SUBJECT
PARTNERING WITH THETitleCITY OF SAN DIEGO THROUGH A REVENUE AGREEMENT TO UTILIZE OPIOID SETTLEMENT FUNDS FOR OVERDOSE PREVENTION AND NALOXONE PUBLIC MESSAGING AND AWARENESS (DISTRICTS: ALL)
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OVERVIEW
In October of 2022, the Board of Supervisors approved a framework to combat and address the growing opioid and fentanyl crisis in the region. The framework was developed after a series of convenings with regional stakeholders and experts who provided guidance on the expenditure of approximately $100 million of anticipated opioid settlement funding. In December of 2022, City of San Diego Councilmembers Marni von Wilpert and Raul Campillo also engaged City Council and staff to develop solutions to address the opioid and fentanyl crisis in the City of San Diego (City).
Rates of overdose deaths involving illicit fentanyl and fentanyl analogs have increased dramatically over the last several years. According to the Medical Examiner’s Office, the number of accidental fentanyl overdose deaths increased by over 2,300% Countywide, from 33 deaths in 2016 to 815 deaths in 2022. Of the 815 fentanyl-related overdose deaths occurring in the County in 2022, 410 or over 50% of those deaths were due to an overdose event that occurred within the City. These fentanyl-related overdose fatalities in the City represent a rate of approximately 29.7 per 100,000 individuals in the City.
The City of San Diego, along with other jurisdictions in the region, partner with the County to provide essential health services, including public health, medical care, mental health for individual with serious mental illness, and substance use treatment services. The County’s efforts to combat the opioid and fentanyl crisis have a significant effect on regional outcomes, including within the City.
To bolster efforts within the City, I recommend strengthening the County’s partnership with the City by establishing a revenue agreement and authorizing the transfer and acceptance of approximately $1.0 million in Opioid Settlement Funds from the City to the County to support multi-media public messaging and awareness efforts specific for opioid overdose prevention and naloxone awareness within the City. This funding will be instrumental in supporting the County's region-wide efforts to combat opioid misuse and its associated impacts on public health and safety. Accepting these funds will enable the County to further expand its initiatives aimed at prevention, treatment, and recovery support for individuals affected by opioid addiction.
RECOMMENDATION(S)
SUPERVISOR JOEL ANDERSON
1. In accordance with Board Policy B-29, authorize the Agency Director, Health and Human Services Agency or designee to execute a revenue agreement with the City of San Diego for $1.0 million of Opioid Settlement Funds to support multi-media public messaging and awareness efforts for overdose prevention and naloxone awareness. Opioid Settlement Funds from the City will be transferred to the County by June 30, 2024, to be utilized by June 30, 2025.
2. Authorize the Agency Director, Health and Human Services Agency or designee to execute all revenue agreement related documents including any extensions, amendments and/or revisions thereto that do not materially impact or alter the services or funding level.
EQUITY IMPACT STATEMENT
Strengthening our partnership with the City of San Diego by bolstering public health messaging will help to ensure equitable access to information for individuals and communities impacted by opioid addiction across the County of San Diego, regardless of socioeconomic status or geographic location.
SUSTAINABILITY IMPACT STATEMENT
By amplifying public health communication in the City of San Diego and the region at large, channeling opioid settlement funds into broad awareness initiatives to tackle opioid use will significantly enhance the well-being of residents. Heightened awareness of the impacts of opioid and fentanyl use is expected to play a pivotal role in reducing the consumption of detrimental opioid substances and reduce associated deaths in the region.
FISCAL IMPACT
Funds for this request are not included in the Fiscal Year (FY) 2024-25 CAO Recommended Operational Plan for the Health & Human Services Agency, but will be included in the FY 2024-25 CAO Recommended Operational Plan Change Letter in the Health & Human Services Agency. If approved, this will result in one-time costs and revenue of $1.0 million to support multi-media public messaging and awareness efforts for overdose prevention and naloxone awareness in FY 2024-25. The funding source will be Opioid Settlement Funds transferred from the City of San Diego. There will be no change in net General Fund cost and no additional staff years.
BUSINESS IMPACT STATEMENT
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ADVISORY BOARD STATEMENT
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BACKGROUND
In 2019, the City of San Diego (City) joined jurisdictions nationwide in filing suit against Purdue Pharma and other manufacturers and distributors of prescription opioids. Settlement agreements were reached in 2021 with major pharmaceutical distributors and manufacturers, including Janssen Pharmaceuticals and Johnson & Johnson, who are expected to provide the city with $40 million over 18 years.
In October 2023, the City Council held an Opioid Crisis Response Roundtable meeting, signaling the City's intent to allocate the first settlement funds from opioid manufacturers. The purpose of the roundtable meeting was to gather input from regional stakeholders and experts to determine the most effective use of these critical funds. Subsequently, as the Public Safety Chair, Councilmember Marni von Wilpert engaged the County to partner on initiatives on the opioid front that were already being implemented in our respective jurisdiction, particularly the County’s awareness campaign. With opioid-related deaths on the rise, including a staggering 2,300% increase in accidental overdose deaths in the City since 2016, urgent action is needed to join forces to combat this public health crisis.
To support opioid abatement activities, the City received Opioid Settlement Funds (OSF) from the State. Through a collaborative partnership and a formal revenue agreement, the City will transfer $1.0 million of OSF to the County to help address the devastating impact of opioid addiction on communities within the City. The County will utilize the OSF to support collaborative efforts to prevent opioid misuse, including activities such as multi-media public messaging and awareness efforts for opioid overdose prevention and naloxone awareness with the goal of educating the public.
Public health messaging that promotes awareness and access to information about opioid misuse and treatment resources and is responsive to the community is vital to address the stigma and empower individuals impacted by substance use to seek and engage in available services and practice healthy behaviors. The County of San Diego’s Opioid Settlement Framework, which was adopted by the Board of Supervisors on October 25, 2022 (20) and provided additional direction on October 10, 2023 (13), supports outreach and education efforts through community informed public messaging and materials aimed at enhancing community awareness of the harms associated with opioid misuse, overdose prevention, and the availability of community resources. In addition, activities supported by Opioid Settlement Funds have been aimed at engaging parents, family members, schools, community organizations and businesses through ongoing public health messaging campaigns and targeted community naloxone distribution events.
These efforts have offered opportunities to further enhance community members’ understanding of substance use and available treatment resources. Furthermore, public messaging and education efforts have helped to reduce stigma and draw support for behavioral health interventions which can normalize conversations about behavioral health needs, empower individuals to be advocates and allies, and help drive change.
I am, therefore, recommending that that the County accept approximately $1.0 million from the City of San Diego today to help fund our efforts to combat the opioid and fentanyl crisis throughout the San Diego region.
LINKAGE TO THE COUNTY OF SAN DIEGO STRATEGIC PLAN
Accepting the opioid settlement funds from the City of San Diego aligns with the goals and objectives outlined in the County of San Diego's 2024-2029 Strategic Plan. By prioritizing awareness and prevention efforts, we demonstrate our commitment to improving the quality of life for all residents and creating a healthier, more resilient community.
Respectfully submitted,
JOEL ANDERSON
Supervisor, Second District
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