Senate Health & Welfare hears Department of Health on H.660 opioid‑abatement spending; DOH urges pause on new projects

The Senate Health & Welfare Committee on April 7 heard from Department of Health staff about H.660, the bill that would allocate opioid abatement (opioid settlement) funds. Shail Livingston, an advisor in the commissioner’s office at the Vermont Department of Health, told the committee the state has two distinct recommendation sets — the department’s and those from the Opioid Settlement Advisory Committee (OSAC) — and thanked OSAC members for reviewing 67 community proposals.

Livingston said the fund’s estimated new receipts are typically under $5,000,000 per year and will decline substantially after about 2032, so the department is urging a strategic approach to spending. “We really deeply appreciate the amount of work that the members of the opioid settlement advisory committee put in to their recommendations,” Livingston said, and added that DOH recommends pausing new project approvals so the committee and DOH can evaluate the performance and sustainability of projects already funded.

That evaluation focus is reflected in language the department supports in H.660, Livingston said. DOH would like OSAC to review evaluation results for all previously funded projects (not only four initiatives the legislature already asked to sustain) and then recommend which programs merit ongoing base funding or other state support. DOH staff emphasized many initiatives have large carry‑forward balances because start‑up and staffing delays slowed early spending.

DOH outlined specific spending priorities and one‑time startup requests. Among the items discussed were: additional funding for recovery residences (DOH noted $1,400,000 as a current operational pressure tied to higher‑level certified recovery housing), training funds to let emergency medical services provide buprenorphine at overdose responses, and a request to add $287,000 to support a Public Safety Enhancement Team (PSET) run by the Department of Public Safety. Livingston said the buprenorphine training and recovery housing startup funds appear in H.660 in various forms; PSET funding was not in the House-passed bill but DOH seeks to add it.

Committee members pressed DOH for details on how special fund balances are handled and whether the fund earns interest while held. Legislative staff explained special funds do earn short‑term interest like state cash, but interest typically reverts to the general fund unless a statute specifies otherwise. Senators also sought clarity on how appropriations would translate to local delivery: Livingston said EMS training would be done through grant processes and existing systems, not as direct service funding.

The hearing included detailed line‑item discussion. Livingston described reversions listed in H.660 (for example, a DOC medication dosing unit and completed projects that returned funds to the settlement account) and proposed combining geographically specified recovery‑residence line items to allow DOH to pair settlement funds with Rural Health Transformation Program (RHTP) dollars. She said that pairing would better enable renovations or uses that federal RHTP money alone cannot support.

Syringe services and Burlington’s planned overdose prevention center drew specific concern from members. A senator said local constituents had reported litter and other problems associated with syringe service operations; Livingston confirmed the Howard Center has administered syringe services but will transition to a new provider and that DOH is working on grant arrangements to sustain programming in Chittenden County. An area service organization representative told the committee that $850,000 intended as an addition to base ASO grants had never been automatically added in prior years; ASOs have since requested the funds and urged they be made available for FY26 and FY27.

Jessica Schifano, policy director at the Department of Health, told the committee DOH is working with ASOs and that about $2.4 million is already available in grants; she said DOH does not oppose adding the $850,000. Dan Bates, deputy commissioner of public safety, described the PSET work — situation tables, improved data analysis with Crime Research Group, and tri‑annual consortium meetings to coordinate local and state partners — and said $2,248,000 would expand sites and data capacity. Bates said the program is active in multiple districts and offered to provide a budget profile and follow up with detailed numbers.

Committee members repeatedly asked DOH to supply a clearer written plan showing how recovery centers, recovery residences, RHTP, OSAC allocations and the substance misuse prevention fund fit together so senators can assess whether additional requests (for example an $800,000 ask for recovery centers) are one‑time or ongoing obligations and where the money would come from.

The chair said the committee will take a short break and then return for further questions and markup. No formal votes were recorded during the presentation.

Next steps: DOH agreed to provide written language edits for H.660 (including the recovery residence flexibility language) and to follow up with budget profiles and clarifying materials on syringe services, ASO grant adjustments and the PSET budget so the committee can consider amendments during markup.