Plans passed by the House and Senate to respond to Minnesota's epidemic of opioid abuse overlap in many areas.
Both contain a menu of requirements for painkiller prescribers as well as grants for addiction prevention, intervention and programs addressing the epidemic's fallout.
And to pay for it, each would generate roughly $20 million annually from licensing fees at various levels of the opiate distribution network.
But as public deliberations resume Monday with a House-Senate conference committee, a key sticking point remains. Lawmakers are struggling with how the fees are structured.
It's appropriate to make the companies that contributed to the problem also contribute to the solution, said Sen. Julie Rosen, R-Vernon Center. But she said if those same companies reach legal settlements with the state, the new fees should be adjusted accordingly.
"There needs to be a sunset on that licensing fee ongoing," she said. "The governor has pushed back publicly on it. And the House has pushed back."
Rosen said she's firm that the legislation cannot move without a reasonable sunset.
But the DFL's lead lawmaker in conference committee negotiations, Rep. Liz Olson of Duluth, is just as adamant that the Legislature not back down on manufacturers and other industry players.
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The size of the fees would depend on what medicine companies sell, where they fall in the distribution chain and how many pills or units they get into the Minnesota market. But it'll be considerably more than most drug wholesalers and manufacturers pay now to do business here.
"This crisis has been going on for the last 10 years," Olson said. "It has costed our state millions, if not billions of dollars annually. And so, we want to make sure that just getting a small settlement for past wrongdoings doesn't really deal with what we have going into the future — to make sure we actually do something to stem the opioid crisis."
Lawmakers are proceeding with an eye on the courts.
Attorneys general in Oklahoma and West Virginia recently struck legal settlements with opioid manufacturers in the tens of millions of dollars. Similar lawsuits are pending in Minnesota and many other states.
Minnesota Attorney General Keith Ellison said attempts by his office to hold companies accountable should be kept separate from the Legislature's response.
"There's a lot of damage that's been caused — from child protection systems to overburdening treatment programs to impacting schools to hospitals," he said. "I think at the end of the day, the legislative outcome is essentially remedial to those systems. I think the impact to the direct victims is separate from that."
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In 2017, the most recent year for which full Health Department data are available, there were 422 deaths in Minnesota attributed to opioid abuse. More than 2,000 nonfatal overdoses were also recorded. Updated figures are expected soon.
But not everyone who uses opioids is abusing them. Cammie Lavalle of Lakeville, Minn., for example, is on daily prescription medication to help her deal with intractable pain from spine ailments. She's not sold on the proposed legislation and predicts that drug companies will pass their costs down to consumers.
"The money that we are going to be paying extra is going to be going to fund treatment for individuals who sadly have the disease of addiction and some who abuse the very medications that we need in order to have a better quality of life and more function," she said.
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Both bills would fund programs ranging from expanded drug treatment services to additional public awareness to equipping more types of responders with a drug meant to counteract overdoses. They also establish an Opioid Advisory Council to help steer other dollars.
Rep. Dave Baker, R-Willmar, said it's all overdue, and that even $20 million probably isn't enough to address the scope of the problem. He's one of two lawmakers involved in crafting the bill who has lost a son or daughter due to an opioid addiction.
"Our kids are not here, and I think that we feel, every time we see another story, we feel cheated honestly," he said. "We can't legislate with emotion. We see it, and we want to make sure other parents hopefully get some real help with what we're doing."