HomeMy WebLinkAboutAgenda 01-20-2026; 8-i - Revised Opioid Settlement Fund Spending Authorization Resolution and Approval of Budget Amendment #6-A 1
ORD-2026-003
ORANGE COUNTY
BOARD OF COMMISSIONERS
ACTION AGENDA ITEM ABSTRACT
Meeting Date: January 20, 2026
Action Agenda
Item No. 8-i
SUBJECT: Revised Opioid Settlement Fund Spending Authorization Resolution and
Approval of Budget Amendment #6-A
DEPARTMENT: Board of County
Commissioners
ATTACHMENT(S): INFORMATION CONTACT:
Quintana Stewart, Orange County
MOA Spending Authorization Resolution Health Director, 919-245-2412
PURPOSE: To approve a resolution for the final opioid settlement fund spending authorization
for FY 2026, and approve Budget Amendment #6-A.
BACKGROUND: In July 2021, a bipartisan coalition of state attorneys general announced the
National Opioid Settlement — a historic agreement that will help bring desperately needed help to
communities harmed by the opioid epidemic. The State of North Carolina and all 100 counties,
including Orange County, joined the agreement. North Carolina is receiving $1,420,932,713 in
opioid settlement funds from 2022 through 2038. Orange County is expected to receive
$12,748,445 million over an 18-year period.
In September 2022, the BOCC approved the appointment of the Orange County Opioid Advisory
Committee with the following charge:
• Discuss opioid-related health concerns and issues impacting the residents of Orange
County.
• Advise the Board of Commissioners on options to expend funds to prevent opioid abuse
and remedy opioid impacts.
• Plan and host an annual meeting open to the public to receive input on proposed uses of
the settlement funds and to encourage collaboration between local governments.
The Board also approved Option A for the use of the settlement funds per the NC Memorandum
of Agreement Opioid Settlement. County-hosted programs approved for Opioid Settlement
Funding for Fiscal Year 2026 (July 1, 2025 — June 30, 2026) include the following:
• Lantern Project: $201,747
• NC FIT Program: $74,724
• County Vending Machines: $25,000
• PORT Team: $338,350
• Harm Reduction Coordinator: $110,861
• CJRD Clinical Coordinator: $108,191
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At the beginning of the fiscal year, the Opioid Settlement team, in consultation with Budget and
Finance staff, reviewed the amount of available funds in each approved project along with the
status of each projects spending authorization. Upon review, it was determined that multiple
projects needed spending authorization dates extended to account for past spending and allow
for the use of unspent funds from prior years. The attached spending authorization resolution
extends the authorization date for each project until the end of FY 2025-2026, allowing each
project to use all previously allocated funding until the end of the fiscal year.
Additionally, it was determined that the Lantern Project and Harm Reduction Coordinator project
needed additional funds to cover personnel costs in FY 2025-2026. The amendment below
allocates unspent funds from the NC FIT project to account for those additional costs. It also
reallocates the difference in costs for the revised Freedom House contract that was approved by
the Board at the October 21, 2025 Business meeting, with the remainder falling to the unallocated
project.
The formal required resolution providing final opioid settlement fund spending authorization for
FY 2026 is attached for Board approval.
Budget Amendment #6-A amends the grant project ordinance as follows:
Opioid Settlement Fund($0) - Fund#27
Revenues for this project:
Current FY 2025-26 FY 2025-26
FY 2025-26 Amendment Revised
Opioid Settlement Funds $4,654,294 $0 $4,654,294
Total Project Funding $4,654,294 $0 $4,654,294
Appropriated for this project:
Current FY 2025-26 FY 2025-26
FY 2025-26 Amendment Revised
Lantern Project $539,714 $24,345 $564,059
Freedom House $322,485 ($5,577) $316,908
NC FIT $218,224 ($49,629) $168,595
County Vending Machines $93,000 $0 $93,000
SHAC Syringe Exchange Program $101,800 $0 $101,800
Reintegration Support Network $40,000 $0 $40,000
Post-Overdose Response Team $582,370 $0 $582,370
Grow Your World $20,000 $0 $20,000
Harm Reduction Coordinator $218,886 $11,918 $230,804
CJRD Clinical Coordinator $108,191 $0 $108,191
Piedmont Health $50,400 $0 $50,400
EI Futuro $50,000 $0 $50,000
Transition Support and Recovery $20,000 $0 $20,000
Unallocated $2,289,224 $18,943 $2,308,167
Total Costs $4,654,294 $0 $4,654,294
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FINANCIAL IMPACT: Distribution of opioid settlement funds may support programs and services
that serve persons with Opioid Use Disorder or any co-occurring Substance Use Disorder (SUD)
or mental health condition in Orange County. Budget Amendment #6-A reallocates funds within
the awards to amend these project budgets.
ALIGNMENT WITH STRATEGIC PLAN: This item supports:
• GOAL 2: HEALTHY COMMUNITY
OBJECTIVE 1. Improve harm reduction, prevention, and support services for adults and
children experiencing behavioral health issues, substance use disorder, and intellectual or
developmental disability.
RECOMMENDATION(S): The Manager recommends that the Board approve and authorize the
Chair to sign the spending authorization resolution, and approve Budget Amendment #6-A.
RES-2026-005 4
A RESOLUTION BY THE COUNTY OF ORANGE,NORTH CAROLINA
TO DIRECT THE EXPENDITURE OF OPIOID SETTLEMENT FUNDS
WHEREAS Orange County, North Carolina has joined national settlement agreements
with companies engaged in the manufacturing,distribution, and dispensing of opioids, including
settlements with drug distributors Cardinal, McKesson, and AmerisourceBergen,and the drug
maker Johnson& Johnson and its subsidiary Janssen Pharmaceuticals;
WHEREAS the allocation, use,and reporting of funds stemming from these national
settlement agreements and certain bankruptcy resolutions ("Opioid Settlement Funds") are
governed by the Memorandum of Agreement Between the State of North Carolina and Local
Governments on Proceeds Relating to the Settlement of Opioid Litigation("MOA");
WHEREAS Orange County has received Opioid Settlement Funds pursuant to these
national settlement agreements and deposited the Opioid Settlement Funds in a separate special
revenue fund as required by section D of the MOA;
WHEREAS section E.6 of the MOA states:
E.6. Process for drawingfrom om special revenue funds.
a. Budget item or resolution required. Opioid Settlement Funds can be used for a purpose
when the Governing Body includes in its budget or passes a separate resolution
authorizing the expenditure of a stated amount of Opioid Settlement Funds for that
purpose or those purposes during a specified period of time.
b. Budget item or resolution details. The budget or resolution should(i)indicate that it is an
authorization for expenditure of opioid settlement funds; (ii)state the specific strategy or
strategies the county or municipality intends to fund pursuant to Option A or Option B,
using the item letter and/or number in Exhibit A or Exhibit B to identify each funded
strategy, and(iii) state the amount dedicated to each strategy for a stated period of time.
NOW,THEREFORE BE IT RESOLVED, in alignment with the NC MOA, Orange County,
authorizes the expenditure of opioid settlement funds as follows:
1. First strategy authorized
a. Name of strategy: Recovery Su12ort Services
b. Strategy is included in Exhibit A (Exhibit A.Exhibit B)
c. Item letter and/or number in Exhibit A or Exhibit B to the MOA: Strategy
d. Amounted authorized for this strategy: $24.346
e. Period of time during which expenditure may take place:
Start date July 1. 2023 through End date June 30. 2026
f. Description of the program, project, or activity:
The Lantern Project is a collaboration between the Criminal Justice Resource
Department and subcontractor Freedom House Recovery Center. The mission is to
support justice- impacted individuals with substance use disorder through evidence-
based strategies, interventions and programming designed to reduce their
vulnerability to overdose, death, and recidivism. The mission is to light the path to
recovery through harm reduction, diversion, reentry support and treatment.
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g. Provider: Criminal Justice Resource Department
2. Second strategy authorized
a. Name of strategy: Naloxone Distribution
b. Strategy is included in Exhibit A (Exhibit A.Exhibit B)
c. Item letter and/or number in Exhibit A or Exhibit B to the MOA: Strategy 7
d. Amounted authorized for this strategy: $54.198
e. Period of time during which expenditure may take place:
Start date July 1. 2024 through End date June 30, 2026
f. Description of the program,project, or activity:
Funds will be used to purchase Naloxone for Community Vending Machines in
the County.
g. Provider: Criminal Justice Resource Department
3. Third authorized strategy
a. Name of strategy: Syringe Service Program (SSP)
b. Strategy is included in Exhibit A (Exhibit A.Exhibit B)
c. Item letter and/or number in Exhibit A or Exhibit B to the MOA: Strategy
d. Amounted authorized for this strategy: $54.628
e. Period of time during which expenditure may take place:
Start date July 1. 2024 through End date June 30, 2026
f. Description of the program,project, or activity:
UNC Student Health Action Coalition (SHAC) is a harm reduction-based organization
providing sterile injection supplies, fentanyl and xylazine test strips; also provides
referrals to other social and health services for people who use drugs in Orange
County. Seeking funds for Syringe Service Program (SSP) supplies, educational
materials, marketing, travel, and continued funding for paid Program Navigator
position. Desire to open a new SHAC SSP location to increase SSP access; current
distribution occurs at Interfaith Council for Social Service and University Methodist
Church; Hillsborough Pharmacy assists with storage needs.
g. Provider: UNC SHAC
4. Fourth authorized strategy
a. Name of strategy: Early Intervention
b. Strategy is included in Exhibit A (Exhibit A.Exhibit B)
c. Item letter and/or number in Exhibit A or Exhibit B to the MOA: Strategy 6
d. Amounted authorized for this strategy: $20.000
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e. Period of time during which expenditure may take place:
Start date July 1. 2024 through End date June 30,2026
f. Description of the program,project, or activity:
Seeking support for additional mentor trainers to work with youth and emerging
adults (ages 13- 20)navigating substance use,mental health challenges, and/or justice
involvement. Mentors serve as allies and peer support workers, and often have
personal experience with substance use, mental health challenges, and/or justice
involvement.
Mentors receive comprehensive training to recognize and nurture youth strengths,
utilizing Substance Abuse and Mental Health Services Administration(SAMHSA)
Core Competencies (recovery-oriented,person-centered,voluntary,relationship focused,
and trauma-informed practices), active listening skills, SMART goal setting,
and motivational interviewing techniques. Recognizing the profound impact of
poverty and social identities on the youth we serve, Reintegration Support Network(RSN)
is committed to addressing the root causes of inequity through culturally responsive and
person-centered services.
g. Provider: Reintegration SuMport Network(RSN)
5. Fifth authorized strategy
a. Name of strategy: Post-Overdose Response Team(PORT)
b. Strategy is included in Exhibit A (Exhibit A.Exhibit B)
c. Item letter and/or number in Exhibit A or Exhibit B to the MOA: Strategy
d. Amounted authorized for this strategy: $6,621
e. Period of time during which expenditure may take place:
Start date July 1. 2024 through End date June 30. 2026
f. Description of the program,project, or activity:
Development and implementation of a PORT within the geographic constraints of
Orange County,NC; funds will support staff salary, supplies and needed software.
PORTs are specialized teams that respond to opioid overdoses in real time or within
24-72 hours of the overdose event.Upon implementation,the OC-EMS PORT will
meet individuals where they are at in their addiction by providing harm reduction
resources, linkage to treatment services, and medication-assisted treatment (MAT)
induction and administration.
This service will be available to all eligible individuals that OC-EMS interfaces with
during EMS incidents and will be provided as a referral for collaborating
departments, emergency departments, organizations and the community at-large.
PORTS have become the standard of care in post-overdose services nationally and
locally, with 41 North Carolina counties currently having an active PORT in place.
g. Provider: Orange County Emergency Services
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6. Sixth authorized strategy
a. Name of strategy: Collaborative Strategic Planning
b. Strategy is included in Exhibit A (Exhibit A.Exhibit B)
c. Item letter and/or number in Exhibit A or Exhibit B to the MOA: Strategy
d. Amounted authorized for this strategy: $11.919
e. Period of time during which expenditure may take place:
Start date July 1. 2024 through End date June 30, 2026
£ Description of the program,project, or activity:
The Orange County Opioid Program Manager(Harm Reduction Coordinator)will be
responsible for overseeing the development, administration,budget, grant
management, and reporting for Orange County's Opioid Settlement Program. This
position will work with closely with Orange County staff and community partners
involved in community overdose prevention, education, harm reduction, treatment
opportunities and recovery support. They will ensure all reporting requirements are
met for the Opioid Settlement Fund and pursue additional resources to advance this
work.
g. Provider: Orange County Health Department
7. Seventh Authorized Strategy
a. Name of strategy: Evidence-based Addiction Treatment
b. Strategy is included in Exhibit A (Exhibit A.Exhibit B)
c. Item letter and/or number in Exhibit A or Exhibit B to the MOA: Strategy
d. Amounted authorized for this strategy: $48.598
e. Period of time during which expenditure may take place:
Start date July 1. 2025 through End date June 30, 2026
f. Description of the program,project, or activity:
Freedom House connects with individuals screened in the Orange County Detention
Center who have a history of Opioid Use Disorder. The licensed clinician will
conduct a Comprehensive Clinical Assessment to ascertain the best treatment
options for the individual prior to or upon release from incarceration. Freedom
House will utilize a Peer Support Specialist post incarceration to assist individuals
with connecting to the recommended treatment. The Peer will work with the
individual as long as needed to connect them with treatment, community resources,
court appearances and to support the individual in recovery to curb recidivism. The
clinician will reevaluate as needed when and if life circumstances change prior to
engaging in treatment.
g. Provider: Freedom House
The total dollar amount of Opioid Settlement Funds appropriated across the above named and
authorized strategies is $220,310.00.
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Adopted this the 201h day of January 2026.
Jean Hamilton, Chair
Orange County Board of Commissioners
ATTEST:
Laura Jensen, Clerk to the Board
COUNTY SEAL