Opioid Settlement Funds

Overview: County-level Opioid Settlement Funds

County-level opioid settlement funds (OSF) come from legal settlements with companies involved in the opioid crisis, such as pharmaceutical manufacturers, distributors, and retailers. These settlements result from lawsuits alleging harmful practices like deceptive marketing and inadequate oversight. OSF are designated to combat the opioid crisis at the local level, funding treatment, prevention, recovery services, and community health programs. Distribution of funds to states and local governments is based on factors like the severity of the opioid epidemic in each area.

Learn more below about OSF in Marin County and how you can help shape priorities.

Approved Uses: Settlement Funds in California

Pursuant to the California State-Subdivision Agreements, funds must be used for opioid remediation (defined in the National Opioid Settlement Agreements, as the “care, treatment, and other programs and expenditures designed to (1) address the misuse and abuse of opioid products, (2) treat or mitigate opioid use or related disorders, or (3) mitigate other alleged effects of, including on those injured as a result of, the opioid crisis.”). These funds must support approved activities utilizing “core strategies” (referred to as abatement strategies) outlined in each settlement’s Exhibit E. Additional provisions or limitations vary by state and are detailed in each state’s memoranda of understanding. Examples for California are available here. In California, the Department of Health Care Services is responsible to oversee how these funds are used.

Allocation & Management: Settlement Funds in Marin County

Opioid settlement funds received by Marin County are allocated for activities that align with specified opioid abatement goals. These activities include prevention education, awareness building, harm reduction, treatment services, and recovery support. The funds support various initiatives across the county to reduce the impact of opioid use. County of Marin Health and Human Services oversees these efforts through its Public Health and Behavioral Health and Recovery Services divisions, working with community-based providers through a formal RFP and contracting process.

Key Dates: Settlement Funds in Marin County

October 12, 2020	A bankruptcy agreement is reached with Mallinckrodt Pharmaceuticals.
July 21, 2021	The California Attorney General announced final settlement agreements with Janssen Pharmaceuticals and pharmaceutical distributors McKesson, Cardinal Health, and AmerisourceBergen.
March 28, 2023	The Marin County Board of Supervisors approves an annual spending plan for the Janssen & Distributors settlement.
October 12, 2023	Mallinckrodt Pharmaceuticals announces a second bankruptcy filing.
December 5, 2023	The Marin County Board of Supervisors approves a spending plan for the first Mallinckrodt settlement funds.
February 27, 2024	The Marin County Board of Supervisors approves a spending plan for the second Mallinckrodt settlement funds.
Early 2024	Multi-state settlements with Walmart, Walgreens, & CVS (collectively, the Pharmacies) were memorialized in court judgments.
April 17, 2024	The OD Free Marin Ad-hoc Settlement Fund Task Force (AHSFTF) convenes to discuss current and anticipated funding; review high-yield strategies for future funds; identify community priorities, and provide recommendations.
April 18, 2024	AHSFTF priorities presented and discussed at the OD Free Marin Steering Committee. List adopted by the OD Free Marin Budget Committee for future consideration of fund allocation and use.
December 10, 2024	The Marin County Board of Supervisors approves the spending plan for McKinsey and Endo Public Opioid Trust Abatement settlement funds.

Sources & Amounts: Settlement Funds in Marin County

Funding Source	Settlement Amount	Duration	Annual Distribution	Frequency
Janssen Pharmaceuticals & Distributors Settlement	$7,650,000.00 $3,555,000.00	Over 18 years Over 9 years	$829,000.00 $425,000.00	first 9 years last 9 years
Mallinckrodt Pharmaceuticals Settlement #1	$57,500	Single payout	$57,000.00	one time
Mallinckrodt Pharmaceuticals Settlement #2	$67,647.00	Single payout	$67,647.00	one time
McKinsey Settlement Fund	$118,388.00	Single payout	$118,388.00	one time
Endo Public Opioid Trust Abatement Fund	$116,574.00	Single payout	$116,574.00	one time
Pharmacy Settlement	$9,779,817.51	Over 15 years	TBD	TBD

Allocations: Settlement Funds in Marin County

Funding for OD Free Marin, including a new Senior Program Coordinator position to expand community prevention efforts, including maintaining a supply of naloxone for distribution and training within the community.
Contracting with community-based organizations to provide recovery coaching, care navigation, and warm hand-off services.
Expanding treatment infrastructure by contracting with community-based organizations to implement new trauma treatment services for individuals with an opioid use disorder (OUD).
Providing grief support resources for overdose loss survivors and first responders.

Implementing public awareness campaigns about fentanyl, harm reduction, and the availability of naloxone.
Expansion of toxicology screening at the Marin County Coroner’s Office to inform prevention efforts
Implementing trauma-informed treatment for OUD.

Conducting wastewater surveillance to track trends in opioid use and inform prevention activities.
OD Free Marin Website maintenance and enhancements.
Implementing the “Safety First” drug education curriculum in Marin High schools.
Installing a naloxone vending machine in a high-impact healthcare facility.

Substance use prevention education curricula in public Middle and High Schools.
OD Free Marin Youth Action Team support.

Funds awarded and currently unallocated as of Dec. 2024.
Proposed spending plans developed.
Community input being gathered as of Dec. 2024
Present spending plans to the Board of Supervisors in March 2025

Decision Making-Process: Settlement Funds in Marin County

Decisions related to the allocation of OSF in Marin County are informed by the allowable core strategies outlined in the settlement agreements designed to address opioid remediation in Marin County. While local governments are not required to seek public input as to opioid settlement spending specifically, Marin County welcomes public commentary during the Board of Supervisors public meetings. Additional opportunities for community input on priority setting and allocation of OSF in Marin County are outlined in the Community Involvement section below.

Leadership from Marin County Health and Human Services Department (including those from the Public Health and Behavioral Health & Recovery Services divisions propose the allocation of settlement funds, which is brought before the Board of Supervisors in a spending plan format for review, discussion (community members may offer their comments about proposed spending plans at open BOS meetings), and approval. The relevant HHS divisions solicit requests for proposals from community-based organizations and providers. Through RFP and contracting, the opioid remediation activities in Marin are implemented through the work of community partners (>70% of OSF allocations) and County initiated services/programs (<30% OSF allocations). These are designed in alignment with allowable uses as specified in Exhibit E of each settlement.

Community Involvement: Provide Feedback About Priorities

To encourage broader community input, HHS has launched outreach efforts, including hosting listening sessions, providing presentations, and conducting surveys, aimed at gathering feedback from community members who are interested in helping to shape and prioritize how unallocated opioid settlement funds are utilized in Marin County.

To provide your input, please review the list of priorities below, which can also be found in the OSF Community Presentation, and then complete the OSF Community Survey. Thank you!

A list of high-impact opioid abatement activities has been proposed for unallocated OSF to expand the County’s capacity to support the following initiatives in Marin:

Increasing Substance Use Disorder-Related Crisis Response Services
Widening Naloxone Distribution and Harm Reduction Services
Expanding Prevention, Engagement Coordination, and Education for Youth
Convening Suicide & Overdose Fatality Review to Bolster Prevention
Reaching and Supporting those most at risk for overdose, including OD survivors

How would you prioritize OSF allocations to fund the above listed opioid remediation initiatives? What additional priorities in Marin do you think need funding in this effort?

OSF Presentation OSF Survey

Community Collaboration: Join OD Free Marin

OD Free Marin plans to establish an Opioid Settlement Fund (OSF) committee in 2025, as a standing sub-committee of the coalition, rather than to remain an ad-hoc task force of the sterling committee, as was previously the case. The purpose of the OSF committee will be to engage in more significant and consistent involvement in the OSF priority-setting and allocation process. The OSF Committee will be composed of coalition action team members and steering committee members. If you are interested in joining OD Free Marin, please learn more and sign up for an Action Team.

Learn More: Opioid Settlements & Bankruptcies in California

This webpage, updated quarterly, is designed to provide the community greater understanding about opioid settlement funds in Marin County. To learn more, please use the links above.
Questions? email: info@odfreemarin.org