'It's a lot of money.' State, counties figuring out how to spend millions from opioid settlements
LANSING — The first injection of what is expected to be hundreds of millions of dollars from lawsuit settlements with opioid manufacturers and distributors is being funneled to local Michigan governments, leaving local officials to decide what to do with the money.
Michigan is expected to ultimately get about $1.4 billion from opioid damage settlements, with about $776 million from three distributors and a manufacturer of opioid pills in a first settlement, expected to be paid out over 18 years. The rest is expected from other court agreements, according to a January statement from the state Attorney General's Office.
The allocation of the funding is based on the damage believed to have been caused by opioids, using a formula that includes the number of pills, the number of overdoses and other measures of opioid damage.
The state's smaller counties are expected to get larger per-capita settlements, reflecting more intense damage from opioids. For example, the three largest Michigan counties - Wayne, Oakland and Kent - each received an average of less than $20 a person while the three smallest got an average of $30 a person, according to a Lansing State Journal analysis of data from the Michigan Association of Counties.
The Michigan Association of Counties estimates Ingham County should get $7.4 million over 18 years for opioid addiction treatment and prevention; Eaton County, $3.1 million; and Clinton County, $1.7 million.
"It's a lot of money," said Dr. Nike Shoyinka, Ingham County's top health care officer.
She expects Ingham County will use its opioid settlement money for community priorities centered on treatment and prevention that a new committee will establish.
Across the state, the expected payouts range from Wayne County's $35 million to Keweenaw County's $12,087, and include $6.9 million for St. Clair County, $5.5 million for Calhoun County, $2.5 million for Shiawassee County, $2.2 million for Montcalm County, at least $1 million for Gratiot, Ionia and Sanilac counties, and less than $1 million for Barry County, according to the state county association's most recent summer estimates.
The five counties receiving the largest per-capita payments all have 25,000 people or fewer. Ogemaw, Crawford, Roscommon, Iosco and Manistee counties are expected to get between $40 and $100 a person, according to Michigan's county association. The five counties with the smallest per-capita payments - Keweenaw, Ottawa, Midland, Allegan and Missaukee counties - are expected to get between $6 and $12 a person.
While half of the $776 million will be paid to Michigan's local governments, those dollars will also be shared between a total of 269 counties, cities and townships. The Michigan Association of Counties calculated expected county payments, but a similar breakdown of city and township payments was not available from the association, Michigan Municipal League or the Attorney General’s office.
Communities across the state are figuring out how they'll handle their payouts since a Michigan judge dismissed last month an Ottawa County challenge that was preventing distribution of $81 million in settlement money for local governments. Ottawa County contended the money was being disbursed wrongly and its residents deserved more than the $2.6 million it is expected to receive.
The $81 million reflects three months worth of deposits that were delayed by Ottawa County's lawsuit and now will become regular. That $81 million began hitting county, city and township accounts Jan. 31. Representatives from several local governments say they haven't spent the money yet or determined exactly how to spend it.
In Livingston County, which is slated to get $4.5 million over 18 years, the money will likely go to a variety of uses, such as educating first responders, more access for opioid-countering medications and support to interventions, said Matt Bolang, deputy health officer for the county's health department.
"We're starting to think about how to best use this for our community," he said. "It's certainly something we have a need for and we are in the process of prioritizing the need."
Counties are doing the right thing by planning their spending and working with community groups, said Amy Dolinky, technical advisor for opioid settlement funds for the Michigan Association of Counties. There are no pressing deadlines for spending the money, she noted.
So far, Michigan has received about $39 million for the state's share of the national settlement of at least $21 billion, and, in time, the payouts for local governments and the state should be about equal, state officials said.
However, Dolinky emphasized some restrictions for the money both local governments and the state will receive. They fall into three major categories: Mitigating the misuse or abuse of opioids, treating related disorders, and dealing with side effects, Dolinky said.
She added that about 85% of the money needs to be spent on opioid-related efforts, and most of that 85% needs to be spent on future programs. The rest can be spent on administrative costs and other programs that can include reimbursement.
Municipalities should have plenty of options, from providing jail and medications like naloxone (often known as Narcan), supporting treatment centers, adding more staff to handle treatment and outreach efforts and even efforts like career program for at-risk people, she said.
The state's money, at least the first batch, will go toward prevention, training and research and the money should touch those who are addicted, people starting to take opioids, drug stores, medical professionals, first responders, community health groups and treatment centers, health and human services officials said.
The state released on Friday an initial list of projects for its first $39 million.
“In Michigan, we are using this long-term funding to address the multi-generational impact of the opioid epidemic as well as address racial disparities that exist as part of the opioids crisis,” MDHHS Director Elizabeth Hertel said in the release. “Settlement dollars will allow us to invest in supports, improvements and enhancements to further our efforts to decrease substance use disorders, improve treatment options and improve recovery success.”
A survey of 1,000 people in 2022 by the University of Michigan's Centers for Health Research and Transformation found treatment was one of the most sought-after uses for the money in Michigan.
The priorities for the money, according to the survey:
Recovery treatment, including residential centers and mental health assistance
Prevention programs, including in schools and for both first responders and medical workers
Expanding medication access and treatment options for opioids
State figures show drug overdoses, including but not limited to opioids, killed 3,096 people in the state in 2021 and 85% of those, 2,504 deaths, were attributed to opioids, a broad term that health experts say encompasses prescription opioids, heroine, cocaine, stimulants, methamphetamines, and manufactured fentanyl. About three quarters of those opioid overdose deaths involved illicit fentanyl, according to federal CDC figures from 2021, the most recent year available.
Data from the Centers for Disease Control and Prevention indicate indicate street drugs are a bigger problem than prescription drugs. About 2,260 people in Michigan died in 2021 of an overdose linked to illicit fentanyl, that's about 75% of all overdose deaths; about 391 people fatally overdosed with prescription opioids in the same year, according to federal CDC figures from 2021, the most recent year available. Heroin, another opioid, was linked to about 270 deaths in Michigan in 2021.
That was an increase from 2020, when 2,738 people died of overdose. The deaths are most common in young people and men but overdoses for those older than 65 years rose the fastest, accounting for almost 12% more deaths in 2022.
In Ingham County in 2021, 126 deaths involved opioids out of 151 drug-related deaths, according to an annual medical examiner's report. In Eaton County opioids were identified in 15 of 22 drug-related deaths.
Contact Mike Ellis at mellis@lsj.com or on Twitter @MikeEllis_AIM
This article originally appeared on Lansing State Journal: State, counties figuring out how to spend millions from opioid settlements
