The North Carolina Memorandum of Agreement (NC MOA) governs how North Carolina uses proceeds from national opioid settlements and bankruptcies. The MOA requires 85 percent of the funds to go directly to county and municipal governments, while the remaining 15 percent of funds are directed to the General Assembly to be used by the state to address the opioid epidemic in a manner consistent with the national opioid settlement agreements.  Here is how the NCGA has appropriated those funds.

FISCAL YEAR 2021-2022

For Fiscal Year 2021-2022, the General Assembly directed $15,735,496 from the multi-state settlement with McKinsey & Company directly to the North Carolina Department of Health and Human Services (NCDHHS) to support treatment, recovery, and preventions services for individuals battling Opioid Use Disorder. NCDHHS awarded 20 agencies across the state with grant funds to enhance or implement treatment services. A detailed overview of those who received awards from NC DHHS can be found here.

These appropriations for Fiscal Year 2022-2023 are described more fully on pages 217-219 of the 2021-2022 state budget here.

FISCAL YEAR 2022-2023

For Fiscal year 2022-2023, the General Assembly divided funds from the distributor and Johnson & Johnson settlement agreements in two parts. Of the $14,781,203 made available as a result of those agreements, the General Assembly directed $9,225,000 to the NC Department of Health and Human Services to be used as follows:

  • $1,850,000 – Prescription Digital Therapeutics Pilot Program
  • $1,000,000 – Triangle Residential Options for Substance Abusers Inc. (TROSA)
  • $6,000,000 – Local Management Entities and Managed Care Organizations (LME/MCOs) to purchase naloxone and medications for opioid use disorder and for related purposes
  • $375,000 – NC Association of County Commissioners to assist counties in maximizing the long-term positive impact of opioid settlement funds

The remaining funds in the amount of $5,556,203 are directed to the UNC Collaboratory to be used as follows:

  • $400,000 – UNC Injury Prevention Research Center to support their work on the Community Opioid Resources Engine for North Carolina (CORE-NC)
  • $600,000 – NC Central University
  • $2,656,203 – UNC School of Pharmacy’s Eshelman Institute for Innovation
  • $1,900,000 – Expanding grant opportunities across UNC campuses

Regarding the last item – $1,900,000 to expand grant opportunities across UNC campuses – the NC Collaboratory funded the five research projects described here.

These appropriations for Fiscal Year 2022-2023 are described more fully on pages 90-92 of the 2021-2022 state budget here.

FISCAL YEARS 2023-2024 AND 2024-2025

For Fiscal Years 2022-2023 and 2023-2024, the General Assembly appropriated the state share of opioid settlement funds in the following manner:

$5.5 million for FY 23-24 and $5.5 million for FY 24-25 to the University of North Carolina to be used as follows:

  • $5.2 million in FY 23-24 and $5.5 million in FY 24-25 to the University of North Carolina to make grants available on a competitive basis prescribed by the North Carolina Collaboratory to each campus of the constituent institutions of The University of North Carolina for opioid abatement research and development projects.
  • $300,000 in FY 23-24 to the University of North Carolina to conduct the study on judicially managed accountability and recovery courts.

$3,692,461 for FY 23-24 and $4,478,462 for FY 24-25 to the NC Department of Health and Human Services to be allocated as grants to the following entities to respond to the negative impacts of the opioid epidemic:

  • $200,000 for FY 23-24 to Addiction Professionals of NC, a nonprofit in Wake County which provides professional development services and support to professionals working in the field of substance use disorder, prevention, treatment, and recovery in North Carolina. 
  • $78,462 for FY 24-25 to Adult & Teen Challenge of Sandhills NC, a nonprofit in Moore County which provides substance use disorder treatment and recovery services. 
  • $1 million for FY 23-24 to Bridge to Recovery, Inc., a nonprofit in Union County which provides substance use disorder treatment and recovery services.
  • $1 million for FY 24-25 to Clay County NC.
  • $1.4 million for FY 24-25 to Columbus Regional Healthcare System, a nonprofit healthcare system, for its hospital in Columbus County.
  • $950,000 for FY 23-24 to Freedom Farm Ministries, a nonprofit in Watauga County which provides substance use disorder treatment and recovery services.
  • $750,000 for FY 23-24 to Ground 40 Ministries, a nonprofit in Union County which provides substance use disorder treatment and recovery services.
  • $1 million for FY 24-25 to Pamlico County NC.
  • $400,000 for FY 23-24 to Safer Communities Ministry, Inc., a nonprofit in Union County which provides substance use disorder treatment and recovery services.
  • $300,000 for FY 23-24 to The Samaritan Colony, Inc., a nonprofit in Richmond County which provides substance use disorder treatment and recovery services.
  • $92,461 for FY 23-24 to Solus Christus, a nonprofit in Yadkin County which provides substance use disorder treatment and recovery services.
  • $1 million for FY 24-25 to Surry County NC

In connection with the above appropriations, the General Assembly further provided that:  “By September 1, 2024, recipients of funds allocated . . . for the 2023-2024 fiscal year, and by September 1, 2025, recipients of funds allocated . . . for the 2024-2025 fiscal year shall report to the Department of Health and Human Services, Division of Mental Health, Developmental Disabilities, and Substance Use Services; the Joint Legislative Oversight Committee on Health and Human Services; and the Fiscal Research Division [of the NC Generally Assembly] on the use of these allocated funds. The report shall include at least all of the following for each recipient: (1) An itemized list of expenditures. (2) The types of opioid remediation programs, services, and activities funded, broken down by geographic location and the number of people served at each location.”

Additional information is available on pages 272-273 of the state budget here and on pages C107-C109 of the Joint Conference Committee Report here.