Item Q02 �S Q.�
I`�
County of Monroe
�y,4 ' �, "tr, BOARD OF COUNTY COMMISSIONERS
County �a� Mayor Michelle Coldiron,District 2
�1 `ll Mayor Pro Tem David Rice,District 4
-Ile Florida.Keys ��� � � Craig Cates,District 1
Eddie Martinez,District 3
w Mike Forster,District 5
County Commission Meeting
September 15, 2021
Agenda Item Number: Q.2
Agenda Item Summary #8266
BULK ITEM: Yes DEPARTMENT: County Attorney's Office
TIME APPROXIMATE: STAFF CONTACT: Cynthia Hall (305) 292-3470
No
AGENDA ITEM WORDING: Approval of a resolution approving in principle a formula for
distribution of settlement proceeds for opioid litigation.
ITEM BACKGROUND: On 4/3/2019, Monroe County filed a lawsuit against manufacturers and
distributors, including several national retail pharmacy chains, in the federal district court for the
Southern District of Florida, for damages caused to the County by opioids manufactured and
distributed by the defendants. The lawsuit was later removed and consolidated with other cases filed
by other states and local governments, in multi district litigation (MDL)pending in Ohio. In
addition, some states, including Florida and other local governments, filed their own separate suits in
their respective state courts.
Collectively, the parties are at the point where they are considering a nationwide settlement with one
manufacturer (Johnson & Johnson) and three distributors (Amerisource Bergen Corporation,
McKesson, and Cardinal Health). Although no formal settlement documents have been proposed
yet, the State of Florida as well as the attorneys on the Steering Committee for both plaintiffs and
also defendants have requested that local subdivisions indicate at this point whether they are in
general terms with a formula, by which settlement proceeds would be distributed. The Florida
Attorney General's office is strongly in favor of the settlement. The State, which has been part of
the negotiating team, has also specifically requested that all Florida counties and cities give a general
expression at this point in time, regarding whether the local governments are in favor of(a) the
formula that would be used to allocate funds to counties and cities within the state, and (b) the
general guidelines for use of the funds in the future.
The specifics for the proposed settlement for Monroe County are laid out in greater detail in the
attached memo, but in broad terms, the key points for Monroe County are as follows:
➢ The overall amount of the settlement remains to be determined. Currently, the figure that is
being used is approximately $26.5 billion, nationally. That figure may go up as additional
defendants agree to settle.
➢ The national settlement would cover all states as well as all counties and cities, whether they
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Q.2
filed their own lawsuits or not.
➢ Each State will receive an allocation. The percentages have been negotiated. Florida will
receive 7.03%, or approximately $1.6 billion, based on the estimated settlement of$26.5 billion.
➢ On balance, the proposed settlement is a good deal for Monroe County. It will provide
approximately $206,000 per year to the County, and another $22,000 collectively to the five
municipalities, over a period of approximately 17.5 years, for use on substance abuse abatement.
Monroe County would receive a slightly higher share than its pro rata share based on population.
➢ The funds must be earmarked. They can be used for any of the purposes listed in Schedule A
(Core Strategies) or Schedule B (Approved Purposes)to the Memorandum of Understanding
attached as Exhibit 1 to the proposed Resolution.
PREVIOUS RELEVANT BOCC ACTION: On 1/17/18, the BOCC approved issuance of an RFP
for outside counsel. On 4/19/18, the BOCC approved selection of counsel and authorized the suit.
CONTRACT/AGREEMENT CHANGES:
N/A
STAFF RECOMMENDATION: Approval.
DOCUMENTATION:
Resolution approving settlement formula
Exh 1 to Reso --Proposed MOU, Schedules A and B, and spreadsheet
Letter from Dep. AG Guard to Monroe County
Memo to Commissioners Opioid Case 8.31.2021
FINANCIAL IMPACT:
Effective Date: Upon adoption of resolution.
Expiration Date: N/A
Total Dollar Value of Contract:
Total Cost to County:
Current Year Portion:
Budgeted:
Source of Funds:
CPI:
Indirect Costs:
Estimated Ongoing Costs Not Included in above dollar amounts:
Revenue Producing: Yes If yes, amount: TBD
Grant:
County Match:
Insurance Required: No
Additional Details:
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REVIEWED BY:
Cynthia Hall Completed 08/30/2021 8:32 PM
Bob Shillinger Completed 08/31/2021 10:05 AM
Purchasing Completed 08/31/2021 10:07 AM
Budget and Finance Completed 08/31/2021 12:33 PM
Maria Slavik Completed 08/31/2021 12:37 PM
Liz Yongue Completed 08/31/2021 3:00 PM
Board of County Commissioners Pending 09/15/2021 9:00 AM
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Q2.a
RESOLUTION NO. - 2021
A RESOLUTION OF THE BOARD OF COUNTY
COMMISSIONERS OF MONROE COUNTY, FLORIDA,
AUTHORIZING MONROE COUNTY, FLORIDA, TO JOIN WITH
THE STATE OF FLORIDA AND OTHER LOCAL GOVERNMENT
UNITS AS A PARTICIPANT IN THE FLORIDA MEMORANDUM
OF UNDERSTANDING REGARDING OPIOID LITIGATION
WHEREAS, Monroe County, Florida, has suffered harm from the opioid epidemic; and
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WHEREAS, on April 3, 2019, Monroe County filed a complaint against manufacturers
and distributors, including certain national retail pharmacy chains, who have
manufactured, distributed and sold opioid substances, alleging various causes of action y
including violation of 18 U.S.C. § 1961, Racketeer Influenced and Corrupt Organizations
(RICO) Act, violation of the Florida Deceptive and Unfair Trade Practices Act, and other
causes of action, which action was subsequently removed to and consolidated with
lawsuits filed by numerous other states and local governments as part of multi-district
litigation ("MDL"), In re: National Prescription Opiate Litigation, MDL Case number
2804 (N.D. Ohio) (the "Opioid Litigation"), in which Monroe County is a litigating party;
and
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WHEREAS, on May 15, 2018, the State of Florida filed its own complaint in the Circuit
Court for the Sixth Judicial Circuit in and for Pasco County, Case No. 2018-CA-001438- E
CA, which case is currently being litigated in that Circuit Court; and
WHEREAS, lawyers representing the State of Florida and also Florida local
governments have been engaged with the defendants in the MDL litigation as well as
litigation brought by the State of Florida and other states and local governments not part
of the MDL litigation, to discuss potential settlement of the various cases; and
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WHEREAS, lawyers representing the State of Florida lawyers and various other Florida
local governments involved in the Opioid Litigation have proposed a unified plan for the
allocation and use of prospective settlement proceeds from all opioid-related litigation;
and
WHEREAS, the State of Florida has proposed a Florida Memorandum of Understanding
(the "Florida Plan"), Exhibit 1 to this Resolution including Schedules A and B to the
exhibit, which sets forth a framework for a unified plan for the proposed allocation and
use of settlement proceeds from the opioid proceeds and shows a formula for
distribution of settlement proceeds among the State of Florida, Florida counties, and
Florida cities; and
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Q2.a
WHEREAS, participation in the Florida Plan by a large majority of Florida cities and
counties will improve Florida's relative bargaining position during settlement
negotiations and may increase the amount of funds available to the State of Florida and
its local governments; and
WHEREAS, in order to achieve these objectives, the State of Florida has requested that
local governments sign on to approval of the formula in principle for distribution of
potential settlement proceeds contained in the Florida Plan by September 30, 20217
with the understanding that (a) the actual dollar figures for any proposed settlements
and (b) settlement agreements would need to be brought back separately for approval
by the local governing bodies, including the Monroe County Board of County
Commissioners.
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NOW, THEREFORE, BE IT RESOLVED BY THE BOARD OF COUNTY
COMMISSIONERS OF MONROE COUNTY, THAT:
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1. The Board of County Commissioners for Monroe County, Florida, finds that
participation in the Florida Plan would be in the best interests of Monroe County
and its citizens in that such a plan will ensure that the majority of settlement
funds will go to Monroe County and its municipalities in order to abate the opioid
epidemic.
2. The Board of County Commissioners for Monroe County, Florida, expresses its
support for a unified state-wide plan for the allocation and use of opioid
settlement proceeds as generally described in the Florida Plan, attached hereto
as Exhibit 1 to this Resolution, including Schedule A (Core Strategies) and
Schedule B (Approved Uses).
3. If approval to the MOU is required, the County Administrator is authorized to y
execute the MOU provided it is in substantially the form contained in Exhibit 1,
after review by the County Attorney's Office. Any other formal settlement
agreements
4. The Clerk is authorized to record this Resolution in the appropriate record book
upon its adoption. y
5. The Clerk is requested to furnish a certified copy of this Resolution to the Florida
Attorney General at the following address:
Attorney General Ashley Moody
c/o Chief Deputy Attorney General John M. Guard
The Capitol
P L-01
Tallahassee, FL 32399-1050
6. This Resolution shall become effective immediately upon adoption.
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Q2.a
PASSED AND ADOPTED by the Board of County Commissioners of Monroe County,
Florida, at a regular meeting of the Board held on September 15, 2021.
Mayor Michelle Coldiron
Mayor Pro Tern David Rice
Commissioner Craig Cates
Commissioner Mike Forster
Commissioner Eddie Martinez
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(Attest) BOARD OF COUNTY COMMISSIONERS
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KEVIN MADOK, CLERK OF THE COURT OF MONROE COUNTY, FLORIDA
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By: By:
As Deputy Clerk Mayor
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Approved as to form and legal sufficiency:
MONROE COUNTY ATTORNEY'S OFFICE
Assistant County Attorney August 30, 2021
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Q.2.b
PROPOSAL
MEMORANDUM OF UNDERSTANDING
Whereas, the people of the State of Florida and its communities have been harmed by o
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 0.
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; 0
Whereas, the State of Florida and its Local Governments share a common desire to abate 4
and alleviate the impacts of that misfeasance, nonfeasance and malfeasance throughout the State 6
of Florida; 2
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 Cd
Understanding("MOU")relating to the allocation and use of the proceeds of Settlements described
herein; and
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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.
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A. Definitions
As used in this MOU:
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1. "Approved Purpose(s)" shall mean forward-looking strategies, programming and
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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. w
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
000003/01288125_1
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Q.2.b
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. o
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 0.
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. 0
6. "Negotiating Committee" shall mean a three-member group comprised by 4
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 2
(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
g tY tY N
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 2
Prescription Opiate Litigation, MDL No. 2804 (N.D. Ohio). The website is located at
https:HalIocationmap.iclaimsonline.com.
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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 0.
of Ohio.
12. "Pharmaceutical Supply Chain"shall mean the process and channels through which
Controlled Substances are manufactured, marketed,promoted, distributed or dispensed.
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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 w
analgesic.
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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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Q.2.b
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 0
County will only include Opioid Funds for Municipalities whose claims are released by the r_
Municipality or Opioid Funds for Municipalities whose claims are otherwise barred.
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16. "SAMHSA" shall mean the U.S. Department of Health & Human Services, 2
Substance Abuse and Mental Health Services Administration. 0
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 (13)(1)below.
18. "State" shall mean the State of Florida. y
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 Cd
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.
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2. Avoid Claw Back and Recoupment-Both the State and Local Governments wish 0
to maximize any Settlement and Opioid Funds. In addition to committing to only using funds for 0.
the Expense Funds,Administrative Costs and Approved Purposes,both Parties will agree to utilize a
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
0
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 1°
is reached with the United States, then there will be no requirement that a percentage be utilized
for Core Strategies. E
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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:
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(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 0
Governments that are not within the definition of County or Municipality, those r_
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 0
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 0
have its share of the City/County Fund go to the County in which it is located.
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(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 y
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 as
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.
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(c) State Fund - The remainder of Opioid Funds after deducting the costs of the 0
Expense Fund detailed in paragraph 9,the City/County Fund and the Regional Fund CL
will be expended by the State on Approved Purposes, including the provisions a
related to Core Strategies, if applicable.
(d) To the extent that Opioid Funds are not appropriated and expended in a year by the c
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 E
deposit.
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Q.2.b
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% o
B. Years 7-9: 35%
C. Years 10-12: 34% .2
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D. Years 13-15: 33%
E. Years 16-18: 30%
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5. Opioid Abatement Taskforce or Council - The State will create an Opioid c
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 t
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. a
(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 C
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 v)
and the other county representative must be from a county whose population
exceeds 200,000 people.
(c) Appointments State - c
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(i) The Governor shall appoint two Members. ;
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(ii) The Speaker of the House shall appoint one Member.
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(iii) The Senate President shall appoint one Member.
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(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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(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 o
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 0.
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 c
shall contain information on how monies were spent the previous fiscal year by the 0
State, each of the Qualified Counties, each of the Managing Entities, and each of 2
the Local Governments. It shall also contain recommendations to the Governor, 0
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 2
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 y
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 31 st 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 Cd
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 U)
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 0
counties that are not Qualified Counties. Each Qualified County may take no more than a 5% CL
0
administrative fee from its share of the Regional Funds. 0
7. Negotiation of Non-Multistate Settlements -If the State begins negotiations with c
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.
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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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Q.2.b
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 o
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 0
Parties agree that an additional expense fund for attorneys who represent Local Governments r-
(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. 0
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(a) The Source of Funds for the Expense Fund- Money for the Expense Fund shall be 0
sourced exclusively from the City/County Fund. 76
(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 y
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 Amount that shall be paid Cd
Participation in the into the Expense Fund
Settlement(by percentage of from (and as a percentage
the population) i /Coun fund
96 to 100% 10%
91 to 95% 7.5%
86 to 90% 5% i)
85% 2.5%
Less than 85% 0%
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If fewer than 85% percent of the litigating Local Governments (by population) 0
participate,then the Expense Fund shall not be funded,and this Section of the MOU �
shall be null and void. c
(c) The Timing _of Payments into the Expense Fund- Although the amount of the Payments into the Expense Fund- Although the amount of the 0
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 w
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 2
years and pay the borrowed amounts back to the Regional Fund during years three
four, and five.
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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:
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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 0
Amount Paid to Expense Fund in 1 st year: $7.5 r_
Amount Paid to Expense Fund in 2nd year $7.5 c
Amount that may be borrowed from Regional Fund in 1 st year: $7.5 0
Ch
Amount that may be borrowed from Regional Fund in 2nd year: $7.5 2
Amount that must be paid back to Regional Fund in 3rd year: $5 0
Amount that must be paid back to Regional Fund in 4th year: $5 76
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Amount that must be paid back to Regional Fund in 5th year: $5 2
(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 ofFlorida, Office of
the Attorney General, Department ofLegal 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 C
Expense Fund and to resolve any disputes concerning the Expense Fund.
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(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 U)
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 0
Negotiation Class Metrics and the rate set forth in their contingency contracts, to 0
calculate a proposed award for each litigating Local Government who timely a.
provided a copy of its contingency contract. 0
10. Dispute resolution- Any one or more of the Local Governments or the State may 0
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 w
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.
Packet Pg. 3056
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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].' '
A. Naloxone or other FDA-approved drug to reverse opioid overdosesCL
C
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 W
L
service. �-
B. Medication-Assisted Treatment("MAT") Distribution and other opioid-related treatment
2
CL
CL
1. Increase distribution of MAT to non-Medicaid eligible or uninsured individuals;
CD
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 0°
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; va
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
OL
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
r
1. Expand comprehensive evidence-based and recovery support for NAS babies;
x
2. Expand services for better continuum of care with infant-need dyad; and
a:
3. Expand long-term treatment and services for medical monitoring of NAS babies and their families.
i 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.
1
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Q.2.b
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;
.2
M
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. ,
CD
0
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.; Cd
3. Funding for medical provider education and outreach regarding best prescribing practices for opioids t°
consistent with the 2016 CDC guidelines,including providers at hospitals (academic detailing);
4. Funding for community drug disposal programs; and
U)
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 OL
L
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.
L Evidence-based data collection and research analyzing the effectiveness of the abatement strategies
within the State.
X
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CD
E
2
Packet Pg. 3058
Q.2.b
Schedule B
Approved Uses
PART ONE: TREATMENT
E
A. TREAT OPIOID USE DISORDER(OUD) M
T
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 .2
strategies that may include,but are not limited to,the following:'
C
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. W
L
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
2
CL
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
a:
recovery support services.
4. Improve oversight of Opioid Treatment Programs (OTPs)to assure evidence-based or evidence- CL
a
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 t°
service providers, such as peer recovery coaches, for persons with OUD and any co-occurring 0°
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.
U)
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.
r
10. Fellowships for addiction medicine specialists for direct patient care,instructors, and clinical x
research for treatments.
11. Scholarships and supports for behavioral health practitioners or workers involved in addressing E
OUD and any co-occurring SUD or mental health conditions,including but not limited to training,
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.
3
Packet Pg. 3059''
Q.2.b
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 .CL
2
Psychiatry's Provider Clinical Support Service-Opioids web-based training curriculum and
motivational interviewing. .2
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
2
CL
CL
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-occurringCL
t°
SUD/MH conditions,including housing,transportation, education,job placement,job training, or
childcare.
cd
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.
a:
3. Provide counseling,peer-support, recovery case management and residential treatment with access to 0
medications for those who need it to persons with OUD and any co-occurring SUD/MH conditions.
U)
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 CD
support services. 0
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5. Provide community support services, including social and legal services,to assist in ;
deinstitutionalizing persons with OUD and any co-occurring SUD/MH conditions. 0
a:
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.
x
LU
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. '
4
Packet Pg. 3060
Q.2.b
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. �,
T
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. CL
r_
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.
L
14. Create and/or support recovery high schools. CL
CL
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- Cd
t°
occurring SUD/MH conditions through evidence-based or evidence-informed programs or strategies
that may include,but are not limited to,the following:
B
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, 0
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. x
w
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. E
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.
5
Packet Pg. 3061
Q.2.b
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. �,
T
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 CL
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
CL
on young people. CL
13. Develop and support best practices on addressing OUD in the workplace.
14. Support assistance programs for health care providers with OUD.
a:
L
15. Engage non-profits and the faith community as a system to support outreach for treatment. v
16. Support centralized call centers that provide information and connections to appropriate servicesCd
t°
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
CD
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, W
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: 0
L
a. Self-referral strategies such as the Angel Programs or the Police Assisted Addiction Recovery 0
:
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 X
naloxone to reverse the effects of an overdose are then linked to treatment programs or other w
appropriate services;
E
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
6
Packet Pg. 3062
Q.2.b
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
CL
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. Cd
E. ADDRESS THE NEEDS OF PREGNANT OR PARENTING WOMEN AND THEIR
FAMILIES, INCLUDING BABIES WITH NEONATAL ABSTINENCE SYNDROME y
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 U)
limited to,the following: 0
1. Support evidence-based or evidence-informed treatment, including MAT, recovery services and y
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.
W
2. Expand comprehensive evidence-based treatment and recovery services, including MAT, for (D
uninsured women with OUD and any co-occurring SUD/MH conditions for up to 12 months
postpartum.
X
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. 0
E
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.
7
Packet Pg. 3063'
Q.2.b
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.
T
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. B
PART TWO: PREVENTION
F. PREVENT OVER-PRESCRIBING AND ENSURE APPROPRIATE PRESCRIBING AND
DISPENSING OF OPIOIDSCL
Support efforts to prevent over-prescribing and ensure appropriate prescribing and dispensing ofCd
1°
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 a
Control and Prevention,including providers at hospitals (academic detailing).
U)
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. 0
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4. Support for non-opioid pain treatment alternatives,including training providers to offer or refer to ,
multi-modal, evidence-informed treatment of pain.
U)
CD
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 E
available to prescribers using PDMPs,by improving the interface that prescribers use to access
PDMP data, or both; or
8
Packet Pg. 3064
Q.2.b
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.
CL
8. Educate Dispensers on appropriate opioid dispensing. r_
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.
B
2. Corrective advertising or affirmative public education campaigns based on evidence.
a:
3. Public education relating to drug disposal. .�
L
4. Drug take-back disposal or destruction programs.
5. Fund community anti-drug coalitions that engage in drug prevention efforts.
om
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, W
including the Strategic Prevention Framework developed by the U.S. Substance Abuse and Mental �0
Health Services Administration (SAMHSA).
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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.
L
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. x
w
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 E
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
9
Packet Pg. 3065;
Q.2.b
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 firstCL
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 CL
members of the general public. B
4. Enable school nurses and other school staff to respond to opioid overdoses, and provide them with
naloXone, training, and support.
a:
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5. Expand, improve, or develop data tracking software and applications for overdoses/naloXone
revivals.
Cd
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
a:
laws.
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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 CD
provided by these programs. 0
L
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. x
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 E
opioids or persons with OUD and any co-occurring SUD/MH conditions.
13. Support screening for fentanyl in routine clinical toxicology testing.
10
Packet Pg. 3066'
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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.
r_
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:
2
0-
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.
CL
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 throughCd
t°
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. U)
4. Provide resources to staff government oversight and management of opioid abatement programs.
K. TRAINING
CL
L
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. x
w
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 E
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
II
Packet Pg. 3067
Q.2.b
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. 0
5. Research on innovative supply-side enforcement efforts such as improved detection of mail-based
delivery of synthetic opioids.
L
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).
B
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.
L
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 Ca
treatment outcomes.
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U)
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U)
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Packet Pg. 3068
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RESOLUTION NO. [INSERT]
A Resolution authorizing [City/County] (herein referred to as this "Governmental Unit")to join
with the State of Florida and other local governmental units as a participant in the Florida Memorandum
of Understanding and Formal Agreements implementing a Unified Plan.
WHEREAS,the [City/County] has suffered harm from the opioid epidemic;
WHEREAS, the [City/County] recognizes that the entire State of Florida has suffered harm as a 0.
result from the opioid epidemic;
0
WHEREAS, the State of Florida has filed an action pending in Pasco County, Florida, and a
0
number of Florida Cities and Counties have also filed an action In re:National Prescription Opiate
Litigation, MDL No. 2804 (N.D. Ohio) (the "Opioid Litigation") and [City/County] [is/is not] a litigating
participant in that action;
2
WHEREAS,the State of Florida and lawyers representing certain various local governments
involved in the Opioid Litigation have proposed a unified plan for the allocation and use of prospective
settlement dollars from opioid related litigation;
WHEREAS,the Florida Memorandum of Understanding (the "Florida Plan") sets forth sets forth
a framework of a unified plan for the proposed allocation and use of opioid settlement proceeds and it
is anticipated that formal agreements implementing the Florida Plan will be entered into at a future y
date; and,
WHEREAS, participation in the Florida Plan by a large majority of Florida cities and counties will
materially increase the amount of funds to Florida and should improve Florida's relative bargaining
position during additional settlement negotiations; y
m
WHEREAS, failure to participate in the Florida Plan will reduce funds available to the State,
[City/County], and every other Florida city and county;
NOW,THEREFORE, BE IT RESOLVED BY THIS GOVERNMENTAL UNIT:
SECTION 1.That this Governmental Unit finds that participation in the Florida Plan would be in
the best interest of the Governmental Unit and its citizens in that such a plan ensures that almost all of y
the settlement funds go to abate and resolve the opioid epidemic and each and every city and county 0.
receives funds for the harm that it has suffered. CL
SECTION 2.That this Governmental Unit hereby expresses its support of a unified plan for the y
allocation and use of opioid settlement proceeds as generally described in the Florida Plan, attached
hereto as Exhibit "A."
SECTION 3.That [official name] is hereby expressly authorized to execute the Florida Plan in
substantially the form contained in Exhibit "A."
SECTION 4. That [official name] is hereby authorized to execute the any formal agreements
implementing a unified plan for the allocation and use of opioid settlement proceeds that is not
substantially inconsistent with the Florida Plan and this Resolution.
Packet Pg. 3069
Q.2.b
SECTION 5. That the Clerk be and hereby is instructed to record this Resolution in the
appropriate record book upon its adoption.
SECTION 6.The clerk of this Governmental Unit is hereby directed to furnish a certified copy of
this Ordinance/Resolution to the Florida
[Florida League of Cities/Florida Association of Counties]
Attorney General Ashley Moody 0.
c\o John M. Guard
The Capitol,
P L-01
Tallahassee, FL 32399-1050
4
0
SECTION 7.This Resolution shall take effect immediately upon its adoption.
0
Adopted this day of, 12021.
(Mayor/Commissioner/etc.) N
ATTEST:
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0.
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CL
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Packet Pg. 3070
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t
OFFICE OF TI11; t1"f"FORNEY GENERAL
* PLA I The Capitol
1 fallalaassee, FT 32399-1050
ASH LEY MOODY Phone(850)41.1-3300
ATTORNEY GENERAL A L Fax(850)-187-0168
STATE OF FLORIDA hup:/'irwir,rrzifloridealegill. 2
ty pri 1 13, 2021 .
0.
Mayor !Michelle Coldiron
Monroe C'ounte=
25 Ships Way �
Big fine Key, I'L 33040
COI.171I�C7N-MICI II11..1 I (ii)MONIZOI,'C OIJN'I`Y-1�I..d.C1OV
G
111", Opioid Litigation
Iycar Mayor- Michelle Coldiron:
G
My name is John GUard and l am the C"hief Dcputy Attorney General for the State of
Florida(the "State"). Since she took office, Attorney General Moody has been heavily involved
in leading both the State's ongoing opioid litigation and Several difTLrent negotiations with
defendants in that litigation. Those negotiations have included litigation coalnsel representing G
cities and counties.
As part of those negotiations to enable I'lorida to achieve the maximum amount
recoverable for both the State and its subdivisions. the State:: has been negotiating for a lengthy
tinge with outside counsel for nearly all litigating political subdivisions within the State. After
multiple sessions and significant compromise by both sides, the attached memorandum of
understanding ("MOO") has been reached. We have offered and the larwyers fi:rr the litigating e
subdivisions are rccornmending to their clients that the attached l°aIOU be accepted. This
proposal is the result of nurneroirs meetim,s and includes feedback and cornnacnts from many
local subdivisions. Based on the status of this litigation, the likely str-areture of'anyf I•esolaltion,
the potential litigation risks in the absence o#`such an agreement, the. State believe that this
proposal reflects a reasonable: compromise between the State and its political subdivisions. E
The purpose ofthis letter is to summarize the primary terms of"the MOO and attempt to
anticipate clucstions that yoga, )sour cornnaission, and your intcr•nal sand/or Bather legal counsel may
have regarding this litigation and allocation proposal.
Page 1 of 7
Packet Pg. 3079
What cases does this i'v OU apply?
I"leis allocation agreement nacnt is intended to govern the distribtrtion of settlement proceeds
obtained tilroaagh the Ptirduc Pharma I.T. ("Purdue") bankruptcy, the Mallinckrodt PL,C
("Mallinckrodt") bankruptcy, the.distributor(Cardinal. I Ietalth, Inc., McKesson Corp., and
Anaerisourcel3c r en Corp. (collectively referred to as the. "Distributors")) and Johanson
Johnson ("J&J") potential deal, as well as any additional settlements obtained related to the
opioid litigation.
Why is -,in :allocation agreement necessary and will, now?
0.
Almost 100 political subdivisions within the State of'Florida, as well as the State of c
Florida itself, have filed suit against tat1mcrous entities cnp{aged I11 flee laaanufIacturrye, marketing,
promotion, distribution or dispensing ofTopioids. Another 310 political subdivisions within the
State ol'Itlorida leave tiled claims in the Purdue bankruptcy.
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The State and the Plaintiffs" FIxecutivc Cotaamittee tOr tlae ()pioid L.itiation Multi-
District 1_.itigation panel (the '`PLC") are in ongoing negotiations with Purdue, Mallinckrodt, the
Distributors, and J&J with potential resolutions anticipated in the conning weeks.
Uhider the likely seulenaent structure for these cases, states and their political subdivisions are
strongly incentivized to reach a joint resolution ofall State and political subdivision claims.
Under the Distributor and J&J deal, the State- and its subdivisions receive a substantially lamer
settlement amount the higher the number of'subdivisions sHm on to the deal. 'I'laerefore. it is in �
the best interest ofall political subdivisions and the State of I°lorida to reach an allocation
agreement which will permit the_joint resolution ofall claims within the state.
G
The deals contemplate the need for relatively quick buy in by subdivisions in order to
maximize recovery. The pace of negotiations is accelerating, and Purdue has filed its flan of
reorganization. Given this accelerating puce. there is a greater sense ol'urgency among all
counsel to come to agreement and resolve how monies are going to be allocated! so that we can
move Purdue, Mallinckrodt, and other potential settlements toward finality. Given the Sunshine
law, tlae likely need for public notice and comment, and tlae complexity oftlac deals, we need to
agree to an allocation plan taoww to etastire that Florida maximizes recovery. e
0
Ilowrt can funds be utilized?
You will sec as you review the l'w OU that tlae ;State and its subdivisions, who execute this
MOU, are agreeing that almost all the funds from any settlement will go to abatement activities.
In other wvords. I'iinds raatIst be utilized 101-stratc<oics, programming and services used to expand
the availability of treatment For individuals impacted by Opio d Use Disorder or co-occurring
Substance Use Disorder and. Mental I lealtla disorders ('-Approved Purposes"). A non-exclusive
list of potential abatement prograanis and uses are included in Exhibits A and I3 to the agreement.
The list was developed nationally consulting with public health officials in multiple states,
experts f'or the states and subdivisions, and officials within ttae Unitcd States Department of
Health and Human Services. These user are intended to best serve tlae overall purpose and
Page 2 of 7
Packet Pg. 3080
intention of this litigation. which is to abate the continuing public health crisis ofopioid
addiction within our communities.
While supported by the `hate, this requirement was imposed the def`endaants for tax and
other reasons. It is also necessary to militate against the United States seeking substantial
announts of settlement fiends from both the State and subdivisions as recoupmeant.
11ONN, are the funds allocated amongst the States?
While not Mart ofthe MOU, the States have been negotiating the national allocation for
almost two years with all agrccmetnt reached in late 2019. Florida's interstate al location is
7.0 a%. That allocation is the: second largest allocation in the nation ahead of Texas, which is tine -
second largest state. Florida is one of a handful of states whose allocation is greater and greater
by a significant percentage above its population (Florida has 6.54% of tine United States' —
population). The only states that have larger gains over their population arc the opioid belt
0
states; West Virginia, Kentucky, etc. The interstate allocation is the product of two measures. �
One calculated by tlae PF C and the other calculated by the States. The data sets chosen are
slightly different (including different years an(] what measures were: selected), but the main
difference is that some :Mates demanded that population play a more significant factor in the state
allocation and it is not as f4actor in the 1'1 C calculation. Given honv much Florida's allocation
percentage is above its population. the need in these settlements to maximize the anunnber of --
states settling. and the potential litivaatio n risks in the absence ol`such an agreement, it would be
oaaa-recommendation that cities and counties accept tlae interstate allocation.
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hoar° much money clots the State expect for it and its subdivisions?
G
It depends. t aach ofthe current or proposed settlements are: ftnr different lengths oftime e
and each contain different variability. In Purdue, payments arc paid over a ten-yeau period and
vary with the perf«rmancc ofthe oangoiang business ofthe new company and payments from third
parties. Ian Mallinckrodt, payment amounts are still being negotiated, but will be paid over seven
years and will vary depending on the value of the emerging company seven years later as part of
the recovery is warrants in the re-emerged company. In the Distributor and ,l&J proposed deal, 6
the proposed deal is over eighteen years and the aaannount paid varies depending on subdivision
participation and whether other subdivisions tile opioid related liti;-aatiotn in the future. As part of c
tine l' OU, the State is willing to seek judiciaal or legislative action to reduce the variability ofthe
annoanics, especially in connection with tine Distributor and .1 J deal. Char current best guess based
on projections and assuming total participation is $120-1 4€ M as year liar tine first few years, $ D
1 f OM a year for the middle years, and then $60-70M a year Cor the later years of tine deal for the
State and its subdivisions. Armin. these numbers can and will vary and hopefully will increase if
additional settlements arc reached. e
l oNv are the funds allocated amongst the State and its subdivisions"?
`]`his Proposal divides all settlement hands between three funds: (I) the City/County I'taand;
(2) the Regionaal Fund: aaancl.. ( ) the State Fund.
Page 3 of 7
Packet Pg. 3081
The C tvlCounhr Fund consists of 15% of the total scttlement amounts allocable to the
State of Florida. These funds are distributed to all counties and qualifying municipalities ill the
State€f'F lorida.
The allocation of the CitV/C.ouraty I"Land between counties and municipalities is based on as
model referred to as the '`Negotiation Class Metrics."This model was developed ill the Irrational
Prescription Opiate MDL by tire.. Pl_:C. and considers: (1) the amount of opioids shipped to the
county; (`?) the number ofopioid deaths that occurred in drat county-, and (3) the number of
people who suffer ol)ioid use disorder in that county. Allocations between counties and
municipalities within each count), tase historical federal data showing how tlae specific county
and the cities within it have made opioids-related expenditures in the past.
G
We have attached a spreadsheet to this letter that provides you ail estimated amount per
year for an amount within each ram,e in the previous question.
6
The Regional Fund consists ol'a sliding scale betwvicen 30% and 40%ofthc total 2
settlement ani€runts allocable to the State of Florida, with the largest percentages Occur-ing ill tlae o
m
immediate years after settlement and decreasing over time. >
These Rands are allocated to counties in accordance with the. "Ncgotiating Class Metries" <
described above. In the case of counties with as population ofover 300,000, and which satisfy
other criteria regarding. abatement infrastructure, (termed "Qualified Counties") these funds arc
provided directly to the county. For the remainder of counties within the State, these funds arc
provided to the Managing Entity (tile entity that tlae State has contracted with to provide
substaance abuse treatment) for that county, to be spent oil approved purposes within the region
that the county is a pant. o
0
Foi-Counties rtrillt l ojmlwions gr�eerter°than 300,000: We encourage you to review the
delinition of Qualified County in the MOU, so that you can understand the other
requirements that you will have to nicct. Importantly, the definition Of Qualified County
requires that you reach all aagreen-rctrt with at least some municipalities (at least 50% of �
the population) within your county as to ]low these funds are spent. The requirements of
such agreements are subk ject to further discussion and ncgotiatiorr.
We have attached as spreadsheet to this letter that provides your ail estimated amount per
year for ail amount within each ravage in tlae Previous question. The amount will vary for
quaalificd counties depending ova bow many municipalities in that County: (I)join a �
settlement: and (2) enter ail agrcctraent with a County.
Foi, C'er mliej.s rt7itlr pol,mhairrta.s less decree 300,000 mar•that elo maul gtwli j,as cr Querlr,i e(l
C'caugv: Currently, as majority of the monies being utilized to respond to the opioid
epidemic in the State 1 oww through Managing 11'ntities located regionally who provide
service in each corrrnararaity. When we traveled the state before COVID and had
discussions with many ofyou, most (outside a couple large cotaratics) indicated that they
Page 4 of 7
Packet Pg. 3082
had a good working relationship with their Managing F ntity. Indeed, several indicated
that they were already involved with their Managing, Entity. The tactual dollar amounts
annually paid to sntaaller counties under the contemplated settlement agreements are not
substantial enough to Support standalone programs. Given that reality, but wvanting to
maximize services locally, it made sense to have the monies flown through the existing
structure to expand services in cacti county. if there are issues or problems with
Manao ing Entities, we are happy to engage, We are also happy to try and help
coataantattities get involved in or ectaage wvith their I'c�lanaging Entity..
We have attached a spreadsheet to this letter that den-aonstrates the amounts attributable to =
cacti county per year for an amount within each range in the previous questioat.
.
G
The State Fund consists of'the remaining 45% to 55% of'the total settlement amounts
allocable to the State ofFlorida, depending on tlae amount of'the Regional I"und above. As with
the City/County Fund and Regional Fund, these funds must be spent on Approved Purposes
Why should ,%ve agree to this aallocaation?
The proposed allocation in the iv OU is better than the alternative that subdivisions will
0.
receive if`they do not enter an agreement with the State. "Cwvo of`the defendants who we have 0.
negotiated with, Purdue Land Mallinckrodt are now in bankruptcy. In advance ofand in
connection with those bankruptcies. the states.. the P C:, and city and county representatives
negotiated as default intrastate allocation and agreed that it will apply tactless a state and its cities
and counties agree to something_ else. A Deputy County attorney for Browvaard. County, Florida,
was involved in the negotiations related to Purdue. Something like. the Purdue defiiult allocation
is currently in the draft connected to the Distributor and J&J deal. G
G
The allocation above is superior for Florida's subdivisions than that defsault allocation,
Indeed. the State offered substantial improvements over those terms from the beginning ofthe
negotiations that led to this N IOU. We have attached a copy of the Purdue abatement term sliest
for your review. [ruder that defaatalt allocation, there is no city county fiend. Only subdivisions
with populations greaatcr than 400,000 people are eligible to receive any anonics directly. Almost
6
all the monies will flow through the Managing Entities who are regionally supplying services.
The allocation percentages for the regional bucket are dollar based and decrease to hall; far more
quickly than in the MOU. In other words, the allocation in this MOU allows as far greater
recovery directly to cacti Florida city" and county than the alternative and greater recoveries
regionally for all subdivisions.
The allocation is also better than the cities and counties would achieve if dacnaages were
proportionally allocated. Ill the Purdue bankrUptcy, over one hundred twenty-five Florida
subdivisions filed proofs of`claaints. When the sire ofthose claims is compared to that of the
States claim,. the Staate's claim was more than hour, almost five tines larger than all the:
subdivisions' claims combined. Subdivisions aregetting substantially more than what their
proportional share would be. The State is willing to agree to the larger because it frankly reflects
the reality of how monies are currently being spent and is consistent with howwf the legislature has
been appropriating monies to combat this crisis.
Page 5 of 7
Packet Pg. 3083
If individual subdivisions do not agree to as settleaaaent,,svhaat NN,ill happen?
If there are hold outs or subdivisions that do not respond, the MOM contemplates that the
State will cither file a new suit or serer its claims sa(minst settling defendants from its existing
opioid lawsuit and add political subdivisions and through either as class action mechanism or
declaratory relief seek to bar future subdivision claims. Such action is necessary to ensure that
the State and any subdivisions that agree to a settlement maximize their recoveries. This not a.
novel position and there is a substantial body of I{lorida law that exists that the State may resolve
and release public claims including subdivision claims.' "That being said,. the State would prefer
that we reach agreement on the allocation under the proposed MOU and handle things
consensually. But, if there are holdouts, the State is prepared to litigate or seek legislation from �
the legislature to ensure that cities and counties that agree to this Mou are protected andwill -
receive the recovery contemplated under the allocation.
What are the next steps and the timeline?
We would {ask that you review the attached MOU and proposed model resolution
supporting. an agreement can the MOU terms. We will be scheduling calls to answer questions
about tlae Pv1OU We would ask cash subdivision to think about who is attending each session
and ensure that any of'thosc discussions will not violateFlorida's government-in-the-sunshilie
law. If you will contact nay administrLator, Jaanna Barineau, by c-naaail �--
fi a asa.11aat iaac Kau l.taar flcri�cl al e�atl.c om), we Brill include you in these discussions. after those
discussions we would then ask that you follow Florida lase for approving such a resolution by
your commission and in due course, Maass it, and return a copy to me at the address can the first �
page of the letter. Potential settlements are anticipated in the conning weeks or months, but 1
cannot tell you exactly wlacta a settlement will be finalized. 'These proposed settlements are
G
Sec, Fla. Staat. §50 1.207(1)(c)(authorizing the .attorney General to bring ``[aa-In action on c
behalf of one or more consumers or government entities f«r actual cdaamages...`' underFlorida's
T)eceptive and Unfair Trade Practices fact); e.g., Isikgl€a v. ,!rggeu Group, hm-., 945 So. 2d 1246,
1258-62 (Fla.. 2006); I orrkg v. d1lrumi Beach lrrrIrr°mv nient C'o., 46 So. 2d 26, 30 (I°la. 1950);
C'crstro ar. Sim Bank gl'Bal Harbour, 370 So. 2d 392, 39 3 (Fla. 3d DCA 1979); Oly q/'Neit, Port
Richej,v. 51we ex rel. O'11ullej,, 145 So. 903, 905 (Fla. 2d DCA 1962); also .�Iafe (#'f'lor i&i e
rel. Slrc rin a� Exxo r C'car7)., 526 1�.2d 266 275 (5 "' Cir. 1976) (holding that the Attorney General
could tile suit seeking damages for injuries sustaained by government entities who had not
specifically authorized the Attorney General to do sea); IlaT�=c -s a°. Fitt`q/'K jt, [V sl, 2007 G 1,
9702450, at *3 (S.D. Fla. Feb. 26. 2007) (concluding -JaIpplicable Florida lass states that as
judgment in an action brought against a public entity that adjudicates matters of general interest
to the citizens of the Jurisdiction is binding; on all citizens ol'that jurisdiction."); Aergjet-Gener(d
C'017). ar. llske t#, 366 F. Supp. 901, 908-11 (N.D. Fla. 1973).
[gage 6 of 7
Packet Pg. 3084
anticipated to include provisions sions which establish time limits can agreements between states and
political subdivisions. As a result, «Je WOUlcl rccqucst that YOU pass a resolution in the next 60-90
clays, i l;possi ble.
UIN
)eefMcputyl�Attorney
erelr',
3
M. Guad.
General
cc: l�c�l�ert Sl�illinge:r Jr.
P.O. Box 1026
KcV West, FT, 3 041
shillingcr-bohl\-�r monroec:ou sty-11.gov
0
[,,'Inc. Proposal with 1;x. A and 13 �
Recovery Spreadsheet
1'urduc Abatement Term Sheet
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C
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4-
Page 7 of 7
Packet Pg. 3085
Q.2.d
MEMORANDUM
Office of the Monroe County Attorney
TO: Monroe County Board of County Commissioners
Roman Gastesi, County Administrator
THRU: Bob Shillinger, County Attorney
FROM: Cynthia L. Hall, Assistant County Attorney
0.
DATE: August 31, 2021
0
SUBJECT: Proposed Settlement of Opioid Litigation 0
4
0
On 4/3/2019, Monroe County, with authorization from the Board of County Commissioners, >
filed suit in federal district for the Southern District of Florida against opioid manufacturers, 2
distributors, and pharmacies, for damages caused in Monroe County by the opioid epidemic.
The suit was later moved and made part of multi district litigation ("MDL") consisting of similar
lawsuits by states (including the State of Florida) and many local governments. N
N
After several years of negotiation, attorneys representing various states and the localco
governments (including Monroe County) have brought back a proposed settlement with one
manufacturer, Johnson & Johnson (through its U.S.-based company, Janssen), and the three ti
largest distributors (Amerisource Bergen Corporation, Cardinal Health, and McKesson
Corporation) ("Distributors"). Although no formal settlement documents have been drafted yet, 0.
the attorneys for the various plaintiffs and the defendants, included Deputy Attorney General 0
John Guard on behalf of the State of Florida, have requested that local governments indicate by
no later than September 30, 2021 whether the subdivisions are generally in agreement with the 2
principles of the settlement. y E
The purpose of this memorandum is to lay out the general terms of the proposed settlement plan U
for you. The proposed settlement plan is contained in the Memorandum of Understanding 0
(MOU) attached as Exhibit 1 to a resolution filed with this agenda item, with Schedules A and B c
E
to the MOU. (The MOU is sometimes referred to as the "Florida Plan.")
In this agenda item,you will be asked for your approval to the resolution, which will express a
agreement in principle to the settlements. Specific settlement agreements will be brought back
to you at a later date.
EXECUTIVE SUMMARY:
1. On balance, the proposed settlement is a good deal for Monroe County. It will provide
approximately $206,000 per year to the County, and another $22,000 collectively to the
five municipalities, over a period of approximately 17.5 years, which can be used on
1
Packet Pg. 3086
Q.2.d
substance abuse abatement problems. 1 Monroe County receives a slightly higher share
than its pro rata share would be based on population.
2. Without this settlement, it is possible that plaintiffs would receive less from these
defendants. It is also possible that other defendants would file for the protection of the
bankruptcy court, which would drag out potential settlements even further.
3. The State of Florida is behind this settlement formula.
0
IN MORE DETAIL,KEY TERMS OF THE MOU ARE AS FOLLOWS: 0.
0
• There is a proposed national settlement of approximately $26.5 billion. From that, $2 C
billion will be set aside to pay fees and costs from all attorneys representing all plaintiffs
in the litigation ("National Fund"), leaving a net of$24.5 billion. 0
a�
• The national settlement is contingent on attaining a"critical mass" of supporting states 4
and subdivisions. Florida has approved and is looking for buy-in from all subdivisions.
• Each state will receive an allocation. The percentages have been negotiated. Florida will 2
receive approximately $1.6 billion total (the"Florida Allocation") minus a set-aside for
attorney fees and costs. The Florida "net" is $1.3 billion.
N
• Distributor Deal: N
o Settling states and subdivisions will share up to $21 billion minus attorney's fees co
co
and costs (net is $18 billion). Of that, State of Florida and subdivisions will
receive approximately $1.3 billion. ti
o Payable over 16.5 years. .2
o The first two payouts will occur in April 2022. 0
• Johnson & Johnson Deal:
o Up to $5 billion over 9 years / $3.7 billion paid in the first 3 years. Of that,
Florida will receive approximately $300 million. E
E
o First two payments will occur in April 2022.
0
• The Florida Allocation will be divided into three funds: c
E
o The City/County Fund(15%) -- shared between all counties and their cities
o The Regional Fund (sliding scale over term of payout: 40% at beginning, down
to 30% at end, but average of approximately 35%) E
o State Fund(total Florida Allocation minus City/County Fund and Regional Fund;
on average, 50%)
i This is an estimate based on best information available at this time. The figures may change
depending on overall recovery, allocation to particular counties and cities, and what percentage
is removed for payment of legal fees and costs.
2
Packet Pg. 3087
Q.2.d
• Within Florida, the amount that each county and city receives is loosely based on
population and a few other factors, based on information supplied by each individual
county in the litigation. Monroe County's projected share for the County as a whole is
about half again greater than what its share would be based on population alone.
• This settlement would resolve all claims against Johnson & Johnson and the distributor
defendants. Additional funds may be added into the settlement pot by other defendants,
including the pharmacies. o
OTHER KEY POINTS: 0.
0
• The City/County Fund comes directly to the County and its five municipalities. The
Regional Fund either goes to cities with populations over 300,000, if there are any in the
county ("Qualified Counties"), or to a"Regional Managing Entity" — one of seven
behavioral health networks with which the State of Florida has a contract. In the case of 4
Monroe County, the Regional Managing Entity is the South Florida Behavioral Health
Network, Inc., d/b/a Thriving Minds, based in Miami (the "Network"). Therefore, all of 2
Monroe County's Regional Fund share will come through Thriving Minds.
e(
• The funds would be earmarked. They can be used for any of the purposes listed in
Schedules A (Core Strategies) or Schedules B (Approved Purposes).
N
• The State will create an Opioid Abatement Taskforce or Council to advise the Governor, co
�?
Legislature, Florida Department of Children and Families (DCF) and local governments
on priorities for expenditures. The Council will have 10 members: 5 appointed by the
Governor and the State, and 5 from local governments (2 appointed by Florida League of -�
Cities, 2 appointed by FAC, and one alternating between those two).
0.
• Prior to July 1 of each year, the State and each local government must report to 0
Department of Children and Families (DCF) how they intend to expend their funds for
the upcoming year. Prior to August 31 of each year, the State and each local government
must report to DCF how they have expended their funds during the previous year.
However, the Council does not appear to have any right to veto local expenditures (past
0
or future). U
0
• The County has a contingency fee agreement with its attorneys, which calls for payment 0
of fees and costs equal to 17.5%for litigation settled at this stage. The current plan is E
that$1.6 billion of the total national recovery will be earmarked as a fee fund for
attorneys representing subdivisions, in lieu of fees and costs that they would receive from
any contingency fee agreement from the client's recovery. If there is a fee fund, then E
county and city attorneys will be paid from the fund. If there is no fee fund, the attorneys
will look to each client's recovery to be paid. It is expected that the MDL judge will enter
a fee order that will push attorneys to the fee fund.
• The State is entitled to take 5% from the State Fund and 5% from the Regional Fund
portion not going to Qualified Counties as an administrative fee.
3
Packet Pg. 3088
Q.2.d
• The settlement is not intended to compensate Monroe County, or any of the
municipalities, for past damages. It is intended to fund future abatement programs.
0.
0
0
4
0
2
cv
cv
CO
0.
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0
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0
0
4
Packet Pg. 3089