Connecticut is part of a recently approved $26 billion multistate opioid settlement agreement with the following prescription drug manufacturers: AmerisourceBergen, Cardinal, McKesson, and Johnson & Johnson. All states and U.S. territories have signed on to the agreement and in Connecticut, all municipalities have joined.

The state is expected to receive approximately $300 million over 18 years. (Municipalities will receive 15% of the state’s allocation.) The settlement agreement requires funds to be used for opioid abatement, including expanding access to opioid use disorder prevention, intervention, treatment, and recovery.

In March 2022, Connecticut, along with eight other states and the District of Columbia, reached a $6 billion opioid settlement agreement with Purdue Pharma and the Sackler family. The state is expected to receive approximately $95 million over 18 years and is authorized to use a portion of the funds to establish an Opioid Survivors Trust to directly assist opioid epidemic survivors and victims.

This bill establishes an Opioid Settlement Fund as a separate non-lapsing fund administered by a 37-member Opioid Settlement Advisory Committee with assistance from the Department of Mental Health and Addition Services (DMHAS).

Under the bill, the fund must contain moneys the state receives from opioid-related judgments, consent decrees, or settlements finalized on or after July 1, 2021. The moneys must be generally used prospectively and only for specified substance use disorder abatement purposes.

If the DMHAS commissioner and the attorney general certify that a judgment’s, consent decree’s, or settlement’s purpose is inconsistent with the fund’s intent, the bill establishes a process for them to deposit the moneys into an alternative account or fund, which includes, among other things, reporting to the Public Health Committee before doing so.

§§ 2 & 4 — Opioid Settlement Fund

The bill establishes an Opioid Settlement Fund as a separate non- lapsing fund administered by the Opioid Settlement Advisory Committee that the bill also establishes (see below).

Under the bill, the fund must contain certain moneys the state receives that are intended to address opioid use, related disorders, or the impact of the opioid crisis. This includes moneys (1) received from any judgment, consent decree, or settlement paid by any defendant that is finalized on or after July 1, 2021, and (2) related to opioid production, distribution, dispensing, and other opioid-related activities. Moneys remaining in the fund at the end of a fiscal year remain in the fund and do not revert to the General Fund.

Among other things, the bill:

1. generally requires proceeds from any state settlement to be allocated only to municipalities with an agreement to participate in the settlement and adhere its terms;
2. requires the DMHAS commissioner to obtain the advisory committee’s approval before making or refusing to make fund disbursements;
3. prohibits the DMHAS commissioner from making fund disbursements unless the Office of Policy and Management (OPM) secretary verifies that the funds appropriated in that fiscal year’s budget for substance use disorder purposes at least equal the total amount appropriated in the prior fiscal year’s budget;
4. requires the advisory committee to hold quarterly public meetings and specifies that it terminates when all settlement moneys are received and disbursed, unless the state anticipates receiving additional moneys;
5. specifies that disbursements do not supplant or replace any other funds that would have otherwise been used for the same purposes (e.g., insurance benefits or governmental funding);
6. requires fund recipients, starting by October 1, 2023, to annually file with the advisory committee a report for the prior fiscal year that details the effectiveness of funded programs, services, supports, or resources;
7. requires the advisory committee, starting by January 15, 2023, to annually report on the fund to the Appropriations and Public Health committees; and
8. authorizes the state to fund a trust to provide direct support and services to opioid epidemic survivors and victims, in accordance with the March 11, 2022, settlement agreement with Purdue Pharma and the Sackler family.

Use of Funds: The bill requires the fund’s moneys to be used only in accordance with the controlling judgment, consent decree, or settlement, as confirmed by the attorney general and after the committee’s and the OPM secretary’s approval. It restricts use of the moneys to the following substance use disorder abatement purposes:

1. statewide, regional, or community substance use disorder needs assessments to identify structural gaps and needs to inform fund expenditures;
2. infrastructure (e.g., personnel, buildings, equipment) required for evidence-based substance use disorder prevention, treatment, recovery, or harm reduction programs (e.g., syringe service programs and naloxone distribution), services, and supports;
3. programs, services, supports, and resources for evidence-based substance use disorder prevention, treatment, recovery, or harm reduction (i.e., an attempted or actual reduction in the adverse consequences of substance use, including by addressing the underlying causes and conditions);
4. evidenced-informed substance use disorder prevention, treatment, recovery, or harm reduction pilot programs or demonstration studies that are not evidenced-based, but are approved by the advisory committee as an appropriate use of moneys for a limited time period the advisory committee sets, so long as it assesses whether the evidence supports funding the programs or studies or if the evidence provides a basis to fund them with an expectation of creating an evidence base for them;
5. evaluating the effectiveness and outcomes reporting for substance use disorder abatement infrastructure, programs, services, supports, and resources for which the fund’s moneys were disbursed, including the (a) impact on access to harm reduction services or substance use disorder treatment or (b) reduction in drug-related deaths;
6. at least one publicly available data interface the DMHAS commissioner manages to aggregate, track, and report (a) substance use disorders, overdoses, and drug-related harms; (b) spending recommendations, plans, and reports; and (c) outcomes of programs, services, supports, and resources for which the fund’s moneys were disbursed;
7. opioid abatement research, including developing evidence-based treatment, treatment barriers, nonopioid treatment of chronic pain, and harm reduction supply-side enforcement;
8. documented expenses (a) to administer and staff the fund and the advisory committee and (b) incurred by the state or municipalities in securing settlement proceeds deposited in the fund (including legal fees), permitted by the controlling judgment, consent decree, or settlement;
9. documented expenses to manage, invest, and disburse the fund’s moneys; and
10. documented expenses, including legal fees, incurred by the state or a municipality in securing settlement proceeds deposited in the fund, to the extent they are not otherwise reimbursed under a fee agreement provided for by the controlling judgment, consent decree, or settlement.

Eligibility: The bill requires proceeds from any state settlement of claims against a defendant to be allocated only to municipalities that execute an agreement to participate in the settlement and adhere to the agreement’s terms. However, it does not preclude or limit an allocation or disbursement to benefit residents within a municipality that does not execute an agreement or adhere to an agreement’s terms.

Under the bill, government and nonprofit nongovernmental entities are eligible to receive fund moneys for programs, services, supports, and resources for prevention, treatment, recovery, and harm reduction.

Fund Disbursement Process: The bill requires the DMHAS commissioner to obtain the Opioid Settlement Advisory Committee’s approval before making or refusing to make fund disbursements. The commissioner must adhere to the advisory committee’s decisions about fund disbursements, as long as they are permissible expenditures.

The bill requires fund recipients, starting by October 1, 2023, to file with the advisory committee an annual report for the prior fiscal year that details the effectiveness of funded infrastructure, programs, services, supports, or resources,

§§ 3 & 5 — Opioid Settlement Fund Advisory Committee

The bill establishes a 37-member Opioid Settlement Advisory Committee to ensure (1) proceeds received by the state are allocated and spent on the substance use disorder abatement purposes described above and (2) robust public involvement, accountability, and transparency in allocating and accounting for the fund’s moneys.

§ 6 — Trust for Survivors and Victims

The bill provides that its provisions do not preclude the state from funding a trust to provide direct support and services to survivors and victims of the opioid epidemic, and their family members who have been directly impacted by the epidemic, in accordance with the March 11, 2022, settlement agreement with Purdue Pharma and the Sackler family.