The MOSS Center: How Maine Supports Local Governments with Opioid Settlement Fund Management
What you need to know: The Maine Opioid Settlement Support (MOSS) Center is a one‑stop resource that Maine local governments can turn to for guidance on managing opioid settlement funds. The MOSS Center and its work is a project of the Maine Attorney General, Aaron M. Frey, funded through the Attorney General’s share of the state’s opioid settlement. The Center offers an example of how states can build a centralized technical assistance infrastructure, grounded in local context, to support effective, transparent use of these funds.
In addition to providing free expertise and technical assistance on opioid settlement fund management to Maine local governments, the MOSS Center promotes transparency into how Maine’s settlement funds are expended. This includes:
- Administration of an annual survey to support local governments’ compliance with Maine State Law LD 110, which requires yearly reports on local government opioid settlement expenditures.
Who we spoke with: The Principles Team spoke with Lindsey Smith, MSW, PhD (MOSS Center Director) and Jennah Godo, MS (MOSS Center Outreach and Communications Coordinator) to learn more about the MOSS Center’s work.
Q1: How has the MOSS Center worked with Maine’s local governments?
Lindsey Smith: Grounding our work in the principles of implementation science and public health engagement has underpinned much of our success. We knew buy-in from the local officials responsible for managing settlement funds was critical; our strategy early on was to get in front of these groups as often as possible to ensure they understood how we could support them. We made it clear in initial meetings that our approach to technical assistance was one of partnership and joint problem-solving.
Jennah Godo: Picking up the phone goes a long way too. Maine’s local governments each have their own decision-making infrastructures for opioid settlement fund spending. Identifying the right people we should be talking to in a given locality was complicated. Speaking with people over the phone sped up what could have taken weeks or months longer over email. This emphasis on grassroots engagement has helped us make some form of connection with all 39 Maine localities receiving settlement funds.
Lindsey Smith: Word of mouth also helped once we started fulfilling technical assistance requests. Some of the localities we supported initially were really struggling and facing public scrutiny. We were able to help them turn things around pretty rapidly. A lot of these stories get picked up in local media, like the Maine Monitor, which prompts decision-makers elsewhere facing similar challenges to reach out.
Q2: Can you talk about some of the common requests for assistance the MOSS Center receives?
Lindsey Smith: A lot of our initial support has focused on education and infrastructure building. Opioid remediation was a new subject area for some of the decision makers in our smaller localities, and they were struggling with where to start. We created some foundational educational resources to address knowledge gaps. This included a detailed process map (informed by the Principles) outlining best practices at each stage of the opioid settlement fund planning process and one pagers summarizing the four pillars of opioid settlement fund spending (prevention, harm reduction, treatment, and recovery). Our infrastructure building support has run the full spectrum—including helping localities set up settlement councils, develop RFPs and scoring approaches for proposals, align spending priorities with local needs assessment findings, and build data collection capacity to track the impact of funded programs. It goes beyond getting that first RFP out. If local governments want to keep funding these programs or leverage other funding sources, they’re going to have to monitor and demonstrate impact.
Q3: Can you share a specific example of support the MOSS Center has provided to a local government? What was the impact?
Lindsey Smith: Prior to our Center’s creation, a county had formed a settlement committee and released an RFP. Challenges developed within the group, which led to the committee being dissolved. So, they were one of the first groups that came to us. Within a short amount of time, about a year, we helped them reformulate a committee, develop a system for grant tracking, and create a more user-friendly RFP application. Now they’re successfully moving on to their second round of funding, and their RFPs have been receiving a significant number of applicants.
Jennah Godo: I’d add a quote from a feedback survey we recently administered: “[We] would have not been able to put out proposals, score the proposals, or understand survey methods without the folks at MOSS.”
It’s from a county we’ve gone through an extensive technical assistance process with. We’ve helped them with a community engagement process to understand local needs, develop and administer an RFP, and implement quarterly reporting and evaluation processes. We are still closely involved in supporting them with their second RFP round. But I have seen them gain so much knowledge throughout our collaboration and start to think better about what they are seeing at each stage of the process.
Lindsey Smith: To Jennah’s point, one of our goals is to help localities strengthen their capacity to manage these funds independently. Local governments’ needs are going to be changing over time. Improving their capacity to manage settlement funds positions us to address new needs as they arise.
Q4: The MOSS Center website notes new dashboards focused on assistance provided by the MOSS Center, and the impacts of opioid settlement-funded programs are forthcoming. Can you share more about these planned dashboards?
Lindsey Smith: The technical assistance dashboard will display which local governments have engaged with the MOSS Center and categorize the type of support we have provided to them. It’s important for us to be transparent and accountable for our work. The Center is funded with opioid settlement dollars, and we should be held to the same standard everyone else is held to. Knowing who’s engaged with us, and at what level, also helps local advocacy groups better understand what’s happening on the ground in the community.
Our impact dashboard will be continuously evolving, but we are starting with a substance use vulnerability index. It’s a model Michigan developed that we are tailoring specifically for Maine. The model provides a composite measure on local area substance use vulnerability using community level inputs on substance use burden, resources available to reduce burden, and the CDC’s social vulnerability index. Our adaptation will incorporate data from Maine’s All Payer Claims Database. We are the first group using a more extensive extract from this database on substance related services. So, we’re really excited about that.
Q5: What advice do you have for states that may be interested in providing more support to local governments with managing their opioid settlement funds, or for local governments looking for more support?
Lindsey Smith: For other states, it starts with knowing your local context. What infrastructure does the state already have? Can it be leveraged to help localities manage settlement funds? If not, what building blocks do you need to put in place to set people up for success?
In Maine, most counties do not have local public health departments. So, we knew some form of centralized support was needed. Maine has a long list of statewide entities doing great work in the addiction space. But this is a new content area for many of the decision-makers tasked with managing local settlement funds, and it can be hard to identify the best group for the specific question you have. This informed the decision to create a new standalone entity that Maine local governments could turn to for all their support needs.
Jennah Godo: For local governments, just think about any groups within your community that are already working in this area and have expertise. Does your community have any treatment centers? A recovery center or recovery community? Organizations distributing naloxone or providing syringe services? Existing school-based prevention programming? So, starting locally to find those connections, because that’s sometimes how you form your committee, and that’s sometimes how you connect with people with lived experience. Even if localities receiving settlement funds have access to state-level support, it’s still local work that requires local conversations.
For more, visit the MOSS Center’s resources page