HHS announces second round of funding for State Opioid Response grants
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On March 20, the U.S. Department of Health and Human Services (HHS) announced a second installment of $437 million in funding for the two-year Opioid-State Targeted Response (STR) grants first authorized in 2016 under the 21st Century Cures Act (P.L. 114-255). Combined with the $933 million in continuation funding to be posted later in 2019, Opioid-STR grant funding to states will total approximately $1.4 billion for FY 2019, a nearly $500 million increase above FY 2018 funding for the program.
Administered by the Substance Abuse and Mental Health Administration (SAMHSA), Opioid-STR grants are formula funds awarded to states, territories and jurisdictions to support the expansion of addiction treatment and recovery activities, with the aim of reducing unmet treatment needs and opioid overdose deaths. Specifically, Opioid-STR grants provide funding for states and other jurisdictions to identify gaps in current treatment activities and capacity, expand access to medication-assisted treatment (MAT) therapies and advance substance misuse prevention in coordination with federal agencies such as the Centers for Disease Control and Prevention (CDC). As frontline providers of federal health, human services and justice programs in many states, counties play a central role in administering and funding federal programs.
HHS’ announcement follows a flurry of recent legislative and administrative activity aimed at addressing the nation’s ongoing opioid epidemic. In November 2018, HHS announced changes to the Medicaid Institutions for Mental Diseases (IMD) exclusion aimed at improving the ability of health providers – many of which are county-operated – to treat individuals with mental and behavioral health disorders. Additionally, in October 2018, Congress passed and President Trump signed comprehensive legislation enabling counties to better respond to the epidemic in local communities.
NACo has closely monitored congressional appropriators’ activity around the Opioid-STR grants and other funding in an analysis of the FY 2018 and FY 2019 omnibus bills. As Congress prepares for the FY 2020 appropriations cycle, NACo will continue to work closely with legislators to ensure counties have the resources necessary to meet local need to prevent and reduce substance use disorders.

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