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Principles Coalition Announces 2023 Quarter 4 Award Winners

April 4, 2024

Principles Coalition Announces 2023 Quarter 4 Award Winners

The Principles coalition is excited to announce the recipients of the Award for Excellence in the Application of the Opioid Litigation Principles for the 4th Quarter of 2023: Milwaukee County, Wisconsin and Jefferson County, Tennessee. These quarterly awards are based on a set of evidence-based guidelines developed by faculty at the Johns Hopkins Bloomberg School of Public Health, known as the Principles. The award is designated by a coalition of endorsing organizations that are committed to helping policymakers use opioid settlement funds effectively and equitably

The Excellence Awards were launched in the first quarter of 2023, Previous winners include Rock County, WI, the states of Colorado, Rhode Island, North Carolina; and the commonwealth of Virginia

More than 670,000 people in the U.S. fatally overdosed from prescription and illicit opioids between 1999 and 2021. As the crisis deepened, states and localities filed lawsuits against drug manufacturers, pharmaceutical distributors, and pharmacies for their role in these deaths and other harms. Funds from litigation settlements are directing billions of dollars to states and localities to combat the opioid overdose crisis. 

To guide states and localities in spending the money from these settlements, faculty at the Johns Hopkins Bloomberg School of Public Health worked with collaborators across the country to create the Principles for the Use of Funds from the Opioid Litigation. Announced in January 2021, the Principles have been endorsed by more than 60 organizations across the U.S..

The Principles are:

  • Principle 1: Spend the money to save lives
  • Principle 2: Use evidence to guide spending
  • Principle 3: Invest in youth prevention
  • Principle 4: Focus on racial equity
  • Principle 5: Develop a fair and transparent process for deciding where to spend the funding

Details about how to apply the Principles and other resources for effective settlement spending are available at the website here. 

To recognize jurisdictions and encourage broad use of the Principles, a coalition of endorsing organizations launched the Excellence in the Application of the Opioid Litigation Principles Award. The quarterly awards recognize jurisdictions that have demonstrated rigorous application of the Principles in their decision-making process, including a focus on evidence, equity, and transparency. A committee drawn from organizations that have endorsed the Principles, including representatives from the Bloomberg School, Shatterproof, Yale Program of Addiction Medicine, the Colorado Consortium for Prescription Drug Abuse Prevention, and Partnership to End Addiction, reviewed this quarter’s applications.

This quarter, two counties stood out to the reviewers. 

Milwaukee County, Wisconsin

Milwaukee County has incorporated all five Principles into their planning process. To best utilize opioid settlement funds, Milwaukee County set a five-year goal to reduce fatal and non-fatal drug incidents in the county while addressing disparities across race or ethnicity. Before beginning with any plans for how to spend the funds, they held community listening sessions to best understand what the citizens of Milwaukee County believed to be the most pressing needs of the community. From these listening sessions, the County identified a need to bridge existing gaps impacting the community by making intentional investments upstream to address the root cause of health disparities. 

All departments within Milwaukee County impacted by the opioid epidemic were invited to participate in an application for a portion of the county’s funds. The County has a long-standing commitment to achieving racial equity, and first declared racism to be a public health crisis in 2019. In line with the spirit of the Vision Statement of Milwaukee County, submitted proposals were required to address how their proposal would address known inequities.

After applications were submitted, an independent panel comprised of subject matter experts and individuals with lived experience evaluated and scored each of the proposals. When reviewing proposals, priority was given to applications that emphasized intended efforts aimed at populations that were historically underserved in order to address racial inequities. Awards were made to the departments in early 2023, and after approval from the Milwaukee County Board of Supervisors, departments were able to begin implementation of their funded projects. 

Throughout the planning process, the County notes that there has been a commitment to make decision-making a fair, transparent, and equitable process – and to level the playing field so that small but often very passionate and effective community-based organizations have the opportunity to receive funds as well. The County noted that building this process has taken time, and though they were hoping to launch the application for community regranting by the 2nd quarter of 2024, it has taken longer than the community may have preferred. However, the County hopes that by building a strong process through listening and thoughtfulness, they will be able to make investments that continue to unify the community and spark innovation to address the needs of the community. 

“For years, local leaders and organizations across Wisconsin have been on the frontlines of the opioid crisis. The $102 million in opioid settlement funds have the potential to be transformative for our community, helping to save lives from this epidemic and mitigate continued suffering for residents and their loved ones,” said Milwaukee County Executive David Crowley. “Thank you to the Johns Hopkins Bloomberg School of Public Health for recognizing our efforts. Looking ahead, Milwaukee County is committed to doing all we can to combat the opioid crisis, make the best use of these funds and deliver critical resources into the community – because lives depend on it.”

Jefferson County, Tennessee

Under the recommendation of the county mayor and subsequent approval by the county commission, Jefferson County established an Opioid Board composed of content experts and community leaders across various sectors, including membership includes representatives from local hospitals, emergency management services, the criminal justice system, educational institutions, and individuals with lived experience to oversee their opioid settlement funds.

While the Jefferson County Opioid Board will oversee the ongoing Request for Proposals (RFP) and a grant application process to distribute opioid settlement funds to programs to address opioid use disorder; they also recognize that urgent needs may arise. To ensure that funds can be nimble, should the need arise, the grant process incorporates a provision allowing the board to retain 20% of the opioid funds each cycle as an emergency fund. This serves as a contingency to swiftly respond to emergency situations, such as spikes in overdoses or emerging contaminants. Any unutilized emergency funds will be rolled into the subsequent funding cycle, ensuring a proactive and flexible approach to community needs.

An additional aspect of Jefferson County’s process includes a focus on fostering strong community and government relationships. The county acknowledges that establishing a collaborative relationship between the community and government entities is fundamental for the effective allocation and expenditure of resources. To accomplish this, they actively work to bring together key stakeholders, including those with lived experience, those working with individuals using drugs or in recovery to determine the most impactful use of funds. The County believes that this collaborative approach not only garners local support but also cultivates an environment where novel and innovative ideas can emerge but also contributes to a more comprehensive understanding of community needs and potential solutions.

One of the key partners in Jefferson County is the University of Tennessee SMART Initiative (Substance Misuse and Addiction Resource for TN). Each fiscal year, the UT SMART team will assist with the reviewing and scoring of RFP applications. There is an additional requirement for agency contracts to include quarterly and annual metric and outcome reporting. The UT SMART team will help to evaluate the success of programs and identify areas for enhancement or expansion. The UT SMART team will also assist in conducting an inventory of existing resources in the community and surrounding areas, coupled with data analysis, aids in identifying gaps in resources and pinpointing successful programs already in operation. For future funding rounds, Jefferson County hopes to share local data (from EMS, ED, forensic center, etc.) with UT SMART  to have more timely and accurate data on the community’s overdose population and the substances involved. This information will help identify populations and areas with increased need.

“The recognition of Jefferson County Opioid Task force is directly related to all the members of the task force, nonprofits, UT SMART Initiative, and the people of Jefferson County.”  Mark Potts, Mayor of Jefferson County

To learn more about Milwaukee County and Jefferson County visit: 

Nominations are currently being accepted from or on behalf of state or local governments that demonstrate robust application of the Principles. Submit nominations here. The deadline for the next quarter is April 30, 2024.