HomeMy WebLinkAboutAgenda - 06-18-2024; 8-x - Approval of Budget Amendment #11-C to Provide Supplemental Grant Funding for the Emergency Services’ Post-Overdose Response Team (PORT) 1
ORD-2024-020
ORANGE COUNTY
BOARD OF COMMISSIONERS
ACTION AGENDA ITEM ABSTRACT
Meeting Date: June 18, 2024
Action Agenda
Item No. 8-x
SUBJECT: Approval of Budget Amendment #11-C to Provide Supplemental Grant Funding
for the Emergency Services' Post-Overdose Response Team (PORT)
DEPARTMENT: Emergency Services
ATTACHMENT(S): INFORMATION CONTACT:
Kirby Saunders, 919-245-6123
Attachment 1. Draft Alliance Healthcare Kim Woodward, 919-245-6133
Funding Agreement
Attachment 2. Year-to-Date Budget
Summary
PURPOSE: To approve Budget Amendment#11-C to provide supplemental grant funding for the
Emergency Services' Post-Overdose Response Team (PORT) to support operational expenses
not previously funded by the Opioid Settlement Funds, in collaboration with Alliance Healthcare.
BACKGROUND: The Orange County Emergency Services Department previously received
$244,021 in Opioid Settlement Funding to create and implement a Post-Overdose Response
Team (PORT). This funding provided the funding necessary to initialize the PORT program,
including base salaries for (2) PORT Paramedics and (1) Peer Support Specialist, medication
expenses, and some software expenses. The primary mission of the PORT team is to respond to
overdoses, provide follow-up care, initiate medication assisted treatment (MAT) when warranted,
and provide referral to recovery support services.
In January 2024, Alliance Healthcare submitted a survey issued by North Carolina Department of
Health and Human Services, Division of Mental Health, Developmental Disabilities, and
Substance Use Services (NC DHHS DMH/DD/SUS) for crisis services projects in the LME-MCO
catchment areas. NC DHHS was seeking information about crisis service projects that already
existed, were in the design phase or planned future projects to help inform them of budget funding
priorities. In collaboration with Orange County, Alliance Healthcare submitted a lengthy survey
regarding the PORT Team proposal.
On May 15, 2024 Emergency Services received notification that Alliance Healthcare would fund
$201,484 from its existing funds. The purpose of this grant is to assist the County in fully funding
the Post Overdose Response Team through June 30, 2025. The funding allows Emergency
Services to purchase additional equipment, additional harm-reduction supplies, and a software
bridge between the emergency medical services (EMS) electronic patient care reporting and case
management software. Additionally, this grant provides funding to cover personnel base salaries
from May 2025 until June 2025 and all overtime expenses through FY 2024-25, thus expanding
2
the availability of the PORT Paramedics to 12 hours a day, 7 seven days a week. This expanded
availability will improve the delivery of medication assisted treatment and harm reduction efforts.
The Post-Overdose Response Team is expected to be fully operational by July 1, 2025. Below is
a break-down of the annual funding (by source) and start-up cost needed to support the program.
Post-Overdose Response Team (PORT) Expenses
EXPENSES AMOUNT TOTAL OPIOID FUNDS GRANT FUNDS
Personnel
PORT Paramedics (2) $195,987 $177,128 $18,859
Peer Support Specialist(1) $59,186 $50,388 $8,798
Overtime PORT Paramedics $25,500 $0 $25,500
Holiday Pay PORT Paramedics $9,390 $0 $9,390
Equipment/Supplies $92,937 $0 $92,937
Software $32,020 $7,020 $25,000
Medication $30,000 $9,000 $21,000
TOTAL $466,020 $243,536 $201,484
FY 2023-24: Start-up costs of $96,161 to support the acquisition of supplies and equipment not
funded by the Opioid Settlement Funds.
FY 2024-25: Ongoing operational costs of $105,323, including the following not supported by
Opioid Settlement Funds:
• Salary and benefits gap funding $27,657
• Holiday and Overtime Pay $34,890
• Software bridge $25,000
• Additional medication, Narcan, and other harm reduction supplies $21,000
Budget Amendment #11-C creates the following grant ordinance in the Multi-year Grant Fund:
ALLIANCE HEALTHCARE PORT GRANT($222,484) - Project#71502
Revenues for thisproject:
Current FY 2023-24 FY 2023-24
FY 2023-24 Amendment Revised
Grant Revenue $0 $201,484 $201,484
Total Project Funding $0 $201,484 $201,484
Appropriated for thisproject:
Current FY 2023-24 FY 2023-24
FY 2023-24 Amendment Revised
Expenditures $0 $201,484 $201,484
Total Project Funding $0 $201,484 $201,484
FINANCIAL IMPACT: This amendment increases the authorization in the multi-year grant fund
by $201,484.
SOCIAL JUSTICE IMPACT: The following Orange County Social Justice Goals are applicable
to this item:
3
• GOAL: CREATE A SAFE COMMUNITY
The reduction of risks from vehicle/traffic accidents, childhood and senior injuries, gang
activity, substance abuse and domestic violence.
• GOAL: FOSTER A COMMUNITY CULTURE THAT REJECTS OPPRESSION AND
INEQUITY
The fair treatment and meaningful involvement of all people regardless of race or color;
religious or philosophical beliefs; sex, gender or sexual orientation; national origin or ethnic
background; age; military service; disability; and familial, residential or economic status.
• 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.
ENVIRONMENTAL IMPACT: There are no known Orange County Environmental Responsibility
Goal impacts associated with this item at this time.
RECOMMENDATION(S): The Manager recommends that the Board approve Budget
Amendment #11-C to include $201,484 in a Multi-Year Grant Fund to support the start-up,
operational and sustainment funding for the EMS Post-Overdose Response Team for expenses
not supported by the Opioid Settlement Funds. The Manager also recommends that the Board
approve the Draft Agreement for the Manager's signature subject to any modifications made by
the County Attorney.
4
AGREEMENT
BETWEEN ORANGE COUNTY
AND ALLIANCE HEALTH
THIS AGREEMENT is made and entered into June 1,2024,by and between the COUNTY OF ORANGE
(hereinafter referred to as the "County") and ALLIANCE HEALTH, a political subdivision of the state
of North Carolina and a Local Management Entity/Managed Care Organization as those term is defined in
NCGS 122C-3 (hereinafter referred to as"Alliance") collectively referred to as the Parties.
WITNESSETH:
WHEREAS, Orange County is implementing a Post Overdose Response Team(Referred to herein
as "PORT")program with the mission to provide harm reduction resources, linkage to treatment services,
and medication-assisted treatment administration,by responding to opioid overdoses in real time or within
24-72 hours of the overdose event.
WHEREAS,PORT will serve the entirety of Orange County.
; and
WHEREAS, Alliance has agreed to provide funding for the program to operate as of June 1, 2024
through June 30,2025.
NOW THEREFORE, and in consideration of mutual covenants herein and the mutual benefits to
result therefrom,the parties hereby agree as follows:
SECTION 1. FUNDING. Alliance shall provide to the County funding in the amount of Ninety six
thousand one hundred sixty one dollar for the remainder of FY 2024($96,161), and One hundred five
thousand three hundred and twenty three dollars for FY 2025. ($105,323) (Hereinafter referred to as the
"Funds") to support staffing of the PORT, software bridge, equipment and supplies to support the 2024-
2025 fiscal year.If the Funds are not exhausted by June 30,2025,and the remaining funds are still available,
the County may submit a written request to Alliance for approval to use the remaining balance for the fiscal
year beginning July 1, 2026.
SECTION 2.USE OF FUNDS. The Funds shall be used exclusively for Qualified Expenses of the PORT
program outlined in Attachment 1, Scope of Work,and corresponding Budget provided to and approved by
Alliance. The County shall promptly return, without the necessity of a request from Alliance, any portion
of the Funds not used for such purpose or submit a written request to Alliance to utilize the remaining
balance as described above in Section 1. Funding. No substantial changes in the purposes, term or
conditions may be made without a prior written amendment to this Agreement. In the event it is determined
by Alliance,that the County expended any amount of Funds in violation of the funding requirements or this
Agreement,the County shall be required to return that amount of money to Alliance. The implementation
of this Agreement and the PORT program shall be carried out in strict compliance with all Federal, State,
and local laws.
SECTION 3. PAYMENT OF FUNDS. Alliance will reimburse the County for Qualified Expenses
incurred. The County must submit a completed Alliance Non-UCR Invoice Template that lists Qualified
Expenses and supporting documentation. Supporting documentation includes,but is not limited to,receipts
of purchases, itemized invoices and other documentation on how the expense is related to the deliverable.
If proper supporting documentation is not provided with the Invoice Template, further payments may be
withheld. See Attachment 2: Alliance Non-UCR Invoice Template.
5
a) Provider shall prepare and submit the Invoice for payment to:
accountspayablegalliancehealthplan.org,unless otherwise directed by Alliance.
b) Electronic reporting must be submitted in accordance with the privacy and security
requirements set forth in Section 16—Confidentiality.
c) All payments of Funds will be made via electronic funds transfer within 30 days of invoice
approval.
SECTION 4.TERM. The term of this Agreement shall begin June 1,2024,and end the earlier of June 30,
2025, or upon expenditure of all of the Funds. If the Funds are not exhausted by June 30, 2025, and the
remaining funds are still available,the County may submit a written request to Alliance for approval to use
the remaining balance for the fiscal year beginning July 1, 2026.
SECTION 5. TERMINATION. This Agreement may be terminated immediately, for cause, by the
nonbreaching party notifying the breaching party in writing of a failure to perform the provisions of this
Agreement. This Agreement may also be terminated immediately by Alliance if the Funds are no longer
available to Alliance. The termination shall be effective upon receipt of the notice of termination. Upon
such termination, the parties shall be entitled to such additional rights and remedies as may be allowed by
relevant law.
SECTION 6. REPORTING. Within 60 days from the end of the Term, unless otherwise agreed to, the
County shall provide Alliance an end of year report detailing the overall utilization rate and utilization of
the PORT program by participant county of residence and recidivism rates.
SECTION 7.NO WARRANTY BY ALLIANCE: Alliance makes no warranty,either express or implied,
that the Funds are or will be sufficient to pay all or any particular portion of the cost of the PORT program
or permit the programs successful completion.
SECTION 8. AMENDMENTS. This Agreement may be amended at any time upon mutual written
agreement of Alliance and the County.
SECTION 9. GOVERNING LAW. This Agreement shall be governed by and in accordance with the
laws of the State of North Carolina. All actions relating in any way to this Agreement shall be brought in
the General Court of Justice in the County of Wake and the State of North Carolina.
SECTION 10.NO THIRD-PARTY BENEFICIARIES: This Agreement is not intended for the benefit
of any third party. The rights and obligations contained herein belong exclusively to the parties hereto and
shall not confer any rights or remedies upon any person or entity other than the parties hereto.
SECTION 11. ENTIRE AGREEMENT This Agreement together with the agreements referenced in this
Agreement, shall constitute the entire understanding between Alliance and the County and shall supersede
all prior understandings and agreements relating to the subject matter hereof.
SECTION 12.SEVERABILITY. In the event any provision of this MOU is adjudged to be unenforceable
or found invalid, such provision shall be stricken and the remaining provisions shall be valid and
enforceable.
SECTION 13. NOTICE. Any and all notices, designations, consents, offers, acceptances, or any other
communications provided for herein shall be given in writing by registered or certified mail,return receipt
requested, to the respective Parties at the addresses listed below, unless each party has notified the others
of a different address by means of the notification formalities described in this paragraph.
6
If to Alliance Health: Attention: Robert Robinson, CEO
5200 West Paramount Parkway Suite 200
Morrisville,North Carolina 27560
If to Orange County: Attention: , Orange County Manager
,North Carolina
SECTION 14.AUDIT RIGHTS. For all Services being provided hereunder,Alliance shall have the right
to inspect, examine, and make copies of any and all books, accounts, invoices, records and other writings
relating to the performance of the Services identified in this contract. Audits shall take place at times and
locations mutually agreed upon by both parties.Notwithstanding the foregoing,the County must make the
materials to be audited available within two (2)weeks of the request for them.
SECTION 15. NON-DISCRIMINATION - EQUITABLE TREATMENT OF PARTICIPANTS. The
County shall not discriminate in their treatment of participants in the PORT program based on participants'health
status, source of payment,cost of treatment or participation in a health benefit plan,genetic information,or
ethnicity. Further, the County agrees that Lesbian, Gay, Bisexual, Transgender, or Questioning (LGBTQ)
participants who obtain covered services shall not be subject to treatment or bias that does not affirm the
member's identifying orientation.
SECTION 16. CONFIDENTIALITY. The Parties hereto agree to comply with any and all applicable
laws and regulations concerning the confidentiality of participant records, files, or communications in
addition to the terms of this Agreement.All parties agree to secure privacy,confidentiality,and integrity of
participant, employee, and administrative data. Electronic exchange of confidential information of any
email, which will include invoices, customer billing information, and any other information regarding the
service delivery of the customer,must be sent and received via encrypted methods.
IN WITNESS WHEREOF, Alliance and County have authorized this Agreement to be executed and
attested by their undersigned officers,to be effective from and after the date first written above.
COUNTY OF ORANGE
, County Manager Date
ALLIANCE HEALTH
Robert Robinson, CEO or Designee Date
This instrument has been pre-audited in the manner
required by the Local Government Budget and Fiscal Control Act.
7
Alliance Health Date
8
Attachment 1 —Scope of Work
Name of Program/Services
Orange County Post Overdose Response Team
Description of use of funds:
The PORT team will launch on July 1, 2024. The PORT will serve all of Orange County,North
Carolina. The PORT Team consists of two Community Paramedics (CPs) and one Peer Support
Specialist. The PORT CPs will provide coverage seven days a week, 365 days per year. The
Peer Support specialist will be in service eight hours per day Monday—Friday. The mission is
to provide harm reduction resources, linkage to treatment services and Medication
Administration Treatment. This will also increase therapeutic interventions and direction to
resources.
Required Elements of the Program/Service
The PORT Team shall:
• Respond to overdose calls that occur during their operating hours.
• Provide up to seven days of medication assisted treatment guided by approved Orange
County EMS protocols.
• Ensure warm handoff occurs with treatment programs across Orange County.
• Respond as directed to overdose calls
• Follow up on EMS, ED, Criminal Justice Resource referrals.
• Provide Harm reduction education and supplies.
• Transportation and Referrals can be made to other services and supports.
• Follow up engagement will be included.
Collaboration
• Supervision of the staff for the Pilot will be provided by the Chapel Hill Police
Department Crisis Unit and EMS Town of Chapel Hill
• Orange County: Emergency Services and CJRD
• Alliance Health
• UNC School of Government Criminal Justice Innovation Lab
Outcomes
• Connecting client with effective treatment resources
• Decreased incidence of opioid overdose death within Orange County
• Decreased Emergency Department OUD utilization by individuals enrolled in PORT
programs
• Decreased repeat OUD related utilization of individuals who have previously interfaced
with OC-EMS and are enrolled in the PORT programs
• Increased EMS provider ability to effectively interface with OUD patients;
• Improved EMS provider morale and engagement as it pertains to OUD patient
encounters;
• Increased intake of enrollees through referrals from community partners
• Decreased frequency of individuals released from Orange County Detention Center
experiencing a gap in MAT
9
Reporting Requirements
The data collection is a requirement of the Orange County EMS Peer Review Process and the
Orange County Opioid Settlement Advisory Committee. Regular data reports will be completed
utilizing the Alliance Health Enhanced Report template.
Finance:
FY 2024: Start-up costs of$96,161,
FY 2025: $105,323 annual operating costs.
Oualified Expenses:
Start up costs for the PORT may include equipment, vehicle lease, uniforms, and UNC School of
Government Criminal Justice Innovation Lab Evaluation. Partial annual funding costs needed to
support the PORT may include salary and benefits for EMT, Mobile Crisis Counselor, and Peer
Support Specialist, training, harm reduction supplies, medical supplies and client needs, and gas
and vehicle maintenance. The County may submit a request in writing to Alliance for
consideration of other expenses not listed above.
Attachment 2—Alliance Non-UCR Invoice Template
Download the Alliance Non-UCR Invoice Template:
https://www.alliancehealthplan.org/resources/document-library/
Please reference the assigned Alliance Health Contract Number(see below)when submitting invoices.
Contract Number:
Start Date: July 1, 2024
Completion Date: June 30,2025,unless extended by Alliance.
10
Year-To-Date Budget Summary
Fiscal Year 2023-24
Fund Budget Summary Grants Fund
Original Budget Revenue $357,000
Interfund Transfer Revenue
Fund Balance Appropiation
Total Original Budget $357,000
Additional Revenue Received Through
Budget Amendment#11-C (June 18th, 2024)
Grant Funds $1,472,070
Non Grant Funds $29,000
Additional Interfund Transfer Revenue $23,750
Additional Fund Balance Appropriation
Total Amended Budget $1,881,820
Dollar Change in 2023-24 Approved Budget $1,524,820
Change in 2023-24 Approved Budget 427.12%
Authorized Full Time Equivalent Positions
Original Approved Full Time Equivalent Positions (includes
Permanent and Time Limited)
Changes to Full Time Equivalent Positions
Total Approved Full-Time-Equivalent Positions for Fiscal
Year 2023-24 0.000