Iowa’s Ashley Hinson pushes oversight of opioid settlement funds

Iowa’s U.S. Rep. Ashley Hinson has joined a bipartisan group in Congress demanding federal oversight of billions of dollars received by state and local governments -- including Iowa -- through nationwide settlements with opioid drug manufacturers.

State and local governments began spending opioid settlement money over the past two years, with some using it to plug budget holes rather than fight the addiction crisis, according to Hinson.

With fentanyl leading to a high number of drug overdose deaths in the United States — and synthetic opioids in general driving a rise in drug overdoses — Hinson said “everyone knows someone who has been impacted by the opioid crisis.”

“I’ve heard from families who have lost loved ones to the opioid crisis,” said Hinson, a Republican from Marion. “I’ve heard from concerned moms who know these drugs are in our neighborhoods, even coming into our schools, and law enforcement who are trying desperately to get these deadly drugs off our streets. It’s vital that we ensure that every dime of these settlement funds goes to help curb this deadly epidemic.”

More than a dozen drugmakers, pharmaceutical distributors and retail pharmacies have agreed to pay more than $50 billion over 18 years in legal settlements intended to resolve their roles in the opioid addiction crisis. The multistate lawsuits, of which Iowa joined, accused the companies of downplaying the risks of prescription opioids, triggering an increase in addictions, overdoses and deaths.

Hinson’s bill would put guardrails around the use of billions of opioid settlement funds, aimed at ensuring the funds are used to fight the epidemic and are focused toward treatment, prevention, education and enforcement.

Most settlement agreements specify that states must spend at least 85 percent of the funds to address the opioid epidemic, and provide a list of suggest uses, many of which are allowed under the bill sponsored by Hinson and U.S. Rep. Marcy Kaptur, D-Ohio.

KFF Health News, though, has reported a lack of transparency and enforcement have made it difficult to determine if states are meeting that threshold. Hinson cited a county in Tennessee that used settlement funds to pay back old debt and purchase a government vehicle.

“The federal government needs to ensure that these … dollars coming in from these settlements are directed and allocated to explicitly fund efforts to curb this tragic crisis,” Hinson said. “I think we should also learn our lesson from the tobacco settlements from the ‘90s, where many states used the money coming for transportation projects … and balancing budgets instead of actually going to tobacco cessation and prevention efforts.”

The proposed Opioid Settlement Accountability Act directs that settlement dollars be used strictly to invest in treatment, prevention, equipment for law enforcement and first responders, housing or employment training for people in recovery, programs to help patients reduce or quit their use of opioids and to educate doctors and nurses about non-opioid pain management strategies.

Iowa is expected to receive $345 million over the next 18 years resulting from settlements with pharmaceutical companies, distributors, pharmacies and others. Settlement funds will be allocated among state agencies and county governments in accordance with the Iowa Opioid Memorandum of Understanding, and must be used for opioid abatement activities, according to the Iowa Attorney General’s Office website.

A report by the Iowa State Auditor’s Office estimates Iowa’s 99 counties are expected to receive more than $77 million over the settlement term. Linn County is expected to receive more than $5.6 million, according to the report. Johnson County is slated to receive roughly $3 million.

The Iowa Opioid Settlement Fund contained about $20 million as of May of last year. The Iowa Attorney General’s Office did not return a message seeking comment and an update on the status of opioid settlement funds received by the state.

The final decision as to how that money will be spent is up to state legislators, according to Iowa law.

State Republican lawmakers punted last year on deciding how to spend the money. Lawmakers said they planned to work on a holistic approach for how best to use the funds for prevention, harm reduction, treatment and recovery services.

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Iowa Gov. Kim Reynolds in her Condition of the State address earlier this month said she is proposing lawmakers use the money the state has received to invest in substance abuse prevention, treatment and recovery programs for Iowans struggling with opioid addiction.

Reynolds proposal would:

Reynolds also has proposed an overhaul of the state’s mental health and substance use treatment systems, presenting lawmakers with a plan to merge several programs into a unified behavioral health system.

“The results will be a greater investment on the ground, improved connectivity between providers, districts and the state, and — most important — treatment delivered to Iowans when and where they need it,” the governor said in her annual address.

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