REPORT/RECOMMENDATION TO THE BOARD OF SUPERVISORS
OF SAN BERNARDINO COUNTY
AND RECORD OF ACTION
September 1, 2026
FROM
LUTHER SNOKE, Chief Executive Officer, County Administrative Office
SUBJECT
Title
Opioid Settlement Funding Expenditure Plan
End
RECOMMENDATION(S)
Recommendation
1. Approve the 2026-27 County Opioid Settlement Funding Expenditure Plan to address the opioid epidemic within the County, decreasing the amount for 2026-27 by $433,388, from $25,251,066 to $24,817,678, for the period of July 1, 2026 through June 30, 2027.
2. Authorize the addition of eight positions to assist with the Department of Behavioral Health’s Substance Use Disorder Services Initiatives, under the following classifications:
a. One Clinical Therapist I, Professional Unit, Range 58 ($79,227-$111,696)
b. One Alcohol and Drug Counselor, Administrative Services Unit, Range 43 ($53,643-75,650)
c. Three Senior Office Assistants - Healthcare, Clerical Unit, Range 31A ($40,539-$57,096)
d. Two Staff Analyst IIs, Administrative Services Unit, Range 56 ($73,694-$103,792)
e. One Social Worker II, Administrative Services Unit, Range 47 ($59,218-$83,283)
(Presenter: Matthew Erickson, County Chief Financial Officer, 387-5423)
Body
COUNTY AND CHIEF EXECUTIVE OFFICER GOALS & OBJECTIVES
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 Discretionary General Funding (Net County Cost). The 2026-27 County Opioid Settlement Funding (OSF) Expenditure Plan, totaling $24,817,678, will support an expansion of initiatives aimed at addressing the opioid epidemic throughout San Bernardino County (County). This budget is fully funded by opioid settlement agreements with pharmaceutical manufacturers, distributors, pharmacies, and other entities responsible for aiding the opioid epidemic (Opioid Settlement Defendants). Adequate appropriations and revenue have been included in the Opioid Settlement Fund 2026-27 budget.
BACKGROUND INFORMATION
The County has been a party to several national opioid litigation settlements with Opioid Settlement Defendants for their involvement in the opioid crisis across the country. To date, the County has secured approximately $51,892,912 in settlement funds and anticipates receiving additional disbursements spread over an 18-year period to combat the effects of the opioid crisis.
To continue to effectively address the opioid crisis within the county, the Department of Behavioral Health (DBH), Department of Public Health (DPH), Sheriff/Coroner/Public Administrator’s Department (Sheriff), and Human Services Administration (HSA) are requesting a revision to the previously approved County OSF Expenditure Plan and to allocate $24,817,678 in available opioid settlement funding toward the following strategic initiatives:
|
Department |
Initiative |
Type |
2025-26 Approved Total |
2026-27 Revised Total |
Total Adjustment |
|
DBH |
Substance Use Disorder (SUD) Services Initiative |
On-going |
$6,651,555 |
$9,368,253 |
$2,716,698 |
|
DBH |
SUD Withdrawal Management/Residential Facility Infrastructure Support (WMRIS) |
One-Time |
$14,115,519 |
$10,100,000 |
($4,015,519) |
|
DPH |
Opioid Response Initiative (ORI) |
On-going |
$2,008,992 |
$2,499,425 |
$490,433 |
|
Sheriff |
Medication Assisted Treatment (MAT) Program |
On-going |
$2,400,000 |
$2,725,000 |
$325,000 |
|
HSA |
Administrative Support and Oversight |
On-going |
$75,000 |
$125,000 |
$50,000 |
|
Total |
$25,251,066 |
$24,817,678 |
($433,388) |
The net increase of $2,716,698 to DBH’s SUD Services Initiative is primarily due to the expansion of Withdrawal Management and Residential Treatment services, which significantly enhances 24-hour SUD treatment capacity countywide. This expansion of services will increase detox and residential capacity by approximately 2,144 unduplicated clients annually. As overdose trends continue to rise, particularly those involving fentanyl, this increased capacity is essential for ensuring immediate access to clinically appropriate levels of care. All expanded sites will offer MAT to support safe withdrawal, reduce cravings, and improve continuity of care. To support this expansion, DBH is requesting to add one Staff Analyst II (increase of $103,792) and one Social Worker II (increase of $83,283) to provide administrative support and regulatory oversight.
In addition to the two positions requested above, DBH is also requesting six additional positions to support SUD services across several opioid-related sub-initiatives. Three positions will support the DBH and Children and Family Services (CFS) Collaboration, which expands youth substance use treatment and coordinated care at Phoenix Clinic in San Bernardino. These positions include one Clinical Therapist I (increase of $111,696), who will serve as the access point for CFS youth; one Alcohol and Drug Counselor (increase of $75,650), who will be responsible for conducting clinical outpatient services; and one Senior Office Assistant - Healthcare (increase of $57,096), who will provide clerical support for the clinic.
Two additional Senior Office Assistant - Healthcare (increase of $114,192) positions will provide clerical support to DBH’s Criminal Justice Population services, which enhance outpatient treatment services at Probation Day Reporting Centers and serve approximately 200 clients annually at the San Bernardino location.
DBH is requesting one Staff Analyst II (increase of $103,792) to support the Targeted Overdose Prevention and Outreach sub-initiative. This sub-initiative focuses on outreach, fentanyl education, and the distribution of overdose-prevention kits in high-burden areas and serves about 1,400 community members while improving connections to treatment. The Staff Analyst II will provide project management, program monitoring, and administrative oversight.
The net $490,433 increase to DPH’s ORI primarily reflects the salary costs for five existing positions: one Health Education Assistant, one Health Education Specialist I, one Health Education Specialist II, one Extra-Help Media Specialist, and one Supervising Health Education Supervisor reassigned to support the Friday Night Live (FNL) Expansion Program. FNL promotes youth leadership and substance-use prevention through school and community engagement that encourages healthy, alcohol- and drug-free lifestyles. Expansion efforts will increase the number of participating sites, enhance adult mentorship, and provide resources for youth-led prevention activities across the county.
The Sheriff’s request to increase their opioid budget by $325,000 will support additional eligible expenditures related to the purchase and administration of opioid medication within the MAT program. The additional funding will cover increased staffing costs as well as anticipated rises in medication expenses for incarcerated individuals.
HSA is requesting a $50,000 increase to their opioid budget. The additional funding will support increased staff costs associated with expanded review of evolving opioid regulations, detailed invoice review, and growing reporting requirements.
The net increased costs for DBH, DPH, Sheriff, and HAS’s opioid budget will be offset by a $4,015,519 decrease in projected 2026-27 expenses from DBH’s SUD WMRIS Initiative, achieved through updated cost estimates for renovating the 60-bed treatment facility, which reflect lower anticipated construction and renovation costs than previously projected.
On July 11, 2023 (Item No. 21), the Board of Supervisors (Board) approved the County OSF Expenditure Plan allocating $23,500,000 in available opioid settlement funding toward the following three strategic initiatives: DBH SUD Services Initiative ($2,100,000), DPH ORI ($1,400,000), and DBH’s SUD WMRIS ($20,000,000).
On July 23, 2024 (Item No. 27), the Board approved a revision to the County OSF Expenditure Plan allocating $21,209,602 in available opioid settlement funding toward the following three strategic initiatives: DBH’s SUD Services Initiative ($5,218,083), DPH’s ORI ($1,542,000), and DBH’s SUD WMRIS ($14,116,519).
On January 14, 2025 (Item No. 29), the Board approved a revision to the County OSF Expenditure Plan allocating $1,039,930 in available opioid settlement funds toward the addition of three positions: two Health Education Specialist I’s and one Public Health Program Coordinator to support the DPH FNL ($964,930) which is part of the DPH’s ORI, and a $75,000 increase for HSA to provide administrative support and oversight.
On May 6, 2025 (Item No. 11), the Board approved the 2024-25 Budget Adjustments for increased hospital expenses for Arrowhead Regional Medical Center and added the Sheriff’s MAT Services Initiative to the OSF Expenditure Plan. This included an increase in the planned expenditure amount by $1,000,000, from $22,249,532 to $23,249,532, to support the Sheriff’s MAT Services Initiative.
On August 19, 2025 (Item No. 26), the Board approved a revision to the County OSF Expenditure Plan increasing the amount for 2025-26 by $1,101,534, from $23,249,532 to $24,351,066, to support DBH’s SUD Services Initiative, including the new Recovery Residence Expansion Project ($487,819), and an increase of $945,653 to the Targeted Overdose Prevention and Outreach program for opioid advertising and prevention materials and the addition of two positions: a Mental Health Clinic Supervisor and an Alcohol and Drug Counselor. These increases to DBH SUD Services Initiatives were offset primarily by a decrease to DPH’s ORI. In addition, the Sheriff’s Department requested $500,000 to expand its MAT program, including establishing a contract with a community provider.
On April 21, 2026 (Item No. 17), the Board approved the revision to the County OSF Expenditure Plan, increasing the amount by $900,000, from $24,351,066 to $25,251,066, to expand the Sheriff’s MAT program, which provides opioid medication to incarcerated individuals. The increase is driven by rising pharmaceutical costs and will fund clinical staff who directly administer medication within correctional facilities, as well as the costs of opioid medication.
Due to the extensive review that was required, this request to the Board was postponed to the September 1, 2026 Board meeting. While there is no lapse in service, delaying the approval of or postponing this item to a future Board date will result in further delays in recruitment and the implementation of services for individuals and families affected by the opioid crisis.
PROCUREMENT
Not applicable.
REVIEW BY OTHERS
This item has been reviewed by Behavioral Health (Michael Sweitzer, Senior Program Manager, 658-1816) on August 10, 2026; Public Health (Jonathan Pinedo, Senior Supervising Accountant, 387-9188) on July 16, 2026; Sheriff/Coroner/Public Administrator (Carolina Mendoza, Chief Deputy Director, 387-0640) on July 16, 2026; County Counsel (Charles Phan, Supervising Deputy County Counsel, and Cynthia O’Neill, Chief Assistant County Counsel, 387-5455) on July 28, 2026; Human Resources (Jose Mancilla, Recruitment Division Chief, 387-6080) on August 10, 2026; and County Finance and Administration (Chris Lange, Deputy Director, 386-8393, Iliana Rodriguez, 386-8392, and Erika Rodarte, 387-4919, Administrative Analysts) on August 13, 2026.