HomeMy WebLinkAboutAgenda - 09-06-2022; 6-a - Opioid Update and the Creation of an Opioid Advisory Committee 1
ORANGE COUNTY
BOARD OF COMMISSIONERS
ACTION AGENDA ITEM ABSTRACT
Meeting Date: September 6, 2022
Action Agenda
Item No. 6-a
SUBJECT: Opioid Update and Proposed Charge and Composition of the Opioid Advisory
Committee
DEPARTMENT: County Commissioners
ATTACHMENT(S): INFORMATION CONTACT:
Quintana Stewart, Orange County
Opioid Update PowerPoint Health Director, 919-245-2412
Orange County Opioid Advisory
Committee — Proposed Charge &
Composition
PURPOSE: To:
1) Receive an update on the Opioid Settlement Memorandum of Agreement (MOA) between
the State of North Carolina and local governments on proceeds relating to the settlement
of Opioid Litigation;
2) Select Option A or Option B regarding how the County will spend opioid settlement funds
on opioid remediation activities;
3) Discuss and consider a proposed charge and composition establishing the proposed
Orange County Opioid Advisory Committee; and
4) Authorize the Clerk's office to begin soliciting membership applications based on the
Committee composition so that the Board can review applications and make appointments
by the November 15, 2022.
BACKGROUND: In July 2021, a bipartisan coalition of state attorneys general announced the
National Opioid Settlement — a historic $26 billion agreement that will help bring desperately
needed help to communities harmed by the opioid epidemic. The State of North Carolina and all
100 counties, including Orange County, joined the agreement. Orange County is expected to
receive $6,799,780 over an 18-year period.
A Memorandum of Agreement between the state and local government directs how opioid
settlement funds will be distributed in the state. These funds can only be used to address the
opioid epidemic.
In follow-up to the update, the Board is asked to make a decision on whether the County will
spend opioid settlement funds on opioid remediation activities either under Option A or Option B
as detailed in the MOA.
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The Board also needs to discuss the charge and proposed membership composition of an Opioid
Advisory Committee. Staff seeks direction from the Board on:
• the appropriate entities or areas of expertise that should be represented on the Committee;
• the number of at-large residents that should serve on the Committee;
• the total number of members the Committee should include;
• whether there will be a formal application process; and
• any other details regarding the establishment of the Committee.
Assuming there is an application process, a formal determination now of the general composition
and number of members of the committee will allow the Clerk's office to begin soliciting
membership applications and should allow for a pool of candidates for the Board to review by
November 2022 and make formal appointments.
FINANCIAL IMPACT: Distribution of opioid settlement funds may support programs and services
that serve persons with Opioid Use Disorder or ay co-occurring Substance Use Disorder (SUD)
or mental health condition in Orange County.
SOCIAL JUSTICE IMPACT: The following Orange County Social Justice Goals are applicable
to this item:
• GOAL: ENSURE ECONOMIC SELF-SUFFICIENCY
The creation and preservation of infrastructure, policies, programs and funding necessary
for residents to provide shelter, food, clothing and medical care for themselves and their
dependents.
• GOAL: CREATE A SAFE COMMUNITY
The reduction of risks from vehicle/traffic accidents, childhood and senior injuries, gang
activity, substance abuse and domestic violence.
Efforts to address opioid abuse will create a safe community and ensure a community network of
basic human services and infrastructure that maintains, protects and promotes the well-being of
all residents in Orange County.
ENVIRONMENTAL IMPACT: There is no Orange County Environmental Responsibility Goal
impact associated with this item.
RECOMMENDATION(S): The Manager recommends the Board:
1) Receive an update on the Opioid Settlement Memorandum of Agreement (MOA) between
the State of North Carolina and local governments on proceeds relating to the settlement
of Opioid Litigation;
2) Select Option A or Option B regarding how the County will spend opioid settlement funds
on opioid remediation activities;
3) Discuss and consider a proposed charge and composition establishing the proposed
Orange County Opioid Advisory Committee; and
4) Authorize the Clerk's office to begin soliciting membership applications based on the
Committee composition so that the Board can review applications and make appointments
by the November 15, 2022.
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Orange County, NC
Opioid Update
September 6, 2022
Quintana Stewart, MPA
Orange County Health Director
Opioid Impact in Orange County
Deaths in Orange
The rate of overdose dent-is aniong residents of Orange r. 2021 (Annual)
was 19.5.
(Rate per 100.000 residents- Numbor of deaths. 29)
NC 35.8(Annual)
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Orange 19.5(Annuai)
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Opioid Impact in Orange County
ED Visits in Orange
The rate of overdose ED visits among residents of derange iri 2021 (Annual)
was 74.1.
(Rete per 100,000 residents_ Number of ED visits: 110)
NC 149,9
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Opioid I in Orange County
Buprenorphine in Orange
The percent of residents receiving dispensed buprenorphine perscrip ions i'�
Orange in 2021 (Annual) was 0.4..
Residents receiving buprenorphine_ Number of patients: 525)
NG 0.5(Annual)
Orange 0.4 CA...ia
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2DOG 2002 2004 2006 2006 2010 2012 2016 2016 2018 202G 2022 2024
Funding Timeline and Amount
• Total Payment for Orange County $6,799,780.00; 2022-2038
( 18 Year Period)
• We were scheduled to receive $261,245 in the "Spring" of
2022 and another $574,528 in the "Summer" of 2022.
• We have now received the initial payment of $261,245.
• The payments decline after the first year.
https://ncopioidsettlement.org/data-dashboards/payment-schedule/
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Payment Timetable
18 Year Payment to Orange during 2022-2038:
$6,799,78
Payments Over Time - Orange
ti00 r:
400K
o _Y
200K $26 475
In 0K
2023 2025 2027 2029 2031 2033 2435 2037 2039
Payment Table - Orange
vea S— ,
2022 S—;ng $261:24.5
5 um mer $574,528
2023. Sum mere-+OE
2024 Summer $548,423
2025 Summer $554,574
2026 Summer 5350,1-
2027 Summer $350,1—
2028. Summer $40EI,5E5
2029 Sum mer -1 6_='',E
2030 Sum-
203--L
ummer2031 Sum mer
2032 Sum mer
2033 Summer '$300._-=
2034 Summer
2035 Summer
2036 Summer 3=J=
2037 Sum
2035- Sum mer 3
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NC Memorandum of Agreement
• The MOA governs the allocation, use, and reporting of certain opioid settlement funds in
North Carolina.
• To comply with the MOA, a local government receiving opioid settlement funds must do
the following:
• A. Establish a fund. A local government receiving opioid settlement funds must secure them in a
special revenue fund. These funds are subject to audit and cannot be commingled with other
funds.
• B. Authorizespending. Before spending opioid settlement funds, a local government must
authorize the expenditure of such funds. This must take place through a formal budget or
resolution that includes certain details including the amount, time period, and specific strategy
funded.
• C. Understand and follow the options. A local government must spend opioid settlement funds
on opioid remediation activities authorized under Option A or Option B as detailed in the MOA.
• D. Report spending and impact. A local government that receives, spends, or holds opioid
settlement tunds during a tiscal year must file an annual financial report within 90 days of the end
of the fiscal year. (This report is required if funds are received or held, even if they are not spent.)
A local government that spends opioid settlement funds during a fiscal year must file an annual
impact report within 90 days of the end of the fiscal year.
• E. Hold annual meetin . The MOA requires that each county receiving opioid settlement funds
ho at east one annua meeting open to the public, with all municipalities in the county invited to
the meeting. The purpose of the meeting is to receive input from municipalities on proposed uses
of the opioid settlement funds and to encourage collaboration between local governments.
https://ncdoi.gov/wp-content/uploads/2022/03/NCACC-web-version-Final-Opioid-MOA-.pdf
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Option A- High- Impact Opioid Abatement Strategies
1.Collaborative Strategic Planning
2.Evidence-based addiction treatment
3.Recovery support services
4.Recovery housing support
5.Employment-related services
6.Early intervention
7.Naloxone distribution
8.Post-overdose response team
9.Syringe Service Program
10.Criminal justice diversion programs
11.Addiction treatment for incarcerated persons
12.Reentry Programs
https://www.more PowerfuInc.org/wp-content/u loads 2021 10 C-
MOA-3.pdf
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Option B- Strategic Planning
• Under Option B, a local government engages in a collaborative strategic
planning process involving adiverse array ofstakeholders an may then'
I
n a strategy from the Option A list or a longer list of
strategies included in the national settlements.
• Must report out more detail on the planning/collaborative work
• Identify engaged diverse stakeholders
• Local officials
• Healthcare providers
• Social service providers
• Education & Employment service providers
• Payers & Funders (Prepaid Health Plans, LME-MCO, Foundations, etc)
• Law Enforcement
• Employers (Business Leaders)
• Community Groups
• Community Members with "lived experience" (those with addiction, in medication-
assisted or other treatment, in recovery, in criminal justice involvement, and family
members or loved ones of those listed)
• Ensure racial, ethnic, economic and cultural diversity
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Option B- Strategic Planning
• Part 1: Treatment
• Treat Opioid Use Disorder (OUD)
• Support People in Treatment & Recovery
• Connect People who need help to the help they need (Connections to Care)
• Address the needs of criminal-justice involved persons
• Address the needs of pregnant or parenting women and their families, including babies with
neonatal abstinence syndrome
• Part 2: Prevention
• Prevent over pre-scribing and ensure appropriate prescribing and dispensing of opioids
• Prevent misuse of opioids
• Prevent overdose deaths and other harms (Harm Reduction)
• Part 3: Other Strategies
• First Responders
• Leadership, Planning & Coordination
• Training
• Research
https://www.morepowerfuInc.org/wp-content/uploads/2022/06/Exhibit-B-to-NC-MOA.pdf
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Orange County Opioid Task Force
In October 20191 Orange County Health Department and UNC Health
requested the Board's approval for a joint collaboration to build and sustain
a local task force to convene stakeholders and coordinate activities to
address the opioid epidemic.
The Task Force identified 3 priorities to initially address:
• Education;
• Reduce oversupply of prescription opioids; and
• Expand treatment and recovery oriented systems of care.
These priorities were in alignment with the State Opioid Action Plan.
With the arrival of COVID in March 20201, the group did not meet again until
January 2022.
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Proposed Orange County
Opioid Advisory Committee
With the arrival of settlement funds and the need to formalize our
work related to opioid abuse remediation, we propose the
appointment of an Opioid Advisory Committee.
Proposed Charge for the Committee
To include but not limited to the following:
• Discuss opioid-related health concerns and issues impacting the
residents of Orange County;
• Advise the Board of Commissioners on options to expend funds to
remedy opioid impacts;
• Plan and host an annual meeting open to the public to receive input
on proposed uses of the settlement funds and to encourage
collaboration between local governments.
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Proposed Orange County
Opioid ACommittee
Proposed Composition
RepresentationProcess
• Suggested engaged diverse
Orange County Resident with lived experience —At Application Process
stakeholders as listed in them
Large-2
MOA Orange County Sheriff Dept- 1 Sheriff's Designee
Hillsborough Police Dept-1 Town Designee
Chapel Hill Police Dept- 1 Town Designee
• Odd number for voting Carrboro Police Dept-1 Town Designee
purposes Mental Health Representative-1 Alliance Health Designee
UNC Hospital Representative-1 UNC Hospital Designee
Public Health Department-1 County Manager Designee
Social Services Department -1 County Manager Designee
Substance Use Treatment Provider-1 Application Process
Orange County Emergency Services-1 County Manager Designee
Criminal Justice Resource Dept-1 County Manager Designee
Community Group Working on Opioid-Related Application Process
Concerns—1
Employment Provider-1 Application Process
Orange County School District -1 OCS Designee
Chapel Hill Carrboro School District-1 CHCCS Designee
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Next Steps
• BOCC select Option A or Option B regarding how the
County will spend opioid settlement funds on opioid
remediation activities;
• BOCC discuss and consider proposed charge and
composition for the proposed Opioid Advisory Committee
• Authorize the Clerk's office to begin soliciting membership
applications based on the Committee composition so that
the Board can review applications and make appointments
by the November 15, 2022.
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ORANGE COUNTY OPIOID ADVISORY COMMITTEE
PROPOSED CHARGE & COMPOSITION
PROPOSED CHARGE
The purpose of the Advisory Committee is to:
1. Discuss opioid-related health concerns and issues impacting the residents of
Orange County and advise the Board of Commissioners on options to expend
funds to remedy opioid impacts;
2. Plan and host at least one annual meeting open to the public to receive input from
municipalities on proposed uses of the settlement funds and to encourage
collaboration between local governments;
PROPOSED COMPOSITION
Position Representation Appointment Process
1 Orange County Resident with lived Application Process
2 experience — At Large - 2
3 Orange County Sheriff Dept - 1 Sheriff's Designee
4 Hillsborough Police Dept - 1 Town Designee
5 Chapel Hill Police Dept - 1 Town Designee
6 Carrboro Police Dept - 1 Town Designee
7 Mental Health Representative - 1 Alliance Health Designee
8 UNC Hospital Representative - 1 UNC Hospital Designee
9 Public Health Department - 1 County Manager Designee
10 Social Services Department - 1 County Manager Designee
11 Substance Use Treatment Provider - 1 Application Process
12 Orange County Emergency Services - 1 County Manager Designee
13 Criminal Justice Resource Dept - 1 County Manager Designee
14 Community Group Working on Opioid- Application Process
Related Concerns - 1
15 Employment Provider - 1 Application Process
16 Orange County School District - 1 OCS Designee
17 Chapel Hill Carrboro School District - 1 CHCCS Designee
Technical Support:
• Health Director