County Settlement Hightlights

Each quarter, we highlight the implementation of evidence-based strategies funded by opioid settlement money across the state. These highlights also showcase examples of how some counties are managing their funds, with one example from each grand division (West, Middle and East).

Q1 2025

East Tennessee: Union County

The Union County Opioid Abatement Board (UCOAB) has worked diligently and collaboratively to implement a growing list of abatement projects. Through these efforts, the county has helped provide needed recovery support, prevention and harm reduction programs.

Improving recovery support services for the justice-involved population has been an ongoing priority for the UCOAB. As an initial step, county settlement dollars were approved to hire a full-time recovery court coordinator to oversee the recovery court program. This coordinator is also a Certified Peer Recovery Specialist (CPRS) who partners with various agencies to provide peer support services in the community and county jail.

The program has already had an impact. Since onboarding, the CPRS designed a new intake survey for the county jail, identifying client needs and opportunities to coordinate services to address needs upon release. Furthermore, data from this survey has been analyzed and used to help design the county’s future jail, which will include new space for comprehensive treatment and recovery programming.

As a next step, the UCOAB recently received approval to fund a part-time peer support specialist to work alongside the recovery court coordinator to increase access to peer support for recovery court participants, expanding the impact of CPRS services, which have been shown to improve treatment adherence and outcomes, as well as other aspects of recovery.

In addition to prioritizing recovery support, the UCOAB has emphasized prevention and harm reduction as core components of their overall abatement strategy. Last year, the board focused on preventing new cases of opioid use disorder by installing medication disposal boxes at county dump centers and distributing Deterra at-home disposal bags in the community. To date, 184 pounds of medication have been collected, and 1,000 Deterra bags have been distributed.

Finally, the board has also worked with various agencies to improve overdose response efforts in the county. With the support of various local agencies, the county has implemented ODMAP to track timely overdose data and conduct outreach in communities at risk of overdose spikes. In addition, the board has worked in partnership with the county EMS and other local and state agencies to establish an EMS naloxone leave-behind program.

Chaired by Finance Director Doug Lukonen with General Sessions & Juvenile Court Judge Doug Chapman as vice chair, the Maury County Opioid Abatement Committee had a busy autumn, approving the allocation of $920,770 to pay for multiple remediation efforts.

Numerous organizations applied to the county’s community grant process, covering multiple abatement strategies.

  • Delta Recovery was awarded $297,060 to support un- and under-insured individuals in treatment, harm reduction resources and recovery housing support,
  • Maury Regional Medical Center will receive $360,000 to onboard a new Federally Qualified Health Center psychiatrist and two care navigators for opioid use disorder to increase the healthcare workforce and improve continuity of care, 
  • The Maury County Prevention Coalition will receive $120,710 to hire new key personnel to significantly expand their impact, increasing the number and uptake of local youth prevention programs, 
  • Place of Hope has been awarded $70,000 to help cover the cost of residential treatment services and onboard an additional licensed counselor and case manager, 
  • GWP Recovery Ministries will receive $38,000 to provide transportation services and funding for their recovery services,
  • $20,000 has been set aside for the county to build a website to house a comprehensive catalog and central database of information that would “aid any person affected by opioid use,” and 
  • South Central Human Resource Agency has been given $15,000 for drug testing supplies to support the local Recovery Court program.


These programs address the substance use crisis from multiple fronts: treatment, housing, prevention and more. Maury County’s Office of Financial Management has done exemplary work tracking and maintaining information from applicants to keep the committee informed and its procedures efficient. A recommendation for other counties employing a community grant model would be to create and maintain a similar database.

The breadth of the abatement strategies covered is also a testament to the composition of the committee itself, which includes the county sheriff, health director, a public defender and leaders from local healthcare and recovery organizations. By representing so many perspectives from across the recovery ecosystem, the committee has ensured that potential projects get careful consideration from all angles.

The next application period for Maury County opioid abatement community grants will open in March 2025 in anticipation for FY 25-26. Application details can be found on the county website.

Seeking to improve both treatment outcomes as well as continuity of care between services, Lake County has funded a certified peer recovery specialist (CPRS) to work directly in the county jail.

A CPRS is an individual in recovery who has met training requirements and is certified by the state of Tennessee to provide peer-to-peer support services. CPRS services have been shown to have a positive impact on treatment attendance and outcomes, cravings, risky behaviors and other components of recovery, but they are underutilized.

Concerned over high recidivism rates and the fact that the risk of overdose is at its highest within the first two weeks of release from jail, the Lake County Prevention Coalition presented the idea to the mayor and county commission and it quickly grew into an executable plan. Jeff Roberson, CPRS, has since been hired and has begun offering services, and program partners have also connected the sheriff’s office to the local Mobile Health Unit to explore additional services among other options intended to improve the success of re-entry.

Roberson encourages stakeholders in other counties to find common ground. “Find that cohesion and, usually, things can work. I wish that I could name everyone individually, but I’m sure I would forget someone. We have a wonderful health department, school system, courthouse, jail staff, commission, community centers, so many amazing community members, and we can’t forget the support and guidance of the SMART initiative.”

He also stressed the importance of strong leadership.  “All of the programs, community support and all efforts involved would be ineffective without the driving force of our mayor, Danny Cook.”

Q4 2024

East Tennessee: Roane County

Roane County has been awarded the Excellence in the Application of the Opioid Litigation Principles. These principles, crafted by a coalition of organizations across the substance use field and expert faculty from the Johns Hopkins Bloomberg School of Public Health, represents a set of evidence-based strategies designed to guide state and local policymakers on effective use of  national settlement funds.

This award recognizes Roane County’s exemplary adherence to the following Principles:

  1. Spend the Money to Save Lives
  2. Use Evidence to Guide Spending
  3. Invest in Youth Prevention
  4. Focus on Racial Equity
  5. Develop a Fair and Transparent Process for Deciding Where to Spend the Funding

Roane County formalized its Opioid Settlement Funds Advisory Committee in April 2023. The group is comprised of a diverse panel of over two dozen local stakeholders ranging from service providers to employers to local residents with lived experience in recovery. The committee convenes monthly to share information and develop data-driven, collaborative strategies for the effective spending of opioid settlement funds for the county government to consider.

Roane worked closely with Sarah McCall, UT SMART’s substance use response consultant for East Tennessee, during phase one of the committee’s approach, which involved identifying gaps in services to determine priority spending areas. This involved the creation and maintenance of a living recovery ecosystem resource map, based on a design created by the East Tennessee State University Addiction Science Center. These efforts led to the committee’s prioritization to enhance peer support and trauma-informed care. (UT SMART and partners ETSU, UT Martin and UT Southern have been awarded a UT Grand Challenges grant to expand this resource map across the state).

The phase one proposal was unanimously approved by the Roane County Commission in December 2023, funding an emergency department recovery navigator, a community peer navigator for justice-involved people with substance use disorder, and a trauma-informed specialist to work with at-risk youth and families through the local school system.

In phase two  the Roane County Opioid Settlement Funds Advisory Committee is developing a comprehensive three-year strategic plan to manage settlement funds equitably and effectively, and to serve in an advocacy capacity for this mission.

The Sumner County Opioid Abatement Committee (OAC) has focused on immediate and long-term goals with their funding. In doing so, the committee has set aside half of its funds from each year to focus on projects that could continue once the settlement funding ends.

For year one, Highpoint Health hospital, Volunteer Behavioral Health, the Sumner Prevention Coalition, and multiple county departments have come together to create a plan that will focus on those needing immediate assistance. As the data show that 51% of all those who overdose go to Highpoint Health for medical attention, the goal will be to increase warm handoffs from the emergency department to local mental health and recovery services to improve the continuity of care and get more people who overdose into sustained recovery.

For the upcoming OAC meeting, these applicants will present the project and request the funding. For year two, the OAC has set aside funds to assist the Recovery Court with an anticipated project to be named in November.

Trevor Henderson, UT SMART’s substance use response consultant for Middle Tennessee, has been working closely with the county to highlight the wide range of perspectives represented in these initiatives. The county departments involved (Health, Emergency Communications, Emergency Medical Services and Finance) cover a wide array of government services and logistics that complement the experiences from the region’s flagship hospital and mental healthcare services alongside the county’s prevention coalition. The crucial impact of this range of experiences is the breaking down of data and information silos, which are often a barrier to evidence-based decision-making.

Dyer County reached an important milestone in the formation of its own regional opioid abatement committee. The county is now developing a community grant model so that local treatment, prevention, harm reduction and recovery support organizations can apply for funding.

UT SMART is bringing particular attention to the makeup of the Dyer County Opioid Abatement Committee, which features public health, health education, fire and first response, child abuse prevention, faith-based and women-focused recovery support, governmental officials (featuring the budget committee), law enforcement, and criminal justice. This breadth of experience and perspectives covers nearly the entirety of the prevention and recovery ecosystem, which is essential to tackling this crisis.

Officials from Dyer County were first served by UT SMART at the West Tennessee Opioid Settlement Summit, hosted by Tipton County. Courtney Collier, UT SMART’s substance use response consultant for West Tennessee, has since worked closely with Dyer County Mayor David Quick to assist in forming the committee and the community grant process.

Q3 2024

East Tennessee: Jefferson County

Jefferson County was awarded Excellence in the Application of the Opioid Litigation Principles by Johns Hopkins Bloomberg School of Public Health for using the following evidence-based principles in helping guide the effective spending of their settlement dollars:

  1. 1. Spend the Money to Save Lives
  2. Use Evidence to Guide Spending
  3. Invest in Youth Prevention
  4. Focus on Racial Equity
  5. Develop a Fair and Transparent Process for Deciding Where to Spend the Funding

Jefferson County established an Advisory Opioid Board composed of content experts and community leaders across various sectors and formed a partnership with the University of Tennessee Institute for Public Service SMART initiative in the process of deciding how to spend their funding.

“The recognition of Jefferson County Opioid Task force is directly related to all the members of the task force, nonprofits, UT SMART Initiative, and the people of Jefferson County,” said Mark Potts, Jefferson County mayor.

In Davidson County, the Mental Health Cooperative (MHC) was awarded $2.4 million from the Metro Nashville Public Health Dept., which oversees the county’s opioid abatement funding. These funds will be dispersed over 15 months to create low-threshold access to buprenorphine treatment and will be focused heavily on flexibility and accessibility for individuals seeking substance use treatment. Additionally, the grant will ensure access to transportation and assist with hiring peer support specialists, care coordinators and providers. MHC partners with regional emergency medical services and the Metro Nashville Police Department in the Partners in Care (PIC) and Responders Engaged and Committed to Helping (REACH) programs.

The Madison County Opioid Abatement Committee voted to adopt a community grant model for dispersing their opioid settlement funding during their second official meeting held in May.  Applications are expected to open later this year, and organizations based in Madison County that work in prevention, treatment, recovery support, harm reduction, and other related services will be welcome to apply.  The committee co-chair acknowledged that some treatment providers located in Jackson, the capital of Madison County, also provide services to surrounding counties and the committee will be taking this reality into funding decisions.  The committee also voted to withhold 20% of the funds, in line with national guidelines, in order to “ensure funding in the future.”

The committee was commissioned by Madison County Mayor AJ Massey and is chaired by Sheriff Julian Wiser and co-chaired by Deputy Mayor Terica Smith.  In this second meeting, they also voted to approve District Attorney Jody Pickens as the ninth member.