Bloomberg's $150 Million Overdose Bet Adds Washington and Leaves Pennsylvania and Michigan. There Is No Application.

At the ninth annual Bloomberg American Health Summit in Baltimore on October 20, 2026, Michael Bloomberg announced a new $150 million commitment to Bloomberg Philanthropies' Overdose Prevention Initiative. The money extends the initiative to Washington state, continues it in Kentucky, New Jersey, New Mexico, North Carolina and Wisconsin, and ends work in Pennsylvania and Michigan, the two states where it started in 2018.

With this round, the foundation's overdose prevention spending reaches $335 million since 2018. The stated goal for the six states is that opioid use disorder treatment "will soon reach all incarcerated individuals and every hospital emergency department."

For nonprofits, health systems, jails and county health departments, the first question is whether they can apply. The answer is no, at least not in the usual sense. Bloomberg's overdose work is not an open grant program. It runs through partnerships with state governments and a small group of national technical partners. But the money will still shape which programs get built, staffed and sustained in six states over the next few years, and organizations there can position themselves to benefit.

How the initiative has grown

The 2018 and 2021 figures add up to $170 million. Adding the new $150 million gives $320 million, so the reported $335 million total implies about $15 million in other overdose-related spending between rounds. The foundation has not itemized it.

What has not changed is the model. Bloomberg picks a small number of states, embeds technical assistance with state agencies, funds national partners to provide expertise, and pushes for policy and system changes such as Medicaid coverage, prison treatment protocols, naloxone distribution rules and emergency department buprenorphine programs. These changes are meant to outlast the grant. That is why the foundation describes Pennsylvania and Michigan as states that have "built infrastructure to sustain progress on their own," not as states it is abandoning.

What eight years produced

Coverage of the announcement cited these results:

• Pennsylvania: all 24 state prisons now provide buprenorphine.
• New Jersey and Wisconsin: all state prisons provide medications for opioid use disorder (MOUD).
• New Jersey, Michigan and Pennsylvania: more than 75% of hospital emergency departments provide MOUD, up from an average of 28%.
• Michigan: an online portal lets community organizations order naloxone by mail and distribute it without individual prescriptions. Gov. Gretchen Whitmer credits it with helping prevent thousands of overdose deaths.
• Kentucky: Medicaid-covered treatment expanded for postpartum parents.
• New Mexico: expanded access to fentanyl test strips.
• Opioid settlement guidance: the foundation says it helped more than half of U.S. states adopt evidence-based guidelines for spending opioid settlement money.
• Outcomes: in 2024, overdose deaths in the initiative's focus states fell nearly 15% more than the national average. As one outlet noted, that comparison does not establish how much of the decline the funding caused.

The two settings the new money targets, jails and prisons and hospital emergency departments, were chosen deliberately. Both are places where people with opioid use disorder show up in crisis and where medication can be started immediately. The announcement cited a Washington state study that found people leaving prison had 129 times the general population's risk of overdose death in their first two weeks after release. That study dates to 2007, but the risk it describes is why jail-based MOUD has become a policy priority across the country.

Why Washington, and what "every jail" means there

Washington has one of the highest overdose death rates in the country even after recent improvement. It is a different kind of target from the original states. Its corrections and public health systems are relatively decentralized, and county jails, not just state prisons, hold most people in short-term custody. Getting MOUD to "all incarcerated individuals" in Washington means working with dozens of county jail systems that set their own medical contracts and budgets.

The same is true in the continuing states. New Jersey and Wisconsin already have MOUD in every state prison. The remaining gap is local jails, where stays are short, medical care is often outsourced to private contractors, and continuity of care at release is weak. If the goal really is "all incarcerated individuals," the next phase is mostly a county jail story.

For emergency departments, the gap is in the remaining hospitals that do not start buprenorphine in the ED and in the handoff from ED to ongoing treatment, the "bridge clinic" problem.

How organizations can engage when there is no RFP

Bloomberg does not publish an application for this initiative, and cold proposals to the foundation are unlikely to succeed. But the money tends to flow outward in predictable ways.

1. Follow the state agency, not the foundation. In each initiative state, the work is coordinated with the governor's office, the state health department and the corrections and Medicaid agencies. When those agencies launch jail MOUD expansions, ED bridge programs or naloxone distribution networks, they often issue state RFPs, subgrants or contracts, sometimes funded with opioid settlement money rather than Bloomberg dollars. Watch state procurement and health department funding pages in Washington, Kentucky, New Jersey, New Mexico, North Carolina and Wisconsin for the next 12 to 24 months.

2. Treat opioid settlement funds as the main pool. Bloomberg's grants are small next to the opioid settlements, which total more than $50 billion nationally over roughly two decades. Much of that flows to counties and cities. The initiative's influence on how states spend settlement money is arguably its biggest lever. Counties in the six states that adopt the evidence-based guidelines it promotes will favor exactly the programs the initiative champions: MOUD in jails, ED-initiated treatment, naloxone distribution, and post-release linkage. If you run one of those programs, your settlement-fund application should use the same evidence language and outcome measures.

3. Position as the implementation partner. When a state commits to MOUD in every county jail, someone has to deliver it: community health centers, opioid treatment programs, telehealth prescribers, peer recovery organizations and reentry nonprofits. Organizations that can show data-sharing agreements with a jail, a prescribing workforce, and a release-to-community handoff protocol are the ones that win the downstream contracts. Build those agreements now.

4. Hospitals: document your ED baseline. If your emergency department does not yet start buprenorphine, you will likely be a target for state technical assistance. If it does, you are a candidate to mentor peers or host a regional bridge clinic. Either way, have your current MOUD initiation numbers ready.

5. Plan for the federal backdrop. At the summit, Maryland Gov. Wes Moore warned that federal funding cuts and Medicaid changes will put pressure on health services. Medicaid pays for most MOUD in many states, so any eligibility or work-requirement changes could undercut the pipeline that philanthropic system-building relies on. Applicants to state and settlement funds should show how their programs will hold up if Medicaid enrollment drops. Sustainability plans that assume flat coverage will look naive to reviewers.

For Pennsylvania and Michigan organizations

The exit matters even though the infrastructure stays. Technical assistance positions and partner-funded staff in state agencies may wind down over the coming months. Pennsylvania Gov. Josh Shapiro pledged to continue the work, but pledges become budget lines only through the appropriations process. Organizations whose programs relied on initiative-supported state staff should do three things:

• Find out which state agency is taking over each function and who the new contact is.
• Make settlement-fund applications at the county level the main sustainability strategy.
• Use the initiative's published results, such as all 24 prisons offering buprenorphine and more than 75% of EDs providing MOUD, as baseline evidence in grant narratives. Those numbers are now public benchmarks that funders will recognize.

What it signals for philanthropy

Two features of this commitment are worth noting for anyone tracking foundation strategy.

First, Bloomberg exited states on purpose. Large foundations rarely announce an end to work in a place, and when they do it is usually framed as a funding cut. Here the exit is presented as success: the systems are built and the states can run them. Whether that holds in Pennsylvania and Michigan over the next three years will be a useful test of the "build infrastructure, then leave" model.

Second, the commitment is narrow on purpose. Two settings, six states, one class of medication. Bloomberg Philanthropies distributed $4.3 billion in 2025 across public health, education, the environment, the arts and government innovation. That it chose to concentrate this round rather than spread it across more states reflects a bet that full coverage in a few places is more valuable, and easier to prove, than partial coverage in many.

For nonprofits outside the six states, the practical takeaway is the playbook, not the money. Jail MOUD, ED-initiated treatment and settlement-fund guidance now have eight years of evidence behind them. That is a strong basis for a settlement-fund or SAMHSA application anywhere.

Related reading

For federal overdose funding, see our analysis of SAMHSA's August 2026 overdose prevention awards. For Bloomberg's other recent place-based commitment, see our coverage of the 30 City Halls housing initiative.

If you are drafting an opioid settlement application or a state subgrant proposal for jail-based or ED-initiated treatment, Granted can help you build the evidence base and sustainability plan reviewers will look for.

Sources: Inside Philanthropy, "Philanthropy News, Oct. 20, 2026"; Lifestyles Magazine, "$150 million latest effort from Mike Bloomberg will expand overdose prevention initiative," October 2026; NJ.com via Yahoo News, "New $150M investment targets opioid crisis in N.J., 5 other states," October 21, 2026; Bloomberg Philanthropies press materials (2018, 2021, 2026).