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Agenda 06-02-2026; 6-a - Opioid Advisory Committee Settlement Use Recommendations
1 ORANGE COUNTY BOARD OF COMMISSIONERS ACTION AGENDA ITEM ABSTRACT Meeting Date: June 2, 2026 Action Agenda Item No. 6-a SUBJECT: Opioid Advisory Committee Settlement Use Recommendations DEPARTMENT: County Commissioners ATTACHMENT(S): INFORMATION CONTACT: Application Form Tonya Stancil, Orange County Harm OAC Scoring Rubric Reduction Coordinator, 919-245-2429 Application Proposal Ratings EI Futuro Proposal Freedom House Proposal UNC — Student Wellness Proposal PowerPoint Presentation PURPOSE: To: 1) receive an update on the Opioid Advisory Committee (OAC); 2) receive OAC recommendations for use of Opioid Settlement Funds that support Option A of the NC Memorandum of Agreement on the Allocation and Use of Opioid Settlement Funds in North Carolina; and 3) direct staff to present a final spending authorization resolution at the Board's June 16, 2026, Business meeting. BACKGROUND: In July 2021, a bipartisan coalition of state attorneys general announced the National Opioid Settlement — a historic $26 billion agreement that will help bring desperately needed help to communities harmed by the opioid epidemic. The State of North Carolina and all 100 counties, including Orange County, joined the agreement. Orange County is expected to receive $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. 2 In FY 2025-26, Orange County has received a total of $1,020,216.03. Additionally, $56,236 of interest has been recorded. The Request for Proposals (RFP) process opened on January 1, 2026. Four (4) Application Workshops were conducted with two (2) in-person and two (2) virtual options. Technical assistance was provided to applicants during the RFP process. Six (6) community applications were received by the February 20, 2026 deadline. The Application Subcommittee of the Opioid Advisory Committee (OAC) reviewed applications and made recommendations to OAC. The OAC as a whole reviewed the Subcommittee's recommendations on April 13, 2026. The following recommendations for the 2026 — 2027 funding cycle are as follows: • Freedom House — $85,906 — Reentry • EI Futuro — $66,310 — Early Intervention • UNC-Student Wellness — $10,000 — Naloxone Distribution • TOTAL RECOMMENDATION — $162,216 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. Allocation of this funding for FY 2026-27 will be added as a proposed staff amendment to the Manager's recommended FY 2026-27 operating budget. ALIGNMENT WITH STRATEGIC PLAN: This item supports: • GOAL 2: HEALTHY COMMUNITY OBJECTIVE 1. Improve harm reduction, prevention, and therapeutic interventions for adults and children experiencing behavioral health issues, substance use disorder, and intellectual or developmental disability. OBJECTIVE 8. Invest in services and programs that improve the health and quality of life of the community (e.g., recreation and public open spaces, arts, etc.) RECOMMENDATION(S): The Manager recommends that the Board: 1) receive an update on the Opioid Advisory Committee (OAC); 2) receive OAC recommendations for use of Opioid Settlement Funds that support Option A of the NC Memorandum of Agreement on the Allocation and Use of Opioid Settlement Funds in North Carolina; and 3) direct staff to present a final spending authorization resolution at the Board's June 16, 2026, Business meeting. 3 ORANGE COUNTY ORANGE COUNTY I �! HIGH IMPACT OPIOID ABATEMENT STRATEGIES NORTH CAROLINA Funding Proposal Application Form Before completing application, please review Attorney Application Due Date: February 20, 2026 General Bondi's Memo providing guidance for recipients of Federal Funding regarding unlawful discrimination. See link: https://www.iustice.gov/ag/media/1409486/dl Applicant Agency: General Information Legal Name Click or tap here to enter text. Address Click or tap here to enter text. Type of Agency ❑ Government/ check one ❑ Non-Profit ❑ For-Profit Business Telephone Click or tap here to enter text. Website Click or tap here to enter text. Primary Contact Full Name Click or tap here to enter text. Title Click or tap here to enter text. Email Click or tap here to enter text. Telephone Click or tap here to enter text. Secondary Contact Full Name Click or tap here to enter text. Title Click or tap here to enter text. Email Click or tap here to enter text. Telephone Click or tap here to enter text. Name of Project Click or tap here to enter text. Total Application Funding Requested $ Click or tap here to enter text. Click or tap Start here to enter End Funding Period Requested (MM/DD/YYYY) Date text. Date Click or tap here to enter text. Selected NC MOA Option A Strategy(Number and Name) Click or tap here to enter text. Agency Mission and Vision Statements Click or tap here to enter text. Use font size 12 throughout document. As a separate Excel file,submit a completed Budget Worksheet. Submit application to tstancil@orangecountync.gov with a subject line of—RFA:Opioid Settlement Funds— [Organization name]. Will receive Receipt of Application email upon submission. If email is not received within 24 business hours, reach out to Tonya Stancil, Harm Reduction Coordinator at tstancil@orangecountync.gov. i 4 1. Proposal Summary(no more than 250 words, required but not scored) Delete the following prompts to make room for your response. Provide a brief(no more than 250 words)overview of the planned project. Summary must include a purpose statement describing how your application will address the needs of people with Opioid Use Disorder(OUD)or any co-occurring Substance Use Disorder(SUD)or mental health condition in the community with particular considerations for historically economically disadvantaged populations. Click or tap here to enter text. ii 5 2. Project Narrative A. Assessment of Community Need (16 points, page limit: not to exceed 1% pages) Delete the following prompts to make room for your response. • List the geographic area to be served by the proposed project and the overdose burden in that area. • Provide any pertinent and/or necessary information as it relates to the need for this work in your community. Identify any gaps in services you intend to address by identifying and/or defining current programs/providers. • Describe the needs of the priority population that this proposal will serve and how those needs were determined(e.g.,focus groups, survey, patient engagement). Priority populations in Orange County are defined as persons with opioid us%pioid use disorder(OUD) or co-occurring substance use disorder(SUD)or mental health conditions, including: • Individuals at highest risk for overdose in Orange County, such as historically economically disadvantaged populations, individuals with multiple Adverse Childhood Experiences(ACES), Substance Use Disorder during pregnancy and in first year of Post Partum. • Children and adolescents at risk for drug use. • Individuals in treatment or recovery. • Individuals involved, or at risk of becoming involved, in the Criminal Justice System. Individuals recently released from jail or prison. NOTE:Provide citations/reference sources for any included community demographic or health status data. Current and relevant data is available at: https://www.ncdhhs.goy/opioid-and-substance-use-action-plan-data-dashboard https.Iliniuryfreenc.ncdhhs.govIDataSurveillancelPoisoning.htm https://nc211.org/data/ https://medicaid.ncdhhs.gov/reports/dashboards#annual Click or tap here to enter text. B. Project Description and Program Sustainability(28 points, page limit:not to exceed 3 pages) Delete the following prompts to make room for your response. • Clearly identify which implementation strategy from the NC MOA's Option A list of eligible strategies are included in the proposal, including the number(e.g., "Strategy 2: Evidence-Based Addiction Treatment"). Only one eligible strategy may be selected for each proposal, however, other strategies may be referenced that apply. • Describe the proposed project in detail including its expected impact on preventing opioid overdose, increasing access and linkages to care for the most marginalized and underserved socioeconomic populations, and building local infrastructure to respond to the opioid overdose crisis. • Explain how you will engage or have already engaged the priority population in developing this proposed project. • Detail how this project will advance your organization's goals. 1 6 • Include timelines for project implementation with specific program objectives as they relate to performance measures and budget(e.g., hiring staff or subcontractors,purchasing supplies, establishing policies and protocols, enrolling participants, etc.)including who is responsible for associated activities. • Explain how the project will increase the capacity of your organization or your community over time to address opioid use disorder. Note that applications must describe how they will plan for enhancements, improvements, or increases achieved during the project year to be sustained past the funding secured during the project period. • Describe obstacles that may affect your organization's ability to sustain this program after the project cycle and potential solutions to identified challenges. • Detail any other funding sources that will be used towards this project. Click or tap here to enter text. C. Equity Impact (8 points, page limit: not to exceed % page) Delete the following prompts to make room for your response. • Describe how the proposed project addresses health inequities and reaches historically economically disadvantaged populations.Additionally, describe how the proposed project addresses the needs of the uninsured and underinsured. Finally, describe how the proposed project will address social determinants of health (transportation, housing, employment, etc.)directly or through collaboration with other agencies. Click or tap here to enter text. D. Organizational Readiness (20 points, page limit: not to exceed 3 pages) Delete the following prompts to make room for your response. • Describe the capacity of the fiscal agent/organization that will take total responsibility for the fiscal, reporting, and grant-related compliance requirements to manage grants and comply with financial and monitoring requirements. (If applicable, provide an example of a prior project.) • If applicable, identify any proposed subcontractors and their role on the proposed project. If the specific subcontractor is not yet identified, describe how the subcontractor will be selected. • Provide specific examples of the organization's or partnership/collaboration of multiple organizations'capacity to deliver information in a humble, sensitive, and appropriate manner. The applicant must demonstrate an understanding of issues specifically affecting people who use drugs(PWUD)and/or other intersecting historically economically disadvantaged populations. A successful applicant will have staff and/or volunteers who are sensitive to drug user health issues. o If applicable, provide specific examples of how any identified subcontractors demonstrate these capacities. • Describe your organization's or partnership/collaboration of multiple organizations'history promoting the health and dignity of individuals and communities impacted by drug use or your plans to incorporate this mission into your core activities and how your organization will be delivering program activities in an appropriate manner. 2 7 o If applicable, provide specific examples of how any identified subcontractors demonstrate these capacities. • If applicable, highlight if your organization or partnership/collaboration of multiple organizations and/or any proposed subcontractors serve the following prioritized groups: o Those experiencing financial disability. o Those transitioning from correctional settings to the community. Click or tap here to enter text. E. Evidence of Collaborations/Partnerships (10 points, page limit: not to exceed 1 % pages) Delete the following prompts to make room for your response. • Describe how you will collaborate on this project or initiative with other relevant organizations in your community and how this project will improve collaboration between local stakeholders and/or engage new ones. • Describe how you will verify that projects or services are not being duplicated in the community and with the population served. Click or tap here to enter text. F. Performance Measures and Program Evaluation (18 points, page limit:not to exceed 1 page) Delete the following prompts to make room for your response. • Detail how you will evaluate your project. • Describe how you will intend to engage the priority population in the design and implementation of the evaluation of this project. • Recipients providing direct services will be required to report client-level data on elements including but not limited to demographic characteristics, substance use, diagnosis(es), services received, and types of medications for opioid use disorder received. Explain how you will capture this data. (See https://nctopps.ncdmh.net/dev/gettingstartedwithnctopps.asp for a suggested tool.) • Explain how you will monitor the project and capture metrics for each of the supported strategy included in your project. You may wish to include metrics in a table format. Click or tap here to enter text. 3 8 Include in the same PDF document as this form, after the Certifications section below, the following required documents. If an item is not applicable to your organization, please indicate this by an "N/A" and explain why it is not applicable. 3. Letters of Commitment and/or Support (Up to 5 letters) 4. Latest Audited Financial Statements (schedule of Receipts and Expenditures if receipts are less than $500,000), including Management letter (Attach letter of explanation if unable to provide) 5. Documentation of Tax Identification Number(can be IRS Determination Letter for non-profit agencies) 6. Certificate of Insurance 7. For non-profit agencies only: A. IRS Determination Letter: provide a copy of an IRS determination letter which states that your organization has been granted exemption from federal income tax under section 501(c)(3) of the Internal Revenue Code.The organization's name on the letter must match your current organization's name and address.This IRS determination letter can also satisfy the documentation requirement of your organization's tax identification number(TIN). B. Verification of 501(c)(3) Status Form: If applicable, an Authorized Representative must annually submit verification that the organization remains a qualified 501(c)(3)tax-exempt organization. C. Copy of Form 990 Federal Tax return filed for latest fiscal year. D. Agency organizational chart. E. Current Board of Directors Roster with names, addresses, office terms (with dates), and professional and/or community affiliations. 8. For-profit agencies only: A. Current Board of Directors Roster with names, addresses, office terms (with dates), and professional and/or community affiliations. B. Appropriate tax form filed with IRS filed for latest fiscal year. C. Agency organizational chart. Insert/Attach these required documents here. 1 9 9. Certifications and Required Forms A. Application Certification I have reviewed this application for accuracy. I understand that Opioid Abatement funds are intended to address specific remediation activities as identified under the NC Memorandum of Agreement(MOA)for the Opioid Settlement Funds. I understand that these opioid settlement funds are subject to State laws and regulations, and I have read the MOA and agree to the requirements. I certify that the requested funds will be used in compliance with these requirements and with all requirements outlined in the Orange County High Impact Opioid Abatement Strategies RFA. I agree to submit invoices and other relevant documentation to Orange County to pay or be reimbursed, as well as quarterly status reports, by the date stated in the contract. I understand that Orange County requires agencies with receipts less than $500,000 that do not have a financial audit (or a financial report), prepared by a certified public accountant (CPA)to complete schedule of Receipts and Expenditures form. An agency does not need to complete this form if it has a prepared audit/report it can submit for the calendar year ending December 31, 2024 or the fiscal year ending June 30, 2025. Agencies with receipts totaling$500,000 or more, from any source, must submit a CPA-certified financial audit. financial statements for each year that opioid settlement funding is provided to my organization, and that Orange County may monitor the program during the award period. Agency Authorized Official (print name) Click or tap here to enter text. Signature Title Click or tap here to enter text. Date Click or tap here to enter text. Board Chair/Elected Official (print name) Click or tap here to enter text. Signature Title Click or tap here to enter text. Date Click or tap here to enter text. 1 10 B. Non-profit agencies only:Verification of 501(c)(3)Status Form IRS Tax Exemption Verification Form (Annual) I, , hereby state that I am of (Printed Name) (Title) ("Organization"), and by that authority duly (Legal Name of Organization) given and as the act and deed of the Organization, state that the Organization's status continues to be designated as 501(c)(3) pursuant to U.S. Internal Revenue Code, and the documentation on file with the North Carolina Department of Health and Human Services is current and accurate. I understand that the penalty for perjury is a Class F Felony in North Carolina pursuant to N.C. Gen. Stat. § 14-209, and that other state laws, including N.C. Gen. Stat. § 143C-10-1, and federal laws may also apply for making perjured and/or false statements or misrepresentations. I declare under penalty of perjury that the foregoing is true and correct. Executed on this the day of , 20 (Signature) 2 11 C. Certification of No Overdue Tax Debts Date of Certification MM/DD/YYYY Certification: We certify that [ORGANIZATION NAME] does not have any overdue tax debts, as defined by N.C.G.S. 105-243.1, at the federal, State, or local level. We further understand that any person who makes a false statement in violation of N.C.G.S. 143C-6-23(c) is guilty of a criminal offense punishable as provided by N.C.G.S.) 143C-10-1b. Sworn Statement: [Name of Board Chair] and [Name of Second Authorizing Official] being duly sworn, say that we are the Board Chair and [Title of the Second Authorizing Official], respectively, of[insert name of organization] of [City] in the State of [Name of State]; and that the foregoing certification is true, accurate and complete to the best of our knowledge and was made and subscribed by us. We also acknowledge and understand that any misuse of State funds will be reported to the appropriate authorities for further action. Board Chair Signature [TITLE OF SECOND AUTHORIZING OFFICIAL] Sworn to and subscribed before me on the day of the date of said certification. My Commission Expires: (Notary Signature and Seal) 1 G.S. 105-243.1 defines: Overdue tax debt.—Any part of a tax debt that remains unpaid 90 days or more after the notice of final assessment was mailed to the taxpayer.The term does not include a tax debt, however, if the taxpayer entered into an installment agreement for the tax debt under G.S. 105-237 within 90 days after the notice of final assessment was mailed and has not failed to make any payments due under the installment agreement." 3 12 D. Code of Conduct Policy Each recipient of award shall maintain a written Code of Standards of Conduct which shall govern the performance of its officers, employees or agents in contracting with and/or expending Older Americans Act funds and State appropriations. The recipient Agency's officers, employees or agents shall neither solicit nor accept gratuities, favors or anything of monetary value from contractors or potential contractors.To the extent permissible under state or local laws, rules or regulations, such standards shall provide for appropriate penalties, sanctions, or other disciplinary actions to be applied for violations of such standards either by the officers, employees or agents of the recipient Agency or by contractors or their agents. Awards will be made only to responsible Agency(ies) possessing the ability to perform successfully under the terms and conditions of a proposed procurement. Consideration will be given to such matters as Agency's integrity, compliance with public policy, record of past performance, and financial and technical resources. I have read and fully understand the context of the information above. Authorized Official Signature Title Date 4 13 E. Conflict of Interest Policy The Board of Directors/Trustees or other governing persons, officers, employees or agents are to avoid any conflict of interest, even the appearance of a conflict of interest.The Organization's Board of Directors/Trustees or other governing body, officers, staff and agents are obligated to always act in the best interest of the organization.This obligation requires that any Board member or other governing person, officer, employee or agent, in the performance of Organization duties, seek only the furtherance of the Organization mission. At all times, Board members or other governing persons, officers, employees or agents, are prohibited from using their job title,the Organization's name or property,for private profit or benefit. a. The Board members or other governing persons, officers, employees, or agents of the Organization should neither solicit nor accept gratuities,favors, or anything of monetary value from current or potential contractors/vendors, persons receiving benefits from the Organization or persons who may benefit from the actions of any Board member or other governing person, officer, employee or agent. This is not intended to preclude bona-fide Organization fund raising- activities. b. A Board or other governing body member may, with the approval of Board or other governing body, receive honoraria for lectures and other such activities while not acting in any official capacity for the Organization. Officers may,with the approval of the Board or other governing body, receive honoraria for lectures and other such activities while on personal days, compensatory time, annual leave, or leave without pay. Employees may, with the prior written approval of their supervisor, receive honoraria for lectures and other such activities while on personal days, compensatory time, annual leave, or leave without pay. If a Board or other governing body member, officer, employee or agent is acting in any official capacity, honoraria received in connection with activities relating to the Organization are to be paid to the Organization. c. No Board member or other governing person, officer, employee, or agent of the Organization shall participate in the selection, award, or administration of a purchase or contract with a vendor where,to his knowledge, any of the following has a financial interest in that purchase or contract: 1. The Board member or other governing person, officer, employee, or agent; 2. Any member of their family or personal relationship; 3. An organization in which any of the above is an officer, director, or employee; 4. A person or organization with whom any of the above individuals is negotiating or has any arrangement concerning prospective employment or contracts. d. Duty to Disclosure--Any conflict of interest, potential conflict of interest, or the appearance of a conflict of interest is to be reported to the Board or other governing body or one's supervisor immediately. 5 14 e. Board Action --When a conflict of interest is relevant to a matter requiring action by the Board of Directors/Trustees or other governing body, the Board member or other governing person, officer, employee, or agent (person(s)) must disclose the existence of the conflict of interest and be given the opportunity to disclose all material facts to the Board and members of committees with governing board delegated powers considering the possible conflict of interest. After disclosure of all material facts, and after any discussion with the person,they shall leave the governing board or committee meeting while the determination of a conflict of interest is discussed and voted upon.The remaining board or committee members shall decide if a conflict of interest exists. In addition,the person(s) shall not participate in the final deliberation or decision regarding the matter under consideration and shall leave the meeting during the discussion of and vote of the Board of Directors/Trustees or other governing body. I have read and fully understand the context of the information above. Authorized Official Signature Title Date 6 15 F. Appendix E: E-Verify STATE OF NORTH CAROLINA AFFIDAVIT COUNTY OF ORANGE . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . I, (the individual attesting below), being duly authorized by and on behalf of (the entity contracting with Orange County hereinafter "Employer") after first being duly sworn hereby swears or affirms as follows: 1. Employer understands that E-Verify is the federal E-Verify program operated by the United States Department of Homeland Security and other federal agencies, or any successor or equivalent program used to verify the work authorization of newly hired employees pursuant to federal law in accordance with NCGS §64-25(5). 2. Employer understands that Employers Must Use E-Verify. Each employer, if employing 25 or more employees in this State, after hiring an employee to work in the United States, shall verify the work authorization of the employee through E-Verify in accordance with NCGS§64-26(a). 3. Employer is a person, business entity, or other organization that transacts business in this State and that employs 25 or more employees in this State. (Mark Yes or No) a.YES ❑ or b. NO ❑ 4. Employer's subcontractors comply with E-Verify, and Employer will ensure compliance with E-Verify by any subcontractors subsequently hired by Employer during the term of its contract with Orange County. This day of , 20 Signature of Affiant Print or Type Name NORTH CAROLINA NOTARY ACKNOWLEDGEMENT THE STATE OF NORTH CAROLINA, COUNTY OF Signed and sworn to (or affirmed) before me, this day of , 20_. My Commission Expires: Notary Public, Notary Public Signature: [Official Seal] 7 16 G. Discrimination Policy Each recipient of award shall maintain a discrimination policy ensuring that they do not discriminate on the basis of race, color, national origin, disability, religion, age, sex/gender, sexual orientation, gender identity and expression, marital status,veteran status, or source of income in the administration of its programs or activities, as required by applicable loa wans regulations. The recipient agency should identify officer, employee or agent responsible for coordination of compliance efforts and receipt of inquiries concerning non-discrimination requirements implemented by 40 C.F.R. Parts 5 and 7, including Title VI of the Civil Rights Act of 1964, as amended; Section 504 of the Rehabilitation Act of 1973; the Age Distribution Act of 1975, and Title IX of the Education Amendments of 1972, and other applicable laws. Said officer, employee or agent's contact information shall be included below. Discrimination complaint form should be attached or link to discrimination form included below. Responsible officer/employee/agent: Responsible officer/employee/agent phone number: Responsible officer/employee/agent email address: Link to discrimination complaint form (if not attached): Authorized Official Signature Title Date 8 17 H. Authorization for Individuals to Sign Contracts and Submit Reporting [Letter from Board President/Chairperson identifying individuals as authorized to sign contracts, expenditure reports, and performance reports] I, , Board President/Chairperson of [Agency/Organization's legal name] hereby identify the following individual(s) who is (are) authorized to sign and/or submit documentation for the organization named above: Contracts: Printed Name: Title: Email address: Click or tap here to Click or tap here to 1. enter text. enter text. Click or tap here to enter text. Click or tap here to Click or tap here to 2. enter text. enter text. Click or tap here to enter text. Click or tap here to Click or tap here to 3. enter text. enter text. Click or tap here to enter text. Expenditure Reports: Printed Name: Title: Email address: Click or tap here to Click or tap here to 1. enter text. enter text. Click or tap here to enter text. Click or tap here to Click or tap here to 2. enter text. enter text. Click or tap here to enter text. Click or tap here to Click or tap here to 3. enter text. enter text. Click or tap here to enter text. 9 18 Performance Reports: Printed Name: Title: Email address: Click or tap here to Click or tap here to 1. enter text. enter text. Click or tap here to enter text. Click or tap here to Click or tap here to 2. enter text. enter text. Click or tap here to enter text. Click or tap here to Click or tap here to 3. enter text. enter text. Click or tap here to enter text. Board President or Chair printed name *Title Signature Date 10 19 I. Business Associate Addendum THIS ADDENDUM is made this day of Click or tap here to enter text., 20Click or tap here to enter text. to a contractual arrangement between the parties ("Agreement"). WHEREAS Orange County is itself a Covered Entity, as that term is defined in HIPAA and will be referred to as "Covered Entity"; and WHEREAS, Click or tap here to enter text. is, or may be, a Business Associate of Covered Entity and will be referred to as "Business Associate"; and WHEREAS, Business Associate performs certain services on behalf of or for Covered Entity that require the exchange of information about patients that is protected by the Health Insurance Portability and Accountability Act of 1996, as amended, and the Privacy, Security, Breach Notification, and Enforcement Rules at 45 CFR Part 160 and Part 164(collectively"HIPAA"). NOW,THEREFORE, the parties to the Agreement are entering into this Addendum to establish the responsibilities of both parties regarding HIPAA-covered information and to bring the Agreement into compliance with HIPAA. I. DEFINITIONS Except as otherwise defined herein,terms used in this Addendum shall have the same meaning as the terms are defined in HIPAA. II. OBLIGATIONS OF BUSINESS ASSOCIATE To comply with the Privacy, Security, and Breach Notification obligations imposed by HIPAA, Business Associate agrees to: A. Privacy and Security Obligations: 1. Not use nor disclose information other than as permitted or required by the Agreement, this Addendum or as required by law. 2. Use appropriate safeguards to prevent use or disclosure of the information other than as provided for by the Agreement and this Addendum. 3. Comply with Subpart C of 45 CFR Part 164 with respect to electronic PHI (protected health information)to prevent use or disclosure of PHI other than as provided for by the Agreement. 4. Report to Covered Entity any use or disclosure of the information not provided for by the Agreement of which Business Associate becomes aware, including breaches of Unsecured PHI as required by 45 CFR 164.410. 5. In accordance with 45 CFR 164.502(e)(1)(ii) and 164.308(b)(2), if applicable, ensure that any agents or subcontractors that create, receive, maintain, or transmit PHI on behalf of Business Associate agree, in writing,to the same restrictions, conditions, and requirements that apply to Business Associate with respect to such information. 6. Make available PHI in a designated set record set to Covered Entity upon request within three (3) working days as necessary to satisfy Covered Entity's obligations under 45 CFR 164.524. If Business Associate receives a request for access directly from the individual,then 11 20 Business Associate will forward the individual's request to Covered Entity within three (3) working days to be fulfilled by Covered Entity. 7. If Business Associate receives a request pursuant to 45 CFR 164.526 to make any amendment(s)to PHI in a designated record set directly from the individual,then Business Associate will forward the individual's request to Covered Entity within three (3) working days to be fulfilled by Covered Entity. 8. Maintain and make available upon request within three (3) working days the information required to provide an accounting of disclosures to Covered Entity as necessary to satisfy Covered Entity's obligations under 45 CFR 164.528. If Business Associate receives a request to provide an accounting of disclosures directly from the individual, then Business Associate will forward the individual's request to Covered Entity within three (3) working days to be fulfilled by Covered Entity. 9. Make its internal practices, books, and records relating to the use of PHI received from Covered Entity, or created or received by Business Associate on behalf of Covered Entity, available to the Secretary of DHHS and Covered Entity for purposes of determining compliance with HIPAA. 10. To the extent practicable, mitigate any harmful effects that are known to Business Associate of a use or disclosure of PHI or a breach of Unsecured PHI in violation of this Addendum. 11. Use and disclose an individual's PHI only if such use or disclosure is in compliance with the applicable requirements of 45 CFR 164.504(e) and the terms of this Addendum. 12. Refrain from exchanging any PHI with any entity of which Business Associate knows of a pattern of activity or practice that constitutes a breach as defined by North Carolina State Law, HIPAA, or this Addendum. 13. To the extent Business Associate is to carry out one or more of Covered Entity's obligation(s) under Subpart E of 45 CFR Part 164, comply with the requirements of Subpart E that apply to Covered Entity in the performance of such obligation(s). B. Breach Notification: In the event that Business Associate discovers any use or disclosure of PHI not provided for by the Agreement, including breaches of Unsecured PHI as required at 45 CFR 164.410, and any security incident of which it becomes aware, Business Associate agrees to take the following measures within three (3) working days after Business Associate first becomes aware of the incident: 1. To notify Covered Entity of any incident involving the acquisition, access, use or disclosure of Unsecured PHI in a manner not permitted under 45 CFR Part E. Such notice by Business Associate shall be provided without unreasonable delay, except where a law enforcement official determines that a notification would impede a criminal investigation or cause damage to national security. For purposes of clarity for this provision, Business Associate must notify Covered Entity of any such incident within the above timeframe even if Business Associate has not conclusively determined within that time that the incident constitutes a breach as defined by HIPAA. For purposes of this Addendum, Business Associate is deemed to have become aware of the breach as of the first day on which such breach is known or reasonably should have been known to such entity or associate of Business Associate, including any person, other than the individual committing the breach,that is an employee, officer or other agent of Business Associate or an associate of Business Associate. 12 21 2. To include in the above-described notification the names of the individuals whose Unsecured PHI has been, or is reasonably believed to have been,the subject of a breach. 3. To provide a draft letter to Covered Entity to utilize to notify the individuals that their Unsecured PHI has been, or is reasonably believed to have been,the subject of a breach. The draft letter must include,to the extent possible: a. A brief description of what happened, including the date of the breach and the date of the discovery of the breach, if known; b. A description of the types of Unsecured PHI that were involved in the breach (such as full name, Social Security Number, date of birth, home address, account number, disability code, or other types of information that were involved); c. Any steps the individuals should take to protect themselves from potential harm resulting from the breach: d. A brief description of what Covered Entity and Business Associate are doing to investigate the breach, to mitigate losses, and to protect against any further breaches; and e. Contact information for individuals to ask questions or learn additional information, which shall include a toll-free telephone number, an email address,web site, or postal address. III.TERMINATION A. This Addendum will terminate automatically, without further action by either party, upon termination of the Agreement to which it is attached. B. Covered Entity may terminate this Addendum if Covered Entity determines that Business Associate has violated a material term of the Agreement or this Addendum. C. Upon Covered Entity's gaining knowledge of a breach, as defined by North Carolina State Law or HIPAA, by Business Associate or any of its agents or subcontractors, of the Agreement or this Addendum, Covered Entity shall either: 1. Provide an opportunity for Business Associate to cure the breach or end the violation, and if Business Associate does not cure the breach or end the violation within the time specified by Covered Entity,terminate this Addendum and the attached Agreement; or 2. Immediately terminate this Addendum and the attached Agreement if either has been breached by a Business Associate, and a cure is not possible. D. In situations where it is not practicable to terminate this Agreement, Covered Entity shall report Business Associate's breach as defined by North Carolina State Law or HIPAA to the Secretary of DHHS, and continue under the existing arrangement with Business Associate until a reasonable alternative becomes available, or until directed by the Secretary of DHHS to terminate the Agreement. E. At termination of the attached Agreement and this Addendum, or upon request of Covered Entity, whichever occurs first, Business Associate shall: 1. If feasible, return or destroy all PHI that Business Associate still maintains in any form, received from Covered Entity or created, maintained or received by Business Associate on behalf of Covered Entity. Business Associate shall only destroy PHI with the written approval of Covered Entity. After return or destruction, Business Associate shall retain no copies of such information. 2. If return or destruction is not feasible, Business Associate will provide Covered Entity with documentation explaining the reason it is not feasible. If the PHI is not returned or destroyed, Business Associate will extend the protection of this Addendum to the 13 22 information and limit further uses and disclosures to those purposes that make the return or destruction of the information not feasible. F. The obligations of Business Associate under this Addendum shall survive the expiration, termination or cancellation of the attached Agreement and this Addendum, and shall continue to bind Business Associate, its agents, employees, contractors, successors and assigns, as set forth herein. G. Business Associate shall indemnify Covered Entity for costs associated with any incident involving the acquisition, access, use or disclosure of Unsecured PHI by Business Associate, any agent or subcontractor, in a manner not permitted under 45 CFR Subpart E. IV. MISCELLANEOUS A. All PHI that is created or received by Covered Entity and disclosed or made available in any form, including paper record, oral communication, audio recording and electronic display by Covered Entity or its operating units to Business Associate, or is created or received by Business Associate on Covered Entity's behalf, shall be subject to this Addendum. B. In the event of an inconsistency between the provisions of this Addendum and the mandatory provisions of HIPAA, as amended, HIPAA shall control. Where provisions of this Addendum are not included as mandated provisions in HIPAA, but are nonetheless permitted by HIPAA,the provisions of this Addendum shall control. C. Except as expressly stated herein or in HIPAA,the parties to this Addendum do not intend to create any rights in any third parties. D. This Addendum may be amended or modified only in writing signed by the parties. No party may assign it rights or obligations under this Addendum without the prior written consent of the other party. None of the provisions of this Addendum are intended to create, nor will they be deemed to create, any relationship between the parties other than that of independent parties, contracting with each other solely for the purpose of effecting the provisions of this Addendum and any other agreements between the parties concerning their business relationship. E. This Addendum will be governed by the laws of the State of North Carolina, venue Orange County. F. No change,waiver, or discharge of any liability or obligation hereunder on any one or more occasion shall be deemed a waiver of performance of any continuing obligation, or prohibit enforcement of any obligation, on any other occasion. G. In the event that any documentation of the arrangement pursuant to which Business Associate provides services to Covered Entity contains provisions relating to the use or disclosure of PHI that are more restrictive than the provisions of this Addendum, the provisions of the more restrictive documentation will control. H. In the event that any provision of this Addendum is held by a court of competent jurisdiction to be invalid or unenforceable,the remaining provisions of this Addendum shall remain in full force and effect. I. Headings in this Addendum are for convenience of reference only and shall not define or limit any of the terms or provisions hereof. J. A reference in this Addendum to a section in HIPAA means the section as in effect or as amended. K. Any ambiguity in this Addendum shall be interpreted to permit compliance with HIPAA. L. Business Associate will not use an agent or subcontractor without written agreement by Covered Entity. 14 23 IN WITNESS WHEREOF,the parties have hereunto executed this Business Associate Addendum on the day and year first written above. Orange County By: Travis, Myren,Orange County Manager ATTESTED: BUSINESS ASSOCIATE By: Title: ATTESTED: 15 24 Application Scoring Criteria Applications will be scored based on the responses to the application content areas in the chart below. Each content area shall be scored on a scale of 1-4 based on the scale below: 1. POOR Applicant only marginally addressed the application area 2. AVERAGE Applicant adequately addressed the application area 3. GOOD Applicant did a thorough job of addressing the application area 4. EXCELLENT Applicant provided a superior response to the application area Each content area will be weighted and the score of 1 to 4 will be multiplied by the assigned weight of the content area.The following represents the evaluation criteria and relative importance of each criterion (criteria weight): Evaluation Criteria Score Weight Weighted Distribution Score 1. Proposal Summary:deduct 2 points if missing 0 pts. -- 2. Assessment of Need a. Clear and appropriate geographic area to be served b. Clear statement of needs and gaps in services c. Thorough description of priority populations that is well supported by evidence Priority populations in Orange County are defined as persons with opioid use/opioid use disorder(OUD) or co-occurring substance use disorder(SUD) or mental health conditions, 0 pts. if including: missing. 8 • Individuals at highest risk for overdose in Orange County, such as historically Otherwise, 4 underserved socioeconomic populations, individuals with multiple Adverse Childhood Experiences (ACES), Substance Use Disorder during pregnancy and in first 4-16 pts. year of Post Partum. • Children and adolescents at risk for drug use. • Individuals in treatment or recovery. • Individuals involved, or at risk of becoming involved, in the Criminal Justice System. • Individuals recently released from jail or prison. 3. Project Description and Sustainability a. Exactly one of the eligible Option A strategies is selected and proposed project clearly supports the identified strategy b. Well-planned project that is likely to lead to the intended opioid-related impacts, based on the evidence base about strategy and/or activity effectiveness for the 0 pts. if prioritized population missing. c. Clear and appropriate plans to incorporate feedback from program participants Otherwise, 7 to inform program delivery d. Intended impacts of project will likely meet community needs/service gaps e. Applicant has engaged or is likely to engage the priority population meaningfully 7-28 pts. in developing the proposed project f. Proposed project fits applicant's organizational goals well g. Project timelines are achievable and adequate to make intended impacts h. Clear and appropriate plans for project sustainability 0 pts. 4. Equity Impact g missing. 2 a. Project is likely to improve health inequities and/or social determinants of health Otherwise, 25 b. Project is likely to reach, benefit, and equitably engage uninsured and underinsured people. 2-8 pts. S. Organizational Readiness a. Applicant demonstrates the skills and capacity needed to manage the funding award and meet reporting and compliance requirements. b. Subcontractors are clearly identified, if applicable, and will enhance the success of the project c. Applicant (team) has demonstrated the capacity to conduct culturally humble, 0 pts. if sensitive, and appropriate work missing. d. Applicant (team)has demonstrated clear understanding of issues that affect Otherwise, 5 people who use drugs e. Applicant(team) has demonstrated experience and/or clear and adequate plans 5-20 pts. for promoting the health and dignity of people and communities impacted by drug use f. Applicant (team) has demonstrated experience serving those experiencing homelessness and housing instability; and/or those transitioning from correctional settings to the community 6. Evidence of Collaborations/Partnerships, Letters of Commitment/Support a. Clear plan to collaborate with other relevant community organizations that is 0 pts. if likely to improve collaboration between local stakeholders missing. b. Clear plan to verify that projects or services are not being duplicated in the Otherwise, 2.5 community and with the population served c. Letters of commitment/support are present from all key project partners and 2.5- 10 pts. match partners' proposed roles in the project 7. Performance Measures and Program Evaluation a. Specific, achievable plans for program evaluation that will yield meaningful 0 pts. if assessment of project's success missing. b. Clear and appropriate plans to engage priority population in evaluation design Otherwise, 4.5 and implementation c. Clear and appropriate plans to capture client data (if applicable) and proposed 4.5- 18 pts. metrics,and to monitor project progress on a regular basis 8. Priority Strategy: If the program addresses one of the strategies determined to be a priority within Orange County communities, 5 points will be added. You will find the priorities listed in the 2024 Community Meeting Report: 5 pts https://www.orangecountync.gov/DocumentCenter/View/30434/OAC-Comm unity- Meeting-Report-6-002?bid1d= 9. Project Budget: If budget is incomplete and/or does not appropriately support the 0 pts. -- proposed project, deduct up to 10 points Total 26 Criterion 3b: "Well-planned activity that is likely to lead to the intended opioid-related impacts, based on the evidence base about strategy and/or activity effectiveness for the prioritized population." The "priority population" as defined for this purpose: • Selective and indicated populations ( IOM terminology, for an explanation see * below) at high risk for opioid abuse, or already manifesting signs and symptoms of abuse • Populations actively misusing opioids, for whom drug treatment, with or without short term or extended MAT, is appropriate. • Harm reduction supplies and approaches, including naloxone distribution. • Users in recovery seeking ongoing support Average Amount Program OAC Applicant Score Strategy Requested Proposed Application Review Notes Decision UNC 72.33 Naloxone $106,906.24 Funding is requested for There is an unreported Recommend funding of Student Distribution naloxone cartons, naloxone overdose crisis affecting the $10,000 for Naloxone Wellness kits, and ONEboxes to expand campus community. supply. campus overdose prevention Performance measures and efforts. This funding ensures evaluation methods could Committee felt as though first responders and the provide data needed to gain UNC should be campus community have more support from the responsible for funding immediate access to university. the infrastructure of the lifesaving resources. program, however, did At the recommendation of not want the program to ONEbox installation at AED the OAC, the applicant not have a supply of stations and other strategic formed a coalition to naloxone needed in order distribution points in high address the silos on campus to reach individuals in traffic areas such as campus working to address need. libraries, student recreation substance/opioid use on centers, and Student Union) campus. The coalition has 27 engaged various campus Build on existing harm and county stakeholders to reduction infrastructure include OCHD reps, the through integration with Sheriff and EMS. The current campus pharmacy applicant has attended distribution, supplying UNC numerous meetings and police naloxone cartons and assisted with community peer program expansion gatherings related to OUD. Applicant staff leaders encourage students in recovery to lead program efforts. Location of some of the harm reduction distribution points will be in central locations to community members as well; easily accessible to those without transportation. Documented evidence of other states that have used their funding to support students on college campuses. 28 EI Futuro 89.35 Early $69,309.79 EI Futuro proposes to Lydia Kiefer recused herself Funding recommendation Intervention enhance early identification from scoring application for$69,310.00. and prevention of SUD among due to her association with historically marginalized program. Latino youth and young adults in Orange County. • Substance use is underreported in Latino This initiative will train populations due to fear CMHWs in SBIRT and and lack of culturally Motivational Interviewing competent services (MI) to strengthen early intervention efforts and • There are limited expand access to culturally Spanish-language and linguistically appropriate behavioral health services. services in Orange County. Developing and distributing Spanish-language educational . The Early Intervention materials and conducting Program will address bilingual workshops, social health inequities for media campaigns, and youth- Latino youth and young focused community adults in Orange engagement that increases County, who face knowledge of opioid risks, language barriers, improves awareness of stigma, and a lack of behavioral health services, culturally competent and ensures targeted providers, delaying care populations receive accurate, and increasing reliance stigma-free information and on costly emergency access to early intervention services. services. 29 • Serves high risk populations. • Well established organization. • Knows the community that they serve. • Did very well in the Equity Impact section. Freedom 82.5 Reentry $85,906.70 Freedom House connects • Application was initially Funding recommendation House with individuals screened in submitted under for $85,906.00. the Orange County Detention Criminal Justice Center who have a history of Diversion Programs. Opioid Use Disorder. The • Previously applied licensed clinician conducts a under Criminal Justice comprehensive clinical Diversion Program assessment to ascertain the (2025-2026) and best treatment options for Recovery Support the individual prior to or Services (2023-2025). upon release from • During application incarceration. evaluation process, OSTAT (state agency) The Peer Support Specialist reviewed recommended assists individuals with applications for whether getting to treatment, court they were appropriate appearances, linkage to for Opioid Settlement community resources and funding. other needs to curb . Their initial suggestion recidivism. was to break up the funding in half, either 30 Funds would cover under Criminal Justice salary/benefits, cell phone Diversion Programs service, mileage and training funding the Licensed for a Licensed Clinician and a clinician or under Peer Support Specialist. Recovery Support Services funding the Peer Support Specialist. • When brought to the Opioid Advisory Committee, the committee concluded that they felt that both portions were vital to the programming and felt that the program should be fully funded. • When meeting with the OSTAT team, they assisted in determining that if the program was funded under the Reentry strategy, the entire program could be funded under that one strategy. • The agency reviewed the metrics for that strategy and confirmed that they would be able to operate under that strategy. 31 UNC SHAC 72.21 Syringe $64,141 Harm reduction-based • Out of$37,600 awarded Program not Support organization providing sterile for 25-26, only $966.34 recommended for Program injection supplies, naloxone, has been reported as funding as program still first aid supplies, fentanyl and having been spent. has a large amount of xylazine test strips and • Contract was just funds from current year referrals to other social and completed last month. and has history of not health services to PWUD in • Had money left over using funds in time Orange County. from 24-25. allotted within contracts. • Had to update Seeking funds for SSP resolution to extend supplies, educational time for that money to materials, marketing, travel, be spent. and reinstatement of paid . States in organizational Program Navigator position. readiness that they have successfully managed New initiatives to be included OSF award and has in funding request: Open new provided progress SHAC SSP location to increase reports and compliance SSP access: assist entry into requirements (Have Low-Cost Behavioral and not medical care; Establish . IPRC is responsible for Emergency Use Naloxone administering award Boxes; Community Advisory and has administered Board and continue building over $4mil and many collaborations through awards. educational conferences. 32 RSN 61.67 Early $20,000 Programming will be Application is not as strong Intervention enhanced by integrating harm as other applications. Program not reduction principles and recommended for providing overdose RSN has previously funding. prevention training to staff struggled with applications, and mentors in addition to reports and providing continuing to implement information over time . Family Resilience framework. Seven mentors will be Concerns: onboarded and trained to • Inadequate engage 18 at risk youth or application youth engaged in substance . Application does not use. discuss what happens if they Funding is being requested to don't get funding support mentors as . Does not speak to independent contractors, Equity Impact. providing mentors with . Have collaborated training and professional with other development opportunities in organizations but healthcare and recovery field. would have been nice to have letters of support. • Would have liked to see supporting data for data points in Program Evaluation. 33 UNC— Recovery $99,999.90 Program will work with older Tonya Stancil recused Recommended to not be FOCUS- Support adults and their caregivers herself from scoring due to funded. OAC Services within Orange County. her association with There is a gap in health project. professionals with regard to addressing harmful Project is supported by PI, substance use among CPL, CPL researcher, older adults. Community Partners Program will involve older • OC Department On adults, caregivers, UNC Aging Community Practice Lab . PORT faculty and staff in order . Starting Point Rural to create community Harm Reduction generated explorative and Collective solutions focused substance use support for Concerns: older adults and their . Does not seem to be in caregivers. line with purpose of Opioid Settlement Program will use Funds community engaged • Assessment participatory research o Did not seem to approach. provide a direct Emphasizes community benefit to member engagement in individuals. defining, exploring, and o Seems to be a addressing community- pilot study to be identified challenges. able to go for more money 34 Findings from research will be o What would the applied in developing a immediate community substance use impact of the care network emphasizing program be? interpersonal collaboration, o What is the community strengths and demonstrated non-stigmatizing, harm need? reduction lenses to enhance equitable access to a broader Was very well written but spectrum of SU support feels as though it belongs services. somewhere else. Funds will be used to: Doesn't naturally align with • Support establishment the strategies. and application of community engaged Letters of support are from advisory board. Orange County. • Support FOCUS-OAC Opioid Community Secondary contact is an Consultation Team employee of OC Subcommittee Department of Aging • Educational tools • Resources Would have like to have • Trainings for targeting flushed out more Orange county healthcare County data and providers incorporate. • Community organizations • Older adults Seemed to be trying to • Caregivers understand need in older • Critical community adults as opposed to partners 35 • Services will target meeting needs of older older adults and adults. caregivers, those in active and long term opioid and substances recovery and those looking to engage in or support and individual in preventative and harm reduction methods. Not Early $97,000 Sustaining Youth Health and Application was not Due to application being EIEIOP scored Intervention Wellness Through Substance complete when received. incomplete at deadline, Misuse Prevention Education Budget worksheet was not application was not Program. completed until after considered. notified that it was missing Program is community-based and requested on Monday prevention and early February 23, 2026. intervention. Designed to reduce opioid and substance misuse risk among youth. Addresses intervening before at-risk individual enters healthcare after crisis. Nurse educators linking individuals to care 36 37 ORANGE O�I COUNTY ORANGE COUNTY HIGH IMPACT OPIOID ABATEMENT STRATEGIES NORTH CAROLINA Funding Proposal Application Form Before completing application, please review Attorney Application Due Date: February 20, 2026 General Bondi's Memo providing guidance for recipients of Federal Funding regarding unlawful discrimination. See link: https://www.mustice.gov/ag/media/1409486/dl Applicant Agency: General Information Legal Name EI Futuro Address 2020 Chapel Hill Road, Suite 23 Type of Agency ❑ Government/ © Non-Profit ❑ For-Profit Business Telephone 919-688-7101 Website www.elfuturo-nc.org Primary Contact Full Kerry Brock Title Associate Director Email kbrock@elfuturo-nc.org Telephone 919-688-7101 ext. 632 Secondary Contact Full Lisa Colquhoun Title Lead Grant Writer& Strategist Email Icolquhoun@elfuturo-nc.org Telephone 919-688-7101 Name of Project Orange County Latino Early Intervention & SBIRT Expansion Program Total Application Funding Requested $ 76,256.56 Funding Period Requested End (MM/DD/YYYY) Start Date 7/1/2026 Date 6/30/2027 Selected NC MOA Option A Strategy (Number and Name) 6. Early Intervention Agency Mission and Vision Statements EI Futuro's mission is to nurture stronger familias to live out their dreams. We do this by providing bilingual and culturally-responsive therapy, psychiatry, case management, substance use prevention/treatment, and other mental health services in a welcoming environment of healing and hope. i 38 1. Proposal Summary (no more than 250 words, required but not scored) This program builds on last year's efforts to prevent and address substance use disorders (SUD), including opioid use disorder (OUD), and co-occurring mental health conditions among economically disadvantaged youth, young adults, and caregivers in Orange County, specializing in Spanish-speakers and people with high rates of Adverse Childhood Experiences (ACEs). These populations face disproportionate barriers to care and limited access to affordable behavioral health services, making early intervention critical. This program will expand Screening, Brief Intervention, and Referral to Treatment (SBIRT) services into EI Futuro's Walk-In Clinic for Orange County residents, while continuing community-based screenings. Community Mental Health Workers (CMHWs) and clinical staff will receive additional training in SBIRT, motivational interviewing, and culturally responsive practices. The program integrates Strong Minds, Strong Communities screening tools for early substance use detection and intervention, connecting clients to treatment, behavioral health services, and supportive resources. Expected outcomes include screening 180 individuals annually for substance use and co- occurring mental health concerns, providing timely brief interventions to >85% of those identified at risk, and connecting >75% of clients to treatment or supportive services when high risk is identified. Caregivers will participate in bilingual psychoeducation workshops to reinforce prevention strategies and reduce stigma. By leveraging evidence-based protocols, trained staff, and trusted community partnerships, this initiative strengthens early intervention capacity, improves timely access to care, and promotes measurable reductions in OUD and SUD risk among economically disadvantaged Spanish- speaking and other populations.These outcomes will enhance health equity, community resilience, and sustainable behavioral health infrastructure in Orange County. 1 39 2. Project Narrative A. Assessment of Community Need (16 points, page limit: not to exceed 1 % pages) Geographic Area and Overdose Burden EI Futuro's proposed Orange County Latino Early Intervention & SBIRT Expansion Program will serve economically disadvantaged youth, young adults, and caregivers in Orange County, specializing in services for Spanish-speakers and those with high rates of ACEs. Drug and opioid overdoses remain a significant public health challenge across the state and nation. According to provisional North Carolina Department of Health and Human Services (NC DHHS) surveillance data, an estimated 3,025 suspected overdose deaths occurred statewide in 2024, reflecting ongoing drug-related mortality beyond 2023. Monthly overdose surveillance in early 2025 shows continued high counts of suspected overdose deaths — for example, 270 suspected overdose deaths reported in March 2025 — indicating that overdose burden persists as a pressing health issue. (NC DHHS Overdose Epidemic Data, 2025) While county-level overdose mortality counts are often suppressed due to small numbers, publicly available emergency department surveillance reports show ongoing overdose-related visits in Orange County, consistent with statewide trends. (NC DHHS Injury & Violence Prevention, 2025)These patterns demonstrate that overdose risk, particularly from opioids and synthetic opioids such as fentanyl, remains a critical public health priority in Orange County and across North Carolina,justifying the need for culturally responsive, early intervention strategies. These trends underscore the ongoing urgency for culturally responsive early intervention and prevention-focused programming. Need for This Work and Gaps in Services Data from the 2024 National Survey on Drug Use and Health (NSDUH) show that behavioral health challenges remain widespread across the United States, with approximately 23.4% of adults experiencing any mental illness and 16.8% of people aged 12 or older meeting criteria for a substance use disorder (SUD) in the past year, underscoring ongoing community behavioral health needs. (NSDUH, 2024) Despite similar or higher rates of behavioral health symptoms, Hispanic/Latino adults are less likely to receive treatment than the overall U.S. population; in 2024, Hispanic/Latino individuals accessed mental health care at rates about 28% lower than the national average, highlighting persistent disparities in service utilization. (SAMHSA NSDUH/Office of Minority Health, 2025) At the state level, North Carolina health surveillance data indicate that Latino and Hispanic residents continue to experience barriers to accessing services due to insurance coverage gaps and structural inequities. According to the 2024 Behavioral Risk Factor Surveillance System (BRFSS), approximately 49.1% of Hispanic residents under age 65 lacked health insurance, significantly higher than the non-Hispanic white population, which limits access to early intervention, screening, and follow-up care for both substance use and co-occurring mental health concerns. (NC DHHS BRFSS, 2025) 2 40 Needs of the Priority Population EI Futuro's proposed SBIRT-based early intervention project will serve youth,young adults, and their caregivers in Orange County, with particular attention to historically economically disadvantaged populations, those at highest risk for opioid and substance use disorder (SUD), those with high rates of ACEs, and Spanish-speakers. Targeted priority populations, consistent with Orange County guidance, include: (1) Individuals at highest risk for overdose; (2) Individuals with Risky Usage; (3) Children and adolescents at risk for drug use; (4) Patients with Potential Co-occurring Disorders: Individuals with mental health concerns; and (5) Individuals involved, or at risk of becoming involved, in the criminal justice system. Client surveys and feedback from EI Futuro's clinical services and outreach events indicate ongoing demand for culturally and linguistically responsive prevention and early intervention services among Latino youth, young adults, and caregivers and others with high rates of ACEs. Language barriers, stigma related to seeking care, and difficulty navigating the behavioral health system persist as obstacles to access. Rationale for Early Intervention SBIRT is a widely recognized evidence-based model for identifying substance use risk and engaging individuals before problems escalate. Embedding SBIRT into EI Futuro's clinical and community services will bridge critical gaps, allowing culturally tailored screening and brief intervention for at-risk individuals and improving access to subsequent care. Integrating SBIRT directly addresses inequities in behavioral health access and supports Orange County's efforts to reduce substance use-related harm across historically underserved populations. B. Project Description and Program Sustainability (28 points, page limit:not to exceed 3 pages) Implementation Strategy EI Futuro proposes Strategy 6: Early Intervention Services from the North Carolina Memorandum of Agreement (MOA) Option A list of eligible strategies. This strategy focuses on early identification and prevention of SUDS among historically marginalized populations, including individuals with co-occurring mental health conditions. While this application focuses on early intervention,the project will integrate awareness of other strategies, such as harm reduction and treatment referral,to strengthen participant outcomes and community capacity. Project Overview and Expected Impact Last year we focused on training all of our client-facing staff in SBIRT and Motivational Interviewing (MI), including our Clinical Team, our Community Mental Health workers, and our Peer Support Specialists.The proposed project will expand SBIRT services for youth, young adults, and caregivers in Orange County, specializing in services for Spanish-speakers. With our trained CMHWs and clinicians, the program will: 3 41 • Prevent opioid overdoses: Early identification of substance use risk factors allows timely interventions, reducing progression to opioid use and overdose. • Increase access to care: Participants identified through screenings will be linked to culturally and linguistically responsive behavioral health services, SUD treatment, and social determinants of health supports. • Strengthen local infrastructure: Embedding SBIRT into EI Futuro's clinical and community services enhances the long-term capacity of the organization and its partners to respond to the overdose crisis. • Strengthen our Collaboration: We will actively collaborate with local service providers, public health partners, and community-based organizations, and serve as an engaged member of the Orange County Partnership for Alcohol and Drugs Free Youth Coalition to align strategies, share data, and strengthen coordinated prevention and early intervention efforts to maximize impact across Orange County. Engagement of Priority Population EI Futuro has actively involved the priority population in project development through focus groups, surveys, and youth advisory council feedback. Latino youth and caregivers and those with high rates of ACEs have helped shape culturally responsive screening tools, outreach strategies, and educational content. This participatory approach ensures the program meets the unique needs of the community it serves. Alignment with Organizational Goals This initiative advances EI Futuro's mission to provide culturally and linguistically appropriate mental health and substance use services. By integrating SBIRT into routine practice, the program expands service capacity, reduces access barriers, and strengthens community trust, all critical to long-term impact. Implementation Timeline and Responsibilities PHASE KEY ACTIVIES TIMELINE STAFF RESPONSIBLE Phase 1: Quality Conduct SBIRT July—Aug 2026 Substance Use Improvement& Staff fidelity review; Programs Director, Refresh provide refresher Substance Use training in SBIRT and Counselors, Director Motivational of Client Care and Interviewing (MI); Engagement*, update screening Clinical Director*, workflows based on Project Manager, Year 1 data Community Mental Health Workers*, Community Mental Health Educator* 4 42 Phase 2: Targeted Expand SBIRT to Sept-Oct 2026 Clinical Team*, Expansion & additional entry Substance Use Community points (e.g., Programs Director, Integration community events, Substance Use partner referrals); Counselors, Project strengthen referral Manager, Community pathways with Mental Health treatment providers Workers* and Community Mental Health Educator* Phase 3: Data-Driven Analyze screening Nov - May 26 Project Manager& Impact & Coalition and referral Director of Substance Alignment outcomes; present Use Programs findings to Coalition; align strategies with county priorities; adjust outreach based on identified ga ps Phase 4: Develop May -June 26 Executive Sustainability & sustainability plan; Leadership*, Project Capacity Building pursue Manager & Director reimbursement of Substance Use opportunities; cross- Programs train additional staff; document best practices; prepare annual impact report for stakeholders and funders *Not funded through this award Capacity Building and Sustainability This project strengthens EI Futuro's workforce and infrastructure to sustain early intervention beyond the grant period. CMHWs trained in SBIRT and MI will remain part of the permanent clinical staff, ensuring ongoing capacity. Integration into existing programs allows scalable expansion to other communities or population groups in future years. 5 43 Obstacles and Solutions POTENTIAL CHALLENGE PROPOSED SOLUTION Limited funding for Pursue diverse funding streams, including state/federal grants CMHWs and insurance reimbursement for SBIRT services. Need for higher-level care Develop a comprehensive referral network with local treatment for clients providers. Workforce burnout Implement regular supervision, professional development, and operational feedback loops. Awareness and Use culturally tailored outreach via trusted peer networks, engagement gaps bilingual materials, and youth advisory input. Other Funding Sources In addition to the Orange County Opioid Settlement Funds, EI Futuro will leverage state and federal funding opportunities, private foundation support, and Medicaid-billable SBIRT services to maintain and expand program capacity. These resources will ensure long-term sustainability and integration of early intervention services across Orange County. C. Equity Impact (8 points, page limit: not to exceed % page). EI Futuro's proposed SBIRT Early Intervention Program directly addresses health inequities by prioritizing historically economically disadvantaged Latino youth, young adults, and caregivers in Orange County and those with high rates of ACEs. These populations experience disproportionate barriers to behavioral health and substance use services, including language, cultural stigma, and systemic inequities, which delay care and increase overdose risk. By providing free, bilingual SBIRT screenings and brief interventions, the project reduces these barriers and ensures early identification and support for those most at risk of opioid use disorder (OUD) and co-occurring mental health conditions. The program explicitly serves uninsured and underinsured individuals, who are often unable to access care due to financial barriers. Latino residents in Orange County are disproportionately affected, with over 28% of those under 65 lacking health insurance, compared with 9% of non- Hispanic white residents (NC DH HS, 2025). EI Futuro leverages a robust referral network to connect clients to affordable treatment, primary care, and behavioral health services, ensuring access regardless of insurance status. In addition, the program addresses social determinants of health (SDOH) by integrating screenings for housing instability, employment challenges, transportation barriers, and food 6 44 insecurity into routine intake. CMHWs offer services in conveniently located host sites in Orange County and provide care navigation and referrals to local agencies, including workforce development programs, housing support services, and community resource networks,to mitigate these structural barriers. Once connected to EI Futuro, clients are referred to one of our case managers to support them with any barriers to care. By combining culturally responsive clinical care with targeted SDOH support, EI Futuro strengthens resilience and promotes long-term recovery outcomes, ensuring that early intervention services are equitable, accessible, and effective for marginalized communities. D. Organizational Readiness (20 points, page limit: not to exceed 3 pages) EI Futuro has a proven track record of managing complex, multi-year grants and maintaining rigorous fiscal, reporting, and compliance standards. As the fiscal agent for this project, EI Futuro assumes full responsibility for financial oversight, grant reporting, and adherence to all funding requirements. The organization employs a dedicated finance and grants management team that ensures timely and accurate reporting, tracks expenditures against budgets, and oversees compliance with both federal and state grant regulations. EI Futuro undergoes an annual independent audit, reinforcing transparency and accountability, and has successfully managed grants from NC DHHS, the Governor's Crime Commission, and private foundations including the William R. Kenan, Jr. Charitable Trust and Oak Foundation, demonstrating capacity to administer high-dollar and multi-year funding. EI Futuro may engage subcontractors for specific program elements, such as community outreach or specialized behavioral health services. Any subcontractor will be selected through a competitive process prioritizing culturally competent, bilingual providers with experience serving historically underserved populations, and agreements will include clear deliverables and compliance expectations. The organization has deep experience delivering services in a humble, sensitive, and culturally responsive manner, and specializing in Latino youth, young adults, and caregivers who experience stigma related to substance use, mental health conditions, or systemic inequities. Over 75% of staff identify as Latino and are bilingual, enabling effective engagement with clients, families, and community partners. Staff are trained in SBIRT, harm reduction, and motivational interviewing, ensuring respectful and nonjudgmental interaction with people who use drugs (PWUD) and other historically marginalized populations. EI Futuro has long promoted the health and dignity of individuals impacted by drug use, integrating substance use prevention and early intervention into core behavioral health services. Through partnerships with community-based organizations, faith leaders, and schools, EI Futuro strengthens culturally competent service delivery and supports clients experiencing 7 45 financial hardship or transitioning from correctional settings, connecting them with behavioral health care, social services, and community resources. This experience demonstrates that EI Futuro possesses the operational, fiscal, and programmatic capacity to implement and sustain the proposed SBIRT Early Intervention Program with fidelity, accountability, and cultural competence. E. Evidence of Collaborations/Partnerships (10 points, page limit: not to exceed 1 % pages) EI Futuro has a long-standing commitment to collaboration with community-based organizations, health providers, schools, and faith-based institutions in Orange County, ensuring culturally and linguistically appropriate services for Latino youth, young adults, and caregivers. Through the SBIRT Early Intervention Program, EI Futuro will strengthen existing partnerships and establish new collaborations to enhance early identification, prevention, and referral for substance use and co-occurring mental health conditions. Key partnerships include organizations with strong connections to historically underserved Latino communities, including Justice United, EI Centro Hispano, United Church of Chapel Hill, and the Orange County Partnership for Alcohol and Drug-Free Youth Coalition, among others. These collaborations will support outreach, psychoeducation, SBIRT screenings, caregiver engagement, and connections to behavioral health services, creating a coordinated network of early intervention supports. Other partners include Orange County Rape Crisis Center, Holy Family Catholic Church, St Thomas More Catholic Church, Efland Community Center, and others. To avoid duplication of services, EI Futuro actively maps community resources and maintains communication with local health departments, harm reduction programs, and behavioral health providers. The organization participates in county-level opioid response and behavioral health coalitions, sharing program plans and updates to ensure that services complement existing initiatives and fill identified gaps in early intervention and culturally responsive care. Community engagement is further enhanced through youth and family advisory councils, which provide feedback on service delivery, program relevance, and emerging needs. These mechanisms ensure that interventions are tailored to the local population while leveraging existing partnerships to maximize reach and impact. By integrating multiple stakeholders into program implementation, the SBIRT Early Intervention Program will strengthen local infrastructure for substance use prevention, foster sustainable collaboration, and improve equitable access to culturally responsive behavioral health services across Orange County. F. Performance Measures and Program Evaluation (18 points, page limit:not to exceed 1 page) 8 46 Performance Measures and Program Evaluation EI Futuro will implement a comprehensive evaluation plan to measure program impact, client outcomes, and community engagement for the SBIRT Early Intervention Program. Evaluation activities will follow evidence-based frameworks, ensuring early identification of substance use risks, timely interventions, and effective referrals to treatment. Engaging the Priority Population Latino youth, young adults, and caregivers, and others with high rates of ACEs, will be actively involved in shaping the evaluation process through advisory councils and feedback sessions. Youth and caregiver input will inform survey design, outreach approaches, and interpretation of findings, ensuring that evaluation metrics are culturally responsive and meaningful to the population served. Data Collection and Client-Level Reporting EI Futuro will collect client-level data on demographics, substance use, co-occurring mental health conditions, services received, and medications for opioid use disorder, in alignment with NCTOPPS reporting requirements. Data will be captured through EI Futuro's secure electronic health record system and SBIRT tracking forms. Monthly monitoring will ensure completeness, accuracy, and timely reporting for funders. Monitoring Metrics Key performance indicators will track program implementation, reach, and outcomes: METRIC TARGET DATA SOURCE FREQUENCY # of individuals 180+annually SBIRT Tracking Forms Monthly screened using SBIRT (Screening, Brief Intervention, and Referral to Treatment) % of screened clients 85% SBIRT Tracking Forms Quarterly receiving brief intervention % of clients identified 75% Referral Monthly as needing and documentation wanting specialized treatment, will be successfully referred to receive treatment % of workshop 85% Pre/Post Quarterly participants who report confidence in being able to identify the signs of an opioid overdose and 9 47 understand basic steps to take in response % of caregivers who 85% Pre/Post Quarterly report feeling more prepared to talk with their child about substance use and mental health % of clients who 70% Pre/Post client Quarterly report increased surveys understanding of the negative consequences of substance use % of clients screened 100% SDOH Assessment Monthly for social determinants of health (SDOH) Evaluation findings will guide adaptations and continuous quality improvement, ensuring that program implementation remains culturally appropriate, accessible, and effective in preventing opioid misuse and supporting early intervention for historically underserved populations. 10 48 Patrickollo Morgan February 18, 2026 To Whom It May Concern, I am pleased to provide this letter in support of El Futuro's application to the 2027 Orange County Opioid Settlement Funds for its Early Intervention program using Screening, Brief Intervention, and Referral to Treatment (SBIRT). While I am not directly involved in their operations, I am aware of EI Futuro's work in providing behavioral health services to Latino and immigrant communities in Orange County. SBIRT is a widely recognized, evidence-based approach to early intervention that can help identify substance use risk early and connect individuals to appropriate support. 49 From a professional perspective, initiatives like this are critical to improving community well-being and preventing challenges from escalating. I support this application and believe that B Futuro's program has the potential to make a meaningful impact on the community. Sincerely, Cristian Diaz Office Manager 50 Attorney 3I 1 E.Main Street, Durham,NC 27701 February 17, 2026 To Whom It May Concern, I am pleased to provide this letter in support of El Futuro's application to the 2027 Orange County Opioid Settlement Funds for its Early Intervention program using Screening, Brief Intervention, and Referral to Treatment(SKIRT). While I am not directly involved in their operations, I am aware of EL Futuro's work in providing behavioral health services to Latina and immigrant communities in Orange County. SBIRT is a widely recognized, evidence-based approach to early intervention that can help identify substance use risk early and connect individuals to appropriate support. From a professional perspective, initiatives like this are critical to improving community well-being and preventing challenges from escalating. I support this application and believe that E€ Futuro's program has the potential to make a meaningful impact on the community. ce e rcu Hi 1. 919.688.1941 919.688.2628 marcus@marcushillattorney.com 51 ORANGE M.RTUSHIP FLIP ALCO,HOL AND DRUG FREE YOM'H February 13, 2026 RE: Letter of Support for EI Futuro's Screening, Brief Intervention and Referral to Treatment (SBIRT) To Whom It May Concern, On behalf of the Orange Partnership for Alcohol and Drug Free Youth, I am pleased to support EI Futuro's application to the 2026 Orange County Opioid Settlement Funds for its proposed Early Intervention initiative using Screening, Brief Intervention, and Referral to Treatment (SBIRT). As a countywide prevention coalition, our role is to strengthen the systems and conditions that reduce substance use and promote healthy development across the lifespan. From a population health perspective, early identification and brief clinical intervention are essential tools for interrupting risk trajectories before substance use patterns become entrenched. EI Futuro's SBIRT model complements county prevention efforts by embedding evidence-based screening and intervention within trusted community-based clinical settings. This approach supports a more integrated prevention infrastructure that connects public health, behavioral health, and community systems. Their proposed program represents a strategically important investment in early intervention capacity within Orange County's broader substance use prevention landscape. This approach aligns closely with the county's priorities in addressing opioid use and related behavioral health challenges, particularly among underserved Latino residents who often face language and systemic barriers to care. EI Futuro is a highly credible provider with demonstrated expertise in culturally responsive care for Latino and immigrant populations. We support this application and view this initiative as aligned with long-term county and Opioid Advisory Board's goals related to early intervention and health equity. Respectfully, Gayane Chambless, M.A.NCC Program Director Orange Partnership Gayane.ckfreedomhouserecovery.org Orange Partnership for Alcohol and Drug Free Youth 104 New Stateside Dr. Chapel Hill NC 27516 www.orangcpartnership.org A�, CENTRO February 18th, 2026 v HISPANO www.ekentronc.org • * • To Whom It May Concern, EI Centro Hispano, Inc. Durham Office: 2000 Chapel Hill Road EI Centro Hispano is pleased to offer this letter in support of EI Futuro's application to Suite 26A Durham, NC 27707 the 2027 Orange County Opioid Settlement Funds for its Early Intervention program Tel: (919) 687-4635 centered on Screening, Brief Intervention, and Referral to Treatment (SBIRT). Fax: (919) 687-0401 Carrboro Office: 201 W. Weaver Street For more than 30 years, EI Centro Hispano has worked to empower Latino communities Carrboro, NC 27510 in the Triangle by improving access to education, health resources, and community Tel: (919) 945-0132 supports.Through our work, we see firsthand the growing need for culturally responsive Raleigh Office: 421 Chapanoke Rd approaches to substance use prevention and early behavioral health intervention. Suite 156 Raleigh, NC 27603 EI Futuro's SBIRT model represents a proactive and evidence-based strategy to identify www.elcentronc.org substance use risk early, engage individuals in brief, meaningful intervention, and Board of Directors connect them to appropriate services before challenges become more severe. We Officers believe this approach is especially well-suited for the communities we serve, where Art Ehuan stigma, language barriers, and limited access to care can delay treatment. Board Chair Patrick Byker Vice-Chair EI Futuro is a highly respected partner in the Latino health ecosystem and a leader in providing linguistically and culturally grounded behavioral health services. We are Cristina Lara Treasurer confident in their ability to implement this program effectively and in alignment with Ernesto Escobar Orange County's prevention and early intervention priorities. Secretary General Members We strongly support this application and commend EI Futuro's continued commitment to Carolina Mejia improving community mental health and substance use outcomes. Wendy Clark Holly Fraccaro Anthony J. Hickey Javier Olave Sincerely, Emeritus Members Judith Montenegro Susan Denman Erik Valera Pilar Rocha-Goldberg Carol Gallione President& CEO Rebecca Reyes EI Centro Hispano, Inc President &CEO Pilar Rocha-Goldberg 53 Orange County Justice United Orange County JUSTICE PO Box 9484 Chapel Hill,NC 27515 UNITED February 18, 2026 To Whom It May Concern, As Executive Director and Lead Organizer of Orange County Justice United, I write in full support of El Futuro's application to the 2027 Orange County Opioid Settlement Funds for its Early Intervention program using Screening, Brief Intervention, and Referral to Treatment (SBIRT). Orange County Justice United("Justice United")has worked closely with El Futuro for the past five years, connecting hundreds of Latino and immigrant members to El Futuro's gold-standard behavioral health services. Many members have shared first-hand reports of the effectiveness of El Futuro's work, and how it has transformed their family's lives for the better. SBIRT is a widely recognized, evidence-based approach to early intervention that can help identify substance use risk early and connect individuals to appropriate support. This past spring,when many immigrant parents involved in Justice United were especially concerned about the stresses facing their adolescent children, one of El Futuro's SBIRT specialists provided workshops and resources. Many parents are still referencing the critical information they learned in that training, and how it's helped them support their children and other community members. I hear daily from directly-impacted community members that initiatives like SBIRT are critical to improving community well-being and preventing challenges from escalating. I support this application and believe that El Futuro's program will make a meaningful impact. Sincerely, ,W.-aS"'Tr Julia Sendor Executive Director and Lead Organizer Orange County Justice United Contact:julia@ocjusticeunited.org 1 (336) 524-7985 Orange County Justice United I PO Box 9484, Chapel Hill,NC 27515 I www.ocj'usticcunitcd.org 54 ORANGE COUNTY ORANGE COUW�� HIGH IMPACT OPIOID ABATEMENT STRATEGIES NCR t-1 CAROtANs'-_ Funding Proposal Application Form Before completing application, please review Attorney Application Due Date: February 20, 2026 General Bondi's Memo providing guidance for recipients of Federal Funding regarding unlawful discrimination. See link:https:Z/www.iustice.gov/`ag/media/1409486/di ppplcantAgencyGO' r Legal Name Freedom House Recovery Center, Inc. Address 104 New Stateside Drive,Chapel Hill, NC 27516 Type of Agency 0 Government/ (check one Public Author Non-Profit - El For-Profit Business Telephone 919-442-1830 Website Freedom Ho useRecovery.org Primary Contact Full Name Joyce Harper Title CEO Email Joyce.H@freedomhouserecovery.org Telephone 919-879-6073 Secondary Contact Full Name Shaneka Parker Title CFO Email Shaneka.P@freedomhouserecovery.org Telephone 919-884-6917 Name of Project Reentry Support for Justice Involved Adults Total Application Funding Requested $ 85,907.00 Start End Funding Period Requested(MM/DD/YYYY) Date July 1, 2026 Date July 31,2027 Selected NC MCA Option A Strategy(Number and Name) Criminal Justice Diversion Program Agency Mission and Vision Statements To serve all in our community on their path to recovery— no ecovery—no matter who they are or what challenges they face. Our vision is that all seeking recovery are connected to the care and resources they need to reach their fullest potential. Use font:size'*12:thr6ughou'*t doc'uhient. As a separate Excel file,submit a completed Budget Worksheet. 55 Submit application to tstand,(Porangecountync.gov with a subject line of—RFA:Opioid Settlement Funds— [Organization name]. Will receive Receipt of Application email upon submission. If email is not received within 24 business hours,reach out to Tonya Stancil,Harm Reduction Coordinator at zstancilPorangecountync.gov. ii 56 1. Proposal Summary(no more than 250 words, required but not scored) Freedom House Recovery Center(FHRC) is excited to submit this proposal under Option A, Implementation Strategy 10: Criminal Justice Diversion Programs, aimed at enhancing pre-arrest and post-arrest diversion initiatives, as well as pre-trial services for individuals entangled in the justice system due to substance use disorders (SUD) and opioid use disorders (OUD). We propose strengthening our ongoing collaboration with the Criminal Justice Resource Department (CJRD)through the Lantern Project. FHRC offers evidence-based treatment options and recovery support services designed to effectively connect justice-involved individuals— especially those from marginalized communities—who have a history of OUD and SUD with appropriate treatment resources. Our mission is to serve all in our community on their path to recovery–no matter who they are or what challenges they face. We achieve this by providing essential treatment resources and peer support that foster recovery and promote healthier outcomes among historically underserved populations involved in the justice system. Our services facilitate access to stable employment, secure housing, and meaningful family reunification. For Lantern Project participants, we deliver vital re-entry support and treatment assistance to significantly reduce rates of recidivism and relapse while enhancing the chances of long-term recovery among low-level Class H and Class I offenders,where substance use often plays a significant role. Launched in 2021, Lantern Project serves as a critical resource for law enforcement diversion, harm reduction, and treatment for individuals grappling with SUD and OUD.This initiative, a partnership with FHRC,was established to tackle the devastating opioid crisis and address the increasing number of individuals with OUD cycling through the Orange County justice system. iii 57 2. Project Narrative A. Assessment of Community Need (16 points, page limit: not to exceed 1% pages) The cycle of drug addiction in Orange County, NC, is intricately linked to ongoing criminal activity, with drug-involved offenders exhibiting alarmingly high rates of relapse and recidivism. Individuals recently released from incarceration are more than 12 times more likely to die from an overdose in the first two weeks after release compared to their counterparts (source: news.unchealthcare.org). Research consistently suggests that the risk of overdose rises significantly when individuals relapse after a period of sobriety.These statistics represent not just numbers but individual lives that could be saved. Effective screening and timely referrals to substance misuse treatment initiated during incarceration and seamlessly continued post- release could help to redirect individuals away from relapse and further justice system involvement. Recent crime statistics from the North Carolina State Bureau of Investigation further underscore the pressing need for intervention. In 2024,the Orange County Sheriff's Office recorded 487 total offenses, with theft comprising the largest category at approximately 51% (250 incidents),followed by burglary at 17% (84 incidents) and motor vehicle theft at 10% (49 incidents). Statewide data shows that in 2024, 70.6%of all North Carolina property crimes were larceny-thefts.These property crimes are frequently linked to substance use as both a driver of offending behavior and an indicator of underlying addiction requiring intervention. Moreover, data from the North Carolina Injury and Violence Prevention Branch reveals that illicit opioids account for an estimated 65.6% of all overdose deaths in Orange County, marking a critical public health crisis that reflects a 3%rise from the previous year. Additionally, in 2023, 72.8% of children in foster care were due to parental substance misuse, one of the highest rates in North Carolina, despite a slight decline compared to the previous year. These alarming statistics illuminate the immediate need for ongoing substance use treatment, particularly during and immediately following incarceration.To maximize impact,treatment must begin while incarcerated and continue without interruption post-release.The North Carolina Injury and Violence Prevention Branch states that, in 2023, only 336.6 individuals per 100,000 residents accessed treatment services in Orange County.This figure reflects 507 uninsured individuals and Medicaid beneficiaries who received treatment for Opioid Use Disorder (OUD), marking an increase from the 461 individuals treated in 2022, which equated to a rate of 306.8 per 100,000 residents. Orange County's property crime profile and substance use data suggests a strong correlation between the two.Therefore, in response to this urgent need, Freedom House Recovery Center (FHRC) proposes to continue its effective partnership with the Criminal Justice Resource Department(CJRD)through Lantern Project—which serves as the primary treatment source for justice-involved individuals exiting the Orange County jail with OUD or co-occurring SUD. Since its inception in 2021, Lantern Project has supported well over 250 unduplicated justice-involved individuals,facilitating connections to treatment, peer support, housing, and comprehensive community-based resources. 1 58 FHRC and CJRD remain committed to enhancing evidence-based treatment options and recovery support services for justice involved individuals through Lantern Project.This initiative focuses on law enforcement diversion, harm reduction, and treatment for individuals struggling with OUD or co-occurring SUD.Through our support of Lantern Project, FHRC provides access to critical behavioral health treatment resources and peer support to help improve recovery outcomes and promote healthier lives among historically marginalized populations involved in the justice system. Additionally, FHRC helps reduce trauma and alleviate the financial burdens associated with court involvement and incarceration. Our efforts also aim to lessen the financial strain on law enforcement and the court system around low-level Class H or I offenses, which are often influenced by substance use. By providing Lantern clients with essential re-entry treatment assistance,we will lower recidivism and relapse rates while enhancing the chances of sustained recovery.This includes facilitating pathways to gainful employment, stable housing, and family reunification. The combination of alarming statistics related to opioid misuse,the relationship between drug addiction and criminal behavior, and the urgent demand for effective treatment underscores the necessity for grant funding to significantly enhance treatment access for individuals involved, or at risk of ongoing involvement in the Criminal Justice System—ultimately leading to safer communities and improved outcomes for individuals affected by opioid use disorder. B. Project Description and Program Sustainability(28 points,page limit:not to exceed 3 pages) Freedom House Recovery Center (FHRC) is submitting this proposal under Option A, Implementation Strategy 10: Criminal Justice Diversion Programs.This initiative is aimed at supporting pre-arrest or post-arrest diversion programs and pre-trial services for individuals with Substance Use Disorders (SUD), Opioid Use Disorders (OUD) and mental health diagnosis. In collaboration with the Criminal Justice Resource Department (CJRD), FHRC will continue the Lantern Project,which provides evidence-based addiction treatment, recovery support, harm reduction services, housing assistance, employment services, peer support, and ongoing outpatient treatment for justice-involved individuals in Orange County.The Lantern Project has consistently worked to increase access to treatment for justice-involved individuals, particularly among underserved socioeconomic populations with a history of opioid use. FHRC employs a licensed clinician and a Certified Peer Support Specialist(PSS)who are dedicated to diverting individuals from the Orange County justice system and jail into appropriate substance misuse treatment. This approach aims to reduce ongoing involvement in the justice system. By facilitating immediate access to treatment upon release from jail, FHRC also helps decrease the risk of opioid overdoses and supports individuals in avoiding relapse. CJRD collaborates with the magistrate and district attorney to identify low-level offenders with a history of substance use. Eligible clients are referred to Freedom House for ongoing treatment 2 59 with their consent.The clinician visits potential clients while they are incarcerated for initial engagement and assessment. If warranted,the clinician will refer the client to the PSS to assist in preparing for their transition after release. Upon referral, individuals begin with a clinical assessment conducted by the licensed clinician. This assessment helps the clinician understand the client's history,current needs, and treatment recommendations. Clinicians use Motivational Interviewing(MI), an evidence-based practice, to help clients recognize their desire for change and address any ambivalence. MI encourages clients to progress at their own pace while exploring barriers to change. After the assessment, once the client is released,the PSS facilitates the next steps,which include scheduling an appointment with a Psychiatric Mental Health Nurse Practitioner (PMHNP)for medical evaluation.The PMHNP determines appropriate medication options, such as Buprenorphine or Naltrexone, and if appropriate, schedules the client for their first dose of evidence-based Medication Assisted Treatment (MAT), combined with counseling and behavioral health therapies for OUD. For clients already on MAT,the PMHNP will ensure safe continuation of services. As part of the clinical assessment, individuals with a historical addiction and those re-entering the community from prison may be enrolled in Seeking Safety group therapy—an evidence- based program aimed at those dealing with trauma, PTSD, and substance misuse.This flexible, present-focused treatment allows clients to join at any point and is suitable for early treatment stages as it emphasizes stabilization. New this year, FHRC and CJRD will co-facilitate a Seeking Safety group on site in the Orange County Detentions Center. Upon release, clients will continue Seeking Safety in the community providing seamless continuity of care. If the client requires housing,they may begin the enrollment process for our residential program.This involves collaboration with the Halfway House Manager, who has Qualified Professional credentials,to develop a person-centered treatment plan outlining the client's goals during their stay in this supportive environment. The residential treatment program offers a structured, six-month housing program, staffed 24/7 by trained Peers who assist clients in solving problems, accessing resources, and stabilizing their mental and physical health. The Peers facilitate evidence-based practices such as Wellness Recovery Action Planning (WRAP) and Wellness Management and Recovery(WMR), along with life skills groups to help clients develop essential living and coping skills.The interdisciplinary treatment team collaborates to ensure strategies are effective and meets weekly to evaluate each client's progress toward their recovery, behavioral health, and physical health goals. Goals are updated as clients achieve them or as they clarify their future aspirations. FHRC views recovery as a step-by-step process that includes many small victories leading to long-term stability. 3 60 The FHRC clinician and PSS serve as liaisons with CAD staff.With appropriate consents, they communicate each Lantern client's progress towards their goals and assist in tracking outcomes. FHRC engages with CAD through regular case conferences to review care and progress,while CAD informs FHRC of new referrals and updates on court involvement. FHRC employs a team approach to support justice-involved clients. Weekly multidisciplinary team meetings allow for discussions about clients' needs and challenges, helping connect them with a broader array of services.Treatment discussions can commence while clients are still incarcerated or in the community.The Lantern PSS and clinician also work to address social determinants of health, ensuring clients access Medicaid, housing, food resources,job training, and employment opportunities. FHRC encourages continuous treatment support for up to 12 months, aligning with recommendations for sustained recovery and improved life functioning. Over the past four years, Freedom House has partnered with CJRD on the Lantern Project, significantly influencing efforts to combat the opioid epidemic in Orange County. Recent data from the North Carolina Division of Public Health indicates a drop in fentanyl-related deaths, from 28 in 2021 to 11 in 2024.The overdose death rate decreased from 36 per 100,000 residents in 2022 to 21 per 100,000 in 2023.These statistics underscore FHRC's vision that everyone seeking recovery is connected to the necessary care and resources. Through Lantern Project, FHRC can further our capacity to integrate recovery support into the long-term goals of justice involved individuals and to expand the application of treatment goals to foster long-term engagement and support.This initiative will ensure individuals have access to necessary resources, leading to improved health outcomes and reduced stigma around seeking help within the community. Sustaining Lantern Project beyond the current grant period will require us to navigate several interrelated challenges and to activate complementary strategies that mitigate each risk.The first and most immediate obstacle is maintaining client engagement once individuals leave the structured environment of the jail. Housing instability, shifting court obligations, and the urgency of securing employment often derail treatment plans.To counter this, we have established a peer-led "warm-hand-off" model in which peers schedule clients'first clinic visit before release, physically accompany them to those appointments, and provide weekly phone, text, or tele-health check-ins. A related barrier is the transient housing and economic fragility that characterize our population. When a release date is set for a client who will need housing,the Lantern PSS works closely with the Residential Supervisor and House Manager to determine if, or when, a bed will be available. Lantern clients receive priority placement when they are released from jail. These measures ensure that unstable living situations do not interrupt continuity of care. 4 61 Financial sustainability after the grant term is another critical concern. Therefore, FHRC works closely with Lantern Project clients upon release to find alternative funding sources that will ensure long term continuity of care. Funding options explored for each client include Medicaid, State Funded services, private insurance as well as fundraising and grant options. Taken together,these strategies form a cohesive sustainability plan that addresses engagement, housing, and funding. By tackling each obstacle with specific, evidence-based solutions, FHRC is confident it can support Lantern Project well beyond the grant cycle and continue reducing opioid misuse and recidivism in Orange County. C. Equity Impact (8 points, page limit: not to exceed %page) In Orange County, barriers related to behavioral health and social determinants of health have made access to substance use treatment more challenging for the justice-involved population. Key obstacles include a lack of transportation, unmanaged mental health issues, being uninsured or underinsured, and limited awareness of available local resources. Additionally, social determinants such as housing instability, homelessness, and food insecurity frequently contribute to substance use issues. Per the December 2023 North Carolina Criminal Justice Data Snapshot, drug overdose deaths exceeded those from suicide and homicide combined in 2022. In January 2022, 9,382 people in North Carolina were experiencing homelessness,translating to a rate of 88 per 100,000 residents, ranking as the 8th-highest state homelessness rate in the region. Among those released from prison in 2012, 71%were rearrested within five years, with 54% convicted of a new offense and 46% returned to prison. Through our work with Lantern Project, FHRC targets two priority populations: individuals who are currently incarcerated or recently released with opioid use disorders, and those at risk of involvement in the justice system due to addiction-related behaviors. FHRC will work with CJRD to serve justice involved individuals through the Orange County jail who may have difficulty accessing resources and services. FHRC boasts a robust track record of collaboration with community organizations, including CJRD, to deliver evidence-based, person-centered services and comprehensive support.The staff at FHRC consists of licensed and/or certified.peers who have firsthand experience with justice involvement, either personally or through a loved one.This unique lived experience significantly enhances their ability to connect with clients and their families, facilitating engagement in a range of services designed to promote sustained recovery and meaningful life transformation. Individuals referred to FHRC are accepted regardless of their county of residence, insurance status, or ability to pay.The assessment process allows clinicians to evaluate clients' histories, 5 62 needs, and preferences, leading to tailored treatment recommendations. Clinicians use Motivational Interviewing (MI), an evidence-based practice, to facilitate client progress at their own pace while addressing any emotional, psychosocial, or environmental barriers. Licensed clinicians and peer support specialists work collaboratively with individuals to connect them to local resources and support services, including housing,food assistance, public benefits applications, healthcare, harm reduction resources, and behavioral health services. D. Organizational Readiness (20 points, page limit: not to exceed 3 pages) For 50 years, Freedom House Recovery Center, a 501(c)(3) non-profit organization, has been a pioneer in behavioral health treatment in our community. Our mission is to serve all in our community on their path to recovery—no matter who they are or what challenges they face. We are committed to promoting, enhancing, and supporting recovery for men and women affected by substance misuse and/or mental health diagnoses through an evidence-based, comprehensive, and person-centered approach. The agency began in 1974 as a social setting detox and halfway house in Chapel Hill and has consistently grown to address the critical and changing needs of North Carolinians in our service areas. Currently, Freedom House operates outpatient behavioral health clinics in Chapel Hill, Roxboro, Durham, and Warrenton. We also operate a 10-bed men's house and a 12-bed women's house in Chapel Hill; an 11-bed men's house and two 6-bed women's houses in Durham; a 12-bed men's house in Norlina and we will be opening a 9-bed men's house in Roxboro by July 2026. In addition to our outpatient clinics and halfway houses, Freedom House also operates a 16-bed facility-based crisis unit in Chapel Hill that receives clients from all 100 North Carolina Counties,and we provide mobile crisis services in Alamance, Person, Durham, Orange, Warren and Caswell counties. Freedom House is credentialled and contracted with all four Tailored Plans in addition to the Standard Plans and other private insurances.This agency has consistently held contracts with LMEs/MCOs dating back to their origination. Our contracts have consistently been renewed without loss and have never been stopped early. Contracted services include clinical assessment, outpatient individual and group therapy, medication management, medication- assisted treatment, peer support individual and group (WRAP, WMR); facility-based crisis, substance use halfway house; and mobile crisis team. In the last five years, Freedom House has received three SAMHSA grants, including a two-year Community Mental Health Center (CMHQ a four-year grant for Increasing Mental Health Awareness (MHAT) and a two-year Certified Community Behavioral Health Clinic (CCBHC) grant resulting in Freedom House receiving full attestation from SAMHSA for certification. Freedom House offers a variety of services geared toward meeting client needs in the community. Our outpatient clinics provide individualized and community-based services to adults and children who have a moderate to chronic substance use diagnosis, mental illness, or 6 -- 63 those who are dually diagnosed with MH/SUDs or MH/IDD or SUDS/IDD.The intensity and frequency of services depend on the client's readiness for treatment and life-domain needs. Freedom House utilizes evidence-based practices to engage clients, and their families and natural supports in an array of services to begin and maintain recovery or crisis stabilization. We hold a strong belief that by supporting people in need, Freedom House is supporting positive changes to help the entire community. Freedom House has strong connections with law enforcement in each of the counties we serve, along with many local and regional treatment courts, probation and parole boards, local juvenile justice coalitions, and hospitals—including a contract with Person Memorial Hospital to provide crisis support services. Freedom House's experience of working on behalf of justice- involved individuals includes its work with the Drug Treatment Courts in Orange and Durham Counties, and its work with the Orange County Criminal Justice Resource Department (CJRD) on multiple grant funded diversion projects to support justice-involved individuals with an Opioid Use Disorder and Mental Health diagnoses. Since its inception, the Criminal Justice Resource Department has partnered closely with Freedom House Recovery Center. Freedom House has served as a primary treatment referral source for hundreds of CJRD clients.The Lantern Project is a partnership between Orange County Criminal Justice Resource Department and Freedom House and works to support justice involved people with substance use disorders by connecting them to treatment support as soon as possible and staying with them through their journey by providing a licensed clinician and peer support.The Lantern Project has two referral paths—the diversion path works with people who have been arrested or are at risk of being arrested and the re-entry path collaborates with people who are currently incarcerated and working towards reentry. Freedom House works collaboratively with multiple service providers to ensure all the clients we serve are connected to the care and resources they need to reach their fullest potential. Our agencywide referral partners include Oxford House for step down housing, EI Futuro for culturally competent training and services, Healing Transitions for aftercare services, UNC Hospital, Duke University Medical Center, Person Memorial Hospital as referral partners and Morse Clinics for support with Methadone dosing—just to name a few of our partners. Currently, Freedom House employs over 160 staff across disciplines serving over 3,000 clients per year. We have learned that recovery is not a one-time event, and it does not occur in a particular order. Our clients require flexibility, consistency, and understanding.They thrive when they have someone who can walk with them withoutjudgment—regardless of how long the walk may be. Freedom House makes employing"peers"—people who are in long term recovery or who are supporting a loved one in recovery—a priority at every level throughout the organization. We acknowledge that where a person starts their recovery journey is not as important as where they end up. Which is why we work with our clients to restore the benefits 7 64 and privileges that may have been lost due to substance use or uncontrolled mental illness including, driving privileges, safe housing,steady employment, and family relationships. We do this by collaborating with each client individually and by providing safe, supportive opportunities for families to talk, learn, connect and heal. E. Evidence of Collaborations/Partnerships (10 points, page limit: not to exceed 1% pages) To enhance collaboration and improve service delivery for Lantern Project,CJRD has a clear plan focusing on partnerships with community organizations. Freedom House, as the largest community-based behavioral health provider in Orange County, serves clients referred by Lantern's Linkage Coordinator.These clients are screened for substance abuse and are either actively incarcerated at the Orange County jail or have recently been released, working with the Orange County Local Re-entry Council to reintegrate into the community. By working closely with GRD, Freedom House can create a robust support system that aids clients in their transition. To ensure that services are not duplicated in the community, FHRC has established a systematic collaboration with CJRD,which screens individuals for substance use disorder and prioritizes those with Opioid Use Disorder.Through a process of warm handoffs, CJRD facilitates client engagement with FHRC while individuals are still incarcerated, allowing for the determination of appropriate evidence-based treatment options and social supports before and immediately following their release.This joint effort is essential for providing harm reduction education and equipping clients with harm reduction kits upon release, ultimately reducing the risk of overdose. Maintaining an ongoing dialogue and coordination with all stakeholders involved further enhances collaboration and helps manage resources efficiently. By leveraging the strengths and services of each organization involved in the Lantern Project, including law enforcement and local re-entry support services, FHRC and CJRD can provide comprehensive and non-duplicative care that effectively addresses the needs of those we serve. The Lantern Project's linkage coordinator will work with colleagues at the court,jail and other CJRD staff to oversee all the re-entry services for the county. Lantern staff will ensure that they are not working with reentry or diversion services in another county. FHRC will screen each client at intake and assessment to ensure they are not currently enrolled in duplicative services with another North Carolina agency. If we find that the client is enrolled in SLID, OUD or mental health services with another provider, FHRC staff will work to reconnect the client with those services, if still appropriate. If the client is enrolled, but it is decided that the level of care or the services a no longer clinically appropriate, FHRC will work with that agency to have the client discharged or transferred to a more appropriate level of care. 8 65 F. Performance Measures and Program Evaluation (18 points, page limit:not to exceed 1 page) Freedom House will use a variety of methods to evaluate project success.These include: ➢ Regular team meetings-FHRC staff will meet regularly with URD staff to review: ■ the number and flow of client referrals as they relate to service targets. Referrals will be adjusted as necessary to ensure targets are met or exceeded. ■ the number of clients successfully connected to each service and/or any additional services needed. ■ any barriers to service provision so they may quickly be resolved. ■ client satisfaction with services as evidenced by ongoing engagement in services and client satisfaction surveys administered every 6 months. ■ The resolution of social determinants of health needs such as connection to housing, medical services, harm reduction services,food assistance, and other programs necessary for sustained recovery. ➢ Formal tracking of referrals to the program, and all services received, using an internal tracking form.The internal tracking form is designed to capture all client-level data needed for quarterly and annual reports. Referrals for outpatient services that are part of the FHRC service array are made and tracked in a weekly case conference at the Freedom House outpatient clinic as well as in the electronic medical record. For services beyond those that FHRC provides,the Peer Support staff assists in reporting on successful connections each week. ➢ Client satisfaction surveys are administered to clients in the program every six months and at program discharge via the National Outcome Measures Survey (NOMS).The NOMS tool is a validated outcome measure used by the Substance Abuse and Mental Health Services Administration (SAMHSA).The NOMS measures multiple points of client satisfaction with the quality of services received and their impact on their life in recovery. ➢ FHRC includes clients in the design and implementation of program evaluation routinely. Each client signs an informed consent prior to program participation allowing the client's specific needs, services, outcomes and feedback to be shared in the weekly team staffing. Information shared in the weekly staffing is used to address the client's unique needs and circumstances as well as to address patterns of unmet needs among our clients. ➢ Additionally, Clients enrolled with Freedom House participate in the NOMS survey every six months and at program discharge. Data from the 6 months and discharge surveys are pulled monthly(as applicable)to evaluate client satisfaction with services received. Client satisfaction data is reviewed each month in Freedom House's Continuous Quality Improvement Committee and changes are made, as necessary,to increase client satisfaction with services. 9 66 The data collected will serve as a vital resource for accurately reporting on the direct services provided and the outcomes achieved by our clients. By consistently measuring and analyzing these performance indicators, we can ensure transparency, enhance service delivery, and ultimately improve client satisfaction and success rates.This commitment to data-driven decision-making will not only reinforce our accountability but also guide our strategic initiatives moving forward,fostering an environment of continuous improvement and excellence in service provision. 10 67 9. Certifications and Required Forms A. Application Certification II I have reviewed this application for accuracy. I understand that Opioid Abatement funds are intended to address specific remediation activities as identified under the NC Memorandum of Agreement(MOA)for the Opioid Settlement Funds. I understand that these opioid settlement funds are subject to State laws and regulations,and I have read the MOA and agree to the requirements, I certify that the requested funds will be used in compliance with these requirements and with all requirements outlined in the Orange County High impact Opioid Abatement Strategies RFA. I agree to submit invoices and other relevant documentation to Orange County to pay or be reimbursed, as well as quarterly status reports, by the date stated in the contract. I understand that Orange County requires agencies with receipts less than$500,000 that do not have a financial audit(or a financial report),prepared by a certified public accountant(GPA)to complete schedule of Receipts and Expenditures form. An agency does not need to complete this form if it has a prepared audit/report it can submit for the calendar year ending December 31,2024 or the fiscal year ending June 30,2025. Agencies with receipts totaling$500,000 or more,from any source, must submit a CPA-certified financial audit. financial statements for each year that opioid settlement funding is provided to my organization,and that Orange County may monitor the program during the award period. Agency Authorized Official (print name) Joyce rper Signature Title CEO Date 2/16J2026 Board Chair/Elected Official (print name) Paula Harrington ` Signature Title Board Chair Date 2/16/2026 1 68 B. Non-profit agencies only:Verification of 501(c)(3)Status Form IRS Tax Exemption Verification Form (Annual) f,Joyce Harper hereby state that I am Chief Executive Officer of (Printed Name) (Title) Freedom House Recovery Center("Organization"),and by that authority duly (Legal Name of Organization) given and as the act and deed of the Organization,state that the Organization's status continues to be designated as 501(c)(3) pursuant to U.S. Internal Revenue Code,and the documentation on file with the North Carolina Department of Health and Human Services is current and accurate. I understand that the penalty for perjury is a Class F Felony in North Carolina pursuant to N.C. Gen.Stat.§ 14-209, and that other state laws,including N.C.Gen.Stat.§143C-10-1,and federal laws may also apply for making perjured and/or false statements or misrepresentations. I declare under penalty of perjury that the foregoing is true and correct. Executed on this the 16 day of February __—,--2_0_26_'_' (Signat e) 2 . . . .._-_.._............. 69 C. Certification of No Overdue Tax Debts Date of Certification 02/16/2026 Certification: We certify that Freedom House Recovery Center does not have any overdue tax debts,as defined by N.C.G.S.105-243.1,at the federal,State,or local level.We further understand that any person who makes a false statement in violation of N.C.G.S. 143C-6-23(c)is guilty of a criminal offense punishable as provided by N.C.G.S.)143C-10-1b. Sworn Statement: Paula Harrington and Joyce Harper being duly sworn,say that we are the Board Chair and CEO, respectively,of Freedom House Recovery Center of Chapel Hill in the State of North Carolina;and that the foregoing certification is true,accurate and complete to the best of our knowledge and was made j and subscribed by us.We also acknowledge and understand that any misuse of State funds will be ti reported to the appropriate authorities for further action. Boar hair Si re I C f Sworn to and subscribed before me on the day of the date of said certification. My Commission Expires: °�o ry Signature and Sea[) 1 G.S. 105-243.1 defines:Overdue tax debt.—Any part of a tax debt that remains unpaid 90 days or more after the notice of final assessment was mailed to the taxpayer.The term does not include a tax debt, however,if the taxpayer entered into an installment agreement for the tax debt under G.S. 105-237 within 90 days after the notice of final assessment was mailed and has not failed to make any payments due under the installment agreement:' �vwa►a�, SKY WWYpt s lO :Q 3 70 D. Code of Conduct Policy Each recipient of award shall maintain a written Code of Standards of Conduct which shall govern the performance of its officers,employees or agents in contracting with and/or expending Older Americans Act funds and State appropriations. The recipient Agency's officers,employees or agents shall neither solicit nor accept gratuities,favors or anything of monetary value from contractors or potential contractors.To the extent permissible under state or local laws, rules or regulations, such standards shall provide for appropriate penalties, sanctions, or other disciplinary actions to be applied for violations of such standards either by the officers, employees or agents of the recipient Agency or by contractors or their agents, Awards will be made only to responsible Agency(ies) possessing the ability to perform successfully under the terms and conditions of a proposed procurement.Consideration will be given to such matters as Agency's integrity,compliance with public policy, record of past performance, and financial and technical resources. I haver d and fully erstand the context of the information above. CEO 2/16/2026 A41r, Official Signature Title Date 4 71 i I I E. Conflict of Interest Policy I i I The Board of Directors/Trustees or other governing persons, officers,employees or agents are to avoid ! any conflict of interest, even the appearance of a conflict of interest.The Organization's Board of Directors/Trustees or other governing body,officers,staff and agents are obligated to always act in the best interest of the organization.This obligation requires that any Board member or other governing person,officer,employee or agent,in the performance of Organization duties,seek only the furtherance of the Organization mission.At all times, Board members or other governing persons, officers, employees or agents,are prohibited from using their job title,the Organization's name or property,for private profit or benefit. a. The Board members or other governing persons, officers,employees, or agents of the Organization should neither solicit nor accept gratuities,favors,or anything of monetary value from current or potential contractors/vendors, persons receiving benefits from the Organization or persons who may benefit from the actions of any Board member or other governing person, officer,employee or agent.This is not intended to preclude bona-fide Organization fund raising- activities. b. A Board or other governing body member may,with the approval of Board or other governing body, receive honoraria for lectures and other such activities while not acting in any official capacity for the Organization. Officers may,with the approval of the Board or other governing body, receive honoraria for lectures and other such activities while on personal days, compensatory time,annual leave,or leave without pay. Employees may,with the prior written approval of their supervisor, receive honoraria for lectures and other such activities while on personal days, compensatory time, annual leave,or leave without pay. If a Board or other governing body member,officer,employee or agent is acting in any official capacity, honoraria received in connection with activities relating to the Organization are to be paid to the Organization. c. No Board member or other governing person,officer,employee,or agent of the Organization shall participate in the selection, award,or administration of a purchase or contract with a vendor where,to his knowledge,any of the following has a financial interest in that purchase or contract: 1. The Board member or other governing person,officer,employee,or agent; 2. Any member of their family or personal relationship; 3. An organization in which any of the above is an officer,director,or employee; 4. A person or organization with whom any of the above individuals is negotiating or has any arrangement concerning prospective employment or contracts. d. Duty to Disclosure--Any conflict of interest, potential conflict of interest,or the appearance of a conflict of interest is to be reported to the Board or other governing body or one's supervisor immediately. 5 72 e. Board Action--When a conflict of interest is relevant to a matter requiring action by the Board of Directors/Trustees or other governing body,the Board member or other governing person, officer,employee,or agent(person(s)) must disclose the existence of the conflict of interest and be given the opportunity to disclose all material facts to the Board and members of committees with governing board delegated powers considering the possible conflict of interest.After disclosure of all material facts,and after any discussion with the person,they shall leave the governing board or committee meeting while the determination of a conflict of interest is discussed and voted upon.The remaining board or committee members shall decide if a conflict of interest exists. In addition,the person(s)shall not participate in the final deliberation or decision regarding the matter under consideration and shall leave the meeting during the discussion of and vote of the Board of Directors/Trustees or other governing body. I have re nd fully u rstand the context of the information above. CEO 2/16/2026 Authori d Official Signature Title Date 6 . .................. 73 F. Appendix E:E-Verify STATE OF NORTH CAROLINA AFFIDAVIT COUNTY OF ORANGE urrrrrrrrrrrrrrrrrrEggs rrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrsrrrrrra■rrr I,Joyce Harper (the individual attesting below), being duly authorized by and on behalf of Freedom House Recovery Center(the entity contracting with Orange County hereinafter "Employer")after first being duly sworn hereby swears or affirms as follows: 1. Employer understands that E-Verifyis the federal E-Verify program operated by the United States Department of Homeland Security and other federal agencies,or any successor or equivalent program used to verify the work authorization of newly hired employees pursuant to federal law in accordance with NCGS§64-25(5). 2. Employer understands that Employers Must Use E-Verify. Each employer, if employing 25 or more employees in this State, after hiring an employee to work in the United States,shall verify the work authorization of the employee through E-Verify in accordance with NCGS§64-26(a). 3. Employer is a person, business entity,or other organization that transacts business in this State and that employs 25 or more employees in this State. (Mark Yes or No) a.YES ® or b. NO ❑ 4. Employer's subcontractors comply with E-Verify, and Employer will ensure compliance with E-Verify by any subcontractors subsequently hired by Employer during the term of its contract with Orange County. This 16 day of Februar Signature of Affiant Print or Type Name Joyce Harper NORTH CAROLINA NOTARY ACKNOWLEDGEMENT�� ) THE STATE OF NORTH CAROLINA,COUNTY OF K e, Signed and sworn to (or affirmed) before me,this day of , 20-�* My Commission Expires: Notary Public, — Notary Public Signature: ,�. [Official Seal] 7 74 G. Discrimination Policy Each recipient of award shall maintain a discrimination policy ensuring that they do not discriminate on the basis of race,color, national origin, disability,religion,age,sex/gender,sexual orientation,gender identity and expression, marital status,veteran status,or source of income in the administration of its programs or activities,as required by applicable loa wans regulations. The recipient agency should identify officer,employee or agent responsible for coordination of compliance efforts and receipt of inquiries concerning non-discrimination requirements implemented by 40 C.F.R. Parts 5 and 7,including Title VI of the Civil Rights Act of 1964, as amended;Section 504 of the Rehabilitation Act of 1973;the Age Distribution Act of 1975, and Title IX of the Education Amendments of 1972,and other applicable laws. Said officer,employee or agent's contact information shall be included below. Discrimination complaint form should be attached or link to discrimination form included below. Responsible officer/employee/agent: Joyce Harper Responsible officer/employee/agent phone number: 919-442-1830 Responsible officer/employee/agent email address:Joyce H@freedom houserecovery.org Link to discrimination complaint form (if not attached): attached CEO 2/26/2026 Authprrzecl Official Signature Title Date 8 75 H. Authorization for Individuals to Sign Contracts and Submit Reporting [Letter from Board President/Chairperson identifying individuals as authorized to sign contracts, expenditure reports, and performance reports] I, Paula Harrington , Board President/Chairperson of Freedom House Recovery Center[Agency/Organization's legal name] hereby identify the following individual(s)who is(are)authorized to sign and/or submit documentation for the organization named above: Contracts. Printed Name: Title: Email address: 1. Joyce Harper CEO Joyce.H@freedomhouserecovery.org 2. Shaneka Parker CFO Shaneka.P@freedomhouserecovery.org Click or tap here to Click or tap here to 3. enter text. enter text. Click or tap here to enter text. Expenditure Reports: Printed Name: Title: Email address: 1. Shaneka Parker CFO Shaneka.P@freedomhouserecovery.org Accounting 2. Emmanuella Bedard Supervisor emmanuella.b@freedomhouserecovery.org 3. Leon Lashway Accounts Receivable leon.l@freedomhouserecovery.org 9 76 Performance Reports: Printed Name: Title: Email address: !, Heather Griffin- 1, Heathey VP QA&Training Heather.G@freedomhouserecovery.org 2, Amanda Church Data Analyst amanda.c@freedomhouserecovery.org Click or tap here to Click or tap here to 3. enter text. enter text. Click or tap here to enter text. _ Paula Harrington Board Chair Board President or C4air printed name *Title 2/2612026 Signature Date a 10 77 I. Business Associate Addendum THIS ADDENDUM is made this 16 day of February,2026 to a contractual arrangement between the parties("Agreement"). WHEREAS Orange County is itself a Covered Entity,as that term is defined in HIPAA and will be referred to as"Covered Entity"; and WHEREAS, Freedom House Recovery Center is,or may be, a Business Associate of Covered Entity and will be referred to as"Business Associate";and WHEREAS, Business Associate performs certain services on behalf of or for Covered Entity that require the exchange of information about patients that is protected by the Health Insurance Portability and Accountability Act of 1996,as amended,and the Privacy,Security, Breach Notification, and Enforcement Rules at 45 CFR Part 160 and Part 164(collectively"HIPAA"). NOW,THEREFORE,the parties to the Agreement are entering into this Addendum to establish the responsibilities of both parties regarding HIPAA-covered information and to bring the Agreement into compliance with HIPAA. 1. DEFINITIONS Except as otherwise defined herein,terms used in this Addendum shall have the same meaning as the terms are defined in HIPAA. II.OBLIGATIONS OF BUSINESS ASSOCIATE To comply with the Privacy,Security, and Breach Notification obligations imposed by HIPAA, Business Associate agrees to: A. Privacy and Security Obligations: 1. Not use nor disclose information other than as permitted or required by the Agreement,this Addendum or as required by law. 2. Use appropriate safeguards to prevent use or disclosure of the information other than as provided for by the Agreement and this Addendum. 3. Comply with Subpart C of 45 CFR Part 164 with respect to electronic PHI (protected health information)to prevent use or disclosure of PHI other than as provided for by the Agreement. 4. Report to Covered Entity any use or disclosure of the information not provided for by the Agreement of which Business Associate becomes aware, including breaches of Unsecured PHI as required by 45 CFR 164.410. 5. In accordance with 45 CFR 164.502(e)(1)(ii)and 164.308(b)(2),if applicable,ensure that any agents or subcontractors that create,receive, maintain,or transmit PHI on behalf of Business Associate agree, in writing,to the same restrictions, conditions,and requirements that apply to Business Associate with respect to such information. 6. Make available PHI in a designated set record set to Covered Entity upon request within three(3)working days as necessary to satisfy Covered Entity's obligations under 45 CFR 164.524. If Business Associate receives a request for access directly from the individual,then 11 78 Business Associate will forward the individual's request to Covered Entity within three (3) working days to be fulfilled by Covered Entity. 7. If Business Associate receives a request pursuant to 45 CFR 164.526 to make any amendment(s)to PHI in a designated record set directly from the individual,then Business Associate will forward the individual's request to Covered Entity within three(3)working days to be fulfilled by Covered Entity. 8. Maintain and make available upon request within three (3)working days the information required to provide an accounting of disclosures to Covered Entity as necessary to satisfy Covered Entity's obligations under 45 CFR 164.528. If Business Associate receives a request to provide an accounting of disclosures directly from the individual,then Business Associate will forward the individual's request to Covered Entity within three (3)working days to be fulfilled by Covered Entity. 9. Make its internal practices,books, and records relating to the use of PHI received from Covered Entity, or created or received by Business Associate on behalf of Covered Entity, available to the Secretary of DHHS and Covered Entity for purposes of determining compliance with HIPAA. 10. To the extent practicable,mitigate any harmful effects that are known to Business Associate of a use or disclosure of PHI or a breach of Unsecured PHI in violation of this Addendum. 11. Use and disclose an individual's PHI only if such use or disclosure is in compliance with the applicable requirements of 45 CFR 164.504(e)and the terms of this Addendum. 12. Refrain from exchanging any PHI with any entity of which Business Associate knows of a pattern of activity or practice that constitutes a breach as defined by North Carolina State Law, HIPAA,or this Addendum. 13. To the extent Business Associate is to carry out one or more of Covered Entity's obligation(s) under Subpart E of 45 CFR Part 164,comply with the requirements of Subpart E that apply to Covered Entity in the performance of such obligation(s). B. Breach Notification: In the event that Business Associate discovers any use or disclosure of PHI not provided for by the Agreement,including breaches of Unsecured PHI as required at 45 CFR 164.410, and any security incident of which it becomes aware, Business Associate agrees to take the following measures within three (3)working days after Business Associate first becomes aware of the incident: 1. To notify Covered Entity of any incident involving the acquisition, access, use or disclosure of Unsecured PHI in a manner not permitted under 45 CFR Part E.Such notice by Business Associate shall be provided without unreasonable delay,except where a law enforcement official determines that a notification would impede a criminal investigation or cause damage to national security. For purposes of clarity for this provision, Business Associate must notify Covered Entity of any such incident within the above timeframe even if Business Associate has not conclusively determined within that time that the incident constitutes a breach as defined by HIPAA. For purposes of this Addendum, Business Associate is deemed to have become aware of the breach as of the first day on which such breach is known or reasonably should have been known to such entity or associate of Business Associate, including any person,other than the individual committing the breach,that is an employee, officer or other agent of Business Associate or an associate of Business Associate. 12 79 2. To include in the above-described notification the names of the individuals whose Unsecured PHI has been, or is reasonably believed to have been,the subject of a breach. 3. To provide a draft letter to Covered Entity to utilize to notify the individuals that their Unsecured PHI has been, or is reasonably believed to have been,the subject of a breach. The draft letter must include,to the extent possible: a. A brief description of what happened, including the date of the breach and the date of the discovery of the breach, if known; b. A description of the types of Unsecured PHI that were involved in the breach(such as full name,Social Security Number, date of birth, home address,account number, disability code,or other types of information that were involved); c. Any steps the individuals should take to protect themselves from potential harm resulting from the breach: d. A brief description of what Covered Entity and Business Associate are doing to investigate the breach,to mitigate losses,and to protect against any further breaches; and e. Contact information for individuals to ask questions or learn additional information, which shall include a toll-free telephone number,an email address,web site,or postal address. III.TERMINATION A. This Addendum will terminate automatically,without further action by either party, upon termination of the Agreement to which it is attached. B. Covered Entity may terminate this Addendum if Covered Entity determines that Business Associate has violated a material term of the Agreement or this Addendum. C. Upon Covered Entity's gaining knowledge of a breach,as defined by North Carolina State Law or HIPAA, by Business Associate or any of its agents or subcontractors,of the Agreement or this Addendum, Covered Entity shall either: 1. Provide an opportunity for Business Associate to cure the breach or end the violation,and if Business Associate does not cure the breach or end the violation within the time specified by Covered Entity,terminate this Addendum and the attached Agreement;or 2. Immediately terminate this Addendum and the attached Agreement if either has been breached by a Business Associate, and a cure is not possible. D. In situations where it is not practicable to terminate this Agreement,Covered Entity shall report Business Associate's breach as defined by North Carolina State Law or HIPAA to the Secretary of DHHS, and continue under the existing arrangement with Business Associate until a reasonable alternative becomes available,or until directed by the Secretary of DHHS to terminate the Agreement. E. At termination of the attached Agreement and this Addendum,or upon request of Covered Entity,whichever occurs first, Business Associate shall: 1. If feasible, return or destroy all PHI that Business Associate still maintains in any form, received from Covered Entity or created, maintained or received by Business Associate on behalf of Covered Entity. Business Associate shall only destroy PHI with the written approval of Covered Entity.After return or destruction, Business Associate shall retain no copies of such information. 2. If return or destruction is not feasible, Business Associate will provide Covered Entity with documentation explaining the reason it is not feasible. If the PHI is not returned or destroyed, Business Associate will extend the protection of this Addendum to the 13 80 information and limit further uses and disclosures to those purposes that make the return or destruction of the information not feasible. F. The obligations of Business Associate under this Addendum shall survive the expiration, termination or cancellation of the attached Agreement and this Addendum,and shall continue to bind Business Associate,its agents,employees, contractors,successors and assigns, as set forth herein. G. Business Associate shall indemnify Covered Entity for costs associated with any incident involving the acquisition,access, use or disclosure of Unsecured PHI by Business Associate, any agent or subcontractor,in a manner not permitted under 45 CFR Subpart E. IV. MISCELLANEOUS A. All PHI that is created or received by Covered Entity and disclosed or made available in any form, including paper record,oral communication, audio recording and electronic display by Covered Entity or its operating units to Business Associate,or is created or received by Business Associate on Covered Entity's behalf,shall be subject to this Addendum. B. In the event of an inconsistency between the provisions of this Addendum and the mandatory provisions of HIPAA,as amended, HIPAA shall control.Where provisions of this Addendum are not included as mandated provisions in HIPAA, but are nonetheless permitted by HIPAA,the provisions of this Addendum shall control. C. Except as expressly stated herein or in HIPAA,the parties to this Addendum do not intend to create any rights in any third parties. D. This Addendum may be amended or modified only in writing signed by the parties. No party may assign it rights or obligations under this Addendum without the prior written consent of the other party. None of the provisions of this Addendum are intended to create, nor will they be deemed to create,any relationship between the parties other than that of independent parties, contracting with each other solely for the purpose of effecting the provisions of this Addendum and any other agreements between the parties concerning their business relationship. E. This Addendum will be governed by the laws of the State of North Carolina,venue Orange County. F. No change,waiver,or discharge of any liability or obligation hereunder on any one or more occasion shall be deemed a waiver of performance of any continuing obligation,or prohibit enforcement of any obligation,on any other occasion. G. In the event that any documentation of the arrangement pursuant to which Business Associate provides services to Covered Entity contains provisions relating to the use or disclosure of PHI that are more restrictive than the provisions of this Addendum,the provisions of the more restrictive documentation will control. H. In the event that any provision of this Addendum is held by a court of competent jurisdiction to be invalid or unenforceable,the remaining provisions of this Addendum shall remain in full force and effect. I. Headings in this Addendum are for convenience of reference only and shall not define or limit any of the terms or provisions hereof. J. A reference in this Addendum to a section in HIPAA means the section as in effect or as amended. K. Any ambiguity in this Addendum shall be interpreted to permit compliance with HIPAA. L. Business Associate will not use an agent or subcontractor without written agreement by Covered Entity. 14 81 IN WITNESS WHEREOF,the parties have hereunto executed this Business Associate Addendum on the day and year first written above. Orange County By: Travis,Myren,Orange County Manager ATTESTED: BUSINESS ASSOCIATE By: Joy arper, reedom House Recovery Center Title: Chief Executive Officer ATTESTED: 15 82 Orange County Office: (919)245-2304 Courthouse Fax: (919) 640-1729 106 East Margaret Lane azirkel@orangecountync.gov Hillsborough, NC 27278 CRIh11NAL JUSTICE RESOURCE DEPARTMENT February 12,2026 To Whom It May Concern: This letter is being written in support of Freedom House Recovery Center's application for opioid settlement funding for FY 26-27.The collaboration with Freedom House is a critical component of the Lantern Project.The CJRD Lantern Project has continued to benefit from ongoing collaboration with the Freedom House Lantern Peer Support Specialist and the Clinician. ORD engages in routine staffing meetings with the relevant Freedom House staff. Many Lantern clients benefit from peersupport and other services provided at Freedom House.The assistance in completing jail-based CCA's by the clinician is especially valued and needed.We are beginningto have conversations about implementing substance use treatmentgroups at the detention centerand I am hopeful that the Freedom House clinician will be able to support facilitation of these groups. Please feel free to reach out to me if you have any other questions or concerns. Sincerely, Jo-" Allison Zirkel, LCSW, LCAS azirkel orangecountync.gov Clinical Coordinator Office:919-245-2304/Cell: 919-748-2196 ORANGE COUNTY NOFUH €-AROJANA 83 ORANGE COUNTY ORANGE COUNTY HIGH IMPACT OPIOID ABATEMENT STRATEGIES NORTH CAROLINA Funding Proposal Application Form Application Due Date: February 20,2026 Before completing application, please review Attorney General Bondi's Memo providing guidance for recipients of Federal Funding regarding unlawful discrimination. See link: https://www.justice.gov/ag/media/1409486/dl Applicant Agency: General Information Student Wellness Department- University of North Carolina at Legal Name Chapel Hill Address 405 Ridge Rd., Suite 0103, SASB North, CB#7475, Chapel Hill, NC Type of Agency ❑ Government/ (check one) Public Authority ❑X Non-Profit ❑ For-Profit Business Telephone 919-962-9355 Website Studentwellness.unc.edu Primary Contact Full Name Hayden Graham Title Collegiate Recovery Programs Coordinator Email Hayden.graham@unc.edu Telephone 336-690-1387 Secondary Contact Full Name Dean Blackburn Title Director—Student Wellness Email blackburn@unc.edu Telephone 919-962-9355 Name of Project UNC-CH Campus Community Naloxone Supply Total Application Funding Requested $ 106,906.24 Sta rt E n d Funding Period Requested (MM/DD/YYYY) Date 07/01/2026 Date 06/30/2027 Selected NC MOA Option A Strategy(Number and Name) (7) Naloxone Distribution Agency Mission and Vision Statements MISSION: We educate, advocate, support, and promote individual and community health and well- being. VISION: We envision a thriving campus culture that is safe, equitable, and well. i 84 1. Proposal Summary (no more than 250 words, required but not scored) Student Wellness at the University of North Carolina at Chapel Hill (UNC-CH) seeks funding from the Orange County opioid settlement to sustain and expand its campus-wide opioid overdose prevention education and naloxone distribution program. Currently, Student Wellness serves as the backbone organization for HRC@UNC, a campus-community harm reduction coalition. HRC@UNC provides naloxone kits, fentanyl and xylazine test strips, educational materials, and DisposeRx drug deactivation packets at no cost to students through our two campus pharmacies, Student Wellness, and direct distribution efforts. Our current funding for these resources will expire at the end of the fiscal year, creating a gap in access to these life-saving tools. This proposal aligns with High Impact Opioid Abatement Strategy#7: Naloxone Distribution and aims to increase the availability of naloxone in high-traffic areas on campus. Key initiatives include installing ONEboxes—emergency overdose reversal kits with bilingual video training—at Automated External Defibrillator (AED) stations in partnership with Environment, Health & Safety. In addition, naloxone distribution points will be established in the Student Union, recreation centers, and other high-traffic locations, using repurposed newspaper boxes in collaboration with local media outlets. This project prioritizes historically marginalized populations, including both undergrad and graduate/professional students who face stigma, financial constraints, or lack awareness of these resources. By enhancing the accessibility, visibility, and education surrounding naloxone, this initiative will directly address the overdose crisis affecting the campus community and ensure the long-term sustainability of harm reduction efforts. ii 85 2. Project Narrative A. Assessment of Community Need Orange County, North Carolina, and the surrounding areas where our students reside have experienced an increase in consumption of opioid infused substances and related overdoses over recent years. According to the North Carolina Department of Health and Human Services (NCDHHS, 2024), opioid-related emergency department visits in the county have risen by over 40% in the past five years. This rate is affirmed by our own local UNC Health ER. This concerning trend affects our campus community of approximately 32,200 students at the University of North Carolina at Chapel Hill (UNC Office of Institutional Research, 2025). UNC-Chapel Hill's naloxone distribution initiative operates through two campus pharmacies, the Student Wellness department, and other pop-up venues. These have been funded by a prior NC DHHS grant that expired on June 30, 2025. This funding gap disrupts access to anonymous, no- cost overdose prevention and reversal resources that serve our diverse campus community. Without continued funding, we are losing crucial harm reduction services when needed. Additionally, and anecdotally, there has been a rise of 7-OH usage (the opioid receptor agonist found in Kratom) on our campus - our recovery coordinator has seen multiple students who have engaged with this substance. Our colleagues in Campus Health, our Counseling Center, and UNC Health ER corroborate this trend. The additional naloxone provided by this grant will put the university in a position of strategic reaction instead of unpreparedness to the increase of this drug's usage. The National Institute on Drug Abuse (2023) identifies several barriers to naloxone access among college students, including stigma, cost barriers, and lack of awareness about where to obtain the medication. Our proposal aims to address these specific barriers by: 1. Expanding anonymous access points across campus 2. Eliminating cost barriers through settlement funding 3. Integrating naloxone distribution with existing emergency response infrastructure (e.g., co-location with AED stations) Our institution's unique characteristics make this program particularly crucial: • Geographic Area: Multiple residential locations across Chapel Hill with high-density student housing areas requiring comprehensive coverage • Current Infrastructure: Two campus pharmacies currently distribute naloxone, along with other channels detailed in sections below • Existing Programs: Carolina Recovery Program and HRC@UNC provide foundational harm reduction services 1 86 • Integrated campus community engagement and education: Student Wellness pairs naloxone distribution with population specific-focused outreach, educational programming, and recovery support services tailored to college and community environments, something that SHAC's broader community clinical services are not designed to specifically provide. The proposed expansion would complement existing services while addressing critical gaps in our current distribution model. Several states have demonstrated the effectiveness of using opioid settlement funds for campus-based naloxone programs. In Ohio, for example, the state health department has successfully implemented emergency naloxone access cabinets across public and private universities through state opioid response initiatives (Ohio Department of Health, 2023). Similarly, the Virginia Department of Health now includes public universities as authorized partners in their statewide overdose prevention strategy, establishing a precedent for using settlement funds to support campus-based distribution programs (Virginia Department of Health, 2023). Implementing similar evidence-based approaches at UNC-Chapel Hill can ensure sustainable access to life-saving naloxone while addressing the documented needs of our campus community. Several eastern states already supply public institutions of higher education with naloxone for accessible distribution using opioid settlement funds: • Institutions of Higher Education in Ohio: The Governor established a successful model for expanding naloxone access on college campuses. Through state opioid response initiatives, it has provided free emergency naloxone access cabinets to both public and private universities, demonstrating how state-level programs can effectively support campus-based overdose prevention efforts. • Institutions of Higher Education in Virginia: The Department of Health provides no- cost naloxone to public universities as authorized partners in their statewide overdose prevention strategy. This demonstrates an established precedent for state opioid settlement funds to support campus-based naloxone distribution programs. • University of Rhode Island: URI's College of Pharmacy has been instrumental in distributing naloxone kits. Through the Community First Responder Program, thousands of free naloxone kits have been provided to the public. These efforts are supported by opioid settlement funds (URI, 2023). • Marshall University: In collaboration with West Virginia state health officials, Marshall University has proposed a $20 million project to reduce overdoses. This initiative is part of West Virginia's broader strategy to allocate opioid settlement funds effectively, and university involvement plays a key role in addressing the crisis (Associated Press, 2023). 2 87 • University of Central Arkansas: Awarded nearly$24,000 from the Arkansas Opioid Recovery Partnership, UCA launched the Naloxone Hero Project. This initiative supplies naloxone doses and offers training to students, faculty, and staff, enabling campus employees to administer naloxone (Opioid Recovery Partnership, n.d.). • Saint Joseph's University: Received $400,000 from Pennsylvania's $10 billion Opioid Crisis Relief settlement. The funds are allocated to support substance use education, prevention, and treatment programs within the community (Saint Joseph's University, 2023). B. Project Description and Program Sustainability This proposal aligns with High Impact Opioid Abatement Strategy#7: Naloxone Distribution through evidence-based practices modeled after successful state-supported university programs in Virginia and Ohio. Project Components: 1. ONEbox Installation at AED Stations • Partnership with Environment, Health & Safety (EHS) to co-locate naloxone with existing emergency response infrastructure • Each ONEbox includes: 0 2 naloxone cartons (carton = 2 doses of 4mg nasal naloxone (e.g., NARCAN) o Bilingual video instructions, including a 'training mode' option o Personal protective equipment o Tamper-evident seals for monitoring and data collection 2. Strategic Distribution Points • Pilot ONEboxes were installed in February 2025 at four campus libraries. • Installation of secured distribution boxes in high-traffic areas based on campus safety data: o Campus libraries o Student recreation centers o Student Union o Residence hall clusters 3. Campus Integration Program • Build on existing harm reduction infrastructure through: o Integration with current campus pharmacy distribution o Supplying UNC Police naloxone cartons o Peer program expansion: partnership with UNC EMS's Stop the Bleed training; distribution events; educational workshops; Carolina Recovery (collegiate recovery program); HRC@UNC (Harm Reduction Coalition); and StOMP (pharmacy student organization) partnerships Implementation Timeline: 3 88 Month 1-2 (Planning Phase): • Establish implementation team and protocols • Finalize distribution locations with Environment, Health & Safety • Create monitoring and evaluation protocols • Train responsible parties on ordering supplies • Monitor pilot ONEboxes at campus libraries • Contact local news agencies about donated unused newspaper boxes Month 3-4 (Initial Implementation): • Install the next phase of ONEboxes at AED locations • Launch distribution tracking system • Begin staff and peer educator training • Design, print, and install wraps on donated newspaper boxes Month 5-6 (Expansion): • Install standalone distribution points (wrapped newspaper boxes) • Integrate with existing harm reduction programs • Implement a data collection system Month 7-12 (Full Implementation and Evaluation): • Complete campus-wide installation • Analyze distribution patterns and usage data • Establish best practices for program continuation • Prepare a sustainability plan based on first-year data Sustainability Plan: 1. Infrastructure Integration • Incorporate naloxone maintenance into existing safety protocols • Establish regular restocking procedures • Develop a comprehensive staff training program 2. Institutional Support • Leverage established partnerships with: o EHS o Student Affairs departments o Residential Life o HRC@UNC members • Reduce stigma through educational programs and naloxone awareness • Build rapport with senior leadership to increase University buy-in • Begin to explore the expansion of naloxone distribution to off-campus locations, such as local public libraries, bars, and other high-traffic areas, to extend outreach and access as HRC@UNC grows and additional resources become available. 3. Data Collection and Evaluation • Track distribution metrics • Monitor usage patterns • Document program impact 4 89 • Report outcomes to stakeholders 4. Long-term Funding Strategy • Initial implementation through opioid settlement funds o Demonstrate campus demand for harm reduction tools through metrics • Sustainability through: o Integration into campus safety budget o Coordination with UNC Systems Office and NC DHHS to expand naloxone access at public NC institutions of higher education o Strengthening HRC@UNC partnerships and securing HRC@UNC funding Potential Obstacles and Solutions: 1. Supply Chain Management • Solution: Protocols for employees responsible for ordering • Maintain adequate inventory based on usage data 2. Program Continuity • Solution: Create detailed operational procedures • Integrate into existing campus safety infrastructure • Train multiple staff across departments 3. Resource Sustainability • Solution: Document program impact • Demonstrate cost-effectiveness • Build diverse funding partnerships Current Resources: • Two campus pharmacies with established naloxone distribution • Existing collegiate recovery program • EHS, UNC Police, UNC EMS, and Campus Health partnerships • Harm reduction programming experience • HRC@UNC with the interdisciplinary executive committee This project will enhance our capacity to address opioid overdose risk by: 1. Expanding naloxone access points across campus 2. Strengthening harm reduction infrastructure 3. Building sustainable distribution systems 4. Creating replicable protocols for future health initiatives 5 90 Implementing this comprehensive naloxone distribution program, HRC@UNC, through Student Wellness will establish a sustainable model for campus-based harm reduction that aligns with state and national efforts to prevent overdose deaths. C. Equity Impact The proposed project addresses health inequities by prioritizing access to naloxone for historically marginalized populations. This includes first-generation students, individuals with mental health or substance use concerns, and those at higher risk for overdose, such as students experiencing housing and food insecurity. These groups face higher overdose rates due to systemic barriers to healthcare access, stigma, and a lack of culturally competent resources. By ensuring that naloxone is accessible across the public university campus, the project offers equitable opportunities for students, faculty, staff, and community members to obtain life- saving resources, regardless of their background or financial status. Although students are generally required to have health insurance, some lose access to it after verifying their coverage. This project eliminates financial barriers by providing naloxone and overdose prevention education at no cost. The distribution strategy ensures that people facing financial constraints or lacking healthcare access can quickly obtain naloxone. As a public university initiative, this program will also be available to all individuals in the surrounding community, extending valuable support beyond the student body. The central location of the campus in Chapel Hill makes it accessible for those with limited transportation options. Looking ahead, the project plans to expand its impact by building even more capacity for HRC@UNC and extending access to naloxone and harm reduction education to the surrounding community. This will ensure a comprehensive approach to student and community well-being. Through these efforts, we aim to create a lasting and inclusive framework for health equity and overdose prevention. D. Organizational Readiness Student Wellness at the University of North Carolina at Chapel Hill is fully prepared to implement and expand opioid harm reduction initiatives with coalition colleagues through opioid settlement funding. Our department operates within a comprehensive public health and harm reduction framework grounded in social work ethics and evidence-based substance use prevention and intervention practices. We have the administrative infrastructure and clinical and community expertise necessary to manage this award responsibly while promoting the health and dignity of people impacted by drug use. What we currently lack is dedicated funding to further expand our reach to the campus and surrounding community. Currently, the University is not positioned to provide those additional resources. 6 91 Grant Management, Fiscal Oversight, and Compliance Capacity Student Wellness has managed more than $300,000 in prior grant funding from the North Carolina Department of Health and Human Services (NC DHHS) and related agencies, including a grant dedicated specifically to naloxone education and distribution. Through these awards, we have demonstrated capacity in procurement, inventory management, data tracking, reporting, and regulatory compliance. All financial management and reporting will be administered through UNC-Chapel Hill's Office of Sponsored Programs (OSP), which provides centralized oversight for budgeting, expenditure tracking, audit compliance, and required reporting. We will not require subcontractors. Student Wellness works closely with OSP to ensure: • Accurate tracking of expenditures by approved budget categories • Timely submission of fiscal and programmatic reports • Documentation consistent with state and university requirements • Compliance with procurement, inventory, and distribution policies Our team includes administrative leadership overseeing fiscal compliance; a Primary Prevention Coordinator implementing prevention science and harm reduction strategies; a Licensed Clinical Social Worker (LCSW) providing clinical integration and early intervention; and the Carolina Recovery Program Coordinator leading recovery and peer engagement initiatives. This structure ensures clear accountability, operational efficiency, and program continuity. Established Naloxone Distribution Infrastructure Student Wellness has developed a multi-channel naloxone distribution network across campus and into the broader Orange County community. Current distribution avenues include: • UNC Campus Pharmacies (serving students, faculty, staff, and community members) • HRC@UNC regular Narcan tabling • Carolina Recovery Community (CRC) weekly distribution events • Student Wellness-hosted distribution tabling • StOMP outreach events • Recovery Zone trainings incorporating naloxone education • Direct distribution through the Student Wellness LCSW • Provision of naloxone to UNC-Chapel Hill Campus Police officers • Provision of naloxone to campus EMS • Collaboration with SHAC for distribution Standardized distribution workflows, educational materials, overdose response protocols, and inventory tracking systems are already in place. Staff and trained student leaders provide overdose prevention education, naloxone administration instruction, and information about fentanyl and xylazine contamination risks. 7 92 Understanding Issues Affecting People Who Use Drugs Student Wellness approaches opioid harm reduction with a clear understanding of the structural and developmental factors affecting people who use drugs. College students may face: • High-risk polysubstance environments • Stigma associated with carrying naloxone • Fear of disciplinary consequences • Limited awareness of fentanyl contamination • Mental health challenges • Transition stressors (first-generation, rural, and transfer students) We recognize that punitive-only responses are ineffective. Effective overdose prevention requires normalization of harm reduction tools, stigma reduction, and accessible support pathways. Our "party pack" initiative, developed with the Campus & Community Coalition (CCC) and the Office for Off-Campus Life, reflects this approach. Students who voluntarily register off-campus gatherings receive kits containing naloxone, fentanyl and xylazine test strips, DisposeRx packets, and educational materials. This initiative: • Places harm reduction tools in high-risk settings • Reduces stigma around carrying naloxone • Encourages proactive safety planning • Strengthens student—law enforcement collaboration This model acknowledges real-world substance use contexts while promoting safety and dignity. Culturally Humble and Dignity-Centered Practice Student Wellness staff are trained in culturally responsive and trauma-informed approaches grounded in client self-determination and nonjudgmental engagement. We serve a diverse campus population, including: Students: • First-generation college students • Students from rural NC communities disproportionately impacted by opioid use • Students of color • LGBTQ+ students • Students with prior justice system involvement • Students experiencing housing instability • Students in recovery Faculty/Staff/Alumni/Visitors: • Individuals with diverse identities and lived experiences • Campus employees who regularly access naloxone resources Our messaging avoids moral framing and emphasizes safety, compassion, and shared responsibility. Naloxone education affirms that carrying Narcan is an act of care, not an admission of personal drug use. 8 93 The Carolina Recovery Community (CRC) further reflects this commitment. CRC offers weekly peer support meetings, community-building events, milestone celebrations, and one-on-one recovery coaching. The Recovery Program Coordinator brings lived recovery experience, enhancing credibility and relatability. Students are supported in abstinence-based or harm reduction pathways without judgment. Promotion of Health and Dignity for Impacted Communities Naloxone distribution is integrated within a broader health equity framework. Student Wellness includes interdisciplinary staff across prevention, health promotion, communications, assessment, health equity programming, and clinical services. The LCSW provides BASICS, motivational interviewing, and ongoing substance use counseling, maintaining an active caseload of approximately 25 students. Students with prior documented infractions participate in a structured consultation that serves as early intervention and risk mitigation. These meetings are confidential, person-centered, and focused on assessing needs, building skills, reinforcing safety strategies, and connecting students with supportive resources. Many subsequently engage in recovery programming or continued counseling. Naloxone encounters function as supportive entry points into broader services. Overdose prevention is embedded within a comprehensive strategy promoting student well-being and community safety. Experience Serving Individuals Experiencing Housing Instability and Justice System Transitions UNC-Chapel Hill includes students experiencing housing instability, financial precarity, and court involvement. Student Wellness collaborates with campus and community partners, including the Dean of Students, UNC Health Emergency Department, Campus Health and Counseling Services, Oxford Houses, food banks, and related resources, to support students facing housing, food, financial, or reentry-related challenges. Our harm reduction programming is intentionally low barrier. Naloxone distribution requires no proof of identity, campus affiliation, abstinence commitment, disclosure of substance use, or payment. Community members encountered through tabling or outreach are served without screening barriers, reducing obstacles for those who may distrust institutions due to prior justice involvement or unstable housing. By equipping campus police with naloxone and maintaining collaborative relationships, we further increase the likelihood of overdose reversal without escalation and promote trust- centered public safety responses. E. Evidence of Collaborations/Partnerships The success of this initiative depends on collaboration across multiple campus and community stakeholders: • Environment, Health & Safety: Co-leads the installation of ONEboxes at AED stations. 9 94 • Campus Pharmacies: Provides free nasal naloxone campus community members can access anonymously • Campus Police & EMS: Ensures integration with emergency response systems. • Carolina Recovery: Provides peer support, stigma-reduction, and outreach. • StOMP (Student Pharmacists Opioid Misuse Prevention): Offers student-led advocacy and training. • HRC@UNC: Amplifies existing resources and expands awareness and accessibility of harm reduction efforts. • Campus & Community Coalition (for High-Risk Alcohol Consumption): Substance use data hub, supportive partner, and mentor organization for HRC@UNC. These partnerships, coupled with local media outlets and community organizations, will facilitate a holistic and sustainable overdose prevention strategy. In addition to these key campus partners, local media outlets may collaborate to repurpose newspaper boxes for naloxone distribution points, further enhancing visibility and accessibility. Local community organizations, such as the Orange County Health Department, will also support the program's educational efforts and outreach initiatives. F. Performance Measures and Program Evaluation The effectiveness of the expanded naloxone distribution program will be evaluated using both quantitative and qualitative measures to assess its impact, engagement, and effectiveness: 1. Naloxone Kits Distributed: The number of naloxone kits distributed will be tracked through inventory logs, with monthly reporting to monitor supply and demand and ensure adequate stock levels. 2. ONEbox Usage Data: Data from ONEboxes will be monitored through tamper tags and anonymous usage reports, allowing for the assessment of their effectiveness in emergencies. 3. Training Engagement: Participation in naloxone training sessions will be recorded, and pre/post surveys will measure increases in students' knowledge and confidence in using naloxone. 4. Student Feedback: Surveys and focus groups will be conducted to gather student feedback, identify barriers to access, and assess overall satisfaction with naloxone availability and training. 5. Overdose Reversal Reports: Voluntary and anonymous reports of naloxone use to reverse overdoses will be collected to determine the program's effectiveness in preventing fatalities and mitigating overdose risks. 10 95 Additionally, the following broader evaluation metrics will be implemented: 6. Active Naloxone Access Locations: Geographic Information System (GIS) mapping will monitor the placement and accessibility of naloxone stations, ensuring they are strategically located for maximum reach. Regular accessibility audits will ensure the locations meet the needs of the target populations. 7. Training Completion Rates: The completion rates of naloxone training sessions for students and staff will be tracked. Pre/post-surveys will evaluate the effectiveness of educational outreach efforts in increasing awareness and understanding. 8. Emergency Use Reports: Data on naloxone use in emergencies will be collected in collaboration with campus emergency services to evaluate the program's direct impact on reversing overdoses and preventing fatalities. 9. Awareness and Utilization Rates: Annual surveys will assess overall awareness of naloxone access points on campus and utilization rates to ensure that students know where to obtain naloxone and feel confident in using it. Program Evaluation and Reporting • Quarterly Data Reviews: Data will be reviewed quarterly to assess trends in naloxone distribution, usage, and training participation. This review will inform program adjustments and identify areas for improvement. • Annual Impact Reports: Reports will be submitted to funding agencies to demonstrate the program's outcomes, success in expanding naloxone access, and continued need for support. • Student Feedback Sessions: Ongoing student feedback sessions will be held to refine the accessibility and effectiveness of the program, ensuring it meets the evolving needs of the campus community. These performance measures and evaluation methods will provide critical data to guide program improvements, demonstrate the program's impact, and ensure long-term sustainability. Through ongoing data collection and feedback, the program will evolve to serve students better and reduce overdose risks on campus. 11 96 References Coyne, C. (2024, December 10). Marshall involved in new addiction initiative receiving $20M in WV First Foundation funds. The Herold-Dispatch. https://www.herald- dispatch.com/news/marshall-involved-in-new-addiction-initiative-receiving-20m-in-wv-first- foundation-funds/article Oaee520a-b74d-11ef-8cea-8726eaa6063d.html JAMA Network. (2023). Cost-effectiveness of opioid settlement-funded naloxone programs. JAMA Network, 22(7), 479-485. https://doi.org/10.1001/gama.2023.0937 Michigan Medicine. (2023). University of Michigan naloxone distribution program reaches 1,000 kits in first year. Michigan Medicine. https://medicine.umich.edu/medschool National Institute on Drug Abuse. (2023). Naloxone and opioid overdose. National Institute on Drug Abuse. https://nida.nih.gov National Public Radio. (2024). Opioid settlement funds in North Carolina: A new era for prevention. NPR. https://www.npr.org/sections/health/2024 North Carolina Department of Health and Human Services. (2024). Opioid-related overdose data and trends in North Carolina. NCDHHS. https://www.ncdhhs.gov Opioid Recovery Partnership. (n.d.). University of Central Arkansas: Naloxone Hero Project. Opioid Recovery Partnership. https://www.arkansasopioidrecoverypartnership.org Saint Joseph's University. (2023). Opioid Crisis Relief funds support prevention programs. Saint Joseph's University. https://www.sou.edu UNC Office of Institutional Research. (2024). Student enrollment statistics. University of North Carolina at Chapel Hill. https://institutionalresearch.unc.edu UNC-CH Office of Student Wellness. (2024). Fentanyl and substance concerns among students. UNC Office of Student Wellness. https://wellness.unc.edu University of Hawaii. (2025). Hawai'i Opioid Settlement Project: Enhancing transparency in opioid prevention. University of Hawaii. https://www.hawaii.edu/opioidsettlement University of Rhode Island. (2023). Community First Responder Program: Delivering naloxone to the public. University of Rhode Island. https://www.uri.edu/firstresponder 12 97 3. Letters of Commitment and/or Support(Up to 5 letters) • Carolina Nursing • Campus and Community Coalition (for High-Risk Alcohol Consumption) • Environment, Health,&Safety(UNC-CH) • Student Government and HRC@UNC 4. Latest Audited Financial Statements i. Despite the size of the University's overall budget,the majority of funds are already dedicated to other commitments, and the University is not currently positioned to dedicate funds specifically to Narcan distribution. Grant funding allows us to continue this important service. 5. Documentation of Tax Identification Number 6. Certificate of Insurance 7. For non-profit agencies only: A. IRS Determination Letter B. Verification of 501(c)(3) Status Form C. Copy of Form 990 Federal Tax return filed for latest fiscal year. D. Agency organizational chart E. Current Board of Directors Roster with names, addresses, office terms (with dates), and professional and/or community affiliations. • No Board of Directors—confirmed with Tonya Stancil that Dean Blackburn would suffice for this list. • Dean Blackburn Director of Student Wellness Associate Dean of Students 450 Ridge Road SASB North,Suite 0103 Chapel Hill, NC 27599 1 98 CAROLINA NURSING Program for Nursing Excellence in Whole Health Care NP's Leading the way m Behavioral Health Integration February 12,2026 RE:Letter of Support for UNC—Chapel Hill Campus Naloxone Supply Grant Orange County Opioid Settlement Funds To Whom It May Concern, I am pleased to express my strong support for the University of North Carolina at Chapel Hill's proposal to expand access to over-the-counter nasal naloxone and strengthen overdose prevention on campus.This initiative directly aligns with the priorities of the Orange County Opioid Settlement Funds by advancing harm reduction,overdose prevention,and access to life-saving interventions. As a family psychiatric nurse practitioner and Professor,I have seen the profound impact of opioid misuse and the consequences of limited access to naloxone and overdose education. Expanding naloxone availability in a university setting is an evidence-based,public health strategy that saves lives. The Harm Reduction Coalition at UNC—Chapel Hill has developed a thoughtful,well-aligned plan that includes installing naloxone ONE boxes at AED locations,providing free over-the-counter naloxone in private settings, expanding overdose response training,and integrating harm-reduction education into existing wellness programs.This project prioritizes high-risk populations,leverages existing campus infrastructure,and maximizes impact with minimal overhead. I have partnered with the Coalition to engage graduate nurse practitioner student volunteers,enhancing both the reach and sustainability of this effort while supporting workforce development. I am confident this proposal will meaningfully advance Orange County's opioid response goals and have a measurable,life-saving impact within the UNC—Chapel Hill community. I strongly support this application. Sincerely, lV W- VV4, / ". -d1A#. Victoria Solds Jarrett,Ph.D.,PMHNP-BC,FAANP,FAAN Carol Morde Ross Distinguished Professor Family Psychiatric-Mental Health Nurse Practitioner 11 { Carrington Hall �+ ���✓✓✓ Campus Box i 460 Chapel Hll;. `i[:27599 7460 Phone 919.966 3731 nursing un,edu 99 COALITION February 16, 2026 Dear Orange County Opioid Advisory Committee, I am pleased to support the proposal submitted by the UNC Student Wellness to the Orange County Opioid Settlement Fund Awards.The activities of Student Wellness are aligned with the Award's goals, and further,they are aligned with the Campus and Community Coalition's(CCC)mission and objectives to reduce the harms associated with high-risk drinking in our campus community. Student Wellness's proposal to educate and increase Naloxone distribution to the campus and community fills a deep gap in freely accessible harm-reduction resources for our community's young people.And while it may be perceived that the only beneficiary of their proposal is UNC students,the education opportunities and distribution of Naloxone in the channels proposed would have a community-wide impact,inclusive of non-student community members. In addition,the distribution of Naloxone to UNC students would positively influence outcomes among other populations with whom they interact(i.e., other youth, unhoused persons, non-student adults, neighbors, et al.), both within and outside our Orange County community.Further, Student Wellness already employs an approach in which harm reduction and prevention lie on a spectrum, and carrying Naloxone, among other behaviors, changes the community's culture toward substance use, support seeking, and recovery allyship. Student Wellness has deep roots with collaborative partners on and off campus, including Student Affairs, Environmental Health and Safety,Campus Police, Libraries, Recovery Communities, students, and others. Leveraging these collaborations, as well as those within the CCC, will facilitate the successful implementation of the proposed activities and integrate well into our community's collective harm reduction initiatives. I look forward to continued collaboration with Student Wellness and emphasize my support for their proposal. I strongly believe their work is essential to supporting the health of our entire community. About The CCC: The CCC is a collaborative public health coalition that brings together university and community partners to address harms associated with high-risk drinking. By fostering open dialogue, employing data-driven systems change strategies,and working collaboratively create actionable and sustainable solutions,we create an environment where everyone can thrive socially, academically, and economically. This environment is ever-changing, and the rise of substance use among our community's young adults and youth has been alarming. The environments in which high-risk drinking occurs are often the same ones where other substances, including opioids, are available and used. Sincerely, Samantha Luu,MPH Director, Campus&Community Coalition 100 01 Campus Safety February 10, 2026 Dean Blackburn Director,Student Wellness University of North Carolina at Chapel Hill Suite 1310,Student Academic&Services Building(SASE) Chapel Hill, North Carolina 27599-7475 Dear Mr. Blackburn, In my role as Executive Director of Environment, Health, and Safety(EHS)at the University of North Carolina, I was pleased to hearthat UNC Student Wellness is submitting a grant application to Orange County to continue educating students and employees at UNC-CH with opioid addiction resources and distribution of naloxone. As a member of the Campus Safety division, EHS shares the mutual goal of educating and protecting the health and safety of the campus community and fostering collaborative relationships towards this goal. UNC Student Wellness has a strong reputation on campus in providing essential programs and outreach services to UNC-CH community members, including substance abuse services, harm reduction coalition building and naloxone distribution and education. EHS is currently partnering with UNC Student Wellness to install OneBox*Naloxone kits adjacent to Automated External Defibrillators (AED) in select campus buildings. EHS manages the AED program on campus to provide easily accessible safety equipment for the community and we believe the addition of Naloxone distribution contributes to this goal. I fully support this grant submittal and continuing our collaboration with UNC Student Wellness to increase campus health and safety at the University of North Carolina at Chapel Hill. Sincerely, Catherine R. Brennan Executive Director Environment, Health and Safety&Risk Management University of North Carolina at Chapel Hill 101 STUDENT GOVERNMENT February 18,2026 RE:Letter of Support for UNC--Chapel Hill Campus Naloxone Supply Grant Orange County Opioid Settlement Funds To the Orange County Opioid Advisory Committee, I am writing in strong support of the University of North Carolina at Chapel Hill Student Wellness proposal to expand naloxone access and overdose prevention initiatives on our campus through the Orange County Opioid Settlement Funds.As Executive Director for the Harm Reduction Coalition at UNC(HRC@UNC)and a Deputy Director within the UNC Student Government,I have witnessed the urgent need for accessible harm reduction resources and the impact of this kind of public health initiative. HRC@UNC works directly with students and the community population to provide overdose prevention education,reduce stigma around substance use,and distribute life-saving resources such as naloxone.Our coalition consistently engages community members who are concerned about their peers but unsure how to intervene safely.Expanding access to free naloxone through the installation of ONE Boxes alongside AEDs in addition to free,over-the-counter distribution in private,low-barrier settings will significantly strengthen our campus safety net. From a Student Government perspective,this initiative reflects our institutional commitment to student health,safety,and well-being. Student leaders regularly hear concerns about substance use,mental health crises,and barriers to accessing confidential support. Increasing naloxone availability normalizes preparedness,empowers bystanders,and reinforces a campus culture rooted in care and shared responsibility.Importantly,this effort extends beyond UNC students as our campus is deeply interconnected with the broader Orange County community.Equipping students and community members with naloxone has ripple effects far beyond the campus community, including off-campus housing, workplaces,and community spaces. The collaboration between Student Wellness,HRC@UNC,campus partners,and student leadership demonstrates both readiness and sustainability.This proposal builds upon established infrastructure, trusted peer networks,and existing educational programming to ensure that funds are used efficiently and effectively. I strongly support this application and am confident that expanding naloxone access at UNC- Chapel Hill will have measurable, life-saving impacts for students and the broader community.Thank you for your consideration and for your continued commitment to advancing harm reduction efforts in Orange County. Sincerely, Christian McFadyen Executive Director,Harm Reduction Coalition at UNC-Chapel Hill(HRC@UNC) Deputy Director,UNC Student Government Department of Student Wellness and Safety University of North Carolina at Chapel Hill ORANGE COUNTY, N OPIOID ADVISORYJune 2, 2026 COMMITTE 103 NC Memorandum of Agreement ( MOA) • The MOA governs the allocation, use, and reporting of certain opioid settlement funds in North Carolina. • To comply with the MOA, a local government receiving opioid settlement funds must do the following: • A. Establish a fund. A local government receiving opioid settlement funds must secure them in a special revenue fund. These funds are subject to audit and cannot be commingled with other funds. • B. Authorize spending. Before spending opioid settlement funds, a local government must authorize the expenditure of such funds. This must take place through a formal budget or resolution that includes certain details including the amount, time period, and specific strategy funded. • C. Understand and follow the options. A local government must spend opioid settlement funds on opioid remediation activities authorized under Option A or Option B as detailed in the MOA. • D. Report spending and impact. A local government that receives, spends, or holds opioid settlement funds during a fiscal year must file an annual financial report within 90 days of the end of the fiscal year. (This report is required if funds are received or held, even if they are not spent.) A local government that spends opioid settlement funds during a fiscal year must file an annual impact report within 90 days of the end of the fiscal year. • E. Hold annual meeting. The MOA requires that each county receiving opioid settlement funds hold at least one annual meeting open to the public, with all municipalities in the county invited to the meeting. The purpose of the meeting is to receive input from municipalities on proposed uses of the opioid settlement funds and to encourage collaboration between local governments. https://ncdoo.gov/wp-content/uploads/2022/03/NCACC-web-version-Final-Opioid-MOA-.pdf 104 Option A- High-impact Opioid Abatement Strategies 1. Collaborative Strategic Planning 2. Evidence-based addiction treatment 3. Recovery support services 4. Recovery housing support s. Employment-related services 6. Early intervention 7. Naloxone distribution s. Post-overdose response team 9. Syringe Service Program Zo.Criminal justice diversion programs 11.Addiction treatment for incarcerated persons 12.Reentry Programs https://www.morepowerfulnc.org/wp-content/uploads/2021/10/Exhibit-A-to-NC-MOA-3.pdf 1 Advise the Board of Plan and host an annual meeting Discuss opioid-related health Commissioners on options to open to the public to receiv concerns and issues impacting expend funds to prevent opioid input on proposed uses of the the residents of Orange County; abuse and remedy opioid settlement funds and to impacts; encourage collaboration between local governments 106 2026-2027 Opioid Settlement Fund Proposals • Applications for the 2026-2027 Opioid Settlement Funds became available January 1, 2026. • Application Workshops were offered: • January 151h — Whitted Human Services, Hillsborough, NC • January 13th — Southern Human Services, Chapel Hill, NC • January 20th and 22nd - Virtual • Open Question Period • February 2rd _ 131h, 2026 • Frequently Asked Questions (FAQs) posted online and updated • February 20, 2026, 5 p.m. — Applications Due via Email to Harm Reduction Coordinator, Tonya Stancil. • March — April 2026 — OAC Funding Subcommittee review applications • June 2026 — Funding Recommendations presented to BOCC • July 1, 2026 — Awarded Contracts begin 107 FundingProposal • Agency General Information • Proposal Summary (required but not scored) • Project Narrative (16 points) • Project Description & Program Sustainability (28 points) • Equity Impact (8 points) • Organizational Readiness (20 points) • Evidence of Collaborative/Partnerships (10 points) • Performance Measures & Program Evaluation (18 points) • Priority Strategy (5 extra points) • Supporting Documents Included: • Letters of Commitment and/or Support (Up to 5 letters) • Latest Audited Financial Statements, including Management letter (Attach letter of explanation if unable to provide) • Documentation of Tax Identification Number (can be IRS Determination Letter for non-profit agencies) • Certificate of Insurance • Non-Profit Agencies - IRS Determination Letter, Verification of 501(c)(3) status form, 990 Form Tax Form, Board of Directors Roster • For-Profit Agencies— Board of Directors Roster, Agency Org Chart, IRS Tax Form used for latest fiscal year filing 108 Subcommittee Criterion Discussion Application Scoring Criteria Applications will bescored based on theresps—to the application content areas'n the ch an below.Each content area shall he sc°red on a wale of 1-4 based on the scale below' 1. POOR Applicant..IV marginally addle—elthe application a.Pa Criterion 3b: "Well—planned activity that is likely to lead to the 2. A"ERAGE AZinontadegnately addressed the appll`adon area intended opioid—related impacts, based on the evidence base 3. GOCD Applicant did a thorough job of addressing the application area 4. E)ICELLEM Applicant provided asuperior response to the application awa about strategy and/or activity effectiveness for the prioritized Eachcontent area will be weighted and the score of 1 to 4 will be multiplied ev the assigned weight of the content area The following represents the eualuadon criteria and relative importance of each criterion(criteria_ightl' population.' Evaluation Criteria Score e"ght Weighted Disnibudon Score 1. Proposal Summary:deduct 2 points 4 missing 0 pts. — 2. AssessmentofNeed The "priority population" as defined for this purpose: . Clear and appropriate geographic.area to be Served b. Clear statement of needs and gaps in service Thorough deuription of priority populations that is well supported by evidence Priority populations in Orange County are defined as persons with opioid use opioid use Individuals at highest risk for overdose in Orange County disorder[CUD]or co-occurring substance use disorder(SUDi or mental health conditions, D pts.if including; missing. g r Individuals at highest risk for overdose in Drange County,such as historically Otherwise, 4 underserved sociaecnnci populations,individuals with multiple Adverse Individuals with multiple Adverse Childhood Experiences (ACES) Childhood Experiences(ACES),Snhstanre Ilse Nsiorder during pregnancy and in first 4-16 pts. year ofChilre anclast aole, Substance Use Disorder during pregnancy and in first year of Children and adcleuenh at risk for drug use. Individuals in treatment or recovery. Individuals involved,or at risk of becominginvolved,in the Criminal Justice System. Post Partum. Individuals recently released from jail or .priso n. 3. Pmjed Description and Sustainability a. Exactly one of the eligible Didion A strategies is selected and proposed project clearly supports the identifiedjUAtent Children and adolescents at risk for drug use. b. Well-planned project that is Pkely,to lead to the intended opioid-related imparts, based on the eveence base about strategy and/or activity effect!veness for the D Pts.f prioritized pawdaillm u c. Clear and appropriate plans to incorporate feedback from program participants missing. Individuals in treatment or recovery. to inform programdelivery Otherwise, 7 d. Intended impacts of project will likely meet community—cls/service gaps e. Applicant has engaged or is likely to engage the priority population meaningfully 7-28 pts. ,. i deosedPgtheect P P*'"p gani=ationalguahwed Individuals involved, or at risk of becoming involved, in the g. Project time"nes are achievable and adequate goals "take intended impacts Criminal Justice system. h. Clear and appropriate plans for project sustainability 4. Equity Impact 0 Pt iif ' 109 Opioid SettlementFundApplications (7) Applications Received 1) EI Futuro $66,309.79 2) Freedom House $85,907.00 3) UNC — Student Wellness $106,906.24 4) UNC - SHAC — $64,141 5) UNC — FOCUS — OAC - $99,999.90 6) Reintegration Support Network - $20,000 7) Early Identification Early Intervention Outreach Program — Budget worksheet was not completed and submitted until after deadline and therefore was not scored and considered. 110 Funding Recommendation : EI Futuro • Option A, Strategy 6 (Early Intervention) • Funding Period — July 1, 2026 — June 30, 2027 • Funding request — $66,309.79 • Funding recommendation — $66,310.00 • Description of Activity — EI Futuro will build upon last year's programming preventing and addressing substance use disorders (SUD), including opioid use disorder (OUD) and co-occurring mental health conditions among economically disadvantaged youth and young adults. ➢This initiative will train Community Mental Health Workers (CMHWs) in Screening, Brief Intervention, and Referral to Treatment (SBIRT) and Motivational Interviewing (MI) to strengthen early intervention efforts and expand access to culturally and linguistically appropriate services. Developing and distributing Spanish-Iangpage educational materials and conducting bilingual workshops, social media campaigns, and youth-focused community engagement that increases knowledge of opioid risks, improves awareness of behavioral health services, and ensures targeted populations receive accurate, stigma-free information and access to early intervention services. This will include education on the dangers of medication sharing and harm reduction strategies. 111 Funding Recommendation : Freedom House • Option A, Strategies iz (Reentry) • Funding Period —J U ly 1, 2026 — June 30, 2027 • Funding request — $ 85,907.00 • Funding recommendation — x85,907.00 • Provider— Freedom House Recovery Center • Description of Activity — Freedom House connects with individuals screened in the Orange County Detention Center who have a history of Opioid Use Disorder. The licensed clinician was formerly funded 2023 — 2025 and conducts a comprehensive clinical assessment to ascertain the best treatment options for the individual prior to or upon release from incarceration. The Peer Support Specialist assists individuals with getting to treatment, court appearances, linkage to community resources and other needs to curb recidivism.-Position formerly funded with Opioid Settlement funds 2023-2025 and 2025 — 2026. Funds would cover salary/benefits, cell phone service, mileage and training. 112 Funding Recommendation : UNC — Student Wellness • Option A, Strategy 7 (Naloxone Distribution) • Funding Period - July 1, 2026 - June 30, 2027 • Funding request - $ 106,906.24 • Funding recommendation - $10,000 • Description of Activity - ➢Aims to increase the availability of naloxone to expand campus-wide opioid overdose prevention education and naloxone distribution program. Program aims to increase the availability of naloxone in high-traffic areas on campus. ➢ Funding would provide naloxone supply for use in distribution. An Funding recommendations presented to BOCC in June 2026 BOCC decides on final funding decisions. OCHD Staff notify grant awardees and work on contracts. Contracts to be completed and reporting requirements explained to grantees by Julys, 2026 mr, ' 7