How Baltimore plans to manage funds for opioid litigation

Baltimore Mayor Brandon Scott on Thursday morning unveiled plans for how the city will manage and spend money raised from settlements with major opioid manufacturers and distributors, including the creation of an advisory committee and two new leadership positions in his office.

The city has already received more than $240 million in settlements with pharmaceutical companies – most recently a $152.5 million deal with drug distributor Cardinal Health and before that smaller deals with CVS and Allergan – and officials expect to receive hundreds of millions more dollars until the ongoing litigation is resolved.

The trial in the city's lawsuit – which argues that drug manufacturers and distributors flooded Baltimore with millions of opioid prescriptions while downplaying the drugs' addictive potential – is scheduled to begin Sept. 16.

On Thursday, Scott announced that $20 million of the settlement money already won will go to the Baltimore City Health Department to bolster its efforts to curb Baltimore's overdose crisis.

These funds will benefit, among others, the SPOT Mobile Clinic, a public-private partnership between the Ministry of Health and the Johns Hopkins University School of Medicine that offers buprenorphine treatment for opioid use disorder, among other low-threshold health services.

“We have an unprecedented opportunity today to help the people of this city,” said Bobby Harris, medical director of the city's health department's mobile clinical services, at Thursday's press conference. “We look forward to working together to strengthen the city's role and lead the way in combating the opioid syndemic.” [the epidemic and the factors contributing to it] through tireless work, dedication and urgency in the service of our people, who have a right to well-being.”

As part of the settlements, $42 million has already been awarded to several organizations and service providers working to address the crisis, including Baltimore Safe Haven, Charm City Connection and the Enoch Pratt Free Library's Peer Navigators program.

Baltimore decided to go its own way about two years ago and dropped out of a comprehensive global settlement with several major opioid companies that the state of Maryland and most local jurisdictions joined. So far, Scott and other city officials say that decision has paid off — if the city had joined the global settlement, it would have received about $7 million over the course of seven years.

“Every community is affected by the opioid overdose epidemic, but here in Baltimore, we are disproportionately affected – especially due to the actions of ruthless criminals in the pharmaceutical industry,” Scott said in a press release Thursday morning.

“We decided to pursue our lawsuit against these companies to the end and forego the global settlements that were offered to us over time because we knew how badly our community was affected and how important it was that these companies take appropriate financial responsibility. But it's not enough to win the funds – we have to put them to work.”

Going forward, citizen engagement through town hall meetings, focus groups and an online survey will be a central part of the city's decision-making process on how to use the comparison funds, Scott said.

He announced an executive order Thursday that spelled out the process for administering the money. The order established an opioid settlement fund into which settlement amounts would be deposited and provided guidelines for how the funds would be distributed – including for drug prevention, treatment, recovery and harm reduction programs, as well as services to mitigate other harms caused by the opioid epidemic.

To make more concrete decisions about how to spend the money, the city plans to establish a Restitution Advisory Board. The board would be comprised of city employees such as the health officer and fire chief, as well as non-city employees such as a peer recovery specialist, a licensed social worker and at least four Baltimore residents with experience with substance abuse.

Panel members will review grant applications and make funding recommendations that will be reviewed by the Mayor's Overdose Cabinet and given final approval by the mayor, city officials said in a news conference Wednesday evening. Panel members who are not city employees will receive $15,000 a year for their participation.

Scott's executive order also created two new positions in his office: an executive director for overdose response, who will coordinate the city's response to the epidemic, and an opioid redress program manager, who will support the advisory board, among other duties.

The order also established a trust fund — which officials compared at Wednesday's meeting to the endowment of a major university — that will maintain the money for at least 15 years. The interest generated will be used only for drug control and will not be returned to the city's general fund unless the budget committee approves otherwise.

The City also plans to release several documents to better ensure that resources are appropriately used to address the opioid crisis, including an overdose reduction strategy, a community needs assessment related to substance use, and community engagement and transparency plans.

The plan is to launch a dashboard with information on the programs receiving funding and to provide an annual report to the Mayor and City Council on the programs funded. The Mayor's Office of Reconstruction Programs will Manage notifications of funding availability and monitor the performance of organizations that have received grants.

Sara Whaley, a senior fellow at the Johns Hopkins Bloomberg School of Public Health, advised the city in drafting the ordinance announced Thursday. Whaley is the lead author of a list of best practices for jurisdictions' use of opioid litigation agents and is considered a national expert in the field.

“This order builds on best practices across the country,” she said in Thursday's press release, “and lays the foundation for ensuring the funds have the greatest possible impact by protecting the funds and ensuring their longevity, by thinking holistically about the role of compensation funds as part of a comprehensive overdose response, and by basing decision-making on the expertise of a diverse range of voices.”

Originally published: August 29, 2024 at 9:30 am