Counties and cities have a choice: take the opioid money or go it alone?



Letters were sent to every county and city in Minnesota last week, advising local government leaders of a choice they will soon have to make: will they sign a massive national deal with some of the wealthiest companies accused of fueling the opioid epidemic?

Over the past two decades, the public health crisis has cost communities in Minnesota thousands of lives and millions of dollars. Accepting the proposed deal would mean an influx of money that could help pay for drug addiction programs, law enforcement, child protection services, or the many other expenses incurred because the manufacturers and distributors of drugs have saturated the country with a deadly flood of prescription pills.

“The need is endless. We can’t make it right with all the money in the world,” said State Representative Dave Baker, R-Willmar, who helped craft Minnesota’s landmark law on the response. to opioid epidemics after her son died of a drug overdose.

As communities scramble to respond to an ever-growing number of overdoses, Minnesota could receive up to $ 337 million over 18 years from pharmaceutical giant Johnson & Johnson and three major drug distributors. But the proposed settlement is structured so that the state will receive less money if certain counties and cities do not sign the agreement, choosing instead to retain the right to pursue disputes on their own.

As local leaders begin to reflect on their options ahead of the year-end deadline, discussions about how Minnesota should divide and spend its payment intensifies. Attorney General Keith Ellison convenes a 20-person panel of public health experts, first responders and service providers to recommend how the state should allocate and distribute its settlement dollars.

“They – not lawyers or elected officials – are the best people to understand how these funds can help as many Minnesotans as possible as quickly as possible,” he said in a statement.

The radical $ 26 billion settlement is a complex and unusual deal that aims to avoid the pitfalls of the Big Tobacco regulation of 1998. The big cigarette companies have agreed to distribute $ 246 billion to escape liability for damages caused by tobacco use, but some of that money ended up filling the holes in the state budget instead of funding anti-smoking campaigns or treatment programs.

With the resulting skepticism that the gains from opioid litigation would trickle down to their coffers, many local governments across the country – including 26 counties and seven cities in Minnesota – have filed their own lawsuits against them. industry players.

Drug distributors Cardinal Health, AmerisourceBergen and McKesson have been accused of turning a blind eye for years as pharmacies ordering excessive amounts of prescription drugs, while Johnson & Johnson is accused of downplaying the addictive nature of opioids.

Some pharmaceutical companies continue to fight such charges in court, while others have only been resolved with state governments. This deal is an attempt by opioid defendants to achieve comprehensive peace with local governments by resolving as many cases as possible. The proposed deal would force distributors to submit to new monitoring requirements and specify that funds must be spent on overdose prevention, addiction recovery, education and other drug-related services. epidemic.

News of the regulation, which was announced in July, came as the increasing spread of fentanyl and the isolation of the COVID-19 pandemic have led to a record increase in drug overdose deaths in the United States, according to the U.S. Centers for Disease Control and Prevention.

Last year, Minnesota recorded 1,008 overdose deaths, a 27% increase from 2019. Julie Bauch, Hennepin County’s opioid response coordinator, said data from the first half of 2021 allows county to surpass the record number of overdose deaths of 2020 – 164 deaths occurred between January and June, 36 more than what the county saw during the same period in 2020.

“Things are bad and they are getting worse,” Bauch said. “We need a significant influx of cash to be able to make a dent in what is going on.”

Similar appeals from communities across the country fueled calls for local governments to accept the settlement. Minnesota and 41 other states officially joined the settlement in early September, while a handful of states pulled out, seeking more money by going it alone.

The companies said enough states have signed on for them to pursue the deal. But if, at a later date, they believe that an insufficient number of counties and cities have signed on, more than 3,000 lawsuits could be referred to their home courts, where trials could take years.

“This money could make a very big difference to us,” said Tami Jo Lieberg, director of community corrections in Kandiyohi, who said she was hopeful that the settlement funds could help fund a prison treatment program in Kandiyohi. the rural county west of the Twin Cities.

Minnesota counties are vying for a significant chunk of the state’s allocation, arguing that their public health and social service infrastructure puts them well in a position to coordinate prevention efforts and help those facing drug addiction. .

Julie Ring, executive director of the Minnesota Counties Association, said her group was looking to North Carolina’s already approved allocation model as an example. Counties and large municipalities received 80% of the state’s settlement money there.

The Minneapolis City Attorney’s Office said in a statement that the city was working with officials at all levels of government “to ensure a fair and equitable distribution of all funds raised in the settlements.”

“Guiding these negotiations is the belief that funds distributed in accordance with the regulations should be distributed directly to agencies that provide reduction services to those most affected by the opioid crisis. These agencies include the Minneapolis Department Health, the Minneapolis Police Department, and the Minneapolis Fire Department. “

Currently, all of the money the state receives from opioid-related settlements is funneled into its Opioid Outbreak Response Fund, which is managed by a 19-member Citizen Advisory Council.

Half of the money in the fund, which also receives drug manufacturer fee dollars, is going to counties and tribes to pay for child welfare services.

The remainder is supposed to be allocated to public and private service providers through grants, although last year the advisory board canceled its application process due to a shortfall. A spokesperson for the State Department of Social Services said the council plans to distribute $ 4.9 million in grants this year; a request for proposals has not yet been issued.

As counties seek larger direct payments from the settlement, Ring said local officials were open to discussions about changing the structure of the response fund.

Although the costs of child protection have skyrocketed due to the outbreak, many counties would prefer more flexibility in deciding how to spend money to deal with the crisis, she said. .

Ellison is asking his panel of experts to suggest an allocation model by the first week of November so that county councils and city councils have time to vote on the proposal.

Ring said she expects negotiators to come up with a plan that most counties and cities will approve in order to maximize the settlement funds Minnesota receives.

“I think everyone has this common interest,” she said, “to do what’s best for our state”.

Katie Galioto • 612-673-4478



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