This information was compiled based on information from publicly available legislation, state memorandums or executive orders, state websites, and press releases, as well as supplemental interviews with state officials with a role in administering opioid settlement funding.
It offers a snapshot of settlement spending and priorities at the state level (e.g., funding administered by state agencies or designated statewide abatement funds) as well as laws, agreements, and processes that the state has established for allocating funds. NASHP does not track spending at the local or county level, but includes any relevant state-level reports or dashboards that capture local spending within a state. For details on the definitions used here, check out the definitions at the bottom of this page. You can also get an overview of opioid settlement decisions in all states.
Settlement Spending Status
Background
The Missouri Department of Mental Health (DMH), the lead agency for reporting settlement expenditures for the state, releases yearly reports to the Missouri General Assembly with general information on distributions from both the state and subdivision shares of opioid settlement funding. DMH also publishes more detailed summaries of programs and initiatives funded from the state share over the past several fiscal years.
Has the state awarded settlement funds?
Yes. In fiscal year 2025, $70 million in settlement funding from the state share was appropriated to a variety of state agencies, with the majority ($41.8 million) going to DMH and the Department of Health and Senior Services ($14.8 million). A long list of programs funded from DMH include addiction fellowships, fentanyl test strips, and recovery community centers.
Has the state announced priorities or recommendations for spending?
No publicly available information.
Previous spending details
In previous fiscal years (2022, 2023, 2024), funding from the state share was appropriated to the departments of Mental Health, Corrections, Health and Senior Services, and Social Services, and the Office of Administration. Across all years, DMH consistently received the largest sum. Reports on expenditures from these appropriations can be generated for the state as a whole or for specific recipients – these reports include descriptions of the funded projects and the abatement category they fall under (e.g. harm reduction).
Statewide reporting of local spending
The state’s annual reports include expenditure summaries for all participating local governments. The reports highlight what percentage of local governments met the reporting requirements and categorizes expenditures into opioid abatement categories, such as prevention, treatment and recovery, etc.
State Settlement Website or Dashboard
Process for Settlement Disbursement
Legislation requires the state treasurer to disburse money from the state share to various departments within the state government, specifically listing the Department of Mental Health, the Department of Health and Senior Services, the Department of Social Services, the Department of Public Safety, the Department of Corrections, and the judiciary as departments that can use the money in the fund. The local share is distributed directly to cities, counties, and political subdivisions by settlement administrators. It is up to the governing body of each locality to determine how to spend the funds and for ensuring compliance with the terms of the settlement agreements and state MOU.
State and Political Subdivision Split
Structure
State Controlled (>50 percent of funding controlled by states)
Allocation Formula
60 percent state, 40 percent litigating subdivisions
Role of Advisory Committee
Not applicable.
