Title
Receive an updated response to Board Referral No. 2022.26 seeking to devise a comprehensive program for providing treatment and other services to local communities utilizing the opioid settlement dollars designated for all Monterey County local governments.
Report
RECOMMENDATION:
It is recommended that the Board of Supervisors:
Receive an updated response to Board Referral No. 2021.16 seeking to devise a comprehensive program for providing treatment and other services to local communities utilizing the opioid settlement dollars designated for all Monterey County local governments.
SUMMARY/DISCUSSION:
On November 22, 2022, Board Referral No. 2022.26 was assigned to the Health Department in anticipation of receipt of National Opioid Settlement Funds to assure there is a comprehensive plan developed for expenditure in accordance with allowable uses included in the Settlement Agreements entered with settling defendants. The largest of these settlement funds are with the “Big 3” opioid distributor defendants-McKesson, Amerisource Bergen, and Cardinal Health-and opioid manufacturer defendant Janssen/Johnson & Johnson. The County of Monterey and most of the eligible cities within the County will be receiving a direct allocation to support implementation of strategies and activities in the areas of prevention, treatment and other strategies including education of first responders; efforts to provide leadership, planning, and coordination; training; and research.
The Health Department is tasked with developing a Comprehensive Strategy and Plan to address opioid misuse and impact on our county residents and systems. Department staff met with representatives from Monterey County Prescribe Safe Coalition to discuss opportunities for investment based on data trends, current services and interventions available in our community, and other available funding opportunities. Additionally, initial discussions with personnel from cities eligible to receive direct allocation were held. Cities with populations over 10,000 are eligible for funding and include City of King, City of Marina, City of Monterey, City of Soledad, and City of Salinas and the City of Greenfield, all of whom elected to receive direct allocation, except for City of Greenfield, which opted to have its allocation directed to the County.
The County received $1.26 million in funding (“Big 3” opioid distributors’ Years 1 and 2 disbursements) during the months of November and December and anticipates receiving annual disbursements with declining amounts in out years for a total of 18 years. The County also received $730,000 (opioid manufacturer’s Years 1 and 2 disbursement) in the month of February and expects to receive annual disbursements of lower amounts for another seven years.
Based on initial discussions held with stakeholders, there is a need to invest initial funds in strategies focused on prevention including education of youth and families, development of a community distribution program for Naloxone, and media campaign, and delivery of treatment services in the community for our homeless residents.
PROPOSED STRATEGY/ INITIAL ANNUAL FUNDING AMOUNT (Up to Amount)
Youth and Family Education: $50,000
Expansion of tri-County “Let’s Talk” Campaign in partnership with Monterey County Office of Education and Prescribe Safe with distribution of educational resources for families of 9th graders on status of substance use amongst our youth and what parents can do to help prevent use by their youth. Funding will also be used to adapt materials for families of 6th graders. Educational workshops will also be made available for families.
Media Campaign: $100,000
The County will partner with a community-based organization to develop a media campaign focused on educating youth about dangers of using substances in hopes of preventing use of substances. The County will work with local media outlets to air campaign.
Development of a “Naloxone Now Monterey” Program: $40,000
Model after San Luis Obispo’s Program that provides free mail-delivery Naloxone kits to residents.
Continuation of Substance Use Response Team Efforts: $500,000
Multi-disciplinary team that will conduct outreach and engagement services with homeless individuals experiencing a substance use disorder and in need of treatment services in the field. DHCS Behavioral Health Justice Intervention Services funding for this effort is set to end in the coming months. These funds will sustain current level of service and expand services in the city of Salinas and south county cities.
Coordination of Efforts: $95,000
The Health Department will hire a 0.50 FTE Management Analyst II to coordinate and present on Opioid prevention and mitigation efforts; develop and manage Service Agreements; and comply with mandatory reporting requirements under Settlement Agreements.
Other Strategies to be Developed: $200,000
The level of Settlement funding may be insufficient in meeting the needs of the community to combat the impacts from opioid misuse on individuals, families, the community and service providers. The County will continue to meet with stakeholders to refine and expand strategies to be recommended for prioritization for expenditure using County Opioid Settlement funds. The Health Department will present the resulting Agreements for services for the Board’s consideration for approval in the coming months. Prospectively, the Health Department proposes to provide bi-annual Opioid Program updates to the Board’s Health, Housing, and Human Services Committee and annually to the Board of Supervisors.
This work supports the Monterey County Health Department 2018-2022 Strategic Plan initiatives: 1) Empower the community to improve health through programs, policies, and activities; and 2) Enhance community health and safety by emphasizing prevention; and 3) Ensure access to culturally and linguistically appropriate, customer-friendly quality health services. It also supports several of the ten essential public health services, specifically: 3) Inform, educate, and employer people about health issues, 4) Mobilize community partnerships and action to identify and solve health problems.
OTHER AGENCY INVOLVEMENT:
The Health Department staff will continue to have discussions with representatives from Monterey County Prescribe Safe; education system; community-based organizations; and cities of King, Greenfield, Soledad, Salinas, Marina, and Monterey to further refine strategies to be funded with settlement funds.
FINANCING:
There is no impact to the County General Fund with receipt of this report. As of publishing of this report, the County was in receipt of disbursements for Years 1 and 2 from settlements with the “Big 3” opioid manufacturers and opioid distributor, approximately $1.26 million and $730,000, respectively. These funds are deposited into a separate balance sheet account for ease in tracking and reporting expenditures.
BOARD OF SUPERVISORS STRATEGIC INITIATIVES:
Check the related Board of Supervisors Strategic Initiatives:
☐Economic Development:
• Through collaboration, strengthen economic development to ensure a diversified and healthy economy.
☐Administration:
• Promote an organization that practices efficient and effective resource management and is recognized for responsiveness, strong customer orientation, accountability and transparency.
☒Health & Human Services:
• Improve health and quality of life through County supported policies, programs, and services; promoting access to equitable opportunities for healthy choices and healthy environments in collaboration with communities.
☐Infrastructure:
• Plan and develop a sustainable, physical infrastructure that improves the quality of life for County residents and supports economic development results.
☐Public Safety:
• Create a safe environment for people to achieve their potential, leading businesses and communities to thrive and grow by reducing violent crimes as well as crimes in general.
Prepared and Approved by:
Elsa Mendoza Jimenez, Director of Health Services, x4526
Attachments:
Board Report
Referral No. 2022.26