More than $600 million in opioid settlement money is flowing to Wisconsin counties and cities with no state agency assigned to audit how the funds are spent, according to a report released Tuesday by the Institute for Reforming Government.
Wisconsin is slated to receive more than $874 million through 2038 from lawsuits against opioid manufacturers, distributors and pharmacies. Seventy percent goes to 71 counties and 16 municipalities. The remaining 30% is managed by the state Department of Health Services.
The organization’s report, “Drug Money: How Wisconsin’s Counties Are (Mis)Spending Millions in Opioid Settlement Funds Without Oversight or Accountability,” says local governments largely police themselves. The result, the group said, is vague annual reports, spending with tenuous ties to opioid abatement, and millions sitting unused.
Opioids killed 1,415 Wisconsinites in 2023, or nearly four people a day, state health data show. Sixty-eight of the state’s 72 counties recorded opioid-related deaths that year.
Counties must file annual reports on receipts and spending, but state law does not require detailed breakdowns. The Legislature’s Joint Finance Committee, the Department of Justice and the Department of Health Services all have roles in the settlements. None is charged with directly monitoring or auditing local spending, the report said.
Manitowoc County reported spending exactly $500,000 on “Prevention Programs” with no itemization, according to the institute. The city of Milwaukee reported more than $1.6 million across four broad categories.
Milwaukee County created 20 positions, spent $19,000 on five autopsy carts and $192,000 on a portable body cooler, and allocated $2.2 million to the medical examiner’s office, including student loan forgiveness for a forensic pathologist, the report said.
Other examples cited include clean needles and smoking kits; license-plate readers in Oconto and Clark counties; rent subsidies in Marquette County and West Allis; gas cards and smoke alarms in Waushara County; and programs in Dane and Milwaukee counties that the institute said focused solely on minority communities.
Several counties reported no spending despite large balances, including La Crosse County ($2.9 million), Marathon County ($2.2 million) and Dodge County ($2.1 million). Some local governments may have failed to file required reports at all, the group said.
“The money paid out to counties from the Opioid Settlement Fund is supposed to address the opioid crisis, and right now almost no one is watching how it gets spent,” said Maryjane Behm, the institute’s deputy director for policy and reform. “County reports are often vague, questionable spending can look more like a local wish list than opioid abatement, and there is no state watchdog responsible for making sure taxpayers can see where the money went.”
Wisconsin is about a quarter of the way through payments scheduled from 2022 through 2038. The institute urged lawmakers to create a dedicated oversight body, a searchable public reporting portal, more detailed expenditure and grant reporting, clearer rules on allowable uses, and legislative hearings on spending to date.
Local governments have previously said they need flexibility to match local needs and that unused balances often reflect planning for multiyear programs. Settlement agreements generally require funds to be used for opioid abatement, including treatment, prevention and harm reduction.
