Christine Minhee, founder of OpioidSettlementTracker.com, analyzed each state’s plan for handling opioid settlement funds, along with relevant laws, executive orders, and public statements, to identify requirements to report how the money is spent. She is sharing her analysis first with KHN.

Although some governments may opt to be more transparent than required, Minhee’s determinations were based only on promises they had made in writing as of Feb. 24, 2023.

For a state to be classified as publicly reporting 100% of its funds, it needed to meet the following criteria:

• Reporting requirements are specific about both where the money is going and what it is for. For instance, saying $1 million went to the health department wouldn’t qualify, but saying $1 million went to the health department to buy naloxone for first responders would. Requirements that mention audits or monitoring compliance without mandating listing of specific expenditures would not meet the standard.
• Reporting requirements apply to all settlement funds, including those controlled by state agencies, local governments, and councils overseeing abatement funds.
• Requirements pass the “Googleability test”: Could a typical person reasonably find their state’s opioid settlement expenditures by searching online? If people must file public records requests or weed through a 100-page budget document for the information, that state would fall short.

If a reporting requirement did not pass the “Googleability test” but stipulated that, for example, local governments report their expenditures to the legislature or that the state health department report its expenditures to the attorney general, it could instead be classified as going to an oversight body. Although these reports may eventually surface, they were not counted as public because there was no explicit requirement for them to be made accessible to the average person.

The documents Minhee analyzed originated primarily from states’ planning for settlements with “the distributors” — AmerisourceBergen, Cardinal Health, and McKesson — and drugmaker Johnson & Johnson, which were the first national opioid settlements to be finalized. Several other settlements have yet to be finalized, including with Purdue Pharma. KHN’s Aneri Pattani, Colleen DeGuzman, and Megan Kalata reached out to all 50 states and Washington, D.C., to determine if the reporting requirements identified in their documents would apply to settlements with all companies or just the distributors and Johnson & Johnson. Four states did not answer the question: Florida, Georgia, Louisiana, and Texas. KHN’s determinations for them derive from how widely or narrowly they defined “settlement” in their public documents.

Information on the finalized dollar amounts from the distributor and Johnson & Johnson settlements, as well as who controls the money in each state, comes from attorney general press releases and public statements compiled by Minhee.

Information about which settlements each state is participating in comes from National Opioid Settlement, a website run by the Plaintiffs’ Executive Committee involved in opioid litigation.

The information presented is expected to change as states pass new laws and enter into new settlements. Visit Minhee’s site for updates.