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Want to know how states are spending money from the opioid litigation? Look no further…

August 19, 2022

Jodi Manz, MSW, is the Director for Behavioral Health, Aging, and Disability at The National Academy for State Health Policy (NASHP), a nonpartisan organization committed to developing and advancing state health policy innovations and solutions. She previously served as Assistant Secretary of Health and Human Resources for the Commonwealth of Virginia. We talked to her to learn more about NASHP’s State Opioid Policy Center.

What are the goals of NASHP’s State Opioid Policy Center?

The State Opioid Policy Center serves as a hub for NASHP’s work on state substance use disorder policy and is funded through our work with the Foundation for Opioid Response Efforts (FORE). The goal is for NASHP to provide a virtual platform that can be a place for state policymakers to find the kinds of policy information and analysis that can help move innovation forward in their states. Over the last few years, we’ve created and disseminated resources through the Center on a variety of topics that were responsive to state policymakers’ stated needs. We started the Center right as the COVID pandemic was beginning across states, so our first toolkit was on how states could implement policy to support access to treatment in this very new environment. We also developed toolkits on providing substance use disorder treatment within the legal system, implementing evidence-based treatment for special populations, developing workforce, and funding for substance use disorder in states. We’ll continue to build that out over time, especially that last piece on funding, and it’s where we will post our abatement tracking and analysis as well.

What are some of the specific policies that the Center will be exploring over the next couple of years?

For this project, NASHP has historically taken on various topic areas with the input and direction of a fantastic steering committee composed of state leaders. We do deep policy dives on those topics – interviewing state leaders, analyzing state statute, regulations, and budgets – and we develop toolkits, briefs, and other resources. Over the coming years, we’ll continue to do that; our steering committee has expressed interest in state policy regarding pregnancy and substance use disorder, so that will be our next policy area. We’ll be doing policy reviews and analyses to understand how states can best support individuals with substance use disorder throughout pregnancy and how systems come together to provide evidence-based treatment for families.

We’re also simultaneously building on work we’ve done on how states fund substance use disorder initiatives. The administrative component of that is a major challenge for states, particularly with multiple agencies responsible for multiple funding streams with multiple sets of restrictions on use. Abatement funds represent the newest challenge in that space – how will states integrate these funds into an already complex resource pool, while maximizing opportunities to support evidence-based practice and policy? NASHP will be tracking how states are administering these funds, especially the interaction between state and local leaders, and analyzing emerging themes in administrative strategies and tools. Beyond that, we’ll be researching and highlighting policy and programmatic innovations supported by funds, particularly those that reflect items that are not able to be funded through other resources like federal grant dollars and Medicaid reimbursement.

How do you envision state leaders using the resources and information that you’ll be putting out?

Our goal at NASHP is always to provide tangible and practical policy solutions to states. As a former state policy person who worked in this space, I ask at the beginning of every project, “What would have helped make my job easier?” The resources that we create and disseminate will help state leaders understand the policy options – maybe in states similar to theirs, maybe in states that have different resources or political landscapes – that they can look to as they encounter barriers. While what works in one state may not be feasible in another, we provide information and analysis on the nuts and bolts of how good policy is being enacted in order to create roadmaps for state leaders.

Specific to abatement funds, we hope to help states lay the groundwork for many years of abatement spending by drawing out good policy and administrative practice. Many states have had active task forces or workgroups around substance use disorder for several years, some of them spanning gubernatorial administrations, and the infusion of abatement funds into their resource landscapes creates a moment for reflection, realignment if necessary, and an opportunity to draw on what has been working well. In tracking and analyzing abatement work for these first few years of the settlements, NASHP will be helping states to see what is most helpful early on, allowing them to build on what works in order to administer these funds well for years to come.

What are you seeing so far that you think is interesting?

While states are only at the beginning of what will be years of work administering abatement funds, we’re already seeing significant variation in how states are organizing. We’re looking at how states are appointing leadership, which agencies and stakeholders are represented in the decision-making process, and how local-state agreements are being enacted. The variation is not unexpected, and we anticipate that it may lead to different priorities and innovative policies emerging from states.