One in an occasional series of articles about issues that are likely to return for debate in next year’s session of the Iowa Legislature.
DES MOINES — More than $25 million intended for treatment and prevention of opioid use disorder in Iowa will remain unspent this year after last-minute negotiations broke down this month between Republican state lawmakers on how to allocate the funds.
Lawmakers in 2022 set up the Opioid Settlement Fund to hold the money recovered by the state from lawsuits against opioid manufacturers and distributors, including Johnson & Johnson, Teva, CVS and Walgreens. The fund had about $26.8 million in February, according to the State Treasurer’s Office, and the state is expected to receive about $144 million over the next several years — split evenly between state and local governments.
State law requires the use of the state funds be decided and approved by the Iowa Legislature. But for two years, lawmakers have not passed a plan to fund treatment and recovery operations.
As the money largely sits unspent, lawmakers who worked on the proposals for doing so said they were disappointed they weren’t able to get the spending passed in this year’s legislative session.
“The problem is much greater than anyone can imagine,” said Rep. Timi Brown-Powers, D-Waterloo, the ranking member of the House Appropriations Committee. “And we don’t have the beds, and we don’t have the programs. It is vital for those persons with the addiction and for those families that we do better, and we just didn’t do anything. And that’s too bad.”
In the session’s final two days this month, which both stretched into the early morning hours, the Republican-led House and Senate each put forward conflicting proposals to allocate the money.
The Senate’s original proposal called for 75 percent of money in the fund to be sent to the Iowa Department of Health and Human Services each year, while 25 percent would be sent to Attorney General Brenna Bird’s office. The agencies would have broad control over spending the funds, but within the terms of the settlements.
The House bill, which the chamber passed after amending the Senate proposal, called for creating a council in the Health and Human Services Department, consisting of agency heads and stakeholder experts, which would review applications for projects and recommend grants, which would need approval by lawmakers. The bill also included about $12.5 million in funding for specific projects, taken from a proposal from Gov. Kim Reynolds.
Late April 19, as both chambers were reaching adjournment for the year, the Senate deleted the ongoing funding altogether, passing a bill that instead included $12.5 million in funding for centers in Ames and Polk County and for Bird’s “billion-pill pledge” program, which promotes alternatives to opioid prescriptions after surgery.
The Senate adjourned before the bill came up in the House. When the House did consider the bill, Rep. Joel Fry, R-Osceola, the floor manager, recommended the House not agree to the Senate amendment, effectively killing it.
Sen. Mark Costello, a Republican from Imogene who ran the bill in the Senate, said he hopes the chambers can find a resolution next year to start funding treatment and recovery projects in Iowa.
“It’s a little disappointing, but we’ll get to it next year, I would hope,” he said. “I probably will try to get working on it a little earlier in the session.”
Reynolds, a Republican, proposed a bill to fund specific projects using $20 million in opioid settlement money, but the bill didn’t get much attention in the House. Some of the projects it called for made it into the last — and doomed — bill.
Every state is receiving money from multibillion dollar settlements with drugmakers over their role in fueling the opioid crisis. Thirty-eight states have created councils to oversee the spending of the settlement funds, according to KFF Health News.
Council, oversight disagreements
The central disagreement, lawmakers said, was over the need for an advisory council to administer the treatment funding. House lawmakers said that was an important piece of the proposal — to ensure oversight over how the funds are spent.
The House proposal also would have given lawmakers more say in the spending of the funds.
“We think that’s something that at least while it gets off the ground, some of these programs and investments, that it should have legislative input,” House Speaker Pat Grassley, R-New Hartford, said after the session ended. “And we just couldn’t find resolution with the Senate on that issue.”
Costello said Senate leaders did not think a council was needed. He said he was worried the council would add unnecessary steps.
“For the departments, particularly HHS, they know, they work with these people, they already have prevention and treatment programs for all kinds of addictive disorders, so that’s kind of their arena,” Costello said.
House Rep. Brent Siegrist, R-Council Bluffs, said he would have liked to see a plan be agreed to before lawmakers went home for the year.
“The money’s just sitting there, and you have people dying from opioid abuse, and the Senate wanted to go home and they couldn’t be bothered to take up that bill,” Siegrist said. “And so that money sits there, not helping anybody, and I just think that’s inexcusable.”
Costello, though, said the Senate’s final bill, which directed $12.5 million from the fund toward specific projects, would have been a good start while lawmakers work on a long-term agreement.
“I thought when we sent it over to them, they might take it and we’d at least get started with that $12 million or so we had agreed on, but I guess I’m not sure what happened over there,” he said. “…I told them clearly that we weren’t going to take their bill, but I wanted to give them the opportunity just to get that money out.”
