The Principles Quick Guide on Transparency for Opioid Settlement Fund Management

The Principles for the Use of Funds From the Opioid Litigation are nationally recognized guidance for states, counties and cities receiving money from the lawsuits against entities that contributed to the opioid epidemic. These planning Principles, coordinated by faculty at the Johns Hopkins Bloomberg School of Public Health, can help jurisdictions create a foundation for effective spending of the monies to save lives from overdose. This report has been adapted from the Michigan County Opioid Settlement Funds: Transparency, Monitoring & Accountability Guide developed by the Michigan Association of Counties.

The Principles for the Use of Funds From the Opioid Litigation encourage governments to create a fair and transparent process for the use of opioid settlement funds (Principle 5). Governments currently in possession of settlement funds are encouraged to adopt strategies and practices that disclose information related to their planning process, funding decisions and monitoring activities. This type of transparent disclosure of actions related to opioid settlement dollars is not only a responsibility to the public, but also a vital tool that enables effective utilization of opioid settlement funds, ensuring resources reach populations and communities most impacted by the overdose crisis.

What is Transparency?

Transparency in governance relates to providing the public with access to information about policies, activities and decision making in formats that are useful and understandable. For opioid settlement funds, it serves as a means for governments to showcase responsible stewardship of settlement dollars. Effective transparency requires both providing information but also intentional efforts to ensure that information is accessible, comprehensible and readily available to all constituents, particularly marginalized communities. Transparency encompasses both the availability and accessibility of information related to opioid settlement funds and their management. Centering availability and accessibility involves developing communication strategies that address public information needs, preferred formats for information presentation and accessible channels for information retrieval.

Why is Transparency Important?

State and local governments are receiving funds as settlements for the damages inflicted by opioid manufacturers, distributors and retailers on communities. Given the suffering and loss caused by the drug overdose crisis, there is a responsibility to ensure the public has access to relevant information and is included in planning and decision-making processes.

Transparency also fulfills public accountability and offers government officials a tool for clarifying decision-making processes and outcomes. Understanding how the public seeks information can enhance engagement and foster improvements in governmental actions.

When to Start Planning for Transparency?

Transparency efforts should begin at the initial planning stage and continue throughout all planning phases, integrating insights on planning, funding and monitoring. Critical components of transparency include community engagement, the management of conflicts of interest and the establishment of a centralized repository for opioid settlement-related information. The approaches to transparency can be incremental and should be tailored to meet local community needs.

Steps to Ensure Transparency

Transparency can be categorized into three key phases: planning, funding and monitoring. Throughout each phase of work, three universal considerations should also be incorporated: community inclusion, conflict of interest management and the establishment of a centralized information platform.

1. Planning

During the planning phases, jurisdictions are setting up their process for settlement spending decision-making. This may include creating a dedicated fund, conducting a needs assessment, setting up a settlement council or advisory board or integrating decision-making into an existing entity. Sharing information throughout this process can ensure that the public is made aware of the steps the jurisdiction is taking before investment decisions have been made. Jurisdictions can also include an opportunity for public comment on their plans to ensure that their plan aligns with how the public would like to be involved and receive information. Some important factors to consider during this phase include:

• Settlement Council Creation
  • Include community stakeholders in settlement councils.
  • Publish meeting documentation and provide virtual access to meetings.
• Needs Assessment
  • Analyze local strengths, gaps, barriers and perceptions of substance use. (For more on how to conduct a needs assessment: NACo Principles Quick Guide to Conducting a Needs Assessment)
  • Prioritize stakeholder engagement particularly with individuals possessing lived and living experience
• Public Process Documentation
  • Share timelines and points of contact for public inquiries.
  • Provide opportunities for community input and feedback.

2. Funding

During the funding phase, jurisdictions are determining how determinations around allocations will be made and which strategies will be funded. This may include development of requests for proposal processes and reporting guidelines. Sharing information on the background of the settlements, how much money is expected to be received, has been received and where and how much money has been spent are keys to public understanding of settlements and expenditures. Some important factors to consider during this phase include:

• Funds Management
  • Communicate the background and amount of settlement funds received.
  • Clearly outline the administrative process for fund distribution.
• Transparency in Allocation
  • Regularly report on fund allocations, expenditures and the entities receiving funds.
  • Ensure public accessibility to proposal processes and funding guidelines.

3. Monitoring & Evaluation

During the monitoring and evaluation phases, jurisdictions focus on the impacts associated with their processes and expenditures. This may include development of annual reports, dashboards and ongoing community input strategies. Some important factors to consider during this phase include:

• Impact Metrics
  • Develop metrics for assessing the overall impact of fund utilization.
  • Share progress and results from grantees or vendors.
• Process Improvement
  • Facilitate community feedback mechanisms to identify areas for improvement
  • Annually report on actions taken and their outcomes

4. Reflect & Refine

Payments for settlement funds are slated to occur over a span of 18 years ending in 2039. This means that jurisdictions have opportunities to reflect on their existing process and refine their policies and activities if needed.

Universal Considerations

1. Community Inclusion

Community inclusion involves meaningful engagement with individuals and communities impacted by the drug overdose crisis throughout the opioid settlement process. Methods to engage with community members may include, but are not limited to:

• Identify Areas of Need: Conduct a through review of local data, strategic plans, action plans and other relevant information sources to pinpoint gaps and opportunities within the existing landscape. This assessment will help to clearly define where additional resources and efforts are needed.
• Engage Community Stakeholders: Involve community members and organizations who interact with various facets of the drug overdose crisis in the planning process. This collaboration should include local experts from diverse fields related to substance use, with particular emphasis on incorporating individuals with lived and living experience. Public input is essential and can be gathered through various methods.
• Ensure Diverse Representation in Planning and Decision-Making: When planning for and allocating funds, it is crucial to ensure that representation reflects the diversity of impacted communities. Communities that have been most significantly impacted should have a voice, with particular attention given to the needs of Black, Indigenous and People of Color (BIPOC) communities.

2. Conflict of Interest Management

Identifying and addressing potential conflicts of interest is crucial during all phases of fund management. Conflicts may arise when individuals involved have financial or institutional interests that could influence their judgment. Ethical and legal considerations should guide these efforts, especially in the context of settlement councils. O’Neill Institute for National and global Health Law outlines recommendations for settlement councils:

• Disclosure and Recusal: All members should be required to disclose any conflicts of interest and recuse themselves from voting on matters involving organizations with which they have a conflict.
• Transparency: Meetings should be open to the public, with all proceedings made accessible online. Relevant materials should be posted for public review.
• Diversity and Representation: Prioritize a diverse composition of members in decision-making and steering committees to reflect the communities served.
• Core Strategies: Establish core strategies to inform the decision-making processes of settlement councils.
• Prioritize Ethical Standards: Ongoing training should be provided to all members, along with mechanisms for obtaining guidance on ethical practices.
• Enforce Ethical Standards: Implement a system for reporting potential ethics violations to ensure accountability and adherence to ethical guidelines. 

3. Centralized Information Platform

Establishing a centralized platform for public access to opioid settlement information is vital across all planning phases. This could take the form of websites, dashboards, newsletters or other communication channels. The information should be presented in an accessible manner and promoted effectively to ensure broad community engagement.

Key Actions Include:  

• Development of a centralized repository for settlement-specific information.
• Clear instructions for public inquiries, feedback and participation.
• Ensuring accessibility in language and presentation to accommodate diverse populations.