Brown County Board to Discuss Opioid Settlement Grant Applications at Next Meeting

Brown County Board to Discuss Opioid Settlement Grant Applications at Next Meeting

Image above via CFAH . Image below citing 2016 data from the National Survey on Drug Use and Health (NSDUH) survey.  

By Robert Lawson

Publisher

info@nicolletcountyledger.com


The Brown County Board of Commissioners usually has a pretty big laundry list of items to discuss at each meeting, sometimes taking a few hours to adjourn. This next meeting on December 29 is likely to be no different with a full agenda including some discussion on opioid settlement grant applications that are available through the State of Minnesota. 

The state’s Attorney General Keith Ellison and his office have engaged in lawsuits against big pharma companies that marketed, packaged, distributed and sold opioids that have contributed greatly to the nation’s soaring rates of narcotics additions to opioid drugs like oxycodone, fentanyl and heroin. 

On June 2, the attorney general’s office reached a $102.5 million national settlement with Suboxone for alleged illegal monopoly tactics, according to a press release. Minnesota will receive around $1.7 million from a settlement in that case. Settlement payouts in the Johnson & Johnson and distributors’ suits, which are tabulated on the AG’s website. Maximum distributions to participating local governments for the proposed Settlements with Teva, Allergan, Walgreens, Walmart and CVS (the ‘Second Wave Settlements’) are provided.  The amounts are “contingent on achieving maximum participation in the settlements.” Payments 1 and 2 of the Distributor settlement have already been distributed, with the next payment scheduled for July 2023.  Payments 1 through 5 of the Johnson & Johnson settlement have already been distributed, with the next payment scheduled for July 2026. Nicollet County will receive $324,652.32 for the Johnson & Johnson and Distributors payment and another $264,251.60 for the Second Wave Settlements. Brown County will receive $686,585.87 and $558,848.36 respectively. 

MPR News reported in June that a settlement of more than $560 million could be disrupted by a bankruptcy pending in court for the company, Mallinkrodt, who missed a $200 million payment earlier this year. 

McKinsey, a consulting firm who helped market opioids and boost sales for pharmaceutical industry giants like Purdue Pharma recently paid out another $230 million to settle remaining claims. The firm previously paid out $641.5 million to various cities, counties and school districts in all 50 U.S. states, but as in this recent settlement, admits no wrongdoing in the case. They have thus far paid a total of $870 million, according to reporting from the Financial Times. The firm also reached a separate agreement in a case with claims brought by indigenous tribes. 

The Minnesota Department of Health has devised a strategy and guidance for using grant funds. Here is the excerpt from their website, where you can find useful information about the grant applications: 

Local Public Health Guide to Spending Opioid Settlement Funds. This [webpage] was developed to be a resource for local public health as they convene stakeholders around settlement fund decisions and implement strategies to abate the harms of the overdose epidemic.

MDH plans on updating this webpage continually with new resources and content. Please send your feedback or content ideas to health.drugodprev@state.mn.us. 

Framework for spending funds

Minnesota has the chance to use settlement funds to save lives and mitigate lifelong harms from drug misuse. To do this, settlement funds should be spent on effective interventions that are based on evidence. Settlement funds present a critical opportunity to work in synergy with other available resources. Maximizing the impact of the settlement funds will require coordination and thoughtful utilization. Below are resources to guide your community in deciding how best to allocate the dollars your community receives in order to maximize its impact.

Johns Hopkins Principles for the Use of Funds from the Opioid Litigation provides five overarching principles that should be adopted to make sure that funds are spent most effectively:

Spend the money to save lives

Use evidence to guide spending

Invest in youth prevention

Focus on racial equity

Develop a fair and transparent process for deciding where to spend funds

This Health Equity Checklist (PDF), developed by NACCHO and the Legal Action Center, provides health equity considerations for local health departments as they guide their community in deciding how to spend settlement funds.

Consider the RAND Helpful Hints for Avoiding Pitfalls and their four takeaways for effectively spending funds in order to maximize impact and avoid ineffective spending of settlement dollars.

The Colorado Opioid Crisis Response Blueprint (PDF) provides a guide for prioritizing needs and getting buy-in from stakeholders. The blueprint can be adapted for use in local communities.

The Association of Minnesota Counties Opioid Settlement Toolkit (PDF) provides Minnesota-specific information about the settlement agreement.

The Strategic Prevention Framework developed by SAMHSA, provides steps that communities may find helpful as they make decisions about how to spend settlement funds. Decision-making groups should go through the framework’s five steps and ask themselves the corresponding questions. The five steps are:

Assessment: Identify local needs based on data. What is the problem?

Capacity: Build off local resources and readiness to address needs. What do we have to work with?

Planning: Find out what works to address the identified needs and how to do it well. What should we do and how should we do it?

Implementation: Deliver evidence-based programs and practices as intended. How can we put our plan into action?

Evaluation: Examine the process and outcomes of programs and practices. Is our plan succeeding?

The framework is guided by two cross-cutting principles that should be integrated into each step: cultural competence and sustainability. When deciding what strategies to fund with settlement dollars, communities should also consider the strategy’s evidence of effectiveness, conceptual fit, and practical fit.

Evidence of effectiveness is the proof that a strategy will address the factors it is meant to address.

Conceptual fit is the degree to which a strategy addresses the priority factors driving substance use or overdose and has been shown to have positive outcomes for the focus population.

Practical fit is the degree to which a strategy is culturally relevant for the focus population, the community has the capacity to support it, and it enhances existing prevention activities.

Data sources

There are several data sources that can inform your decisions on how to spend your community’s settlement funds. Below is a list of data sources to consider using to assess your community’s needs. Try to use as many data sources as possible to get a more comprehensive picture of overdose and substance use in your community.

Death certificates

State Unintentional Drug Overdose Reporting System (SUDORS)

Hospital discharge data (I.e., emergency department visits and inpatient hospitalizations)

Ambulance runs

Treatment admissions

Law enforcement Record Management System (RMS)

Drug seizures

Minnesota Student Survey

Data resources

Below is a list of data reports and resources that can help you obtain data for your community.

Use the Drug Overdose Data Request form to request fatal or non-fatal overdose data for your community from the Minnesota Department of Health.

County Profiles

Substance Use in Minnesota (SUMN)

Drug Overdose Dashboard

Non-Fatal Overdose Dashboard

Non-Fatal Opioid Overdose Surveillance Dashboard (EMS data)

Overdose Detection Mapping Application (ODMAP)

Minnesota Drug Overdose and Substance Use Surveillance Activity (MNDOSA)

Race Rate Disparities

The Use of Evidence in Opioid Epidemic Response Spending/ Minnesota Management and Budget (MMB)

Resources for implementing strategies

This section is meant to be used alongside Exhibit A of the Minnesota Opioid Memorandum of Agreement (PDF). The agreement provides 13 categories of strategies (A through M) that communities can implement using opioid settlement funds as well as a list of specific examples of strategies that fall under the category. Below you will find the same list of categories (A through M) with resources that can assist with implementation of strategies that fall under that category.

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