HomeMy WebLinkAboutResolution 2021-140 Approving and Authorizing the Town Manager to Execute the One Arizona Distribution of Opioid Settlement Funds Agreement and Related Settlement Agreements MARANA RESOLUTION NO. 2021-140
RELATING TO THE LEGAL DEPARTMENT; APPROVING AND AUTHORIZING THE
TOWN MANAGER TO EXECUTE THE ONE ARIZONA DISTRIBUTION OF OPIOID
SETTLEMENT FUNDS AGREEMENT AND RELATED SETTLEMENT AGREEMENTS
WHEREAS the opioid epidemic has had a devastating impact on communities
across the country including the Town of Marana; and
WHEREAS state and local governments across the country have filed lawsuits
against the manufacturers and distributors of opioids due to the impacts of the opioid
epidemic; and
WHEREAS the proceeds from settlements of these lawsuits are distributed to the
states, and then within the state, the proceeds are distributed to state and local
governments; and
WHEREAS on December 15, 2020, the Town Council authorized the Town
Manager to sign the One Arizona Opioid Settlement Memorandum of Understanding
("MOU") which provides a framework for distributing opioid settlement funds to the
state and local governments by employing formulas and data collected regarding opioid
use disorder, opioid overdose deaths, and the amount and potency of opioids shipped to
each community; and
WHEREAS the State of Arizona,all fifteen counties and 90 of 91 cities,have agreed
to the MOU; and
WHEREAS settlements have been reached with three opioid distributors:
McKesson; Amerisource Bergen; and Cardinal (the "Distributors Settlement") and one
opioid manufacturer,Johnson&Johnson(the "J&J Settlement") and the Arizona Attorney
General has formally indicated Arizona's conditional approval for the settlements; and
WHEREAS the One Arizona Distribution of Opioid Settlement Funds Agreement
("Agreement") is a binding distribution agreement for the settlement funds and the Town
must also sign the Distributors Settlement agreement and the J&J Settlement agreement
to receive funds; and
WHEREAS the Town Council finds that it is in the best interests of the community
to execute the Agreement, the Distributors Settlement agreement, and the J&J Settlement
agreement so that the Town of Marana can receive its share of the opioid settlement funds
and be able to use those funds to address the opioid epidemic in the community.
00073534.DOCX/3
Resolution No.2021-140 - 1 -
NOW, THEREFORE, BE IT RESOLVED BY THE MAYOR AND COUNCIL OF
THE TOWN OF MARANA, ARIZONA, as follows:
SECTION 1. The One Arizona Distribution of Opioid Settlement Funds
Agreement,attached to and incorporated by this reference in this resolution as Exhibit A,
is hereby approved, and the Town Manager is hereby authorized and directed to execute
it for and on behalf of the Town of Marana.
SECTION 2. The Town Manager is further authorized and directed to execute the
Distributors Settlement agreement and the J&J Settlement agreement upon receipt by the
Town of those documents and when the Town Attorney or designee has reviewed and
approved the documents as to form and substance.
SECTION 3. The Town's Manager and staff are hereby directed and authorized to
undertake all other and further tasks required or beneficial to carry out the terms,
obligations,and objectives of the Agreement,the Distributors Settlement agreement, and
the J&J Settlement agreement.
PASSED AND ADOPTED by the Mayor and Council of the Town of Marana,
Arizona, this 3rd day of November, 2021.
61.: M
Mayor E Honea
ATTEST: APPROVED AS TO FORM:
41, ./ /..
Cherry L. La son, Town Clerk Jade Eairall, Town Attorney
MARANA AZ
5 4' B!+..}53iEP ,977
00073534.DOCX/3
Resolution No.2021-140 -2 -
ONE ARIZONA DISTRIBUTION OF OPIOID SETTLEMENT FUNDS
AGREEMENT
General Principles
• The people of the State of Arizona and Arizona communities have been harmed by the
opioid epidemic, which was caused by entities within the Pharmaceutical Supply Chain.
• The State of Arizona, ex rel. Mark Brnovich, Attorney General (the"State"), and certain
Participating Local Governments are separately engaged in litigation seeking to hold the
Pharmaceutical Supply Chain Participants accountable for the damage they caused.
• The State and the Participating Local Governments share a common desire to abate and
alleviate the impacts of the Pharmaceutical Supply Chain Participants' misconduct
throughout the State of Arizona.
• The State and the Participating Local Governments previously entered into the One
Arizona Opioid Settlement Memorandum of Understanding for the purpose of jointly
approaching Settlement negotiations with the Pharmaceutical Supply Chain Participants.
• The State and the Participating Local Governments now enter into this One Arizona
Distribution of Opioid Settlement Funds Agreement ("Agreement") to establish binding
terms for the distribution and spending of funds from Settlements with the Pharmaceutical
Supply Chain Participants.
A. Definitions
As used in this Agreement:
1. "Approved Purpose(s)" shall mean those uses identified in the agreed Opioid Abatement
Strategies attached as Exhibit A.
2. "Contingency Fee Fund"shall mean a sub fund established in a Settlement for the purpose
of paying contingency fees, such as the Attorney Fee Fund described in Section I.V of the
Settlement with the Settling Distributors and the sub fund of the Attorney Fee Fund
described in Section II.D of the Settlement with J&J.1
3. "J&J" shall mean Johnson & Johnson, Janssen Pharmaceuticals, Inc., OrthoMcNeil-
Janssen Pharmaceuticals,Inc.,and Janssen Pharmaceutica,Inc.
4. "Litigation"means existing or potential legal claims against Pharmaceutical Supply Chain
Participants seeking to hold them accountable for the damage caused by their misfeasance,
nonfeasance,and malfeasance relating to the unlawful manufacture,marketing,promotion,
distribution,or dispensing of prescription opioids.
Text of both settlements available at https://nationalopioidsettlement.com.
5. "Opioid Funds"shall mean monetary amounts obtained through a Settlement as defined in
this Agreement.
6. "Participating Local Government(s)" shall mean all counties, cities, and towns within the
geographic boundaries of the State that have chosen to sign on to this Agreement and each
applicable Settlement.The Participating Local Governments may be referred to separately
in this Agreement as "Participating Counties" and "Participating Cities and Towns" (or
"Participating Cities or Towns,"as appropriate).
7. "Parties"shall mean the State and the Participating Local Governments.
8. "Pharmaceutical Supply Chain" shall mean the process and channels through which licit
opioids are manufactured,marketed,promoted,distributed,or dispensed.
9. "Pharmaceutical Supply Chain Participant" shall mean any entity that engages in or has
engaged in the manufacture, marketing, promotion, distribution, or dispensing of licit
opioids.
10. "Settlement" shall mean the negotiated resolution of legal or equitable claims against a
Pharmaceutical Supply Chain Participant when that resolution has been jointly entered into
by the State and the Participating Local Government and approved as final by a court of
competent jurisdiction.
11."Settling Distributors" shall mean McKesson Corporation, Cardinal Health, Inc., and
AmerisourceBergen Corporation.
12."Trustee" shall mean either (1) an independent trustee who shall be responsible for the
ministerial task of releasing the Opioid Funds that are in trust as authorized herein and
accounting for all payments into or out of the trust,or(2)a settlement fund administrator,
in the event that the Settlement includes a fund administrator. In either case, the Trustee
will distribute funds in accordance with this Agreement.
B.Intrastate Regions
1. The State of Arizona will be divided into regions, each of which will be referred to as a
"Region" and will consist of: (1) a single Participating County and all of its Participating
Cities and Towns; or (2) all of the Participating Cities and Towns within a non-
Participating County. If there is only one Participating City or Town within a non-
Participating County,that single Participating City or Town will still constitute a Region.
Two or more Regions may at their discretion form a group ("Multicounty Region").
Regions that do not choose to form a Multicounty Region will be their own Region.
Participating Cities and Towns within a non-Participating County may not form a Region
with Participating Cities and Towns in another county.
2. The LG Share funds described in Section C(1)will be distributed to each Region according
to the percentages set forth in Exhibit B.The Regional allocation model uses three equally
weighted factors:(1)the amount of opioids shipped to the Region;(2)the number of opioid
deaths that occurred in that Region; and (3)the number of people who suffer opioid use
disorder in that Region.In the event any county does not participate in this Agreement,that
2
county's percentage share shall be reallocated proportionally amongst the Participating
Counties by applying this same methodology to only the Participating Counties.
3. In single-county Regions, that county's health department will serve as the lead agency
responsible for distributing the LG Share funds.That health department,acting as the lead
agency, shall consult with the cities and towns in the county regarding distribution of the
LG Share funds.
4. For each Multicounty Region, an advisory council shall be formed from the Participating
Local Governments in the Multicounty Region to distribute the collective LG Share funds.
Each advisory council shall include at least three Participating Local Government
representatives, not all of whom may reside in the same county. Each advisory council
shall consult with the Participating Local Governments in the Multicounty Region
regarding distribution of the collective LG Share funds.
5. For each Region consisting of the Participating Cities and Towns within a non-
Participating County,an advisory council shall be formed from the Participating Cities and
Towns in the Region to distribute the LG Share funds.Each advisory council shall include
at least three representatives from the Participating Cities and Towns in the Region, or a
representative from each Participating City and Town if the Region consists of fewer than
three Participating Cities and Towns. In no event may more than one individual represent
the same city or town. To the extent any Participating Cities or Towns in the Region are
not represented on the advisory council, the advisory council shall consult with the non-
represented Participating Cities and Towns regarding distribution of the collective LG
Share funds.
C.Allocation of Settlement Proceeds
1. All Opioid Funds shall be divided with 44% to the State ("State Share") and 56%to the
Participating Local Governments("LG Share").2
2. All Opioid Funds,except those allocated to payment of counsel and litigation expenses as
set forth in Section E, shall be utilized in a manner consistent with the Approved Purposes
definition.Compliance with this requirement shall be verified through reporting,as set out
in Section F.
3. Each LG Share will be distributed to each Region or Multicounty Region as set forth in
Section B(2). Participating Counties and their constituent Participating Cities and Towns
may distribute the funds allocated to the Region or Multicounty Region amongst
themselves in any manner they choose.If a county and its cities and towns cannot agree on
how to allocate the funds, the default allocation in Exhibit C will apply. The default
allocation formula uses historical federal data showing how each county and the cities and
towns within it have made opioids-related expenditures in the past.If a county or any cities
or towns within a Region or Multicounty Region do not sign on to this Agreement and each
2 This Agreement assumes that any opioid settlement for Native American Tribes and Third-Party
Payors, including municipal insurance pools,will be dealt with separately.
3
Settlement, and if the Participating Local Governments in the Region or Multicounty
Region cannot agree on how to allocate the funds from that Settlement amongst
themselves, the funds shall be reallocated proportionally by applying this same
methodology to only the Participating Local Governments in the Region or Multicounty
Region.
4. If the LG Share for a given Participating Local Government is less than $500, then that
amount will instead be distributed to the Region or Multicounty Region in which the
Participating Local Government is located to allow practical application of the abatement
remedy.If the county did not sign on to the Settlement as defined herein,the funds will be
reallocated to the State Share.
5. The State Share shall be paid by check or wire transfer directly to the State through the
Trustee,who shall hold the funds in trust,or as otherwise required by a Settlement for the
benefit of the State,to be timely distributed as set forth in C(1)herein.The LG Share shall
be paid by check or wire transfer directly to the Regions or Multicounty Regions through
the Trustee, who shall hold the funds in trust,or as otherwise required by a Settlement for
the benefit of the Participating Local Governments,to be timely distributed as set forth in
B(2),C(1),C(3),and C(4)herein.
6. The State Share shall be used only for(1)Approved Purposes within the State or(2)grants
to organizations for Approved Purposes within the State.
7. The LG Share shall be used only for (1) Approved Purposes by Participating Local
Governments within a Region or Multicounty Region or (2) grants to organizations for
Approved Purposes within a Region or Multicounty Region.
8. The State will endeavor to prioritize up to 30%of the State Share for opioid education and
advertising related to awareness, addiction, or treatment; Department of Corrections and
related prison and jail opioid uses; and opioid interdiction and abatement on Arizona's
southern border, including grants to assist with the building, remodeling and/or operation
of centers for treatment, drug testing, medication-assisted treatment services, probation,
job training,and/or counseling services,among other programs.
9. If the federal Center for Medicare and Medicaid Services("CMS") disallows any federal
funding for the State's Medicaid programs pursuant to 42 U.S.C. § 1396b as a consequence
of sums received pursuant to resolution of any Litigation with Pharmaceutical Supply
Chain Participants,or otherwise seeks to recover sums it regards as the federal share of any
Settlement, the amount recovered by CMS shall first be paid from the total amount of
Opioid Funds available to the Parties under that Settlement and the distribution to the State
and Participating Local Governments shall thereafter be made from the remaining funds.
10.The Parties acknowledge and agree that any Settlement may require Participating Local
Governments to release all their claims against the settling Pharmaceutical Supply Chain
Participants to receive Opioid Funds.The Parties further acknowledge and agree based on
the terms of any such national Settlement, a Participating Local Government will not
receive funds through this Agreement until it has complied with all requirements set forth
4
in that national Settlement to release its claims. This Agreement is not a promise by any
Party that any Settlement(including any Settlement resolved through bankruptcy)will be
finalized or executed.
D.Participation of Cities and Towns
1. By signing on to the Agreement and any Settlement, a Participating County will receive
60%of its available LG Share for that Settlement when distribution under that Settlement
occurs.Any such Participating County will receive up to an additional 40%of its available
LG Share for that Settlement by securing the participation of its constituent cities and towns
as signatories to this Agreement and that Settlement when distribution under that
Settlement occurs.The sliding scale attached as Exhibit D will determine the share of funds
available to the Participating County?
2. If a Participating County does not achieve 100%participation of its cities and towns within
the period of time required in a Settlement document for subdivision participation, the
remaining portions of the LG Share that were otherwise available to the Participating
County will be reallocated to(i)the State Share and (ii)the LG Share for the Participating
Counties which have achieved 100%participation of their cities and towns in accordance
with the percentages described in Sections B(2), C(1), and C(3), and set forth in Exhibits
B and C.
E.Payment of Counsel and Litigation Expenses
1. The Parties anticipate that any Settlement will provide for the payment of all or a portion
of the fees and litigation expenses of certain state and local governments.
2. If the court in In Re:National Prescription Opiate Litigation,MDL No.2804(N.D.Ohio)
or if a Settlement establishes a common benefit fund or similar device to compensate
attorneys for services rendered and expenses incurred that have benefited plaintiffs
generally in the litigation (the "Common Benefit Fund"), and requires certain
governmental plaintiffs to pay a share of their recoveries from defendants into the Common
Benefit Fund as a"tax,"then the Participating Local Governments shall first seek to have
the settling defendants pay the "tax." If the settling defendants do not agree to pay the
"tax,"then the"tax"shall be paid from the LG Share prior to allocation and distribution of
funds to the Participating Local Governments 4
3 Population allocation of cities and towns within counties will be derived from the population
data included in any national Settlement. If such data is not included in the respective national
Settlement, then population allocation will be determined from those cities and towns listed in
Exhibit C.The data in Exhibit C is derived from the U.S.Census Estimate(July 1,2019).
4 This paragraph shall not apply to the Settlement with the Settling Distributors or the Settlement
with J&J.
5
3. Any governmental entity that seeks attorneys' fees and expenses from the Litigation shall
seek those fees and expenses first from the national Settlement.'In addition, the Parties
agree that the Participating Local Governments will create a supplemental attorney's fees
and costs fund(the"Backstop Fund").
4. In the event that any Settlement imposes additional limitations or obligations on the
payment of counsel and litigation expenses, those limitations and obligations take
precedence over this Agreement.
5. The Backstop Fund is to be used to compensate counsel for Participating Local
Governments that filed opioid lawsuits by September 1, 2020 ("Litigating Participating
Local Governments"). Payments out of the Backstop Fund shall be determined by a
committee consisting of one representative from each of the Litigating Participating Local
Governments(the"Opioid Fee and Expense Committee").
6. The amount of the Backstop Fund shall be determined as follows: From any national
Settlement, the funds in the Backstop Fund shall equal 14.25% of the LG Share for that
Settlement. No portion of the State Share shall be used for the Backstop Fund or in any
other way to fund any Participating Local Government's attorney's fees and costs. If
required to do so by any Settlement, Participating Local Governments must report to the
national Settlement Fund Administrator regarding contributions to,or payments from,the
Backstop Fund.
7. The maximum percentage of any contingency fee agreement permitted for compensation
shall be 25% of the portion of the LG Share attributable to the Litigating Participating
Local Government that is a party to the contingency fee agreement, plus expenses
attributable to that Litigating Participating Local Government,unless a Settlement or other
court order imposes a lower limitation on contingency fees. Under no circumstances may
counsel collect more for its work on behalf of a Litigating Participating Local Government
than it would under its contingency agreement with that Litigating Participating Local
Government.
S. Payments to counsel for Participating Local Governments shall be made from the Backstop
Fund in the same percentages and over the same period of time as the national Contingency
Fee Fund for each settlement. The Attorneys' Fees and Costs schedule for the Settling
Distributors is listed in Exhibit R §(II)(S)(1) of the Settlement with the Settling
The State retained outside counsel in the Purdue litigation and if it is unable to secure payment
of attorneys' fees and expenses from the bankruptcy proceedings in an amount sufficient to
compensate outside counsel consistent with the terms of the State's contract with that outside
counsel,any remaining attorneys' fees and expenses related to the representation of the State will
first be paid directly from the total amount of Opioid Funds available to the Parties under that
Settlement, up to the agreed amount in the outside counsel contract, and the distribution to the
State and Participating Local Governments shall thereafter be made from the remaining funds.
6
Distributors.6 The Attorneys' Fees and Costs schedule for J&J is listed in Exhibit R
§(II)(A)(1)of the Settlement with J&J.7 For future Settlements with other defendants in the
Pharmaceutical Supply Chain, any necessary payments to counsel for Participating Local
Governments shall be made from the Backstop Fund in the same percentages and over the
same periods of time as the fee funds for those Settlements, if applicable, subject to the
limitations set forth in this Agreement set form in paragraph E(7)above.
9. Any funds remaining in the Backstop Fund in excess of the amounts needed to cover
private counsel's representation agreements shall revert to the Participating Local
Governments according to the percentages set forth in Exhibits B and C, to be used for
Approved Purposes as set forth herein and in Exhibit A.
F. Compliance Reporting and Accountability
1. If the State and Participating Local Governments use a Trustee for purposes of distributing
funds pursuant to any Settlement, the Trustee shall be requested to provide timely an up-
to-date accounting of payments into or out of any trust established to hold such funds and/or
its subaccounts upon written request of the State or a Participating Local Government.
2. The State, Regions, and Participating Local Governments may object to an allocation or
expenditure of Opioid Funds solely on the basis that the allocation or expenditure at issue
(1)is inconsistent with provision C(1)hereof with respect to the amount of the State Share
or LG Share;(2)is inconsistent with an agreed-upon allocation,or the default allocations
in Exhibits B and C, as contemplated by Section C(3); or (3) violates the limitations set
forth in F(3)with respect to compensation of the Trustee.The objector shall have the right
to bring that objection within two years of the date of its discovery to a superior court in
Maricopa County, Arizona.
3. In the event that the State and Participating Local Governments use a Trustee,
compensation for Trustee's expenses of fund administration may be paid out of the Opioid
Funds for reasonable expenses; provided that, reasonable expenses do not exceed the
administrative expenses allowed under the terms of the relevant Settlement.
4. The Parties shall maintain, for a period of at least five years, records of abatement
expenditures and documents underlying those expenditures, so that it can be verified that
funds are being or have been utilized in a manner consistent with the Approved Purposes
definition. This requirement supersedes any shorter period of time specified in any
applicable document retention or destruction policy.
5. At least annually,by July 31 of each year,each Region or Multicounty Region shall provide
to the State a report detailing for the preceding fiscal year(1)the amount of the LG Share
received by each Participating Local Government within the Region or Multicounty
Region, (2) the allocation of any awards approved (listing the recipient, the amount
awarded, the program to be funded, and disbursement terms), and (3) the amounts
6 Text of settlement available at https:ttnationalopioidsetticment.com.
7 Text of settlement available at https://nationalopioidsettlement.com.
7
disbursed on approved allocations. In order to facilitate this reporting, each Participating
Local Government within a Region or Multicounty Region shall provide information
necessary to meet these reporting obligations to a delegate(s) selected by the Region or
Multicounty Region to provide its annual report to the State. Any Participating Local
Government shall also comply with any reporting requirements imposed by any
Settlement.
6. No later than September 30 of each year, the State shall publish on its website a report
detailing for the preceding fiscal year (1) the amount of the State Share received, (2)the
allocation of any awards approved(listing the recipient,the amount awarded,the program
to be funded, and disbursement terms), and (3) the amounts disbursed on approved
allocations.In addition,the State shall publish on its website the reports described in F(5)
above. The State shall also comply with any reporting requirements imposed by any
Settlement.
7. If it appears to the State, a Region, or a Multicounty Region that the State or another
Region or Multicounty Region is using or has used Settlement funds for non-Approved
Purposes, the State, Region, or Multicounty Region may on written request seek and
obtain the documentation underlying the report(s)described in F(5)or F(6),as applicable,
including documentation described in F(4). The State, Region, or Multicounty Region
receiving such request shall have 14 days to provide the requested information. The
requesting party and the State, Region, or Multicounty Region receiving such request
may extend the time period for compliance with the request only upon mutual agreement.
8. Following a request made pursuant to F(7) and when it appears that LG Share funds are
being or have been spent on non-Approved Purposes,the State may seek and obtain in an
action in a court of competent jurisdiction in Maricopa County, Arizona an injunction
prohibiting the Region or Multicounty Region from spending LG Share funds on non-
Approved Purposes and requiring the Region or Multicounty Region to return the monies
that it spent on non-Approved Purposes after notice as is required by the rules of civil
procedure. So long as the action is pending, distribution of LG Share funds to the Region
or Multicounty Region temporarily will be suspended. Once the action is resolved, the
suspended payments will resume, less any amounts that were ordered returned but have
not been returned by the time the action is resolved.
9. Following a request made pursuant to F(7) and when it appears to at least eight
Participating Counties that have signed on to this Agreement and a subsequent Settlement
that the State Share funds are being or have been spent on non-Approved Purposes, the
Participating Counties may seek and obtain in an action in a superior court of Maricopa
County, Arizona an injunction prohibiting the State from spending State Share funds on
non-Approved Purposes and requiring the State to return the monies it spent on non-
Approved Purposes after notice as is required by the rules of civil procedure. So long as
the action is pending, distribution of State Share funds to the State temporarily will be
suspended. Once the action is resolved, the suspended payments will resume, less any
monies that were ordered returned but have not been returned by the time the action is
resolved.
8
10.In an action brought pursuant to F(8) or F(9), attorney's fees and costs shall not be
recoverable.
G.Settlement Negotiations
1. The State and the Participating Local Governments agree to inform each other in advance
of any negotiations relating to an Arizona-only settlement with a Pharmaceutical Supply
Chain Participant that includes both the State and the Participating Local Governments and
shall provide each other the opportunity to participate in all such negotiations.
2. The State and the Participating Local Governments further agree to keep each other
reasonably informed of all other global settlement negotiations with Pharmaceutical
Supply Chain Participants.Neither this provision,nor any other,shall be construed to state
or imply that either the State or the Participating Local Governments (collectively, the
"Arizona Parties") are unauthorized to engage in settlement negotiations with
Pharmaceutical Supply Chain Participants without prior consent or contemporaneous
participation of the other,or that either party is entitled to participate as an active or direct
participant in settlement negotiations with the other. Rather, while the State's and the
Participating Local Government's efforts to achieve worthwhile settlements are to be
collaborative,incremental stages need not be so.
3. The State or any Participating Local Government may withdraw from coordinated
Settlement discussions detailed in this Section upon 10 business days'written notice to the
other Arizona Parties and counsel for any affected Pharmaceutical Supply Chain
Participant. The withdrawal of any Arizona Party releases the remaining Arizona Parties
from the restrictions and obligations in this Section.
4. The obligations in this Section shall not affect any Party's right to proceed with trial or,
within 30 days of the date upon which a trial involving that Party's claims against a specific
Pharmaceutical Supply Chain Participant is scheduled to begin, reach a case-specific
resolution with that particular Pharmaceutical Supply Chain Participant.
H.Amendments
1. The Parties agree to make such amendments as necessary to implement the intent of this
Agreement.
One Arizona Distribution of Opioid Settlement Funds Agreement ACCEPTED by the undersigned
and executed this day of ,2021.
ARIZONA ATTORNEY GENERAL
Mark Brnovich
9
APACHE COUNTY
APACHE COUNTY EAGER TOWN
By: By:
Its: Its:
SPRINGERVILLE TOWN ST JOHNS CITY
By: By:
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COCHISE COUNTY
COCHISE COUNTY BENSON CITY
By: By:
Its: Its:
BISBEE CITY DOUGLAS CITY
By: By:
Its: Its:
HUACHUCA CITY TOWN SIERRA VISTA CITY
By: By:
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TOMBSTONE CITY WILLCOX CITY
By: By:
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COCONINO COUNTY
COCONINO COUNTY FLAGSTAFF CITY
By: By:
Its: Its:
FREDONIA TOWN PAGE CITY
By: By:
Its: Its:
SEDONA CITY TUSAYAN TOWN
By: By:
Its: Its:
WILLIAMS CITY
By:
Its:
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12
GILA COUNTY
GILA COUNTY GLOBE CITY
By: By:
Its: Its:
HAYDEN CITY MIAMI TOWN
By: By:
Its: Its:
PAYSON TOWN STAR VALLEY TOWN
By: By:
Its: Its:
WINKELMAN TOWN
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Its:
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GRAHAM COUNTY
GRAHAM COUNTY PIMA TOWN
By: By:
Its: Its:
SAFFORD CITY THATCHER TOWN
By: By:
Its: Its:
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GREENLEE COUNTY
GREENLEE COUNTY CLIFTON TOWN
By: By:
Its: Its:
DUNCAN TOWN
By:
Its:
15
LA PAZ COUNTY
LA PAZ COUNTY PARKER TOWN
By: By:
Its: Its:
QUARTZITE TOWN
By:
Its:
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MARICOPA COUNTY
MARICOPA COUNTY APACHE JUNCTION CITY
By: By:
Its: Its:
AVONDALE CITY BUCKEYE TOWN
By: By:
Its: Its:
CAREFREE TOWN CAVE CREEK TOWN
By: By:
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CHANDLER CITY EL MIRAGE CITY
By: By:
Its: Its:
FOUNTAIN HILLS TOWN GILA BEND TOWN
By: By:
Its: Its:
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MARICOPA COUNTY
GILBERT TOWN GLENDALE CITY
By: By:
Its: Its:
GOODYEAR CITY GUADALUPE TOWN
By: By:
Its: Its:
LITCHFIELD PARK CITY MESA CITY
By: By:
Its: Its:
PARADISE VALLEY TOWN PEORIA CITY
By: By:
Its: Its:
PHOENIX CITY QUEEN CREEK TOWN
By: By:
Its: Its:
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MARICOPA COUNTY
SCOTTSDALE CITY SURPRISE CITY
By: By:
Its: Its:
TEMPE CITY TOLLESON CITY
By: By:
Its: Its:
WICKENBURG TOWN YOUNGTOWN TOWN
By: By:
Its: Its:
19
MOHAVE COUNTY
MOHAVE COUNTY BULLHEAD CITY
By: By:
Its: Its:
COLORADO CITY TOWN KINGMAN CITY
By: By:
Its: Its:
LAKE HAVASU CITY
By:
Its:
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NAVAJO COUNTY
NAVAJO COUNTY HOLBROOK CITY
By: By:
Its: Its:
PINETOP-LAKESIDE TOWN SHOW LOW CITY
By: By:
Its: Its:
SNOWFLAKE TOWN TAYLOR TOWN
By: By:
Its: Its:
WINSLOW CITY
By:
Its:
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PIMA COUNTY
PIMA COUNTY MARANA TOWN
By: By:
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ORO VALLEY TOWN SAHUARITA TOWN
By: By:
Its: Its:
SOUTH TUCSON CITY TUCSON CITY
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PENAL COUNTY
PENAL COUNTY CASA GRANDE CITY
By: By:
Its: Its:
COOLIDGE CITY ELOY CITY
By: By:
Its: Its:
FLORENCE TOWN KEARNY TOWN
By: By:
Its: Its:
MAMMOTH TOWN MARICOPA CITY
By: By:
Its: Its:
SUPERIOR TOWN
By:
Its:
23
SANTA CRUZ COUNTY
SANTA CRUZ COUNTY NOGALES CITY
By: By:
Its: Its:
PATAGONIA TOWN
By:
Its:
24
YAVAPAI COUNTY
YAVAPA[COUNTY CAMP VERDE TOWN
By: By:
Its: Its:
CHINO VALLEY TOWN CLARKDALE TOWN
By: By:
Its: Its:
COTTONWOOD CITY DEWEY-HUMBOLDT TOWN
By: By:
Its: Its:
JEROME TOWN PRESCOTT CITY
By: By:
Its: Its:
PRESCOTT VALLEY TOWN
By:
Its:
25
YUMA COUNTY
YUMA COUNTY SAN LUIS CITY
By: By:Its: Its:
SOMERTON CITY WELLTON TOWN
By: By:
Its: Its:
YUMA CITY
By:
Its:
26
Exhibit A
OPIOID ABATEMENT STRATEGIES
PART ONE: TREATMENT
A. TREAT OPIOID USE DISORDER(OUD)
Support treatment of Opioid Use Disorder (OUD) and any co-occurring Substance Use
Disorder or Mental Health (SUD/MH) conditions, co-usage, and/or co-addiction through
evidence-based, evidence-informed, or promising programs or strategies that may include,
but are not limited to,the following:
1. Expand availability of treatment for OUD and any co-occurring SUD/MH conditions,
co-usage, and/or co-addiction, including all forms of Medication-Assisted Treatment
(MAT)approved by the U.S. Food and Drug Administration.
2. Support and reimburse services that include the full American Society of Addiction
Medicine (ASAM) continuum of care for OUD and any co-occurring SUD/MH
conditions,co-usage,and/or co-addiction, including but not limited to:
a. Medication-Assisted Treatment(MAT);
b. Abstinence-based treatment;
c. Treatment, recovery, or other services provided by states, subdivisions,
community health centers;non-for-profit providers;or for-profit providers;
d. Treatment by providers that focus on OUD treatment as well as treatment by
providers that offer OUD treatment along with treatment for other SUD/MH
conditions,co-usage,and/or co-addiction; or
e. Evidence-informed residential services programs, as noted below.
3. Expand telehealth to increase access to treatment for OUD and any co-occurring
SUD/MH conditions, co-usage, and/or co-addiction, including MAT, as well as
counseling, psychiatric support, and other treatment and recovery support services.
4. Improve oversight of Opioid Treatment Programs (OTPs) to assure evidence-based,
evidence-informed,or promising practices such as adequate methadone dosing.
5. Support mobile intervention, treatment, and recovery services, offered by qualified
professionals and service providers, such as peer recovery coaches, for persons with
OUD and any co-occurring SUD/MH conditions, co-usage, and/or co-addiction and
for persons who have experienced an opioid overdose.
6. Support treatment of mental health trauma resulting from the traumatic experiences of
the opioid user(e.g.,violence,sexual assault,human trafficking,or adverse childhood
experiences) and family members (e.g., surviving family members after an overdose
or overdose fatality),and training of health care personnel to identify and address such
trauma.
7. Support detoxification(detox)and withdrawal management services for persons with
OUD and any co-occurring SUD/MH conditions, co-usage, and/or co-addiction,
including medical detox, referral to treatment, or connections to other services or
supports.
8. Support training on MAT for health care providers, students, or other supporting
professionals, such as peer recovery coaches or recovery outreach specialists,
including telementoring to assist community-based providers in rural or underserved
areas.
9. Support workforce development for addiction professionals who work with persons
with OUD and any co-occurring SUD/MH conditions,co-usage, and/or co-addiction.
10.Provide fellowships for addiction medicine specialists for direct patient care,
instructors,and clinical research for treatments.
11.Provide funding and training for clinicians to obtain a waiver under the federal Drug
Addiction Treatment Act of 2000 (DATA 2000) to prescribe MAT for OUD, and
provide technical assistance and professional support to clinicians who have obtained
a DATA 2000 waiver.
12. Support the dissemination of web-based training curricula, such as the American
Academy of Addiction Psychiatry's Provider Clinical Support Service-Opioids web-
based training curriculum and motivational interviewing.
13. Support the development and dissemination of new curricula, such as the American
Academy of Addiction Psychiatry's Provider Clinical Support Service for Medication-
Assisted Treatment.
B. SUPPORT PEOPLE IN TREATMENT AND RECOVERY
Support people in treatment for and recovery from OUD and any co-occurring SUD/MH
conditions, co-usage, and/or co-addiction through evidence-based, evidence-informed, or
promising programs or strategies that may include,but are not limited to,the following:
1. Provide the full continuum of care of recovery services for OUD and any co-occurring
SUD/MH conditions, co-usage, and/or co-addiction, including supportive housing,
residential treatment, medical detox services, peer support services and counseling,
community navigators, case management, and connections to community-based
services.
2. Provide counseling, peer-support, recovery case management and residential
treatment with access to medications for those who need it to persons with OUD and
any co-occurring SUD/MH conditions,co-usage,and/or co-addiction.
3. Provide access to housing for people with OUD and any co-occurring SUD/MH
conditions, co-usage, and/or co-addiction, including supportive housing, recovery
housing,housing assistance programs,or training for housing providers.
4. Provide community support services, including social and legal services, to assist in
deinstitutionalizing persons with OUD and any co-occurring SUD/MH conditions,co-
usage,and/or co-addiction.
5. Support or expand peer-recovery centers, which may include support groups, social
events,computer access,or other services for persons with OUD and any co-occurring
SUD/MH conditions,co-usage,and/or co-addiction.
6. Provide employment training or educational services for persons in treatment for or
recovery from OUD and any co-occurring SUD/MH conditions, co-usage, and/or co-
addiction.
7. 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.
8. Engage non-profits, faith-based communities, and community coalitions to support
people in treatment and recovery and to support family members in their efforts to
manage the opioid user in the family.
9. Provide training and development of procedures for government staff to appropriately
interact and provide social and other services to current and recovering opioid users,
including reducing stigma.
10. Support stigma reduction efforts regarding treatment and support for persons with
OUD, including reducing the stigma on effective treatment.
C. CONNECT PEOPLE WHO NEED HELP TO THE HELP THEY NEED
(CONNEC'TIONS TO CARE)
Provide connections to care for people who have—or are at risk of developing—OUD and
any co-occurring SUD/MH conditions, co-usage, and/or co-addiction through evidence-
based, evidence-informed, or promising programs or strategies that may include,but are not
limited to,the following:
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. Support Screening, Brief Intervention and Referral to Treatment (SBIRT) programs
to reduce the transition from use to disorders.
3. Provide training and long-term implementation of SBIRT in key systems (health,
schools, colleges, criminal justice, and probation), with a focus on youth and young
adults when transition from misuse to opioid disorder is common.
4. Purchase automated versions of SBIRT and support ongoing costs of the technology.
5. Support training for emergency room personnel treating opioid overdose patients on
post-discharge planning, including community referrals for MAT, recovery case
management or support services.
6. Support hospital programs that transition persons with OUD and any co-occurring
SUD/MH conditions,co-usage,and/or co-addiction,or persons who have experienced
an opioid overdose, into community treatment or recovery services through a bridge
clinic or similar approach.
7. Support crisis stabilization centers that serve as an alternative to hospital emergency
departments for persons with OUD and any co-occurring SUD/MH conditions, co-
usage, and/or co-addiction or persons that have experienced an opioid overdose.
8. 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.
9. Provide funding for peer support specialists or recovery coaches in emergency
departments, detox facilities, recovery centers, recovery housing, or similar settings;
offer services, supports, or connections to care to persons with OUD and any co-
occurring SUD/MH conditions,co-usage,and/or co-addiction or to persons who have
experienced an opioid overdose.
10.Provide funding for peer navigators, recovery coaches, care coordinators, or care
managers that offer assistance to persons with OUD and any co-occurring SUD/MH
conditions, co-usage, and/or co-addiction or to persons who have experienced on
opioid overdose.
11. Create or support school-based contacts that parents can engage with to seek
immediate treatment services for their child; and support prevention, intervention,
treatment,and recovery programs focused on young people.
12.Develop and support best practices on addressing OUD in the workplace.
13. Support assistance programs for health care providers with OUD.
14.Engage non-profits and the faith community as a system to support outreach for
treatment.
15. Support centralized call centers that provide information and connections to
appropriate services and supports for persons with OUD and any co-occurring
SUD/MH conditions, co-usage,and/or co-addiction.
16.Create or support intake and call centers to facilitate education and access to treatment,
prevention, and recovery services for persons with OUD and any co-occurring
SUD/MH conditions,co-usage,and/or co-addiction.
17.Develop or support a National Treatment Availability Clearinghouse — a
multistate/nationally accessible database whereby health care providers can list
locations for currently available in-patient and out-patient OUD treatment services
that are accessible on a real-time basis by persons who seek treatment.
D. ADDRESS THE NEEDS OF CRIMINAL-JUSTICE-INVOLVED PERSONS
Address the needs of persons with OUD and any co-occurring SUD/MH conditions,co-usage,
and/or co-addiction who are involved—or are at risk of becoming involved—in the criminal
justice system through evidence-based, evidence-informed, or promising programs or
strategies that may include,but are not limited to,the following:
1. Support pre-arrest or post-arrest diversion and deflection strategies for persons with
OUD and any co-occurring SUD/MH conditions, co-usage, and/or co-addiction,
including established strategies such as:
a. Self-referral strategies such as the Angel Programs or the Police Assisted
Addiction Recovery Initiative(PAARI);
b. Active outreach strategies such as the Drug Abuse Response Team (DART)
model;
c. "Naloxone Plus" strategies, which work to ensure that individuals who have
received naloxone to reverse the effects of an overdose are then linked to treatment
programs or other appropriate services;
d. Officer prevention strategies, such as the Law Enforcement Assisted Diversion
(LEAD)model;
e. Officer intervention strategies such as the Leon County, Florida Adult Civil
Citation Network or the Chicago Westside Narcotics Diversion to Treatment
Initiative;
f. Co-responder and/or alternative responder models to address OUD-related 911
calls with greater SUD expertise and to reduce perceived barriers associated with
law enforcement 911 responses;or
g. County prosecution diversion programs, including diversion officer salary, only
for counties with a population of 50,000 or less.Any diversion services in matters
involving opioids must include drug testing, monitoring,or treatment.
2. Support pre-trial services that connect individuals with OUD and any co-occurring
SUD/MH conditions, co-usage, and/or co-addiction to evidence-informed treatment,
including MAT, and related services.
3. Support treatment and recovery courts for persons with OUD and any co-occurring
SUD/MH conditions, co-usage, and/or co-addiction, but only if these courts provide
referrals to evidence-informed treatment, including MAT.
4. Provide evidence-informed treatment, including MAT, recovery support, or other
appropriate services to individuals with OUD and any co-occurring SUD/MH
conditions,co-usage, and/or co-addiction who are incarcerated in jail or prison.
5. Provide evidence-informed treatment, including MAT, recovery support, or other
appropriate services to individuals with OUD and any co-occurring SUD/MH
conditions, co-usage, and/or co-addiction who are leaving jail or prison have recently
left jail or prison, are on probation or parole, are under community corrections
supervision,or are in re-entry programs or facilities.
6. Support critical time interventions(CTI),particularly for individuals living with dual-
diagnosis OUD/serious mental illness, and services for individuals who face
immediate risks and service needs and risks upon release from correctional settings.
7. Provide training on best practices for addressing the needs of criminal-justice-
involved persons with OUD and any co-occurring SUD/MH conditions, co-usage,
and/or co-addiction to law enforcement, correctional, or judicial personnel or to
providers of treatment, recovery, case management, or other services offered in
connection with any of the strategies described in this section.
E. ADDRESS THE NEEDS OF PREGNANT OR PARENTING WOMEN AND
THEIR FAMILIES,INCLUDING BABIES WITH NEONATAL ABSTINENCE
SYNDROME
Address the needs of pregnant or parenting women with OUD and any co-occurring SUD/MH
conditions, co-usage, and/or co-addiction, and the needs of their families, including babies
with neonatal abstinence syndrome, through evidence-based, evidence-informed, or
promising programs or strategies that may include,but are not limited to,the following:
1. Support evidence-based,evidence-informed,or promising treatment, including MAT,
recovery services and supports, and prevention services for pregnant women — or
women who could become pregnant—who have OUD and any co-occurring SUD/MH
conditions, co-usage,and/or co-addiction,and other measures to educate and provide
support to families affected by Neonatal Abstinence Syndrome.
2. Provide 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, co-usage,and/or co-addiction.
3. 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.
4. 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.
5. Offer enhanced family supports and home-based wrap-around services to persons with
OUD and any co-occurring SUD/MH conditions, co-usage, and/or co-addiction,
including but not limited to parent skills training.
6. Support for Children's Services — Fund additional positions and services, including
supportive housing and other residential services, relating to children being removed
from the home and/or placed in foster care due to custodial opioid use.
PART TWO: PREVENTION
F, PREVENT OVER-PRESCRIBING AND ENSURE APPROPRIATE
PRESCRIBING AND DISPENSING OF OPIOIDS
Support efforts to prevent over-prescribing and ensure appropriate prescribing and dispensing
of opioids through evidence-based, evidence-informed, or promising programs or strategies
that may include, but are not limited to,the following:
1. Training for health care providers regarding safe and responsible opioid prescribing,
dosing, and tapering patients off opioids.
2. Academic counter-detailing to educate prescribers on appropriate opioid prescribing.
3. Continuing Medical Education (CME) on appropriate prescribing of opioids.
4. Support for non-opioid pain treatment alternatives, including training providers to
offer or refer to multi-modal,evidence-informed treatment of pain.
5. Support enhancements or improvements to Prescription Drug Monitoring Programs
(PDMPs), including but not limited to improvements that:
a. Increase the number of prescribers using PDMPs;
b. Improve point-of-care decision-making by increasing the quantity, quality, or
format of data available to prescribers using PDMPs or by improving the
interface that prescribers use to access PDMP data,or both;or
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.
6. Development and implementation of a national PDMP — Fund development of a
multistate/national PDMP that permits information sharing while providing
appropriate safeguards on sharing of private health information, including but not
limited to:
a. Integration of PDMP data with electronic health records, overdose episodes,
and decision support tools for health care providers relating to OUD.
b. Ensuring PDMPs incorporate available overdose/naloxone deployment data,
including the United States Department of Transportation's Emergency
Medical Technician overdose database.
7. Increase electronic prescribing to prevent diversion or forgery.
8. Educate Dispensers on appropriate opioid dispensing.
G. PREVENT MISUSE OF OPIOIDS
Support efforts to discourage or prevent misuse of opioids through evidence-based,evidence-
informed, or promising programs or strategies that may include, but are not limited to, the
following:
1. Corrective advertising or affirmative public education campaigns based on evidence.
2. Public education relating to drug disposal.
3. Drug take-back disposal or destruction programs.
4. Fund community anti-drug coalitions that engage in drug prevention efforts.
5. Support community coalitions in implementing evidence-informed prevention, such
as reduced social access and physical access, stigma reduction— including staffing,
educational campaigns, support for people in treatment or recovery, or training of
coalitions in evidence-informed implementation, including the Strategic Prevention
Framework developed by the U.S. Substance Abuse and Mental Health Services
Administration(SAMHSA).
6. Engage non-profits and faith-based communities as systems to support prevention.
7. Support evidence-informed school and community education programs and
campaigns for students,families, school employees,school athletic programs, parent-
teacher and student associations, and others.
8. 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.
9. Support community-based education or intervention services for families,youth, and
adolescents at risk for OUD and any co-occurring SUD/MH conditions, co-usage,
and/or co-addiction.
10. Support evidence-informed programs or curricula to address mental health needs of
young people who may be at risk of misusing opioids or other drugs, including
emotional modulation and resilience skills.
11. Support greater access to mental health services and supports for young people,
including services and supports provided by school nurses or other school staff, to
address 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
Support efforts to prevent or reduce overdose deaths or other opioid-related harms through
evidence-based, evidence-informed, or promising programs or strategies that may include,
but are not limited to,the following:
1. Increase availability and distribution of naloxone and other drugs that treat overdoses
for first responders, overdose patients, opioid users, families and friends of opioid
users, schools, community navigators and outreach workers, drug offenders upon
release from jail/prison, or other members of the general public.
2. Provision by public health entities of free naloxone to anyone in the community,
including but not limited to provision of intra-nasal naloxone in settings where other
options are not available or allowed.
3. Training and education regarding naloxone and other drugs that treat overdoses for
first responders,overdose patients,patients taking opioids,families,schools,and other
members of the general public.
4. Enable school nurses and other school staff to respond to opioid overdoses, and
provide them with naloxone,training, and support.
5. Expand, improve, or develop data tracking software and applications for
overdoses/naloxone revivals.
6. Public education relating to emergency responses to overdoses.
7. Public education relating to immunity and Good Samaritan laws.
8. Educate first responders regarding the existence and operation of immunity and Good
Samaritan laws.
9. Expand access to testing and treatment for infectious diseases such as HIV and
Hepatitis C resulting from intravenous opioid use.
10. Support mobile units that offer or provide referrals to 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,co-usage, and/or co-addiction.
11.Provide training in treatment and recovery strategies to health care providers,students,
peer recovery coaches, recovery outreach specialists, or other professionals that
provide care to persons who use opioids or persons with OUD and any co-occurring
SUD/MH conditions, co-usage, and/or co-addiction.
12. Support screening for fentanyl in routine clinical toxicology testing.
PART THREE: OTI-IER STRATEGIES
I. FIRST RESPONDERS
In addition to items C8, Dl through D7,FI1, 113, and H8, support the following:
1. Current and future law enforcement expenditures relating to the opioid epidemic.
2. Educate law enforcement or other first responders regarding appropriate practices and
precautions when dealing with fentanyl or other drugs.
J. LEADERSHIP,PLANNING AND COORDINATION
Support efforts to provide leadership,planning,and coordination to abate the opioid epidemic
through activities, programs, or strategies that may include, but are not limited to, the
following:
1. Community regional planning to identify goals for reducing harms related to the
opioid epidemic,to identify areas and populations with the greatest needs for treatment
intervention services, or to support other strategies to abate the opioid epidemic
described in this opioid abatement strategy list.
2. A government dashboard to track key opioid-related indicators and supports as
identified through collaborative 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,co-usage, and/or co-addiction, supporting them in
treatment or recovery, connecting them to care, or implementing other strategies to
abate the opioid epidemic described in this opioid abatement strategy list.
4. Provide resources to staff government oversight and management of opioid abatement
programs.
K. TRAINING
In addition to the training referred to in various items above, support training to abate the
opioid epidemic through activities, programs, or strategies that may include, but are not
limited to, the following:
I. Provide funding for staff training or networking programs and services to improve the
capability of government, community, and not-for-profit entities to abate the opioid
crisis.
2. Invest in 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, co-usage, and/or co-addiction, or implement other
strategies to abate the opioid epidemic described in this opioid abatement strategy list
(e.g.,health care, primary care,pharmacies,PDMPs, etc.).
L. RESEARCH
Support opioid abatement research that may include, but is not limited to,the following:
1. Monitoring, surveillance, 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 innovative supply-side enforcement efforts such as improved detection
of mail-based delivery of synthetic opioids.
5. 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).
6. Research on expanded modalities such as prescription methadone that can expand
access to MAT.
Exhibit B
E hibi B
Allocation to Arizona Connties/Reaions
Conn ty/Region Percentage of IA; Share
APACHE 0.690%
COCHISE 1.855%
COCONINO 1.688%
GILA 1.142%
GRAHAM 0.719%
GREENLEE 0.090%
LA PAZ 0.301%
MARICOPA 57.930%
MOHAVE 4.898%
NAVAJO 1.535%
PIMA 18.647%
PINAL 3.836%
SANTA CRUZ 0.370%
YAVAPAI 4.291%
YUMA 2.008%
Exhibit C
Government Name County Name State Name Government Type Census ID Intra-county Allocation (%)
Based on Past Spending
APACHE COUNTY
APACHE COliNTY i Apache County . ARIZONA County 3100100100000 56.63%
EAGAR TOWN Apache County ARIZONA City 3200100100000 20.66%
SPRINGERVILLE TOWN Apache County ARIZONA City 3200100300000 10.73%
ST JOHNS CITY Apache County ARIZONA City 3200100200000 11.98%
COCHISE COUNTY
COCHISE COUNTY Cochise County ARIZONA County 3100200200000 63.47%
BENSON CITY Cochise County ARIZONA City 3200200100000 3.52%
BISBEE CITY Cochise County ARIZONA City 3200200200000 3.47%
DOUGLAS CITY Cochise County ARIZONA City 3200200300000 8.44c,vo
. _
HUACHUCA CITY TOWN Cochise County ARIZONA City 3200250100000 0.91%
SIERRA VISTA CITY Cochise County ARIZONA City 3200200400000 16.63%
TOMBSTONE CITY Cochise County ARIZONA City 3200200500000 1.16%
WIIIC'OX CITY Cochise County ARIZONA _City 3200200600000 2.39%
COCONINO COUNTY _
COCONINO COUNTY Coconino County i ARIZONA County 3100300300000 71.16%
FLAGSTAFF CITY Coconino County I ARIZONA City 3200300100000 18.45%
FREDONIA TOWN Coconino County ARIZONA City 3200300300000 0.31%
PAGE CITY Coconino County ARIZONA City 3200390100000 3.41%
SEDONA CITY Coconino County ARIZONA City 3201340200000 4.09%
TUSAYAN TOWN Coconino County ARIZONA City 3200310100000 0.67%
WILLIAMS CITY Coconino County ARIZONA City 3200300200000 1.92%
GILA COUNTY
GILA COUNTY Gila County i ARIZONA County 3100400400000 ' 68.13%
GLOBE CITY Gila County I ARIZONA City 3200400100000 10.23%
HAYDEN TOWN Gila County ARIZONA City 3200450100000 2.31%
MIAMI TOWN Gila County ARIZONA City 3200400200000 2.71%
PAYSON TOWN Gila County ARIZONA City 3200490100000 16.17%
STAR VALLEY TOWN Gila County ARIZONA City 3200410100000 0.35%
WINKELMAN TOWN Gila County ARIZONA City 3200400300000 0.10%
GRAHAM COUNTY
G12R AI IAM COUNTY Graham Count v ARIZONA Count v 3100N00500000 62.26%
PIMA TOWN Graham County ARIZONA City 3200500100000 2.22%
SAFFORD CITY Graham County ARIZONA City 3200500200000 26.83°.
THATCIIER TOWN Graham County ARIZONA City 3200500300000 8.68%
GREENLEE COUNTY
GREENLEE COUNTY Greenlee County ARIZONA County 3100600600000 88.29%
CLIFTON TOWN Greenlee County ARIZONA City 3200600100000 11.43%
DUNCAN TOWN Greenlee County ARIZONA City 3200600200000 0.28%
LA PAZ COUNTY
LA PAZ COUNTY I,a Paz County ARIZONA County 3101501500000 88.71%
PARKER TOWN La Paz County ARIZONA City 3201560100000 5.19%
QUARTZSITE TOWN La Paz County ARIZONA City 3201540100000 6.11%
MARICOPA COUNTY
MARICOPA COUNTY Maricopa County ARIZONA County 3100700700000 51.53%
APACHE JUNCTION CITY Maricopa County ARIZONA City 3201160100000 0.38%
AVONDALE CITY Maricopa County rARIZONA City 3200700100000 0.98%
BUCKEYE TOWN Maricopa County ARIZONA City 3200700200000 0.46%
CAREFREE TOWN Maricopa County ARIZONA City 3200740100000 0.04%
CAVE CREEK TOWN Maricopa County ARIZONA City 3200740200000 0.06%
CHANDLER CITY Maricopa County ARIZONA City 3200700300000 2.86%
EL MIRAGE CITY Maricopa County ARIZONA City 3200700400000 0.39%
FOUNTAIN HILLS TOWN Maricopa County ARIZONA City 3200740400000 0.17%
GILA BEND TOWN Maricopa County ARIZONA City 3200770100000 0.03%
GILBERT TOWN Maricopa County ARIZONA City 3200700500000 1.71%
GI,ENDAI,E CITY Maricopa County , ARIZONA City 3200700600000 2.63%
GOODYEAR CITY Maricopa County ARIZONA City 3200700700000 0.76%
GUADALUPE TOWN Maricopa County ARIZONA City 3200790100000 0.00%
LITCHFIELD PARK CITY Maricopa County ARIZONA City
3200740300000 0.04%
MESA CITY Maricopa County ARIZONA City 3200700800000 6.06%
PARADISE VALLEY TOWN Maricopa County ARIZONA City 3200750100000 0.34%
PEORIA CITY Maricopa County ARIZONA City 3200700900000 1.51%
PHOENIX CITY Maricopa County ARIZONA City 3200701000000 21.28%
QUEEN CREEK TOWN Maricopa County ARIZONA City 3200740500000 0.11%
SCOTTSDALE CITY Maricopa County ARIZONA City 3200701100000 3.99%
SURPRISE CITY Maricopa County ARIZONA City 3200750200000 0.98%
TEMPE CITY Maricopa County ARIZONA City 3200701200000 3.27%
TOLLESON CITY Maricopa County ARIZONA City 3200701300000 0.27%
WICKENBURG TOWN Maricopa County ARIZONA City 3200701400000 0.10%
YOUNGTOWN TOWN Maricopa County ARIZONA City 3200750300000 0.05%
MOHAVE COUNTY
MOHAVE COUNTY Mohave County ARIZONA County 3100800800000 62.51%
BULLHEAD CITY CITY Mohave County ARIZONA City 3200840100000 13.10%
COLORADO CITY TOWN Mohave County ARIZONA City 3200840200000 0.61%
KINGMAN CITY Mohave County ARIZONA City 3200800100000 9.91% 1
LAKE HAVASU CITY CITY Mohave County ARIZONA City 3200860100000 13.87%
NAVAJO COUNTY
NAVAJO COUNTY Navajo County ARIZONA County 3100900900000 70.29%
HOLBROOK CITY Navajo County ARIZONA City 3200900100000 3.75%
PINETOP-LAKESIDE TOWN Navajo Coimty ARIZONA City, I 3200940100000 4.75%
SHOW LOW CITY Navajo County ARIZONA City 3200900200000 9.39%
SNOWFLAKE TOWN Navajo County ARIZONA City 3200900300000 2.94%
TAYLOR TOWN Navajo County ARIZONA City 3200980100000 2.68%
WINSLOW CITY Navajo County ARIZONA City 3200900400000 6.19%
t _ ii ,
PIMA COUNTY Pima County ARIZONA County 3101001000000 72.19%
MARANA TOWN Pima County ARIZONA City 3201090200000 2.06%
ORO VALLEY TOWN Pima County ARIZONA City 3201090100000 1 72%
SAHUARITA TOWN Pima County ARIZONA +City 3201020100000 0.81%
SOUTH TUCSON CITY Pima County ARIZONA -City 3201000100000 0.31%
TUCSON CITY Pima County ARIZONA City 3201000200000 22.91%
PINAL COUNTY eV
PINAL COUNTY Pinal County ARIZONA County 3101 101 100000 53.01%
CASA GRANDE CITY Pinal County ARIZONA City 3201100100000 5.54%
COOLIDGE CITY Final County ARIZONA City 3201 100200000 1.68%
ELOY CITY Pinal County ARIZONA City 3201100300000 34.98%
FLORENCE TOWN Pinal County ARIZONA City 3201 100400000 1.19%
KEARNY TOWN Final County ARIZONA City 3201150100000 0.28%
MAMMOTH TOWN Final County ARIZONA City 3201150200000 0.16%
MARICOPA CITY Final County ARIZONA City 3201110100000 2.73%
SUPERIOR TOWN Pinal County ARIZONA City 3201 190100000 0.44%
,N SANTA CRUZ COUNTY
SANTA CRUZ COUNTY Santa Cruz County ARIZONA County 3101201200000 76.78%
NOGALES CITY Santa Cruz County ARIZONA City 3201200100000 22.55%
PATAGONIA TOWN Santa Cruz County ARIZONA City 3201200200000 0.67%
wit
YAVAPAI COUNTY
YAVAPAI COUNTY Yavapai County ARIZONA County 3101301300000 69.31%
CAMP VERDE TOWN Yavapai County ARIZONA City 3201340100000 0.97%
CHINO VALLEY TOWN Yavapai County ARIZONA City 3201380100000 0.68%
CLARKDALE TOWN Yavapai County ARIZONA City 3201350100000 0.72%
COTTONWOOD CITY Yavapai County ARIZONA City 3201350200000 4.89%
DEWEY-HUMROLDT Yavapai County ARIZONA City 3201310100000 1.54%
TOWN
JEROME TOWN Yavapai County ARIZONA City _ A 3201300100000 0.03%
PRESCOTT CITY Yavapai County ARIZONA City 3201300200000 13.79%
PRESCOTT VALLEY TOWN Yavapai County ARIZONA City 3201360100000 8.09%
YUMA COUNTY
YUMA COUNTY Yuma County ARIZONA County 3101401400000 66.03%
SAN LUIS CITY Yuma County ARIZONA City 3201460100000 4.80%
SOMERTON CITY Yuma County ARIZONA City 3201400200000 2.24%
WELLTON TOWN Yuma County ARIZONA City 3201480100000 0.61%
YUMA CITY Yuma County ARIZONA City 3201400300000 26.32%
Exhibit D
Percent
Participation of AFFard
Cities
0 0%
5 2%
10 4%
15 6%
20 8%
25 10%
30 12%
35 14%
40 16%
45 18%
50 20%
5522%
60__..._ 24%
65 26%
70 28%
75 30%
80 32%
85 34%
90 36%
95 38%
100 40%