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HomeMy WebLinkAbout2025-758-E-Health Dept-UNC-CH-Services and support programs that serve persons with Opioid Use DisorderOrange County Opioid Funding Agency Performance Agreement Revised 07/25 Page 1 of 10 OPIOID FUNDING AGENCY PERFORMANCE AGREEMENT THIS AGREEMENT, made and entered into the first day of July 2025, (“Effective Date”) by and between the County of Orange, a political subdivision of the State of North Carolina, Post Office Box 8181, Hillsborough, North Carolina, 27278, ("County") and University of North Carolina at Chapel Hill, located at 104 Airport Drive, Suite 2200, Chapel Hill, North Carolina 27599 (“Provider”). WITNESSETH: WHEREAS, it is in the interests of the County that said program be assisted by the County and thereby enhance its availability to residents of the County, and said program addresses an important community human services need, as identified by the Board of Commissioners. NOW, THEREFORE, in consideration of the above and the mutual covenants and conditions hereafter set forth, the County and Provider agree as follows: 1. Term of the Agreement. The term of this Agreement shall be a program year beginning July 1, 2025 to June 30, 2026. 2. Scope of Services. a. Provider will provide services, as outlined in Exhibit A to NC MOA: High-Impact Opioid Abatement Strategies (“OPTION A” List) - to the residents of Orange County. The Scope of Services and the Program Budget (Exhibit B) may be different from the original application based on County appropriation; however, any revisions or amendments to this Agreement must be approved in writing by the County and attached to this Agreement as Exhibit C. b. The Provider shall be solely responsible for the means, methods, techniques, sequence, safety program and procedures necessary to properly and fully complete the work set forth in the Scope of Services. 3. Funding. a. The County agrees to appropriate for the provision of services described in Exhibit B, Scope of Services and more particularly described in the Revised Program Budget, the maximum sum of $37,600.00. b. All funds appropriated shall be used for purposes described in Scope of Services. Any funds not used for the purposes stated shall be returned to the County. Any changes in the use of funds must be authorized in writing by the County prior to any expenditure of the funds by the Provider. If the funds are expended not in accordance with the Scope of Services, at the discretion of the County the Provider may be required to repay the funds to the County. c. The Provider shall be paid in four equal installments in the amount of $9,400.00. The first payment is contingent upon receipt of the agency’s performance agreement; the remaining payments are contingent upon receipt of the request for reimbursement and related supporting documentation. d. The County’s obligation to make the quarterly payments is contingent upon receipt of Progress Reports (Attachment A), which show satisfactory progress toward completion of performance measures and an accounting of expenditures as detailed in the Scope of Docusign Envelope ID: 29556FD2-008F-43BA-A984-596F90EB929E Orange County Opioid Funding Agency Performance Agreement Rev.07/25 Page 2 of 10 Services. Final payment is contingent upon a final Progress Report as well as the narrative story and accounting of expenditures. e. Once Provider has satisfied its obligations as provided in (d) payment will be made 21 days after receipt of the Progress Report and Request for Reimbursement or 21 days after due date of Progress Report whichever is later. f. The County is not obligated to provide any other support to Provider in this or in succeeding fiscal years. 4. Agency Reporting. a. Provider will provide Orange County a Progress Report that includes a fiscal report and updates on performance measures as outlined in the Scope of Services.  Quarters 1 and 2 progress and financial reports due January 10 for reporting months July 1 – December 31.  Quarter 3 progress and financial report due April 10 for reporting months January 1 – March 31.  Final progress report due August 15 for reporting months July 1 – June 30.  Final financial report due August 15 for reporting months April 1 – June 30. b. Provider agrees to allow the County to inspect its financial books and records, which document costs of those services, upon reasonable notice during normal working hours. 5. Termination. a. Termination for Cause. In the event of any of the circumstances set forth below (hereinafter referred to as “default”), the County may immediately terminate this Agreement, in whole or in part, and from time to time. Notice of termination must be in writing, state the reason or reasons for the termination, and specify the effective date of the termination: i. In the event that Provider shall cease to exist as an organization or shall enter bankruptcy proceedings, be declared insolvent, or liquidate all or substantially all of its assets, or significantly reduce its services or accessibility to Orange County residents during the term of this Agreement; or ii. In the event that Provider shall fail to render a satisfactory accounting as provided section 4 above, the County may terminate this Agreement and Provider shall return all payments already made to it by the County for services which have not been provided or for which no satisfactory accounting has been rendered; or iii. In the event of any fraudulent representation by the Provider in an invoice or other verification required to obtain payment under this Agreement or other dishonesty on a material matter relating to the performance of services under this Agreement. iv. Nonperformance, incomplete service or performance, or failure to satisfactorily perform any part of the work identified in the Scope of Services or to comply with any provision of this Agreement, as determined by the County in its sole discretion. v. Failure to adhere to the terms of applicable county, state or federal laws, regulations, or stated public policy. . Docusign Envelope ID: 29556FD2-008F-43BA-A984-596F90EB929E Orange County Opioid Funding Agency Performance Agreement Rev.07/25 Page 3 of 10 b. In the event of default by the Provider, including but not limited to failure to perform services in accordance with this Agreement or noncompliance with applicable reporting, documentation, or funding requirements, the County may elect to terminate this Agreement in whole or in part. The County shall pay Provider for all properly performed services accepted by the County up to the effective date of termination, including services identified by the Provider in a written list submitted within 30 days of termination notice, detailing services performed since the last report and their associated costs, subject to County review and acceptance. The County shall not be responsible for payment of any non-cancellable commitments entered into by the Provider without the County’s prior written consent, except for those costs that were expressly included in the approved budget (showing in Exhibit B) and incurred in accordance with this Agreement prior to termination. The County may (but shall not be required to) grant the Provider an opportunity to cure the default without termination of this Agreement. This clause shall not be interpreted to limit the County’s remedies in law or in equity, including the right to recover any funds determined to have been improperly expended under this Agreement. If any funds are determined to be improperly expended under this Agreement, the Provider shall repay such funds within thirty (30) business days. c. Notwithstanding the foregoing, either party may terminate the agreement at any time without penalty, provided that written notice of such termination is furnished to the other party at least thirty (30) days prior to termination. In the event of such termination, the County shall pay the Provider for all properly performed services accepted by the County through the effective date of termination, including services identified by the Provider in a written list submitted within 30 days of termination notice, detailing services performed since the last report and their associated costs, subject to County review and acceptance. The County shall not be responsible for any non-cancellable commitments or obligations incurred by the Provider without the County’s prior written consent, except for those costs that were expressly included in the approved budget (showing in Exhibit B) and incurred in accordance with this Agreement prior to termination. Any unused funds shall be returned to the County within thirty (30) days of termination. d. Any termination of this Agreement for default under this section that is later deemed to be unjustified shall be deemed a termination for convenience. e. 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. 6. Responsibilities of the County. 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. Docusign Envelope ID: 29556FD2-008F-43BA-A984-596F90EB929E Orange County Opioid Funding Agency Performance Agreement Rev.07/25 Page 4 of 10 7. Insurance. a. General Requirements. Provider, an agency of the State of North Carolina, is responsible for its and its employees’ negligence as provided under North Carolina law. The Provider is a self-insured entity and carries insurance limits as required by the state of North Carolina. The Provider will be responsible for its own negligence in accordance with the North Carolina Tort Claims Act. A copy of Provider’s Certificate of Insurance will be provided to County upon request. i. Nothing in this section is intended to affect or abrogate the County’s sovereign immunity defenses. 8. General Provisions. a. 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 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. b. Non-Discrimination. Provider agrees as part of consideration of the granting of funds by Orange County the parties hereto for themselves, their agents, officials, employees and servants agree not to discriminate in any manner of these basis of race, color, gender, national origin, age, handicap, religion, sexual orientation, familial status or veterans status with reference to any activities carried out by the grantee, no matter how remote. The parties hereto further agree in all respects to conform to the provision and intent of Orange County Civil Rights Ordinance, as amended and the Orange County Non-discrimination Policy, which is incorporated herein by reference and can be viewed at http://www.orangecountync.gov/departments/purchasing_division/contracts.php. The County may enforce this provision by an action for specific performance, injunctive relief, or other remedy as by law provided; this provision shall be binding on the grantees, the successors and assigns of the parties hereto with reference to the above subject manner. c. 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. d. Relationship of the Parties. Provider is an independent contractor of the County. Provider represents that they have or will secure, at his own expense, all personnel required in performing the services under this Agreement. Such personnel shall not be employees or have any contractual relationship with the County. All personnel engaged in work under this Agreement shall be fully qualified and shall be authorized and permitted under federal, state and local law to perform such services. Docusign Envelope ID: 29556FD2-008F-43BA-A984-596F90EB929E Orange County Opioid Funding Agency Performance Agreement Rev.07/25 Page 5 of 10 e. Compliance with all Laws. The Provider, at its sole expense, shall comply with all laws, ordinances, orders and regulations of the federal, state or local governments, as well as their respective departments, commissions, boards, and officers, which are in effect at the time of execution of this Agreement or are adopted at any time following execution of this agreement. f. Subcontract. The County and Provider deem the services provided under this Agreement to be personal in nature and Provider may not subcontract any rights or duties under this Agreement to any other party without prior written consent from the County. g. Assignment. The Provider shall not assign this Agreement, including the rights to payment, to any other party without the prior written consent of the County. h. Indemnification. Provider agrees to defend, indemnify, and hold harmless the County, for all loss, liability, claims or expense arising from bodily injury, including death or property damage, to any person or persons caused in whole or in part by the negligence of the Provider, except to the extent same are caused by the negligence of the County. It is the intent of this section to require Provider to indemnify the County to the extent permitted by the North Carolina Tort Claims Act. Nothing in this section shall be construed as a waiver of any defenses or immunities available to either party under North Carolina law, including but not limited to sovereign immunity and governmental immunity. i. Non-Appropriation. This Agreement is subject to the availability of funds to purchase the specified services and may be terminated at any time if such funds become unavailable. j. Severability. All clauses found herein shall act independently of each other. If a clause is found to be illegal or unenforceable, it shall have no effect on the other provisions of this Agreement. It is understood by the parties hereto that if any part, term or provision of this Agreement is by the Courts held to be illegal or in conflict with any laws of the State of North Carolina or the United States, the validity of the remaining portions or provisions shall not be affected, and the rights and obligations of the parties shall be construed and enforced as if the Agreement did not contain the particular part, term or provision held to be invalid. k. 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. l. 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 The University of North Carolina at Chapel Hill Attention: Kimberlee Quatrone Attention: Penny Gordon-Larsen P.O. Box 8181 104 Airport Dr., Suite 2200 300 W. Tryon St. Chapel Hill, NC 27599 Hillsborough, NC 27278 Email: SponsoredPrograms@unc.edu Email:kquatrone@orangecountync.gov m. Signatures. This Agreement together with any amendments or modifications may be executed electronically. All electronic signatures affixed hereto evidence the intent of the Parties to comply with Article 11A and Article 40 of North Carolina General Statute Chapter 66. Docusign Envelope ID: 29556FD2-008F-43BA-A984-596F90EB929E Orange County Opioid Funding Agency Performance Agreement Rev.07/25 Page 6 of 10 IN WITNESS WHEREOF, the Orange County and the Provider have signed this Agreement, effective on the last date this Agreement is signed by both parties as indicated by the dates set forth under signatures below. For and on behalf of the Provider Penny Gordon-Larsen, Vice Chancellor for Research Date For and on behalf of Orange County Government Travis Myren, County Manager Date Lexi Damacus on behalf ofPenny Gordon-Larsen 12/18/2025 Docusign Envelope ID: 29556FD2-008F-43BA-A984-596F90EB929E 12/23/2025 Orange County Opioid Funding Agency Performance Agreement Rev.07/25 Page 7 of 10 ORANGE COUNTY—INTERNAL USE ONLY Finance Information Vendor Name: UNC-CH Vendor Contact Person: Lexi Damacus Phone: 919-962-8003 Address: 104 Airport Dr., Suite 2200 City Chapel Hill State: NC Zip: 27599 Department: Health Amount: $37,600.00 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: ) (Most Recent Amendment ) Effective Date 7-1-25 End Date 6-30-26 Notice Date (Notice Purpose ) Award Approved by Board (Agenda Date: May 20,2025); 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. 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: Docusign Envelope ID: 29556FD2-008F-43BA-A984-596F90EB929E 12/19/2025 12/22/2025 12/22/2025 12/23/2025 Exhibits, page 1 Exhibit A 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 Docusign Envelope ID: 29556FD2-008F-43BA-A984-596F90EB929E Exhibits, page 2 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. Docusign Envelope ID: 29556FD2-008F-43BA-A984-596F90EB929E Exhibit B: Scope of Services Project Description and Program Sustainability The primary implementation strategy addressed by this proposal is Strategy 9: Syringe Service Program. Our work also addresses Strategy 7: Naloxone Distribution. The proposed project is funding for the Student Health Action Coalition (SHAC) SSP. SHAC SSP is a volunteer- based organization that seeks to improve health outcomes for people who use substances and improve community knowledge of drug safety. We are founded on the principles of harm reduction, which seek to center the humanity of people who use substances while working to reduce higher-risk behaviors through delivery of non-judgmental care. We aim to “meet people where they are” and rebuild trust between people with substance use disorder (SUD) and the medical community. SHAC SSP serves a diverse clientele and is the only fixed location SSP operated out of and focused exclusively on Orange County. Our parent organization, SHAC, is a 501(c)(3) nonprofit that is managed through the UNC Health Foundation and is part of the National Association of Free Clinics and North Carolina Association of Free and Charitable Clinics. SHAC’s mission is to provide free “comprehensive health care and social needs support.” Due to capacity constraints, SHAC is unable to administer large awards in-house. Therefore, we are applying with the UNC Injury Prevention Research Center (IPRC) who will administer the award, including overseeing the financial, personnel, and compliance aspects of the program. SHAC SSP was awarded Orange County Opioid Settlement funds in a previous cycle and the contract is currently administered through IPRC. SHAC SSP registered with the North Carolina Department of Health and Human Services as an SSP in Spring of 2022. Since our inception in 2022 we have provided safer use supplies to over 175 unique SSP clients, including more than 456 doses of naloxone and 2,002 syringes. We also provide sterile injection supplies, fentanyl and xylazine test strips, first aid supplies, drug checking kits, referrals to local organizations for substance use disorder treatment, and referrals to other clinics within SHAC for free medical and dental care, STI and HIV testing and treatment, and more. Our leadership team has been trained to lead educational activities related to naloxone administration, harm reduction principles, North Carolina Good Samaritan laws, and fentanyl awareness. In the last year, our volunteer base increased from 15 to 83 active volunteers with undergraduates, nursing students, public health students, and medical students receiving training on topics important for SSP shift staffing including how to teach participants about naloxone use. Our tracked statistics from May 2022-May 2023, prior to receiving Orange County Opioid Settlement Funding, compared to June 2023-June 2024 with funding show that we substantially increased our supply provision to participants. Overall, our number of participants served increased from 65 in 2022-2023 to 124 in 2023-2024. Our provision of naloxone doses increased 109% in 2023-2024 compared to 2022-2023 from 99 to 207, and our number of syringes distributed increased 115% from 439 to 946. Additionally, we expanded from one to two weekly supply distribution shifts during the last funding period. We are seeking funding for SSP supplies, educational materials, marketing, travel, and continued funding for the paid Program Navigator position within SHAC SSP. Supplies include purchases of naloxone, syringes, fentanyl and xylazine test strips, basic first aid supplies, and other items comprising the total inventory of 26 harm reduction-related items we supply. The program navigator hired within the last funded year provides program management and support, including development of educational materials, volunteer management and training, Docusign Envelope ID: 29556FD2-008F-43BA-A984-596F90EB929E program expansion, management of community partnerships, and direct staffing of supply distribution shifts. This funding will let us meet organizational goals by increasing supply distribution and starting new initiatives as detailed below. Our grant through the Orange County Opioid Settlement Fund is currently our only source of funding. Challenges for our program beyond the current project cycle include maintaining our Program Navigator role, which is currently a temporary position pending grant funding. However, we will work with our program navigator for whatever time we can fund this position to create streamlined workflows that are more sustainable for a student-run organization. Streamlining processes for inventory, supply ordering, maintaining records, and interfacing with other programs will enable us to continue to grow and maintain access to necessary safer use supplies for residents of Orange County. Another challenge for our program is that we currently receive nasal Naloxone for free via the Addiction Medicine program at UNC but are not guaranteed to continue receiving this resource indefinitely. To address this, we developed our budget such that if needed we can shift spending to be able to purchase Naloxone. We would also explore other sources of free or reduced cost Naloxone via connections with other SSPs. For the initiatives below, three student co-directors and the program navigator will share responsibility for oversight and completion of all tasks, with our student volunteer base providing staffing for routine SSP activities. Upcoming initiatives for new funding period: 1. Open a new SHAC SSP location to increase SSP access: With our program navigator available to staff shifts weekly and the significant growth of our volunteer base, our bandwidth for shift staffing has increased greatly. We are actively seeking an additional location in Chapel Hill to host a third weekly distribution shift. This location will be selected to complement our weekly shift locations in Chapel Hill and Carrboro and our supply site at Hillsborough Pharmacy and serve a population to whom these locations are not easily accessible. We are utilizing participant feedback and EMS data on overdose locations to select this site. An additional distribution shift per week in a visible and easily accessible location within Orange County will enhance the quantity of safe injection supplies and Naloxone we can distribute. We will seek to start shifts at our new site at the start of the Fall undergraduate semester in August 2025. 2. Initiate SHAC SSP material distribution within the UNC Emergency Department (ED): We are in the process of incorporating information on the SHAC SSP into discharge materials for patients admitted to the UNC ED with substance use-related chief complaints or those who discuss substance use with their provider. Through discussions with ED leadership, it became apparent that the current guidance materials for treatment of SUD are out of date and our program is assisting in revision of these materials. Our program will also be giving a presentation to the UNC Emergency Medicine Residency Program to educate medical residents on SUD treatment, harm reduction, and SSPs. This will benefit patients in our community by streamlining the process with the UNC ED for patients to access lifesaving resources through our program. This will represent a significant improvement in how patients who use opioids are treated within the UNC Healthcare system and open a line of dialogue so we may continue to improve healthcare providers’ knowledge and awareness as the opioid crisis evolves. The presentation will occur in Summer 2025 and guidance materials updated throughout Fall 2025, with this initiative led by the program co-directors in conjunction with medical student volunteers. 3. Establish Emergency Use Naloxone Boxes: We plan to expand access to free naloxone in Docusign Envelope ID: 29556FD2-008F-43BA-A984-596F90EB929E Orange County through a selection of data-driven locations with a high risk of opioid overdoses. This initiative will include installing emergency naloxone boxes (similar to public-use AEDs and EpiPens) in locations that were sites of overdoses in 2020-2023. These efforts will initially focus on parking garages and public spaces, with further locations determined through ongoing collaboration with Orange County PORT. We plan to initiate this project during Summer 2025. This project would build local infrastructure to respond to the opioid crisis by significantly increasing access to overdose resources in our community. We will commit to continuously restocking these boxes throughout and beyond the proposed funding period. 4. Improve and streamline referrals: During the prior fiscal year we strengthened our connections with local programs providing resources that may be helpful for our participants such as free primary care, dental care, counseling and mental health care, and STI and HIV testing. We have previously referred participants to these resources on an as-needed basis upon request or based on volunteers’ assessment of participant needs. In this grant period, we will seek to streamline and increase the frequency of referrals by integrating a standardized checkout form for our distribution shifts that will include referrals as items to offer every participant. This will increase frequency of referrals, improving linkage to needed resources for vulnerable Orange County residents. We will also continue to offer referrals to substance use disorder treatment centers in a non-prescriptive, participant-initiated manner. The standardized checkout form will be iteratively improved to incorporate feedback from participants throughout the funded period. 5. Engage with and compensate SSP participants for their feedback to improve services: As an organization composed of and led by UNC students, we are conscious of our need to incorporate perspectives from individuals with lived experience with substance use into the direction and leadership of our program to better serve our population. In the next fiscal year, we will strive to integrate participant feedback and include the input of community members with lived experience in a more regimented manner. We will develop and implement surveys on the performance of our programs, including any unmet needs, and compensate participants financially for filling out these questionnaires. We will also identify our most engaged participants and create a community advisory board (CAB) so they can share their input on the program with us at quarterly meetings and as needed throughout the funded period. CAB meetings will begin in Fall 2025. 6. Disseminate our program’s work and continue building collaborations through educational conferences: To further engage with other agencies in the state, learn about new harm reduction approaches, and increase our awareness of other local resources, we plan to have our program directors and navigator attend conferences in this fiscal year. They will attend the twice-yearly NC Safer Syringe Initiative Learning Collaboratives for education and training on topics such as wound care that will enhance the services our SSP offers. We will also seek to disseminate our program’s unique student-led SSP model by presenting at the American Society of Addiction Medicine conference in April 2026, with abstract submission in January 2026. We hope that the presentation will inspire and guide the creation of student-run SSPs at other institutions. Docusign Envelope ID: 29556FD2-008F-43BA-A984-596F90EB929E Overall Program Budget Agency Proposed Program Title Total Program Revenue Budget 2025 2026 2027 Project Period Total Revenues: Opioid Settlement Funds Other Funding Sources Total Opioid Settlement Funds Other Funding Sources Total Opioid Settlement Funds Other Funding Sources Total Orange County Opioid Settlement Funding $ - $ - $ - $ -$ -$ - $ - $ - $ -$ - $ - $ - $ -$ - $ - $ - $ -$ - $ - $ - $ -$ - $ - $ - $ -$ - Total Revenues: $ - $ - $ - $ - $ -$ - $ - $ -$ -$ - Total Program Expense Budget 2025 2026 2027 Project Period Total Expenses: Opioid Settlement Funds Other Funding Sources Total Opioid Settlement Funds Other Funding Sources Total Opioid Settlement Funds Other Funding Sources Total Personnel and Benefits: 22,360.00 - 22,360.00 - - -- --22,360.00 Operations Expenses: 15,240.00 - 15,240.00 - - -- --15,240.00 Subcontractor Services: Subcontractor 1 name - - -- - -- --- Subcontractor 2 name - - -- - -- --- Subcontractor 3 name - - -- - -- --- Capital - - - - --- Administrative/Indirect cost (no more than 10%) - - -- - -- --- Total Expenses: 37,600.00 - 37,600.00 - ----37,600.00 University of North Carolina at Chapel Hill Student Health Action Coalition Syringe Service Program Complete this form for all revenue sources, as well as expense sources other than Opioid Settlement funds. Figures for expenses using Opioid Settlement funds will automatically populate from detail tabs of spreadsheet, except for the administrative/indirect cost line item, which should be filled out in this tab. Add rows as needed. Enter information in yellow shaded cells only. Docusign Envelope ID: 29556FD2-008F-43BA-A984-596F90EB929E Opioid Settlement Strategies RFA Budget Narrative Agency Proposed Program Title Year Direct Personnel and Fringe Benefits Other Direct Costs (Non-Personnel) Subcontractor/Consultant Services Administrative Costs The Director of Outreach, Training, and Education (0.48 calendar months/4.01% FTE) for the SHAC SSP award will oversee overall management of the award, ensuring its programmatic and fiscal integrity. The Director of Outreach, Training, and Education will ensure timely submission of financial invoices, programmtic reports, and proactive communication with Orange County representatives. She will directly supervise the Syringe Service Program Navigator and liaise with the co-directors of the syringe service program. The Syringe Service Program Navigator (2.84 calendar months/23.65% FTE) will provide management of the syringe service program, including development of educational and marketing materials, training & onboarding new volunteers, managing existing volunteers, and staffing supply distribution shifts. This position will also be responsible for identifying opportunities for program expansion in Orange County in addition to developing and maintaining relationships with community partners. Fringe Benefits: The University of North Carolina at Chapel Hill fringe benefits are calculated at a rate of 24.7679% (6.2%+1.45% social security; 14.24% retirement; 1% worker's comp; 1.8779% leave payout, transit, and communications) of annual salary plus $8,095/FTE/year for health insurance. Fringe benefits for part-time and temporary employees are calculated at 9.5279% of annual salary (6.2%+1.45% social security; 1% worker's comp; 0.8779% transit and communications). Safe injection supplies: are included in harm reduction kits that are handed out to SSP participants on an as-needed basis.These supplies include sterile syringes, tourniquets, cookers, cotton pellets, triple antibiotic ointment, saline ampoules, alcohol prep pads, Vitamin C packers, small bandages, 5 qt sharps containers, 1 qt sharp containers. Overdose prevention and reversal supplies are lifesaving products that help prevent and reverse overdoses. People who use drigs (PWUD) are most likely that anyone else to reverse an overdose, so it is vital that these supplies are distributed to program participants. These supplies include naloxone, fentanyl test strips, and CPR face shields. General first aid supplies are provided to program participants because PWUD often experience wounds related to their injection drug use, especially with xylazine in the supply. Additionally, we work with a population that is largely unhoused, so we believe it is important to provide them with basic necessities, such as hand warmers and mosquito repellent to keep them safe in the outdoor environment. These supplies include large bandages, 3x3 gauze pads, surgical tape rolls, nitrile gloves, hand warmers, and mosquito repellent. Safe sex supplies are distributed to decrease the spread of STIs and other blood borne pathogens. These supplies include condoms, lubricant sachets, dental dams, and pregnancy test strips. Educational materials include: -Trifold pamphlets will provide information about the services offered by the SSP and the importance of having an SSP in the community. Pamphlets will also include a list of other resources for participants. -"I carry naloxone" stickers will be provided to individuals who are trained through the SSP to use naloxone so they can be easily identified as a resource in the community. -"How to use test strips" cards will be provided with test strips to instruct individuals on how to use and read fentanyl and xylazine test strips. -SHAC SSP Manual will be provided to all new volunteers and shift managers to ensure that the SSP procedures, policies, and protocols are followed and the program is run efficiently. Travel within Orange County accounts for mileage driven by the program navigator and SSP co-directors to deliver supplies to program sites, travel to staff supply distribution shifts, and travel to meetings with community partners. Travel within North Carolina will allow the program navigator and SSP co-directors to attend in person meetings of the North Carolina Safer Syringe Iniative held by NC Department of Health & Human Services' Injury & Violence Prevention Branch. Marketing materials will be used to increase knowledge and awarness of the SSP in Orange County to increase participation and ensure all who may need these services are aware of them. Marketing materials will also aim to communicate the importance of SSPs in the health and safety of communities to increase community buy-in for the program. These materials include yard signs, banners, business cards, and flyers. N/A N/A Student Health Action Coalition Syringe Service Program 2025-2026 Docusign Envelope ID: 29556FD2-008F-43BA-A984-596F90EB929E MIKE CAUSEY INSURANCE COMMISSIONER BRIAN TAYLOR STATE FIRE MARSHAL OFFICE OF STATE FIRE MARSHAL 1202 MAIL SERVICE CENTER I RALEIGH NC 27699-1202 I TEL 919.647.0000 I Fax 866.851.6508 I WWW.NC OSFM.GOV February 19, 2024 Re: NC State Tort The State of North Carolina, being self-insured and holding sovereign immunity, is not susceptible to legal action without its explicit permission. Consequently, we do not procure liability insurance. However, pursuant to statute (Chapter 143, Article 31), the State has chosen to waive its sovereign immunity concerning suits related to the negligence of its employees or agents, leading to injuries. The indemnity extends up to a maximum of $1,000,000 for any single individual arising from a singular incident (NCGS § 143-299.2). The North Carolina Industrial Commission is constituted as a court for the purpose of hearing and passing upon tort claims against departments, institutions, or agencies. The State tort is not attached to a policy, therefore does not expire, or require an expiration date to be placed on the certificate of coverage. We trust that the above information provides the necessary certification needed by your organization. If you have any questions or need additional information, please let us know. Sincerely, Latarsha Y. Silver, CRM Risk Manager Docusign Envelope ID: 29556FD2-008F-43BA-A984-596F90EB929E MIKE CAUSEY INSURANCE COMMISSIONER BRIAN TAYLOR STATE FIRE MARSHAL OFFICE OF STATE FIRE MARSHAL 1202 MAIL SERVICE CENTER I RALEIGH NC 27699-1202 I TEL 919.647.0000 I Fax 866.851.6508 I WWW.NCOSFM.GOV CERTIFICATE OF COVERAGE Insurer: State of North Carolina Authorization: North Carolina General Statute Sections 143-291 to 143-300.1A, commonly referred to as the State Tort Claims Act. Coverage: Tort Claims against Departments, Agencies, and Employees must be filed in the North Carolina Industrial Commission and a legal defense is provided by the State. 1. Workers’ Compensation Limits $1,000,000 statutory damage to any one person arising out of any one occurrence. NCGS § 143-299.2 2. Statutory Limits for Workers’ Compensation Description: University of North Carolina at Chapel Hill and its employees, officers, agents, as covered by the Defense of State Employees as per NCGS § 143 300.2. The State Tort does not expire. Administrator: Department Insurance - Risk Management Division Office of State Fire Marshal 1202 Mail Service Center, Raleigh, NC 27699-1202 Note: This Certificate is for informational purposes only and does not alter any provision of the Tort Claims or Defense of State Employees General Statutes of the State. Verified By: Latarsha Y. Silver, CRM Risk Manager Docusign Envelope ID: 29556FD2-008F-43BA-A984-596F90EB929E