RE 2021-1109.1 Texas Opioid Abatement Fund Council and Settlement Allocation Term Sheet
RESOLUTION NO.
A RESOLUTION OF THE CITY COUNCIL OF THE CITY OF COPPELL, TEXAS,
ADOPTINGTHETEXASTERMSHEETANDITSINTRASTATEALLOCATION
SCHEDULE REGARDING THE GLOBAL OPIOID SETTLEMENT; AND PROVIDING AN
EFFECTIVE DATE
WHEREAS, the Cityof Coppellobtainedinformationindicatingthatcertaindrug
companies and their corporate affiliates, parents, subsidiaries, and such other defendants as may be
addedto thelitigation(collectively,Defendants)haveengagedinfraudulentand/orreckless
marketing and/ordistribution of opioids that have resulted in addictions and overdoses; and
WHEREAS,these actions,conductandmisconducthave resulted insignificantfinancial
costs to theCity, County and State; and
WHEREAS, on May13,2020, theStateofTexas,through theOfficeoftheAttorney
General, and a negotiation group for Texas political subdivisions entered into an Agreement entitled
Texas Opioid Abatement Fund Council and Settlement Allocation Term Sheet (hereafter, the Texas
TermSheet)approvingtheallocationof anyandallopioidsettlementfundswithinthe Stateof
Texas. The Texas Term Sheet is attached hereto as Exhibit A
WHEREAS,SpecialCounselandtheState ofTexashave recommended thattheCity of
Coppell support the adoption and approval of theTexas Term Sheet in its entirety.
NOW,THEREFORE,BE IT RESOLVEDBYTHE CITY COUNCILOF THE CITY
OFCOPPELL, TEXAS:
SECTION 1.That the CityCouncil supportstheadoptionand approvaloftheTexasTerm
Sheet in itsentirety;and
SECTION 2.That the CityCouncil findsthat thereisasubstantialneedforrepaymentof
opioid-relatedexpendituresandpaymentto abate opioid-related harmsin and about theCityof
Coppell;and
SECTION 3.That the Cityof Coppellsupports in its entirety and hereby adopts the
allocation method for opioid settlement proceeds as set forth in theState of Texasand Texas Political
SOpioid Abatement FundCouncil andSettlementAllocation Term Sheet, attached
hereto as Exhibit A. The CityofCoppellunderstandsthe purpose of this Texas Term Sheet is to
permit collaboration between the State of TexasandPoliticalSubdivisionstoexploreandpotentially
effectuateresolutionoftheOpioidLitigationagainst Pharmaceutical Supply Chain Participants as
defined therein. The CityofCoppellalso understandsthat anadditional purpose is to create an
effective means of distributing any potential settlement fundsobtained under this Texas Term Sheet
between the State of Texas and Political Subdivisions in amannerandmeansthatwouldpromote
aneffectiveandmeaningfuluseofthefundsinabatingtheopioidepidemicin this Cityand
throughout Texas.
SECTION 4.This Resolution shall become effective immediately from and after its
passage.
Њ
EXHIBITA
Opioid Abatement Fund (Texas) Settlement
Opioid Council
As part of the settlement agreement and upon its execution, the parties will form the Texas Opioid
Council (Council) to establish the framework that ensures the funds recovered by Texas (through
the joint actions of the Attorney General and the political subdivisions) are allocated fairly
and spent to remediate the opioid crisis in Texas, using efficient and cost-effective methods that
are directed to the hardest hit regions in Texas while also ensuring that all Texans benefit from
prevention and recovery efforts.
I. Structure
The Council will be responsible for the processes and procedures governing the spending of the
funds held in the Texas Abatement Fund, which will be approximately 70% of all funds obtained
through settlement and/or litigation ofthe claims asserted by the State and its subdivisions in the
investigations and litigation related to the manufacturing, marketing, distribution, and sale of
opioids and related pharmaceuticals.
Money paid into the abatement fund will be held by an independent administrator, who shall be
responsible for the ministerial task of releasing funds solely as authorized below by the Council,
and accounting for all payments to and from the fund.
The Council will be formed when a court of competent jurisdiction enters an order settling the
matter, including any order of a bankruptcy court. The Council members must be appointed
within sixty (60) days of the date the order is entered.
A. Membership
The Council shall be comprised of the following thirteen (13) members:
1. Statewide Members.
Six members appointed by the Governor and Attorney General
interest in opioid abatement. The statewide members are appointed as follows:
a. The Governor shall appoint three (3) members who are licensed health
professionals with significant experience in opioid interventions;
b. The Attorney General shall appoint three (3) members who are licensed
professionals with significant experience in opioid incidences; and
c. The Governor will appoint the Chair of the Council as a non-voting member.
The Chair may only cast a vote in the event there is a tie of the membership.
2. Regional Members.
Six (6) members appointed by the S subdivisions to represent their
designated HHSC Regional Healthcare
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Partnership (Regions)to ensure dedicated regional, urban,and rural representation on the
Council.The regional appointees must be from either academia or the medical profession
with significant experience in opioid interventions. The regional members are appointed as
follows:
a. One member representing Regions 9 and 10 (Dallas Ft-Worth);
b. One member representing Region 3 (Houston);
c. One member representing Regions 11, 12, 13, 14, 15, 19 (West Texas);
d. One member representing Regions 6, 7, 8, 16 (Austin-San Antonio);
e. One member representing Regions 1, 2, 17, 18 (East Texas); and
f. One member representing Regions 4, 5, 20 (South Texas).
B. Terms
All members of the Council are appointed to serve staggered two-year terms, with the terms of
members expiring February 1 of each year. A member may serve no more than two consecutive
terms, for a total of four consecutive years. For the first term, four (4) members (two (2) statewide
and two (2) for the subdivisions) will serve a three-year term. A vacancy on the Council shall be
filled for the unexpired term in the same manner as the original appointment. The Governor will
appoint the Chair of the Council who will not vote on Council business unless there is a tie vote,
and the subdivisions will appoint a Vice-Chair voting member from one of the regional members.
C. Governance
1. Administration
The Council is attached administratively to the Comptroller. The Council is an
independent, quasi-governmental agency because it is responsible for the statewide
distribution of the abatement settlement funds. The Council is exempt from the following
statutes:
a. Chapter 316 of the Government Code (Appropriations);
b. Chapter 322 of the Government Code (Legislative Budget Board);
c. Chapter 325 of the Government Code (Sunset);
d. Chapter 783 of the Government Code (Uniform Grants and Contract
Management);
e. Chapter 2001 of the Government Code (Administrative Procedure);
f. Chapter 2052 of the Government Code (State Agency Reports and Publications);
g. Chapter 2261 of the Government Code (State Contracting Standards and
Oversight);
h. Chapter 2262 of the Government Code (Statewide Contract Management);
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i. Chapter 262 of the Local Government Code (Purchasing and Contracting
Authority of Counties); and
j.Chapter 271 of the Local Government Code (Purchasing and Contracting
Authority of Municipalities, Counties, and Certain Other Local Governments).
2. Transparency
The Council will abide by state laws relating to open meetings and public information,
including Chapters 551 and 552 of the Texas Government Code.
i. The Council shall hold at least four regular meetings each year. The Council may
hold additional meetings on the request of the Chair or on the written request of
three members of the council. All meetings shall be open to the public, and public
notice of meetings shall be given as required by state law.
ii. The Council may convene in a closed, non-public meeting:
a. If the Commission must discuss:
1. Negotiation of contract awards; and
2. Matters specifically exempted from disclosure by federal and
state statutes.
b. All minutes and documents of a closed meeting shall remain under seal,
subject to release only order of a court of competent jurisdiction.
3. Authority
The Council does not have rulemaking authority. The terms of each Judgment, Master
Settlement Agreement, or any Bankruptcy Settlement for Texas control the authority of
the Council and the Council may not stray outside the bounds of the authority and power
vested by such settlements. Should the Council require legal assistance in determining
their authority, the Council may direct the executive director to seek legal advice from the
Attorney General to clarify the issue.
D. Operation and Expenses
The independent administrator will set aside up to one (1) percent of the settlement funds for the
administration of the Council for reasonable costs and expenses of operating the foregoing duties,
including educational activities.
1. Executive Director
The Comptroller will employ the executive director of the Council and other personnel as
necessary to administer the duties of the Council and carry out the functions of the Council.
The executive director must have at least 10 years of experience in governmentor public
administration and is classified as a Director V/B30
Classification. The Comptroller will pay the salaries of the Council employees from the
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one (1) percent of the settlement funds set aside for the administration of the Council. The
Comptroller will request funds from the Texas Abatement Fund Point of Contact.
2. Travel Reimbursement
A person appointed to the Council is entitled to reimbursement for the travel expenses
incurred in attending Council duties. A member of the Council may be reimbursed for
actual expenses for meals, lodging, transportation, and incidental expenses in accordance
with travel rates set by the federal General Services Administration.
II. Duties/Roles
It is the duty of the Council to determine and approve the opioid abatement strategies and funding
awards.
A. Approved Abatement Strategies
The Council will develop the approved Texas list of abatement strategies based on but not limited
to the existing national list of opioid abatement strategies (see attached Appendix A) for
implementing the Texas Abatement Fund.
1. The Council shall only approve strategies which are evidence-informed strategies.
2. The Texas list of abatement strategies must be approved by majority vote. The majority
vote must include a majority from both sides of the statewide members and regional
members in order to be approved, e.g., at least four (4) of six (6) members on each side.
B. Texas Abatement Fund Point of Contact
The Council will determine a single point of contact called the Abatement Fund Point of Contact
(POC) to be established as the sole entity authorized to receive requests for funds and approve
expenditures in Texas and order the release of funds from the Texas Abatement Fund by the
independent administrator. The POC may be an independent third party selected by the Council
with expertise in banking or financial management. The POC will manage the Opioid Council
Bank Account (Account). Upon a vote, the Council will direct the POC to contact the independent
administrator to release funds to the Account. The Account is outside the State Treasury and not
managed by any state or local officials. The POC is responsible for payments to the qualified
entities selected by the Council for abatement fund awards. The POC will submit a monthly
financial statement on the Account to the Council.
C. Auditor
An independent auditor appointed by the Council will perform an audit on the Account on an
annual basis and report its findings, if any, to the Council.
D. Funding Allocation
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The Council is the sole decision-maker on the funding allocation processof the abatement funds.
The Council will develop the application and award process based on the parameters outlined
below. An entity seeking funds from the Council must apply for funds; no funds will be awarded
without an application. The executive director and personnel may assist the Council in gathering
and compiling the applications for consideration; however, the Council members are the sole
decision-makers of awards and funding determination. The Council will use the following
processes to award funds:
1. Statewide Funds. The Council will consider, adopt and approve the allocation
methodology attached as Exhibit C, based upon population health data and prevalence
of opioid incidences, at the Coun. Adoption of such methodology
will allow eachRegion to customize the approved abatement strategies to fit its
communities needs. The statewide regional funds will account for seventy-five (75)
percent of the total overall funds, less the one (1) percent administrative expense
described herein.
2. Targeted Funds. Each Region shall reserve twenty-five (25) percent of the overall
funds, for targeted interventions in the specific Region as identified by opioid incidence
data. The Council must approve on an annual basis the uses for the targeted abatement
strategies and applications available to every Region, including education and outreach
programs. Each Region without approved uses for the targeted funds from the Council,
based upon a greater percentage of opioid incidents compared to its population, is
subject to transfer of all or a portion of the targeted funds for that Region for uses based
targeted funding needs as approved by the Council on an annual basis.
3. Annual Allocation. Statewide regional funds and targeted funds will be allocated on an
annual basis. If a Region lapses its funds, the funds will be reallocated based on all
R
E. Appeal Process
The Council will establish an appeal process to permit the applicants for funding (state or
subdivisions) to challenge decisions by the Council-designated point of contact on requests for
funds or expenditures.
1. To challenge a decision by the designated point of contact, the State or a subdivision
must file an appeal with the Council within thirty (30) days of the decision. The Council
then has thirty (30) days to consider and rule on the appeal.
2. If the Council denies the appeal, the party may file an appeal with the state district court
of record where the final opioid judgmentor Master Settlement Agreement is filed. The
Texas Rules of Civil Procedure and Rules of Evidence will govern these proceedings.
The Council may request representation from the Attorney General in these proceedings.
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In making its determination, the state district court shall apply the same clear error
standards contained herein that the Council must follow when rendering its decision.
3. The state district court will make the final decision and the decision is not appealable.
4. Challenges will be limited and subject to penalty if abused.
5. and costs are not recoverable in these appeals.
F. Education
The Council may determine that a percentage of the funds in the Abatement Fund from the targeted
funds be used to develop an education and outreach program to provide materials on the
consequences of opioid drug use, prevention and interventions. Any material developed will
include online resources and toolkits for communities.
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EXHIBITB
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EXHIBITC
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3
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5
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7
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EXHIBIT E
List of Opioid Remediation Uses
Schedule A
Core Strategies
States and Qualifying Block Grantees shall choose from among the abatement strategies listed in
Core
14
Strategies
A. NALOXONE OR OTHER FDA-APPROVED DRUG TO
REVERSE OPIOID OVERDOSES
1. Expand training for first responders, schools, community
support groups and families; and
2. Increase distribution to individuals who are uninsured or
whose insurance does not cover the needed service.
B. MEDICATION-MAT
DISTRIBUTION AND OTHER OPIOID-RELATED
TREATMENT
1. Increase distribution of MAT to individuals who are
uninsured or whose insurance does not cover the needed
service;
2. Provide education to school-based and youth-focused
programs that discourage or prevent misuse;
3. Provide MAT education and awareness training to
healthcare providers, EMTs, law enforcement, and other
first responders; and
4. Provide treatment and recovery support services such as
residential and inpatient treatment, intensive outpatient
treatment, outpatient therapy or counseling, and recovery
housing that allow or integrate medication and with other
support services.
14
rence for
new or existing programs.
E-1
C. PREGNANT & POSTPARTUM WOMEN
1. Expand Screening, Brief Intervention, and Referral to
SBIRT-Medicaid eligible or
uninsured pregnant women;
2. Expand comprehensive evidence-based treatment and
recovery services, including MAT, for women with co-
OUD
SUD
for uninsured individuals for up to 12 months postpartum;
and
3. Provide comprehensive wrap-around services to individuals
with OUD, including housing, transportation, job
placement/training, and childcare.
D. EXPANDING TREATMENT FOR NEONATAL
NAS
1. Expand comprehensive evidence-based and recovery
support for NAS babies;
2. Expand services for better continuum of care with infant-
need dyad; and
3. Expand long-term treatment and services for medical
monitoring of NAS babies and their families.
E. EXPANSION OF WARM HAND-OFF PROGRAMS AND
RECOVERY SERVICES
1. Expand services such as navigators and on-call teams to
begin MAT in hospital emergency departments;
2. Expand warm hand-off services to transition to recovery
services;
3. Broaden scope of recovery services to include co-occurring
SUD or mental health conditions;
4. Provide comprehensive wrap-around services to individuals
in recovery, including housing, transportation, job
placement/training, and childcare; and
5. Hire additional social workers or other behavioral health
workers to facilitate expansions above.
E-2
F. TREATMENT FOR INCARCERATED POPULATION
1. Provide evidence-based treatment and recovery support,
including MAT for persons with OUD and co-occurring
SUD/MH disorders within and transitioning out of the
criminal justice system; and
2. Increase funding for jails to provide treatment to inmates
with OUD.
G. PREVENTION PROGRAMS
1. Funding for media campaigns to prevent opioid use (similar
misusing tobacco);
2. Funding for evidence-based prevention programs in
schools;
3. Funding for medical provider education and outreach
regarding best prescribing practices for opioids consistent
with the 2016 CDC guidelines, including providers at
hospitals (academic detailing);
4. Funding for community drug disposal programs; and
5. Funding and training for first responders to participate in
pre-arrest diversion programs, post-overdose response
teams, or similar strategies that connect at-risk individuals
to behavioral health services and supports.
H. EXPANDING SYRINGE SERVICE PROGRAMS
1. Provide comprehensive syringe services programs with
more wrap-around services, including linkage to OUD
treatment, access to sterile syringes and linkage to care and
treatment of infectious diseases.
I. EVIDENCE-BASED DATA COLLECTION AND
RESEARCH ANALYZING THE EFFECTIVENESS OF THE
ABATEMENT STRATEGIES WITHIN THE STATE
E-3
Schedule B
Approved Uses
Support treatment of Opioid Use Disorder (OUD) and any co-occurring Substance Use Disorder
or Mental Health (SUD/MH) conditions through evidence-based or evidence-informed programs
or strategies that may include, but are not limited to, the following:
PART ONE: TREATMENT
A. TREAT OPIOID USE DISORDER (OUD)
OUD-occurring Substance Use
SUD/MHitions through evidence-based or evidence-
15
informed programs or strategies that may include, but are not limited to, those that:
1. Expand availability of treatment for OUD and any co-occurring SUD/MH
conditions, including all forms of Medication-Assisted MAT
approved by the U.S. Food and Drug Administration.
2. Support and reimburse evidence-based services that adhere to the American
ASAM-
occurring SUD/MH conditions.
3. Expand telehealth to increase access to treatment for OUD and any co-occurring
SUD/MH conditions, including MAT, as well as counseling, psychiatric support,
and other treatment and recovery support services.
4. OTPs to assure evidence-
based or evidence-informed practices such as adequate methadone dosing and low
threshold approaches to treatment.
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 and for persons
who have experienced an opioid overdose.
6. Provide treatment of trauma for individuals with OUD (e.g., violence, sexual
assault, human trafficking, or adverse childhood experiences) and family
members (e.g., surviving family members after an overdose or overdose fatality),
and training of health care personnel to identify and address such trauma.
7. Support evidence-based withdrawal management services for people with OUD
and any co-occurring mental health conditions.
15
new or existing programs.
E-4
8. Provide training on MAT for health care providers, first responders, 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.
10. Offer fellowships for addiction medicine specialists for direct patient care,
instructors, and clinical research for treatments.
11. Offer scholarships and supports for behavioral health practitioners or workers
involved in addressing OUD and any co-occurring SUD/MH or mental health
conditions, including, but not limited to, training, scholarships, fellowships, loan
repayment programs, or other incentives for providers to work in rural or
underserved areas.
12. Provide funding and training for clinicians to obtain a waiver under the federal
Drug Addiction Treatment DATA 2000
OUD, and provide technical assistance and professional support to clinicians who
have obtained a DATA 2000 waiver.
13. Disseminate of web-based training curricula, such as the American Academy of
Addiction PsychiaOpioids web-based
training curriculum and motivational interviewing.
14. Develop and disseminate new curricula, such as the American Academy of
Assisted Treatment.
B. SUPPORT PEOPLE IN TREATMENT AND RECOVERY
Support people in recovery from OUD and any co-occurring SUD/MH conditions
through evidence-based or evidence-informed programs or strategies that may include,
but are not limited to, the programs or strategies that:
1. Provide comprehensive wrap-around services to individuals with OUD and any
co-occurring SUD/MH conditions, including housing, transportation, education,
job placement, job training, or childcare.
2. Provide the full continuum of care of treatment and recovery services for OUD
and any co-occurring SUD/MH conditions, including supportive housing, peer
support services and counseling, community navigators, case management, and
connections to community-based services.
3. 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.
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4. Provide access to housing for people with OUD and any co-occurring SUD/MH
conditions, including supportive housing, recovery housing, housing assistance
programs, training for housing providers, or recovery housing programs that allow
or integrate FDA-approved mediation with other support services.
5. Provide community support services, including social and legal services, to assist
in deinstitutionalizing persons with OUD and any co-occurring SUD/MH
conditions.
6. 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.
7. Provide or support transportation to treatment or recovery programs or services
for persons with OUD and any co-occurring SUD/MH conditions.
8. Provide employment training or educational services for persons in treatment for
or recovery from OUD and any co-occurring SUD/MH conditions.
9. 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.
10. 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 support the person with OUD in the family.
11. Provide training and development of procedures for government staff to
appropriately interact and provide social and other services to individuals with or
in recovery from OUD, including reducing stigma.
12. Support stigma reduction efforts regarding treatment and support for persons with
OUD, including reducing the stigma on effective treatment.
13. Create or support culturally appropriate services and programs for persons with
OUD and any co-occurring SUD/MH conditions, including new Americans.
14. Create and/or support recovery high schools.
15. Hire or train behavioral health workers to provide or expand any of the services or
supports listed above.
C. CONNECT PEOPLE WHO NEED HELP TO THE HELP THEY NEED
(CONNECTIONS TO CARE)
Provide connections to care for people who haveor are at risk of developingOUD
and any co-occurring SUD/MH conditions through evidence-based or evidence-informed
programs or strategies that may include, but are not limited to, those that:
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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. Fund SBIRT programs to reduce the transition from use to disorders, including
SBIRT services to pregnant women who are uninsured or not eligible for
Medicaid.
3. Provide training and long-term implementation of SBIRT 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.
4. Purchase automated versions of SBIRT and support ongoing costs of the
technology.
5. Expand services such as navigators and on-call teams to begin MAT in hospital
emergency departments.
6. Provide training for emergency room personnel treating opioid overdose patients
on post-discharge planning, including community referrals for MAT, recovery
case management or support services.
7. Support hospital programs that transition persons with OUD and any co-occurring
SUD/MH conditions, or persons who have experienced an opioid overdose, into
clinically appropriate follow-up care through a bridge clinic or similar approach.
8. Support crisis stabilization centers that serve as an alternative to hospital
emergency departments for persons with OUD and any co-occurring SUD/MH
conditions or persons that have experienced an opioid overdose.
9. 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.
10. 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 or to persons who have experienced an
opioid overdose.
11. Expand warm hand-off services to transition to recovery services.
12. 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.
13. Develop and support best practices on addressing OUD in the workplace.
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14. Support assistance programs for health care providers with OUD.
15. Engage non-profits and the faith community as a system to support outreach for
treatment.
16. 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.
D. ADDRESS THE NEEDS OF CRIMINAL JUSTICE-INVOLVED PERSONS
Address the needs of persons with OUD and any co-occurring SUD/MH conditions who
are involved in, are at risk of becoming involved in, or are transitioning out of the
criminal justice system through evidence-based or evidence-informed programs or
strategies that may include, but are not limited to, those that:
1. Support pre-arrest or pre-arraignment diversion and deflection strategies for
persons with OUD and any co-occurring SUD/MH conditions, including
established strategies such as:
1. Self-referral strategies such as the Angel Programs or the Police Assisted
PAARI
2. Active outreach strategies such as the Drug Abuse Response Team
DART
3.
have received naloxone to reverse the effects of an overdose are then
linked to treatment programs or other appropriate services;
4. Officer prevention strategies, such as the Law Enforcement Assisted
LEAD
5. Officer intervention strategies such as the Leon County, Florida Adult
Civil Citation Network or the Chicago Westside Narcotics Diversion to
Treatment Initiative; or
6. Co-responder and/or alternative responder models to address OUD-related
911 calls with greater SUD expertise.
2. Support pre-trial services that connect individuals with OUD and any co-
occurring SUD/MH conditions to evidence-informed treatment, including MAT,
and related services.
3. Support treatment and recovery courts that provide evidence-based options for
persons with OUD and any co-occurring SUD/MH conditions.
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4. Provide evidence-informed treatment, including MAT, recovery support, harm
reduction, or other appropriate services to individuals with OUD and any co-
occurring SUD/MH conditions who are incarcerated in jail or prison.
5. Provide evidence-informed treatment, including MAT, recovery support, harm
reduction, or other appropriate services to individuals with OUD and any co-
occurring SUD/MH conditions who are leaving jail or prison or 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. CTI
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 to law
enforcement, correctional, or judicial personnel or to providers of treatment,
recovery, harm reduction, 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, and the needs of their families, including babies with neonatal
NAS-based or evidence-informed programs
or strategies that may include, but are not limited to, those that:
1. Support evidence-based or evidence-informed treatment, including MAT,
recovery services and supports, and prevention services for pregnant womenor
women who could become pregnantwho have OUD and any co-occurring
SUD/MH conditions, and other measures to educate and provide support to
families affected by Neonatal Abstinence Syndrome.
2. Expand comprehensive evidence-based treatment and recovery services, including
MAT, for uninsured women with OUD and any co-occurring SUD/MH
conditions for up to 12 months postpartum.
3. Provide training for obstetricians or other healthcare personnel who work with
pregnant women and their families regarding treatment of OUD and any co-
occurring SUD/MH conditions.
4. Expand comprehensive evidence-based treatment and recovery support for NAS
babies; expand services for better continuum of care with infant-need dyad; and
expand long-term treatment and services for medical monitoring of NAS babies
and their families.
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5. 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 NAS get referred to appropriate services and receive a plan of safe care.
6. Provide child and family supports for parenting women with OUD and any co-
occurring SUD/MH conditions.
7. Provide enhanced family support and child care services for parents with OUD
and any co-occurring SUD/MH conditions.
8. 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.
9. Offer home-based wrap-around services to persons with OUD and any co-
occurring SUD/MH conditions, including, but not limited to, parent skills
training.
10. 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 or evidence-informed programs or
strategies that may include, but are not limited to, the following:
1. Funding medical provider education and outreach regarding best prescribing
practices for opioids consistent with the Guidelines for Prescribing Opioids for
Chronic Pain from the U.S. Centers for Disease Control and Prevention, including
providers at hospitals (academic detailing).
2. Training for health care providers regarding safe and responsible opioid
prescribing, dosing, and tapering patients off opioids.
3. Continuing Medical Education (CME) on appropriate prescribing of opioids.
4. Providing Support for non-opioid pain treatment alternatives, including training
providers to offer or refer to multi-modal, evidence-informed treatment of pain.
5. Supporting enhancements or improvements to Prescription Drug Monitoring
PDMPs, but not limited to, improvements that:
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1. Increase the number of prescribers using PDMPs;
2. Improve point-of-care decision-making by increasing the quantity, quality,
or format of data available to prescribers using PDMPs, by improving the
interface that prescribers use to access PDMP data, or both; or
3. 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 in a manner that
complies with all relevant privacy and security laws and rules.
6. Ensuring PDMPs incorporate available overdose/naloxone deployment data,
Technician overdose database in a manner that complies with all relevant privacy
and security laws and rules.
7. Increasing electronic prescribing to prevent diversion or forgery.
8. Educating dispensers on appropriate opioid dispensing.
G. PREVENT MISUSE OF OPIOIDS
Support efforts to discourage or prevent misuse of opioids through evidence-based or
evidence-informed programs or strategies that may include, but are not limited to, the
following:
1. Funding media campaigns to prevent opioid misuse.
2. Corrective advertising or affirmative public education campaigns based on
evidence.
3. Public education relating to drug disposal.
4. Drug take-back disposal or destruction programs.
5. Funding community anti-drug coalitions that engage in drug prevention efforts.
6. Supporting community coalitions in implementing evidence-informed prevention,
such as reduced social access and physical access, stigma reductionincluding
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
SAMHSA
7. Engaging non-profits and faith-based communities as systems to support
prevention.
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8. Funding evidence-based prevention programs in schools or evidence-informed
school and community education programs and campaigns for students, families,
school employees, school athletic programs, parent-teacher and student
associations, and others.
9. 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.
10. Create or support community-based education or intervention services for
families, youth, and adolescents at risk for OUD and any co-occurring SUD/MH
conditions.
11. 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.
12. Support greater access to mental health services and supports for young people,
including services and supports provided by school nurses, behavioral health
workers or other school staff, to address mental health needs in young people that
(when not properly addressed) increase the risk of opioid or another drug misuse.
H. PREVENT OVERDOSE DEATHS AND OTHER HARMS (HARM REDUCTION)
Support efforts to prevent or reduce overdose deaths or other opioid-related harms
through evidence-based or evidence-informed programs or strategies that may include,
but are not limited to, the following:
1. Increased availability and distribution of naloxone and other drugs that treat
overdoses for first responders, overdose patients, individuals with OUD and their
friends and family members, schools, community navigators and outreach
workers, persons being released from jail or prison, or other members of the
general public.
2. Public health entities providing free naloxone to anyone in the community.
3. Training and education regarding naloxone and other drugs that treat overdoses
for first responders, overdose patients, patients taking opioids, families, schools,
community support groups, and other members of the general public.
4. Enabling school nurses and other school staff to respond to opioid overdoses, and
provide them with naloxone, training, and support.
5. Expanding, improving, or developing data tracking software and applications for
overdoses/naloxone revivals.
6. Public education relating to emergency responses to overdoses.
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7. Public education relating to immunity and Good Samaritan laws.
8. Educating first responders regarding the existence and operation of immunity and
Good Samaritan laws.
9. Syringe service programs and other evidence-informed programs to reduce harms
associated with intravenous drug use, including supplies, staffing, space, peer
support services, referrals to treatment, fentanyl checking, connections to care,
and the full range of harm reduction and treatment services provided by these
programs.
10. Expanding access to testing and treatment for infectious diseases such as HIV and
Hepatitis C resulting from intravenous opioid use.
11. Supporting mobile units that offer or provide referrals to harm reduction services,
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.
12. Providing training in harm reduction 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.
13. Supporting screening for fentanyl in routine clinical toxicology testing.
PART THREE: OTHER STRATEGIES
I.FIRST RESPONDERS
In addition to items in section C, D and H relating to first responders, support the
following:
1. Education of law enforcement or other first responders regarding appropriate
practices and precautions when dealing with fentanyl or other drugs.
2. Provision of wellness and support services for first responders and others who
experience secondary trauma associated with opioid-related emergency events.
J. LEADERSHIP, PLANNING AND COORDINATION
Support efforts to provide leadership, planning, coordination, facilitations, training and
technical assistance to abate the opioid epidemic through activities, programs, or
strategies that may include, but are not limited to, the following:
1. Statewide, regional, local or community regional planning to identify root causes
of addiction and overdose, goals for reducing harms related to the opioid
epidemic, and areas and populations with the greatest needs for treatment
E-13
intervention services, and to support training and technical assistance and other
strategies to abate the opioid epidemic described in this opioid abatement strategy
list.
2. A dashboard to (a) share reports, recommendations, or plans to spend opioid
settlement funds; (b) to show how opioid settlement funds have been spent; (c) to
report program or strategy outcomes; or (d) to track, share or visualize key opioid-
or health-related indicators and supports as identified through collaborative
statewide, regional, local or 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, 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 throughout this document, support training to abate
the opioid epidemic through activities, programs, or strategies that may include, but are
not limited to, those that:
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. Support 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, or implement other 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, data collection 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 SBIRT that
demonstrate promising but mixed results in populations vulnerable to
opioid use disorders.
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4. Research on novel harm reduction and prevention efforts such as the
provision of fentanyl test strips.
5. Research on innovative supply-side enforcement efforts such as improved
detection of mail-based delivery of synthetic opioids.
6. 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).
7. Epidemiological surveillance of OUD-related behaviors in critical
populations, including individuals entering the criminal justice system,
including, but not limited to approaches modeled on the Arrestee Drug
ADAM
8. Qualitative and quantitative research regarding public health risks and
harm reduction opportunities within illicit drug markets, including surveys
of market participants who sell or distribute illicit opioids.
9. Geospatial analysis of access barriers to MAT and their association with
treatment engagement and treatment outcomes.
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EXHIBIT K
Subdivision Settlement Participation Form
Governmental Entity: State:
Authorized Official:
Address 1:
Address 2:
City, State, Zip:
Phone:
Email:
Governmental Entityorder to obtain and
in consideration for the benefits provided to the Governmental Entity pursuant to the Settlement
Agreement dated July 21, 2021 Distributor Settlementand acting through the undersigned
authorized official, hereby elects to participate in the Distributor Settlement, release all Released
Claims against all Released Entities, and agrees as follows.
1. The Governmental Entity is aware of and has reviewed the Distributor Settlement,
understands that all terms in this Participation Form have the meanings defined therein,
and agrees that by signing this Participation Form, the Governmental Entity elects to
participate in the Distributor Settlement and become a Participating Subdivision as
provided therein.
2. The Governmental Entity shall, within 14 days of the Reference Date and prior to the
filing of the Consent Judgment, secure the dismissal with prejudice of any Released
Claims that it has filed.
3. The Governmental Entity agrees to the terms of the Distributor Settlement pertaining to
Subdivisions as defined therein.
4. By agreeing to the terms of the Distributor Settlement and becoming a Releasor, the
Governmental Entity is entitled to the benefits provided therein, including, if applicable,
monetary payments beginning after the Effective Date.
5. The Governmental Entity agrees to use any monies it receives through the Distributor
Settlement solely for the purposes provided therein.
6. The Governmental Entity submits to the jurisdiction of the court in the Governmental
as provided in, and for resolving disputes to the extent provided in, the Distributor
Settlement. The Governmental Entity likewise agrees to arbitrate before the National
Arbitration Panel as provided in, and for resolving disputes to the extent otherwise
provided in, the Distributor Settlement.
K-1
7. The Governmental Entity has the right to enforce the Distributor Settlement as provided
therein.
8. The Governmental Entity, as a Participating Subdivision, hereby becomes a Releasor for
all purposes in the Distributor Settlement, including, but not limited to, all provisions of
Part XI, and along with all departments, agencies, divisions, boards, commissions,
districts, instrumentalities of any kind and attorneys, and any person in their official
capacity elected or appointed to serve any of the foregoing and any agency, person, or
other entity claiming by or through any of the foregoing, and any other entity identified in
the definition of Releasor, provides for a release to the fullest extent of its authority. As a
Releasor, the Governmental Entity hereby absolutely, unconditionally, and irrevocably
covenants not to bring, file, or claim, or to cause, assist or permit to be brought, filed, or
claimed, or to otherwise seek to establish liability for any Released Claims against any
Released Entity in any forum whatsoever. The releases provided for in the Distributor
Settlement are intended by the Parties to be broad and shall be interpreted so as to give
the Released Entities the broadest possible bar against any liability relating in any way to
Released Claims and extend to the full extent of the power of the Governmental Entity to
release claims. The Distributor Settlement shall be a complete bar to any Released
Claim.
9. The Governmental Entity hereby takes on all rights and obligations of a Participating
Subdivision as set forth in the Distributor Settlement.
10. In connection with the releases provided for in the Distributor Settlement, each
Governmental Entity expressly waives, releases, and forever discharges any and all
provisions, rights, and benefits conferred by any law of any state or territory of the
United States or other jurisdiction, or principle of common law, which is similar,
comparable, or equivalent to § 1542 of the California Civil Code, which reads:
General Release; extent. A general release does not extend to claims that
the creditor or releasing party does not know or suspect to exist in his or
her favor at the time of executing the release, and that if known by him or
her would have materially affected his or her settlement with the debtor or
released party.
A Releasor may hereafter discover facts other than or different from those which it
knows, believes, or assumes to be true with respect to the Released Claims, but each
Governmental Entity hereby expressly waives and fully, finally, and forever settles,
releases and discharges, upon the Effective Date, any and all Released Claims that may
exist as of such date but which Releasors do not know or suspect to exist, whether
through ignorance, oversight, error, negligence or through no fault whatsoever, and
participate in the Distributor Settlement.
K-2
11. Nothing herein is intended to modify in any way the terms of the Distributor Settlement,
to which Governmental Entity hereby agrees. To the extent this Participation Form is
interpreted differently from the Distributor Settlement in any respect, the Distributor
Settlement controls.
I have all necessary power and authorization to execute this Participation Form on behalf of the
Governmental Entity.
Signature: _____________________________
Name: _____________________________
Title: _____________________________
Date: _____________________________
K-3
EXHIBIT K
Settlement Participation Form
Governmental Entity: State:
Authorized Official:
Address 1:
Address 2:
City, State, Zip:
Phone:
Email:
The order to obtain and in
consideration for the benefits provided to the Governmental Entity pursuant to the Settlement
Agreement dated July 21, 2021 cting through the undersigned
authorized official, hereby elects to participate in the Janssen Settlement, release all Released
Claims against all Released Entities, and agrees as follows.
1. The Governmental Entity is aware of and has reviewed the Janssen Settlement,
understands that all terms in this Election and Release have the meanings defined therein,
and agrees that by this Election, the Governmental Entity elects to participate in the
Janssen Settlement and become a Participating Subdivision as provided therein.
2. The Governmental Entity shall, within 14 days of the Reference Date and prior to the
filing of the Consent Judgment, dismiss with prejudice any Released Claims that it has
filed.
3. The Governmental Entity agrees to the terms of the Janssen Settlement pertaining to
Subdivisions as defined therein.
4. By agreeing to the terms of the Janssen Settlement and becoming a Releasor, the
Governmental Entity is entitled to the benefits provided therein, including, if applicable,
monetary payments beginning after the Effective Date.
5. The Governmental Entity agrees to use any monies it receives through the Janssen
Settlement solely for the purposes provided therein.
6. The Governmental Entity submits to the jurisdiction of the court in the Governmental
as provided in, and for resolving disputes to the extent provided in, the Janssen
Settlement.
7. The Governmental Entity has the right to enforce the Janssen Settlement as provided
therein.
8. The Governmental Entity, as a Participating Subdivision, hereby becomes a Releasor for
all purposes in the Janssen Settlement, including but not limited to all provisions of
86
Section IV (Release), and along with all departments, agencies, divisions, boards,
commissions, districts, instrumentalities of any kind and attorneys, and any person in
their official capacity elected or appointed to serve any of the foregoing and any agency,
person, or other entity claiming by or through any of the foregoing, and any other entity
identified in the definition of Releasor, provides for a release to the fullest extent of its
authority. As a Releasor, the Governmental Entity hereby absolutely, unconditionally,
and irrevocably covenants not to bring, file, or claim, or to cause, assist or permit to be
brought, filed, or claimed, or to otherwise seek to establish liability for any Released
Claims against any Released Entity in any forum whatsoever. The releases provided for
in the Janssen Settlement are intended by the Parties to be broad and shall be interpreted
so as to give the Released Entities the broadest possible bar against any liability relating
in any way to Released Claims and extend to the full extent of the power of the
Governmental Entity to release claims. The Janssen Settlement shall be a complete bar to
any Released Claim.
9. In connection with the releases provided for in the Janssen Settlement, each
Governmental Entity expressly waives, releases, and forever discharges any and all
provisions, rights, and benefits conferred by any law of any state or territory of the
United States or other jurisdiction, or principle of common law, which is similar,
comparable, or equivalent to § 1542 of the California Civil Code, which reads:
General Release; extent. A general release does not extend to claims that
the creditor or releasing party does not know or suspect to exist in his or
her favor at the time of executing the release that, if known by him or her,
would have materially affected his or her settlement with the debtor or
released party.
A Releasor may hereafter discover facts other than or different from those which it
knows, believes, or assumes to be true with respect to the Released Claims, but each
Governmental Entity hereby expressly waives and fully, finally, and forever settles,
releases and discharges, upon the Effective Date, any and all Released Claims that may
exist as of such date but which Releasors do not know or suspect to exist, whether
through ignorance, oversight, error, negligence or through no fault whatsoever, and
whic
participate in the Janssen Settlement.
10. Nothing herein is intended to modify in any way the terms of the Janssen Settlement, to
which Governmental Entity hereby agrees. To the extent this Election and Release is
interpreted differently from the Janssen Settlement in any respect, the Janssen Settlement
controls.
87
I have all necessary power and authorization to execute this Election and Release on behalf of
the Governmental Entity.
Signature: _____________________________
Name: _____________________________
Title: _____________________________
Date: _____________________________
88