Coastal Georgia governments jockey to influence how opioid settlement money will be spent

This spring, some local governments in Coastal Georgia are competing to place local dignitaries on the regional boards that will be deciding how to divvy up the millions of dollars expected to flow into Georgia each year for the next decade. 

In 2022, Gov. Brian Kemp signed into law a mechanism by which the state and all 159 counties would be eligible for funds from two national opioid abuse court settlements.

The State of Georgia is party to two multimillion-dollar settlements with opioid manufacturers and distributors, totalling $638 million. The state will keep 75%, or $479 million, of which 40%, or $191.6 million, must be spent regionally. But little information has been made public about the process of distributing these funds.

The state has entered into a memorandum of understanding (MOU) with “participating local governments” that includes a basic formula for distributing monies from the two settlements to different municipal and county authorities. 

These include 159 counties, 107 cities, 22 sheriff’s departments, 12 hospitals or hospital authorities, 16 community service boards, and one school district. Sheriff’s departments will get 9.4% of their county’s opioid funds, while hospitals will get 2% and school systems will get 1%, according to the MOU.

Who gets to decide?

SB 500, which was signed into law in May 2022, provides for a system of Regional Advisory Councils (RACs), which will have at least three and as many as seven members, representing multiple local government entities in their region. 

Each RAC must include at least one member from a county board of health, one executive team member from a Community Service Board, and one sheriff or representative of that sheriff’s choosing. 

Those three mandated members have the option of choosing up to four additional board members — or none at all. That has drawn criticism from some in the recovery community who want to make sure their expertise and needs are represented, especially as sheriffs, who are elected officials largely responsible for jails, rather than public health, are guaranteed representation.

The RACs will vet grant applications, then make recommendations to the Georgia Opioid Settlement Advisory Committee (GOSAC), an eight-member committee chaired by a ninth non-voting member and created by the governor in May 2023. Those officials include state public health experts.

On Feb. 19, Kemp appointed  Dr. Chris Rustin to the GOSAC board. Rustin is deputy commissioner of Georgia Department of Public Health, public health administrator of the Chatham County Health Department, and who lives in Effingham County.

Liberty County’s Board of Commissioners is expected to nominate a county representative for the regional committee at its next scheduled meeting. But there’s no guarantee that Liberty’s choice would represent Region 5, Brown said, as other parties to the settlement in Coastal Georgia would also be submitting names. A meeting to settle that matter takes place March 26 at the Appling County Courthouse Annex in Baxley. 

Liberty County Administrator Joey Brown told commissioners that they needed to act quickly as he just received information from the state committee that day.

One payment from the settlement funds already has reached Liberty County, Brown told The Current. He said the previous money went to shore up the Coastal Health District’s established opioid program.

More details come to light

At the BOC’s Feb. 15 meeting, Brown shared slides explaining how the Regional Advisory Councils, or RACs, are set up. 

The recommendation, he said, was that the committees should have, in addition to the mandated members, experts including an academic, a “substance use provider” licensed by the Department of Community Health (DCH), a member with “lived experience” as either an opioid user or a family member of an opioid user, and a member of the judiciary.

Chairman Donald Lovette asked the pertinent question: How the regional committees will decide on which projects to fund. The District 5 region includes 34 Southeast counties. The divisions are based on existing Department of Behavioral Health and Developmental Disability (DBHDD) regions. 

Follow the money

The settlement funds are coming to Georgia from two sources. According to a March 2023 memo from the Georgia Department of Audits and Accounts, “$517,000,000 will come from the National Distributors’ Settlement over the course of 18 years. An additional $118,000,000 will come from the Janssen/J&J Settlement over the next nine years.”

The funds can only go to purposes approved under the MOU: prevention, treatment, recovery, harm reduction, and research and evaluation. Specific strategies include naloxone or other FDA-approved overdose reversal drugs, medication-assisted treatment distribution and “other opioid treatment,” support for pregnant and postpartum women, expanded treatment for neonatal abstinence syndrome, more “warm hand-off” programs and recovery services, treatment for incarcerated people, prevention programs, syringe services, and evidence-based data collection and research on how effective such programs are.

If the state finds out that a local entity has spent the funds on something other than settlement-approved purposes, the MOU provides for a clawback of those funds in Gwinnett County Superior Court.

Chatham County’s spending

Chatham County received some national opioid settlement funds on March 20 and May 12, 2023. On Dec. 15, according to BOC minutes, the county commission had accepted $415,524, then was awarded another $94,458. The funds were dedicated “to educate individuals, family members, and health professionals; and increase awareness of the negative impact of opioids.” 

At that same meeting, the board accepted $66,810 in opioid settlement funds as a direct federal payment for a joint “Positive Peer Influencer Program” between the Savannah-Chatham County Public Schools and the Chatham-Savannah Counter-Narcotics Team (CNT). The program trains high school students to teach middle school students about the dangers of opioids and fentanyl.

CNT also has an Adult Drug Awareness Program (ADAP), which uses a demonstration trailer set up as a teenager’s bedroom to teach adults how to spot red flags of possible teen drug use.

At its Feb. 2 meeting, the Chatham County BOC voted to spend $71,900 on a “non-typical replacement vehicle for CNT” — a 2024 Chevy Silverado 2500 to tow the trailer.

Recent minutes and agendas from Glynn County and Bryan County did not mention the opioid settlement funds.