States promised opioid settlement spending transparency, but many have already strayed from commitment

When states and local governments anticipated billions in opioid settlement dollars, 12 states committed to 100% spending transparency, "promising annual reports 'specifying the activities and amounts,' they have funded," reports Aneri Pattani of KFF Health News. "But many of those reports remain difficult, if not impossible, for the average person to decipher."

Idaho settlement dollars are an example. The attorney general’s website hosts "more than 90 standardized spending reports from state and local entities. Sounds great. But in reality, it reads like this: 'In fiscal 2023, the city of Chubbuck spent about $39,000 on Section G, Subsection 9.' Cracking that code requires a separate document," Pattani explains. "The Idaho attorney general’s office, which oversees the state’s opioid settlement reports, did not respond to requests for comment."

New Hampshire has a different transparency problem. "The state government controls 85% of the state’s settlement funds and posts reports from grant recipients on its opioid abatement website," Pattani reports. "The reports explain the projects and populations served but lack a key detail: how much money each organization received."

Accessing dollars and cents details means searching through "the opioid abatement advisory commission’s meeting minutes, which date back several years" or other state government meetings and notes.

Graph by Aneri Pattani and Lydia Zuraw, KFF Health News and Christine Minhee, OpioidSettlementTracker.com

Idaho and New Hampshire aren't the only states falling short of their commitment. Other states have zero reporting, even though many residents are asking for the information. Pattani writes, "One of the loudest and most frequent questions from the public has been: Where are the dollars going? Victims of the crisis, along with their advocates and public policy experts, have repeatedly called on governments to transparently report how they’re using these funds, which many consider 'blood money.'"

Of the 12 states that promised spending accountability, seven have "reported 100% of their expenditures in a way that is easy for the public to find and understand," Pattani reports. "There are also states such as Indiana that didn’t originally promise 100% transparency but are now publishing detailed accounts of their expenditures."

Sharing settlement spending information not only helps the public hold state and local officials accountable for their spending choices, but it can also foster hope. Norman Litchfield, the director of addiction medicine at St. Luke’s Health System in Idaho, told Pattani, "A lot of people simply are just not aware that these funds exist and that these funds are currently being utilized in ways that are helping."