Last June the Press published an article titled “Unsettled: How Harvard landed an opioid settlement windfall while others got shortchanged.” The article outlined how the team of lawyers responsible for determining how much opioid settlement money each state, county, and town in the U.S. would receive used a questionable method to determine town allocations for several New England states, including Massachusetts.
As a result, Harvard, with very low opioid-use statistics, received an allocation of over $620,000. Neighboring Shirley, with a higher population and higher opioid-use numbers, received just under $19,000.
Why?
For most states, settlement money was allocated to counties, and the percentage each county received was based on evidence of opioid use disorder within the county. County governments then defined their own methods to distribute the money to their cities and towns. But in Massachusetts, most counties no longer have a county government, or they have weak ones with little functionality, so that method of allocation would not have worked here.
While the goal of the lawyers was to base the distribution of the settlement funds on evidence of opioid use, that evidence proved to be hard to come by at the town level. The lawyers wanted to ensure that the opioid-use evidence data that they collected would be as consistent as possible, so they chose to use only federal data. That data was available at the county level but not at the town level. Massachusetts, for instance, had statistics on the number of opioid-related deaths in each of its towns, but that data was not used.
The chosen solution
To solve the town data problem, the lawyers turned to a U.S. Census Bureau municipal survey that tracked annual spending and revenue, by category, for every town in the country. From that survey, they chose nine spending categories that they thought might indicate the degree of a town’s opioid use problem. Those categories were elementary and secondary education, fire protection, police protection, public welfare, health, hospitals (town-run only), judicial and legal, correction, and housing and community development.
Each town was then assigned a percentage of spending within its county, based on how much it spent on operations in those nine categories in 2012 (the most recent survey available at the time the settlements were being negotiated). In Worcester County, for example, Harvard reported spending $19,050,000 on operational expenses for those categories, which amounted to 1.36% of the amount spent in the entire county. That percentage was then used to determine the allocation each town in a county would receive. Harvard received 1.36% percent of Worcester County’s entire allocation.
In the states such as Massachusetts where this method was used the towns that spent more, got more, regardless of any direct evidence of opioid use. And, since education accounted for the bulk of spending in the nine categories, (about 82% in Worcester County), spending on schools in 2012 became the primary determinant of how much opioid settlement money each town in Massachusetts received.
Towns with regional school systems received little
In the 2012 survey, educational spending was reported in two different sections depending on whether a town administered its own schools or whether it contributed funds to a regional school system. For some unknown reason, the section of the survey where regional school spending was reported was not included in the data collected by the lawyers. Educational spending for towns whose elementary and secondary schools were regional was considered $0, leaving each of them with a much lower percentage of a county’s total spending, and, as a result, a much lower percentage of the county’s opioid settlement funds.
For instance, the Worcester County town of Barre, whose 2010 population was nearly the same as Harvard’s, was allocated $36,388. Harvard’s allocation was $620,576. All of Barre’s schools are part of a regional school district, so its operational spending did not include anything for education. Its spending in the nine categories was just over a million dollars, while Harvard’s was over 19 million, 93% of which was for educational operations.
While Harvard received more opioid settlement money per resident than any other town in Worcester County, state opioid- use statistics indicate that Harvard’s opioid use is one of the county’s lowest. In 2023, Harvard had no opioid-related overdose deaths, and the number of residents who received prescriptions for buprenorphine, a drug prescribed to manage opioid addiction withdrawal, was 10. In Barre, there were four opioid-related overdose deaths in 2023, and 88 residents received buprenorphine prescriptions.
Barre is not the only Massachusetts town with an opioid-use problem and little settlement money to deal with it. In Worcester County, the five towns of Dudley, Spencer, Athol, Westminster, and Charlton, all in regional school districts and all with populations higher than Harvard’s, received a total of $516,755 in settlement funds, about $100,000 less than Harvard. Combined, the towns had 17 opioid-related overdose deaths in 2023 (at least two in each town), and 733 residents received buprenorphine prescriptions (more than 100 in each town).
Does the ‘spending indicates opioid-use’ assumption hold water?
Setting the regional school issue aside, state opioid-use data does not support the assumption that towns who spend more on operations in the nine categories may be doing so because they have a higher opioid-use problem. In fact, it shows an opposite correlation. The Press looked at the amounts spent on school operations as reported in the 2022 Census Bureau municipal government survey for the 25 nonregionalized Worcester County towns. The towns of Gardner, North Brookfield, Winchendon, and Webster spent the least amount per resident on education but had some of the county’s highest percentages of their population receiving buprenorphine prescriptions in fiscal 2023. Gardner topped both the lowest amount spent on education ($1,650 per resident in 2022) and the highest percentage of the population receiving buprenorphine (1.69%) in the county.
Conversely, Grafton, Hopedale, Westborough, and Harvard spent the most money per resident on education, and their buprenorphine usage numbers were some of the lowest. Harvard topped both statistics, spending the most on education ($4,164 per resident in 2022) and having the least per-resident buprenorphine use in 2023, only 0.18% of its population. (See graph above.)
Another settlement set to arrive soon
Massachusetts is part of a new settlement with Purdue Pharma, the maker of the opioid Oxycontin, and the state is expecting to receive up to $105 million over the next 15 years, bringing the state total to just over $1 billion. The state will likely follow the same allocation process that it did with the funds from the other seven settlements; 40% goes to the towns and cities using the 2012 operational spending data to divide it up. If that happens, each town will receive about 10% more than its current allocation. For Harvard, that will be about $62,000. For less fortunate towns, like Barre—which would receive about $3,600—the addition of the Purdue settlement will be practically inconsequential.
The chart above shows the four Worcester County towns that spend the least per resident on school operations in 2022 (Gardner, North Brookfield, Winchendon, and Webster) and the four who spent the most (Grafton, Hopedale, Westborough, and Harvard). It also shows the number of residents who received prescriptions for buprenorphine, a medication that reduces opioid withdrawal symptoms and cravings, in fiscal 2023. Buprenorphine use is one of the state’s opioid-use disorder statistics that is available by town.
Note: Sources for graphics and information in this news analysis and in “Pooling resources: Harvard makes progress toward sharing its outsized opioid settlement with neighboring towns” are as follows:
- Allocation methodology. “Class Counsel Memorandum: How the Allocation Model Works,” Negotiation Class Counsel, Sept. 10, 2019.
- Allocation amounts. www.mass.gov/lists/municipal-abate ment-payments, as initially published in 2023. The latest allocation amounts published by the state are a few dollars lower to reflect small administrative fees.
- Population numbers. U.S. Census Bureau, except for Harvard. Its population is from the town’s Annual Reports, which do not include the population of the Federal Medical Center at Devens.
- 2012 and 2022 town spending. U.S. Census Bureau’s State and Local Government Finance datasets and documentation.
- Massachusetts opioid-use statistics. mass.gov/info-details/bureau-of-substance-addiction-services-bsas-dashboard.
