Opioid settlement advisory committee reviews FY26 spending priorities; recovery campus, contingency management debated

The Opioid Settlement Advisory Committee on Wednesday reviewed a slate of proposed FY26 spending priorities drawn from the state's opioid abatement fund, with members pressing state health officials for details about unspent grant obligations, timing of new settlements and how several new proposals would be staffed and measured.

Committee members focused on both recurring commitments the legislature signaled should continue and about 17 new proposals that would pilot or expand services in specific regions. Mark Levine, commissioner of health, outlined the mix of repeat items and new grants and flagged a large potential one-time payment from the Sackler settlement that could affect future planning: "we have not yet received an application for a grant from the city of Burlington," Levine said when discussing the proposed overdose prevention center and the committee's lack of an active grant application from Burlington.

Why it matters: the committee allocates variable annual payments from multiple settlements; this year's roughly $12 million in available funds must cover ongoing obligations, recurring items legislatively encouraged for annual renewal and a set of pilot programs intended to fill local gaps in prevention, treatment and recovery support. Members said they need prompt accounting of currently obligated but unspent grant funds before finalizing FY26 requests.

Most prominent items discussed

- Case management staff: Last year's appropriation funded approximately $2 million for case management positions in the preferred provider network; Levine and committee members noted roughly $1.5 million of those awards remain obligated but not yet drawn down, and asked the Department of Health to confirm what portion can be carried forward and when drawdowns are expected.

- Overdose prevention center (Burlington): The committee maintained a policy-level commitment but acknowledged the city of Burlington has not yet submitted a grant application; Levine said this timing makes it "unlikely" the facility would require ongoing FY26 operating funds because it is not yet operational.

- Recovery residences: Grants funded two new recovery residences (Good Samaritan and Shires), each adding about eight beds; committee members queried why award dollars for those grants show as obligated but not spent and requested an update from the department's business office.

- Syringe service expansion: The committee set $700,000 to continue existing syringe service providers and $350,000 for geographic expansion. An RFP closed Jan. 21 with a single $50,000 proposal; Levine said the department expects to reissue the solicitation to meet the legislative intent for geographic expansion.

- Contingency management (stimulant use disorder): The committee recommended continuing funding for contingency management, a reward-based intervention that uses incentives such as gift cards tied to objective testing. Members noted the prior $800,000 award focused largely on statewide training; the committee recommended future grants include measurement requirements to track redemption and outcomes.

- Recovery campus proposal: A substantial part of the discussion centered on a governor's budget request for a recovery campus concept that blends lower-level residential support, recovery housing, transportation, workforce connections and clinical services. The administration requested $1.5 million ongoing for operations and $500,000 one-time for fit-up and capital work for a campus-scale model. Levine said some elements of the continuum already exist (for example, serenity house in Rutland and stabilization beds) and that the recovery campus idea is intended to fill gaps in transitions out of higher-intensity residential care.

Committee questions and staff directions

Members repeatedly asked the department to provide: (1) a near-term accounting of obligated-but-unspent grant awards and how much of those funds could be carried forward; (2) clarification on which proposed line items might be matchable to Medicaid or other federal funds; and (3) updates on solicitations that returned few proposals (notably the syringe service RFP). Representative Garfunnel pressed the point on expenditures for newly opened recovery residences: "If these have been opened, shouldn't there be some spent expenses associated with them?" she asked, requesting detail on drawdown timing.

Levine and staff said they would supply committee staff the requested grant-status details ASAP and noted some items (for example, Medicaid matchability of parts of the campus proposal) would be addressed by agency finance staff and the secretary in subsequent briefings.

What was decided

No formal votes were recorded in the transcript. The discussion produced staff follow-up directions: department staff will report unspent-obligation amounts and carryforward expectations to committee staff; the department intends to reissue the syringe service RFP; and the committee emphasized that future grants should include measurable outcome requirements.

Context and next steps

Committee members said they expect to hear additional testimony from the settlement committee and from the secretary in upcoming meetings to resolve outstanding questions about matchability and timelines. The committee also noted the possible arrival of a one-time Sackler payment (discussed by Levine as an expected $22,000,000 lump sum under one scenario) could complicate how funds are appropriated in future years compared with the previously anticipated multi-year payout schedule.

Ending: Committee members asked for an electronic version of the colored budget spreadsheet and repeated the need for a prompt accounting of unspent obligations before making final FY26 recommendations; staff agreed to follow up with the requested financial and procurement details.