HomeMy WebLinkAbout07/25/2023 08. Strategies regarding use of opioid pharmacy and manufacturer settlement funds 5l
BUSINESS OF THE CITY COUNCIL
YAKIMA, WASHINGTON
AGENDA STATEMENT
Item No. 8.
For Meeting of: July 25, 2023
ITEM TITLE: Strategies regarding use of opioid pharmacy and manufacturer
settlement funds
SUBMITTED BY: Sara Watkins, City Attorney
SUMMARY EXPLANATION:
The City Council approved settlement agreements with various opioid pharmacies and
manufacturers. The City of Yakima will have access to settlement funds to use for specific
strategies allowed for by the settlement agreement. Those allowed uses are provided with this
agenda statement. Prior to determining which strategy or strategies the City would like to address
with its settlement funding, the City is required to hold a public meeting to hear input from the
community. The following is the anticipated agenda for this portion of the meeting:
1. Presentation from the Finance Director regarding the funding amounts and timing of
payment.
2. Presentation from the City Attorney on the allowed uses under the settlement agreement.
3. Presentation from the City Prosecutor with regards to a proposed strategy to use some or
all of the funding.
4. Open the floor to public comment.
5. Council discussion.
ITEM BUDGETED: Yes
STRATEGIC PRIORITY: Neighborhood and Community Building
APPROVED FOR SUBMITTAL BY THE CITY MANAGER
RECOMMENDATION:
ATTACHMENTS:
2
Description Upload Date Type
Cpioid Settlement Approved Uses 7/13/2023 Backup Material
D Memo city Attomey_Opied Settle -nt Funds 7/17/2023 Backup Material
D powerpoint 7/20/2023 Presentation
OPIOID ABATEMENT STRATEGIES
PART ONE: TREATMENT
A. TREAT OPIOID USE DISORDER (OUD)
Support treatment of Opioid Use Disorder (OUD) and any co-occurring Substance Use
Disorder or Mental Health (SUD/MH) conditions, co-usage, and/or co-addiction through
evidence-based, evidence-informed, or promising programs or strategies that may include,
but are not limited to, the following:
1. Expand availability of treatment for OUD and any co-occurring SUD/MH conditions,
co-usage, and/or co-addiction, including all forms of Medication-Assisted Treatment
(MAT) approved by the U.S. Food and Drug Administration.
2. Support and reimburse services that include the full American Society of Addiction
Medicine (AS AM) continuum of care for OUD and any co-occurring SUD/MH
conditions, co-usage, andior co-addiction, including but not limited to:
a Medication-Assisted Treatment (MAT);
b. Abstinence-based treatment;
c. Treatment, recovery, or other services provided by states, subdivisions,
community health centers; non-for-profit providers; or for-profit providers;
d. Treatment by providers that focus on OUD treatment as well as treatment by
providers that offer OUD treatment along with treatment for other SUD/MH
conditions, co-usage, andfor co-addiction; or
e. Evidence-informed residential services programs, as noted below.
3. Expand telehealth to increase access to treatment for OUD and any co-occurring
SUD/MH conditions, co-usage, and/or co-addiction, including MAT, as well as
counseling, psychiatric support, and other treatment and recovery support services.
4. Improve oversight of Opioid Treatment Programs (OTPs) to assure evidence-based,
evidence-informed, or promising practices such as adequate methadone dosing.
5. Support mobile intervention, treatment, and recovery services, offered by qualified
professionals and service providers, such as peer recovery coaches, for persons with
OUD and any co-occurring SUD/MH conditions, co-usage, and/or co-addiction and
for persons who have experienced an opioid overdose.
6. Support treatment of mental health trauma resulting from the traumatic experiences of
the opioid user (e.g., violence, sexual assault, human trafficking, or adverse childhood
experiences) and family members (e.g., surviving family members after an overdose
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or overdose fatality), and training of health care personnel to identify and address such
trauma.
7. Support detoxification (detox) and withdrawal management services for persons with
OUD and any co-occurring SUD/MH conditions, co-usage, and/or co-addiction,
including medical detox, referral to treatment, or connections to other services or
supports.
8. Support training on MAT for health care providers, students, or other supporting
professionals, such as peer recovery coaches or recovery outreach specialists,
including telementoring to assist community-based providers in rural or underserved
areas.
9. Support workforce development for addiction professionals who work with persons
with OUD and any co-occurring SUD/MH conditions, co-usage, and/or co-addiction.
10. Provide fellowships for addiction medicine specialists for direct patient care,
instructors, and clinical research for treatments.
11. Provide funding and training for clinicians to obtain a waiver under the federal Drug
Addiction Treatment Act of 2000 (DATA 2000) to prescribe MAT for OUD, and
provide technical assistance and professional support to clinicians who have obtained
a DATA 2000 waiver.
12. Support the dissemination of web-based training curricula, such as the American
Academy of Addiction Psychiatry's Provider Clinical Support Service-Opioids web-
based training curriculum and motivational interviewing.
13. Support the development and dissemination of new curricula, such as the American
Academy of Addiction Psychiatry's Provider Clinical Support Service for
Medication-Assisted Treatment.
B. SUPPORT PEOPLE IN TREATMENT AND RECOVERY
Support people in treatment for and recovery from OUD and any co-occurring SUD/MH
conditions, co-usage, and/or co-addiction through evidence-based, evidence-informed, or
promising programs or strategies that may include, but are not limited to, the following:
1. Provide the full continuum of care of recovery services for OUD and any co-occurring
SUD/MH conditions, co-usage, and/or co-addiction, including supportive housing,
residential treatment, medical detox services, peer support services and counseling,
community navigators, case management, and connections to community-based
services.
2. Provide counseling, peer-support, recovery case management and residential
treatment with access to medications for those who need it to persons with OUD and
any co-occurring SUD/MH conditions, co-usage, and/or co-addiction.
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3. Provide access to housing for people with OUD and any co-occurring SUD/MH
conditions, co-usage, and/or co-addiction, including supportive housing, recovery
housing, housing assistance programs, or training for housing providers.
4. Provide community support services, including social and legal services, to assist in
deinstitutionalizing persons with OUD and any co-occurring SUD/MH conditions, co-
usage, and/or co-addiction.
5. Support or expand peer-recovery centers, which may include support groups, social
events, computer access, or other services for persons with OUD and any co-occurring
SUD/MH conditions, co-usage, and/or co-addiction.
6. Provide employment training or educational services for persons in treatment for or
recovery from OUD and any co-occurring SUD/MH conditions, co-usage, and/or co-
addiction.
7. Identify successful recovery programs such as physician, pilot, and college recovery
programs, and provide support and technical assistance to increase the number and
capacity of high-quality programs to help those in recovery.
8. Engage non-profits, faith-based communities, and community coalitions to support
people in treatment and recovery and to support family members in their efforts to
manage the opioid user in the family.
9. Provide training and development of procedures for government staff to appropriately
interact and provide social and other services to current and recovering opioid users,
including reducing stigma.
10. Support stigma reduction efforts regarding treatment and support for persons with
OUD, including reducing the stigma on effective treatment.
C. CONNECT PEOPLE WHO NEED HELP TO THE HELP THEY NEED
(CO IONS TO CARE)
Provide connections to care for people who have -- or are at risk of developing — OUD and
any co-occurring SUD/MH conditions. co-usage, and/or co-addiction through evidence-
based, evidence-informed, or promising programs or strategies that may include, but are not
limited to, the following:
1. Ensure that health care providers are screening for OUD and other risk factors and
know how to appropriately counsel and treat (or refer if necessary) a patient for OUD
treatment.
2. Support Screening, Brief Intervention and Referral to Treatment (SBIRT) programs to
reduce the transition from use to disorders.
3. Provide training and long-term implementation of SHIRT in key systems (health,
schools, colleges, criminal justice, and probation), with a focus on youth and young
adults when transition from misuse to opioid disorder is common.
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4. Purchase automated versions of SHIRT and support ongoing costs of the technology.
5. Support training for emergency room personnel treating opioid overdose patients on
post-discharge planning, including community referrals for MAT, recovery case
management or support services.
6. Support hospital programs that transition persons with OUD and any co-occurring
SUD/MH conditions, co-usage, and/or co-addiction, or persons who have experienced
an opioid overdose, into community treatment or recovery services through a bridge
clinic or similar approach.
7. Support crisis stabilization centers that serve as an alternative to hospital emergency
departments for persons with OUD and any co-occurring SUD/MH conditions, co-
usage, and/or co-addiction or persons that have experienced an opioid overdose.
8. Support the work of Emergency Medical Systems, including peer support specialists,
to connect individuals to treatment or other appropriate services following an opioid
overdose or other opioid-related adverse event.
9. Provide funding for peer support specialists or recovery coaches in emergency
departments, detox facilities, recovery centers, recovery housing, or similar settings;
offer services, supports, or connections to care to persons with OUD and any co-
occurring SUD/MH conditions, co-usage, and/or co-addiction or to persons who have
experienced an opioid overdose.
10. Provide funding for peer navigators, recovery coaches, care coordinators, or care
managers that offer assistance to persons with OUD and any co-occurring SUD/MH
conditions, co-usage, and/or co-addiction or to persons who have experienced on
opioid overdose.
11. Create or support school-based contacts that parents can engage with to seek
immediate treatment services for their child; and support prevention, intervention,
treatment, and recovery programs focused on young people.
12. Develop and support best practices on addressing OUD in the workplace.
13. Support assistance programs for health care providers with OUD.
14. Engage non-profits and the faith community as a system to support outreach for
treatment.
15. Support centralized call centers that provide information and connections to
appropriate services and supports for persons with OUD and any co-occurring
SUD/MH conditions, co-usage, andfor co-addiction.
16. Create or support intake and call centers to facilitate education and access to
treatment, prevention, and recovery services for persons with OUD and any co-
occurring SUD/MH conditions, co-usage, andlor co-addiction.
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17. Develop or support a National Treatment Availability Clearinghouse — a
multistate/nationally accessible database whereby health care providers can list
locations for currently available in-patient and out-patient OUD treatment services
that are accessible on a real-time basis by persons who seek treatment.
D. ADDRESS THE NEEDS OF CRIMINAL-JUSTICE-INVOLVED PERSONS
Address the needs of persons with OUD and any co-occurring SUD/MH conditions, co-
usage, and/or co-addiction who are involved — or are at risk of becoming involved — in the
criminal justice system through evidence-based, evidence-informed, or promising programs
or strategies that may include, but are not limited to, the following:
1. Support pre-arrest or post-arrest diversion and deflection strategies for persons with
OUD and any co-occurring SUD/MH conditions, co-usage, and/or co-addiction,
including established strategies such as:
a. Self-referral strategies such as the Angel Programs or the Police Assisted
Addiction Recovery Initiative (PAARI);
b. Active outreach strategies such as the Drug Abuse Response Team (DART)
model;
c. "Naloxone Plus" strategies, which work to ensure that individuals who have
received naloxone to reverse the effects of an overdose are then linked to
treatment programs or other appropriate services;
d. Officer prevention strategies, such as the Law Enforcement Assisted Diversion
(LEAD) model;
e. Officer intervention strategies such as the Leon County, Florida Adult Civil
Citation Network or the Chicago Westside Narcotics Diversion to Treatment
Initiative;
f. Co-responder and/or alternative responder models to address OUD-related 911
calls with greater SUD expertise and to reduce perceived barriers associated with
law enforcement 911 responses; or
g. County prosecution diversion programs, including diversion officer salary, only
for counties with a population of 50,000 or less. Any diversion services in matters
involving opioids must include drug testing, monitoring, or treatment.
2. Support pre-trial services that connect individuals with OUD and any co-occurring
SUD/MH conditions, co-usage, and/or co-addiction to evidence-informed treatment,
including MAT, and related services.
3. Support treatment and recovery courts for persons with OUD and any co-occurring
SUD/MH conditions, co-usage, and/or co-addiction, but only if these courts provide
referrals to evidence-informed treatment, including MAT.
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4. Provide evidence-informed treatment, including MAT, recovery support, or other
appropriate services to individuals with OUD and any co-occurring SUD/MH
conditions, co-usage, and/or co-addiction who are incarcerated in jail or prison.
5. Provide evidence-informed treatment, including MAT, recovery support, or other
appropriate services to individuals with OUD and any co-occurring SUD/MH
conditions, co-usage, and/or co-addiction who are leaving jail or prison have recently
left jail or prison, are on probation or parole, are under community corrections
supervision, or are in re-entry programs or facilities.
6. Support critical time interventions (CTI), particularly for individuals living with dual-
diagnosis OUD/serious mental illness, and services for individuals who face
immediate risks and service needs and risks upon release from correctional settings.
7. Provide training on best practices for addressing the needs of criminal-justice-
involved persons with OUD and any co-occurring SUD/MH conditions, co-usage,
and/or co-addiction to law enforcement, correctional, or judicial personnel or to
providers of treatment, recovery, case management, or other services offered in
connection with any of the strategies described in this section.
E. ADDRESS THE NEEDS OF PREGNANT OR PARENTING WOMEN AND
THEIR FAMILIES, INCLUDING BABIES WITH NEONATAL ABSTINENCE
SYNDROME
Address the needs of pregnant or parenting women with OUD and any co-occurring
SUD/MH conditions, co-usage, and/or co-addiction, and the needs of their families, including
babies with neonatal abstinence syndrome, through evidence-based, evidence-informed, or
promising programs or strategies that may include, but are not limited to, the following:
1. Support evidence-based, evidence-informed, or promising treatment, including MAT,
recovery services and supports, and prevention services for pregnant women — or
women who could become pregnant — who have OUD and any co-occurring SUD/MH
conditions, co-usage, andlor co-addiction, and other measures to educate and provide
support to families affected by Neonatal Abstinence Syndrome.
2. Provide training for obstetricians or other healthcare personnel that work with
pregnant women and their families regarding treatment of OUD and any co-occurring
SUD/MH conditions, co-usage, and/or co-addiction.
3. Provide training to health care providers who work with pregnant or parenting women
on best practices for compliance with federal requirements that children born with
Neonatal Abstinence Syndrome get referred to appropriate services and receive a plan
of safe care.
4. Provide enhanced support for children and family members suffering trauma as a
result of addiction in the family; and offer trauma-informed behavioral health
treatment for adverse childhood events.
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5. Offer enhanced family supports and home-based wrap-around services to persons with
OUD and any co-occurring SUD/MH conditions, co-usage, and/or co-addiction,
including but not limited to parent skills training.
6. Support for Children's Services — Fund additional positions and services, including
supportive housing and other residential services, relating to children being removed
from the home and/or placed in foster care due to custodial opioid use.
PART TWO: PREVENTION
F. PREVENT OVER-PRESCRIBING AND ENSURE APPROPRIATE
PRESCRIBING AND DISPENSING OF OPIOIDS
Support efforts to prevent over-prescribing and ensure appropriate prescribing and dispensing
of opioids through evidence-based, evidence-informed, or promising programs or strategies
that may include, but are not limited to, the following:
1. Training for health care providers regarding safe and responsible opioid prescribing,
dosing, and tapering patients off opioids.
2. Academic counter-detailing to educate prescribers on appropriate opioid prescribing.
3. Continuing Medical Education (CME) on appropriate prescribing of opioids.
4. Support for non-opioid pain treatment alternatives, including training providers to
offer or refer to multi-modal, evidence-informed treatment of pain.
5. Support enhancements or improvements to Prescription Drug Monitoring Programs
(PDMPs), including but not limited to improvements that:
a. Increase the number of prescribers using PDMPs;
b. Improve point-of-care decision-making by increasing the quantity, quality, or
format of data available to prescribers using PDMPs or by improving the
interface that prescribers use to access PDMP data, or both; or
c. Enable states to use PDMP data in support of surveillance or intervention
strategies, including MAT referrals and follow-up for individuals identified
within PDMP data as likely to experience OUD.
6. Development and implementation of a national PDMP — Fund development of a
multistate/national PDMP that permits information sharing while providing
appropriate safeguards on sharing of private health information, including but not
limited to:
a. Integration of PDMP data with electronic health records, overdose episodes,
and decision support tools for health care providers relating to OUD.
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b. Ensuring PDMPs incorporate available overdose/naloxone deployment data,
including the United States Department of Transportation's Emergency
Medical Technician overdose database.
7. Increase electronic prescribing to prevent diversion or forgery.
8. Educate Dispensers on appropriate opioid dispensing.
G. PREVENT MISUSE OF OPIOIDS
Support efforts to discourage or prevent misuse of opioids through evidence-based, evidence-
informed, or promising programs or strategies that may include, but are not limited to, the
following:
1. Corrective advertising or affirmative public education campaigns based on evidence.
2. Public education relating to drug disposal.
3. Drug take-back disposal or destruction programs.
4. Fund community anti-drug coalitions that engage in drug prevention efforts.
5. Support community coalitions in implementing evidence-informed prevention, such
as reduced social access and physical access, stigma reduction — including staffing,
educational campaigns, support for people in treatment or recovery, or training of
coalitions in evidence-informed implementation, including the Strategic Prevention
Framework developed by the U.S. Substance Abuse and Mental Health Services
Administration (SAMHSA).
6. Engage non-profits and faith-based communities as systems to support prevention.
7. Support evidence-informed school and community education programs and
campaigns for students, families, school employees, school athletic programs, parent-
teacher and student associations, and others.
8. School-based or youth-focused programs or strategies that have demonstrated
effectiveness in preventing drug misuse and seem likely to be effective in preventing
the uptake and use of opioids.
9. Support community-based education or intervention services for families, youth, and
adolescents at risk for DUD and any co-occurring SUD/MH conditions, co-usage,
and/or co-addiction.
10. Support evidence-informed programs or curricula to address mental health needs of
young people who may be at risk of misusing opioids or other drugs, including
emotional modulation and resilience skills.
11. Support greater access to mental health services and supports for young people,
including services and supports provided by school nurses or other school staff, to
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address mental health needs in young people that (when not properly addressed)
increase the risk of opioid or other drug misuse.
H. PREVENT OVERDOSE DEATHS AND OTHER HARMS
Support efforts to prevent or reduce overdose deaths or other opioid-related harms through
evidence-based, evidence-informed, or promising programs or strategies that may include,
but are not limited to, the following:
1. Increase availability and distribution of naloxone and other drugs that treat overdoses
for first responders, overdose patients, opioid users, families and friends of opioid
users, schools, community navigators and outreach workers, drug offenders upon
release from jail/prison, or other members of the general public.
2. Provision by public health entities of free naloxone to anyone in the community,
including but not limited to provision of intra-nasal naloxone in settings where other
options are not available or allowed.
3. Training and education regarding naloxone and other drugs that treat overdoses for
first responders, overdose patients, patients taking opioids, families, schools, and
other members of the general public.
4. Enable school nurses and other school staff to respond to opioid overdoses, and
provide them with naloxone, training, and support.
5. Expand, improve, or develop data tracking software and applications for
overdoses/naloxone revivals,
6. Public education relating to emergency responses to overdoses.
7. Public education relating to immunity and Good Samaritan laws.
8. Educate first responders regarding the existence and operation of immunity and Good
Samaritan laws.
9. Expand access to testing and treatment for infectious diseases such as HIV and
Hepatitis C resulting from intravenous opioid use.
10. Support mobile units that offer or provide referrals to treatment, recovery supports,
health care, or other appropriate services to persons that use opioids or persons with
OUD and any co-occurring SUD/MH conditions, co-usage, and/or co-addiction.
11. Provide training in treatment and recovery strategies to health care providers,
students, peer recovery coaches, recovery outreach specialists, or other professionals
that provide care to persons who use opioids or persons with OUD and any co-
occurring SUD/MH conditions, co-usage, andlor co-addiction.
12. Support screening for fentanyl in routine clinical toxicology testing.
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PART THREE: OTHER STRATEGIES
L FIRST RESPONDERS
In addition to items C8. D1 through D7, H1, H3, and H8, support the following:
1. Current and future law enforcement expenditures relating to the opioid epidemic.
2. Educate law enforcement or other first responders regarding appropriate practices and
precautions when dealing with fentanyl or other drugs.
J. LEADERSHIP, PLANNING AND COORDINATION
Support efforts to provide leadership, planning, and coordination to abate the opioid epidemic
through activities, progams, or strategies that may include, but are not limited to, the
following:
1. Community regional planning to identify goals for reducing harms related to the
opioid epidemic, to identify areas and populations with the greatest needs for
treatment intervention services, or to support other strategies to abate the opioid
epidemic described in this opioid abatement strategy list.
2. A government dashboard to track key opioid-related indicators and supports as
identified through collaborative community processes.
3. Invest in infrastructure or staffing at government or not-for-profit agencies to support
collaborative, cross-system coordination with the purpose of preventing
overprescribing, opioid misuse, or opioid overdoses, treating those with OUD and any
co-occurring SUD/MH conditions, co-usage, and/or co-addiction, supporting them in
treatment or recovery, connecting them to care, or implementing other strategies to
abate the opioid epidemic described in this opioid abatement strategy list.
4. Provide resources to staff government oversight and management of opioid abatement
programs.
K. TRAINING
In addition to the training referred to in various items above, support training to abate the
opioid epidemic through activities, programs, or strategies that may include, but are not
limited to, the following:
1. Provide funding for staff training or networking programs and services to improve the
capability of government, community, and not-for-profit entities to abate the opioid
crisis.
2. Invest in infrastructure and staffing for collaborative cross-system coordination to
prevent opioid misuse, prevent overdoses, and treat those with OUD and any co-
occurring SUD/MH conditions, co-usage, and/or co-addiction, or implement other
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strategies to abate the opioid epidemic described in this opioid abatement strategy list
(e.g., health care, primary care, pharmacies, PDMPs, etc.).
L. RESEARCH
Support opioid abatement research that may include, but is not limited to, the following:
1. Monitoring, surveillance, and evaluation of programs and strategies described in this
opioid abatement strategy list.
2. Research non-opioid treatment of chronic pain.
3. Research on improved service delivery for modalities such as SHIRT that demonstrate
promising but mixed results in populations vulnerable to opioid use disorders.
4. Research on innovative supply-side enforcement efforts such as improved detection of
mail-based delivery of synthetic opioids.
5. Expanded research on swift/certain/fair models to reduce and deter opioid misuse
within criminal justice populations that build upon promising approaches used to
address other substances (e.g. Hawaii HOPE and Dakota 24/7).
6. Research on expanded modalities such as prescription methadone that can expand
access to MAT.
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Office of the City Attorney
City of Yakima
MEMORANDUM
July 17, 2023
TO: Sara Watkins, City Attorney
FROM: Cynthia Martinez, Senior Assistant City Attorney
SUBJECT: Opioid Funds —Community Diversion Program
On July 18, 2023, Council will learn the amount of money the City will receive and have discretion
to award from the state opioid settlement or proceeds from the state lawsuit. I have studied the
permitted uses for the money and believe the money could be utilized to enhance the City of
Yakima Community Diversion Program (CDP).
CDP is designed to address the root causes of criminal behavior which are often substance abuse
and mental health issues. Participants also complete community service hours and a life skills
program. CDP is a prosecution led initiative staffed by a multidisciplinary team comprised of
defense attorneys, a part-time case manager, substance abuse and mental health service
providers. When participants successfully complete the program, a graduation ceremony is held
in the courtroom. When last assessed, seventy-seven percent of graduates remained crime free.
Municipal Court Judge Aryn Masters is interested in more court involvement with the program.
This is great news because studies show that court involvement increases accountability and
success rates. We are in the process of retooling the program to include more court oversight
and to meet the needs of the potential Drug Possession and Use of Drug in Public cases expected
as a result of the City adoption of the Blake fix RCWs. Although CDP has great partners in
Comprehensive Healthcare and Triumph Treatment Center, we are exploring a partnership with
the Recovery Navigator Program. The Recovery Navigator program is mentioned multiple times
in the Blake fix legislation and is considered an evidence-based program to connect participants
with opioid and substance abuse programs. We are meeting with Shereen Hunt of Merit
Resources to discuss a potential partnership next week.
200 South Third Street,2nd Fl. I Yakima,WA 98901
P:509.575.6030 I F:509.575.6160
15
Sara Watkins, City Attorney
July 17, 2023
Page 2
This memo is being drafted during a period of transition, but looking ahead I see two potential
opioid abatement strategies that could enhance the Community Diversion Program. Each one is
discussed below.
Strategy Al. TREAT OPIOD USE DISORDER- support treatment of Opioid Use Disorder(OUD)
and any co-occurring SUD or Mental Health conditions, co usage, and/or co-addiction through
evidence-based, evidence informed or promising programs or strategies that may include...
1. Expand the availability of treatment for OUD and any co-occurring SUD/MH conditions
co-usage and or co-addiction, including all forms of Medication Assisted Treatment
(MAT) approved by the US. Food and Drug Administration.
A certain percentage of CDP participant's benefits are on Medicare, which does
not cover mental health treatment. Depending on the financial situation of the defendant,
which is typically not adequate, the lack of coverage makes it difficult for the individual to
complete the CDP program. It would be helpful to be able to grant participants the money
for mental health treatment, which is almost always implicated with substance abuse
issues.
Strategy D2. ADDRESS THE NEEDS OF CRIMINAL JUSTICE INVOLVED PERSONS —
Address the needs of persons with OUD and any co-occurring SUD/MH conditions, co-usage,
and or co-addiction who are involved or are at risk of becoming involved in the criminal justice
system through evidence-based, evidence-informed or promising programs or strategies that may
include...
2. Support pre-trial services that connect individuals with OUD and any co-occurring
SUD/MH conditions, co-usage, and/or co-addiction to evidence -informed treatment
including MAT, and related services.
The City contracts with People for People to provide a part-time case manager.
With the anticipated increase in participants due to newly adopted crimes, a full-time case
manager may be warranted. As part of the retool of the program, the team has considered
changing the role of the case manager to include being a more active liaison between the
treatment providers and the court, or expanding duties to include care coordinator
functions.
Both of these strategies would enhance the City of Yakima Community Diversion Program to
better meet the needs of participants, and depending on the amount of the award of funds to the
City, fit the permitted uses and may be funded from the opioid money.
Thank you for your consideration of these proposals.
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APPROVED STRATEGIES FOR USE OF OPIOID
SETTLEMENT FUNDS
PUBLIC MEETING:JUL. 25, 2023
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AG E N DA
■ Brief summary of opioid lawsuit settlements
■ Presentation from the City's Finance Director regarding the funding amounts and
timing of payment
■ Presentation by the City Attorney regarding the allowed uses and approved
strategies under the settlement agreement
■ Presentation from Senior Assistant City Attorney/City Prosecutor regarding one
proposed strategy to use some or all of the settlement funding
■ Public comment
■ Council discussion
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OPIOID LAWSUITS AND SETTLEMENT
BRIEF SUMMARY
In 2022 and 2023, the State of Washington, through Attorney General Ferguson, settled multiple lawsuits
with opioid manufacturers and distributors for damages caused to the State, and its municipalities, due to
the over prescription and over distribution of opioids to the public.
The settlements were part of national opioids settlements against manufacturers and distributors. The
settling parties were: Allergen, CVS,Walgreens,Walmart,Johnson & Johnson,Teva,AmerisourceBergen,
Cardinal Health and McKesson.
Settlement amounts are paid out over the course of a number of years (it differs from agreement to
agreement). In other cases, the State can choose to either take settlement amounts in monetary amounts
or in Narcan/equivalent product.
Washington State jurisdictions who signed onto the settlement agreements entered into a Memorandum
of Understanding as to how the settlement proceeds would be spent. That MOU dictates how the City
Council can utilized the settlement proceeds allocated and distributed to the City. The MOU provides that
the City must use the funding under one of three broad categories—treatment, prevention, or other
strategies. These will be discussed more later in the presentation.
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SETTLEMENT FUNDS
JENNIFER FERRER-SANTA INES, FINANCE DIRECTOR
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OPIOID FUNDS UPDATE
■ Yakima expected total distribution =
$ 1 , 302 , 988
• Payable to City over 17 years
■ YTD receipt total $97 , 093 . 51
■ Annual distributions in July
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ALLOWED USES AND APPROVED STRATEGIES
HOW THE CITY CAN USE THE SETTLEMENT FUNDS PURSUANT TO THE MOU
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STRATEGY # 1 : TREATMENT
SUPPORT PEOPLE IN TREATMENT AND
TREAT OPIOID USE DISORDER RECOVERY
• Support treatment and any co-occurring substance • Support continuum of care of recovery services and
use disorder or mental health conditions any co-occurring substance use disorder or mental
• Support mental health trauma resulting from health conditions
traumatic experiences of the opioid user • Providing counseling, peer support and treatment
•
Support detox and withdrawal management services with access to medications
• Support continuum of care services, which include
• Provide community support services
medication-assisted treatment, recovery services, • Support or expand peer-recovery centers
evidence-informed residential service programs • Provide support to successful recovery programs to
• Support mobile intervention, treatment and increase their capacity
recovery services, including co-occurring substance
use disorders or mental health conditions.
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STRATEGY # 1 : TREATMENT
ADDRESS THE NEEDS OF CRIMINAL-
CONNECTIONS TO CARE JUSTICE INVOLVED PERSONS
• Connect people who need help to the help that they • Support pre-trial services that connect individuals with
need opioid use disorders and co-occurring conditions to
•
Provide connections to care to people who have opioid treatment and related services
use disorders or are at risk of developing such a • Provide evidence-informed treatment to those who are
disorder, including co-occurring conditions incarcerated in jail, those who are leaving jail, persons
•
Support screening, brief intervention and referral to on probation, or those who have recently left jail
treatment programs • Provide training on best practices for addressing the
Support trainingfor ERpersonnel on post-discharge needs of criminal-justice involved persons with opioid
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planning and community service referrals
Support mobile intervention,treatment and recovery • Support pre-arrest and/or post-arrest diversion and
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services, including co-occurring substance use disorders
or mental health conditions.
• Support services and needs of pregnant or parenting
women with opioid use disorders and their families
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STRATEGY #2: PREVENTION
PREVENT OVER-PRESCRIBING AND PREVENT OVERDOSE DEATHS AND
MISUSE OF OPIOIDS OTHER HARMS
• Support efforts to prevent over-prescribing and ensure • Support efforts to prevent or reduce overdose deaths
appropriate prescribing and dispensing of opioids • Increase availability and distribution of naloxone and/or
• Support efforts to discourage or prevent misuse of other drugs that treat overdoses
opioids • Provide training and education regarding naloxone and
• Support training for health care providers regarding safe other drugs that treat overdoses
and responsible prescribing, dosing and tapering • Support mobile units that offer or provide referrals to
• Support non-opioid pain treatment alternatives through treatment
training • Expand access to testing and treatment for infectious
• Public education campaigns and drug take-back program diseases resulting from intravenous opioid use
funding
• Support screening for fentanyl in routine clinical
• Support education or intervention services in the toxicology testing
community
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STRATEGY #3 : OTHER STRATEGIES
LEADERSHIP, PLANNING AND
FIRST RESPONDERS COORDINATION
■ Fund current and future law enforcement ■ Support efforts to provide leadership, planning, and
expenditures relating to the opioid epidemic (in coordination to abate the opioid epidemic through
addition to the strategies in other categories) specified activities, programs and strategies
■ Educate law enforcement or other first responders ■ Support community regional planning to identify
regarding appropriate practices and precautions goals for reducing harms related to the opioid
when dealing with fentanyl or other drugs epidemic and identify areas of greatest need
■ Create a government dashboard to track opioid
indicators and supports
■ Invest in infrastructure and staffing of organizations
supporting collaborative prevention, treatment and
recovery strategies
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STRATEGY #3 : OTHER STRATEGIES
TRAINING RESEARCH
• Support training to abate the opioid epidemic • Support opioid abatement research
through activities and programs (in addition to those • Support research regarding the evaluation of
trainings specifically outlined in other strategies)
programs and strategies allowed for under the
• Provide funding for staff training or networking settlement agreement
programs to improve the capability of government • Research non-opioid treatment of chronic pain
and community entities to abate the opioid crisis
• Invest in cross-collaborative team training to include
• Research on various models regarding treatment,
treatment providers, ER physicians and team and results achieved
members, pharmacies, non-profits, community • Expand research on models to reduce and deter
groups and the government opioid misuse within criminal justice populations
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PROPOSED STRATEGY FOR SETTLEMENT FUND USE
CITY PROSECUTOR/SENIORASSISTANT CITY ATTORNEY CYNTHIA MARTINEZ
ENHANCE - CITY OFYAKIMA COMMUNITY DIVERSION PROGRAM
■ The Community Diversion Program utilizes a collaborative, problem solving
approach to crime designed to address root causes of low level crime that is
of concern to the community. Participants are assessed to determine needs
and programming is tailored to meet the needs of the individual. Participants
complete:
■ Chemical dependency assessment and treatment
■ Mental health assessment and treatment
■ Life skills programming
■ Community service hours
CITY OF YAK' COMMUNITY DIVERSION PROGRAM
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■ 77% of graduates remain crime-free
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FUND A FULL TIME COMMUNITY DIVERSION CASE MANAGER
Strategy D2. ADDRESS THE NEEDS OF CRIMINAL JUSTICE INVOLVED PERSONS —Address the
needs of persons with OUD and any co-occurring SUD/MH conditions, co-usage, and or co-addiction who
are involved or are at risk of becoming involved in the criminal justice system through evidence-based,
evidence-informed or promising programs or strategies that may include...
Support pre-trial services that connect individuals with OUD and any co-occurring SUD/MH conditions, co-
usage, and/or co-addiction to evidence -informed treatment including MAT, and related services.
■ The city currently contracts with People for People to provide a part time case manager. With the
anticipated increase in participants due to newly adopted RCW's, a full-time case manager may be
warranted. Involvement with the recovery navigator program will add new duties to our case manager.
PROVIDE TREATMENT FUNDING GRANTS FORTHOSE WHO ARE DO
NOT BENEFITS TO COVERTREATMENT
Strategy Al . TREAT OPIOD USE DISORDER - support treatment of Opioid Use Disorder (OUD) and any co-
occurring SUD or Mental Health conditions, co usage, and/or co-addiction through evidence -based, evidence
informed or promising programs or strategies that may include...
Expand the availability of treatment for OUD and any co-occurring SUD/MH conditions co-usage and or co-
addiction, including all forms of Medication Assisted Treatment (MAT) approved by the US. Food and Drug
Administration.
■ A certain percentage of CDP participants are on Medicare, which does not cover mental health
treatment. Depending on the financial situation of the defendant, which is typically not adequate, the lack of
coverage makes it difficult for the individual to complete the CDP program. It would be helpful to be able to
grant participants the money for mental health treatment, which is almost always implicated with substance
abuse issues.
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PUBLIC COMMENT
THE MEETING IS NOW OPEN FOR PUBLIC COMMENT REGARDING USE OF THE SETTLEMENT FUNDS IN
LIGHT OF THE APPROVED STRATEGIES
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COUNCIL DISCUSSION
NO DECISIONS ARE REQUIRED TO BE MADE THIS EVENING