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Date Available
9-10-2026
Year of Publication
2026
Document Type
Graduate Capstone Project
Degree Name
Master of Public Financial Management
College
Graduate School
Department/School/Program
Public Administration
Faculty
Urton Anderson
Committee Member
Rhonda Trautman
Faculty
Margaret Plattner
Abstract
The opioid epidemic continues to present significant public health, economic, and administrative challenges throughout the United States, with rural Kentucky experiencing some of the nation's highest rates of opioid-related morbidity and mortality.
Effectively responding to this crisis requires not only adequate financial resources but also transparent governance, coordinated implementation, and accountability for how public funds are distributed.
This study examines the allocation, governance, and implementation of opioid response funding within the Big Sandy Area Development District (BSADD), a rural multi-county region in eastern Kentucky. Using a qualitative case study and policy analysis approach, the research evaluates four primary funding sources: federal grants, state opioid response programs, opioid settlement funds, and Medicaid reimbursement, analyzing how these resources support the continuum of care, including prevention, harm reduction, treatment, recovery, and long-term stabilization.
The analysis finds that, unlike Kentucky overall where opioid settlement funding is primarily focused on treatment and recovery, the Big Sandy Area Development District places greater emphasis on prevention efforts. Differences in regional funding priorities, combined with limited reporting and transparency, make it difficult to assess whether resources are effectively addressing local needs. The study recommends improved coordination, standardized reporting, greater transparency, and outcome-based performance measures to strengthen accountability and public health outcomes.
Recommended Citation
McCarty, Hayley M., "Allocation and Governance of Opioid Response Funding in Rural Kentucky: A Case Study of the Big Sandy Area Development District" (2026). MPA/MPP/MPFM Capstone Projects. 487.
https://uknowledge.uky.edu/mpampp_etds/487
