The Matanuska‑Susitna Borough will receive about $2.3 million from the national opioid settlement over the next 18 years. At present the money is being handed out in small, advance‑paid grants measured only by head‑count, a method that will not add many treatment beds for the thousands of residents struggling with opioid use disorder.
How the settlement money arrived
For two decades prescription painkillers flooded Alaska through a broken supply chain. Manufacturers marketed the drugs as low‑risk, distributors shipped volumes that no legitimate prescribing could explain, and pharmacy chains filled questionable prescriptions. Thousands of jurisdictions sued, resulting in roughly $50 billion in settlements nationwide. Alaska’s first‑round share was $58 million, split between the state and nine local governments, including the Mat‑Su Borough. The money comes from the companies, not taxpayers, but it is now public money that the borough can direct.
What the law requires
Exhibit E, the rulebook attached to the settlement, mandates that at least 85 percent of the funds go to opioid remediation – treatment, prevention, recovery, and harm‑reduction. The definition is broad: it covers opioid use disorder and any co‑occurring substance‑use disorder, residential and inpatient treatment, recovery housing, job training, placement, and transportation for people in recovery. The rule does not limit the money to nonprofit providers.
Current grant approach and its limits
In 2023 the borough manager created a five‑member committee to assess needs. Three members came from addiction‑treatment nonprofits that could later apply for the money, and two were from the same organization. No physician, emergency‑room, or independent provider sat on the panel. After public meetings, the Assembly adopted a split of 30 percent treatment, 30 percent prevention, 10 percent recovery, 10 percent harm‑reduction, and 20 percent media outreach for the first five years.
Because the borough lacks health powers under state law, the first grant round could only fund training, education, and publicity. Of roughly $233 000 available, about $63 000 was awarded to 501(c)(3) nonprofits. In 2025 the borough gained limited health powers for settlement spending, allowing it to pay for actual treatment and recovery services.
The current round, closing December 4 2026, offers $704 763 for three years. Grants are capped at $25 000 per organization per year, and applications still ask nonprofit‑oriented questions. Payments are made in advance, and the only performance metric is the number of clients served and their community locations.
Why the current model falls short
Thirty percent of $704 763 – about $211 000 – spread over three years funds roughly three organizations at $25 000 each. The rules do not require that money purchase a single treatment day for a resident; it can cover wages, training, or overhead. With only a head‑count metric, the borough will never know whether anyone stays sober a year later.
The Valley’s addiction problem runs into the thousands. Small, scattered grants with no outcome tracking cannot meaningfully address that scale.
A better use of the funds
The borough does not run a hospital or treatment center, and it does not need to. Under the 2025 ordinance, its role is to pass settlement money to qualified providers – nonprofit, for‑profit, or tribal – that have open beds. The borough could purchase treatment days from any state‑licensed provider, letting Medicaid or insurance cover the primary cost and using settlement money for uninsured patients, extended stays, or gaps while Medicaid applications are pending.
This approach stretches the limited fund several times further and puts existing beds to work. It also creates a measurable outcome: a specific resident treated on a specific day.
Leveling the playing field for providers
Nonprofit treatment centers currently enjoy property‑tax exemptions that for‑profit providers do not. Alaska law (AS 29.45.050(m)) allows a municipality to partially or totally exempt economic‑development property if clear eligibility rules are set. The borough could extend a similar exemption to the portion of a for‑profit facility used for addiction treatment, provided the provider accepts Medicaid, serves borough residents, and reports outcomes consistently.
How Mat‑Su compares nationally
National data from KFF Health News, Johns Hopkins, and Shatterproof show that, on average, about 18 percent of settlement money goes to treatment and 14 percent to recovery services. Mat‑Su currently allocates as much to prevention as to treatment, with recovery receiving the smallest share. Our grants are smaller, more scattered, and lack robust outcome tracking.
Path forward
Research from Massachusetts General Hospital and Harvard indicates that sustained remission typically requires about five years, and recovery housing dramatically improves long‑term sobriety, employment, and reduces criminal recidivism. The borough should shift its strategy to purchase treatment days, leverage existing beds, and consider tax‑exempt incentives for for‑profit providers that meet the same accountability standards. Doing so would maximize the impact of the settlement money and give Valley residents a real chance at lasting recovery.
Original reporting: Must Read Alaska (Anchorage) — read the source article.
