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Health and Human Services Agency (HHSA) recommending the Board:
1) Approve the allocation of Opioid Settlement Funding from HHSA for Opioid Remediation services to the following County departments:
a) El Dorado County Sheriff’s Office in the amount $606,000 for the period of July 1, 2026, through June 30, 2029, as outlined in Agreement 10109; and
b) Public Defender and District Attorney’s Office in the amount of $972,627 for Opioid Remediation services, for the term of July 1, 2026, through June 30, 2029, as outlined in Agreement 10110;
2) Make findings that the provision of Opioid Remediation services provided by the El Dorado Community Health Center, Marshall Medical Center, and Tahoe Alliance for Safe Kids (TASK) are in the public's best interest and that due to the limited timeframes, temporary or occasional nature, or schedule for the project or scope of work, the ongoing aggregate of work to be performed is not sufficient to warrant addition of permanent staff in accordance with El Dorado County Ordinance Code, Chapter 3.13.030(C), El Dorado County Charter, Section 210(c)(6);
3) Approve and authorize the Chair to sign Funding Out Agreement 10108 with the El Dorado Community Health Center, in the amount of $1,050,000, and for the term of July 1, 2026, through June 30, 2029;
4) Approve and authorize the Chair to sign Funding Out Agreement 10111 with Marshall Medical Center, in the amount of $750,000, and for the term of July 1, 2026, through June 30, 2029;
65) Approve and authorize the Chair to sign Funding Out Agreement 10112 with Tahoe Alliance for Safe Kids, in the amount of $248,700, and for the term of July 1, 2026, through June 30, 2029;
76) Authorize the Purchasing Agent to execute amendments relating to Funding Out Agreements 10108, 10111, and 10112, contingent upon approval by County Counsel and Risk Management, which do not increase the maximum dollar amount or term of the agreements; and
87) Authorize the HHSA Director, Chief Assistant Director, or Behavioral Health Director, to execute programmatic, administrative, and fiscal documents relating to Funding Out Agreements 10108, 10111, and 10112.
FUNDING: 100% State California Department of Health Care Services Opioid Settlement Disbursement Fund.
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DISCUSSION / BACKGROUND:
The opioid epidemic has become a major U.S. public health crisis, causing nearly 645,000 opioid-related deaths from 1999 to 2021. In 2021, overdose deaths were more than six times higher than in 1999, with opioids involved in 75% of the nearly 107,000 deaths. Increased opioid prescribing played a key role in this rise. State, local, and tribal governments sued drug manufacturers and distributors for improper marketing and distribution practices that contributed to the epidemic. Starting in 2021, nationwide settlements totaling up to $26 billion were reached. California will receive about $2.5 billion through 2038 to support opioid abatement efforts.
The County joined several national class action lawsuits against companies contributing to the opioid epidemic. Settlement funds from these cases were distributed to local jurisdictions, including the County, through BrownGreer PLC, with DHCS providing oversight as required by state law. These funds must be used for approved activities that address and reduce the impacts of substance use. On September 10, 2024, the Board approved HHSA’s Strategic Framework for using the County’s OSF (Legistar file 24-1189). Under DHCS requirements, at least 50% of OSF must support High Impact Abatement Activities (HIAA), such as treatment, prevention, education, and related infrastructure. The County plans to contract with various organizations to provide these HIAA services.
On June 16, 2025, Procurement and Contracts, a Division of the Chief Administrative Office (CAO), posted a Countywide Request for Qualifications (RFQ) No. 2025-0129 to competitively procure opioid remediation services. On October 10, 2025, the County District Attorney’s Office in conjunction with the Public Defender, El Dorado Community Health Center, Marshall Medical Center, and TASK, were published to the resulting Qualified List, based on the competitive evaluation process. El Dorado Sheriff’s Office (EDSO) was awarded funding based on their specialized involvement with local school districts in providing education to children about personal and social consequences of substance abuse.
HHSA recommends the Board approve these allocations and Funding Out Agreements to allow these Grantees to deliver opioid abatement services to individuals with Opioid Use Disorder (OUD); vulnerable populations at risk for opioid abuse and misuse in El Dorado County; pregnant or parenting women with OUD and any co-occurring substance use or mental health conditions, and the needs of their families, including babies with Neonatal Abstinence Syndrome (NAS); unhoused individuals and families, those transitioning out of incarceration; and other populations negatively impacted by opioid use. The agreements use a standard format for consistency and flexibility in the delivery of opioid abatement activities. The funding is planned for the following uses:
- EDSO plans to use the funding to continue their Safeguarding Children through Healthy Initiatives Education Law Enforcement and Deterrence (SCHIELD) Program.
- The Public Defender and District Attorney’s Office will fund positions in both the DA and PD offices to support restorative justice and Proposition 36 collaborative courts and a “One Pill can Kill” presentation will be given to middle school and high school students to educate on the dangers of fentanyl.
- Marshall Medical Center will use the funding for their “Breaking Cycles” Program which is a program to help Proposition 36 eligible individuals break the cycle of substance use and recidivism; offer urgent, same-day to 72-hour access, mental health and Medication Assisted Treatment (MAT) services, and experienced Substance Use Navigators (SUNs) will provide case management, individual therapy, and incorporate elements from various evidence-based programs to ultimately promote recovery skills, prevent relapse, provide social support and family education.
- TASK will use the funding for youth-based prevention education through presentations, campaigns, hands-on activities, and facts and resources focused on preventing opioid and substance use, misuse and abuse.
- El Dorado Community Health Center will use the funds to integrate STEPS program into a Behavioral Health Urgent Care setting to broaden access to co-occurring SUD/MH treatment; initiate Buprenorphine treatment in the Mobile Medication Unit (MMU), allowing patients to receive remote consultations with Addiction Medication Specialists, ultimately reducing barriers for individuals who cannot visit the clinic; and partner with ACCEL/COPE for the Youth Action Counsil, a youth-led prevention and awareness group focused on community engagement and peer-driven outreach.
HHSA anticipated outcomes of these agreements will aid in the remediation and abatement of opioid use in El Dorado County.
ALTERNATIVES:
Should the Board decline to approve this recommendation, HHSA would need to come up with alternatives that meet the DHCS settlement funding requirements for eligible abatement of the opioid epidemic.
PRIOR BOARD ACTION:
09/10/24, 24-1189, HHSA Opioid Settlement Funds Utilization Strategic Framework
OTHER DEPARTMENT / AGENCY INVOLVEMENT:
CAO Procurement and Contracts, County Counsel, and Risk Management.
CAO RECOMMENDATION:
Approve as recommended.
FINANCIAL IMPACT:
There is no General Fund Cost associated with this agenda item as these agreements are funded entirely by the DHCS Opioid Settlement Disbursement Fund. Sufficient appropriations were included in the Fiscal Year 2026-27 Recommended Budget and will be included in future budgets for the terms of the Agreements.
CLERK OF THE BOARD FOLLOW UP ACTIONS:
Clerk of the Board to obtain signature of Chair on the original Funding Out Agreements 10108, 10111, and 10112.
STRATEGIC PLAN COMPONENT:
N/A
CONTACT:
Olivia Byron-Cooper, MPH, Director, Health and Human Services Agency