to
follow
up
with
that.
If
you
have
questions
that
come
up
afterwards,
if
there
was
anything
that
we
did
miss
that
you
put
in
the
chat,
we
will
also
follow
up
over
email
with
those
questions,
but
other
than
that
I'll
turn
it
back
over
to
emily.
A
Our
next
session
in
this
series
is
next
wednesday
may
19th
at
2
pm
eastern
time.
We
will
be
looking
at
enhancing
local
budget
flexibility
and
sustainability,
so
we
hope
you
can
join
us.
We
will
also
be
posting
and
sending
out
the
the
slide
deck
for
today
and
the
recording
will
be
posted
on
our
webpage
in
the
coming
days,
along
with
some
of
the
resources
that
were
mentioned
here
today.