Extracted text (via ocr_local)
36618 characters
MARK BRNOVICH Office of the Attorney General
Attorney General State of Arizona
November 3, 2020
City of El Mirage
C/O Justin Pierce
City Attorney
10000 N El Mirage Rd
EI Mirage, AZ 85335
Re: One Arizona Opioid Settlement Memorandum of Understanding
Dear Mr. Pierce:
State and local governments across the country have been litigating against the opioid
industry in response to their alleged unethical and illegal practices. Arizona now has an opportunity
to settle with some of the manufacturers and distributors and secure financial resources to contend
with the devastation that has been caused to our communities. The total amount of money that
Arizonans receive is dependent upon the number of local governments that participate, so I
invite you to join our efforts.
A major step to facilitating a resolution with the opioid parties was recently achieved. The
State of Arizona and all 15 counties have now agreed to the One Arizona Opioid Settlement
Memorandum of Understanding (the “One Arizona Plan” or “MOU”). This MOU provides a
framework for distributing opioid settlement funds fairly and effectively throughout our state.
Moreover, the One Arizona Plan treats both litigating and non-litigating political subdivisions
equally.
Like all states engaged in this process, Arizona’s MOU employs certain formulas and data
collected by federal agencies such as (i) opioid use disorder rates, (ii) the number of opioid overdose
deaths, and (iii) the amount and potency of opioids shipped to each community. U.S. Census Bureau
data is also used to determine historical expenditures related to opioid abatement for designated
areas. With this in mind, please be assured that my office has made every effort to maximize
recovery for all cities and towns. In fact, under the MOU the State government’s share of funds
actually declines with the participation of more counties and cities. Nevertheless, this structure was
agreed to because it will increase the overall benefit to Arizona’s residents.
Also important to consider is what the One Arizona Plan will not do. Unlike some other
states, Arizona’s MOU does not create new foundations, form boards, or make political
appointments to control the funding. In fact, our MOU does the exact opposite thus cutting red tape
November 3, 2020
Re: One Arizona Opioid Settlement Memorandum of Understanding
and streamlining the grant process to quickly get the funds to those in need. Local governments are
best able to utilize resources targeted for their constituents, so no state authorization is required for
expenditure. The only requirements are that funds be spent in accordance with the approved
purposes detailed in the One Arizona Plan’s Exhibit A, and that basic reciprocal reporting be
completed.
Standing together, we can maximize critically needed resources to assist Arizonans
impacted by the opioid crisis, so our goal is 100% participation among cities and towns. [ urge
you to consider the One Arizona Plan with your legal counsel, execute the MOU in the space
provided and return it to my office. The deadline to submit your signature page is December 15,
2020 at 5:00 pm. Any questions that you have may be addressed to Acting Section Chief Matthew
du Mée at Matthew.duMee@azag.gov, or Assistant Attorney General Jennifer Bonham at
Jennifer. Bonham@azag.gov.
Respectfully yours,
Mark Brnovich
Attorney General
Enclosures:
One Arizona Opioid Settlement Memorandum of Understanding
Exhibits: A-D
City/Town Signature Page
ce: Joseph Sciarrotta, Jr., AGO Civil Litigation Division Chief Counsel
Matthew du Mée, AGO Acting Consumer Protection & Advocacy Section Chief Counsel
Jennifer Bonham, AGO Assistant Attorney General
Tom Belshe, Executive Director — League of Arizona Cities and Towns
Christina Estes- Werther, General Counsel — League of Arizona Cities and Towns
ONE ARIZONA OPIOID SETTLEMENT MEMORANDUM OF
UNDERSTANDING
General Principles
The people of the State of Arizona and Arizona communities have been harmed by the
opioid epidemic, which was caused by entities within the Pharmaceutical Supply Chain.
The State of Arizona, ex rel. Mark Brnovich, Attorney General (the “State”), and certain
Participating Local Governments are separately engaged in litigation seeking to hold the
Pharmaceutical Supply Chain Participants accountable for the damage they caused.
The State and the Participating Local Governments share a common desire to abate and
alleviate the impacts of the Pharmaceutical Supply Chain Participants’ misconduct
throughout the State of Arizona.
The State and the Participating Local Governments enter into this One Arizona Opioid
Settlement Memorandum of Understanding (“MOU”) to jointly approach Settlement
negotiations with the Pharmaceutical Supply Chain Participants.
This MOU has been drafted collaboratively to maintain the Parties’ existing or potential
legal claims (to the extent legally cognizable) while allowing the Parties to cooperate in
exploring all possible means of resolution.
Nothing in this MOU binds the Parties to a specific outcome. Any resolution under this
MOU will require a subsequent acceptance by the State and the Participating Local
Governments ofa final opioid Settlement plan.
Nothing in this MOU should alter or change the right of the State or any Participating
Local Government to pursue its own claim. The intent of this MOU is to join the Parties
to seek a Settlement or Settlements with one or more Pharmaceutical Supply Chain
Participants.
A. Definitions
As used in this MOU:
. “Approved Purpose(s)” shall mean those uses identified in the agreed Opioid Abatement
Strategies attached as Exhibit A.
. “Litigation” means existing or potential legal claims against Pharmaceutical Supply
Chain Participants seeking to hold them accountable for the damage caused by their
misfeasance, nonfeasance, and malfeasance relating to the unlawful manufacture,
marketing, promotion, distribution, or dispensing of prescription opioids.
“Opioid Funds” shall mean monetary amounts obtained through a Settlement as defined
in this MOU.
“Participating Local Government(s)” shall mean all counties, cities, and towns within the
geographic boundaries of the State that have chosen to sign on to this MOU. The
Participating Local Governments may be referred to separately in this MOU as
“Participating Counties” and “Participating Cities and Towns” (or “Participating Cities or
Towns,” as appropriate).
“Parties” shall mean the State and the Participating Local Governments.
“Pharmaceutical Supply Chain” shall mean the process and channels through which licit
opioids are manufactured, marketed, promoted, distributed, or dispensed.
“Pharmaceutical Supply Chain Participant” shall mean any entity that engages in or has
engaged in the manufacture, marketing, promotion, distribution, or dispensing of licit
opioids.
“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 the Participating Local Governments.
“Trustee” shall mean an independent trustee who shall be responsible for the ministerial
task of releasing the Opioid Funds that are in trust as authorized herein and accounting
for all payments into or out of the trust.
B. Intrastate Regions
I.
The State of Arizona will be divided into regions, each of which will be referred to as a
“Region” and will consist of: (1)a single Participating County and all of its Participating
Cities and Towns; or (2) all of the Participating Cities and Towns within a non-
Participating County. If there is only one Participating City or Town within a non-
Participating County, that single Participating City or Town will still constitute a Region.
Two or more Regions may at their discretion form a group (“Multicounty Region”).
Regions that do not choose to form a Multicounty Region will be their own Region.
Participating Cities and Towns within a non-Participating County may not form a Region
with Participating Cities and Towns in another county.
The LG Share funds described in Section C(1) will be distributed to each Region
according to the percentages set forth in Exhibit B. The Regional allocation model uses
three equally weighted factors: (1) the amount of opioids shipped to the Region; (2) the
number of opioid deaths that occurred in that Region; and (3) the number of people who
suffer opioid use disorder in that Region. In the event any county does not participate in
this MOU, that county’s percentage share shall be reallocated proportionally amongst the
Participating Counties by applying this same methodology to only the Participating
Counties.
In single-county Regions, that county’s health department will serve as the lead agency
responsible for distributing the LG Share funds. That health department, acting as the
2
lead agency, shall consult with the cities and towns in the county regarding distribution of
the LG Share funds.
For each Multicounty Region, an advisory council shall be formed from the Participating
Local Governments in the Multicounty Region to distribute the collective LG Share
funds. Each advisory council shall include at least three Participating Local Government
representatives, not all of whom may reside in the same county. Each advisory council
shall consult with the Participating Local Governments in the Multicounty Region
regarding distribution of the collective LG Share funds.
For each Region consisting of the Participating Cities and Towns within a non-
Participating County, an advisory council shall be formed from the Participating Cities
and Towns in the Region to distribute the LG Share funds. Each advisory council shall
include at least three representatives from the Participating Cities and Towns in the
Region, or a representative from each Participating City and Town if the Region consists
of fewer than three Participating Cities and Towns. In no event may more than one
individual represent the same city or town. To the extent any Participating Cities or
Towns in the Region are not represented on the advisory council, the advisory council
shall consult with the non-represented Participating Cities and Towns regarding
distribution of the collective LG Share funds.
C. Allocation of Settlement Proceeds
1.
All Opioid Funds shall be divided with 44% to the State (“State Share”) and 56% to the
Participating Local Governments (“LG Share”).!
All Opioid Funds, regardless of allocation, shall be utilized in a manner consistent with
the Approved Purposes definition, as ultimately memorialized in a Settlement that
becomes an order of the court. Compliance with this requirement shall be verified
through reporting, as set out in Section F.
The LG Share will be distributed to each Region as set forth in Section B(2).
Participating Counties and their constituent Participating Cities and Towns may distribute
the funds allocated to the Region amongst themselves in any manner they choose. If the
county and its cities and towns cannot agree on how to allocate the funds, Exhibit C
reflects a default allocation that will apply. The default allocation formula uses historical
federal data showing how the specific county and the cities and towns within it have
made opioids-related expenditures in the past. If the county or any cities or towns within
a Region do not sign on to this MOU and subsequent Settlement, and if the Participating
Local Governments in the Region cannot agree on how to allocate the funds amongst
themselves, they shall reallocate the funds proportionally amongst themselves by
applying this same methodology to only the Participating Local Governments in the
Region.
' This MOU assumes that any opioid settlement for Native American Tribes and Third-Party Payors, including
municipal insurance pools, will be dealt with separately.
If the LG Share for a given Participating Local Government is less than $500, then that
amount will instead be distributed to the county in which the Participating Local
Government is located to allow practical application of the abatement remedy. If the
county did not sign on to the Settlement as defined herein, the funds will be reallocated to
the State Share.
The State Share shall be paid by check or wire transfer directly to the State through the
Trustee, who shall hold the funds in trust in a Qualified Settlement Fund (QSF) for the
benefit of the State to be promptly distributed as set forth in C(1) herein. The LG Share
shall be paid by check or wire transfer directly to the Participating Local Governments
through the Trustee, who shall hold the funds in trust in a QSF for the benefit of the
Participating Local Governments to be promptly distributed as set forth in B(2), C(1),
C(3), and C(4) herein.
The State Share shall be used only for (1) Approved Purposes within the State or (2)
grants to organizations for Approved Purposes within the State.
The LG Share shall be used only for (1) Approved Purposes by Participating Local
Governments within a Region or Multicounty Region or (2) grants to organizations for
Approved Purposes within a Region or Multicounty Region.
The State will endeavor to prioritize up to 30% of the State Share for: opioid education
and advertising related to awareness, addiction, or treatment; Department of Corrections
and related prison and jail opioid uses, and opioid interdiction and abatement on
Arizona’s southern border, including grants to assist with the building, remodeling and/or
operation of centers for treatment, drug testing, medication-assisted treatment services,
probation, job training, and/or counseling services, among other programs.
D. Participation of Cities and Towns
1.
By virtue of signing on to the MOU and Settlement, each Participating County will
receive 60% of its available LG Share. The Participating County will receive up to an
additional 40% of its available LG Share by securing the participation of its constituent
cities and towns as signatories to this MOU and the Settlement. The sliding scale attached
as Exhibit D will determine the share of funds available to the Participating County.
If a Participating County does not achieve 100% participation of its cities and towns
within the period of time required in a Settlement document for subdivision participation,
the remaining portions of the LG Share that were otherwise available to the Participating
County will be reallocated to (i) the State Share and (ii) the LG Share for the
Participating Counties which have achieved 100% participation of their cities and towns
in accordance with the percentages described in Sections B(2), C(1), and C(3), and set
forth in Exhibits B and C.
E. Payment of Counsel and Litigation Expenses
l.
The Parties anticipate that any national Settlement will provide for the payment of all or a
portion of the fees and litigation expenses of certain state and local governments.
2. If the court in Jn Re: National Prescription Opiate Litigation, MDL No. 2804 (N.D.
Ohio) or if national Settlement establishes a common benefit fund or similar device to
compensate attorneys for services rendered and expenses incurred that have benefited
plaintiffs generally in the litigation (the “Common Benefit Fund”), and requires certain
governmental plaintiffs to pay a share of their recoveries from defendants into the
Common Benefit Fund as a “tax,” then the Participating Local Governments shall first
seek to have the settling defendants pay the “tax.” If the settling defendants do not agree
to pay the “tax,” then the “tax” shall be paid from the LG Share prior to allocation and
distribution of funds to the Participating Local Governments.”
3. Any governmental entity that seeks attorneys’ fees and expenses from the Litigation shall
seek those fees and expenses first from the national Settlement. In addition, the Parties
agree that the Participating Local Governments will create a supplemental attorney’s fees
and costs fund (the “Backstop Fund”).
4. The Backstop Fund is to be used to compensate counsel for Participating Local
Governments that filed opioid lawsuits by September 1, 2020 (“Litigating Participating
Local Governments”). Payments out of the Backstop Fund shall be determined by a
committee consisting of one representative from each of the Litigating Participating
Local Governments (the “Opioid Fee and Expense Committee”).
5. The Backstop Fund shall be funded as follows: From any national Settlement, the funds
to be deposited in the Backstop Fund shall be 14.25% of the LG Share of each payment
(annual or otherwise) to the State of Arizona for that Settlement. No portion of the State
Share shall be used for the Backstop Fund or in any other way to fund any Participating
Local Government’s attorney’s fees and costs.
6. The maximum percentage of any contingency fee agreement permitted for compensation
shall be 25% of the portion of the LG Share attributable to the Litigating Participating
Local Government that is a party to the contingency fee agreement, plus expenses
attributable to that Litigating Participating Local Government. Under no circumstances
may counsel collect more for its work on behalf of a Litigating Participating Local
Government than it would under its contingency agreement with that Litigating
Participating Local Government.
7. Any funds remaining in the Backstop Fund in excess of the amounts needed to cover
private counsels’ representation agreements shall revert to the Participating Local
Governments according to the percentages set forth in Exhibits B and C, to be used for
Approved Purposes as set forth herein and in Exhibit A.
? This paragraph shall not apply to any Settlement with distributors McKesson, Amerisource Bergen, and Cardinal
Health or manufacturer Johnson & Johnson.
F. Compliance Reporting and Accountability
1.
The Trustee shall provide an up-to-date accounting of payments into or out of the trust
and/or its subaccounts upon written request of the State or a Participating Local
Government.
The State, Regions, and Participating Local Governments may object to an allocation or
expenditure of Opioid Funds solely on the basis that the allocation or expenditure at
issue (1) is inconsistent with provision C(1) hereof with respect to the amount of the
State Share or LG Share; (2) is inconsistent with an agreed-upon allocation, or the
default allocations in Exhibits B and C, as contemplated by Section C(3); or (3) violates
the limitations set forth in F(3) with respect to compensation of the Trustee. The
objector shall have the right to bring that objection within two years of the date of its
discovery to a superior court in Maricopa County, Arizona.
Out of the Opioid Funds, reasonable expenses up to 0.005% shall be paid to the Trustee.
The Parties shall maintain, for a period of at least five years, records of abatement
expenditures and documents underlying those expenditures, so that it can be verified that
funds are being or have been utilized in a manner consistent with the Approved Purposes
definition.
At least annually, each Region or Multicounty Region shall provide to the State a report
detailing for the preceding time period (1) the amount of the LG Share received by each
Participating Local Government within the Region or Multicounty Region, (2) the
allocation of any awards approved (listing the recipient, the amount awarded, the
program to be funded, and disbursement terms), and (3) the amounts disbursed on
approved allocations. In order to facilitate this reporting, each Participating Local
Government within a Region or Multicounty Region shall provide information necessary
to meet these reporting obligations to a delegate(s) selected by the Region or Multicounty
Region to provide its annual report to the State.
At least annually, the State shall publish on its website a report detailing for the preceding
time period (1) the amount of the State Share received, (2) the allocation of any awards
approved (listing the recipient, the amount awarded, the program to be funded, and
disbursement terms), and (3) the amounts disbursed on approved allocations. In addition,
the State shall publish on its website the reports described in F(5) above.
If it appears to the State, a Region, or a Multicounty Region that the State or another
Region or Multicounty Region is using or has used Settlement funds for non-Approved
Purposes, the State, Region, or Multicounty Region may on written request seek and
obtain the documentation underlying the report(s) described in F(5) or F(6), as
applicable, including documentation described in F(4). The State, Region, or
Multicounty Region receiving such request shall have 14 days to provide the requested
information. The requesting party and the State, Region, or Multicounty Region
receiving such request may extend the time period for compliance with the request only
upon mutual agreement.
8. Following a request made pursuant to F(7) and when it appears that LG Share funds are
being or have been spent on non-Approved Purposes, the State may seek and obtain in an
action in a court of competent jurisdiction in Maricopa County, Arizona an injunction
prohibiting the Region or Multicounty Region from spending LG Share funds on non-
Approved Purposes and requiring the Region or Multicounty Region to return the monies
that it spent on non-Approved Purposes after notice as is required by the rules of civil
procedure. So long as the action is pending, distribution of LG Share funds to the Region
or Multicounty Region temporarily will be suspended. Once the action is resolved, the
suspended payments will resume, less any amounts that were ordered returned but have
not been returned by the time the action is resolved.
Following a request made pursuant to F(7) and when it appears to at least eight
Participating Counties that have signed on to this MOU and a subsequent Settlement that
the State Share funds are being or have been spent on non-Approved Purposes, the
Participating Counties may seek and obtain in an action in a superior court of Maricopa
County, Arizona an injunction prohibiting the State from spending State Share funds on
non-Approved Purposes and requiring the State to return the monies it spent on non-
Approved Purposes after notice as is required by the rules of civil procedure. So long as
the action is pending, distribution of State Share funds to the State temporarily will be
suspended. Once the action is resolved, the suspended payments will resume, less any
monies that were ordered returned but have not been returned by the time the action is
resolved.
10. In an action brought pursuant to F(8) or F(9), attorney’s fees and costs shall not be
recoverable.
F. Settlement Negotiations
1.
The State and the Participating Local Governments agree to inform each other in advance
of any negotiations relating to an Arizona-only settlement with a Pharmaceutical Supply
Chain Participant that includes both the State and the Participating Local Governments
and shall provide each other the opportunity to participate in all such negotiations.
The State and the Participating Local Governments further agree to keep each other
reasonably informed of all other global settlement negotiations with Pharmaceutical
Supply Chain Participants. Neither this provision, nor any other, shall be construed to
state or imply that either the State or the Participating Local Governments (collectively,
the “Arizona Parties”) are unauthorized to engage in settlement negotiations with
Pharmaceutical Supply Chain Participants without prior consent or contemporaneous
participation of the other, or that either party is entitled to participate as an active or
direct participant in settlement negotiations with the other. Rather, while the State’s and
the Participating Local Government’s efforts to achieve worthwhile settlements are to be
collaborative, incremental stages need not be so.
The State or any Participating Local Government may withdraw from coordinated
Settlement discussions detailed in this Section upon 10 business days’ written notice to
the other Arizona Parties and counsel for any affected Pharmaceutical Supply Chain
Participant. The withdrawal of any Arizona Party releases the remaining Arizona Parties
from the restrictions and obligations in this Section.
4. The obligations in this Section shall not affect any Party's right to proceed with trial or,
within 30 days of the date upon which a trial involving that Party's claims against a
specific Pharmaceutical Supply Chain Participant is scheduled to begin, reach a case-
specific resolution with that particular Pharmaccutical Supply Chain Participant.
G. Amendments
|. The Parties agree to make such amendments as necessary to implement the intent of this
agreement.
ACCEPTED by the undersigned and executed this f 6 day of Octo hee. 2020.
ARIZONA ATTORNEY GENERAL \
APACHE COUNTY
Michael B. Whiting
COCHISE COUNTY
Brian McIntyre
COCONINO COUNTY
William P. Ring
GILA COUNTY
Bradley B. Beauchamp
Participant. The withdrawal of any Arizona Party releases the remaining Arizona Parties
from the restrictions and obligations in this Section.
4. The obligations in this Section shall not affect any Party’s right to proceed with trial or,
within 30 days of the date upon which a trial involving that Party’s claims against a
specific Pharmaceutical Supply Chain Participant is scheduled to begin, reach a case-
specific resolution with that particular Pharmaceutical Supply Chain Participant.
G. Amendments
1. The Parties agree to make such amendments as necessary to implement the intent of this
agreement.
ACCEPTED by the undersigned and executed this day of , 2020.
ARIZONA ATTORNEY GENERAL
Mark Brnovich
APACHE COUNTY
_ ie B. Whiting
COCHISE COUNTY
LOrWwW CS 10/5/26
‘Brian McIntyre -
Aeneas atawanany Me
COCONINO COUNTY
Elizabeth C, Archuleta, Chair
GILA COUNTY
Bradley B. Beauchamp
#PTXHXPMYOESYERv2
GRAHAM COUNTY
LEZ
Kenny Angle
GREENLEE COUNTY _
fr
A meat t -
jfremy bog / ~
a“
LA PAZ COUNTY
Soh=
Tony Rogers
“A COUNTY
Allister Adel oe
MO) E COUNTY
Matthew J. Smith
BIL y
Brad Carlyon { a
PIMA COUNTY ;
Aacbacee las)
Barbara LaWall oo
PINE COUNTY SANTA CRUZ COUNTY
(i aa GEE
Kent Volkmer George-Silva oe
YAVAPAI COUNTY
ude S Pred
” Sheila Polk
YUMA COUNTY
10
APACHE JUNCTION CITY
By:
Its:
AVONDALE CITY
By:
Its:
BUCKEYE TOWN
By:
Its:
CAREFREE TOWN
By:
Its:
CAVE CREEK TOWN
By:
Its:
CHANDLER CITY
By:
Its:
EL MIRAGE CITY
By:
Its:
MARICOPA COUNTY CITIES & TOWNS
FOUNTAIN HILLS TOWN
By:
Its:
GILA BEND TOWN
By:
Its:
GILBERT TOWN
By:
Its:
GLENDALE CITY
By:
Its:
GOODYEAR CITY
By:
Its:
GUADALUPE TOWN
By:
Its:
LITCHFIELD PARK CITY
By:
Its:
Exhibit A
A.
OPIOID ABATEMENT STRATEGIES
PART ONE: TREATMENT
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, co-usage, and/or co-addiction through
evidence-based, evidence-informed, or promising programs or strategies that may include,
but are not limited to, the following:
1.
Expand availability of treatment for OUD and any co-occurring SUD/MH conditions,
co-usage, and/or co-addiction, including all forms of Medication-Assisted Treatment
(MAT) approved by the U.S. Food and Drug Administration.
Support and reimburse services that include the full American Society of Addiction
Medicine (ASAM) continuum of care for OUD and any co-occurring SUD/MH
conditions, co-usage, and/or co-addiction, including but not limited to:
a. Medication-Assisted Treatment (MAT);
b. Abstinence-based treatment;
c. Treatment, recovery, or other services provided by states, subdivisions,
community health centers; non-for-profit providers; or for-profit providers;
d. Treatment by providers that focus on OUD treatment as well as treatment by
providers that offer OUD treatment along with treatment for other SUD/MH
conditions, co-usage, and/or co-addiction; or
e. Evidence-informed residential services programs, as noted below.
Expand telehealth to increase access to treatment for OUD and any co-occurring
SUD/MH conditions, co-usage, and/or co-addiction, including MAT, as well as
counseling, psychiatric support, and other treatment and recovery support services.
Improve oversight of Opioid Treatment Programs (OTPs) to assure evidence-based,
evidence-informed, or promising practices such as adequate methadone dosing.
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, co-usage, and/or co-addiction and
for persons who have experienced an opioid overdose.
Support treatment of mental health trauma resulting from the traumatic experiences of
the opioid user (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 detoxification (detox) and withdrawal management services for persons with
OUD and any co-occurring SUD/MH conditions, co-usage, and/or co-addiction,
including medical detox, referral to treatment, or connections to other services or
supports.
8. Support training on MAT for health care providers, 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, co-usage, and/or co-addiction.
10. Provide fellowships for addiction medicine specialists for direct patient care,
instructors, and clinical research for treatments.
11. 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.
12. Support the 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.
13. Support the 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 and recovery from OUD and any co-occurring SUD/MH
conditions, co-usage, and/or co-addiction through evidence-based, evidence-informed, or
promising programs or strategies that may include, but are not limited to, the following:
1. Provide the full continuum of care of recovery services for OUD and any co-occurring
SUD/MH conditions, co-usage, and/or co-addiction, including supportive housing,
residential treatment, medical detox services, peer support services and counseling,
community navigators, case management, and connections to community-based
services.
2. 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, co-usage, and/or co-addiction.
Provide access to housing for people with OUD and any co-occurring SUD/MH
conditions, co-usage, and/or co-addiction, including supportive housing, recovery
housing, housing assistance programs, or training for housing providers.
Provide community support services, including social and legal services, to assist in
deinstitutionalizing persons with OUD and any co-occurring SUD/MH conditions, co-
usage, and/or co-addiction.
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, co-usage, and/or co-addiction.
Provide employment training or educational services for persons in treatment for or
recovery from OUD and any co-occurring SUD/MH conditions, co-usage, and/or co-
addiction.
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.
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
manage the opioid user in the family.
Provide training and development of procedures for government staff to appropriately
interact and provide social and other services to current and recovering opioid users,
including reducing stigma.
. Support stigma reduction efforts regarding treatment and support for persons with
OUD, including reducing the stigma on effective treatment.
CONNECT PEOPLE WHO NEED HELP TO THE HELP THEY NEED
(CONNECTIONS TO CARE)
Provide connections to care for people who have — or are at risk of developing - OUD and
any co-occurring SUD/MH conditions, co-usage, and/or co-addiction through evidence-
based, evidence-informed, or promising programs or strategies that may include, but are not
limited to, the following:
I.
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.
Support Screening, Brief Intervention and Referral to Treatment (SBIRT) programs to
reduce the transition from use to disorders.
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.
10.
12.
13.
14.
15.
16.
Purchase automated versions of SBIRT and support ongoing costs of the technology.
Support training for emergency room personnel treating opioid overdose patients on
post-discharge planning, including community referrals for MAT, recovery case
management or support services.
Support hospital programs that transition persons with OUD and any co-occurring
SUD/MH conditions, co-usage, and/or co-addiction, or persons who have experienced
an opioid overdose, into community treatment or recovery services through a bridge
clinic or similar approach.
Support crisis stabilization centers that serve as an alternative to hospital emergency
departments for persons with OUD and any co-occurring SUD/MH conditions, co-
usage, and/or co-addiction or persons that have experienced an opioid overdose.
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.
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, co-usage, and/or co-addiction or to persons who have
experienced an opioid overdose.
Provide funding for peer navigators, recovery coaches, care coordinators, or care
managers that offer assistance to persons with OUD and any co-occurring SUD/MH
conditions, co-usage, and/or co-addiction or to persons who have experienced on
opioid overdose.
. 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.
Develop and support best practices on addressing OUD in the workplace.
Support assistance programs for health care providers with OUD.
Engage non-profits and the faith community as a system to support outreach for
treatment.
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, co-usage, and/or co-addiction.
Create or support intake and call centers to facilitate education and access to
treatment, prevention, and recovery services for persons with OUD and any co-
occurring SUD/MH conditions, co-usage, and/or co-addiction.