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An ordinance establishing the Opioid Settlement Steering Committee’s role in guiding the strategic use of the Metropolitan Government’s opioid settlement funds through a clear, transparent, and data-driven process.
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WHEREAS, overdose deaths and substance use disorder remain acute public-health crises in Nashville and Davidson County and require coordinated, evidence-based, and community-centered responses; and
WHEREAS, opioid settlement funds present an important opportunity to invest in prevention, harm reduction, treatment, recovery support, community education, research, and systems improvements, but such investments must be guided by clear priorities, transparent public reporting, and measurable outcomes; and
WHEREAS, the University of Tennessee’s Substance Misuse and Addiction Resource for Tennessee (“SMART”) Initiative provides guidance and best practices for local governments seeking to implement cost-effective, evidence-based strategies to reduce harm from substance use and improve recovery outcomes; and
WHEREAS, public-facing dashboards and regular reporting improve accountability, help the public understand local needs, and allow for tracking of fatal and non-fatal overdoses, naloxone distribution, treatment capacity, and program performance models already in use at state and local levels in Tennessee; and
WHEREAS, the Tennessee Opioid Abatement Council maintains a public dashboard of grant awards and program descriptions, offering a useful framework for transparent reporting and coordination; and
WHEREAS, best practices for overdose and opioid-fund transparency call for clear metrics, timely data updates, accessible public reporting, and program inventories linked to outcomes enabling continuous improvement and community engagement; and
WHEREAS, a recently published the Office of Internal Audit found that governance, reporting, and monitoring of opioid settlement funds should be strengthened to improve transparency and the ability to assess program effectiveness; and
WHEREAS, the Opioid Settlement Steering Committee, previously established as part of a pilot project use of settlement funds and aligned with the Behavioral Health and Wellness Advisory Council (“BHWAC”) should be designated as the primary advisory body for opioid settlement fund use in Metro Nashville to the benefit of the community.
NOW, THEREFORE, BE IT ENACTED BY THE METROPOLITAN COUNCIL OF NASHVILLE AND DAVIDSON COUNTY:
Section 1. There is hereby established an Opioid Settlement Steering Committee (“the Committee”) as part of the Metropolitan Public Health Department. The Committee shall consist of eleven voting members. The Committee shall monitor the expenditure of opioid settlement funds received or awarded to the Metropolitan Government, assess program efficacy, and ensure funding is administered as consistent with the needs of Nashville and Davidson County residents. The Committee shall recommend the use of opioid settlement funds to ensure the funds are used in appropriate ways that (a) emphasize prevention, harm reduction, treatment, and recovery strategies; (b) follow evidence-based practices; (c) maximize transparency and impact; and (d) support continuous improvement informed by accurate and timely data.
Section 2. The Committee shall consist of eleven voting members and three nonvoting ex officio members. The eleven voting members shall include: one member appointed by the Chief of the Nashville Fire Department and confirmed by the Metropolitan Council; one member appointed by the Chief of the Metropolitan Nashville Police Department and confirmed by the Metropolitan Council; five members appointed by the Mayor and confirmed by the Metropolitan Council, one of whom shall be a representative from a hospital emergency department; and four members selected by the Metropolitan Council. The nonvoting ex officio members shall include the Director of Health or the Director’s designee, one representative of the Metropolitan Council Public Health and Safety Committee, and one designee of the Metropolitan Finance Director. All appointed voting members shall have experience with public health policy, medicine, substance use disorder and addiction treatment, mental health services, drug misuse prevention programs, or drug court diversion, behavioral health, harm reduction, community care, health equity, or lived experience with opioid use disorder. The Committee shall:
1. Recommend a multi-year strategic funding plan aligned with evidence-based best practices, including those identified by the UT SMART Initiative;
2. Develop and publish clear funding priorities and decision criteria that address disparate needs of differing affected communities;
3. Recommend performance metrics and evaluation methods for all funded programs;
4. Receive and review, at least quarterly, financial reporting of opioid settlement funds, including funds received, appropriated, allocated, contracted, invoiced, expended, and remaining, as prepared or reviewed by the Department of Finance;
5. Require a disclosure and recusal process for members connected to funded or applicant organizations.
Voting members of the Committee shall serve for terms of three years. No more than two voting members may be appointed who also serve on the BHWAC, as formed in Mayor David Briley’s Executive Order No. 003.
Section 3. The Metropolitan Government of Nashville and Davidson County shall employ an Opioid Settlement Coordinator to oversee and ensure that all opioid settlement funds are expended in accordance with the terms and restrictions established in the applicable settlement agreements. Responsibilities of this position shall include, but are not limited to, coordinating and facilitating meetings of the Opioid Settlement Steering Committee; collecting, analyzing, and reviewing county-level data to identify local priorities and inform funding decisions; administering and overseeing grant awards to community organizations; monitoring program performance metrics and outcomes; and developing and maintaining a transparent process for communicating settlement fund allocations, expenditures, and outcomes to county leadership and the public.
Section 4. Within 150 days of the formation of the Committee, the Metropolitan Public Health Department, in coordination with the Committee and the Department of Finance, shall establish a publicly accessible Opioid Settlement Transparency Dashboard. The dashboard shall list all funded projects, include standardized metrics, provide visualizations and downloadable data, and document data sources, definitions, and update schedules.
Section 5. Prior to the Committee’s recommendation of any multi-year strategic funding plan, the Committee shall hold at least two public hearings, including one evening meeting and one virtual option.
Section 6. The Committee shall submit an initial strategic plan and dashboard specifications to the Metropolitan Council within 120 days of formation.
Section 7. Each funded program must identify measurable outcomes and report them through the dashboard and annual report to the Metropolitan Council. The Metropolitan Council requests that the Office of Internal Audit initiate a follow-up audit on the issues identified in the June 2026 audit report within three years of the Committee’s formation. The findings of this audit shall be reported through the dashboard and as part of an annual report to the Metropolitan Council.
Section 8. The Metropolitan Government shall comply with state law and coordinate with the Tennessee Opioid Abatement Council, the Tennessee Department of Mental Health and Substance Abuse Services, Tennessee Department of Health, and statewide dashboards.
Section 9. The Committee shall sunset within three years from the effective date of this ordinance, unless extended by resolution of the Metropolitan Council.
Section 10. This ordinance shall take effect on September 1, 2026, the welfare of The Metropolitan Government of Nashville and Davidson County requiring it.