A legislative committee unanimously passed a bill that would create a state fund to house proceeds from opioid settlements, such as those against prominent pharmaceutical companies accused of helping fuel the opioid crisis.

It also would establish a behavioral health crisis hotline using a federally mandated 988 phone number, rather than a longer and harder-to-remember 10-digit number for a suicide hotline.

“This one I have a particularly high level of enthusiasm for because I think both of the components in this bill had the opportunity to really move the needle in our behavioral health,” Sen. Julia Ratti (D-Sparks) said during a hearing of the bill, SB390, on Thursday evening.

Opioid litigation funds

The bill would establish the “Nevada Fund for Healthy Communities,” which would hold the proceeds of state litigation against opioid manufacturers, distributors, sellers and marketers — including the $45 million Nevada is set to receive from the settlement of a lawsuit against consulting firm McKinsey & Company, which provided services for opioid manufacturers.

Ratti, who presented the Senate Health and Human Services Committee measure, explained that the fund would be used by the Department of Health and Human Services to remediate the negative impacts of the opioid crisis on the state.

Ratti said the bill would also work in tandem with another piece of legislation from Assemblywoman Jill Tolles (R-Reno). Her bill, AB374, which passed an Assembly committee this week and faces a possible vote of the full Assembly, would establish a statewide “Substance Use Response Working Group” in the attorney general’s office that would set out to prevent or reduce substance through mitigation and treatment efforts, education and examining behavioral health data.

In distributing the money from the fund, the department would solicit grant applications from local agencies and non-profit organizations and award grants based on recommendations from the working group as well as a comprehensive needs assessment first conducted by the department. Ratti provided one example of what the relationship between the state and local agencies could look like.

“If the county had the resources from their lawsuit to build a transitional housing property, because they got some one shot from these settlements, the state could put some of these dollars into Medicaid to leverage the services to be provided in that facility,” she said. “You might see the two partners collaborating in that way… collaborating together to address the impact.”

The fund could potentially hold billions of dollars in the coming years, Attorney General Aaron Ford said during the hearing presentation. Ford said that his office is pursuing opioid litigation against more than 60 defendants, including pharmaceutical companies Johnson & Johnson, Noramco and Cephalon. He also noted that, similar to the settlement with McKinsey & Company, his office continues to pursue litigation specifically for the benefit of Nevada, rather than as a part of multi-state litigation.

“Nevada's total share would not be enough to address or remediate the harms caused by the opioid epidemic in Nevada,” Ford said. “We are one of the hardest hit states, as I've said. And so my office is continuing to monitor these discussions, but we're moving forward with our own litigation in Nevada.”

Proceeds for the fund might come over a multi-year span, though. Ford said that some litigation was delayed by the pandemic, and because of the differences in litigation being pursued against the more than 60 defendants, money won would likely come in at different times.

Ratti explained that the bill would establish a plan and help generate ideas for how to spend that money as it is received by the state. 

Behavioral health crisis hotline

The bill also would set up a hotline, referred to as 988, that is mandated by the National Suicide Hotline Designation Act of 2020.

The federal bill requires states to move from a 10-digit suicide hotline number to a three-digit number (988), and the rollout of the new behavioral health crisis number has to be complete by July of 2022.

Stephanie Woodard, the state’s senior advisor on behavioral health, said the new number would work as a transition from the existing National Suicide Prevention Lifeline that already has call center personnel in place to a new easier-to-reach number that would improve the state’s behavioral health care system.

“The ideal crisis system would match the right intervention to the right person at the right place in the right time,” Woodard said during the hearing. “Without such services, individuals may forego the care that they need, or unnecessarily use high cost services such as emergency rooms.”

And though the 988 line builds off of the existing suicide prevention line, Ratti noted that part of the work in setting up the line will include ensuring members of the public know they can call the 988 line in the event of a behavioral health emergency, rather than calling 911 as many people are likely accustomed to.

The 988 line received significant support from the public, including the Nevada branch of the National Alliance on Mental Illness.

“A call for help shouldn't result in trauma or tragedy,” said Robin Reedy, executive director for the alliance. “Building a 988 crisis system in our state will move us closer toward a shared goal: a respectful, dignified and effective response to everyone who experienced mental health, substance use or suicidal crisis.”

The measure next faces a possible vote on the Senate floor.