HomeMy WebLinkAboutVIII-06 Resolution Authorizing Participation in the National Opioids Settlement
City Council Memorandum
To: Mayor Fasbender & City Councilmembers
From: City Administrator Dan Wietecha
Date: January 3, 2022
Item: National Opioids Settlement
Council Action Requested:
Adopt resolution Authorizing Participation in National Opioids Settlement.
Background Information:
Minnesota has joined a broad multistate coalition in reaching nationwide settlements with the three
largest opioid distributors – AmerisourceBergen, Cardinal Health, and McKesson – and opioid
manufacturer Johnson & Johnson. The settlements resolve investigations and lawsuits against these
companies for their role in the opioid crisis.
Minnesota will be eligible to receive more than $296M over 18 years. Up to $222M of that will be
paid directly to Minnesota cities and counties (not including City of Hastings). The total amount of
payments to Minnesota will be determined by the overall degree of participation by cities and
counties. Hastings signing on to the settlement agreement will help Minnesota reach a “critical mass”
of participation and receive a greater amount of the potential settlement.
We have filed with the national registration and the associated participation paperwork. The Attorney
General’s Office has requested a City Council resolution authorizing the City’s participation in the
settlement agreement.
Financial Impact:
Not applicable
Committee Discussion:
Not applicable
Attachments:
• Resolution: Authorizing Participation in National Opioids Settlement
• Minnesota Opioids Settlement Executive Summary
• Minnesota Opioids State-Subdivision Memorandum of Agreement
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City of Hastings
Dakota County, Minnesota
Resolution 01- -22
Authorizing Participation in National Opioids Settlement
WHEREAS, the State of Minnesota, Minnesota counties and cities, and their people have been
harmed by misconduct committed by certain entities that engage in or have engaged in the
manufacture, marketing, promotion, distribution, or dispensing of an opioid analgesic;
WHEREAS, the State and Local Governments share a common desire to abate and alleviate the
impacts of the misconduct described above throughout Minnesota;
WHEREAS, while the State and Local Governments recognize the sums which may be available
from the aforementioned litigation will likely be insufficient to fully abate the public health crisis
caused by the opioid epidemic, they share a common interest in dedicating the most resources
possible to the abatement effort;
WHEREAS, Minnesota’s share of settlement funds from the National Settlement Agreements
will be maximized only if all Minnesota counties, and cities of a certain size, participate in the
settlements; and
WHEREAS, a Memorandum of Agreement is intended to facilitate compliance by the State and
by the Local Governments with the terms of the National Settlement Agreements and is intended
to serve as a State-Subdivision Agreement under the National Settlement Agreements.
Now, therefore, be it resolved by the Hastings City Council that authorized Mayor is authorized
to execute the Minnesota Opioids State-Subdivision Memorandum of Agreement, as well as the
associated Distributor Subdivision Settlement Participation Form and Janssen Subdivision
Settlement Participation Form.
Adopted this 3rd day of January, 2022.
________________________________
Mary Fasbender, Mayor
Attest:
________________________________
Kelly Murtaugh, City Clerk
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Minnesota Opioid Settlement Executive Summary
Minnesota has joined a broad multistate coalition in reaching nationwide settlements with the three
largest opioid distributors – AmerisourceBergen, Cardinal Health, and McKesson – and opioid
manufacturer Johnson & Johnson. The settlements resolve investigations and lawsuits against
these companies for their role in the opioid crisis. If the settlements are fully adopted nationally,
the distributors will pay $21 billion over 18 years and Johnson & Johnson will pay $5 billion over
10 years. Most states have already joined the settlements, but for the agreements to become
effective, a critical mass of cities and counties must sign onto the settlements by January 2, 2022.
Settlement Structure
If a critical mass of subdivisions sign on and the settlements become effective:
Minnesota will be eligible to receive more than $296 million over 18 years. Up to $222
million of that will be paid directly to Minnesota cities and counties. The total amount of
payments to Minnesota will be determined by the overall degree of participation by cities
and counties. The more cities and counties that join, the more money everyone in
Minnesota will receive. Distribution within Minnesota will be determined by the state-
subdivision agreement (see below).
o Each state’s share of the funding was determined by agreement among the states
using a formula that takes into account the impact of the crisis on the state—the
number of overdose deaths, the number of residents with substance use disorder,
and the number of opioids prescribed—and the population of the state.
Payments will begin to flow to the state and cities and counties as soon as April 2022. The
Johnson & Johnson settlement provides for payments to be accelerated if cities and
counties sign on early.
The vast majority of the settlement funds must be used to support any of a wide variety of
strategies to fight the opioid crisis. The Attorney General’s Office convened an expert
panel of local, state, and community providers with experience and expertise in public
health and delivery of health care services to determine the best and most effective use of
the settlement funds. The panel selected a comprehensive list of future opioid abatement
and remediation programs that will benefit all regions of the state.
In addition to the financial components, the settlements also require the companies to make
changes in how opioids are distributed and sold. The companies will be subject to far more
oversight and accountability throughout that process to prevent deliveries of opioids to
pharmacies where diversion and misuse occur. The distributors will be required to
establish and fund a centralized, independent clearinghouse using detailed data analytics
to keep close track of opioid distribution throughout the country and raise red flags for
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suspicious orders. Johnson & Johnson will be prohibited from selling or promoting opioids
for ten years.
Minnesota Framework
Minnesota has been preparing for these settlements and the opportunity they present to deliver
substantial funding to needed abatement and remediation programs. In 2019, the Legislature
passed the Opiate Epidemic Response bill, creating a special opioid abatement account and the
Opioid Epidemic Response Advisory Council, which will oversee the spending of the state’s
share of settlement funds.
Additionally, a months-long partnership between the state and cities and counties has resulted in
a state-subdivision agreement (or “Minnesota Memorandum of Agreement”) that is designed to
maximize the settlement funds coming to the State of Minnesota and get them to where they are
needed most. The state-subdivision agreement details how the settlement money will be
allocated within the state and also sets out a structure for the distribution of opioid abatement
funds from pending bankruptcy plans with Purdue Pharma and Mallinckrodt. A copy of the
state-subdivision agreement can be found on the Attorney General’s website at
www.ag.state.mn.us/opioids.
Pursuant to the state-subdivision agreement—and assuming maximum payments—
approximately $296 million in funds paid to Minnesota and its cities and counties from the
Distributor and Johnson & Johnson settlements, as well as tens of millions of additional dollars
from the Purdue Pharma and Mallinckrodt bankruptcies, will be allocated as follows:
Local Government Abatement Fund. Seventy-five percent (75%) of the abatement
funds will be paid directly to counties and certain municipalities that participate in the
settlement. Local government funds will be directly allocated to all participating
counties, and all participating municipalities that: (a) have populations of 30,000 or more,
(b) have filed lawsuits against the settling defendants, or (c) have public health
departments. To promote efficiency in the use of abatement funds and limit the
administratively burdensome disbursements of amounts that are too small to add a
meaningful abatement response, smaller, non-litigating municipalities will not receive a
direct allocation of settlement funds. The allocation percentages for each county and
municipality were determined by counsel for the subdivisions negotiating the national
settlement agreements and were calculated using data reflect the impact of the opioid
crisis on the subdivision. Tribal nations are conducting separate settlement negotiations
with the opioid companies.
State Fund. Twenty-five percent (25) of the abatement funds will be paid directly to the
State. Pursuant to state law, these funds will go into the special opioid abatement account
to be overseen and distributed by the Opioid Epidemic Response Advisory Council.
Under current law, after certain appropriations are made, approximately 50% of the funds
paid into the opioid abatement account are distributed to county social service agencies to
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provide child protection services to children and families who are affected by addiction.
The state-subdivision agreement anticipates a change to this law to allow counties to
receive their share of the settlement funds directly. The agreement requires the state and
subdivisions to work together to achieve this change in law during the 2022 legislative
session, and includes a provision changing the allocation between state and local
governments if the statutory change is not accomplished.
Some municipalities in Minnesota retained attorneys on a contingency fee basis to file lawsuits
against the opioid companies. The national settlements establish an Attorney Fee Fund for
attorneys representing cities and counties that join the settlements. The settlements require
attorneys who recover from this fund to waive enforcement of their contingency fee agreements.
The state-subdivision agreement includes a Backstop Fund, which will be overseen by a Special
Master, that will allow for the payment of reasonable attorney fees to private attorneys to make
up for the difference between what they receive from the national fund and their contingency fee
agreements, which are capped at 15%. Any funds that remain in the Backstop Fund after
payment of reasonable attorney fees will revert to cities and counties for abatement.
Subdivision Participation
It is vital for subdivisions to join the settlements during the initial sign-on period, which ends
January 2, 2022. First, very high levels of subdivision participation nationally are necessary for
the companies to move forward with the settlements and for everyone to benefit from them.
Second, cities or counties cannot receive any portion of the direct settlement funds if they do not
sign on to the settlements. Third, in order to maximize the settlement payments that come to
Minnesota, full joinder by certain categories of counties and cities is needed. Finally, joinder
during the initial sign-on period maximizes the amount of funds available to an individual city or
county.
Next Steps
Now: Cities and counties should have received a settlement notice with additional information
about the sign on process, which begins by registering on the national settlement website:
www.nationalopioidsettlement.com. Registering is a necessary step toward participation in the
settlements. The notice each subdivision received by mail and email provides its unique
subdivision registration code, which must be used to register. Registering does not mean that the
subdivision has accepted the terms of the national settlement agreements or the state-subdivision
agreement.
Next: Each subdivision, via its local legislative body, should adopt a resolution that authorizes a
representative of the subdivision to execute Minnesota’s state-subdivision agreement and both
subdivision settlement participation forms (Distributors and Johnson & Johnson), which are
required to join the settlements. Cities and counties can obtain model resolutions by contacting
the Association of Minnesota Counties or the League of Minnesota Cities. The resolutions
should be submitted to the subdivisions’ legislative body (i.e., county commission or city
council) for approval.
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By January 2, 2022: After the appropriate resolution is passed by each subdivision, the
authorized representative should sign the Minnesota Memorandum of Agreement, the Distributor
Agreement, and the Johnson & Johnson Agreement. The Distributor and Johnson & Johnson
agreements can be signed electronically via DocuSign. Subdivisions should receive an email
with a link to sign electronically upon registering at www.nationalopioidsettlement.com.
Subdivisions are encouraged to sign onto the Minnesota Memorandum of Agreement and the
settlement agreements as soon as possible to avoid scheduling challenges and to ensure that we
meet the national subdivision participation threshold for the settlements to become effective.
Additional information about the settlements and how they are implemented in Minnesota can be
found on the Attorney General’s website: www.ag.state.mn.us/opioids. Subdivisions that are
represented by an attorney with respect to opioid claims should consult with their attorney.
Additionally, specific questions for the Attorney General’s Office can be emailed to
opioids@ag.state.mn.us, or left via voicemail at (612) 429-7126.
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MINNESOTA OPIOIDS STATE-SUBDIVISION MEMORANDUM OF AGREEMENT
WHEREAS, the State of Minnesota, Minnesota counties and cities, and their people have been
harmed by misconduct committed by certain entities that engage in or have engaged in the manufacture, marketing, promotion, distribution, or dispensing of an opioid analgesic; WHEREAS, certain Minnesota counties and cities, through their counsel, and the State, through
its Attorney General, are separately engaged in ongoing investigations, litigation, and settlement
discussions seeking to hold opioid manufacturers and distributors accountable for the damage caused by their misconduct; WHEREAS, the State and Local Governments share a common desire to abate and alleviate the
impacts of the misconduct described above throughout Minnesota;
WHEREAS, while the State and Local Governments recognize the sums which may be available from the aforementioned litigation will likely be insufficient to fully abate the public health crisis caused by the opioid epidemic, they share a common interest in dedicating the most resources
possible to the abatement effort;
WHEREAS, the investigations and litigation with Johnson & Johnson, AmerisourceBergen, Cardinal Health, and McKesson have resulted in National Settlement Agreements with those companies, which the State has already committed to join;
WHEREAS, Minnesota’s share of settlement funds from the National Settlement Agreements will be maximized only if all Minnesota counties, and cities of a certain size, participate in the settlements;
WHEREAS, the National Settlement Agreements will set a default allocation between each state
and its political subdivisions unless they enter into a state-specific agreement regarding the distribution and use of settlement amounts; WHEREAS, this Memorandum of Agreement is intended to facilitate compliance by the State
and by the Local Governments with the terms of the National Settlement Agreements and is
intended to serve as a State-Subdivision Agreement under the National Settlement Agreements; WHEREAS, this Memorandum of Agreement is also intended to serve as a State-Subdivision Agreement under resolutions of claims concerning alleged misconduct in the manufacture,
marketing, promotion, distribution, or dispensing of an opioid analgesic entered in bankruptcy
court that provide for payments (including payments through a trust) to both the State and Minnesota counties and cities and allow for the allocation between a state and its political subdivisions to be set through a state-specific agreement; and
WHEREAS, specifically, this Memorandum of Agreement is intended to serve under the
Bankruptcy Resolutions concerning Purdue Pharma and Mallinckrodt as a qualifying Statewide Abatement Agreement.
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I. Definitions
As used in this MOA (including the preamble above):
“Approved Uses” shall mean forward-looking strategies, programming, and services to abate the opioid epidemic that fall within the list of uses on Exhibit A. Consistent with the terms of the National Settlement Agreements and Bankruptcy Resolutions, “Approved
Uses” shall include the reasonable administrative expenses associated with overseeing and
administering Opioid Settlement Funds. Reimbursement by the State or Local Governments for past expenses are not Approved Uses. “Backstop Fund” is defined in Section VI.B below.
“Bankruptcy Defendants” mean Purdue Pharma L.P. and Mallinckrodt plc. “Bankruptcy Resolution(s)” means resolutions of claims concerning alleged misconduct in manufacture, marketing, promotion, distribution, or dispensing of an opioid analgesic by
the Bankruptcy Defendants entered in bankruptcy court that provide for payments
(including payments through a trust) to both the State and Minnesota counties and municipalities and allow for the allocation between the state and its political subdivisions to be set through a state-specific agreement.
“Counsel” is defined in Section VI.B below.
“County Area” shall mean a county in the State of Minnesota plus the Local Governments, or portion of any Local Government, within that county.
“Governing Body” means (1) for a county, the county commissioners of the county, and
(2) for a municipality, the elected city council or the equivalent legislative body for the municipality. “Legislative Modification” is defined in Section II.C below.
“Litigating Local Governments” mean a Local Government that filed an opioid lawsuit(s) on or before December 3, 2021, as defined in Section VI.B below. “Local Abatement Funds” are defined in Section II.B below.
“Local Government” means all counties and cities within the geographic boundaries of the state of Minnesota. “MDL Matter” means the matter captioned In re National Prescription Opiate Litigation,
MDL 2804, pending in the United States District Court for the Northern District of Ohio.
“Memorandum of Agreement” or “MOA” mean this agreement, the Minnesota Opioids State-Subdivision Memorandum of Agreement.
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“National Settlement Agreements” means the national opioid settlement agreements with
the Parties and one or all of the Settling Defendants concerning alleged misconduct in
manufacture, marketing, promotion, distribution, or dispensing of an opioid analgesic. “Opioid Settlement Funds” shall mean all funds allocated by the National Settlement Agreements and any Bankruptcy Resolutions to the State and Local Governments for
purposes of opioid remediation activities or restitution, as well as any repayment of those
funds and any interest or investment earnings that may accrue as those funds are temporarily held before being expended on opioid remediation strategies. “Opioid Supply Chain Participants” means entities that engage in or have engaged in the
manufacture, marketing, promotion, distribution, or dispensing of an opioid analgesic,
including their officers, directors, employees, or agents, acting in their capacity as such. “Parties” means the State and the Participating Local Governments.
“Participating Local Government” means a county or city within the geographic boundaries
of the State of Minnesota that has signed this Memorandum of Agreement and has executed a release of claims with the Settling Defendants by signing on to the National Settlement Agreements. For the avoidance of doubt, a Local Government must sign this MOA to become a “Participating Local Government.”
“Region” is defined in Section II.H below. “Settling Defendants” means Johnson & Johnson, AmerisourceBergen, Cardinal Health, and McKesson, as well as their subsidiaries, affiliates, officers, and directors named in a
National Settlement Agreement.
“State” means the State of Minnesota by and through its Attorney General, Keith Ellison. “State Abatement Fund” is defined in Section II.B below.
II. Allocation of Settlement Proceeds A. Method of distribution. Pursuant to the National Settlement Agreements and any Bankruptcy Resolutions, Opioid Settlement Funds shall be distributed directly to the State
and directly to Participating Local Governments in such proportions and for such uses as
set forth in this MOA, provided Opioid Settlement Funds shall not be considered funds of the State or any Participating Local Government unless and until such time as each annual distribution is made.
B. Overall allocation of funds. Opioid Settlement Funds will be initially allocated as follows:
(i) 25% directly to the State (“State Abatement Fund”), and (ii) 75% directly to abatement funds established by Participating Local Governments (“Local Abatement Funds”). This initial allocation is subject to modification by Sections II.F, II.G, and II.H, below.
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C. Statutory change.
1. The Parties agree to work together in good faith to propose and lobby for legislation in the 2022 Minnesota legislative session to modify the distribution of the State’s Opiate Epidemic Response Fund under Minnesota Statutes section 256.043, subd. 3(d), so that “50 percent of the remaining amount” is no longer appropriated
to county social services, as related to Opioid Settlement Funds that are ultimately
placed into the Minnesota Opiate Epidemic Response Fund (“Legislative Modification”).1 Such efforts include, but are not limited to, providing testimony and letters in support of the Legislative Modification.
2. It is the intent of the Parties that the Legislative Modification would affect only the
county share under section 256.043, subd. 3(d), and would not impact the provision of funds to tribal social service agencies. Further, it is the intent of the Parties that the Legislative Modification would relate only to disposition of Opioid Settlement Funds and is not predicated on a change to the distribution of the Board of
Pharmacy fee revenue that is deposited into the Opiate Epidemic Response Fund.
D. Bill Drafting Workgroup. The Parties will work together to convene a Bill Drafting Workgroup to recommend draft legislation to achieve this Legislative Modification. The Workgroup will meet as often as practicable in December 2021 and January 2022 until
recommended language is completed. Invitations to participate in the group shall be
extended to the League of Minnesota Cities, the Association of Minnesota Counties, the Coalition of Greater Minnesota Cities, state agencies, the Governor’s Office, the Attorney General’s Office, the Opioid Epidemic Response Advisory Council, the Revisor’s Office, and Minnesota tribal representatives. The Workgroup will host meetings with Members of
the Minnesota House of Representatives and Minnesota Senate who have been involved in
this matter to assist in crafting a bill draft. E. No payments until August 1, 2022. The Parties agree to take all steps necessary to ensure that any Opioid Settlement Funds ready for distribution directly to the State and
Participating Local Governments under the National Settlement Agreements or
Bankruptcy Resolutions are not actually distributed to the Parties until on or after August 1, 2022, in order to allow the Parties to pursue legislative change that would take effect before the Opioid Settlement Funds are received by the Parties. Such steps may include, but are not limited to, the Attorney General’s Office delaying its filing of Consent
Judgments in Minnesota state court memorializing the National Settlement Agreements.
This provision will cease to apply upon the effective date of the Legislative Modification described above, if that date is prior to August 1, 2022.
1 It is the intent of the Parties that counties will continue to fund child protection services for
children and families who are affected by addiction, in compliance with the Approved Uses in Exhibit A.
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F. Effect of no statutory change by August 1, 2022. If the Legislative Modification described above does not take effect by August 1, 2022, the allocation between the Parties set forth
in Section II.B shall be modified as follows: (i) 40% directly to the State Abatement Fund,
and (ii) 60% to Local Abatement Funds. The Parties further agree to discuss potential amendment of this MOA if such legislation does not timely go into effect in accordance with this paragraph.
G. Effect of later statutory change. If the Legislative Modification described above takes
effect after August 1, 2022, the allocation between the Parties will be modified as follows: (i) 25% directly to the State Abatement Fund, and (ii) 75% to Local Abatement Funds. H. Effect of partial statutory change. If any legislative action otherwise modifies or
diminishes the direct allocation of Opioid Settlement Funds to Participating Local
Governments so that as a result the Participating Local Governments would receive less than 75 percent of the Opioid Settlement Funds (inclusive of amounts received by counties per statutory appropriation through the Minnesota Opiate Epidemic Response Fund), then the allocation set forth in Section II.B will be modified to ensure Participating Local
Governments receive 75% of the Opioid Settlement Funds. I. Participating Local Governments receiving payments. The proportions set forth in Exhibit B provide for payments directly to: (i) all Minnesota counties; and (ii) all Minnesota cities that (a) have a population of more than 30,000, based on the United States
Census Bureau’s Vintage 2019 population totals, (b) have funded or otherwise managed
an established health care or treatment infrastructure (e.g., health department or similar agency), or (c) have initiated litigation against the Settling Defendants as of December 3, 2021.
J. Allocation of funds between Participating Local Governments. The Local Abatement
Funds shall be allocated to Participating Local Governments in such proportions as set forth in Exhibit B, attached hereto and incorporated herein by reference, which is based upon the MDL Matter’s Opioid Negotiation Class Model.2 The proportions shall not change based on population changes during the term of the MOA. However, to the extent
required by the terms of the National Settlement Agreements, the proportions set forth in Exhibit B must be adjusted: (i) to provide no payment from the National Settlement Agreements to any listed county or municipality that does not participate in the National Settlement Agreements; and (ii) to provide a reduced payment from the National Settlement Agreements to any listed county or city that signs on to the National Settlement
Agreements after the Initial Participation Date.
K. Redistribution in certain situations. In the event a Participating Local Government merges, dissolves, or ceases to exist, the allocation percentage for that Participating Local
2 More specifically, the proportions in Exhibit B were created based on Exhibit G to the National
Settlement Agreements, which in turn was based on the MDL Matter’s allocation criteria. Cities
under 30,000 in population that had shares under the Exhibit G default allocation were removed and their shares were proportionally reallocated amongst the remaining subdivisions.
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Government shall be redistributed equitably based on the composition of the successor Local Government. In the event an allocation to a Local Government cannot be paid to the
Local Government, such unpaid allocations will be allocated to Local Abatement Funds
and be distributed in such proportions as set forth in Exhibit B. L. City may direct payments to county. Any city allocated a share may elect to have its full share or a portion of its full share of current or future annual distributions of settlement
funds instead directed to the county or counties in which it is located, so long as that county
or counties are Participating Local Governments[s]. Such an election must be made by January 1 each year to apply to the following fiscal year. If a city is located in more than one county, the city’s funds will be directed based on the MDL Matter’s Opioid Negotiation Class Model.
III. Special Revenue Fund A. Creation of special revenue fund. Every Participating Local Government receiving Opioid Settlement Funds through direct distribution shall create a separate special revenue fund,
as described below, that is designated for the receipt and expenditure of Opioid Settlement
Funds. B. Procedures for special revenue fund. Funds in this special revenue fund shall not be commingled with any other money or funds of the Participating Local Government. The
funds in the special revenue fund shall not be used for any loans or pledge of assets, unless
the loan or pledge is for an Approved Use. Participating Local Governments may not assign to another entity their rights to receive payments of Opioid Settlement Funds or their responsibilities for funding decisions, except as provided in Section II.L.
C. Process for drawing from special revenue funds.
1. Opioid Settlement Funds can be used for a purpose when the Governing Body includes in its budget or passes a separate resolution authorizing the expenditure of a stated amount of Opioid Settlement Funds for that purpose or those purposes
during a specified period of time.
2. The budget or resolution must (i) indicate that it is an authorization for expenditures of opioid settlement funds; (ii) state the specific strategy or strategies the county or city intends to fund, using the item letter and/or number in Exhibit A to identify
each funded strategy, if applicable; and (iii) state the amount dedicated to each
strategy for a stated period of time. D. Local government grantmaking. Participating Local Governments may make contracts with or grants to a nonprofit, charity, or other entity with Opioid Settlement Funds.
E. Interest earned on special revenue fund. The funds in the special revenue fund may be invested, consistent with the investment limitations for local governments, and may be
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placed in an interest-bearing bank account. Any interest earned on the special revenue funds must be used in a way that is consistent with this MOA.
IV. Opioid Remediation Activities A. Limitation on use of funds. This MOA requires that Opioid Settlement Funds be utilized only for future opioid remediation activities, and Parties shall expend Opioid Settlement
Funds only for Approved Uses and for expenditures incurred after the effective date of this
MOA, unless execution of the National Settlement Agreements requires a later date. Opioid Settlement Funds cannot be used to pay litigation costs, expenses, or attorney fees arising from the enforcement of legal claims related to the opioid epidemic, except for the portion of Opioid Settlement Funds that comprise the Backstop Fund described in Section
VI. For the avoidance of doubt, counsel for Litigating Local Governments may recover
litigation costs, expenses, or attorney fees from the common benefit, contingency fee, and cost funds established in the National Settlement Agreements, as well as the Backstop Fund described in Section VI.
B. Public health departments as Chief Strategists. For Participating Local Governments that
have public health departments, the public health departments shall serve as the lead agency and Chief Strategist to identify, collaborate, and respond to local issues as Local Governments decide how to leverage and disburse Opioid Settlement Funds. In their role as Chief Strategist, public health departments will convene multi-sector meetings and lead
efforts that build upon local efforts like Community Health Assessments and Community
Health Improvement Plans, while fostering community focused and collaborative evidence-informed approaches that prevent and address addiction across the areas of public health, human services, and public safety. Chief Strategists should consult with municipalities located within their county in the development of any Community Health
Assessment, and are encouraged to collaborate with law enforcement agencies in the
county where appropriate. C. Administrative expenses. Reasonable administrative costs for the State or Local Government to administer its allocation of the Opioid Settlement Funds shall not exceed
actual costs, 10% of the relevant allocation of the Opioid Settlement Funds, or any
administrative expense limitation imposed by the National Settlement Agreements or Bankruptcy Resolution, whichever is less. D. Regions. Two or more Participating Local Governments may at their discretion form a
new group or utilize an existing group (“Region”) to pool their respective shares of
settlement funds and make joint spending decisions. Participating Local Governments may choose to create a Region or utilize an existing Region under a joint exercise of powers under Minn. Stat. § 471.59.
E. Consultation and partnerships.
1. Each county receiving Opioid Settlement Funds must consult annually with the municipalities in the county regarding future use of the settlement funds in the
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county, including by holding an annual meeting with all municipalities in the county in order to receive input as to proposed uses of the Opioid Settlement Funds
and to encourage collaboration between Local Governments both within and
beyond the county. These meetings shall be open to the public. 2. Participating Local Governments within the same County Area have a duty to regularly consult with each other to coordinate spending priorities.
3. Participating Local Governments can form partnerships at the local level whereby Participating Local Governments dedicate a portion of their Opioid Settlement Funds to support city- or community-based work with local stakeholders and partners within the Approved Uses.
F. Collaboration. The State and Participating Local Governments must collaborate to promote effective use of Opioid Settlement Funds, including through the sharing of expertise, training, and technical assistance. They will also coordinate with trusted partners, including community stakeholders, to collect and share information about
successful regional and other high-impact strategies and opioid treatment programs.
V. Reporting and Compliance A. Construction of reporting and compliance provisions. Reporting and compliance
requirements will be developed and mutually agreed upon by the Parties, utilizing the
recommendations provided by the Advisory Panel to the Attorney General on Distribution and Allocation of Opioid Settlement Funds. B. Reporting Workgroup. The Parties will work together to establish a Reporting Workgroup
that includes representatives of the Attorney General’s Office, state stakeholders, and city
and county representatives, who will meet on a regular basis to develop reporting and compliance recommendations. The Reporting Workgroup must produce a set of reporting and compliance measures by June 1, 2022. Such reporting and compliance measures will be effective once approved by representatives of the Attorney General’s Office, the
Governor’s Office, the Association of Minnesota Counties, and the League of Minnesota
Cities that are on the Workgroup. VI. Backstop Fund
A. National Attorney Fee Fund. The National Settlement Agreements provide for the payment
of all or a portion of the attorney fees and costs owed by Litigating Local Governments to private attorneys specifically retained to file suit in the opioid litigation (“National Attorney Fee Fund”). The Parties acknowledge that the National Settlement Agreements may provide for a portion of the attorney fees of Litigating Local Governments.
B. Backstop Fund and Waiver of Contingency Fee. The Parties agree that the Participating
Local Governments will create a supplemental attorney fees fund (the “Backstop Fund”)
to be used to compensate private attorneys (“Counsel”) for Local Governments that filed opioid lawsuits on or before December 3, 2021 (“Litigating Local Governments”). By
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order3 dated August 6, 2021, Judge Polster capped all applicable contingent fee agreements at 15%. Judge Polster’s 15% cap does not limit fees from the National Attorney Fee Fund
or from any state backstop fund for attorney fees, but private attorneys for local
governments must waive their contingent fee agreements to receive payment from the National Attorney Fee Fund. Judge Polster recognized that a state backstop fund can be designed to incentivize private attorneys to waive their right to enforce contingent fee agreements and instead apply to the National Attorney Fee Fund, with the goals of
achieving greater subdivision participation and higher ultimate payouts to both states and
local governments. Accordingly, in order to seek payment from the Backstop Fund, Counsel must agree to waive their contingency fee agreements relating to these National Settlement Agreements and first apply to the National Attorney Fee Fund.
C. Backstop Fund Source. The Backstop Fund will be funded by seven percent (7%) of the
share of each payment made to the Local Abatement Funds from the National Settlement
Agreements (annual or otherwise), based upon the initial allocation of 25% directly to the State Abatement Fund and 75% directly to Local Abatement Funds, and will not include payments resulting from the Purdue or Mallinckrodt Bankruptcies. In the event that the initial allocation is modified pursuant to Section II.F. above, then the Backstop Fund will
be funded by 8.75% of the share of each payment made to the Local Abatement Funds
from the National Settlement Agreements (annual or otherwise), based upon the modified allocation of 40% directly to the State Abatement Fund and 60% directly to the Local Abatement Funds, and will not include payments resulting from the Purdue or Mallinckrodt Bankruptcies. In the event that the allocation is modified pursuant to Section II.G. or
Section II.H. above, back to an allocation of 25% directly to the State Abatement Fund and
75% directly to Local Abatement Funds, then the Backstop Fund will be funded by 7% of the share of each payment made to the Local Abatement Funds from the National Settlement Agreements (annual or otherwise), and will not include payments resulting from the Purdue or Mallinckrodt Bankruptcies.
D. Backstop Fund Payment Cap. Any attorney fees paid from the Backstop Fund, together
with any compensation received from the National Settlement Agreements’ Contingency Fee Fund, shall not exceed 15% of the total gross recovery of the Litigating Local Governments’ share of funds from the National Settlement Agreements. To avoid doubt, in no instance will Counsel receive more than 15% of the amount paid to their respective
Litigating Local Government client(s) when taking into account what private attorneys
receive from both the Backstop Fund and any fees received from the National Settlement Agreements’ Contingency Fee Fund.
E. Requirements to Seek Payment from Backstop Fund. A private attorney may seek payment from the Backstop Fund in the event that funds received by Counsel from the National
Settlement Agreements’ Contingency Fee Fund are insufficient to cover the amount that
would be due to Counsel under any contingency fee agreement with a Litigating Local Government based on any recovery Litigating Local Governments receive from the National Settlement Agreements. Before seeking any payment from the Backstop Fund,
3 Order, In re: Nat’l Prescription Opiate Litig., Case No. 17-MD-02804, Doc. No. 3814 (N.D. Ohio August 6, 2021).
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private attorneys must certify that they first sought fees from the National Settlement Agreements’ Contingency Fee Fund, and must certify that they agreed to accept the
maximum fees payments awarded to them. Nothing in this Section, or in the terms of this
Agreement, shall be construed as a waiver of fees, contractual or otherwise, with respect to fees that may be recovered under a contingency fee agreement or otherwise from other past or future settlements, verdicts, or recoveries related to the opioid litigation.
F. Special Master. A special master will administer the Backstop Fund, including overseeing
any distribution, evaluating the requests of Counsel for payment, and determining the
appropriate amount of any payment from the Backstop Fund. The special master will be selected jointly by the Minnesota Attorney General and the Hennepin County Attorney, and will be one of the following individuals: Hon. Jeffrey Keyes, Hon. David Lillehaug; or Hon. Jack Van de North. The special master will be compensated from the Backstop
Fund. In the event that a successor special master is needed, the Minnesota Attorney
General and the Hennepin County Attorney will jointly select the successor special master from the above-listed individuals. If none of the above-listed individuals is available to serve as the successor special master, then the Minnesota Attorney General and the Hennepin County Attorney will jointly select a successor special master from a list of
individuals that is agreed upon between the Minnesota Attorney General, the Hennepin
County Attorney, and Counsel.
G. Special Master Determinations. The special master will determine the amount and timing of any payment to Counsel from the Backstop Fund. The special master shall make one determination regarding payment of attorney fees to Counsel, which will apply through the
term of the recovery from the National Settlement Agreements. In making such
determinations, the special master shall consider the amounts that have been or will be received by the private attorney’s firm from the National Settlement Agreements’ Contingency Fee Fund relating to Litigating Local Governments; the contingency fee contracts; the dollar amount of recovery for Counsel’s respective clients who are Litigating
Local Governments; the Backstop Fund Payment Cap above; the complexity of the legal
issues involved in the opioid litigation; work done to directly benefit the Local Governments within the State of Minnesota; and the principles set forth in the Minnesota Rules of Professional Conduct, including the reasonable and contingency fee principles of Rule 1.5. In the interest of transparency, Counsel shall provide information in their initial
fee application about the total amount of fees that Counsel have received or will receive
from the National Attorney Fee Fund related to the Litigating Local Governments.
H. Special Master Proceedings. Counsel seeking payment from the Backstop Fund may also provide written submissions to the special master, which may include declarations from counsel, summaries relating to the factors described above, and/or attestation regarding
total payments awarded or anticipated from the National Settlement Agreements’
Contingency Fee Fund. Private attorneys shall not be required to disclose work product, proprietary or confidential information, including but not limited to detailed billing or lodestar records. To the extent that counsel rely upon written submissions to support their application to the special master, the special master will incorporate said submission or
summary into the record. Any proceedings before the special master and documents filed
with the special master shall be public, and the special master’s determinations regarding
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any payment from the Backstop Funds shall be transparent, public, final, and not appealable.
I. Distribution of Any Excess Funds. To the extent the special master determines that the
Backstop Fund exceeds the amount necessary for payment to Counsel, the special master shall distribute any excess amount to Participating Local Governments according to the percentages set forth in Exhibit B.
J. Term. The Backstop Fund will be administered for (a) the length of the National Litigation
Settlement payments; or (b) until all Counsel for Litigating Local Governments have either
(i) received payments equal to the Backstop Fund Payment Cap above or (ii) received the full amount determined by the special master; whichever occurs first.
K. No State Funds Toward Attorney Fees. For the avoidance of doubt, no portion of the State Abatement Fund will be used to fund the Backstop Fund or in any other way to fund any
Litigating Local Government’s attorney fees and expenses. Any funds that the State
receives from the National Settlement Agreements as attorney fees and costs or in lieu of attorney fees and costs, including the Additional Restitution Amounts, will be treated as State Abatement Funds.
VII. General Terms
A. Scope of agreement. This MOA applies to all settlements under the National Settlement Agreements with Settling Defendants and the Bankruptcy Resolutions with Bankruptcy Defendants.4 The Parties agree to discuss the use, as the Parties may deem appropriate in the future, of the settlement terms set out herein (after any necessary amendments) for
resolutions with Opioid Supply Chain Participants not covered by the National Settlement
Agreements or a Bankruptcy Resolution. The Parties acknowledge that this MOA does not excuse any requirements placed upon them by the terms of the National Settlement Agreements or any Bankruptcy Resolution, except to the extent those terms allow for a State-Subdivision Agreement to do so.
B. When MOA takes effect. 1. This MOA shall become effective at the time a sufficient number of Local Governments have joined the MOA to qualify this MOA as a State-Subdivision
Agreement under the National Settlement Agreements or as a Statewide Abatement
Agreement under any Bankruptcy Resolution. If this MOA does not thereby qualify as a State-Subdivision Agreement or Statewide Abatement Agreement, this MOA will have no effect.
2. The Parties may conditionally agree to sign on to the MOA through a letter of intent,
resolution, or similar written statement, declaration, or pronouncement declaring
4 For the avoidance of doubt, this includes settlements reached with AmerisourceBergen, Cardinal
Health, and McKesson, and Janssen, and Bankruptcy Resolutions involving Purdue Pharma L.P., and Mallinckrodt plc.
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their intent to sign on to the MOA if the threshold for Party participation in a specific Settlement is achieved.
C. Dispute resolution. 1. If any Party believes another Party has violated the terms of this MOA, the alleging Party may seek to enforce the terms of this MOA in Ramsey County District Court,
provided the alleging Party first provides notice to the alleged offending Party of
the alleged violation and a reasonable opportunity to cure the alleged violation. 2. If a Party believes another Party, Region, or individual involved in the receipt, distribution, or administration of Opioid Settlement Funds has violated any
applicable ethics codes or rules, a complaint shall be lodged with the appropriate
forum for handling such matters. 3. If a Party believes another Party, Region, or individual involved in the receipt, distribution, or administration of Opioid Settlement Funds violated any Minnesota
criminal law, such conduct shall be reported to the appropriate criminal authorities.
D. Amendments. The Parties agree to make such amendments as necessary to implement the intent of this MOA.
E. Applicable law and venue. Unless otherwise required by the National Settlement
Agreements or a Bankruptcy Resolution, this MOA, including any issues related to interpretation or enforcement, is governed by the laws of the State of Minnesota. Any action related to the provisions of this MOA must be adjudicated by the Ramsey County District Court. If any provision of this MOA is held invalid by any court of competent
jurisdiction, this invalidity does not affect any other provision which can be given effect
without the invalid provision. F. Relationship of this MOA to other agreements and resolutions. All Parties acknowledge and agree that the National Settlement Agreements will require a Participating Local
Government to release all its claims against the Settling Defendants to receive direct
allocation of Opioid Settlement Funds. All Parties further acknowledge and agree that based on the terms of the National Settlement Agreements, a Participating Local Government may receive funds through this MOA only after complying with all requirements set forth in the National Settlement Agreements to release its claims. This
MOA is not a promise from any Party that any National Settlement Agreements or
Bankruptcy Resolution will be finalized or executed. G. When MOA is no longer in effect. This MOA is effective until one year after the last date on which any Opioid Settlement Funds are being spent by the Parties pursuant to the
National Settlement Agreements and any Bankruptcy Resolution.
H. No waiver for failure to exercise. The failure of a Party to exercise any rights under this MOA will not be deemed to be a waiver of any right or any future rights.
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I. No effect on authority of Parties. Nothing in this MOA should be construed to limit the
power or authority of the State of Minnesota, the Attorney General, or the Local
Governments, except as expressly set forth herein. J. Signing and execution. This MOA may be executed in counterparts, each of which constitutes an original, and all of which constitute one and the same agreement. This MOA
may be executed by facsimile or electronic copy in any image format. Each Party
represents that all procedures necessary to authorize such Party’s execution of this MOA have been performed and that the person signing for such Party has been authorized to execute the MOA in an official capacity that binds the Party.
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This Minnesota Opioids State-Subdivision Memorandum of Agreement is signed
this ___day of ____________, ______ by:
____________________________________________
Name and Title: _______________________________
On behalf of: _________________________________
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EXHIBIT A
List of Opioid Remediation Uses
Settlement fund recipients shall choose from among abatement strategies, including but not limited to those listed in this Exhibit. The programs and strategies listed in this Exhibit are not exclusive, and fund recipients shall have flexibility to modify their abatement approach as needed and as new uses are discovered.
PART ONE: TREATMENT
A. TREAT OPIOID USE DISORDER (OUD)
Support treatment of Opioid Use Disorder (“OUD”) and any co-occurring Substance Use Disorder or Mental Health (“SUD/MH”) conditions through evidence-based or evidence-
informed programs5 or strategies that may include, but are not limited to, those that:6
1. Expand availability of treatment for OUD and any co-occurring SUD/MH conditions, including all forms of Medication for Opioid Use Disorder (“MOUD”)7 approved by the U.S. Food and Drug Administration.
2. Support and reimburse evidence-based services that adhere to the American
Society of Addiction Medicine (“ASAM”) continuum of care for OUD and any co-
occurring SUD/MH conditions.
3. Expand telehealth to increase access to treatment for OUD and any co-occurring SUD/MH conditions, including MOUD, as well as counseling, psychiatric support, and other treatment and recovery support services.
4. Improve oversight of Opioid Treatment Programs (“OTPs”) to assure evidence-
based or evidence-informed practices such as adequate methadone dosing and low threshold approaches to treatment.
5 Use of the terms “evidence-based,” “evidence-informed,” or “best practices” shall not limit the ability of recipients to fund innovative services or those built on culturally specific needs. Rather, recipients are encouraged to support culturally appropriate services and programs for persons with
OUD and any co-occurring SUD/MH conditions. 6 As used in this Exhibit, words like “expand,” “fund,” “provide” or the like shall not indicate a preference for new or existing programs. 7 Historically, pharmacological treatment for opioid use disorder was referred to as “Medication-Assisted Treatment” (“MAT”). It has recently been determined that the better term is “Medication
for Opioid Use Disorder” (“MOUD”). This Exhibit will use “MOUD” going forward. Use of the
term MOUD is not intended to and shall in no way limit abatement programs or strategies now or into the future as new strategies and terminology evolve.
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5. Support mobile intervention, treatment, and recovery services, offered by qualified professionals and service providers, such as peer recovery coaches, for
persons with OUD and any co-occurring SUD/MH conditions and for persons
who have experienced an opioid overdose.
6. Provide treatment of trauma for individuals with OUD (e.g., violence, sexual assault, human trafficking, or adverse childhood experiences) and family members (e.g., surviving family members after an overdose or overdose fatality),
and training of health care personnel to identify and address such trauma.
7. Support detoxification (detox) and withdrawal management services for people with OUD and any co-occurring SUD/MH conditions, including but not limited to medical detox, referral to treatment, or connections to other services or supports.
8. Provide training on MOUD for health care providers, first responders, students, or
other supporting professionals, such as peer recovery coaches or recovery
outreach specialists, including telementoring to assist community-based providers in rural or underserved areas.
9. Support workforce development for addiction professionals who work with persons with OUD and any co-occurring SUD/MH or mental health conditions.
10. Offer fellowships for addiction medicine specialists for direct patient care,
instructors, and clinical research for treatments.
11. Offer scholarships and supports for certified addiction counselors, licensed alcohol and drug counselors, licensed clinical social workers, licensed mental health counselors, and other mental and behavioral health practitioners or
workers, including peer recovery coaches, peer recovery supports, and treatment
coordinators, involved in addressing OUD and any co-occurring SUD/MH or mental health conditions, including, but not limited to, training, scholarships, fellowships, loan repayment programs, continuing education, licensing fees, or other incentives for providers to work in rural or underserved areas.
12. Provide funding and training for clinicians to obtain a waiver under the federal
Drug Addiction Treatment Act of 2000 (“DATA 2000”) to prescribe MOUD for OUD, and provide technical assistance and professional support to clinicians who have obtained a DATA 2000 waiver.
13. Dissemination of web-based training curricula, such as the American Academy of
Addiction Psychiatry’s Provider Clinical Support Service–Opioids web-based
training curriculum and motivational interviewing.
14. Develop and disseminate new curricula, such as the American Academy of Addiction Psychiatry’s Provider Clinical Support Service for Medication–Assisted Treatment.
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B. SUPPORT PEOPLE IN TREATMENT AND RECOVERY
Support people in recovery from OUD and any co-occurring SUD/MH conditions
through evidence-based or evidence-informed programs or strategies that may include,
but are not limited to, the programs or strategies that:
1. Provide comprehensive wrap-around services to individuals with OUD and any co-occurring SUD/MH conditions, including housing, transportation, education, job placement, job training, or childcare.
2. Provide the full continuum of care of treatment and recovery services for OUD
and any co-occurring SUD/MH conditions, including supportive housing, peer support services and counseling, community navigators, case management, and connections to community-based services.
3. Provide counseling, peer-support, recovery case management and residential
treatment with access to medications for those who need it to persons with OUD
and any co-occurring SUD/MH conditions.
4. Provide access to housing for people with OUD and any co-occurring SUD/MH conditions, including supportive housing, recovery housing, housing assistance programs, training for housing providers, or recovery housing programs that allow
or integrate FDA-approved medication with other support services.
5. Provide community support services, including social and legal services, to assist in deinstitutionalizing persons with OUD and any co-occurring SUD/MH conditions.
6. Support or expand peer-recovery centers, which may include support groups,
social events, computer access, or other services for persons with OUD and any
co-occurring SUD/MH conditions.
7. Provide or support transportation to treatment or recovery programs or services for persons with OUD and any co-occurring SUD/MH conditions.
8. Provide employment training or educational services for persons in treatment for
or recovery from OUD and any co-occurring SUD/MH conditions.
9. Identify successful recovery programs such as physician, pilot, and college recovery programs, and provide support and technical assistance to increase the number and capacity of high-quality programs to help those in recovery.
10. Engage non-profits, faith-based communities, and community coalitions to
support people in treatment and recovery and to support family members in their
efforts to support the person with OUD in the family.
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11. Provide training and development of procedures for government staff to appropriately interact and provide social and other services to individuals with or
in recovery from OUD, including reducing stigma.
12. Support stigma reduction efforts regarding treatment and support for persons with OUD, including reducing the stigma on effective treatment.
13. Create or support culturally appropriate services and programs for persons with OUD and any co-occurring SUD/MH conditions, including but not limited to new
Americans, African Americans, and American Indians.
14. Create and/or support recovery high schools.
15. Hire or train behavioral health workers to provide or expand any of the services or supports listed above.
C. CONNECT PEOPLE WHO NEED HELP TO THE HELP THEY NEED
(CONNECTIONS TO CARE)
Provide connections to care for people who have—or are at risk of developing—OUD and any co-occurring SUD/MH conditions through evidence-based or evidence-informed programs or strategies that may include, but are not limited to, those that:
1. Ensure that health care providers are screening for OUD and other risk factors and
know how to appropriately counsel and treat (or refer if necessary) a patient for
OUD treatment.
2. Fund Screening, Brief Intervention and Referral to Treatment (“SBIRT”) programs to reduce the transition from use to disorders, including SBIRT services to pregnant women who are uninsured or not eligible for Medicaid.
3. Provide training and long-term implementation of SBIRT in key systems (health,
schools, colleges, criminal justice, and probation), with a focus on youth and young adults when transition from misuse to opioid disorder is common.
4. Purchase automated versions of SBIRT and support ongoing costs of the technology.
5. Expand services such as navigators and on-call teams to begin MOUD in hospital
emergency departments.
6. Provide training for emergency room personnel treating opioid overdose patients on post-discharge planning, including community referrals for MOUD, recovery case management or support services.
7. Support hospital programs that transition persons with OUD and any co-occurring
SUD/MH conditions, or persons who have experienced an opioid overdose, into clinically appropriate follow-up care through a bridge clinic or similar approach.
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8. Support crisis stabilization centers that serve as an alternative to hospital emergency departments for persons with OUD and any co-occurring SUD/MH
conditions or persons that have experienced an opioid overdose.
9. Support the work of Emergency Medical Systems, including peer support specialists, to connect individuals to treatment or other appropriate services following an opioid overdose or other opioid-related adverse event.
10. Provide funding for peer support specialists or recovery coaches in emergency
departments, detox facilities, recovery centers, recovery housing, or similar
settings; offer services, supports, or connections to care to persons with OUD and any co-occurring SUD/MH conditions or to persons who have experienced an opioid overdose.
11. Expand warm hand-off services to transition to recovery services.
12. Create or support school-based contacts that parents can engage with to seek
immediate treatment services for their child; and support prevention, intervention, treatment, and recovery programs focused on young people.
13. Develop and support best practices on addressing OUD in the workplace.
14. Support assistance programs for health care providers with OUD.
15. Engage non-profits and the faith community as a system to support outreach for
treatment.
16. Support centralized call centers that provide information and connections to appropriate services and supports for persons with OUD and any co-occurring SUD/MH conditions.
D. ADDRESS THE NEEDS OF CRIMINAL JUSTICE-INVOLVED PERSONS
Address the needs of persons with OUD and any co-occurring SUD/MH conditions who are involved in, are at risk of becoming involved in, or are transitioning out of the criminal justice system through evidence-based or evidence-informed programs or strategies that may include, but are not limited to, those that:
1. Support pre-arrest or pre-arraignment diversion and deflection strategies for
persons with OUD and any co-occurring SUD/MH conditions, including established strategies such as:
1. Self-referral strategies such as the Angel Programs or the Police Assisted Addiction Recovery Initiative (“PAARI”);
2. Active outreach strategies such as the Drug Abuse Response Team
(“DART”) model;
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3. “Naloxone Plus” strategies, which work to ensure that individuals who have received naloxone to reverse the effects of an overdose are then
linked to treatment programs or other appropriate services;
4. Officer prevention strategies, such as the Law Enforcement Assisted Diversion (“LEAD”) model;
5. Officer intervention strategies such as the Leon County, Florida Adult Civil Citation Network or the Chicago Westside Narcotics Diversion to
Treatment Initiative; or
6. Co-responder and/or alternative responder models to address OUD-related 911 calls with greater SUD expertise.
2. Support pre-trial services that connect individuals with OUD and any co-occurring SUD/MH conditions to evidence-informed treatment, including
MOUD, and related services.
3. Support treatment and recovery courts that provide evidence-based options for persons with OUD and any co-occurring SUD/MH conditions.
4. Provide evidence-informed treatment, including MOUD, recovery support, harm reduction, or other appropriate services to individuals with OUD and any co-
occurring SUD/MH conditions who are incarcerated in jail or prison.
5. Provide evidence-informed treatment, including MOUD, recovery support, harm reduction, or other appropriate services to individuals with OUD and any co-occurring SUD/MH conditions who are leaving jail or prison or have recently left jail or prison, are on probation or parole, are under community corrections
supervision, or are in re-entry programs or facilities.
6. Support critical time interventions (“CTI”), particularly for individuals living with dual-diagnosis OUD/serious mental illness, and services for individuals who face immediate risks and service needs and risks upon release from correctional settings.
7. Provide training on best practices for addressing the needs of criminal justice-
involved persons with OUD and any co-occurring SUD/MH conditions to law enforcement, correctional, or judicial personnel or to providers of treatment, recovery, harm reduction, case management, or other services offered in connection with any of the strategies described in this section.
E. ADDRESS THE NEEDS OF THE PERINATAL POPULATION, CAREGIVERS, AND FAMILIES, INCLUDING BABIES WITH NEONATAL OPIOID WITHDRAWAL SYNDROME.
Address the needs of the perinatal population and caregivers with OUD and any co-occurring SUD/MH conditions, and the needs of their families, including babies with
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neonatal opioid withdrawal syndrome (“NOWS”), through evidence-based or evidence-informed programs or strategies that may include, but are not limited to, those that:
1. Support evidence-based or evidence-informed treatment, including MOUD,
recovery services and supports, and prevention services for the perinatal population—or individuals who could become pregnant—who have OUD and any co-occurring SUD/MH conditions, and other measures to educate and provide support to caregivers and families affected by Neonatal Opioid Withdrawal
Syndrome.
2. Expand comprehensive evidence-based treatment and recovery services, including MOUD, for uninsured individuals with OUD and any co-occurring SUD/MH conditions for up to 12 months postpartum.
3. Provide training for obstetricians or other healthcare personnel who work with the
perinatal population and their families regarding treatment of OUD and any co-
occurring SUD/MH conditions.
4. Expand comprehensive evidence-based treatment and recovery support for NOWS babies; expand services for better continuum of care with infant-caregiver dyad; and expand long-term treatment and services for medical monitoring of
NOWS babies and their caregivers and families.
5. Provide training to health care providers who work with the perinatal population and caregivers on best practices for compliance with federal requirements that children born with NOWS get referred to appropriate services and receive a plan of safe care.
6. Provide child and family supports for caregivers with OUD and any co-occurring
SUD/MH conditions, emphasizing the desire to keep families together.
7. Provide enhanced support for children and family members suffering trauma as a result of addiction in the family; and offer trauma-informed behavioral health treatment for adverse childhood events.
8. Offer home-based wrap-around services to persons with OUD and any co-
occurring SUD/MH conditions, including, but not limited to, parent skills training.
9. Provide support for Children’s Services—Fund additional positions and services, including supportive housing and other residential services, relating to children
being removed from the home and/or placed in foster care due to custodial opioid
use.
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PART TWO: PREVENTION
F. PREVENT OVER-PRESCRIBING AND ENSURE APPROPRIATE
PRESCRIBING AND DISPENSING OF OPIOIDS
Support efforts to prevent over-prescribing and ensure appropriate prescribing and dispensing of opioids through evidence-based or evidence-informed programs or strategies that may include, but are not limited to, the following:
1. Funding medical provider education and outreach regarding best prescribing
practices for opioids consistent with the Guidelines for Prescribing Opioids for
Chronic Pain from the U.S. Centers for Disease Control and Prevention, including providers at hospitals (academic detailing).
2. Training for health care providers regarding safe and responsible opioid prescribing, dosing, and tapering patients off opioids.
3. Continuing Medical Education (CME) on appropriate prescribing of opioids.
4. Providing Support for non-opioid pain treatment alternatives, including training providers to offer or refer to multi-modal, evidence-informed treatment of pain.
5. Supporting enhancements or improvements to Prescription Drug Monitoring Programs (“PDMPs”), including, but not limited to, improvements that:
1. Increase the number of prescribers using PDMPs;
2. Improve point-of-care decision-making by increasing the quantity, quality, or format of data available to prescribers using PDMPs, by improving the interface that prescribers use to access PDMP data, or both; or
3. Enable states to use PDMP data in support of surveillance or intervention
strategies, including MOUD referrals and follow-up for individuals
identified within PDMP data as likely to experience OUD in a manner that complies with all relevant privacy and security laws and rules.
6. Ensuring PDMPs incorporate available overdose/naloxone deployment data, including the United States Department of Transportation’s Emergency Medical
Technician overdose database in a manner that complies with all relevant privacy
and security laws and rules.
7. Increasing electronic prescribing to prevent diversion or forgery.
8. Educating dispensers on appropriate opioid dispensing.
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G. PREVENT MISUSE OF OPIOIDS
Support efforts to discourage or prevent misuse of opioids through evidence-based or
evidence-informed programs or strategies that may include, but are not limited to, the
following:
1. Funding media campaigns to prevent opioid misuse, including but not limited to focusing on risk factors and early interventions.
2. Corrective advertising or affirmative public education campaigns based on
evidence.
3. Public education relating to drug disposal.
4. Drug take-back disposal or destruction programs.
5. Funding community anti-drug coalitions that engage in drug prevention efforts.
6. Supporting community coalitions in implementing evidence-informed prevention,
such as reduced social access and physical access, stigma reduction—including
staffing, educational campaigns, support for people in treatment or recovery, or training of coalitions in evidence-informed implementation, including the Strategic Prevention Framework developed by the U.S. Substance Abuse and Mental Health Services Administration (“SAMHSA”).
7. Engaging non-profits and faith-based communities as systems to support
prevention.
8. Funding evidence-based prevention programs in schools or evidence-informed school and community education programs and campaigns for students, families, school employees, school athletic programs, parent-teacher and student
associations, and others.
9. School-based or youth-focused programs or strategies that have demonstrated effectiveness in preventing drug misuse and seem likely to be effective in preventing the uptake and use of opioids.
10. Create or support community-based education or intervention services for
families, youth, and adolescents at risk for OUD and any co-occurring SUD/MH
conditions.
11. Support evidence-informed programs or curricula to address mental health needs of young people who may be at risk of misusing opioids or other drugs, including emotional modulation and resilience skills.
12. Support greater access to mental health services and supports for young people,
including services and supports provided by school nurses, behavioral health
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workers or other school staff, to address mental health needs in young people that (when not properly addressed) increase the risk of opioid or another drug misuse.
H. PREVENT OVERDOSE DEATHS AND OTHER HARMS (HARM REDUCTION)
Support efforts to prevent or reduce overdose deaths or other opioid-related harms through evidence-based or evidence-informed programs or strategies that may include, but are not limited to, the following:
1. Increased availability and distribution of naloxone and other drugs that treat
overdoses for first responders, overdose patients, individuals with OUD and their
friends and family members, schools, community navigators and outreach workers, persons being released from jail or prison, or other members of the general public.
2. Public health entities providing free naloxone to anyone in the community.
3. Training and education regarding naloxone and other drugs that treat overdoses
for first responders, overdose patients, patients taking opioids, families, schools, community support groups, and other members of the general public.
4. Enabling school nurses and other school staff to respond to opioid overdoses, and provide them with naloxone, training, and support.
5. Expanding, improving, or developing data tracking software and applications for
overdoses/naloxone revivals.
6. Public education relating to emergency responses to overdoses.
7. Public education relating to immunity and Good Samaritan laws.
8. Educating first responders regarding the existence and operation of immunity and
Good Samaritan laws.
9. Syringe service programs and other evidence-informed programs to reduce harms associated with intravenous drug use, including supplies, staffing, space, peer support services, referrals to treatment, fentanyl checking, connections to care, and the full range of harm reduction and treatment services provided by these
programs.
10. Expanding access to testing and treatment for infectious diseases such as HIV and Hepatitis C resulting from intravenous opioid use.
11. Supporting mobile units that offer or provide referrals to harm reduction services, treatment, recovery supports, health care, or other appropriate services to persons
that use opioids or persons with OUD and any co-occurring SUD/MH conditions.
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12. Providing training in harm reduction strategies to health care providers, students, peer recovery coaches, recovery outreach specialists, or other professionals that
provide care to persons who use opioids or persons with OUD and any co-
occurring SUD/MH conditions.
13. Supporting screening for fentanyl in routine clinical toxicology testing.
PART THREE: OTHER STRATEGIES
I. FIRST RESPONDERS
In addition to items in section C, D and H relating to first responders, support the following:
1. Law enforcement expenditures related to the opioid epidemic.
2. Education of law enforcement or other first responders regarding appropriate
practices and precautions when dealing with fentanyl or other drugs.
3. Provision of wellness and support services for first responders and others who experience secondary trauma associated with opioid-related emergency events.
J. LEADERSHIP, PLANNING AND COORDINATION
Support efforts to provide leadership, planning, coordination, facilitations, training and
technical assistance to abate the opioid epidemic through activities, programs, or
strategies that may include, but are not limited to, the following:
1. Statewide, regional, local or community regional planning to identify root causes of addiction and overdose, goals for reducing harms related to the opioid epidemic, and areas and populations with the greatest needs for treatment
intervention services, and to support training and technical assistance and other
strategies to abate the opioid epidemic described in this opioid abatement strategy list.
2. A dashboard to (a) share reports, recommendations, or plans to spend opioid settlement funds; (b) to show how opioid settlement funds have been spent; (c) to
report program or strategy outcomes; or (d) to track, share or visualize key opioid-
or health-related indicators and supports as identified through collaborative statewide, regional, local or community processes.
3. Invest in infrastructure or staffing at government or not-for-profit agencies to support collaborative, cross-system coordination with the purpose of preventing
overprescribing, opioid misuse, or opioid overdoses, treating those with OUD and
any co-occurring SUD/MH conditions, supporting them in treatment or recovery, connecting them to care, or implementing other strategies to abate the opioid epidemic described in this opioid abatement strategy list.
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4. Provide resources to staff government oversight and management of opioid abatement programs.
5. Support multidisciplinary collaborative approaches consisting of, but not limited
to, public health, public safety, behavioral health, harm reduction, and others at the state, regional, local, nonprofit, and community level to maximize collective impact.
K. TRAINING
In addition to the training referred to throughout this document, support training to abate
the opioid epidemic through activities, programs, or strategies that may include, but are not limited to, those that:
1. Provide funding for staff training or networking programs and services to improve the capability of government, community, and not-for-profit entities to abate the
opioid crisis.
2. Support infrastructure and staffing for collaborative cross-system coordination to prevent opioid misuse, prevent overdoses, and treat those with OUD and any co-occurring SUD/MH conditions, or implement other strategies to abate the opioid epidemic described in this opioid abatement strategy list (e.g., health care,
primary care, pharmacies, PDMPs, etc.).
L. RESEARCH
Support opioid abatement research that may include, but is not limited to, the following:
1. Monitoring, surveillance, data collection and evaluation of programs and strategies described in this opioid abatement strategy list.
2. Research non-opioid treatment of chronic pain.
3. Research on improved service delivery for modalities such as SBIRT that demonstrate promising but mixed results in populations vulnerable to opioid use disorders.
4. Research on novel harm reduction and prevention efforts such as the
provision of fentanyl test strips.
5. Research on innovative supply-side enforcement efforts such as improved detection of mail-based delivery of synthetic opioids.
6. Expanded research on swift/certain/fair models to reduce and deter opioid misuse within criminal justice populations that build upon promising
approaches used to address other substances (e.g., Hawaii HOPE and
Dakota 24/7).
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7. Epidemiological surveillance of OUD-related behaviors in critical populations, including individuals entering the criminal justice system,
including, but not limited to approaches modeled on the Arrestee Drug
Abuse Monitoring (“ADAM”) system.
8. Qualitative and quantitative research regarding public health risks and harm reduction opportunities within illicit drug markets, including surveys of market participants who sell or distribute illicit opioids.
9. Geospatial analysis of access barriers to MOUD and their association with
treatment engagement and treatment outcomes.
M. POST-MORTEM
1. Toxicology tests for the range of opioids, including synthetic opioids, seen in overdose deaths as well as newly evolving synthetic opioids infiltrating the drug
supply.
2. Toxicology method development and method validation for the range of synthetic opioids observed now and in the future, including the cost of installation, maintenance, repairs and training of capital equipment.
3. Autopsies in cases of overdose deaths resulting from opioids and synthetic
opioids.
4. Additional storage space/facilities for bodies directly related to opioid or synthetic opioid related deaths.
5. Comprehensive death investigations for individuals where a death is caused by or suspected to have been caused by an opioid or synthetic opioid overdose, whether
intentional or accidental (overdose fatality reviews).
6. Indigent burial for unclaimed remains resulting from overdose deaths.
7. Navigation-to-care services for individuals with opioid use disorder who are encountered by the medical examiner’s office as either family and/or social network members of decedents dying of opioid overdose.
8. Epidemiologic data management and reporting to public health and public safety
stakeholders regarding opioid overdose fatalities.
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EXHIBIT B
Local Abatement Funds Allocation
Subdivision Allocation Percentage
AITKIN COUNTY 0.5760578506020%
Andover city 0.1364919450741%
ANOKA COUNTY 5.0386504680954%
Apple Valley city 0.2990817344560%
BECKER COUNTY 0.6619330684437%
BELTRAMI COUNTY 0.7640787092763%
BENTON COUNTY 0.6440948102319%
BIG STONE COUNTY 0.1194868774775%
Blaine city 0.4249516912759%
Bloomington city 0.4900195550092%
BLUE EARTH COUNTY 0.6635420704652%
Brooklyn Center city 0.1413853902225%
Brooklyn Park city 0.2804136234778%
BROWN COUNTY 0.3325325415732%
Burnsville city 0.5135361296508%
CARLTON COUNTY 0.9839591749060%
CARVER COUNTY 1.1452829659572%
CASS COUNTY 0.8895681513437%
CHIPPEWA COUNTY 0.2092611794436%
CHISAGO COUNTY 0.9950193750117%
CLAY COUNTY 0.9428475281726%
CLEARWATER COUNTY 0.1858592042741%
COOK COUNTY 0.1074594959729%
Coon Rapids city 0.5772642444915%
Cottage Grove city 0.2810994719143%
COTTONWOOD COUNTY 0.1739065270025%
CROW WING COUNTY 1.1394859174804%
DAKOTA COUNTY 4.4207140602835%
DODGE COUNTY 0.2213963257778%
DOUGLAS COUNTY 0.6021779472345%
Duluth city 1.1502115379896%
Eagan city 0.3657951576014%
Eden Prairie city 0.2552171572659%
Edina city 0.1973054822135%
FARIBAULT COUNTY 0.2169409335358%
FILLMORE COUNTY 0.2329591105316%
FREEBORN COUNTY 0.3507169823793%
GOODHUE COUNTY 0.5616542387089%
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Subdivision Allocation Percentage
GRANT COUNTY 0.0764556498477%
HENNEPIN COUNTY 19.0624622261821%
HOUSTON COUNTY 0.3099019273452%
HUBBARD COUNTY 0.4582368775192%
Inver Grove Heights city 0.2193400520297%
ISANTI COUNTY 0.7712992707537%
ITASCA COUNTY 1.1406408131328%
JACKSON COUNTY 0.1408950443531%
KANABEC COUNTY 0.3078966749987%
KANDIYOHI COUNTY 0.1581167542252%
KITTSON COUNTY 0.0812834506382%
KOOCHICHING COUNTY 0.2612581865885%
LAC QUI PARLE COUNTY 0.0985665133485%
LAKE COUNTY 0.1827750320696%
LAKE OF THE WOODS COUNTY 0.1123105027592%
Lakeville city 0.2822249627090%
LE SUEUR COUNTY 0.3225703347466%
LINCOLN COUNTY 0.1091919983965%
LYON COUNTY 0.2935118186364%
MAHNOMEN COUNTY 0.1416417687922%
Mankato city 0.3698584320930%
Maple Grove city 0.1814019046900%
Maplewood city 0.1875101678223%
MARSHALL COUNTY 0.1296352091057%
MARTIN COUNTY 0.2543064014046%
MCLEOD COUNTY 0.1247104517575%
MEEKER COUNTY 0.3744031515243%
MILLE LACS COUNTY 0.9301506695846%
Minneapolis city 4.8777618689374%
Minnetonka city 0.1967231070869%
Moorhead city 0.4337377037965%
MORRISON COUNTY 0.7178981419196%
MOWER COUNTY 0.5801769148506%
MURRAY COUNTY 0.1348775389165%
NICOLLET COUNTY 0.1572381052896%
NOBLES COUNTY 0.1562005111775%
NORMAN COUNTY 0.1087596675165%
North St. Paul city 0.0575844069340%
OLMSTED COUNTY 1.9236715094724%
OTTER TAIL COUNTY 0.8336175418789%
PENNINGTON COUNTY 0.3082576394945%
PINE COUNTY 0.5671222706703%
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Subdivision Allocation Percentage
PIPESTONE COUNTY 0.1535154503112%
Plymouth city 0.1762541472591%
POLK COUNTY 0.8654291473909%
POPE COUNTY 0.1870129873102%
Proctor city 0.0214374127881%
RAMSEY COUNTY 7.1081424150498%
RED LAKE COUNTY 0.0532649128178%
REDWOOD COUNTY 0.2809842366614%
RENVILLE COUNTY 0.2706888807449%
RICE COUNTY 0.2674764397830%
Richfield city 0.2534018444052%
Rochester city 0.7363082848763%
ROCK COUNTY 0.2043437335735%
ROSEAU COUNTY 0.2517872793025%
Roseville city 0.1721905548771%
Savage city 0.1883576635033%
SCOTT COUNTY 1.3274301645797%
Shakopee city 0.2879873611373%
SHERBURNE COUNTY 1.2543449471994%
SIBLEY COUNTY 0.2393480708456%
ST LOUIS COUNTY 4.7407767169807%
St. Cloud city 0.7330089009029%
St. Louis Park city 0.1476314588229%
St. Paul city 3.7475206797569%
STEARNS COUNTY 2.4158085321227%
STEELE COUNTY 0.3969975262520%
STEVENS COUNTY 0.1439474275223%
SWIFT COUNTY 0.1344167568499%
TODD COUNTY 0.4180909816781%
TRAVERSE COUNTY 0.0903964133868%
WABASHA COUNTY 0.3103038996965%
WADENA COUNTY 0.2644094336575%
WASECA COUNTY 0.2857912156338%
WASHINGTON COUNTY 3.0852862512586%
WATONWAN COUNTY 0.1475626355615%
WILKIN COUNTY 0.0937962507119%
WINONA COUNTY 0.7755267356126%
Woodbury city 0.4677270171716%
WRIGHT COUNTY 1.6985269385427%
YELLOW MEDICINE COUNTY 0.1742264836427%
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