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OLR Bill Analysis
sHB 5044 (as amended by House "B")*
AN ACT IMPLEMENTING THE GOVERNOR'S BUDGET
RECOMMENDATIONS REGARDING THE USE OF OPIOID
LITIGATION PROCEEDS.
SUMMARY
This bill establishes an Opioid Settlement Fund as a separate non-
lapsing fund administered by a 37-member Opioid Settlement Advisory
Committee with assistance from the Department of Mental Health and
Addition Services (DMHAS).
Under the bill, the fund must contain moneys the state receives from
opioid-related judgments, consent decrees, or settlements finalized on
or after July 1, 2021 (see BACKGROUND). The moneys must be
generally used prospectively and only for specified substance use
disorder abatement purposes.
If the DMHAS commissioner and the attorney general certify that a
judgment’s, consent decree’s, or settlement’s purpose is inconsistent
with the fund’s intent, the bill establishes a process for them to deposit
the moneys into an alternative account or fund, which includes, among
other things, reporting to the Public Health Committee before doing so.
Among other things, the bill:
1. generally requires proceeds from any state settlement to be
allocated only to municipalities with an agreement to participate
in the settlement and adhere its terms;
2. requires the DMHAS commissioner to obtain the advisory
committee’s approval before making or refusing to make fund
disbursements;
3. prohibits the DMHAS commissioner from making fund
disbursements unless the Office of Policy and Management 2022HB-05044-R01-BA.DOCX
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(OPM) secretary verifies that the funds appropriated in that fiscal
year’s budget for substance use disorder purposes at least equal
the total amount appropriated in the prior fiscal year’s budget;
4. requires the advisory committee to hold quarterly public
meetings and specifies that it terminates when all settlement
moneys are received and disbursed, unless the state anticipates
receiving additional moneys;
5. specifies that disbursements do not supplant or replace any other
funds that would have otherwise been used for the same
purposes (e.g., insurance benefits or governmental funding);
6. requires fund recipients, starting by October 1, 2023, to annually
file with the advisory committee a report for the prior fiscal year
that details the effectiveness of funded programs, services,
supports, or resources;
7. requires the advisory committee, starting by January 15, 2023, to
annually report on the fund to the Appropriations and Public
Health committees; and
8. authorizes the state to fund a trust to provide direct support and
services to opioid epidemic survivors and victims, in accordance
with the March 11, 2022, settlement agreement with Purdue
Pharma and the Sackler family.
* House Amendment “B” replaces the original bill (File 124) and adds
provisions (1) authorizing the state to fund a trust for opioid epidemic
survivors and victims; (2) expanding settlement fund uses to include
opioid abatement research and certain state and municipal expenses
incurred securing settlement proceeds; (3) adding the Appropriations
Committee chairpersons and an additional municipal representative to
the Opioid Settlement Advisory Committee membership and removing
one DMHAS-appointed member; (4) adding a municipal representative
as a co-chairperson of the advisory committee; and (5) specifying that
DMHAS must hire a full-time advisory committee manager, regardless
of the state’s dual job ban for General Assembly members. 2022HB-05044-R01-BA.DOCX
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EFFECTIVE DATE: July 1, 2022
§§ 2 & 4 — OPIOID SETTLEMENT FUND
Fund Establishment
The bill establishes an Opioid Settlement Fund as a separate non-
lapsing fund administered by the Opioid Settlement Advisory
Committee that the bill also establishes (see below).
Under the bill, the fund must contain certain moneys the state
receives that are intended to address opioid use, related disorders, or
the impact of the opioid crisis. This includes moneys (1) received from
any judgment, consent decree, or settlement paid by any defendant that
is finalized on or after July 1, 2021, and (2) related to opioid production,
distribution, dispensing, and other opioid-related activities. Moneys
remaining in the fund at the end of a fiscal year remain in the fund and
do not revert to the General Fund.
However, if the DMHAS commissioner and the attorney general
certify that the purpose of a judgment, consent decree, or settlement are
inconsistent with the fund’s intent, the bill permits them to deposit the
moneys into an alternative fund or account if they do the following:
1. report the certification in writing to the Opioid Settlement
Advisory Committee and include any alternative fund or account
they identified and the reasons for depositing the moneys into it
and
2. jointly report to the Public Health Committee on the intended use
of the moneys in the alternative fund or account.
Fund Balance and Inventory
The bill requires the State Treasurer to determine the Opioid
Settlement Fund balance annually by July 1.
Additionally, starting by December 31, 2022, the State Treasurer must
annually report to the Opioid Settlement Advisory Committee an
inventory of fund investments and the fund’s net income as of the most
recent fiscal year. 2022HB-05044-R01-BA.DOCX
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Use of Funds
The bill requires the fund’s moneys to be used only in accordance
with the controlling judgment, consent decree, or settlement, as
confirmed by the attorney general and after the committee’s and the
OPM secretary’s approval. It restricts use of the moneys to the following
substance use disorder abatement purposes:
1. statewide, regional, or community substance use disorder needs
assessments to identify structural gaps and needs to inform fund
expenditures;
2. infrastructure (e.g., personnel, buildings, equipment) required
for evidence-based substance use disorder prevention, treatment,
recovery, or harm reduction programs (e.g., syringe service
programs and naloxone distribution), services, and supports;
3. programs, services, supports, and resources for evidence-based
substance use disorder prevention, treatment, recovery, or harm
reduction (i.e., an attempted or actual reduction in the adverse
consequences of substance use, including by addressing the
underlying causes and conditions);
4. evidenced-informed substance use disorder prevention,
treatment, recovery, or harm reduction pilot programs or
demonstration studies that are not evidenced-based, but are
approved by the advisory committee as an appropriate use of
moneys for a limited time period the advisory committee sets, so
long as it assesses whether the evidence supports funding the
programs or studies or if the evidence provides a basis to fund
them with an expectation of creating an evidence base for them;
5. evaluating the effectiveness and outcomes reporting for
substance use disorder abatement infrastructure, programs,
services, supports, and resources for which the fund’s moneys
were disbursed, including the (a) impact on access to harm
reduction services or substance use disorder treatment or (b)
reduction in drug-related deaths; 2022HB-05044-R01-BA.DOCX
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6. at least one publicly available data interface the DMHAS
commissioner manages to aggregate, track, and report (a)
substance use disorders, overdoses, and drug-related harms; (b)
spending recommendations, plans, and reports; and (c) outcomes
of programs, services, supports, and resources for which the
fund’s moneys were disbursed;
7. opioid abatement research, including developing evidence-based
treatment, treatment barriers, nonopioid treatment of chronic
pain, and harm reduction supply-side enforcement;
8. documented expenses (a) to administer and staff the fund and the
advisory committee and (b) incurred by the state or
municipalities in securing settlement proceeds deposited in the
fund (including legal fees), permitted by the controlling
judgment, consent decree, or settlement;
9. documented expenses to manage, invest, and disburse the fund’s
moneys; and
10. documented expenses, including legal fees, incurred by the state
or a municipality in securing settlement proceeds deposited in
the fund, to the extent they are not otherwise reimbursed under
a fee agreement provided for by the controlling judgment,
consent decree, or settlement.
The bill requires the fund’s moneys to be used prospectively, and not
to reimburse expenditures from before July 1, 2022, unless:
1. a court order requires a refund to the federal government or
2. the documented expenses were incurred (a) administering the
fund and advisory committee or (b) securing settlement proceeds
deposited in the fund by the state or a municipality.
Under the bill, “evidence-based” means meeting one of the following
evidentiary criteria:
1. meta-analyses or systematic reviews have found the activity, 2022HB-05044-R01-BA.DOCX
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practice, program, service, support, or strategy to be effective;
2. evidence from a scientifically rigorous experimental study,
including a randomized controlled trial, shows that the activity,
practice, program, service, support, or strategy is effective; and
3. multiple observational studies from locations within the U.S.
indicate that the activity, practice, program, service, support, or
strategy is effective.
Eligibility for Fund Disbursements
The bill requires proceeds from any state settlement of claims against
a defendant to be allocated only to municipalities that execute an
agreement to participate in the settlement and adhere to the agreement’s
terms. However, it does not preclude or limit an allocation or
disbursement to benefit residents within a municipality that does not
execute an agreement or adhere to an agreement’s terms.
Under the bill, government and nonprofit nongovernmental entities
are eligible to receive fund moneys for programs, services, supports,
and resources for prevention, treatment, recovery, and harm reduction.
Fund Disbursement Process
The bill requires the DMHAS commissioner to obtain the Opioid
Settlement Advisory Committee’s approval before making or refusing
to make fund disbursements. The commissioner must adhere to the
advisory committee’s decisions about fund disbursements, as long as
they are permissible expenditures (i.e., qualify as one of the substance
use disorder abatement purposes described above).
The bill specifies that the commissioner’s role in distributing the
fund’s moneys after the advisory committee approves it is
administrative and not discretionary.
The bill prohibits the commissioner from making fund
disbursements unless the OPM secretary sends the advisory committee
a letter verifying that the funds appropriated and allocated in the fiscal
year’s budget for substance use disorder purposes for prevention, 2022HB-05044-R01-BA.DOCX
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treatment, recovery, and harm reduction, are in an amount that at least
meets the total amount of funds appropriated and allocated in the
previous fiscal year’s budget.
Under the bill, DMHAS must make fund disbursements in a way that
is consistent with any limitations a controlling court order sets on using
litigation proceeds. If the court order allows expenditures other than or
in excess of what the bill authorizes, DMHAS must adhere to the bill’s
limitations on using the funds. Conversely, if the bill permits
expenditures other than or in excess of what the controlling court order
authorizes, DMHAS must adhere to the order’s limitations.
Supplemental Funds
Under the bill, fund disbursements do not supplant or replace any
other funds that would otherwise have been used for the same purposes
(e.g., insurance benefits or governmental funding). Instead, they are
additional (“supplemental”) funds to ensure that the current fiscal year
funding exceeds the total of federal, state, and local funds allocated in
the previous fiscal year for substance use disorder abatement,
infrastructure, program, service, support, or resource.
§§ 3 & 5 — OPIOID SETTLEMENT FUND ADVISORY COMMITTEE
Purpose
The bill establishes a 37-member Opioid Settlement Advisory
Committee to ensure (1) proceeds received by the state are allocated and
spent on the substance use disorder abatement purposes described
above and (2) robust public involvement, accountability, and
transparency in allocating and accounting for the fund’s moneys.
Membership
Under the bill, the advisory committee consists of the following 31
government officials:
1. the OPM secretary and attorney general, or their designees;
2. the commissioners of children and families, mental health and
addiction services, and public health, or their designees, who 2022HB-05044-R01-BA.DOCX
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serve as ex-officio members;
3. the six top legislative leaders and the Appropriations Committee
chairpersons, or their designees, as long as the designees have
experience living with a substance use disorder or have a family
member with such a disorder;
4. 17 municipal representatives, appointed by the governor; and
5. the Commission on Racial Equity in Public Health executive
director, or a commission representative the executive director
designates.
Additionally, the DMHAS commissioner must appoint the following
six members:
1. one provider each of community-based substance use disorder
treatment services for adults and adolescents, who are non-
voting members;
2. one licensed addiction medicine health care professional with
prescriptive authority (e.g., physician, physician assistant, or
advanced practice registered nurse) who is a non-voting
member; and
3. three individuals with experience living with a substance use
disorder or who are family members of individuals with a
substance use disorder.
Conflicts of Interest
Regardless of state law, the bill specifies that is it not a conflict of
interest for a trustee, director, officer, or employee of an organization,
or any person having a financial interest in the organization to serve as
an advisory committee member. But to do so, the individual must (1)
disclose his or her position or interest to all other advisory committee
members and (2) abstain from any advisory committee deliberation,
action, or vote that specifically concerns the organization.
Appointments and Leadership 2022HB-05044-R01-BA.DOCX
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Under the bill, the committee co-chairpersons are the DMHAS
commissioner and a member representing municipalities selected by the
House speaker and Senate president pro tempore. The co-chairpersons
are nonvoting members.
The bill requires initial committee appointments to be made by
October 1, 2022. Committee members, except ex-officio members, serve
two-year terms and cannot serve more than two consecutive terms.
Members may serve until a successor’s appointment, except when a
vacancy occurs, in which case the appointing authority must fill the
vacancy for the rest of the term.
Under the bill, an appointing authority may remove an advisory
committee member for misfeasance, malfeasance, or willful neglect of
duty.
Meetings
The bill requires the advisory committee to hold quarterly public
meetings, which may be called by the chairperson or a majority of its
members. Members may attend meetings (1) in person, (2) remotely by
audiovisual means, or (3) by audio-only means if the chairperson
approves it.
A majority of the advisory committee’s members constitutes a
quorum for transacting business. If there is a quorum, all advisory
committee actions must be taken by an affirmative vote of the members
present and each voting member has one vote.
Under the bill, the advisory committee ends when all settlement
moneys are received and disbursed, unless the attorney general certifies
that the state anticipates receiving additional moneys.
Duties
Under the bill, the advisory committee must:
1. recommend and approve policies and procedures for its
administration and criteria for applying, awarding, and
disbursing moneys from the Opioid Settlement Fund and 2022HB-05044-R01-BA.DOCX
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2. approve fund allocations.
Additionally, the advisory committee must recommend and approve
goals and objectives, including their rationale, sustainability plans, and
performance indicators related to:
1. substance use disorder prevention, treatment, recovery, and
harm reduction efforts, including methods of engaging people
who use harm reduction services in treatment and recovery;
2. reducing disparities in accessing prevention, treatment, recovery,
and harm reduction programs, services, supports, and resources;
and
3. improving health outcomes in traditionally underserved
populations, including those who live in rural or tribal
communities, are members of ethnic minorities, or were
incarcerated.
DMHAS Responsibilities
The bill requires DMHAS, regardless of the state’s dual job ban for
General Assembly members, to employ a full-time advisory committee
manager and provide public health research and policy expertise,
support staff, facilities, technical assistance, and other resources to:
1. assist the advisory committee manager in planning and
supporting the committee’s functions, including ensuring that
the state’s opioid-related proceeds are allocated and spent
according to the bill’s requirements, and
2. ensure robust public involvement, accountability, and
transparency in allocating and accounting for the fund’s moneys.
Additionally, the bill requires DMHAS to:
1. use, where feasible, General Fund appropriations and existing
infrastructure, programs, services, supports, and other resources
to address substance use disorders, overdoses, and drug-related
harms; 2022HB-05044-R01-BA.DOCX
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2. prepare for the advisory committee’s review and approval, the
department’s goals and objectives and their rationale,
sustainability plans, and performance indicators related to (a)
substance use disorder prevention, treatment, recovery, and
harm reduction efforts, including methods of engaging people
who use harm reduction services in treatment and recovery, and
(b) reducing disparities in accessing prevention, treatment,
recovery, and harm reduction programs, services, supports, and
resources;
3. evaluate applications and make recommendations to the
advisory committee for awarding contracts and fund
disbursements for expenditures allowed under the bill;
4. disburse moneys, after receiving the advisory committee’s final
approval;
5. approve the suspension of fund allocations to recipients the
advisory committee or DMHAS commissioner finds (a) are
substantially out of compliance with applicable contracts,
policies, procedures, rules, regulations, or state or federal law or
(b) used their disbursements for purposes other than those
approved under the bill (but allocations may be subsequently
approved once the committee determines that the recipient
adequately remedied the cause of the suspension);
6. maintain oversight of the fund’s expenditures to ensure they are
only used for the purposes specified in the bill, including
implementing procedures for evaluating the effectiveness of the
infrastructure, programs, services, supports, or resources funded
by the disbursements; and
7. implement and publish on its website the policies and
procedures for (a) administering the advisory committee and (b)
applying, awarding, and disbursing moneys from the fund.
Website
The bill requires DMHAS to create and maintain a website where the 2022HB-05044-R01-BA.DOCX
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advisory committee must publish (1) meeting minutes, including
records of all votes to approve fund expenditures; (2) recipient
agreements and annual reports on fund recipients (see Fund Recipient
Annual Report, below); (3) policies and procedures the advisory
committee approves; and (4) its annual reports.
Annual Report
The bill requires the advisory committee, starting by January 15, 2023,
to annually report to the Appropriations and Public Health committees
on the following:
1. the fund’s opening and closing balance for the most recent fiscal
year;
2. an accounting of all fund expenditures and credits;
3. an inventory of fund investments as of the most recent fiscal year,
and the net income the fund earned for the most recent fiscal
year, as determined by the State Treasurer;
4. the name and description of each fund recipient as well as the
award amount;
5. a description of each award’s intended use, including the (a)
specific program, service, or resource funded; (b) population
served; and (c) measures the recipient will use to assess the
award’s impact;
6. the primary criteria used to determine each recipient and its
award amount;
7. a summary of information included in the recipient annual
reports (see Fund Recipient Annual Report, below);
8. all award applications received during the most recent fiscal
year;
9. a description of any finding or concern about whether all fund
disbursements, other than expenses the bill authorizes, 2022HB-05044-R01-BA.DOCX
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supplemented, and did not supplant or replace, any current or
future local, state, or federal government funding;
10. the performance indicators and progress toward achieving
DMHAS’s goals and objectives, including metrics on improving
outcomes and reducing mortality and other harms related to
substance use disorders;
11. for the most recent fiscal year, the dollar amount and percentage
of the fund balance incurred for (a) the fund’s and advisory
committee’s administrative expenses and staffing and (b) the
fund’s expenses for managing, investing, and disbursing fund
monies; and
12. an explanation of any funds certified by the DMHAS
commissioner and attorney general as being inconsistent with the
bill’s intent and the account or fund where the funds were
deposited.
The bill also requires the DMHAS commissioner to post the annual
report on the department’s website.
§ 3 — FUND RECIPIENT ANNUAL REPORT
The bill requires fund recipients, starting by October 1, 2023, to file
with the advisory committee an annual report for the prior fiscal year
that details the effectiveness of funded infrastructure, programs,
services, supports, or resources, including:
1. how the recipient used the funds for their intended purposes;
2. de-identified information on the number of individuals served,
delineated by race, age, gender, and any other relevant
demographic factors;
3. a specific analysis of whether the infrastructure, program,
service, support, or resources reduced mortality or improved
prevention, treatment, harm reduction, or recovery outcomes;
and 2022HB-05044-R01-BA.DOCX
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4. a summary of any plan to ensure the sustainability of the funded
infrastructure program, service, support, or resources, if the plan
exists.
§ 6 — TRUST FOR SURVIVORS AND VICTIMS
The bill provides that its provisions do not preclude the state from
funding a trust to provide direct support and services to survivors and
victims of the opioid epidemic, and their family members who have
been directly impacted by the epidemic, in accordance with the March
11, 2022, settlement agreement with Purdue Pharma and the Sackler
family (see BACKGROUND).
BACKGROUND
Opioid Settlement Agreement
Connecticut is part of a recently approved $26 billion multistate
opioid settlement agreement with the following prescription drug
manufacturers: AmerisourceBergen, Cardinal, McKesson, and Johnson
& Johnson. All states and U.S. territories have signed on to the
agreement and in Connecticut, all municipalities have joined.
The state is expected to receive approximately $300 million over 18
years. (Municipalities will receive 15% of the state’s allocation.) The
settlement agreement requires funds to be used for opioid abatement,
including expanding access to opioid use disorder prevention,
intervention, treatment, and recovery.
Opioid Survivors Trust
In March 2022, Connecticut, along with eight other states and the
District of Columbia, reached a $6 billion opioid settlement agreement
with Purdue Pharma and the Sackler family. The state is expected to
receive approximately $95 million over 18 years and is authorized to use
a portion of the funds to establish an Opioid Survivors Trust to directly
assist opioid epidemic survivors and victims.
COMMITTEE ACTION
Public Health Committee 2022HB-05044-R01-BA.DOCX
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Joint Favorable Substitute
Yea 31 Nay 0 (03/11/2022)
Appropriations Committee
Joint Favorable
Yea 47 Nay 0 (04/18/2022)