Agenda 10/25/2022 Item #16K1 (To approve the Interlocal Agreement between the City of Naples and Collier County relating to the expenditure of certain settlement funds received from the Stae of Florida)10/25/2022
EXECUTIVE SUMMARY
Recommendation to approve the Interlocal Agreement between the City of Naples and Collier County
relating to the expenditure of certain settlement funds received from the State of Florida regarding In Re:
National Prescription Opioid Litigation in furtherance of the Florida Attorney General’s Memorandum of
Understanding and Resolution 2021-136.
OBJECTIVE: That the Board approve the Interlocal Agreement between the City of Naples and Collier County to
complete the qualification requirements to receive funds directly from the Regional Fund portion of the opioid
settlement agreements in furtherance of the Florida Attorney General’s Memorandum of Understanding and
Resolution 2021-136.
CONSIDERATION: Pursuant to Resolution 2021-136, the Board authorized the County to join the State of
Florida and other local governments as a participant in the Florida Memorandum of Understanding (MOU) to
implement a unified plan relating to the allocation and use of any potential settlement proceeds receive d by the
State of Florida from settlement agreements in In Re: National Prescription Opiate Litigation MDL No. 2804 (N.D.
Ohio) (“Opioid MDL”). Settlement funds must be used for strategies, programming, and services to expand the
availability of treatment for individuals impacted by substance use disorders.
The Allocation Agreement provides the method for distribution and use of any funds received by the State from the
settlement of claims in the Opioid MDL for the benefit of the State and local governments. Under the Agreement,
all settlement funds for claims in the Opioid MDL would go to the State and then be distributed into a City/County
Fund, Regional Fund, and State Fund. Collier County is anticipated to receive monies from the City/County Fund
and Regional Fund. Based upon current projections, Collier County will receive $5,482,105.45 from the
City/County Fund and upwards of $9,611,935.95 from the Regional Fund, if the County meets the requirements to
be considered a Qualifying County under the Regional Fund; however, these figures have yet to be finalized by the
State as the payments to be received by the County and municipalities within the County are based upon
Negotiation Class Metrics.
A percentage of the funds based upon a sliding scale will be placed into the Regional Fund and the amount to be
distributed from the Regional Fund will be determined by the Negotiation Class Metrics. Collier County currently
fulfills three of the four requirements set forth in the Allocation Agreement to be a desi gnated Qualifying County.
The fourth requirement consists of entering the recommended interlocal agreements with Municipalities regarding
the expenditure of the monies within the Regional Fund. If Collier County is not deemed a Qualifying County, the
State will appropriate and pay the money to the Central Florida Behavioral Health Network, the County’s managing
entity selected by and under contract with the Florida Department of Children and Families (DCF) to manage the
daily operational delivery of behavioral health services through a coordinated system of care. To ensure the County
rather than Central Florida Behavioral Health System manages the expenditure of the Regional Fund monies, the
County must complete the interlocal agreements with the City of Naples and City of Marco Island.
If the County is deemed a Qualifying County, the State will calculate the share of the Regional Fund that should be
distributed to the County using the Negotiation Class Metrics. The Interlocal Agreement also authorizes the County
to receive administrative costs and includes reporting and auditing requirements, among others, to ensure the
Regional Fund monies are used in accordance with the Allocation Agreement.
FISCAL IMPACT: The specific fiscal impact is unknown at this time; however, the County anticipates receiving
approximately $5,482,105.45 from the City/County Fund and $9,611,935.95 from the Regional Fund over the
course of 18 years, should the County meet the requirements to be considered a Qualifying County.
GROWTH MANAGEMENT IMPACT: None.
LEGAL CONSIDERATIONS: This item is approved for form and legality and requires a majority vote for
approval. -JAK
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10/25/2022
RECOMMENDATION: Recommendation to approve an Interlocal Agreement between the City of Naples and
Collier County. This agreement will enable the County to be considered a Qualifying County under the
Memorandum of Understanding and enable the County to directly receive settlement funds for the strategies,
programming and services to expand the availability of treatment for individuals impacted by substance use
disorders within Collier County.
Prepared by: Jeffrey A. Klatzkow, County Attorney
ATTACHMENT(S)
1. 2022-14928 UNEX. Collier County (PDF)
2. Interlocal Exhibit A MOU (PDF)
3. Interlocal Exhibit B Resolution 2021-136 (PDF)
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10/25/2022
COLLIER COUNTY
Board of County Commissioners
Item Number: 16.K.1
Doc ID: 23568
Item Summary: Recommendation to approve the Interlocal Agreement between the City of Naples and Collier
County relating to the expenditure of certain settlement funds received from the State of Florida regarding In Re:
National Prescription Opioid Litigation in furtherance of the Florida Attorney General’s Memorandum of
Understanding and Resolution 2021-136.
Meeting Date: 10/25/2022
Prepared by:
Title: – County Attorney's Office
Name: Madison Bird
10/06/2022 2:35 PM
Submitted by:
Title: County Attorney – County Attorney's Office
Name: Jeffrey A. Klatzkow
10/06/2022 2:35 PM
Approved By:
Review:
Community & Human Services Kristi Sonntag Additional Reviewer Completed 10/06/2022 4:42 PM
Office of Management and Budget Debra Windsor Level 3 OMB Gatekeeper Review Completed 10/07/2022 8:35 AM
County Attorney's Office Jeffrey A. Klatzkow Level 3 County Attorney's Office Review Completed 10/07/2022 10:56 AM
Office of Management and Budget Susan Usher Additional Reviewer Completed 10/14/2022 4:43 PM
Office of Management and Budget Christopher Johnson Additional Reviewer Completed 10/17/2022 11:21 AM
County Manager's Office Amy Patterson Level 4 County Manager Review Completed 10/19/2022 9:30 AM
Board of County Commissioners Geoffrey Willig Meeting Pending 10/25/2022 9:00 AM
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COLLIER COUNTY INTERLOCAL AGREEMENT GOVERNING USE OF
REGIONAL OPIOID SETTLEMENT FUNDS
THIS INTERLOCAL AGREEMENT ("Agreement") is made and entered into, by and between
Collier County, a political subdivision of the State of Florida, hereinafter referred to as the
"County," and the City of Naples, a municipal corporation of the State of Florida, hereinafter
referred to as the "City."
WHEREAS, a local, state and national crisis arose as a result of the manufacturing, distribution
and over-prescribing ofopioids, and resulted in opioid abuse, misuse, overdoses, addictions, and
death throughout municipalities, counties, states, and the nation and contributed to the public
health emergency and crisis commonly referred to as the opioid epidemic; and
WHEREAS, Collier County and the municipalities therein are not immune from this nationwide
crisis; and
WHEREAS, the crisis has caused and is causing an undue strain on local government finances
to implement programing to combat the opioid epidemic, to mitigate the harmful effects of the
opioid epidemic in the community, and to increase educational campaigns to counteract mis-
information about the addictive nature and harmful effects ofopioids; and
WHEREAS, opioid abuse rose throughout the United States, Florida has been hit especially hard;
and
WHEREAS, pharmaceutical companies involved in the supply chain including, but not limited
to, distributors, manufacturers, dispensing companies, and marketing agencies contributed to the
great harm suffered by the State of Florida and Collier County as a result of the opioid epidemic;
and
WHEREAS, as a result of litigation filed by the State of Florida and various local
governments against various pharmaceutical companies involved in the supply chain,
multiple defendants have begun to negotiate settlements; and
WHEREAS, the Attorney General for the State of Florida (hereinafter "Attorney General")
anticipates that Settlement funds will be distributed to the State of Florida over multiple years
as part of a global settlement, and not directly to the Cities and Counties; and
WHEREAS, the Attorney General has proposed entering into agreements with local
governments within the State of Florida to receive settlement funds. This agreement
(hereinafter referred to as the "State MOU"), as currently drafted, divides settlement funds
into three portions designated as City/County, Regional, and State funds; and
WHEREAS, it is anticipated that the State MOU will set forth the amount and manner of
distribution of City/County and Regional Settlement funds within Florida, the requirements
to receive and manage Regional funds, and the purposes for which Regional funds may be
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Packet Pg. 1570 Attachment: 2022-14928 UNEX. Collier County (23568 : Interlocal Agreement with the City of Naples on National Prescription Opioid Litigation)
used. The current draft of the State MOU is attached hereto as Exhibit A, and Resolution
2021-136 approving in concept the State MOU by Collier County is attached as Exhibit B;
and
WHEREAS, the parties recognize that local control over settlement funds is in the best
interest of all persons within the geographic boundaries of Collier County and ensures that
settlement funds are available and used to address opioid-related impacts within Collier
County and the parties are committed to the County qualifying as a "Qualified County" and
thereby receiving Regional funds pursuant to the State MOU; and
WHEREAS, the State MOU requires that in order for Collier County to become a Qualified
County eligible to receive Regional Funding, there must be an interlocal agreement among
Collier County and Municipalities, as defined in the MOU, with combined population
exceeding 50% of the total population of the Municipalities within Collier County, with the
term "Municipalities" being defined for the purpose in this Agreement as those municipalities
with a population of 10,000 or more as required by the State MOU; or with population
less than 10,000 who were party plaintiffs; population for purposes of the MOU is
determined by specific Census data; and
WHEREAS, historically, govemment-funded programming geared toward abating the
opioid crisis has been data driven based upon community impacts without regard to
governmental jurisdictional boundaries; and
WHEREAS, the parties recognize that it is in the best interest of the County and the Cities
to enter into this interlocal agreement to ensure Collier County is a "Qualified County" to
receive Regional Funding pursuant to the State MOU;
NOW, THEREFORE, in consideration of the covenants herein contained, and other good
and valuable consideration, the parties agree as follows:
Section 1: DeHnitions:
A. Unless otherwise defined herein, all defined terms in the State MOU are
incorporated herein and shall have the same meanings as in the State MOU.
B. "Collier County Regional Funding" shall mean the amount of the Regional
Funding paid to Collier County in its role as a Qualified County
Section 2: Conditions Precedent:
This Agreement shall become effective on the Commencement Date set forth in Section 4,
so long as the following conditions precedent have been satisfied:
A. Collier County being detennined by the State of Florida to qualify as a "Qualified
County" to receive and disburse Regional Fund monies under the Allocation
Agreement;
B. Execution of this Agreement by the County and the governing bodies of the
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16.K.1.a
Packet Pg. 1571 Attachment: 2022-14928 UNEX. Collier County (23568 : Interlocal Agreement with the City of Naples on National Prescription Opioid Litigation)
municipalities as required by the State MOU to enable Collier County to
become a Qualified County and directly receive Collier County Regional
Funding; and
C. Execution of all documents necessary to effectuate the State MOU in its final form;
and
D. Filing of this Agreement with the Clerk of the Circuit Court for Collier County
as required by Florida Statutes, Section 163.01.
Section 3: Execution:
This Interlocal Agreement may be executed in counterparts by the parties hereto.
Section 4: Term:
The term of this Agreement and the obligations hereunder commences upon the satisfaction of all
conditions precedent, runs concurrently with the State MOU, and will continue until one (1) year
after the expenditure of all Collier County Regional Fundmg, unless otherwise terminated in
accordance with the provisions of the State MOU. Obligations under this Agreement which by
their nature should survive, including, but not limited to any and all obligations relating to
record retention, audit, and indemnification will remain in effect after termination or expiration
of this Agreement.
Section 5: Use of Settlement Proceeds:
A. Collier County Regional Funding will be used in accordance with the requirements
of the State MOU.
B. Collier County Regional Funding may be used to enhance current programs or
develop new programs. However, Collier County Regional Funding is not intended
to supplant current funding sources or general funds.
Section 6: Administrative Costs:
The County is responsible for administering the "Regional Funds" remitted pursuant to the
State MOU and, therefore County staff will provide support services including but not
limited to legal services, as well as contract management, program monitoring, and reporting
required by the State MOU. Accordingly, the County and City agree that the County is
entitled to the maximum allowable administrative fee pursuant to the State MOU. The
administrative fee will be deducted annually from the amount of available Collier County
Regional Funds, and the remaining Collier County Regional Funds will be spent as provided
in the State MOU and as provided herein. The City shall receive no more than its pro rata
share of Collier County Regional Funding, based on the Negotiation Class Metrics
provided for in the State MOU.
Section 7: Local Government S endin and Re ortin Re uirements:
To the extent that the local governmental entity receives Collier County Regional Funds
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Packet Pg. 1572 Attachment: 2022-14928 UNEX. Collier County (23568 : Interlocal Agreement with the City of Naples on National Prescription Opioid Litigation)
directly from the County, any local govermnental entity so receiving funds must spend such
funds for Approved Purposes and must timely satisfy all reporting requirements of the MOU.
Failure to comply with this provision may disqualify the local governmental entity from
further direct receipt of Collier County Regional Funds. Collier County, in its role as
Qualified County receiving Regional Funds that are appropriated for use by another local
governmental entity, is merely a "pass-through" vehicle for such funds, and the
responsibility to spend Regional Funds received on eligible programs and expenses is that
of the receiving local government and not Collier County, Florida.
Section 8: Non-A ro nation:
This Agreement is not a general obligation of the County. It is understood that neither this
Agreement nor any representation by any County official, officer or employee creates any
obligation to appropriate or make monies available for the purposes of the Agreement. The
obligations of the County as to funding required pursuant to the Agreement are limited to an
obligation in any given fiscal year to budget and appropriate from Collier County Regional
Funds annually which are designated for regional use pursuant to the tenns of the State MOU.
No liability shall be incurred by the County beyond the monies budgeted and available for
the purpose of the Agreement from expected settlement funds. If Regional Funds are not
received by the County for any or all of this Agreement for a new fiscal period, the County
is not obligated to pay or spend any sums contemplated by this Agreement beyond the
portions for which Regional Funds were received and appropriated. The County agrees to
promptly notify the Cities in writing of any subsequent non-appropriation, and upon such
notice, this Agreement will terminate on the last day of the current fiscal year without
penalty to the County and all undistributed funds will be spent for programs previously
adopted.
Section 9: Indemnification:
City and the County shall be responsible for their respective employees' acts of negligence
when such employees are acting within the scope of their employment and shall only be
liable for any damages resulting from said negligence to the extent permitted by Section
768.28, Florida Statutes. Nothing herein shall be consfa-ued as a waiver of sovereign
immunity, or the provisions of F.S. § 768.28, by either Party. Nothing herein shall be
consta-ued as consent by either Party to be sued by third parties for any matter arising out of
this Agreement. Collier County, Florida, is not responsible for the failure of City to spend
funds for Approved Purposes and in accordance with the allocation of such funds by Collier
County in its role as a Qualified County. To the extent allowed by law, City indemnifies and
will defend Collier County, Florida, with respect to any legal challenge of any nature related
to City's receipt and/or use of settlement funds, including any Regional Funds received by
City through and/or from Collier County.
Section 10: Severabili :
If any item or provision of this Agreement, or the application thereof to any person or
circumstances shall, to any extent, be held invalid or unenforceable, the remainder of this
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16.K.1.a
Packet Pg. 1573 Attachment: 2022-14928 UNEX. Collier County (23568 : Interlocal Agreement with the City of Naples on National Prescription Opioid Litigation)
Agreement, or the further application of such terms or provision, shall not be affected, and
every other tenn and provision of this Agreement shall be deemed valid and enforceable to
the extent permitted by law.
Section 11: Amendments to A reement:
This Agreement, or amendments hereto, shall be executed on behalf of each participating
jurisdiction by its duly authorized representative and pursuant to an appropriate motion,
resolution, or ordinance of each participating jurisdiction. This Agreement, or any amendment
thereto, shall be deemed adopted upon the date of execution by each authorized representative
and filing in the official records of Collier County, Florida.
Section 12: Filin of A reement:
This Interlocal Agreement shall be filed by the County in the official records of Collier
County, Florida, within ten (10) days of its execution by all parties hereto.
Section 13: Governin Law
This Agreement shall be governed by the laws of the State of Florida. All legal actions to
enforce the Agreement shall be held in the Twentieth Judicial Circuit in and for Collier
County. No remedy conferred in this Agreement is intended to be exclusive of any other
remedy, at law or in equity, or by statute or otherwise. No exercise by any party of any
right, power, or remedy hereunder shall preclude any other or further exercise thereof.
Section 14: Corn lete A reement Modifications to A reement:
This Agreement sets forth the entire agreement between the parties. There are no promises
or understandings other than those stated herein. None of the provisions, terms, or
conditions contained in this Agreement may be modified, superseded, or otherwise altered,
except by written agreement of the parties.
IN WITNESS WHEREOF, City and the County have signed and sealed this Interlocal
Agreement as set forth below.
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Packet Pg. 1574 Attachment: 2022-14928 UNEX. Collier County (23568 : Interlocal Agreement with the City of Naples on National Prescription Opioid Litigation)
Date:
AS TO THE COUNTY:
ATTEST:
Crystal K. Kinzel, Clerk of Courts
BOARD OF COUNTY COMMISSIONERS
COLLIER COUNTY, FLORIDA
By:
, Deputy Clerk
By:
William L. McDaniel, Jr., Chairman
Approved as to form and legality:
Jeffrey A. Klatzkow, County Attorney
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Packet Pg. 1575 Attachment: 2022-14928 UNEX. Collier County (23568 : Interlocal Agreement with the City of Naples on National Prescription Opioid Litigation)
AS TO THE CITY OF NAPLES:
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Teresa Lee Heittnann, ayor
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Na cy Stu rich, City Attorney
[2 l-SHF-00250/1740546/1]
16.K.1.a
Packet Pg. 1576 Attachment: 2022-14928 UNEX. Collier County (23568 : Interlocal Agreement with the City of Naples on National Prescription Opioid Litigation)
000003/01288125_1
PROPOSAL
MEMORANDUM OF UNDERSTANDING
Whereas, the people of the State of Florida and its communities have been harmed by
misfeasance, nonfeasance and malfeasance committed by certain entities within the
Pharmaceutical Supply Chain;
Whereas, the State of Florida, through its Attorney General, and certain Local
Governments, through their elected representatives and counsel, are separately engaged in
litigation seeking to hold Pharmaceutical Supply Chain Participants accountable for the damage
caused by their misfeasance, nonfeasance and malfeasance;
Whereas, the State of Florida and its Local Governments share a common desire to abate
and alleviate the impacts of that misfeasance, nonfeasance and malfeasance throughout the State
of Florida;
Whereas, it is the intent of the State of Florida and its Local Governments to use the
proceeds from Settlements with Pharmaceutical Supply Chain Participants to increase the amount
of funding presently spent on opioid and substance abuse education, treatment and other related
programs and services, such as those identified in Exhibits A and B, and to ensure that the funds
are expended in compliance with evolving evidence-based “best practices”;
Whereas, the State of Florida and its Local Governments, subject to the completion of
formal documents that will effectuate the Parties’ agreements, enter into this Memorandum of
Understanding (“MOU”) relating to the allocation and use of the proceeds of Settlements described
herein; and
Whereas, this MOU is a preliminary non-binding agreement between the Parties, is not
legally enforceable, and only provides a basis to draft formal documents which will effectuate the
Parties’ agreements.
A. Definitions
As used in this MOU:
1. “Approved Purpose(s)” shall mean forward-looking strategies, programming and
services used to expand the availability of treatment for individuals impacted by substance use
disorders, to: (a) develop, promote, and provide evidence-based substance use prevention
strategies; (b) provide substance use avoidance and awareness education; (c) decrease the
oversupply of licit and illicit opioids; and (d) support recovery from addiction. Approved Purposes
shall include, but are not limited to, the opioid abatement strategies listed on Exhibits A and B
which are incorporated herein by reference.
2. “Local Governments” shall mean all counties, cities, towns and villages located
within the geographic boundaries of the State.
3. “Managing Entities” shall mean the corporations selected by and under contract
with the Florida Department of Children and Families or its successor (“DCF”) to manage the
16.K.1.b
Packet Pg. 1577 Attachment: Interlocal Exhibit A MOU (23568 : Interlocal Agreement with the City of Naples on National Prescription Opioid Litigation)
daily operational delivery of behavioral health services through a coordinated system of care. The
singular “Managing Entity” shall refer to a singular of the Managing Entities.
4. “County” shall mean a political subdivision of the state established pursuant to s.
1, Art. VIII of the State Constitution.
5. “Municipalities” shall mean cities, towns, or villages of a County within the State
with a Population greater than 10,000 individuals and shall also include cities, towns or villages
within the State with a Population equal to or less than 10,000 individuals which filed a Complaint
in this litigation against Pharmaceutical Supply Chain Participants. The singular “Municipality”
shall refer to a singular of the Municipalities.
6. ‘‘Negotiating Committee” shall mean a three-member group comprised by
representatives of the following: (1) the State; and (2) two representatives of Local Governments
of which one representative will be from a Municipality and one shall be from a County
(collectively, “Members”) within the State. The State shall be represented by the Attorney General
or her designee.
7. “Negotiation Class Metrics” shall mean those county and city settlement allocations
which come from the official website of the Negotiation Class of counties and cities certified on
September 11, 2019 by the U.S. District for the Northern District of Ohio in In re National
Prescription Opiate Litigation, MDL No. 2804 (N.D. Ohio). The website is located at
https://allocationmap.iclaimsonline.com.
8. “Opioid Funds” shall mean monetary amounts obtained through a Settlement as
defined in this MOU.
9. “Opioid Related” shall have the same meaning and breadth as in the agreed Opioid
Abatement Strategies attached hereto as Exhibits A or B.
10. “Parties” shall mean the State and Local Governments. The singular word “Party”
shall mean either the State or Local Governments.
11. “PEC” shall mean the Plaintiffs’ Executive Committee of the National Prescription
Opiate Multidistrict Litigation pending in the United States District Court for the Northern District
of Ohio.
12. “Pharmaceutical Supply Chain” shall mean the process and channels through which
Controlled Substances are manufactured, marketed, promoted, distributed or dispensed.
13. “Pharmaceutical Supply Chain Participant” shall mean any entity that engages in,
or has engaged in the manufacture, marketing, promotion, distribution or dispensing of an opioid
analgesic.
14. “Population” shall refer to published U.S. Census Bureau population estimates as
of July 1, 2019, released March 2020, and shall remain unchanged during the term of this MOU.
These estimates can currently be found at https://www.census.gov
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Packet Pg. 1578 Attachment: Interlocal Exhibit A MOU (23568 : Interlocal Agreement with the City of Naples on National Prescription Opioid Litigation)
15. “Qualified County” shall mean a charter or non-chartered county within the State
that: has a Population of at least 300,000 individuals and (a) has an opioid taskforce of which it is
a member or operates in connection with its municipalities or others on a local or regional basis;
(b) has an abatement plan that has been either adopted or is being utilized to respond to the opioid
epidemic; (c) is currently either providing or is contracting with others to provide substance abuse
prevention, recovery, and treatment services to its citizens; and (d) has or enters into an agreement
with a majority of Municipalities (Majority is more than 50% of the Municipalities’ total
population) related to the expenditure of Opioid Funds. The Opioid Funds to be paid to a Qualified
County will only include Opioid Funds for Municipalities whose claims are released by the
Municipality or Opioid Funds for Municipalities whose claims are otherwise barred.
16. “SAMHSA” shall mean the U.S. Department of Health & Human Services,
Substance Abuse and Mental Health Services Administration.
17. “Settlement” shall mean the negotiated resolution of legal or equitable claims
against a Pharmaceutical Supply Chain Participant when that resolution has been jointly entered
into by the State and Local Governments or a settlement class as described in (B)(1) below.
18. “State” shall mean the State of Florida.
B. Terms
1. Only Abatement - Other than funds used for the Administrative Costs and Expense
Fund as hereinafter described in paragraph 6 and paragraph 9, respectively), all Opioid Funds shall
be utilized for Approved Purposes. To accomplish this purpose, the State will either file a new action
with Local Governments as Parties or add Local Governments to its existing action, sever settling
defendants, and seek entry of a consent order or other order binding both the State, Local
Governments, and Pharmaceutical Supply Chain Participant(s) (“Order”). The Order may be part
of a class action settlement or similar device. The Order shall provide for continuing jurisdiction of
a state court to address non-performance by any party under the Order. Any Local Government that
objects to or refuses to be included under the Order or entry of documents necessary to effectuate a
Settlement shall not be entitled to any Opioid Funds and its portion of Opioid Funds shall be
distributed to, and for the benefit of, the other Local Governments.
2. Avoid Claw Back and Recoupment - Both the State and Local Governments wish
to maximize any Settlement and Opioid Funds. In addition to committing to only using funds for
the Expense Funds, Administrative Costs and Approved Purposes, both Parties will agree to utilize
a percentage of funds for the core strategies highlighted in Exhibit A. Exhibit A contains the
programs and strategies prioritized by the U.S. Department of Justice and/or the U.S. Department
of Health & Human Services (“Core Strategies”). The State is trying to obtain the United States’
agreement to limit or reduce the United States’ ability to recover or recoup monies from the State
and Local Government in exchange for prioritization of funds to certain projects. If no agreement
is reached with the United States, then there will be no requirement that a percentage be utilized
for Core Strategies.
16.K.1.b
Packet Pg. 1579 Attachment: Interlocal Exhibit A MOU (23568 : Interlocal Agreement with the City of Naples on National Prescription Opioid Litigation)
3. Distribution Scheme - All Opioid Funds will initially go to the State, and then be
distributed according to the following distribution scheme. The Opioid Funds will be divided into
three funds after deducting costs of the Expense Fund detailed in paragraph 9 below:
(a) City/County Fund- The city/county fund will receive 15% of all Opioid Funds to
directly benefit all Counties and Municipalities. The amounts to be distributed to
each County and Municipality shall be determined by the Negotiation Class Metrics
or other metrics agreed upon, in writing, by a County and a Municipality. For Local
Governments that are not within the definition of County or Municipality, those
Local Governments may receive that government’s share of the City/County Fund
under the Negotiation Class Metrics, if that government executes a release as part
of a Settlement. Any Local Government that is not within the definition of County
or Municipality and that does not execute a release as part of a Settlement shall
have its share of the City/County Fund go to the County in which it is located.
(b) Regional Fund- The regional fund will be subdivided into two parts.
(i) The State will annually calculate the share of each County within the State
of the regional fund utilizing the sliding scale in section 4 of the allocation
contained in the Negotiation Class Metrics or other metrics that the Parties
agree upon.
(ii) For Qualified Counties, the Qualified County’s share will be paid to the
Qualified County and expended on Approved Purposes, including the
Core Strategies identified in Exhibit A, if applicable.
(iii) For all other Counties, the regional share for each County will be paid to
the Managing Entities providing service for that County. The Managing
Entities will be required to expend the monies on Approved Purposes,
including the Core Strategies. The Managing Entities shall endeavor to
the greatest extent possible to expend these monies on counties within
the State that are non-Qualified Counties and to ensure that there are
services in every County.
(c) State Fund - The remainder of Opioid Funds after deducting the costs of the
Expense Fund detailed in paragraph 9, the City/County Fund and the Regional Fund
will be expended by the State on Approved Purposes, including the provisions
related to Core Strategies, if applicable.
(d) To the extent that Opioid Funds are not appropriated and expended in a year by the
State, the State shall identify the investments where settlement funds will be
deposited. Any gains, profits, or interest accrued from the deposit of the Opioid
Funds to the extent that any funds are not appropriated and expended within a
calendar year, shall be the sole property of the Party that was entitled to the initial
deposit.
16.K.1.b
Packet Pg. 1580 Attachment: Interlocal Exhibit A MOU (23568 : Interlocal Agreement with the City of Naples on National Prescription Opioid Litigation)
4. Regional Fund Sliding Scale- The Regional Fund shall be calculated by utilizing
the following sliding scale of the Opioid Funds available in any year:
A. Years 1-6: 40%
B. Years 7-9: 35%
C. Years 10-12: 34%
D. Years 13-15: 33%
E. Years 16-18: 30%
5. Opioid Abatement Taskforce or Council - The State will create an Opioid
Abatement Taskforce or Council (sometimes hereinafter “Taskforce” or “Council”) to advise the
Governor, the Legislature, Florida’s Department of Children and Families (“DCF”), and Local
Governments on the priorities that should be addressed as part of the opioid epidemic and to review
how monies have been spent and the results that have been achieved with Opioid Funds.
(a) Size - The Taskforce or Council shall have ten Members equally balanced between
the State and the Local Governments.
(b) Appointments Local Governments - Two Municipality representatives will be
appointed by or through Florida League of Cities. Two county representatives, one
from a Qualified County and one from a county within the State that is not a
Qualified County, will be appointed by or through the Florida Association of
Counties. The final representative will alternate every two years between being a
county representative (appointed by or through Florida Association of Counties) or
a Municipality representative (appointed by or through the Florida League of
Cities). One Municipality representative must be from a city of less than 50,000
people. One county representative must be from a county less than 200,000 people
and the other county representative must be from a county whose population
exceeds 200,000 people.
(c) Appointments State -
(i) The Governor shall appoint two Members.
(ii) The Speaker of the House shall appoint one Member.
(iii) The Senate President shall appoint one Member.
(iv) The Attorney General or her designee shall be a Member.
(d) Chair - The Attorney General or designee shall be the chair of the Taskforce or
Council.
(e) Term - Members will be appointed to serve a two-year term.
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Packet Pg. 1581 Attachment: Interlocal Exhibit A MOU (23568 : Interlocal Agreement with the City of Naples on National Prescription Opioid Litigation)
(f) Support - DCF shall support the Taskforce or Council and the Taskforce or Council
shall be administratively housed in DCF.
(g) Meetings - The Taskforce or Council shall meet quarterly in person or virtually
using communications media technology as defined in section 120.54(5)(b)(2),
Florida Statutes.
(h) Reporting - The Taskforce or Council shall provide and publish a report annually
no later than November 30th or the first business day after November 30th, if
November 30th falls on a weekend or is otherwise not a business day. The report
shall contain information on how monies were spent the previous fiscal year by the
State, each of the Qualified Counties, each of the Managing Entities, and each of
the Local Governments. It shall also contain recommendations to the Governor,
the Legislature, and Local Governments for priorities among the Approved
Purposes for how monies should be spent the coming fiscal year to respond to the
opioid epidemic.
(i) Accountability - Prior to July 1st of each year, the State and each of the Local
Governments shall provide information to DCF about how they intend to expend
Opioid Funds in the upcoming fiscal year. The State and each of the Local
Government shall report its expenditures to DCF no later than August 31st for the
previous fiscal year. The Taskforce or Council will set other data sets that need to
be reported to DCF to demonstrate the effectiveness of Approved Purposes. All
programs and expenditures shall be audited annually in a similar fashion to
SAMHSA programs. Local Governments shall respond and provide documents to
any reasonable requests from the State for data or information about programs
receiving Opioid Funds.
(j) Conflict of Interest - All Members shall adhere to the rules, regulations and laws of
Florida including, but not limited to, Florida Statute §112.311, concerning the
disclosure of conflicts of interest and recusal from discussions or votes on
conflicted matters.
6. Administrative Costs- The State may take no more than a 5% administrative fee
from the State Fund (“Administrative Costs”) and any Regional Fund that it administers for
counties that are not Qualified Counties. Each Qualified County may take no more than a 5%
administrative fee from its share of the Regional Funds.
7. Negotiation of Non-Multistate Settlements - If the State begins negotiations with
a Pharmaceutical Supply Chain Participant that is separate and apart from a multi-state negotiation,
the State shall include Local Governments that are a part of the Negotiating Committee in such
negotiations. No Settlement shall be recommended or accepted without the affirmative votes of
both the State and Local Government representatives of the Negotiating Committee.
8. Negotiation of Multistate or Local Government Settlements - To the extent
practicable and allowed by other parties to a negotiation, both Parties agree to communicate with
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Packet Pg. 1582 Attachment: Interlocal Exhibit A MOU (23568 : Interlocal Agreement with the City of Naples on National Prescription Opioid Litigation)
members of the Negotiation Committee regarding the terms of any other Pharmaceutical Supply
Chain Participant Settlement.
9. Expense Fund - The Parties agree that in any negotiation every effort shall be made
to cause Pharmaceutical Supply Chain Participants to pay costs of litigation, including attorneys’
fees, in addition to any agreed to Opioid Funds in the Settlement. To the extent that a fund
sufficient to pay the entirety of all contingency fee contracts for Local Governments in the State
of Florida is not created as part of a Settlement by a Pharmaceutical Supply Chain Participant, the
Parties agree that an additional expense fund for attorneys who represent Local Governments
(herein “Expense Fund”) shall be created out of the City/County fund for the purpose of paying
the hard costs of a litigating Local Government and then paying attorneys’ fees.
(a) The Source of Funds for the Expense Fund- Money for the Expense Fund shall be
sourced exclusively from the City/County Fund.
(b) The Amount of the Expense Fund- The State recognizes the value litigating Local
Governments bring to the State of Florida in connection with the Settlement
because their participation increases the amount Incentive Payments due from each
Pharmaceutical Supply Chain Participant. In recognition of that value, the amount
of funds that shall be deposited into the Expense fund shall be contingent upon on
the percentage of litigating Local Government participation in the Settlement,
according to the following table:
Litigating Local Government
Participation in the
Settlement (by percentage of
the population)
Amount that shall be paid
into the Expense Fund
from (and as a percentage
of) the City/County fund
96 to 100% 10%
91 to 95% 7.5%
86 to 90% 5%
85% 2.5%
Less than 85% 0%
If fewer than 85% percent of the litigating Local Governments (by population)
participate, then the Expense Fund shall not be funded, and this Section of the MOU
shall be null and void.
(c) The Timing of Payments into the Expense Fund- Although the amount of the
Expense Fund shall be calculated based on the entirety of payments due to the
City/County fund over a ten to eighteen year period, the Expense Fund shall be
funded entirely from payments made by Pharmaceutical Supply Chain Participants
during the first two years of the Settlement. Accordingly, to offset the amounts
being paid from the City/County to the Expense Fund in the first two years,
Counties or Municipalities may borrow from the Regional Fund during the first two
years and pay the borrowed amounts back to the Regional Fund during years three,
four, and five.
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Packet Pg. 1583 Attachment: Interlocal Exhibit A MOU (23568 : Interlocal Agreement with the City of Naples on National Prescription Opioid Litigation)
For the avoidance of doubt, the following provides an illustrative example regarding the
calculation of payments and amounts that may be borrowed under the terms of this MOU,
consistent with the provisions of this Section:
Opioid Funds due to State of Florida and Local Governments (over 10 to 18 years): $1,000
Litigating Local Government Participation: 100%
City/County Fund (over 10 to 18 years): $150
Expense Fund (paid over 2 years): $15
Amount Paid to Expense Fund in 1st year: $7.5
Amount Paid to Expense Fund in 2nd year $7.5
Amount that may be borrowed from Regional Fund in 1st year: $7.5
Amount that may be borrowed from Regional Fund in 2nd year: $7.5
Amount that must be paid back to Regional Fund in 3rd year: $5
Amount that must be paid back to Regional Fund in 4th year: $5
Amount that must be paid back to Regional Fund in 5th year: $5
(d) Creation of and Jurisdiction over the Expense Fund- The Expense Fund shall be
established, consistent with the provisions of this Section of the MOU, by order of
the Circuit Court of the Sixth Judicial Circuit in and for Pasco County, West Pasco
Division New Port Richey, Florida, in the matter of The State of Florida, Office of
the Attorney General, Department of Legal Affairs v. Purdue Pharma L.P., et al.,
Case No. 2018-CA-001438 (the “Court”). The Court shall have jurisdiction over
the Expense Fund, including authority to allocate and disburse amounts from the
Expense Fund and to resolve any disputes concerning the Expense Fund.
(e) Allocation of Payments to Counsel from the Expense Fund- As part of the order
establishing the Expense Fund, counsel for the litigating Local Governments shall
seek to have the Court appoint a third-neutral to serve as a special master for
purposes of allocating the Expense Fund. Within 30 days of entry of the order
appointing a special master for the Expense Fund, any counsel who intend to seek
an award from the Expense Fund shall provide the copies of their contingency fee
contracts to the special master. The special master shall then build a mathematical
model, which shall be based on each litigating Local Government’s share under the
Negotiation Class Metrics and the rate set forth in their contingency contracts, to
calculate a proposed award for each litigating Local Government who timely
provided a copy of its contingency contract.
10. Dispute resolution- Any one or more of the Local Governments or the State may
object to an allocation or expenditure of Opioid Funds solely on the basis that the allocation or
expenditure at issue (a) is inconsistent with the Approved Purposes; (b) is inconsistent with the
distribution scheme as provided in paragraph 3, or (c) violates the limitations set forth herein with
respect to administrative costs or the Expense Fund. There shall be no other basis for bringing an
objection to the approval of an allocation or expenditure of Opioid Funds.
16.K.1.b
Packet Pg. 1584 Attachment: Interlocal Exhibit A MOU (23568 : Interlocal Agreement with the City of Naples on National Prescription Opioid Litigation)
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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”)[, such that a minimum of __% of the [aggregate] state-level abatement distributions shall
be spent on [one or more of] them annually].1
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-Assisted Treatment (“MAT”) Distribution and other opioid-related treatment
1. Increase distribution of MAT to non-Medicaid eligible or uninsured individuals;
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. 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 with other support services.
C. Pregnant & Postpartum Women
1. 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 Opioid Use Disorder (OUD)
including housing, transportation, job placement/training, and childcare.
D. Expanding Treatment for Neonatal Abstinence Syndrome
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.
1 As used in this Schedule A, words like “expand,” “fund,” “provide” or the like shall not indicate a preference for new or
existing programs. Priorities will be established through the mechanisms described in the Term Sheet.
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Packet Pg. 1585 Attachment: Interlocal Exhibit A MOU (23568 : Interlocal Agreement with the City of Naples on National Prescription Opioid Litigation)
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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.
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
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.
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Packet Pg. 1586 Attachment: Interlocal Exhibit A MOU (23568 : Interlocal Agreement with the City of Naples on National Prescription Opioid Litigation)
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Schedule B
Approved Uses
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, the following:2
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. 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.
8. 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. Fellowships for addiction medicine specialists for direct patient care, instructors, and clinical
research for treatments.
11. Scholarships and supports for behavioral health practitioners or workers involved in addressing
OUD and any co-occurring SUD or mental health conditions, including but not limited to training,
2 As used in this Schedule B, words like “expand,” “fund,” “provide” or the like shall not indicate a preference for new or
existing programs. Priorities will be established through the mechanisms described in the Term Sheet.
16.K.1.b
Packet Pg. 1587 Attachment: Interlocal Exhibit A MOU (23568 : Interlocal Agreement with the City of Naples on National Prescription Opioid Litigation)
4
scholarships, fellowships, loan repayment programs, or other incentives for providers to work in rural
or underserved areas.
12. [Intentionally Blank – to be cleaned up later for numbering]
13. 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.
14. Dissemination of web-based training curricula, such as the American Academy of Addiction
Psychiatry’s Provider Clinical Support Service-Opioids web-based training curriculum and
motivational interviewing.
15. Development and dissemination of new curricula, such as the American Academy of Addiction
Psychiatry’s Provider Clinical Support Service for Medication-Assisted Treatment.
B. SUPPORT PEOPLE IN TREATMENT AND RECOVERY
Support people in treatment for or 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 following:
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.
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 medication 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.
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Packet Pg. 1588 Attachment: Interlocal Exhibit A MOU (23568 : Interlocal Agreement with the City of Naples on National Prescription Opioid Litigation)
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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. 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 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, the following:
1. Ensure that health care providers are screening for OUD and other risk factors and know how to
appropriately counsel and treat (or refer if necessary) a patient for OUD treatment.
2. Fund Screening, Brief Intervention and Referral to Treatment (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. 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.
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Packet Pg. 1589 Attachment: Interlocal Exhibit A MOU (23568 : Interlocal Agreement with the City of Naples on National Prescription Opioid Litigation)
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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.
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,
the following:
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:
a. Self-referral strategies such as the Angel Programs or the Police Assisted Addiction Recovery
Initiative (PAARI);
b. Active outreach strategies such as the Drug Abuse Response Team (DART) model;
c. “Naloxone Plus” strategies, which work to ensure that individuals who have received
naloxone to reverse the effects of an overdose are then linked to treatment programs or other
appropriate services;
d. Officer prevention strategies, such as the Law Enforcement Assisted Diversion (LEAD)
model;
e. Officer intervention strategies such as the Leon County, Florida Adult Civil Citation Network
or the Chicago Westside Narcotics Diversion to Treatment Initiative; or
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Packet Pg. 1590 Attachment: Interlocal Exhibit A MOU (23568 : Interlocal Agreement with the City of Naples on National Prescription Opioid Litigation)
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f. 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
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 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 (NAS),
through evidence-based or evidence-informed programs or strategies that may include, but are not
limited to, the following:
1. 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. Training for obstetricians or other healthcare personnel that work with pregnant women and their
families regarding treatment of OUD and any co-occurring SUD/MH conditions.
4. Expand comprehensive evidence-based treatment and recovery support for NAS babies; expand
services for better continuum of care with infant-need dyad; 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 Neonatal Abstinence
Syndrome get referred to appropriate services and receive a plan of safe care.
6. Child and family supports for parenting women with OUD and any co-occurring SUD/MH
conditions.
7. Enhanced family supports 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. 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. Fund medical provider education and outreach regarding best prescribing practices for opioids
consistent with 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. Support for non-opioid pain treatment alternatives, including training providers to offer or refer to
multi-modal, evidence-informed treatment of pain.
5. Support enhancements or improvements to Prescription Drug Monitoring Programs (PDMPs),
including but not limited to improvements that:
a. Increase the number of prescribers using PDMPs;
b. Improve point-of-care decision-making by increasing the quantity, quality, or format of data
available to prescribers using PDMPs, by improving the interface that prescribers use to access
PDMP data, or both; or
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c. Enable states to use PDMP data in support of surveillance or intervention strategies, including
MAT referrals and follow-up for individuals identified within PDMP data as likely to
experience OUD 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. Increase electronic prescribing to prevent diversion or forgery.
8. Educate Dispensers on appropriate opioid dispensing.
G. PREVENT MISUSE OF OPIOIDS
Support efforts to discourage or prevent misuse of opioids through evidence-based or evidence-
informed programs or strategies that may include, but are not limited to, the following:
1. Fund 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. Fund community anti-drug coalitions that engage in drug prevention efforts.
6. Support community coalitions in implementing evidence-informed prevention, such as reduced
social access and physical access, stigma reduction – including staffing, educational campaigns, support
for people in treatment or recovery, or training of coalitions in evidence-informed implementation,
including the Strategic Prevention Framework developed by the U.S. Substance Abuse and Mental
Health Services Administration (SAMHSA).
7. Engage non-profits and faith-based communities as systems to support prevention.
8. Fund 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 of 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
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mental health needs in young people that (when not properly addressed) increase the risk of opioid or
other drug misuse.
H. PREVENT OVERDOSE DEATHS AND OTHER HARMS (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. Increase 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, individuals
at high risk of overdose, schools, community navigators and outreach workers, persons being released
from jail or prison, or other members of the general public.
2. Public health entities provide 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. Enable school nurses and other school staff to respond to opioid overdoses, and provide them with
naloxone, training, and support.
5. Expand, improve, or develop data tracking software and applications for overdoses/naloxone
revivals.
6. Public education relating to emergency responses to overdoses.
7. Public education relating to immunity and Good Samaritan laws.
8. Educate first responders regarding the existence and operation of immunity and Good Samaritan
laws.
9. 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. Expand access to testing and treatment for infectious diseases such as HIV and Hepatitis C resulting
from intravenous opioid use.
11. Support 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. Provide 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. Support screening for fentanyl in routine clinical toxicology testing.
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PART THREE: OTHER STRATEGIES
I. FIRST RESPONDERS
In addition to items in sections C, D, and H relating to first responders, support the following:
1. Educate 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, facilitation, 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 intervention services; to support training and technical assistance; or to
support other strategies to abate the opioid epidemic described in this opioid abatement strategy list.
2. A dashboard to share reports, recommendations, or plans to spend opioid settlement funds; to show
how opioid settlement funds have been spent; to report program or strategy outcomes; or to track, share,
or visualize key opioid-related 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, the
following:
1. Provide funding for staff training or networking programs and services to improve the capability of
government, community, and not-for-profit entities to abate the opioid crisis.
2. 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
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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.
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.
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EXHIBIT A
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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”)[, such that a minimum of __% of the [aggregate] state-level abatement distributions shall
be spent on [one or more of] them annually].1
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-Assisted Treatment (“MAT”) Distribution and other opioid-related treatment
1. Increase distribution of MAT to non-Medicaid eligible or uninsured individuals;
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. 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 with other support services.
C. Pregnant & Postpartum Women
1. 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 Opioid Use Disorder (OUD)
including housing, transportation, job placement/training, and childcare.
D. Expanding Treatment for Neonatal Abstinence Syndrome
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.
1 As used in this Schedule A, words like “expand,” “fund,” “provide” or the like shall not indicate a preference for new or
existing programs. Priorities will be established through the mechanisms described in the Term Sheet.
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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.
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
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.
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EXHIBIT B
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Schedule B
Approved Uses
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, the following:2
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. 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.
8. 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. Fellowships for addiction medicine specialists for direct patient care, instructors, and clinical
research for treatments.
11. Scholarships and supports for behavioral health practitioners or workers involved in addressing
OUD and any co-occurring SUD or mental health conditions, including but not limited to training,
2 As used in this Schedule B, words like “expand,” “fund,” “provide” or the like shall not indicate a preference for new or
existing programs. Priorities will be established through the mechanisms described in the Term Sheet.
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scholarships, fellowships, loan repayment programs, or other incentives for providers to work in rural
or underserved areas.
12. [Intentionally Blank – to be cleaned up later for numbering]
13. 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.
14. Dissemination of web-based training curricula, such as the American Academy of Addiction
Psychiatry’s Provider Clinical Support Service-Opioids web-based training curriculum and
motivational interviewing.
15. Development and dissemination of new curricula, such as the American Academy of Addiction
Psychiatry’s Provider Clinical Support Service for Medication-Assisted Treatment.
B. SUPPORT PEOPLE IN TREATMENT AND RECOVERY
Support people in treatment for or 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 following:
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.
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 medication 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.
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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. 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 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, the following:
1. Ensure that health care providers are screening for OUD and other risk factors and know how to
appropriately counsel and treat (or refer if necessary) a patient for OUD treatment.
2. Fund Screening, Brief Intervention and Referral to Treatment (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. 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.
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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.
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,
the following:
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:
a. Self-referral strategies such as the Angel Programs or the Police Assisted Addiction Recovery
Initiative (PAARI);
b. Active outreach strategies such as the Drug Abuse Response Team (DART) model;
c. “Naloxone Plus” strategies, which work to ensure that individuals who have received
naloxone to reverse the effects of an overdose are then linked to treatment programs or other
appropriate services;
d. Officer prevention strategies, such as the Law Enforcement Assisted Diversion (LEAD)
model;
e. Officer intervention strategies such as the Leon County, Florida Adult Civil Citation Network
or the Chicago Westside Narcotics Diversion to Treatment Initiative; or
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f. 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
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 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 (NAS),
through evidence-based or evidence-informed programs or strategies that may include, but are not
limited to, the following:
1. 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. Training for obstetricians or other healthcare personnel that work with pregnant women and their
families regarding treatment of OUD and any co-occurring SUD/MH conditions.
4. Expand comprehensive evidence-based treatment and recovery support for NAS babies; expand
services for better continuum of care with infant-need dyad; 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 Neonatal Abstinence
Syndrome get referred to appropriate services and receive a plan of safe care.
6. Child and family supports for parenting women with OUD and any co-occurring SUD/MH
conditions.
7. Enhanced family supports 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. 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. Fund medical provider education and outreach regarding best prescribing practices for opioids
consistent with 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. Support for non-opioid pain treatment alternatives, including training providers to offer or refer to
multi-modal, evidence-informed treatment of pain.
5. Support enhancements or improvements to Prescription Drug Monitoring Programs (PDMPs),
including but not limited to improvements that:
a. Increase the number of prescribers using PDMPs;
b. Improve point-of-care decision-making by increasing the quantity, quality, or format of data
available to prescribers using PDMPs, by improving the interface that prescribers use to access
PDMP data, or both; or
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c. Enable states to use PDMP data in support of surveillance or intervention strategies, including
MAT referrals and follow-up for individuals identified within PDMP data as likely to
experience OUD 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. Increase electronic prescribing to prevent diversion or forgery.
8. Educate Dispensers on appropriate opioid dispensing.
G. PREVENT MISUSE OF OPIOIDS
Support efforts to discourage or prevent misuse of opioids through evidence-based or evidence-
informed programs or strategies that may include, but are not limited to, the following:
1. Fund 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. Fund community anti-drug coalitions that engage in drug prevention efforts.
6. Support community coalitions in implementing evidence-informed prevention, such as reduced
social access and physical access, stigma reduction – including staffing, educational campaigns, support
for people in treatment or recovery, or training of coalitions in evidence-informed implementation,
including the Strategic Prevention Framework developed by the U.S. Substance Abuse and Mental
Health Services Administration (SAMHSA).
7. Engage non-profits and faith-based communities as systems to support prevention.
8. Fund 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 of 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
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Packet Pg. 1621 Attachment: Interlocal Exhibit A MOU (23568 : Interlocal Agreement with the City of Naples on National Prescription Opioid Litigation)
mental health needs in young people that (when not properly addressed) increase the risk of opioid or
other drug misuse.
H. PREVENT OVERDOSE DEATHS AND OTHER HARMS (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. Increase 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, individuals
at high risk of overdose, schools, community navigators and outreach workers, persons being released
from jail or prison, or other members of the general public.
2. Public health entities provide 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. Enable school nurses and other school staff to respond to opioid overdoses, and provide them with
naloxone, training, and support.
5. Expand, improve, or develop data tracking software and applications for overdoses/naloxone
revivals.
6. Public education relating to emergency responses to overdoses.
7. Public education relating to immunity and Good Samaritan laws.
8. Educate first responders regarding the existence and operation of immunity and Good Samaritan
laws.
9. 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. Expand access to testing and treatment for infectious diseases such as HIV and Hepatitis C resulting
from intravenous opioid use.
11. Support 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. Provide 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. Support screening for fentanyl in routine clinical toxicology testing.
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Packet Pg. 1622 Attachment: Interlocal Exhibit A MOU (23568 : Interlocal Agreement with the City of Naples on National Prescription Opioid Litigation)
PART THREE: OTHER STRATEGIES
I. FIRST RESPONDERS
In addition to items in sections C, D, and H relating to first responders, support the following:
1. Educate 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, facilitation, 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 intervention services; to support training and technical assistance; or to
support other strategies to abate the opioid epidemic described in this opioid abatement strategy list.
2. A dashboard to share reports, recommendations, or plans to spend opioid settlement funds; to show
how opioid settlement funds have been spent; to report program or strategy outcomes; or to track, share,
or visualize key opioid-related 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, the
following:
1. Provide funding for staff training or networking programs and services to improve the capability of
government, community, and not-for-profit entities to abate the opioid crisis.
2. 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
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Packet Pg. 1623 Attachment: Interlocal Exhibit A MOU (23568 : Interlocal Agreement with the City of Naples on National Prescription Opioid Litigation)
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.
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.
16.K.1.b
Packet Pg. 1624 Attachment: Interlocal Exhibit A MOU (23568 : Interlocal Agreement with the City of Naples on National Prescription Opioid Litigation)
EXHIBIT C
16.K.1.b
Packet Pg. 1625 Attachment: Interlocal Exhibit A MOU (23568 : Interlocal Agreement with the City of Naples on National Prescription Opioid Litigation)
CountyAllocated SubdivisionsRegional % by County for Abatement FundCity/County Fund %Alachua 1.241060164449%Alachua County 0.821689546303%Alachua0.013113332457%Archer0.000219705515%Gainesville0.381597611347%Hawthorne 0.000270546460%High Springs 0.011987568663%La Crosse0.000975056706%Micanopy0.002113530737%Newberry0.006102729215%Waldo0.002988721299%Baker 0.193173804130%Baker County 0.169449240037%Glen St. Mary 0.000096234647%Macclenny0.023628329446%Bay 0.839656373312%Bay County 0.508772605155%Callaway0.024953825527%Lynn Haven 0.039205632015%Mexico Beach 0.005614292988%Panama City 0.155153855596%Panama City Beach 0.080897023117%Parker0.008704696178%Springfield0.016354442736%Bradford 0.189484204081%Bradford County 0.151424309090%Brooker0.000424885045%Hampton0.002839829959%Lawtey 0.003400896108%Starke0.031392468132%Brevard 3.878799180444%Brevard County 2.323022668525%Cape Canaveral 0.045560750209%16.K.1.bPacket Pg. 1626Attachment: Interlocal Exhibit A MOU (23568 : Interlocal Agreement with the City of Naples on National
Cocoa0.149245411423%Cocoa Beach 0.084363286155%Grant‐Valkaria 0.000321387406%Indialantic0.024136738902%Indian Harbour Beach 0.021089913665%Malabar0.002505732317%Melbourne 0.383104682233%Melbourne Beach 0.012091066302%Melbourne Village 0.003782203200%Palm Bay0.404817397481%Palm Shores 0.000127102364%Rockledge0.096603243798%Satellite Beach 0.035975416224%Titusville0.240056418924%West Melbourne 0.051997577066%Broward 9.057962672578%Broward County 3.966403576878%Coconut Creek 0.101131719448%Cooper City 0.073935445073%Coral Springs 0.323406517664%Dania Beach 0.017807041180%Davie0.266922227153%Deerfield Beach 0.202423224725%Fort Lauderdale 0.830581264531%Hallandale Beach 0.154950491814%Hillsboro Beach 0.012407006463%Hollywood0.520164608456%Lauderdale‐By‐The‐Sea 0.022807611325%Lauderdale Lakes 0.062625150435%Lauderhill0.144382838130%Lazy Lake0.000021788977%Lighthouse Point 0.029131861803%Margate0.143683775129%Miramar0.279280208419%North Lauderdale 0.066069624496%16.K.1.bPacket Pg. 1627Attachment: Interlocal Exhibit A MOU (23568 : Interlocal Agreement with the City of Naples on National
Oakland Park 0.100430840699%Ocean Breeze 0.005381877237%Parkland0.045804060448%Pembroke Park 0.024597938908%Pembroke Pines 0.462832363603%Plantation0.213918725664%Pompano Beach 0.335472163493%Sea Ranch Lakes 0.005024174870%Southwest Ranches 0.025979723178%Sunrise0.286071106146%Tamarac0.134492458472%Weston0.138637811283%West Park0.029553115352%Wilton Manors 0.031630331127%Calhoun 0.047127740781%Calhoun County 0.038866087128%Altha0.000366781107%Blountstown 0.007896688293%Charlotte 0.737346233376%Charlotte County 0.690225755587%Punta Gorda 0.047120477789%Citrus 0.969645776606%Citrus County 0.929715661117%Crystal River 0.021928789266%Inverness0.018001326222%Clay 1.193429461456%Clay County 1.055764891131%Green Cove Springs 0.057762577142%Keystone Heights 0.000753535443%Orange Park 0.078589207339%Penney Farms 0.000561066149%Collier 1.551333376427%Collier County 1.354673336030%Everglades0.000148891341%Marco Island 0.062094952003%16.K.1.bPacket Pg. 1628Attachment: Interlocal Exhibit A MOU (23568 : Interlocal Agreement with the City of Naples on National
Naples0.134416197054%Columbia 0.446781150792%Columbia County 0.341887201373%Fort White0.000236047247%Lake City0.104659717920%DeSoto 0.113640407802%DeSoto County 0.096884684746%Arcadia0.016755723056%Dixie 0.103744580900%Dixie County 0.098822087921%Cross City0.004639236282%Horseshoe Beach 0.000281440949%Duval 5.434975156935%Jacksonville 5.270570064997%Atlantic Beach 0.038891507601%Baldwin0.002251527589%Jacksonville Beach 0.100447182431%Neptune Beach 0.022814874318%Escambia 1.341634449244%Escambia County 1.005860871574%Century0.005136751249%Pensacola0.330636826421%Flagler 0.389864712244%Flagler Counry 0.279755934409%Beverly Beach 0.000154338585%Bunnell0.009501809575%Flagler Beach 0.015482883669%Marineland 0.000114392127%Palm Coast 0.084857169626%Franklin 0.049911282550%Franklin County 0.046254365966%Apalachicola 0.001768538606%Carabelle0.001888377978%Gadsden 0.123656074077%Gadsden County 0.090211810642%16.K.1.bPacket Pg. 1629Attachment: Interlocal Exhibit A MOU (23568 : Interlocal Agreement with the City of Naples on National
Chattahoochee 0.004181667772%Greensboro 0.000492067723%Gretna0.002240633101%Havana0.005459954403%Midway0.001202025213%Quincy0.019867915223%Gilchrist 0.064333769355%Gilchrist County 0.061274233881%Bell0.000099866143%Fanning Springs 0.000388570084%Trenton0.002571099247%Glades 0.040612836758%Glades County 0.040420367464%Moore Haven 0.000192469294%Gulf 0.059914238588%Gulf County 0.054715751905%Port St. Joe 0.004817179591%Wewahitchka 0.000381307092%Hamilton 0.047941195910%Hamilton County 0.038817061931%Jasper0.004869836285%Jennings0.002623755940%White Springs 0.001630541754%Hardee 0.067110048132%Hardee County 0.058100306280%Bowling Green 0.001797590575%Wauchula0.006667426860%Zolfo Springs 0.000544724417%Hendry 0.144460915297%Hendry County 0.122147187443%Clewiston0.017589151414%LaBelle0.004724576440%Hernando 1.510075949110%Hernando County 1.447521612849%Brooksville0.061319627583%16.K.1.bPacket Pg. 1630Attachment: Interlocal Exhibit A MOU (23568 : Interlocal Agreement with the City of Naples on National
Weeki Wachee 0.001234708678%Highlands 0.357188510237%Highlands County 0.287621754986%Avon Park0.025829016090%Lake Placid 0.005565267790%Sebring0.038172471371%Hillsborough 8.710984113657%Hillsborough County 6.523111204400%Plant City0.104218491142%Tampa1.975671881253%Temple Terrace 0.107980721113%Holmes 0.081612427851%Holmes County 0.066805002459%Bonifay0.006898026863%Esto0.006269778036%Noma0.001278286631%Ponce de Leon 0.000179759057%Westville0.000179759057%Indian River 0.753076058781%Indian River County 0.623571460217%Fellsmere0.004917045734%Indian River shores 0.025322422382%Orchid0.000306861421%Sebastian0.038315915467%Vero Beach 0.060642353558%Jackson 0.158936058795%Jackson County 0.075213731704%Alford0.000303229925%Bascom0.000061735434%Campbellton 0.001648699234%Cottondale 0.001093080329%Graceville0.002794436257%Grandridge 0.000030867717%Greenwood 0.001292812616%Jacob City0.000481173235%16.K.1.bPacket Pg. 1631Attachment: Interlocal Exhibit A MOU (23568 : Interlocal Agreement with the City of Naples on National
Malone0.000092603151%Marianna0.073519638768%Sneads0.002404050426%Jefferson 0.040821647784%Jefferson County 0.037584169001%Monticello0.003237478783%Lafayette 0.031911772076%Lafayette County 0.031555885457%Mayo0.000355886619%Lake 1.139211224519%Lake County 0.757453827343%Astatula0.002727253579%Clermont0.075909163209%Eustis0.041929254098%Fruitland Park 0.008381493024%Groveland0.026154034992%Howey‐In‐The‐Hills 0.002981458307%Lady Lake0.025048244426%Leesburg0.091339390185%Mascotte0.011415608025%Minneola0.016058475803%Montverde 0.001347285057%Mount Dora 0.041021380070%Tavares0.031820984673%Umatilla0.005623371728%Lee 3.325371883359%Lee County 2.115268407509%Bonita Springs 0.017374893143%Cape Coral0.714429677167%Estero0.012080171813%Fort Myers 0.431100350585%Fort Myers Beach 0.000522935440%Sanibel0.034595447702%Leon 0.897199244939%Leon County 0.471201146391%16.K.1.bPacket Pg. 1632Attachment: Interlocal Exhibit A MOU (23568 : Interlocal Agreement with the City of Naples on National
Tallahassee 0.425998098549%Levy 0.251192401748%Levy County 0.200131750679%Bronson0.005701448894%Cedar Key0.005180329202%Chiefland0.015326729337%Fanning Springs 0.000808007885%Inglis0.004976965420%Otter Creek 0.000408543312%Williston0.017774357715%Yankeetown 0.000884269303%Liberty 0.019399452225%Liberty County 0.019303217578%Bristol0.000096234647%Madison 0.063540287455%Madison County 0.053145129837%Greenville0.000110760631%Lee0.000019973229%Madison0.010264423758%Manatee 2.721323346235%Manatee County 2.201647174006%Anna Maria 0.009930326116%Bradenton0.379930754632%Bradenton Beach 0.014012127744%Holmes Beach 0.028038781473%Longboat Key 0.034895046131%Palmetto0.052869136132%Marion 1.701176168960%Marion County 1.303728892837%Belleview0.009799592256%Dunnellon0.018400790795%McIntosh0.000145259844%Ocala0.368994504094%Reddick0.000107129135%Martin 0.869487298116%16.K.1.bPacket Pg. 1633Attachment: Interlocal Exhibit A MOU (23568 : Interlocal Agreement with the City of Naples on National
Martin County 0.750762795758%Jupiter Island 0.020873839646%Ocean Breeze Park 0.008270732393%Sewall's Point 0.008356072551%Stuart0.081223857767%Miami‐Dade 5.232119784173%Miami‐Dade County 4.282797675552%Aventura0.024619727885%Bal Harbour 0.010041086747%Bay Harbor Islands 0.004272455175%Biscayne Park 0.001134842535%Coral Gables 0.071780152131%Cutler Bay0.009414653668%Doral0.013977628531%El Portal0.000924215760%Florida City 0.003929278792%Golden Beach 0.002847092951%Hialeah0.098015895785%Hialeah Gardens 0.005452691411%Homestead 0.024935668046%Indian Creek 0.002543863026%Key Biscayne 0.013683477346%Medley0.008748274131%Miami0.292793005448%Miami Beach 0.181409572478%Miami Gardens 0.040683650932%Miami Lakes 0.007836768608%Miami Shores 0.006287935516%Miami Springs 0.006169911893%North Bay Village 0.005160355974%North Miami 0.030379280717%North Miami Beach 0.030391990953%Opa‐locka0.007847663096%Palmetto Bay 0.007404620570%Pinecrest0.008296152866%16.K.1.bPacket Pg. 1634Attachment: Interlocal Exhibit A MOU (23568 : Interlocal Agreement with the City of Naples on National
South Miami 0.007833137111%Sunny Isles Beach 0.007693324511%Surfside0.004869836285%Sweetwater 0.004116300842%Virginia Gardens 0.001172973244%West Miami 0.002654623657%Monroe 0.476388738585%Monroe County 0.330124785469%Islamorada 0.022357305808%Key Colony Beach 0.004751812661%Key West0.088087385417%Layton0.000150707089%Marathon0.030916742141%Nassau 0.476933463002%Nassau County 0.392706357951%Callahan0.000225152759%Fernandina Beach 0.083159445195%Hillard0.000842507098%Okaloosa0.819212865955%Okaloosa County 0.612059617545%Cinco Bayou 0.000733562214%Crestview0.070440130066%Destin0.014678507281%Fort Walton Beach 0.077837487644%Laurel Hill0.000079892914%Mary Esther 0.009356549730%Niceville0.021745398713%Shalimar0.001824826796%Valparaiso0.010456893052%Okeechobee 0.353495278692%Okeechobee County 0.314543851405%Okeechobee 0.038951427287%Orange 4.671028214546%Orange County 3.063330386979%Apopka0.097215150892%16.K.1.bPacket Pg. 1635Attachment: Interlocal Exhibit A MOU (23568 : Interlocal Agreement with the City of Naples on National
Bay Lake0.023566594013%Belle Isle0.010798253686%Eatonville0.008325204835%Edgewood0.009716067845%Lake Buena Vista 0.010355211161%Maitland0.046728276209%Oakland0.005429086686%Ocoee0.066599822928%Orlando1.160248481490%Windemere 0.007548064667%Winter Garden 0.056264584996%Winter Park 0.104903028159%Osceola 1.073452092940%Osceola County 0.837248691390%Kissimmee0.162366006872%St. Cloud0.073837394678%Palm Beach 8.601594372053%Palm Beach County 5.552548475026%Atlantis0.018751230169%Belle Glade 0.020828445945%Boca Raton 0.472069073961%Boynton Beach 0.306498271771%Briny Breezes 0.003257452012%Cloud Lake0.000188837798%Delray Beach 0.351846579457%Glen Ridge0.000052656694%Golf0.004283349663%Greenacres 0.076424835657%Gulf Stream 0.010671151322%Haverhill0.001084001589%Highland Beach 0.032510968934%Hypoluxo0.005153092982%Juno Beach 0.016757538804%Jupiter Island 0.125466374888%Jupiter Inlet Colony 0.005276563849%16.K.1.bPacket Pg. 1636Attachment: Interlocal Exhibit A MOU (23568 : Interlocal Agreement with the City of Naples on National
Lake Clarke Shores 0.007560774903%Lake Park0.029433275980%Lake Worth 0.117146617298%Lantana0.024507151505%Loxahatchee Groves 0.002531152789%Manalapan 0.021632822333%Mangonia Park 0.010696571795%North Palm Beach 0.044349646256%Ocean Ridge 0.012786497807%Pahokee0.004018250447%Palm Beach 0.185476848123%Palm Beach Gardens 0.233675880257%Palm Beach Shores 0.014135598612%Palm Springs 0.038021764282%Riviera Beach 0.163617057282%Royal Palm Beach 0.049295743959%South Bay0.001830274040%South Palm Beach 0.005866681967%Tequesta0.031893614595%Wellington 0.050183644758%West Palm Beach 0.549265602541%Pasco 4.692087260494%Pasco County 4.319205239813%Dade City0.055819726723%New Port Richey 0.149879107494%Port Richey 0.049529975458%San Antonio 0.002189792155%St. Leo0.002790804761%Zephyrhills0.112672614089%Pinellas 7.934889816777%Pinellas County 4.546593184553%Belleair0.018095745121%Belleair Beach 0.004261560686%Belleair Bluffs 0.007502670965%Belleair Shore 0.000439411029%16.K.1.bPacket Pg. 1637Attachment: Interlocal Exhibit A MOU (23568 : Interlocal Agreement with the City of Naples on National
Clearwater 0.633863120196%Dunedin0.102440873796%Gulfport0.047893986460%Indian Rocks Beach 0.008953453662%Indian Shores 0.011323004874%Kenneth City 0.017454786058%Largo0.374192990777%Madeira Beach 0.022616957779%North Reddington Beach 0.003820333909%Oldsmar0.039421706033%Pinellas Park 0.251666311991%Redington Beach 0.003611522882%Redington Shores 0.006451352841%Safety Harbor 0.038061710740%Seminole0.095248695748%South Pasadena 0.029968921656%St. Pete Beach 0.071791046619%St. Petersburg 1.456593090134%Tarpon Springs 0.101970595050%Treasure Island 0.040652783215%Polk 2.150483025298%Polk County 1.558049828484%Auburndale 0.028636162584%Bartow0.043971970660%Davenport0.005305615818%Dundee0.005597951255%Eagle Lake0.002580177987%Fort Meade 0.007702403251%Frostproof0.005857603227%Haines City 0.047984773863%Highland Park 0.000063551182%Hillcrest Heights 0.000005447244%Lake Alfred 0.007489960729%Lake Hamilton 0.002540231530%Lakeland0.294875668468%16.K.1.bPacket Pg. 1638Attachment: Interlocal Exhibit A MOU (23568 : Interlocal Agreement with the City of Naples on National
Lake Wales 0.036293172134%Mulberry0.005414560702%Polk City0.001080370093%Winter Haven 0.097033576087%Putnam 0.384893194068%Putnam County 0.329225990182%Crescent City 0.005561636294%Interlachen 0.001877483489%Palatka0.046955244716%Pomona Park 0.000379491344%Welaka0.000893348043%Santa Rosa 0.701267319513%Santa Rosa County 0.592523984216%Gulf Breeze 0.061951507906%Jay0.000159785829%Milton0.046632041562%Sarasota 2.805043857579%Sarasota County 1.924315263251%Longboat Key 0.044489458856%North Port0.209611771277%Sarasota0.484279979635%Venice0.142347384560%Seminole 2.141148264544%Seminole County 1.508694164839%Altamonte Springs 0.081305566430%Casselberry 0.080034542791%Lake Mary0.079767627827%Longwood0.061710013415%Oviedo0.103130858057%Sanford0.164243490362%Winter Springs 0.062262000824%St. Johns 0.710333349554%St. Johns County 0.656334818131%Hastings0.000010894488%Marineland 0.000000000000%16.K.1.bPacket Pg. 1639Attachment: Interlocal Exhibit A MOU (23568 : Interlocal Agreement with the City of Naples on National
St. Augustine 0.046510386442%St. Augustine Beach 0.007477250493%St. Lucie 1.506627843552%St. Lucie County 0.956156584302%Fort Pierce0.159535255654%Port St. Lucie 0.390803453989%St. Lucie Village 0.000132549608%Sumter 0.326398870459%Sumter County 0.302273026046%Bushnell0.006607507174%Center Hill0.001312785844%Coleman0.000748088199%Webster0.001423546476%Wildwood0.014033916721%Suwannee 0.191014879692%Suwannee County 0.161027800555%Branford0.000929663004%Live Oak0.029057416132%Taylor 0.092181897282%Taylor County 0.069969851319%Perry0.022212045963%Union 0.065156303224%Union County 0.063629259109%Lake Butler 0.001398126003%Raiford0.000012710236%Worthington Springs 0.000116207876%Volusia 3.130329674480%Volusia County 1.708575342287%Daytona Beach 0.447556475212%Daytona Beach Shores 0.039743093439%DeBary0.035283616215%DeLand0.098983689498%Deltona0.199329190038%Edgewater0.058042202343%Flagler Beach 0.000223337011%16.K.1.bPacket Pg. 1640Attachment: Interlocal Exhibit A MOU (23568 : Interlocal Agreement with the City of Naples on National
Holly Hill0.031615805143%Lake Helen 0.004918861482%New Smyrna Beach 0.104065968306%Oak Hill0.004820811087%Orange City 0.033562287058%Ormond Beach 0.114644516477%Pierson0.002333236251%Ponce Inlet 0.023813535748%Port Orange 0.177596501562%South Daytona 0.045221205323%Wakulla 0.115129321208%Wakulla County 0.114953193647%Sopchoppy 0.000107129135%St. Marks0.000068998426%Walton 0.268558216151%Walton County 0.224268489581%DeFuniak Springs 0.017057137234%Freeport0.003290135477%Paxton0.023942453860%Washington 0.120124444109%Washington County 0.104908475404%Caryville0.001401757499%Chipley0.012550450560%Ebro0.000221521263%Vernon0.000361333863%Wausau0.000680905521%100.00% 100.00%16.K.1.bPacket Pg. 1641Attachment: Interlocal Exhibit A MOU (23568 : Interlocal Agreement with the City of Naples on National
16.K.1.c
Packet Pg. 1642 Attachment: Interlocal Exhibit B Resolution 2021-136 (23568 : Interlocal Agreement with the City of Naples on National Prescription Opioid
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Packet Pg. 1643 Attachment: Interlocal Exhibit B Resolution 2021-136 (23568 : Interlocal Agreement with the City of Naples on National Prescription Opioid
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Packet Pg. 1644 Attachment: Interlocal Exhibit B Resolution 2021-136 (23568 : Interlocal Agreement with the City of Naples on National Prescription Opioid
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Packet Pg. 1645 Attachment: Interlocal Exhibit B Resolution 2021-136 (23568 : Interlocal Agreement with the City of Naples on National Prescription Opioid
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Packet Pg. 1646 Attachment: Interlocal Exhibit B Resolution 2021-136 (23568 : Interlocal Agreement with the City of Naples on National Prescription Opioid
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Packet Pg. 1647 Attachment: Interlocal Exhibit B Resolution 2021-136 (23568 : Interlocal Agreement with the City of Naples on National Prescription Opioid
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Packet Pg. 1648 Attachment: Interlocal Exhibit B Resolution 2021-136 (23568 : Interlocal Agreement with the City of Naples on National Prescription Opioid
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Packet Pg. 1649 Attachment: Interlocal Exhibit B Resolution 2021-136 (23568 : Interlocal Agreement with the City of Naples on National Prescription Opioid
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Packet Pg. 1650 Attachment: Interlocal Exhibit B Resolution 2021-136 (23568 : Interlocal Agreement with the City of Naples on National Prescription Opioid
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Packet Pg. 1651 Attachment: Interlocal Exhibit B Resolution 2021-136 (23568 : Interlocal Agreement with the City of Naples on National Prescription Opioid
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Packet Pg. 1652 Attachment: Interlocal Exhibit B Resolution 2021-136 (23568 : Interlocal Agreement with the City of Naples on National Prescription Opioid
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Packet Pg. 1653 Attachment: Interlocal Exhibit B Resolution 2021-136 (23568 : Interlocal Agreement with the City of Naples on National Prescription Opioid
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Packet Pg. 1654 Attachment: Interlocal Exhibit B Resolution 2021-136 (23568 : Interlocal Agreement with the City of Naples on National Prescription Opioid
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Packet Pg. 1655 Attachment: Interlocal Exhibit B Resolution 2021-136 (23568 : Interlocal Agreement with the City of Naples on National Prescription Opioid
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Packet Pg. 1656 Attachment: Interlocal Exhibit B Resolution 2021-136 (23568 : Interlocal Agreement with the City of Naples on National Prescription Opioid
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Packet Pg. 1657 Attachment: Interlocal Exhibit B Resolution 2021-136 (23568 : Interlocal Agreement with the City of Naples on National Prescription Opioid
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Packet Pg. 1658 Attachment: Interlocal Exhibit B Resolution 2021-136 (23568 : Interlocal Agreement with the City of Naples on National Prescription Opioid
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Packet Pg. 1659 Attachment: Interlocal Exhibit B Resolution 2021-136 (23568 : Interlocal Agreement with the City of Naples on National Prescription Opioid
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Packet Pg. 1660 Attachment: Interlocal Exhibit B Resolution 2021-136 (23568 : Interlocal Agreement with the City of Naples on National Prescription Opioid
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Packet Pg. 1661 Attachment: Interlocal Exhibit B Resolution 2021-136 (23568 : Interlocal Agreement with the City of Naples on National Prescription Opioid
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Packet Pg. 1662 Attachment: Interlocal Exhibit B Resolution 2021-136 (23568 : Interlocal Agreement with the City of Naples on National Prescription Opioid
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Packet Pg. 1663 Attachment: Interlocal Exhibit B Resolution 2021-136 (23568 : Interlocal Agreement with the City of Naples on National Prescription Opioid