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he Office of innesota Attorney General Keith Ellison elping people afford their lives and live with dignity and respect • www.ag.state.mn.us Minnesota Opioid Settlement Executive Summary Minnesota has joined a broad multistate coalition in reaching nationwide settlements with the three largest opioid distributors — AmerisourceBergen, Cardinal Health, and McKesson — and opioid manufacturer Johnson & Johnson. The settlements resolve investigations and lawsuits against these companies for their role in the opioid crisis. If the settlements are fully adopted nationally, the distributors will pay $21 billion over 18 years and Johnson & Johnson will pay $5 billion over 10 years. Most states have already joined the settlements, but for the agreements to become effective, a critical mass of cities and counties must sign onto the settlements by January 2, 2022. Settlement Structure If a critical mass of subdivisions sign on and the settlements become effective: Minnesota will be eligible to receive more than $296 million over 18 years. Up to $222 million of that will be paid directly to Minnesota cities and counties. The total amount of payments to Minnesota will be determined by the overall degree of participation by cities and counties. The more cities and counties that join, the more money everyone in Minnesota will receive. Distribution within Minnesota will be determined by the state - subdivision agreement (see below). o Each state's share of the funding was determined by agreement among the states using a formula that takes into account the impact of the crisis on the state —the number of overdose deaths, the number of residents with substance use disorder, and the number of opioids prescribed —and the population of the state. Payments will begin to flow to the state and cities and counties as soon as April 2022. The Johnson & Johnson settlement provides for payments to be accelerated if cities and counties sign on early. The vast majority of the settlement funds must be used to support any of a wide variety of strategies to fight the opioid crisis. The Attorney General's Office convened an expert panel of local, state, and community providers with experience and expertise in public health and delivery of health care services to determine the best and most effective use of the settlement funds. The panel selected a comprehensive list of future opioid abatement and remediation programs that will benefit all regions of the state. In addition to the financial components, the settlements also require the companies to make changes in how opioids are distributed and sold. The companies will be subject to far more oversight and accountability throughout that process to prevent deliveries of opioids to pharmacies where diversion and misuse occur. The distributors will be required to establish and fund a centralized, independent clearinghouse using detailed data analytics to keep close track of opioid distribution throughout the country and raise red flags for