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HomeMy WebLinkAboutAgenda 10-21-2025; 8-d - Approval of an Amendment to the Freedom House FY 2024-25 Contract for Opioid Funding 1 ORANGE COUNTY BOARD OF COMMISSIONERS ACTION AGENDA ITEM ABSTRACT Meeting Date: October 21, 2025 Action Agenda Item No. 8-d SUBJECT: Approval of an Amendment to the Freedom House FY 2024-25 Contract for Opioid Funding DEPARTMENT: Health ATTACHMENT(S): INFORMATION CONTACT: Freedom House FY 2024-25 Services Quintana Stewart, Health Director, 919- Agreement with Exhibits A and B 245-2400 Proposed Amendment to Freedom House FY 2024-25 Services Agreement PURPOSE: To approve an amendment to the FY 2024-25 Services Agreement with Freedom House Recovery Center, Inc. to extend the end date from June 30, 2025 to December 31, 2025 in order for Freedom House to fully utilize all approved Opioid funding. BACKGROUND: The contract allocating Opioid funding was granted to Freedom House on April 18, 2023 in the amount of$144,926.53, with the funding to be utilized by June 30, 2025. Freedom House was unable to fully utilize the full amount within the given timeframe. The Health Department proposes with the contract amendment to extend the contract six (6) months to allow Freedom House to utilize the remaining $12,104.84. FINANCIAL IMPACT: There is no additional financial impact associated with this item. ALIGNMENT WITH STRATEGIC PLAN: This item supports: • GOAL 2: HEALTHY COMMUNITY OBJECTIVE 1. Improve harm reduction, prevention, and support services. OBJECTIVE 3. Provide social safety net programming. RECOMMENDATION(S): The Manager recommends that the Board approve and authorize the Manager to sign the amendment to the FY 2024-25 Services Agreement with Freedom House Recovery Center, Inc. to extend the end date from June 30, 2025 to December 31, 2025 in order for Freedom House to fully utilize the remaining $12,104.84 in Opioid funding. 2 [Departmental Use Only] TITLE FFH Opioid Settlement FY 2024-2025 NORTH CAROLINA SERVICES AGREEMENT NO RFP/RFQ ORANGE COUNTY This Services Agreement (hereinafter "Agreement"), made and entered into this first day of July, 2024, ("Effective Date") by and between Orange County, North Carolina a political subdivision of the State of North Carolina (hereinafter, the "County") and Freedom House Recovery Center, Inc, a non-profit corporation, located at 104 New Stateside Drive, Chapel Hill, North Carolina 27516, (hereinafter, the "Provider"). WITNESSETH: That the County and Provider, for the consideration herein named, do hereby agree as follows: 1. Services a. Scope of Work. i) This Agreement is for services to be rendered by Provider to County with respect to (insert type of project): Services and support programs that serve persons with Opioid Use Disorder(OUD). ii) By executing this Agreement, the Provider represents and agrees that Provider is qualified to perform and fully capable of performing and providing the services required or necessary under this Agreement in a fully competent, professional and timely manner. iii) Time is of the essence with respect to this Agreement. iv) The services to be performed under this Agreement consist of Basic Services, as described and designated in Section 3 hereof. Compensation to the Provider for Basic Services under this Agreement shall be as set forth herein. 2. Responsibilities of the Provider a. Services to be provided. The Provider shall provide the County with all services required in Section 3 to satisfactorily complete the Project within the time limitations set forth herein and in accordance with the highest professional standards. b. Standard of Care. i) The Provider shall exercise reasonable care and diligence in performing services under this Agreement in accordance with the highest generally accepted standards of this type of Provider practice throughout the United States and in accordance with applicable federal, state and local laws and regulations applicable to the Revised 01/24 1 3 performance of these services. Provider is solely responsible for the professional quality, accuracy and timely completion and submission of all work related to the Basic Services. ii) Provider shall be responsible for all errors or omissions of its agents, contractors, employees, or assigns in the performance of the Agreement. Provider shall correct any and all errors, omissions, discrepancies, ambiguities, mistakes or conflicts at no additional cost to the County. iii) The Provider shall not, except as otherwise provided for in this Agreement, subcontract the performance of any work under this Agreement without prior written permission of the County. No permission for subcontracting shall create, between the County and the subcontractor, any contract or any other relationship. iv) Provider is an independent contractor of County. Any and all employees of the Provider engaged by the Provider in the performance of any work or services required of the Provider under this Agreement, shall be considered employees or agents of the Provider only and not of the County, and any and all claims that may or might arise under any workers compensation or other law or contract on behalf of said employees while so engaged shall be the sole obligation and responsibility of the Provider. v) If activities related to the performance of this Agreement require specific licenses, certifications, or related credentials Provider represents that it or its employees, agents and subcontractors engaged in such activities possess such licenses, certifications, or credentials and that such licenses certifications, or credentials are current, active, and not in a state of suspension or revocation. vi) Should any documents, exhibits, or addenda be attached to this Agreement, the terms of this Agreement shall have priority in any conflict with or among the terms of such referenced documents, exhibits, or addenda. vii) Should this Agreement involve project designs, the construction or creation of which is to be bid out or fulfilled by other contractors, and bidding or negotiation with contractors produce prices which, when added to the other elements of the approved total project cost, produce a cost that is in excess of the approved total project cost, the Provider shall participate with the County in negotiation and design adjustments to the extent such are necessary to obtain prices within the approved total project cost. All activity of the Provider with respect to these matters shall constitute Basic Services and shall be performed by the Provider without additional compensation. If negotiation and design adjustments fail to bring costs within the total project cost the County may reject all bids and Provider will redesign or reduce portions of the project in an effort to reduce the bid prices to within the total project cost and rebid the project. One such redesign is included within Basic Services. If this second letting for bids does not produce bids that are within the approved total project cost initially or after negotiations with the contractor the cost is not reduced to an amount within the total project cost, the Provider is not obligated to engage in further redesign. Revised 01/24 2 4 3. Basic Services a. Basic Services. The Services to be rendered pursuant to this Agreement are as follows (fully describe services to be provided): Services and support programs, as listed in Exhibit A, that serve persons with Opioid Use Disorder (OUD) or any co-occurring Substance Use Disorder (SUD) or mental health condition as stated in the National Settlement Agreement. Invoices and supporting documentation are to be submitted the 15th day after the end of the quarter (example: October 15, 2024 invoice for exepnses dated July 1, 2024 through September 30, 2024). Per Exhibit B, one metrics report will be required January 15, 2025 (for services dated July 1, 2024 through December 31, 2024) and a final metrics report will be due July 15, 2025 (for services dated January 1, 2025 through June 30, 2025) along with a narrative (success story) of 250 words or less. 4. Duration of Services a. Term. The term of this Agreement shall be from July 1, 2024 to June 30, 2025. b. Scheduling of Services. i) The Provider shall schedule and perform its activities in a timely manner. ii) Should the County determine that the Provider is behind schedule, it may require the Provider to expedite and accelerate its efforts, including providing additional resources and working overtime, as necessary, to perform its services in accordance with the approved project schedule at no additional cost to the County. iii) The Commencement Date for the Provider's Basic Services shall be July 1, 2024. 5. Compensation a. Compensation for Basic Services. Compensation for Basic Services shall include all compensation due the Provider from the County for all services satisfactorily (as determined by the County) performed pursuant to this Agreement. The maximum amount payable for Basic Services shall not exceed One Hundred Forty Four Thousand Nine Hundred Twenty Six and 53/100 Dollars ($144,926.53). Payment for satisfactorily performed Basic Services shall become due and payable within thirty (30) days of Provider properly invoicing County. Payment shall be subject to provisions of Section 5(b). b. Disputes. In the event the amount stated on an invoice is disputed by the County, the County may withhold payment of all or a portion of the amount stated on an invoice until the parties resolve the dispute. Should Provider fail to perform its duties under the terms of this Agreement, County may, without fault or penalty, withhold any payment associated with the work to be performed until such time as said work is completed. c. Additional Services. County shall not be responsible for costs related to any services in addition to the Basic Services performed by Provider unless County requests such additional services in writing and such additional services are evidenced by a written amendment to this Agreement. Revised 01/24 3 5 6. Responsibilities of the County a. Cooperation and Coordination. The County has designated (Orange County Health Director, Quintana Stewart) to act as the County's representative with respect to the Project who shall have the authority to render decisions within guidelines established by the County Manager or the County Board of Commissioners and who shall be available during working hours as often as may be reasonably required to render decisions and to furnish information. 7. Insurance a. General Requirements. Provider shall obtain, at its sole expense, Commercial General Liability Insurance, Automobile Insurance, Workers' Compensation Insurance, and any additional insurance as may be required by County's Risk Manager as such insurance requirements are described in the Orange County Risk Transfer Policy and Orange County Minimum Insurance Coverage Requirements (each document is incorporated herein by reference and may be viewed at http://www.orangecountync.gov/departments/purchasing division/contracts.php). If County's Risk Manager determines additional insurance coverage is required such additional insurance shall consist of Professional Liability and a Molestation/Sexual Assualt rider(if no additional insurance required mark N/A as being not applicable). Provider shall not commence work until such insurance is in effect and certification thereof has been received by the County's Risk Manager. 8. Indemnity a. Indemnity. To the extent authorized by North Carolina law the Provider agrees, without limitation, to defend, indemnify and hold harmless the County from all loss, liability, claims or expense, including attorney's fees, arising out of or related to the Project and arising from property damage or bodily injury including death to any person or persons caused in whole or in part by the negligence or misconduct of the Provider except to the extent same are caused by the negligence or willful misconduct of the County. It is the intent of this provision to require the Provider to indemnify the County to the fullest extent permitted under North Carolina law. 9. Amendments to the Agreement a. Changes in Basic Services. Changes in the Basic Services and entitlement to additional compensation or a change in duration of this Agreement shall be made by a written Amendment to this Agreement executed by the County and the Provider. The Provider shall proceed to perform the Services required by the Amendment only after receiving a fully executed Amendment from the County. 10. Termination a. Termination for Convenience of the County. This Agreement may be terminated without cause by the County and for its convenience upon seven (7) days' prior written notice to the Provider. Revised 01/24 4 6 b. Other Termination. The Provider may terminate this Agreement based upon the County's material breach of this Agreement; provided, the County has not taken all reasonable actions to remedy the breach. The Provider shall give the County seven (7) days' prior written notice of its intent to terminate this Agreement for cause. Either party may terminate this Agreement upon notice to the other party that obligations pursuant to this Agreement are made impractical due to declarations of emergency by Orange County or by North Carolina due to events directly impacting Orange County. Both parties shall remain responsible for all payment and performance due up to the receipt of such notice, but shall have no further obligation or responsibility beyond that date provided the terminating party has taken all reasonable steps to complete the performance of its obligations. c. Compensation After Termination. i) In the event of termination, the Provider shall be paid that portion of the fees and expenses that it has earned to the date of termination, less any costs or expenses incurred or anticipated to be incurred by the County due to errors or omissions of the Provider. Upon request of the County, the Provider shall submit to County all relevant documentation, including but not limited to, job cost records, to support its claims for final compensation. ii) Should this Agreement be terminated, the Provider shall deliver to the County within seven (7) days, at no additional cost, all deliverables including any electronic data or files relating to the Project. d. Waiver. The payment of any sums by the County under this Agreement or the failure of the County to require compliance by the Provider with any provisions of this Agreement or the waiver by the County of any breach of this Agreement shall not constitute a waiver of any claim for damages by the County for any breach of this Agreement or a waiver of any other required compliance with this Agreement. e. Suspension. County may suspend the Basic Services and this Agreement at any time for County's convenience and without penalty to County upon three (3) days' notice to Provider. Upon any suspension by County, Provider shall discontinue work on the Basic Services and shall not resume the Basic Services until notified to proceed by County. 11. Additional Provisions a. Limitation and Assignment. The County and the Provider each bind themselves, their successors, assigns and legal representatives to the terms of this Agreement. Neither the County nor the Provider shall assign or transfer its interest in this Agreement without the written consent of the other. There are no third-party beneficiaries of this Agreement and nothing in this Agreement, express or implied, is intended to confer on any person other than the parties hereto (and their respective successors, heirs and permitted assigns), any rights, remedies, or obligations. b. Governing Law. This Agreement and the duties,responsibilities, obligations and rights of respective parties hereunder shall be governed by the laws of the State of North Revised 01/24 5 7 Carolina. By executing this Agreement Provider affirms that Provider and any subcontractors of Provider are and shall remain in compliance with Article 2 of Chapter 64 of the North Carolina General Statutes. By executing this Agreement Provider certifies that Provider has not been identified, and has not utilized the services of any agent or subcontractor identified, on the list created by the State Treasurer pursuant to G.S. 147-86.58. By executing this Agreement Provider certifies that Provider has not been identified, and has not utilized the services of any agent or subcontractor identified, on the list created by the State Treasurer pursuant to G.S. 147-86.81. c. Non-Discrimination. Provider shall at all times remain in compliance with all applicable local, state, and federal laws, rules, and regulations including but not limited to all state and federal non-discrimination laws, policies, rules, and regulations and the Orange County Non-Discrimination Policy and Orange County Living Wage Policy (each Orange County policy is incorporated herein by reference and may be viewed at http://www.oran eg copptync.gov/departments/purchasing division/contracts.php.) Any violation of the Orange County Non-Discrimination Policy is a breach of this Agreement and County may immediately terminate this Agreement without further obligation on the part of the County. This paragraph is not intended to limit and does not limit the definition of breach to discrimination. d. Dispute Resolution. Any and all suits or actions to enforce, interpret or seek damages with respect to any provision of, or the performance or non-performance of, this Agreement shall be brought in the General Court of Justice of North Carolina sitting in Orange County, North Carolina. It is agreed by the parties that no other court shall have jurisdiction or venue with respect to such suits or actions. Binding arbitration may not be initiated by either Party, however, the Parties may agree to nonbinding mediation of any dispute prior to the bringing of such suit or action. e. Entire Agreement. This Agreement represents the entire and integrated agreement between the County and the Provider and supersedes all prior negotiations, representations or agreements, either written or oral. This Agreement may be amended only by written instrument signed by both parties. Modifications may be evidenced by facsimile signatures. f. Severability. If any provision of this Agreement is held as a matter of law to be unenforceable, the remainder of this Agreement shall be valid and binding upon the Parties. g. Ownership of Work Product. Should Provider's performance of this Agreement generate documents, items or things that are specific to this Project such documents, items or things shall become the property of the County and may be used on any other project without additional compensation to the Provider. The use of the documents, items or things by the County or by any person or entity for any purpose other than the Project as set forth in this Agreement shall be at the full risk of the County. h. Non-Appropriation. Provider acknowledges that County is a governmental entity, and the validity of this Agreement is based upon the availability of public funding under the authority of its statutory mandate. Revised 01/24 6 8 In the event that public funds are unavailable or not appropriated for the performance of County's obligations under this Agreement, then this Agreement shall automatically expire without penalty to County immediately upon written notice to Provider of the unavailability or non-appropriation of public funds. It is expressly agreed that County shall not activate this non-appropriation provision for its convenience or to circumvent the requirements of this Agreement. In the event of a change in the County's statutory authority, mandate or mandated functions, by state or federal legislative or regulatory action, which adversely affects County's authority to continue its obligations under this Agreement, then this Agreement shall automatically terminate without penalty to County upon written notice to Provider of such limitation or change in County's legal authority. i. Si natures. This Agreement together with any amendments or modifications may be executed electronically. All electronic signatures affixed hereto evidence the consent of the Parties to utilize electronic signatures and the intent of the Parties to comply with Article 11A and Article 40 of North Carolina General Statute Chapter 66. j. Notices. Any notice required by this Agreement shall be in writing and delivered by certified or registered mail,return receipt requested to the following: Orange County Provider's Name AttentionXimberlee Quatrone Freedom House Recovery Ctr P.O. Box 8181 104 New Stateside Drive Hillsborough,NC 27278 Chapel Hill,NC 27516 [SIGNATURE PAGE TO FOLLOW] Revised 01/24 9 IN WITNESS WHEREOF, the Parties, by and through their authorized agents, have hereunder set their hands and seal, all as of the day and year first above written. ORANGE COUNTY: PROVIDER: By: By: Jamezetta Bedford, Chair, Orange County Board of County Commissioners Joyce Harper, CEO Printed Name and Title Revised 01/24 8 10 ORANGE COUNTY—INTERNAL USE ONLY Finance Information Vendor Name: Freedom House Vendor Contact Person: Joyce Harper Phone: 919-942-2803 Address: 104 New Stateside Drive City Chapel Hill State:NC Zip:27516 Department: Health Amount: $144,926.53 Purpose: Services and support programs that serve persons with Opioid Use Disorder Budget Code(s):27411020-630000- 92001 Vendor#34104 Vendor Status with NCSOS: Current-Active Non-Profit Vendor is a BOCC consultant: ❑Yes ®No Contract Details Contract Type: ®New ❑Amendment(Original Contract: )(Most Recent Amendment ) Effective Date 7/1/24 End Date 6/30/25 Notice Date (Notice Purpose ) Award ®Approved by Board(Agenda Date:April 18,2023); ❑Made or Administered by Signature Authority - ❑BOCC Express Delegation(Agenda Date: - Policy 9.4: ❑Under$5,000; ❑ Service Under$90,000; ❑Construction Under$250,000 - ❑Budget Policy Section XV(Capital Improvement Project: Bidding ❑Informal Bidding($30k-$90k); ❑Formal RFP($90k+); ❑Other(<$30k); ❑Exception(#-----) Department Affirmation ® This agreement is approved as to technical form and content and I as Department Director affirmatively state work on this project has not been initiated prior to execution of the agreement. ®This agreement is approved as to technical form and content. Services related to this agreement have already begun or been completed.Description of the nature of the emergency condition that was addressed:Waiting on paperwork.Didn't want to stop necessary services to clients while finalizing contract. Department Director's Signature Date: Information Technologies This agreement has been reviewed and is approved as to information technology content and specifications: Office of the Chief Information Officer Date: ®Inapplicable because no hardware/software purchases or related services Risk Management This agreement is approved for sufficiency of insurance standards,specifications,and requirements: Office of the Risk Management Officer Date: Financial Services This instrument has been pre-audited in the manner required by the Local Government Budget and Fiscal Control Act: Office of the Chief Financial Officer Date: Legal Services This agreement is approved as to legal form and sufficiency: Office of the County Attorney Date: Clerk to the Board All Docusign contracts must be copied to the Clerk upon completion: occlerkdocs@orangecountync.gov The following signature block is for hard copies only and is not required for Docusign contracts: Revised 01/24 9 11 Received for record retention: Office of the Clerk to the Board Date: Revised 01/24 10 Exhibit A 12 EXHIBIT A TO NC MOA: HIGH-IMPACT OPIOID ABATEMENT STRATEGIES ("OPTION A" List) In keeping with the National Settlement Agreement, opioid settlement funds may support programs or services listed below that serve persons with Opioid Use Disorder (OUD) or any co-occurring Substance Use Disorder (SUD) or mental health condition. As used in this list, the words `fund"and "support"are used interchangeably and mean to create, expand, or sustain a program, service, or activity. 1. Collaborative strategic planning. Support collaborative strategic planning to address opioid misuse, addiction, overdose, or related issues, including staff support, facilitation services, or any activity or combination of activities listed in Exhibit C to the MOA (collaborative strategic planning). 2. Evidence-based addiction treatment. Support evidence-based addiction treatment consistent with the American Society of Addiction Medicine's national practice guidelines for the treatment of opioid use disorder—including Medication-Assisted Treatment (MAT)with any medication approved for this purpose by the U.S. Food and Drug Administration—through Opioid Treatment Programs, qualified providers of Office-Based Opioid Treatment, Federally Qualified Health Centers, treatment offered in conjunction with justice system programs, or other community-based programs offering evidence-based addiction treatment. This may include capital expenditures for facilities that offer evidence-based treatment for OUD. (If only a portion of a facility offers such treatment, then only that portion qualifies for funding, on a pro rata basis.) 3. Recovery support services. Fund evidence-based recovery support services, including peer support specialists or care navigators based in local health departments, social service offices, detention facilities, community-based organizations, or other settings that support people in treatment or recovery, or people who use drugs, in accessing addiction treatment, recovery support, harm reduction services, primary healthcare, or other services or supports they need to improve their health or well-being. 4. Recovery housing support. Fund programs offering recovery housing support to people in treatment or recovery, or people who use drugs, such as assistance with rent, move-in deposits, or utilities; or fund recovery housing programs that provide housing to individuals receiving Medication-Assisted Treatment for opioid use disorder. 5. Employment-related services. Fund programs offering employment support services to people in treatment or recovery, or people who use drugs, such as job training,job skills, job placement, interview coaching, resume review, professional attire, relevant courses at community colleges or vocational schools, transportation services or transportation vouchers to facilitate any of these activities, or similar services or supports. 6. Early intervention. Fund programs, services, or training to encourage early identification and intervention for children or adolescents who may be struggling with problematic use of drugs or mental health conditions, including Youth Mental Health Exhibits,page 1 13 First Aid,peer-based programs, or similar approaches. Training programs may target parents, family members, caregivers, teachers, school staff,peers, neighbors, health or human services professionals, or others in contact with children or adolescents. 7. Naloxone distribution. Support programs or organizations that distribute naloxone to persons at risk of overdose or their social networks, such as Syringe Service Programs, post-overdose response teams,programs that provide naloxone to persons upon release from jail or prison, emergency medical service providers or hospital emergency departments that provide naloxone to persons at risk of overdose, or community-based organizations that provide services to people who use drugs. Programs or organizations involved in community distribution of naloxone may, in addition,provide naloxone to first responders. 8. Post-overdose response team. Support post-overdose response teams that connect persons who have experienced non-fatal drug overdoses to addiction treatment, recovery support, harm reduction services,primary healthcare, or other services or supports they need to improve their health or well-being. 9. Syringe Service Program. Support Syringe Service Programs operated by any governmental or nongovernmental organization authorized by section 90-113.27 of the North Carolina General Statutes that provide syringes, naloxone, or other harm reduction supplies; that dispose of used syringes; that connect clients to prevention, treatment, recovery support,behavioral healthcare,primary healthcare, or other services or supports they need; or that provide any of these services or supports. 10. Criminal justice diversion programs. Support pre-arrest or post-arrest diversion programs, or pre-trial service programs, that connect individuals involved or at risk of becoming involved in the criminal justice system to addiction treatment, recovery support, harm reduction services, primary healthcare, prevention, or other services or supports they need, or that provide any of these services or supports. 11. Addiction treatment for incarcerated persons. Support evidence-based addiction treatment, including Medication-Assisted Treatment with at least one FDA-approved opioid agonist, to persons who are incarcerated in jail or prison. 12. Reentry Programs. Support programs that connect incarcerated persons to addiction treatment, recovery support, harm reduction services, primary healthcare, or other services or supports they need upon release from jail or prison, or that provide any of these services or supports. Exhibits,page 2 14 Exhibit B 2. Evidence-Based Treatment Start Date: 7/1/2024 Insert Start and End Date forth is Strategy(MM/DD/YYYY) End Date: 6/30/2025 Process measures answer the question,"How much did you do?".Please quantify the process measures relevant to your implementation of this strategy.Indicate whether the count represents efforts supported only by opioid settlement funds or efforts supported by multiple funding sources including opioid settlement funds.Process measures should reflect numbers from the 2024 fiscal year(i.e.,July 1,2024-June 30,2025). STRATEGY-SPECIFIC PROCESS MEASURES Description I Count I How were efforts supported? Notes Additional Information&Helpful Hints about this Measure 4 of naloxone kits distributed I 1A naloxone kit contains two doses. 4 of OTPs that dispense methadone,buprenorphine,and naltrexone 4 of OTPs that dispense only methadone 4 of OTP-based medical providers who prescribe methadone for OUD A provider may participate in multiple support programs so there may be patients some duplication of 4 of providers. 4 of referrals to opioid treatment programs Number of referrals do not equate to number of unique patients because one individual may receive multiple referrals. A unique patient may participate in multiple treatment programs so there may be some duplication of unique patients when numbers across 4 of unique patients with OUD served at OTP programs,project,sites,etc.,are aggregated for the strategy-specific impact report.A patient may receive services across local government boundaries(e.g.,a person with OUD may reside in one county and receive services in another county). 4 of office-based clinics offering MOUD within county 4 of individual OBOT providers who prescribe buprenorphine for A provider may participate in multiple support programs so there may be patients some duplication of 4 of providers. 4 of buprenorphine prescriptions provided at OBOT 4 of naltrexone doses provided at OBOT 4 of referrals to OBOT Number of referrals do not equate to number of unique patients because one individual may receive multiple referrals. A unique patient may participate in multiple treatment programs so there may be some duplication of unique patients when numbers across It of unique patients with OUD served at OBOT programs,project,sites,etc.,are aggregated forthe strategy-specific impact report.A patient may receive services across local government boundaries(e.g.,a person with OUD may reside in one county and receive services in another county). 4 of FQHCs offering MOUD within county 4 of individual FQHC providers who prescribe buprenorphine for A provider may participate in multiple support programs so there may be patients some duplication of 4 of providers. 4 of buprenorphine prescriptions provided at FQHC 4 of naltrexone doses provided at FQHC 4 of referrals to FQHC MAT services Number of referrals do not equate to number of unique patients because one individual may receive multiple referrals. A unique patient may participate in multiple treatment programs so there may be some duplication of unique patients when numbers across 4 of unique patients with OUD served at FQHC programs,project,sites,etc.,are aggregated for the strategy-specific impact report.A patient may receive services across local government boundaries(e.g.,a person with OUD may reside in one county and receive services in another county). 4 of hospitals offering in-patient MOUD within county 4 of hospitalists who prescribe buprenorphine for patients A provider may participate in multiple support programs so there may be some duplication of 4 of providers. If of buprenorphine prescriptions provided through in-patient services in hospitals 4 of naltrexone doses provided through in-patient services in hospitals 15 #of referrals to in-patient MAT services Number of referrals do not equate to number of unique patients because one individual may receive multiple referrals. A unique patient may participate in multiple treatment programs so there may be some duplication of unique patients when numbers across If of unique hospital in-patients with OUD served with MAT programs,project,sites,etc.,are aggregated for the strategy-specific impact report.A patient may receive services across local government boundaries(e.g.,a person with OUD may reside in one county and receive services in another county). q of emergency departments offering MOUD within county p of emergency department providers who prescribe buprenorphine A provider may participate in multiple support programs so there may be for patients some duplication of p of providers. q of short-term buprenorphine prescriptions(14 days or less)provided in the ED #of longer-term buprenorphine prescriptions(15 days or more) provided in the ED N of naltrexone doses provided in the emergency department k of referrals from emergency department to community providers Number of referrals do not equate to number of unique patients because one individual may receive multiple referrals. A unique patient may participate in multiple treatment programs so there may be some duplication of unique patients when numbers across M of unique emergency department patients with OUD served with programs,project,sites,etc.,are aggregated for the strategy-specific MAT impact report.A patient may receive services across local government boundaries(e.g.,a person with OUD may reside in one county and receive services in another county). q of Local Health Departments(LHD)offering MOUD within county N of individual LHD-based providers who prescribe buprenorphine for A provider may participate in multiple support programs so there may be patients some duplication of p of providers. H of buprenorphine prescriptions provided at LHD k of naltrexone doses provided at LHD k of referrals.to LHD MAT services Number of referrals do not equate to number of unique patients because one individual may receive multiple referrals. A unique patient may participate in multiple treatment programs so there may be some duplication of unique patients when numbers across q of unique patients with OUD served at LHD with MAT programs,project,sites,etc.,are aggregated for the strategy-specific impact report.A patient may receive services across local government boundaries(e.g.,a person with OUD may reside In one county and receive services in another county). T k of EMS programs offering MOUD within county k of individual EMS providers who prescribe buprenorphine for A provider may participate in multiple support programs so there may be patients some duplication of p of providers. k of buprenorphine prescriptions provided through EMS-based MAT programs q of naltrexone doses through EMS-based MAT programs N of referrals to EMS-based MAT programs Number of referrals do not equate to number of unique patients because one individual may receive multiple referrals. H of unique patients who received pre-hospital buprenorphine treatment from EMS during a non-fatal overdose encounter p of unique patients with OUD served through EMS-based MAT programs A unique patient may participate in multiple treatment programs so there may be some duplication of unique patients when numbers across a of unique patients with OUD who declined services through EMS- programs,project,sites,etc.,are aggregated for the strategy-specific based MAT programs impact report.A patient may receive services across local government boundaries(e.g.,a person with OUD may reside in one county and receive services in another county). q of Syringe Service Programs(SSPs)offering MOUD within county A provider may participate in multiple support programs so there may be some duplication of p of providers. #of providers who prescribe buprenorphine for patients at/through an SSP N of buprenorphine prescriptions provided through SSPs p of naltrexone doses provided through SSPs k of referrals to SSP-based MAT services Number of referrals do not equate to number of unique patients because one individual may receive multiple referrals. 16 A unique patient may participate in multiple treatment programs so there may be some duplication of unique patients when numbers across #of unique patients with OUD served through SSPs with MAT programs,project,sites,etc.,are aggregated for the strategy-specific impact report.A patient may receive services across local government boundaries(e.g.,a person with OUD may reside in one county and receive services in another county). A unique patient may participate in multiple treatment programs so there may be some duplication of unique patients when numbers across #of patients who are justice-involved that are referred to any MAT programs,project,sites,etc.,are aggregated for the strategy-specific program impact report.A patient may receive services across local government boundaries(e.g.,a person with OUD may reside in one county and receive services in another county). Custom,strategy-specific measures may be entered in this row. Custom,strategy-specific measures may be entered in this row. Custom,strategy-specific measures may be entered in this row. DEMOGRAPHICS:Provide the following information on race and ethnicity for the#of unique patients who have OUD,served during the 2024 fiscal year(i.e.,July 1,2024-June 30,2025). Process Measure Count I Notes Additional Information&Helpful Hints about this Measure A unique patient may participate in multiple treatment programs so there may be some duplication of unique patients when numbers across #of unique patients who have OUD,served programs,project,sites,etc.,are aggregated for the strategy-specific impact report.A patient may receive services across local government boundaries(e.g.,a person with OUD may reside in one county and receive services in another county). Of the#of unique patients who have OUD,served in the count above,how many people identified as: American Indian/Alaska Native Non-Hispanic Asian Non-Hispanic Black Non-Hispanic Native Hawaiian or Other Pacific Islander Non-Hispanic White Non-Hispanic Hispanic Some Other Race or Multiple Races Unknown Sum total of unique patients served(Autocalculated) Does sum total(C87)match the reported#of unique patients(C77)? yes (Autocalculated) Quality measures answer the question,"How well did you do it?".Please quantify the quality measures relevant to your implementation of this strategy.Quality measures should reflect numbers from the 2024 fiscal year(i.e.,July 1,2024-June 30,2025). Description Count Quality Measure Percent(Autocalculated) Notes Additional Information&Helpful Hints about this Measure #of referrals to opioid treatment programs that resulted in 1st %of referrals to OTP services that appointment attended resulted in 1st appointment Incomplete #of referrals too ioid treatment programs attended #of referrals to OBOT services that resulted in 1st appointment %of referrals to OBOT services that attended at office-based clinic resulted in 1st appointment Incomplete #of referrals to OBOT services at office-based clinic attended at office-based clinic #of referrals to OBOT services that resulted in 1st appointment %of referrals to OBOT services that attended at FQHC resulted in 1st appointment Incomplete #of referrals to OBOT services at FQHC attended at FQHC #of referrals to OBOT services that resulted in 1st appointment %of referrals to OBOT services that attended at LHD resulted in 1st appointment for Incomplete #of referrals to OBOT services at LHD treatment attended at LHD #of referrals to EMS-based MAT programs that resulted in 1st %of referrals to EMS-based MAT appointment for treatment attended services that resulted in 1st Incomplete #of referrals to EMS-based MAT programs appointment for treatment #of referrals to SSP-based MAT services that resulted In 1st %of referrals to SSP-based MAT appointment for treatment attended services that resulted in 1st Incomplete #of referrals to SSP-based MAT services appointment for treatment #of patients who are justice-involved that are referred to any MAT %of referrals from justice system program that resulted in 1st appointment for treatment attended programs that resulted in lst Incomplete #of patients who are justice-involved that are referred to any MAT appointment for treatment program attended 17 If of unique patients who have DUD,served,who report they are %of patients,who have DUD,who A unique patient may participate in multiple treatment programs so there satisfied with services are satisfied w/services Incomplete may be some duplication of unique patients when numbers across k of unique patients who have DUD,served programs,project,sites,etc.,are aggregated for the strategy-specific Incomplete Custom,strategy-specific measures may be entered in this row. Incomplete Custom,strategy-specific measures may be entered in this row. Incomplete Custom,strategy-specific measures may be entered in this row. Outcome measures answer the question,"Is anyone better off?".Outcome measures can be at the program-or population-level.Please quantify the outcome measures relevant to your implementation of this strategy.Outcome measures should reflect numbers from the 2024 fiscal year(i.e.,July 1,2024-June 30,2025). STRATEGY-SPECIFIC OUTCOME MEASURES(PROGRAM-LEVEL) Description Count Outcome Measure Percent(Autocalculated) Notes Additional Information&Helpful Hints about this Measure ff of unique patients with DUD served who were connected and %of patients with DUD who adhere Recommended measure at six months.If measure for adherence is taken at adhere to treatment to treatment_months after first Incomplete another increment,please describe this in the"Notes"column. q of unique patients who have DUD,served appointment Jt of patients who have DUD,served who report getting the social and %of patients who report getting the Consider asking patients the Behavioral Risk Factor Surveillance System emotional support they need social and emotional support they Incomplete question, Jf of unique patients who have DUD,served need "How often do you get the social and emotional support you need?" p of community overdose reversals using naloxone tt of community overdose reversals Itl{A. using naloxone Incomplete Custom,strategy-specific measures may be entered in this row. Incomplete Custom,strategy-specific measures may be entered in this row. Incomplete Custom,strategy-specific measures may be entered in this row. In addition to any program-level outcome measures captured above,population-level data on outcome measures are available from the OSUAP Data Dashboard.Please visit the Data Dashboard and become familiar with what is available.Then indicate if STRATEGY-SPECIFIC OUTCOME MEASURES(POPULATION-LEVEL) Description Are you expecting to change this measure as a result of implementing this stragegy? Notes Additional Information&Helpful Hints about this Measure Jt of patients with DUD who received evidence-based addiction The Ooioid and Substance Use Action Plan IOSUAPI Data Dashboard can be treatment services across programs and settings found here.Use the"Metrics"tab to find the"Metric"(i.e.,Outcome Measure Population-Level)and"Place"to find Your count. The Opioid and Substance Use Action Plan(OSUAP,Data Dashboard can be %of residents receiving dispensed buprenorphine prescriptions found here.Use the"Metrics"tab to find the"Metric"(i.e.,outcome Measure Population-Level)and"Place"to find your county. %of individuals with DUD served by treatment programs who are The Ooioid and Substance Use Action Plan(OSUAP)Data Dashboard can be uninsured or Medicaid beneficiaries found here.Use the"Metrics"tab to find the"Metric"(i.e.,Outcome Measure Population-Level)and"Place"to find your county. 18 NORTH CAROLINA CONTRACT AMENDMENT ORANGE COUNTY THIS CONTRACT AMENDMENT ("Amendment") is made and entered into this 22°d day of October, 2025 by and between ORANGE COUNTY (hereinafter referred to as "County") and Freedom House Recovery Center, Inc. (hereinafter referred to as"Provider"). WITNESSETH: THAT WHEREAS, the County and Provider entered into a contract dated July 1, 2024, (hereinafter the "Original Agreement"), for the provision of services for support programs that serve persons with Opioid Use Disorder(OUD); and WHEREAS, the County and Provider desire to amend the Original Agreement while keeping in effect all terms and conditions of the Original Agreement not inconsistent with the terms and conditions set forth below. NOW THEREFORE, for and in consideration of the mutual covenants and agreements made herein, the parties agree to amend the Original Agreement as follows: 1. In order to ensure the completion of the Services identified in the term of the Original Agreement is amended to reflect an end date by which all Services shall be completed of December 31, 2025. 2. Article 3., Section a. is amended to reflect additional invoice dates of October 31,2025 for service period July 1,2025 through September 30,2025,and if funding isn't fully utilized by that time January 15,2026 for service period October 1,2025 through December 31,2025. Supporting documentation is due with the invoice. 3. Article 3., Section a. is amended to reflect an additional reporting date of October 31, 2025 for service period July 1, 2025 through September 30, 2025, and if funding isn't fully utilized by that time January 15, 2026 for service period October 1, 2025 through December 31,2025. The narrative will also be required at the time of the final report. 4. Except for the changes made herein,the Original Agreement shall remain in full force and effect to the extent it is not inconsistent with this Amendment. In the event there is a conflict between the terms of the Original Agreement and the terms of this Amendment,this Amendment shall control. IN TESTIMONY WHEREOF, this Amendment has been executed by the parties hereto, as of the date first above written. ORANGE COUNTY PROVIDER Travis Myren Joyce Harper County Manager Chief Executive Officer Revised 01/24 19 ORANGE COUNTY—INTERNAL USE ONLY Finance Information Vendor Name: UNC-CH Vendor Contact Person: Nathan Jones Phone: 9-966-3411 Address: 104 Airport Dr., Ste 2200 City Chapel Hill State:NC Zip: 27599 Department:Health Amount:$00 Purpose: Services and support programs that serve persons with Opioid Use Disorder Budget Code(s):27411020-630000-92004 Vendor#49882 R9 Vendor Status with NCSOS: Current-Active Non-Profit Vendor is a BOCC consultant: ❑Yes ®No Contract Details Contract Type: ❑New ®Amendment(Original Contract: 12/l/23)(Most Recent Amendment ) Effective Date 7/l/25 End Date 12/31/25 Notice Date (Notice Purpose ) Award ®Approved by Board(Agenda Date:April 18,2024); ❑Made or Administered by Signature Authority ❑BOCC Express Delegation(Agenda Date: - Policy 9.4: ❑Under$5,000; ® Service Under$90,000; ❑Construction Under$250,000 - ❑Budget Policy Section XV(Capital Improvement Project: ) Bidding ❑Informal Bidding($30k-$90k); ❑Formal RFP($90k+); ❑Other(<$30k); ❑Exception(# -) Department Affirmation ® This agreement is approved as to technical form and content and I as Department Director affirmatively state work on this project has not been initiated prior to execution of the agreement. ❑This agreement is approved as to technical form and content. Services related to this agreement have already begun or been completed.Description of the nature of the emergency condition that was addressed: Department Director's Signature Date: Information Technologies This agreement has been reviewed and is approved as to information technology content and specifications: Office of the Chief Information Officer Date: ®Inapplicable because no hardware/software purchases or related services Risk Management This agreement is approved for sufficiency of insurance standards,specifications,and requirements: Office of the Risk Management Officer Date: Financial Services This instrument has been pre-audited in the manner required by the Local Government Budget and Fiscal Control Act: Office of the Chief Financial Officer Date: Legal Services This agreement is approved as to legal form and sufficiency: Office of the County Attorney Date: Clerk to the Board All Docusign contracts must be copied to the Clerk upon completion: occlerkdocs@orangecountync.gov The following signature block is for hard copies only and is not required for Docusign contracts: Received for record retention: Office of the Clerk to the Board Date: Revised 01/24