Mississippi lawmakers veer away from recommendations for nearly $60M in opioid settlement funds

After sitting on tens of millions of dollars in opioid settlement funds for years, the Mississippi Legislature finally began spending the money this session, but it veered away from the system it had created to guide those decisions. 

In the final weeks of the session, a months-long process for reviewing and ranking proposals gave way to legislative discretion. Lawmakers adjusted funding amounts, added organizations that had not been vetted and moved to give themselves broader authority over how the money could be spent. 

The Mississippi Opioid Settlement Fund Advisory Council had reviewed 127 applications, scored them, and submitted recommendations to lawmakers in December. Those rankings were meant to guide spending. Instead, legislators treated them as optional. 

By the end of the session, lawmakers approved nearly $60 million in spending across seven agency budgets. Just over $50 million was restricted to addiction-related uses. About $9 million was left to legislative discretion — including $5 million for clinical trials of the psychedelic drug ibogaine as a potential treatment for addiction.

Then, Gov. Tate Reeves vetoed $1.55 million that lawmakers had directed to three nonprofits — $500,000 to Hope Squad, $800,000 to the Gulf Coast Center for Nonviolence, and $250,000 to Finally First — arguing the groups had not been properly reviewed by the advisory council. 

But all three had submitted applications. Two were never reviewed due to what the Attorney General’s office described as administrative errors. A third was flagged as incomplete because of a typo in its budget. 

The Mississippi House voted to override the vetoes, then the Senate voted to block the override, ending the session with the vetoes standing. 

The chaotic end to the session was in many ways the culmination of tensions that had been building since Mississippi first began trying to figure out how to spend more than $400 million it is set to receive from settlements with opioid manufacturers, marketers, and distributors — money that sat largely untouched for three and a half years while the crisis continued claiming lives. 

Michelle Williams, chief of staff at the Mississippi Attorney General's Office, which oversees the advisory council, described the process as “building the plane as we fly it.” 

Getting the money out the door from here, Williams said, would require the same improvisation that has defined the process from the start. 

“Those would be the wings on the plane that we're building in the air,” Williams said about the funding rollout for applications that were granted by the legislature.

Among the organizations that applied but did not receive funding was the Fairland Center in Dublin — one of only two residential treatment facilities in Mississippi that accept pregnant women and mothers with young children. 

Life Help, the organization that operates Fairland, had applied for $500,000 to expand beds, distribute naloxone and place staff in hospital emergency rooms to connect overdose patients with follow-up care — specifically for pregnant and parenting women. The advisory council ranked their application in the second tier. The Legislature did not fund it. 

Phaedre Cole, Life Help’s executive director, said the organization was “disappointed,” pointing to its decades of work in a region heavily affected by the opioid crisis. 

“The Delta is, if not the poorest area in the country, one of the poorest,” said Jonathan Grantham, the organization’s chief clinical officer. “It’s very important that we have money to provide care to an indigent population who otherwise would not have the resources to receive the services they need.” 

The Fairland Center currently operates 24 funded beds, though the facility can accommodate more. When mothers arrive with children, each child requires a bed — meaning a mother with three children occupies four. 

Lower reimbursement rates for children make expansion financially difficult, even when space is available. Cole said no construction would be needed to grow. 

“We are ready to go,” she said. “You could see the impact immediately.” 

Life Help plans to reapply in the next funding cycle. Cole said lawmakers should rely more heavily on the advisory council’s review process when making funding decisions. 

“We have a proven track record,” she said.

Organizations that had their applications approved often received amounts different from what they applied for or were recommended by the advisory council. End It For Good, an organization that advocates for a health-centered approach to addiction, received almost $10,000 less. 

The organization received $200,000 to launch something founder Christina Dent said Mississippi has never had: structured family support groups designed not just to help loved ones of people struggling with addiction set limits, but to teach them how to stay in a relationship with the person they're trying not to lose. 

"There are far too many families who have taken a tough love approach," Dent said, "and for far too many of them, that rock bottom is death." 

The program will offer free online skills training, in-person support groups in the Jackson metro area and the Gulf Coast and online groups for people who can't access in-person options. Evidence behind similar programs, Dent said, suggests they don't just support family health. They can actually increase the likelihood that the person struggling with addiction will reach out for help themselves. 

But Dent is concerned that the one-year grant structure may not give new programs enough runway to prove their value before the next application round opens. 

"We're building something new for Mississippi as a small nonprofit," she said. "We hope we will have enough time to get it up and running, show results, and make tweaks as the data comes in." 

She described what she hopes the settlement funds can be: a once-in-a-generation opportunity to bring ideas to Mississippi that have never existed here. 

"It might take longer to get up and running. It may take longer to get data," Dent said. "But it could be the most transformative investment we make."

Williams said the Attorney General’s office is working to hire a third-party administrator — funded with $400,000 in non-abatement dollars — to bring more structure to the process. The state aims to have a contract in place by early June. 

The administrator would help manage applications, track reporting and build an online portal for future funding rounds. 

Williams said the decision aligns with concerns raised by advisory council members and recovery advocates during last year's review process, including a call from council member James Moore for outside expertise to guide spending decisions. 

Lawmakers also passed a bill this session tightening conflict-of-interest rules for council members — another response to concerns that highly-ranked applications had come from organizations with representatives on the council itself. 

Williams did not say lawmakers should be bound by the council’s recommendations, instead emphasizing the work the advisory council had done. 

“The hours they put into reviewing applications, bringing all of their different perspectives,” she said. “We’re just so proud of the work that they did.” 

She also said the Mississippi Attorney General’s office wants the process to support organizations building new things, not just reward those that can show fast results because they're already operating at scale. 

“If that's working with a smaller organization to help them get their great idea up off the ground, we want to be as helpful as we possibly can in doing that,” Williams said. 

This story was produced by the Gulf States Newsroom, a collaboration between Mississippi Public Broadcasting, WBHM in Alabama, WWNO and WRKF in Louisiana and NPR.