Title
Health and Human Services Agency (HHSA) recommending the Board:
1) Receive a presentation on HHSA's proposed Opioid Settlement Funds Utilization Strategic Framework for the disbursement of Opioid Settlement funds in El Dorado County; and
2) Provide direction to staff on the proposed Framework as follows:
a) Accept HHSA’s Strategic Framework of approach as presented; or
b) Recommend changes to the Strategic Framework before HHSA moves forward with the ongoing procurements for opioid remediation in the County; or
c) Provide alternative direction to HHSA for the use of these funds.
FUNDING: Funding is settlement money disbursed to California counties and other involved parties from manufacturers, distributors, and other entities related to the opioid epidemic.
Body
DISCUSSION / BACKGROUND:
The opioid overdose epidemic is a major public health crisis that has impacted nearly every region and demographic group in the United States (US). According to research published by the Centers for Disease Control and Prevention (CDC), the number of drug overdose deaths increased more than 16% from 2020 to 2021, with CDC reporting that 75% of the nearly 107,000 drug overdose deaths in 2021 involved an opioid. While the rise in opioid deaths can be attributed to more than one factor, CDC determined that the increased prescription of opioids directly contributed to increased overdose deaths involving prescription opioids.
Consequently, state, local, and tribal governments brought lawsuits against pharmaceutical and drug distribution alleging drug manufacturers and distributors improperly marketed and distributed opioids across the US, leading to the deaths of hundreds of thousands of Americans. Beginning in 2021, lawsuits were settled for large amounts, with the funding settlements to provide substantial funds to county and city governments for the abatement of the opioid epidemic. These settlements were awarded at up to $26 billion in total, in which the State of California (State) is expected to receive approximately $2.5 billion which will be paid through 2038.
The County of El Dorado joined in several national class action lawsuits against manufacturers, distributors, and other entities found responsible for actions contributing to the opioid epidemic. These lawsuits were settled with monies scheduled for distribution to local jurisdictions, including El Dorado County, through BrownGreer PLC with the California Department of Health Care Services (DHCS) acting as the oversight and monitoring agency pursuant to the California State Subdivision Agreements and Government Code, Title 2, Division 3, Part 2, Chapter 6, Article 2, Section 12534. As part of the settlement agreements from these lawsuits, opioid settlement funds must be utilized towards certain specified allowable expenses to mitigate the effects of substance abuse within each community.
In this agenda item, HHSA is presenting its proposed Strategic Framework to guide distribution of Opioid Settlement funds in the County. Subsequently, the Board is being asked to provide direction regarding this proposal and either approve the Strategic Framework as presented or provide alternative guidance on the desired use of Opioid Settlement funds within the County.
The proposed expenditure plan for the Opioid Settlement funding was guided by DHCS’ requirements that at least 50% of these funds must be spent on High Impact Abatement Activities (HIAA). This proposed Strategic Framework compares these activities to several measures of local input and selects four which appear best suited for effectiveness in El Dorado County. Proposed services provided through this Opioid Settlement funding will include infrastructure, treatment, prevention, education and similar resources designed to combat the national opioid epidemic using locally approved, non-invasive, demonstrated effective intervention strategies. These services are designed to increase public awareness and understanding of the Opioid Crisis within the community, reduce addiction, and improve recovery and prevention services designed to combat the opioid crisis.
The highest priority identified across sources is to expand substance use disorder (SUD) infrastructure in the community with an overarching goal of increasing residential treatment resources available to residents in El Dorado County. This is followed by a focus on preventative services including: a) distribution and training in naloxone, an opioid antagonist used for the emergency treatment of known or suspected opioid overdose; b) distribution of test materials for fentanyl and other opioid elements; and c) preventative education for general practice prescribers and community members. Expansion and support for youth services and prevention is also rated as an important area of focus across all reporting sources, as an essential early intervention strategy. Lastly, Medication Assisted Treatment (MAT) as a primary intervention strategy for outpatient treatment is a critical element of the constellation of supportive services necessary in this Strategic Framework.
ALTERNATIVES:
The Board may choose not to provide direction to staff for the Opioid Settlement Funds Utilization Strategic Framework at this time. Should the Board decline to provide direction on this Framework, HHSA would need to come up with alternatives that meet the DHCS settlement agreement requirements for abatement of the opioid epidemic and would most likely move forward with a competitive procurement process to distribute these funds to meet DHCS requirements.
PRIOR BOARD ACTION:
05/21/24, 24-0258, HHSA Opioid Settlement Funding Out Agreements
OTHER DEPARTMENT / AGENCY INVOLVEMENT:
N/A
CAO RECOMMENDATION:
Approve the framework as provided.
FINANCIAL IMPACT:
There is no General Fund Cost associated with this agenda item. Any resulting Opioid Prevention agreements that are generated through the Board’s approval of this proposed Framework will be funded entirely by the California DHCS Opioid Settlement Disbursement Fund.
CLERK OF THE BOARD FOLLOW UP ACTIONS
N/A
STRATEGIC PLAN COMPONENT:
N/A
CONTACT
Olivia Byron-Cooper, MPH, Director, Health and Human Services Agency