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HomeMy WebLinkAbout2021-135 - Resolution RESOLUTION NO. 2021-135 A RESOLUTION OF THE CITY COUNCIL OF THE CITY OF RANCHO CUCAMONGA, CALIFORNIA, AUTHORIZING THE CITY OF RANCHO CUCAMONGA TO ENTER INTO THE SETTLEMENT AGREEMENTS WITH MCKESSON CORPORATION, CARDINAL HEALTH, INC., AMERISOURCEBERGEN CORPORATION, JOHNSON & JOHNSON, JANSSEN PHARMACEUTICALS, INC., ORTHO-MCNEIL-JANSSEN PHARMACEUTICALS, INC., AND JANSSEN PHARMACEUTICA, INC., AGREE TO THE TERMS OF THE STATE-SUBDIVISION AGREEMENTS, AND AUTHORIZE ENTRY INTO THE STATE- SUBDIVISION AGREEMENTS WITH THE ATTORNEY GENERAL WHEREAS, the United States is facing an ongoing public health crisis of opioid abuse, addiction, overdose, and death, forcing the State of California and California counties and cities tospend billions of dollars each year to address the direct consequences of this crisis; and, WHEREAS, pending in the U.S. District Court for the Northern District of Ohio is a multidistrict litigation ("MDL") being pursued by numerous public entity plaintiffs against the manufacturers and distributors of various opioids based on the allegation that the defendants' unlawful conduct caused the opioid epidemic; and, WHEREAS, on or about July 1, 2021, a proposed nationwide tentative settlement was reached between the plaintiffs in the MDL and several of the defendants, specifically McKesson Corporation, Cardinal Health, Inc., AmerisourceBergen Corporation (collectively, "Distributors"), and Johnson & Johnson, Janssen Pharmaceuticals, Inc., Ortho-McNeil-Janssen Pharmaceuticals, Inc., and Janssen Pharmaceutica, Inc. (collectively, "J&J") (all collectively, the "Settling Defendants"); and, WHEREAS, as part of the settlement with the Settling Defendants, local subdivisions, including certain cities, that are not plaintiffs in the MDL may participate in the settlement in exchange for a release of the Settling Defendants; and, WHEREAS, copies of the proposed terms of those proposed nationwide settlements have been set forth in the Distributors Master Settlement Agreement and the J&J Master Settlement Agreement(collectively "Settlement Agreements"); and, WHEREAS, copies of the Settlement Agreements have been provided to the City Council with this Resolution; and, WHEREAS, the Settlement Agreements provide, among other things, for the payment of a certain sum to settling government entities in California including to the State of California and Participating Subdivisions upon occurrence of certain events as defined in the Settlement Agreements ("California Opioid Funds"); and, Resolution No. 2021-135—Page 1 of 4 WHEREAS, California local governments in the MDL have engaged in extensive discussions with the State Attorney General's Office ("AGO") as to how the California Opioid Funds will be allocated, which has resulted in the Proposed California State-Subdivision Agreement Regarding Distribution and Use of Settlement Funds- Distributor Settlement and Proposed California State-Subdivision Agreement Regarding Distribution and Use of Settlement Funds- Janssen Settlement (collectively the "Allocation Agreements,") which are agreements between all of the entities identified in the Allocation Agreements; and, WHEREAS, copies of the Allocation Agreements have been provided with this Resolution; and, WHEREAS, the Allocation Agreements allocate the California Opioid Funds as follows: 15% to the State Fund; 70% to the Abatement Accounts Fund; and 15% to the Subdivision Fund. For the avoidance of doubt, all funds allocated to California from the Settlements shall be combined pursuant to Allocation Agreements, and 15% of that total shall be allocated to the State of California (the "State of California Allocation"), 70% to the California Abatement Accounts Fund ("CA Abatement Accounts Fund"), and 15% to the California Subdivision Fund ("CA Subdivision Fund"); and, WHEREAS, under the Settlement Agreements, certain local subdivisions that did not file a lawsuit against the Settlement Defendants may qualify to participate in the Settlement and obtainfunds from the Abatement Account Fund; and, WHEREAS, the City is eligible to participate in the Settlement and become a CA Participating Subdivision; and, WHEREAS, the funds in the CA Abatement Accounts Fund (the 70% allocation) will be allocated based on the allocation model developed in connection with the proposed negotiating class in the National Prescription Opiate Litigation (MDL No. 2804), as adjusted to reflect only those cities and counties that are eligible, based on population or litigation status, to become a CA Participating Subdivision (those above 10,000 in population). The percentage from the CA Abatement Accounts Fund allocated to each CA Participating Subdivision is set forth in Appendix 1 to the Allocation Agreements and provided to the City Council with this Resolution. The City's share of the CA Abatement Accounts Fund will be a product of the total in the CA Abatement Accounts Fund multiplied by the City's percentage set forth in Appendix 1 (the "Local Allocation"); and, WHEREAS, a CA Participating Subdivision that is a city will be allocated its Local Allocation share as of the date on which it becomes a Participating Subdivision. The Local Allocation share for a city that is a CA Participating Subdivision will be paid to the county in which the city is located, unless the city elects to take a direct election of the settlement funds, so long as: (a) the county is a CA Participating Subdivision, and (b) the city has not advised the Settlement Fund Administrator that it requests direct payment at least 60 days prior to a PaymentDate; and, Resolution No. 2021-135—Page 2 of 4 WHEREAS, it the intent of this Resolution is to authorize the City to enter into the Settlement Agreements by executing the Participation Agreements and to enter into the AllocationAgreements by executing the signature page to those agreements. NOW, THEREFORE, BE IT RESOLVED: the City Council hereby approves and authorizes City Attorney Nicholas Ghirelli to settle and release the City's claims against the Settling Defendants in exchange for the consideration set forth in the Settlement Agreements, Allocation Agreements and all exhibits thereto. BE IT FURTHER RESOLVED that all actions heretofore taken by the City Council and other appropriate public officers and agents of the City with respect to the matters contemplated under this Resolution are hereby ratified, confirmed and approved. Resolution No. 2021-135— Page 3 of 4 PASSED, APPROVED, and ADOPTED this 151h day of December 2021. )!�16qkal idhael, M yor ATTEST: 1 f 1 Ja ce C. Reynolds, City C rk STATE OF CALIFORNIA ) COUNTY OF SAN BERNARDINO ) ss CITY OF RANCHO CUCAMONGA ) I, Janice C. Reynolds, City Clerk of the City of Rancho Cucamonga, do hereby certify that the foregoing Resolution was duly passed, approved, and adopted by the City Council of the City of Rancho Cucamonga, at a Regular Meeting of said Council held on the 151h day of December 2021. AYES: Hutchison, Kennedy, Michael, Scott, Spagnolo NOES: None ABSENT: None ABSTAINED: None Executed this 16'h day of December, 2021, at Rancho Cucamonga, California. J�gice C. Reynolds, City Clerk Resolution No. 2021-135— Page 4 of 4 DISTRIBUTORS' 9.18.21 EXHIBIT UPDATES 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 Schedule B. However, priority shall be given to the following core abatement strategies ("Core Strategies").14 A. NALOXONE OR OTHER FDA-APPROVED DRUG TO REVERSE OPIOID OVERDOSES I. 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-ASSISTED TREATMENT ("MAT") DISTRIBUTION AND OTHER OPIOID-RELATED TREATMENT I. 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. As used in this Schedule A,words like"expand,""fund,""provide"or the like shall not indicate a preference for new or existing programs. ATTACHMENT 2 E-1 DISTRIBUTORS' 9.18.21 EXHIBIT UPDATES C. PREGNANT & POSTPARTUM WOMEN l. Expand Screening, Brief Intervention, and Referral to Treatment("SBIRT') services to non-Medicaid eligible or uninsured pregnant women; 2. Expand comprehensive evidence-based treatment and recovery services, including MAT, for women with co- occurring Opioid Use Disorder("OUD") and other Substance Use Disorder(`SUD")/Mental Health disorders 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 ABSTINENCE SYNDROME ("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 ofNAS 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 DISTRIBUTORS' 9.18.21 EXHIBIT UPDATES 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 to the FDA's ``Real Cost" campaign to prevent youth from 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 l. 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 DISTRIBUTORS' 9.18.21 EXHIBIT UPDATES Schedule B Apl;roved 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) 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,those that:15 1. Expand availability of treatment for OUD and any co-occurring SUD/MH conditions, including all forms of Medication-Assisted Treatment('MAT') approved by the U.S. Food and Drug Administration. 2. Support and reimburse evidence-based services that adhere to the American Society of Addiction Medicine ("ASAM') continuum of care for OUD and any co- 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. Improve oversight of Opioid Treatment Programs ("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. 'As used in this Schedule B,words like"expand,""fund,""provide"or the like shall not indicate a preference for new or existing programs. E-4 DISTRIBUTORS" 9.18.21 EXHIBIT UPDATES 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. 1 l. 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 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. 13. Disseminate 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. 14. Develop and disseminate 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 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 OU D and any co-occurring SUD/MH conditions. E-5 DISTRIBUTORS' 9.18.21 EXHIBIT UPDATES 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 have—or are at risk of developing—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, those that: E-6 DISTRIBUTORS" 9.18.21 EXHIBIT UPDATES 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. E-7 DISTRIBUTORS' 9.18.21 EXHIBIT UPDATES 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 Addiction Recovery Initiative ("PAART'); 2. Active outreach strategies such as the Drug Abuse Response Team ("DARTT') model; 3. "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; 4. Officer prevention strategies. such as the Law Enforcement Assisted Diversion (`LEAD") model. 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. E-8 DISTRIBUTORS' 9.18.21 EXHIBIT UPDATES 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. 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 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 abstinence syndrome (".VAY'), through evidence-based or evidence-informed programs or strategies that may include, but are not limited to, those that: I. Support evidence-based or evidence-informed 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, 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. E-9 DISTRIBUTORS' 9.18.21 EXHIBIT UPDATES 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. Provide 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 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 Programs ("PDMPs"), including, but not limited to, improvements that: E-10 DISTRIBUTORS' 9.18.21 EXHIBIT UPDATES 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, including the United States Department of Transportation's Emergency Medical 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 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'). 7. Engaging non-profits and faith-based communities as systems to support prevention. E-11 DISTRIBUTORS' 9.18.21 EXHIBIT UPDATES 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. E-12 DISTRIBUTORS' 9.18.21 EXHIBIT UPDATES 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: I. 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 DISTRIBUTORS' 9.18.21 EXHIBIT UPDATES 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: l. 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. E-14 DISTRIBUTORS' 9.18.21 EXHIBIT UPDATES 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 Abuse Monitoring ("ADAM") system. 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. E-15