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Leon County
Board of County Commissioners Agenda Item#9 September 17, 2024 |
| To: | Honorable Chairman and Members of the Board |
| From: | Vincent S. Long, County Administrator |
| Title: | Opioid Litigation Settlement Funds for FY 2025 |
| Review and Approval: | Vincent S. Long, County Administrator |
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Department/Division Review and Approval: |
Ken Morris, Assistant County Administrator Shington Lamy, Assistant County Administrator |
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Lead Staff/ Project Team: |
Abigail Thomas, Director, Human Services and Community Partnerships Chad Abrams, Chief, Emergency Medical Services Teresa Broxton, Director, Intervention and Detention Alternatives Marcus West, Neighborhood Engagement and Community Partnerships Manager |
Statement of Issue:
This item seeks Board acceptance of $1,385,286 in direct opioid litigation settlement funds and funding allocated to the County through the State of Florida for FY 2025. The item also requests authorization to execute agreements with the Northwest Florida Health Network to receive and utilize the settlement funds allocated by the State for the restricted provision of substance abuse treatment services resulting from opioid abuse and the purchase of Emergency Medical Services equipment to address opioid use disorders in the community. The item also seeks Board authorization to enter into and execute agreements with DISC Village, Inc., and the Leon County Sheriff’s Office for substance abuse treatment and ancillary services for individuals with opioid and substance use disorders.
Fiscal Impact:
This item has a fiscal impact. For FY 2025, the County has been allocated directly ($220,251) and through the State of Florida ($1,165,045) a total of $1,385,286 in opioid litigation settlement funds to address opioid substance disorders in the community, strictly in accordance with the terms established by the State. A Resolution and associated Budget Amendment (Attachment #1) is provided to realize the funds into the budget.
Staff Recommendations:
Provided on the following page.
Staff Recommendation:
Option #1: Accept the $1,385,286 in direct and State of Florida-allocated opioid litigation settlement funds and authorize the County Administrator to enter into and execute agreements with Big Bend Community Based Care, LLC, doing business as Northwest Florida Health Network, and any amendments thereto, subject to legal review by the County Attorney, to utilize settlement funds for the provision of substance abuse treatment services resulting from opioid abuse and the purchase of EMS equipment to address opioid use disorders in the community.
Option #2: Approve the Resolution and associated Budget Amendment to realize the funds into the budget (Attachment #1).
Option #3: Authorize the County Administrator to enter into and execute an agreement with DISC Village, Inc., to provide substance abuse treatment and ancillary services resulting from opioid abuse, and any amendments thereto, subject to legal review by the County Attorney.
Option #4: Authorize the County Administrator to enter into and execute an agreement with the Leon County Sheriff’s Office, to provide substance abuse treatment and prevention to individuals incarcerated at the Leon County Detention Facility and to provide training on opioid prevention and misuse to youth, and any amendments thereto, subject to legal review by the County Attorney.
Report and Discussion
Background:
This item seeks Board acceptance of $1,385,286 in direct opioid litigation settlement funds and funding allocated to the County through the State of Florida (State) for FY 2025. The item also requests authorization to execute agreements with the Northwest Florida Health Network (NWFHN) to receive and utilize the settlement funds allocated by the State for the restricted provision of substance abuse treatment services resulting from opioid abuse and the purchase of Emergency Medical Services (EMS) equipment to address opioid use disorders in the community. The item also seeks Board authorization to enter into and execute agreements with DISC Village, Inc. (Disc Village) and the Leon County Sheriff’s Office (LCSO) for substance abuse treatment and ancillary services for individuals with opioid and substance use disorders.
This item advances the following FY2022-FY2026 Strategic Initiative:
This particular Strategic Initiative aligns with the Board’s Quality of Life Strategic Priority:
In 2018, the Board authorized the County’s participation in multidistrict opioid litigation against opioid manufacturers, resulting in significant settlement funds allocated to mitigate opioid impacts. On September 14, 2021, the Board approved a Memorandum of Understanding with the Attorney General to participate in settlement negotiations collectively with the State and other local governments. Based on the litigation and subsequent settlements, the Attorney General’s Office provided notification in April 2023 that the County would receive approximately $1.9 million over an 18-year period directly from opioid manufacturers and pharmaceutical companies. NWFHN notified the County in fall 2023 that the County would receive an additional $11.6 million in settlement funds through the State over an 18-year period for a total of $13.5 million. Pursuant to the settlement agreement, all proceeds are restricted to abatement and treatment of opioid use disorder and other limited uses such as mental health and substance abuse recovery and support. NWFHN is allocating the funds on behalf of the Department of Children and Families (DCF). Pursuant to Florida Statutes, NWFHN serves as the local managing entity to plan, coordinate, and contract for the delivery of community mental health and substance abuse services.
On July 10, 2023, the Board ratified actions taken at the FY 2024 Budget Workshop which included approval to utilize opioid settlement funds received directly from opioid manufacturers and pharmaceutical companies from the opioid litigation settlement to provide substance abuse treatment and ancillary services to people involved in the criminal justice system (i.e., pre-trial release, probation, etc.) in coordination with criminal justice partners over the 18-year period as part of the County ongoing commitment to reduce recidivism and manage the population in the Leon County Detention Facility (LCDF).
On April 9, 2024, the Board accepted the first year of funding from the State through NWFHN in the amount of $2,395,366 for the provision of substance abuse treatment services resulting from opioid abuse and the coordination of emergency response for individuals experiencing opioid overdose. At that time, the Board authorized the County Administrator to enter and execute an agreement with NWFHN to accept the funds and an agreement with DISC Village to utilize a portion of the funding to provide substance abuse treatment and ancillary services. The Board also approved contracting with DISC Village to provide treatment services to people involved in the criminal justice system utilizing the funding that the County receives directly from opioid manufacturers and pharmaceutical companies. Additionally, the Board approved the purchase of EMS equipment with opioid settlement funds allocated to the County specifically for the coordination of emergency response for individuals experiencing opioid overdose. This item provides an update on the FY 2024 funds expended thus far.
As detailed in the Analysis section, consistent with the permissible uses of opioid abuse, it is recommended that the County continue to contract with DISC Village to provide substance abuse treatment and ancillary services to individuals with opioid and substance use disorders. DISC Village is recognized by the State to provide substance abuse prevention and treatment services in the Big Bend Region. In addition, consistent with the County’s Strategic Initiative, it is recommended that the County contract with LCSO to provide treatment to individuals incarcerated at the LCDF with substance use disorders and to provide targeted training for school-based personnel on opioid use prevention and misuse information.
Analysis:
Update on FY 2024 Opioid Settlement Funding
The opioid overdose rate in Leon County continues to remain low compared to the State. Overall opioid overdoses in the County per 10,000 individuals have decreased from 6.36 to 4.57. Statewide overdoses per 10,000 individuals have decreased from 18.5 to 13.91. In addition, suspected opioid overdoses have decreased by 28% for the 12 months ending July 31, 2024 compared to the previous year. Statewide suspected opioid overdoses have decreased by 25% in the same period. While overdoses are trending downward, the County and its partners remain committed to addressing the needs of individuals with opioid and substance use disorder by providing treatment and ancillary services to further reduce the impact in the community. To support this work, the County allocated $2,395,366 in FY 2024, which included $1,520,366 for the provision of substance abuse treatment services resulting from opioid abuse and $875,00 for the purchase of EMS equipment to address opioid use disorder.
As directed by the Board, the County contracted with DISC Village for treatment of substance use disorders through medication-assisted treatment (MAT), counseling, prevention, and support services, including peer support groups, recovery coaching, access to housing, job training, and educational resources. DISC Village is a not-for-profit agency recognized by the State to provide substance abuse prevention and treatment services in the Big Bend Region. DISC Village is also recognized by the State as a certified Substance Abuse Treatment provider, is the only local provider of MAT, and currently contracts with NWFHN to provide services throughout the Big Bend Region.
MAT is the use of medications in combination with counseling and behavioral therapies, which the U.S. Food and Drug Administration has reported is effective in the treatment of opioid use disorders and can assist in long-term recovery. Thus far, DISC Village has provided 1,760 sessions of MAT medical services to approximately 150 Leon County residents. Additionally, DISC provided approximately 130 outpatient group and individual counseling sessions and referred at least 18 individuals, who required higher levels of care or more intensive interventions, to detox or intensive outpatient services. Also, as part of the Board’s direction, the County in partnership with criminal justice partners will launch substance abuse services through DISC Village in fall 2024 to individuals involved in the criminal justice system (i.e., pre-trial release, probation, etc.). These services will include detailed substance abuse evaluations, MAT, counseling, prevention, and other support services.
In addition, the Board allocated $875,000 provided specifically to the County for the coordination of emergency response related to opioid overdoses to upgrade EMS equipment to better respond to opioid overdose calls. The County will purchase advanced monitoring equipment for all ambulances and permitted response vehicles. This equipment will be capable of monitoring vital signs, recording 12- and 15-lead EKGs, and tracking respiratory efforts and breathing rates using end-tidal CO2 monitoring and pulse oximetry. These upgrades aim to improve patient outcomes by enabling more efficient management of opioid overdoses during critical emergencies.
In preparation for the purchase of the equipment, the County has been meeting with Tallahassee Memorial Healthcare and HCA Florida Capital Hospital on coordinating with DISC Village to provide intermediate and long-term substance abuse treatment care for EMS patients. The goal is to ensure a warm and responsive hand off of individuals that experience opioid overdose to services and treatment to address their addiction. As presented in the next section, it is recommended that opioid settlement funding allocated by the State to the County for FY 2025 specifically for the coordination of emergency response related to opioid overdoses be utilized for continued upgrades to EMS equipment.
Recommendations for FY 2025 Opioid Settlement Funding
As mentioned earlier, for FY 2025, the County has received or been allocated $1,385,286 directly from opioid manufacturers and pharmaceutical companies ($220,251) and through the State of Florida ($1,165,045). The opioid litigation settlement funds allocated to the County must be utilized to specifically address substance abuse and mental health issues resulting from opioid abuse and for coordination of emergency response related to opioid overdoses. The County must submit an implementation plan annually on the proposed use of opioid settlement funds. The County meets regularly with NWFHN to ensure proposed recommendations for the use of the opioid settlement funds are aligned with the settlement agreement. Therefore, as advised by NWFHN and based on funding restrictions, it is recommended that the County utilize the FY 2025 funding for the following:
It is recommended that the County continue to contract with DISC Village to provide substance abuse treatment and ancillary services that would include MAT, counseling, and behavioral therapy to address opioid withdrawal, peer support and group therapy. DISC Village would also provide substance abuse treatment, as well as ancillary recovery and support services to people involved in the criminal justice system in coordination with the County and criminal justice partners. Similar to the FY 2024 Agreement, the FY 2025 Agreement would detail the anticipated number of clients to be served, the required coordination with community partners, and referral process through first responders, the Courts, and self-referrals. The County would contract up to $847,786 with Disc Village.
It is recommended that $437,500 allocated to the County specifically for the coordination of emergency response related to opioid overdoses be utilized for continued upgrade to EMS equipment and purchase advanced monitoring equipment to better respond to opioid overdose calls. This would be consistent with the action previously taken by the Board in April with the opioid settlement funds for emergency response coordination. The County will purchase approximately 27 advanced monitoring equipment with funds allocated in FY 2024 and FY 2025.
In May 2024, LCSO approached the County to discuss its participation in community-wide initiatives to combat opioid misuse. LCSO’s participation is consistent with the County’s following Strategic Initiative:
LCSO would utilize the funding to implement a 12-week outpatient-level substance use disorder treatment program in coordination with a local provider for individuals incarcerated in the LCDF, focusing on recovery and reducing recidivism. The treatment will include counseling, behavioral therapy, and educational sessions on addiction and recovery. By integrating these services within the correctional setting, the initiative seeks to prepare individuals for a successful transition back into the community and reduce the likelihood of reoffending.
In addition, LCSO would conduct targeted outreach to young men and boys utilizing opioids by training school-based personnel, including School Resource Deputies, on opioid prevention and misuse. The program would be developed in collaboration with the Council on the Status of Men and Boys (Council), a vital partner in addressing issues affecting young men in our community. The Council was established by the County and City as recommended by the Sheriff to identify and provide direct support to men and boys at the greatest risk of becoming a victim or perpetrator of violence in Leon County. By equipping educators and law enforcement with the tools and knowledge needed to effectively communicate the risks associated with opioid use, this initiative aims to reduce youth experimentation with opioids. The inclusion of the Council further strengthens this effort by providing additional support and resources to engage young people in prevention activities, fostering a community-wide approach to addressing the opioid crisis. According to NWFHN, the LCSO’s proposal aligns with the restricted use of the settlement funds. The County would contract up to $100,000 in opioid settlement funds with LCSO.
Options:
Recommendation:
Options #1, #2, #3, and #4
Attachment: