REPORT/RECOMMENDATION TO THE BOARD OF SUPERVISORS
OF SAN BERNARDINO COUNTY
AND RECORD OF ACTION
June 11, 2024
FROM
TRACY REECE, Chief Probation Officer, Probation Department
SUBJECT
Title
Application and Acceptance of Intranasal Naloxone Hydrochloride from California Department of Health Care Services’ Naloxone Distribution Project
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RECOMMENDATION(S)
Recommendation
1. Approve Naloxone Distribution Project Application, including non-standard terms, with the State of California Department of Health Care Services, to apply for and accept 300 units of intranasal Naloxone Hydrochloride.
2. Authorize the Chief Probation Officer to submit the electronic application and accept the distribution of 300 units of intranasal Naloxone Hydrochloride.
(Presenter: Tracy Reece, Chief Probation Officer, 387-5692)
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COUNTY AND CHIEF EXECUTIVE OFFICER GOALS & OBJECTIVES
Operate in a Fiscally-Responsible and Business-Like Manner.
Provide for the Safety, Health and Social Service Needs of County Residents.
FINANCIAL IMPACT
Approval of this item will not result in the use of additional Discretionary General Funding (Net County Cost). The Probation Department (Department) will receive the Naloxone Hydrochloride at no cost. The Department will report any successful overdose reversals to the California Department of Health Care Services.
BACKGROUND INFORMATION
Naloxone Hydrochloride (Naloxone) is a life-saving medication that reverses an opioid overdose, while having little to no effect in the event it is administered on an individual who does not have opioids in their system. Naloxone works by blocking the opioid receptor sites, reversing the toxic effects of the overdose. Naloxone requires a prescription but is not a controlled substance. It has few known adverse effects, and no potential for abuse.
Naloxone is administered when a patient is showing signs of opioid overdose. The medication can be given by intranasal spray, intramuscular (into the muscle), subcutaneous (under the skin), or by intravenous injection. The Department is applying for 300 units of Naloxone intranasal spray.
The Naloxone Distribution Project (NDP) is funded by the Substance Abuse and Mental Health Services Administration (SAMHSA) and administered by the California Department of Health Care Services (DHCS) to combat opioid overdose-related deaths throughout California. The NDP aims to reduce opioid overdose deaths through the provision of free Naloxone, in its nasal spray formulation. Through the NDP, qualified organizations and entities are able to request free Naloxone from DHCS and have it directly shipped to their address. Since October 2018, the NDP has distributed over 4,100,000 units of Naloxone, and recorded over 260,000 overdose reversals.
DHCS considers the Department to be a qualified organization, as a law enforcement and criminal justice partner. The Department is requesting 300 units of Naloxone to be carried by Probation Officer IIs, Probation Officer IIIs, and Supervising Probation Officers while serving approximately 8,499 adult offenders and 2,001 youthful offenders throughout the county. Naloxone intranasal spray has an estimated shelf life of up to 36 months. The Department previously received Naloxone under this program in 2019, 2020 and 2022. Since January 2022 the Department’s Naloxone use has resulted in eight overdose reversals.
Per County Policy 11-05, contracts containing non-standard contract language must be approved by the Board. The application requires submission of an online form that includes several terms and conditions that differ from the standard County contract:
1. The application requires the Department to allow DHCS to contact the County and to use information provided on the application form to track the use and distribution of the naloxone and conduct other public health and epidemiological surveillance activities.
• The County’s standard contract form does not require it to disclose information that may be used for reporting public health and epidemiological surveillance activities.
• Potential Impact: The County must allow DHCS to contact it and use any information provided on the submission form, but no significant impact is anticipated other than the requirement to share information, which does not include protected health information disclosure.
2. The Naloxone application process requires a standing order to administer the medication.
• The County’s standard terms do not require it to have specific orders.
• Potential Impact: The Department is required to obtain a standing order, which it has obtained for Naloxone administration from Dr. Neeki, D.O, Chief Medical Officer, valid effective July 21, 2023 through July 20, 2024. The County will be required to renew the standing order to utilize the Naloxone.
Once the application is submitted online, DHCS directly ships to address on the application. There is no separate award letter from DHCS. Approval of the recommended actions by the Board, including the non-standard terms, is recommended as the non-standard terms do not have a significant impact to the County and will allow submission of the application and acceptance of intranasal Naloxone from DHCS.
PROCUREMENT
N/A
REVIEW BY OTHERS
This item has been reviewed by County Counsel (Maria Insixiengmay, Deputy County Counsel, 387-5455) on May 3, 2024; Finance (Jevin Kaye, Principal Administrative Analyst, 387-3078) on May 15, 2024; and County Finance and Administration (Robert Saldana, Deputy Executive Officer, 387-5423) on May 23, 2024.