To: County of Sonoma Board of Supervisors
Department or Agency Name(s): Department of Health Services
Staff Name and Phone Number: Jennifer Solito, 707-565-7901
Vote Requirement: Informational Only
Supervisorial District(s): Countywide
Title:
Title
Opioid Settlement Funds -Workshop
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Recommended Action:
Recommended action
Receive a report on the status of Opioid Settlement Funds and receive Board input on potential uses.
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Executive Summary:
Within the 2018 Multi-District Litigation (MDL) regarding prescription opioids, national settlements up to $26 billion to be collected over the next 14 years have been secured from opioid manufacturers and distributors to create the Opioid Settlement Fund. Of this, the State of California is expected to receive approximately $2.05 billion to be paid through calendar year 2038. To date, Sonoma County has received approximately $12 million which must be used on activities tied to ending, reducing or lessening the effects of the opioid crisis in our jurisdiction.
This workshop will inform the Board of allowable uses for these funds under the terms of the various settlement agreements and seeks Board direction on areas staff should exploration related to specific usage of these funds.
Discussion:
Background
In July, 2021, settlement agreements were announced by California Attorney General Rob Bonta with the first prescription manufacturers in the MDL that would provide substantial funds for the abatement of the opioid epidemic in California. This was the first of several settlements with various opioid defendants in the national opioid lawsuit. All settlements have identified unique distribution amounts to the County. Pharmaceutical distributors McKesson, Cardinal Health and AmerisourceBergen (collectively, the Distributors), and with manufacturers Janssen Pharmaceuticals, Inc.), reached a settlement in 2022. Teva, and Allergan reached a settlement in 2023. Walmart, Walgreens, and CVS (collectively, the Pharmacies) reached a settlement in early 2024. Numerous litigations are still pending and funding allocations are expected to grow following conclusion of the remaining active litigations.
The County has received approximately $12 million in Opioid Settlement Funds, currently held in fund balance. Additionally, $31 million is expected to be received through 2038 for a total of $43 million to Sonoma County. This amount may change should additional settlements be reached and secured for the benefit of Sonoma County. Additionally, local cities have the option to retain their dedicated settlement funds, or may opt to yield their funds to the local county for use and distribution. The Town of Winsor and cities of Rohnert Park and Sonoma have chosen to direct their settlement funds to the County.
Per data collects by DHS epidemiology and data staff, from 2016 to 2021, Sonoma County saw a 164% increase in fatal drug overdoses, recording approximately 160 deaths in 2021. Of those deaths, there was a 384% increase in deaths involving opioids during the same time period. Sonoma County has one of the highest drug overdose death rates per capita, ranking number 10 among counties in California.
This crisis is complex, and the settlement funds will allow for a much-needed opportunity for expansion of extensive education, outreach, care, and community services.
Allowable expenditures
Allowable expenditures guidelines are set forth by the State of California and usage will be overseen and audited by the State. Generally, the funds must be used for activities tied to ending, reducing, or lessening the effects of the opioid epidemic in communities and include prevention, intervention, harm reduction, treatment, and recovery services.
See attached presentation for allowed and unallowed uses.
Potential County of Sonoma Uses
The following are initial use ideas estimated to benefit Sonoma County community residents, as developed by staff.
• Substance Use Treatment and Recovery Services
o Additional SUD residential treatment beds and/or facility
o Additional residential treatment beds for clients currently in jail needing placement
o Adolescent Residential, Outpatient, and Office Based Opioid (OBOT) Treatment
o Funding for Recovery Housing and aftercare services
o Dual Diagnosis Substance Use Disorder treatment program w/Medication Assisted Treatment (MAT)
• Opioid Prevention and Community Crisis Grant Program -establish a community grant program for local community-based non-profit organizations, administered by DHS.
• Support the Sheriff’s Office Opioid Prevention, Education, Research and Abatement Team
• Behavioral Health Continuum Infrastructure Program (BHCIP) - source of match funds for SUD-related State grant submissions
• SUDS-related large-scale projects, such as Behavioral Health Housing Unit (BHHU), and SB 43 implementation. SB 43 is the California law governing involuntary detention, treatment, and conservatorship of people with behavioral health conditions, which is to be implemented by January 1, 2026.
• Outreach and Marketing for Prevention to be implemented by the District Attorney’s Office and DHS, such as:
o Sonoma County podcast focusing on prevention.
o Mental Health workshops for local schools
o Outreach to wineries: DUI prevention training, Responsible Beverage Service
o Prevention outreach, advertising materials
o Sonoma County Community Alcohol and Drug Education Nights
o Expand contractor(s) for opioid/meth education/workshops
o Equity and inclusion focused cultural art such as murals, paintings, décor, etc.
The Board may also wish to consider directing staff to create a stakeholder group for input on potential County usages, outreach and potential partnership with other local counties towards a regional approach, as well as potentially developing a funding allocation policy, which would apply to future funds received.
Strategic Plan:
N/A
Racial Equity:
Was this item identified as an opportunity to apply the Racial Equity Toolkit?
Yes
This item is intended to be a Board Workshop and source input from the Board and community. Once specific recommendations and action items are identified, the Racial Equity Toolkit will be applied for analysis.
Prior Board Actions:
N/A
Fiscal Summary
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Narrative Explanation of Fiscal Impacts:
There is no fiscal impact related to this item.
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Narrative Explanation of Staffing Impacts (If Required):
N/A
Attachments:
Attachment 1: Presentation
Attachment 2: Opioid Settlement Allocations
Attachment 3: Racial Equity Analysis
Related Items “On File” with the Clerk of the Board:
None