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Health and Human Services Agency (HHSA) recommending the Board:
1) Approve and authorize the Chair to sign Memorandum of Understanding (MOU) 9114 with the City of Placerville (City), authorizing the acceptance and transfer of City Opioid Settlement Agreement funds to the County in the estimated amount of $522,387, with a perpetual term effective upon execution, that is anticipated to cover an 18-year period, for the delivery of opioid remediation services to El Dorado County residents in need; and
2) Authorize the HHSA Director or Chief Assistant Director to execute amendments relating to MOU 9114, contingent upon approval by County Counsel, which do not increase Net County Cost.
FUNDING: 100% State California Department of Health Care Services Opioid Settlement Disbursement Fund awarded to City of Placerville.
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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 (U.S.). According to research published by the Centers for Disease Control and Prevention (CDC), from 1999-2021, nearly 645,000 people died from an overdose involving an opioid, which included overdose deaths caused from prescription and illicit opioids. Consequently, state, local, and tribal governments brought lawsuits against pharmaceutical and drug distribution companies alleging drug manufacturers and suppliers 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. Within the State, DHCS was tasked with overseeing local county and city government opioid settlements.
In early 2023, the County and City began receiving opioid settlement funding from DHCS. DHCS, as the funding administrator, stipulated that the opioid settlement funds must be spent on opioid remediation activities, and outlined that allowable services include activities tied to the ending, reduction, or lessening the effects of the opioid epidemic in communities and include prevention, intervention, harm reduction, treatment, and recovery services.
On January 9, 2024, the City of Placerville’s City Council adopted Resolution 92-70 authorizing their City Manager to negotiate and enter an MOU with the County of El Dorado (County) and to take all actions necessary to transfer existing and future awarded City Opioid Settlement Agreement Funds to the County. As a result of this action, the City issued MOU 9114 to the County which transfers City settlement funds to the County and defines the responsibilities of both parties. As outlined in this MOU, the County agrees to accept the Opioid Settlement Agreement funding from the City in an estimated amount of $522,387 over an anticipated 18-year period and agrees to implement and use the opioid abatement funds in accordance with the approved settlement agreements. Further, the County agrees to prepare and submit all auditing, accounting, and reporting required by the approved Settlement Agreements on the City's behalf and to share such reports with the City.
As approved by the Board on May 21, 2024, HHSA has contracted with four local community providers, the County Probation Department, and El Dorado County Sheriff’s Office (EDSO) 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 (Legistar file 24-0258).
Should the Board accept this funding, in alignment with the Opioid Settlement Utilization Strategic Framework approved by the Board on September 10, 2024, HHSA intends to utilize these Opioid Settlement Funds to further enhance opioid abatement services provided in El Dorado County (Legistar file 24-1189). HHSA plans to utilize an informal bidding process to identify future qualified providers to subaward this funding to provide enhanced opioid remediation services within the community. The anticipated outcomes of sub-awarding this funding include the remediation and abatement of opioid use in El Dorado County.
ALTERNATIVES:
Should the Board decline to approve this recommendation, the County will not accept the City’s Settlement Agreement funding and would not increase opioid abatement services beyond what the County’s Board-accepted Opioid Settlement funding allocations allow.
PRIOR BOARD ACTION:
1) 05/21/24, 24-0258, HHSA Opioid Settlement Funding Out Agreements
2) 09/10/24, 24-1189, HHSA Opioid Settlement Funds Utilization Strategic Framework
OTHER DEPARTMENT / AGENCY INVOLVEMENT:
County Counsel, and City of Placerville.
CAO RECOMMENDATION:
Approve as recommended.
FINANCIAL IMPACT:
There is no General Fund Cost associated with this agenda item as the funding would be revenue accepted into the County, funded entirely by the California DHCS Opioid Settlement Disbursement Fund. Sufficient appropriations have been included in the Fiscal Year 2024-25 Budget and will be included in future budgets for the term of the MOU.
CLERK OF THE BOARD FOLLOW UP ACTIONS:
Clerk of the Board to obtain signature of Chair on the original MOU 9114.
STRATEGIC PLAN COMPONENT:
N/A
CONTACT:
Olivia Byron-Cooper, MPH, Director, Health and Human Services Agency