05-17-2021 Agenda Packet BOCPERSON COUNTY
BOARD OF COUNTY COMMISSIONERS
MEETING AGENDA
304 South Morgan Street, Room 215
Roxboro, NC 27573-5245
336-597-1720
Fax 336-599-1609
May 17, 2021
9:00am
This meeting will convene in the County Office Building Auditorium.
CALL TO ORDER………………………………………………….. Chairman Powell
INVOCATION
PLEDGE OF ALLEGIANCE
DISCUSSION/ADJUSTMENT/APPROVAL OF AGENDA
INFORMAL COMMENTS
The Person County Board of Commissioners established a 10-minute segment
which is open for informal comments and/or questions from citizens of this
county on issues, other than those issues for which a public hearing has been
scheduled. The time will be divided equally among those wishing to comment.
It is requested that any person who wishes to address the Board, register with
the Clerk to the Board prior to the meeting.
ITEM #1
DISCUSSION/ADJUSTMENT/APPROVAL OF CONSENT AGENDA A.Budget Amendments #16 and #17 (pgs. 3-4),
B.Home & Community Care Block Grant Funding Revision 2020-2021 for the
Dept. of Social Services for a total of $38,627 for In-Home Aid Level II and III
Personal Care (pgs 5-6), andC.Timberlake Firefighters’ Relief Fund Board of Trustees Appointment (pg 7)
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NEW BUSINESS:
ITEM #2 (pg 8)
Broadband Update – RiverStreet Networks ………………………. Katherine Cathey
ITEM #3 (pg 9)
Advanced Technology Center for PCC ………………………….. Dr. Pamela Senegal
ITEM #4 (pgs 10-60)
Resolution Approving the Memorandum of Agreement between
the State of North Carolina and Local Governments on Proceeds
Relating to the Settlement of Opioid Litigation ……………………………Heidi York
ITEM #5 (pgs 61-78)
Falls Watershed Regulations – Interim Alternative
Implementation Approach Possible Projects ……………… Lori Oakley & John Hill
ITEM #6 (pg79)
Presentation of the Fiscal Year 2021-2022 Proposed Budget ……………. Heidi York
CHAIRMAN’S REPORT
MANAGER’S REPORT
COMMISSIONER REPORTS/COMMENTS
CLOSED SESSION #1
A motion to enter into Closed Session per General Statute 143-318.11(a)(4) for the
purpose of discussion of matters relating to the location or expansion of industries or
other businesses in the area served by the public body, including agreement on a
tentative list of economic development incentives that may be offered by the public
body in negotiations with the following individuals permitted to attend: County
Manager, Heidi York, Clerk to the Board, Brenda Reaves, Economic Development
Director, Sherry Wilborn and County Attorney, Ellis Hankins.
Note: All Items on the Agenda are for Discussion and Action as deemed appropriate
by the Board.
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5/17/2021
Dept./Acct No.Department Name Amount
Incr / (Decr)
EXPENDITURES General Fund
General Government 8,998
Public Safety 1,034
Human Services 318,309
Culture & Recreation 4,686
Self-Funded Health Insurance Fund 1,418,208
Transfer to Other Funds 426,041
REVENUES General Fund
Intergovernmental Revenue 318,109
Sales Tax Distribution 1,844,249
Other Revenue 6,158
Fund Balance Appropriation 8,760
EXPENDITURES Capital Investment Fund 426,041
REVENUES Capital Investment Fund
Transfer from General Fund/Sch Sales Tax 426,041
Explanation:
BUDGET AMENDMENT
Receipt of insurance claims for damage to EMS ambulance ($1,034) and for repairs to various parks and
replacement of the IT generator due to the 2021 ice storm ($4,924); appropriate CARES Act funds for cameras and
wireless microphone equipment for Commissioner meetings in PCOB auditorium ($7,000) and GoTo Assist Remote
Support costs paid for November 2020 through February 2021 ($1,760); utilizing remaining sales tax estimates for
FY21 to support high claims expense in the Self-Funded Health insurance Fund ($1,418,208) and transfer the set-
aside portion of sales tax to the CIF Fund for schools ($426,041); recognizing State funds received for the
Communicable Disease Grant in the Health Department ($316,279); making necessary adjustments for the Crisis
and Duke Energy Neighbor Programs in DSS ($1,830); and recognizing donation in DSS for the Foster Care
Program ($200).
BA‐163
5/17/2021
Dept./Acct No.Department Name Amount
Incr / (Decr)
EXPENDITURES General Fund
General Government 70,395
Public Safety 218,384
Transportation 17,781
Human Services 23,338
Economic & Physical Development 4,151
Contingency (334,049)
Explanation:
BUDGET AMENDMENT
Transferring budget reserved in Contingency-Compression Study (-$193,502) to department salary and fringe benefit
line items ($192,502) that were impacted by Phase III of the Compression Study for the current year; transferring
budget from Contingency-Parental Leave (-$15,547) for EMS Overtime ($12,547) and IT Part-time ($3,000); and
transferring budget from Contingency-COVID 19 Leave (-$125,000) for impacts to EMS Overtime ($125,000).
BA‐174
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AGENDA ABSTRACT
Meeting Date: May 17, 2021
Agenda Title: Timberlake Firefighters’ Relief Fund Board of Trustees Appointment
Summary of Information: The Firefighters’ Relief Fund and Rescue Squad Worker's Relief Fund
programs are designed to financially assist firefighter and rescue personnel in the event of line of
duty injury or death. It may also be used for supplemental retirement, educational benefits and to
purchase other insurance/pension plans.
A local Firefighters' Relief Fund Board of Trustee's shall be elected/appointed to control the local
funds. The Firefighters' Relief Fund Board of Trustee's is comprised of five (5) people: two shall be
elected by the fire department and shall either be a resident of the fire district or an active or retired
member of the fire department; two shall be elected by the County governing body (or by the City
governing body, if located inside the City), and members appointed pursuant to this section shall be
residents of the fire district; and one shall be appointed by the Insurance Commissioner. The
member appointed pursuant to this section shall be either a resident of the fire district or an active
or retired member of the fire department. One of the local relief fund board members will be chosen
to serve as the Firefighters' Relief Fund Treasurer. The state provides a bond to cover Treasurers of
local Firefighters' Relief Funds.
The Timberlake Volunteer Fire Department Chief, Jason Fletcher, and the Deputy Chief/President
Timberlake Fire & Rescue Relief Fund, Todd Lane, request that the Board of Commissioners
appoint the following resident of their fire district to their Firefighters’ Relief Fund Board of
Trustees:
Alan Woody
244 Ashley Ave.
Timberlake, NC 27583
(336) 364-7480
Recommended Action: Appoint Alan Woody as one of the two Commissioner representatives to
replace Thomas Drumwright whom retired due to health.
Submitted By: Keith Duncan, County Fire Marshal
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AGENDA ABSTRACT
Meeting Date: May 17, 2021
Agenda Title: Broadband Update – RiverStreet Networks
Summary of Information: RiverStreet Networks will provide an update regarding their current
deployment of broadband service across Person County as well as their future goals for broadband
service expansion.
Bill Shillito, Business Development Manager for RiverStreet Networks, will present information on
the following topics:
Woodland, Mt. Tirzah, Bethel Hill and Bushy Fork towers and public wi-fi hotspots are fully
operational.
Currently in the process of establishing the final public wi-fi hotspot (Uptown Roxboro
location).
Leasing space on Oak Lane Tower (owned by American Tower) near Hyco Lake.
Constructing new tower in southeastern Person County.
Recommended Action: Receive and discuss information provided in presentation.
Submitted By: Katherine M. Cathey, Assistant County Manager
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AGENDA ABSTRACT
Meeting Date: May 17, 2021
Agenda Title: Advanced Technology Center (ATC) for PCC
Summary of Information: Update on plans underway to identify funding in support of ATC
for economic and workforce development in the region.
Recommended Action: Commitment to continued progress on ATC funding model as
presented.
Submitted By: Dr. Pamela G. Senegal
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AGENDA ABSTRACT
Meeting Date: May 17, 2021
Agenda Title: Resolution Approving the Memorandum of Agreement between the State
of North Carolina and Local Governments on Proceeds Relating to the
Settlement of Opioid Litigation
Summary of Information: Person County is one of seventy-six counties that have joined state
and national litigation efforts by filing lawsuits against companies for the manufacturing,
marketing, promotion, and distribution of prescription opioid drugs. Working with the State, we
are hopeful that a National Settlement Agreement will be forthcoming along with proceeds from
a related bankruptcy resolution. The proposed NC Memorandum of Agreement governs how NC
would use its share of opioid settlement funds to be transparent and accountable.
Under the NC Memorandum of Agreement all settlement funds would be directed as follows:
15% to the State (for strategies to address the epidemic)
80% to local governments through a formula developed by attorneys involved in the
national litigation (for strategies to support programs and services to address the epidemic)
An additional 5% into an incentive fund for any county in which all municipalities within
the county with a population of 30,000 or more also signs the NC Memorandum of
Agreement (Note: Person County will receive the additional 5% but Roxboro should still
be requested to agree to the MOA to avoid a reduction in funds in the future)
These potential settlements and resolutions could bring as much as $850 million to North Carolina
over an 18-year period to support state and local efforts to address the epidemic. Counties are
being asked to sign the Resolution of Agreement as soon as possible to increase the percentage of
opioid settlement funds that come to North Carolina.
Recommended Action: Receive the information and adopt the Resolution in Support of the
Memorandum of Agreement.
Submitted By: Heidi York, County Manager
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A RESOLUTION BY THE COUNTY OF PERSON
APPROVING THE MEMORANDUM OF AGREEMENT (MOA) BETWEEN THE STATE OF
NORTH CAROLINA AND LOCAL GOVERNMENTS ON PROCEEDS RELATING TO THE
SETTLEMENT OF OPIOID LITIGATION
WHEREAS, as of 2019, the opioid epidemic had taken the lives of more than 16,500 North
Carolinians, torn families apart, and ravaged communities from the mountains to the coast; and
WHEREAS, the COVID-19 pandemic has compounded the opioid crisis, increasing levels of
drug misuse, addiction, and overdose death; and
WHEREAS, the Centers for Disease Control and Prevention estimates the total "economic
burden" of prescription opioid misuse alone in the United States is $78.5 billion a year, including the
costs of healthcare, lost productivity, addiction treatment, and criminal justice involvement; and
WHEREAS, certain counties and municipalities in North Carolina joined with thousands of
local governments across the country to file lawsuit against opioid manufacturers and pharmaceutical
distribution companies and hold those companies accountable for their misconduct; and
WHEREAS, representatives of local North Carolina governments, the North Carolina
Association of County Commissioners, and the North Carolina Department of Justice have negotiated
and prepared a Memorandum of Agreement (MOA) to provide for the equitable distribution of any
proceeds from a settlement of national opioid litigation to the State of North Carolina and to individual
local governments; and
WHEREAS, Local Governments and the State of North Carolina anticipate a settlement in the
national opioid litigation to be forthcoming; and
WHEREAS, by signing onto the MOA, the state and local governments maximize North
Carolina’s share of opioid settlement funds to ensure the needed resources reach communities, once a
negotiation is finalized, as quickly, effectively, and directly as possible; and
WHEREAS, it is advantageous to all North Carolinians for local governments, including Person
County and its citizens, to sign onto the MOA and demonstrate solidarity in response to the opioid
epidemic, and to maximize the share of opioid settlement funds received both in the state and this
county to help abate the harm; and
WHEREAS, the MOA directs substantial resources over multiple years to local governments on
the front lines of the opioid epidemic while ensuring that these resources are used in an effective way to
address the crisis.
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NOW, THEREFORE BE IT RESOLVED, Person County Board of Commissioners hereby
approves the Memorandum of Agreement Between the State of North Carolina and Local Governments
on Proceeds Relating to the Settlement of Opioid Litigation, and any subsequent settlement funds that
may come into North Carolina as a result of the opioid crisis. Furthermore, Person County authorizes
the County Manager (or County Attorney) take such measures as necessary to comply with the terms of
the MOA and receive any settlement funds, including executing any documents related to the allocation
of opioid settlement funds and settlement of lawsuits related to this matter. Be it further resolved copies
of this resolution and the signed MOA be sent to opioiddocs@ncdoj.gov as well as forwarded to the
North Carolina Association of County Commissioners at communications@ncacc.org.
Adopted this the 17th day of May 2021.
__________________________________________
Gordon Powell, Chairman
Person County Board of Commissioners
ATTEST:
________________________________
Brenda B. Reaves, Clerk to the Board
(SEAL)
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MEMORANDUM OF AGREEMENT
BETWEEN THE STATE OF NORTH CAROLINA AND LOCAL GOVERNMENTS
ON PROCEEDS RELATING TO THE SETTLEMENT OF OPIOID LITIGATION
Contents
Background Statement .....................................................................................................................3
Statement of Agreement ..................................................................................................................4
A. Definitions............................................................................................................................4
B. Allocation of Settlement Proceeds
1. Method of distribution .............................................................................................5
2. Overall allocation of funds.......................................................................................5
3. Allocation of funds between Local Governments ...................................................5
4. Municipal allocations
a. Local Governments receiving payments ......................................................6
b. Municipality may direct payments to county ...............................................6
5. Use of funds for opioid remediation activities .........................................................6
6. Relationship of this MOA to other agreements and resolutions ..............................6
C. Payment of Litigating and Non-Litigating Parties ...............................................................6
D. Special Revenue Fund
1. Creation of special revenue fund .............................................................................6
2. Procedures for special revenue fund ........................................................................6
3. Interest earned on special revenue fund ...................................................................7
E. Opioid Remediation Activities
1. Limitation on use of funds .......................................................................................7
2. Opportunity to cure inconsistent expenditures ........................................................7
3. Consequences of failure to cure inconsistent expenditures .....................................7
4. Annual meeting of counties and municipalities within each county .......................7
5. Use of settlement funds under Option A and Option B
a. Option A.......................................................................................................8
b. Option B .......................................................................................................8
6. Process for drawing from special revenue funds
a. Budget item or resolution required ..............................................................9
b. Budget item or resolution details .................................................................9
7. Coordination group ..................................................................................................9
F. Auditing, Compliance, Reporting, and Accountability
1. Audits under Local Government Budget and Fiscal Control Act ............................9
2. Audits under other acts and requirements ................................................................9
3. Audit costs ...............................................................................................................9
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4. Access to persons and records .................................................................................9
5. Preservation of records ..........................................................................................10
6. Reporting
a. Annual financial report required ................................................................10
b. Annual financial report timing and contents ..............................................10
c. Reporting to statewide opioid settlement dashboard .................................10
d. Copy to NCDOJ of any additional reporting .............................................11
e. Compliance and non-compliance ...............................................................11
7. Collaboration..........................................................................................................11
G. County Incentive Fund .......................................................................................................11
H. Effectiveness
1. When MOA takes effect ........................................................................................12
2. Amendments to MOA
a. Amendments to conform to final national documents ...............................12
b. Coordination group ....................................................................................12
c. No amendments to allocation between local governments ........................12
d. General amendment power ........................................................................12
3. Acknowledgement .................................................................................................12
4. When MOA is no longer in effect ..........................................................................12
5. Application of MOA to settlements and bankruptcy resolutions...........................12
6. Applicable law and venue ......................................................................................13
7. Scope of MOA .......................................................................................................13
8. No third party beneficiaries ...................................................................................13
9. No effect on authority of parties ............................................................................13
10. Signing and execution of MOA .............................................................................13
Signature Pages
Exhibits
A. High-Impact Opioid Abatement Strategies Under Option A ...............................................1
B. Additional Opioid Remediation Activities Under Option B ...............................................3
C. Collaborative Strategic Planning Process Under Option B ...............................................14
D. Coordination Group ...........................................................................................................16
E. Annual Financial Report ....................................................................................................19
F. Impact Information ............................................................................................................20
G. Local Government Allocation Proportions ........................................................................22
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Background Statement
Capitalized terms not defined below have the meanings set forth in the Definitions section of the
Statement of Agreement.
WHEREAS, the State of North Carolina (the “State”), North Carolina counties and
municipalities, and their people have been harmed by misconduct committed by certain entities
that engage in or have engaged in the manufacture, marketing, promotion, distribution, or
dispensing of an opioid analgesic (“Pharmaceutical Supply Chain Participants”); and
WHEREAS, certain North Carolina counties and municipalities, through their counsel,
and the State, through its Attorney General, are separately engaged in ongoing investigations,
litigation and settlement discussions seeking to hold Pharmaceutical Supply Chain Participants
accountable for the damage caused by their misconduct; and
WHEREAS, the State and the Local Governments share a common desire to abate and
alleviate the impacts of the misconduct described above throughout North Carolina and in its local
communities; and
WHEREAS, while the Local Governments and the State recognize the sums which may
be available from the aforementioned litigation will likely be insufficient to fully abate the public
health crisis caused by the opioid epidemic, they share a common interest in dedicating the most
resources possible to the abatement effort; and
WHEREAS, settlements resulting from the investigations and litigation with Johnson &
Johnson, AmerisourceBergen, Cardinal Health, and McKesson are anticipated to take the form of
a National Settlement Agreement; and
WHEREAS, this Memorandum of Agreement (“MOA”) is intended to facilitate
compliance by the State and by the Local Governments with the terms of the National Settlement
Agreement and, to the extent appropriate, in other settlements related to the opioid epidemic
reached by the state of North Carolina; and
WHEREAS, North Carolina’s share of settlement funds from the National Settlement
Agreement will be maximized only if all North Carolina counties, and municipalities of a certain
size, participate in the settlement; and
WHEREAS, the National Settlement Agreement will set a default allocation between each
state and its political subdivisions unless they enter into a state-specific agreement regarding the
distribution and use of settlement amounts (a “State-Subdivision Agreement”); and
WHEREAS, this MOA is intended to serve as such a State-Subdivision Agreement under
the National Settlement Agreement; and
WHEREAS, the aforementioned investigations and litigation have caused some
Pharmaceutical Supply Chain Participants to declare bankruptcy, and it may cause additional
entities to declare bankruptcy in the future; and
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WHEREAS, this MOA is also intended to serve as a State-Subdivision Agreement under
resolutions of claims concerning alleged misconduct in manufacture, marketing, promotion,
distribution, or dispensing of an opioid analgesic entered in bankruptcy court that provide for
payments (including payments through a trust) to both the State and North Carolina counties and
municipalities and allow for the allocation between a state and its political subdivisions to be set
through a state-specific agreement (“Bankruptcy Resolutions”); and
WHEREAS, specifically, this MOA is intended to serve under the Bankruptcy Resolution
concerning Purdue Pharma L.P. as a statewide abatement agreement, and under this MOA, a
statewide abatement agreement is a type of State-Subdivision Agreement.
Statement of Agreement
The parties hereto agree as follows:
A. Definitions
As used in this MOA:
The terms “Bankruptcy Resolution,” “MOA,” “Pharmaceutical Supply Chain Participant,”
“State,” and “State-Subdivision Agreement” are defined in the recitals to this MOA.
“Coordination group” refers to the group described in Section E.7 below.
“County Incentive Fund” is defined in Section G below.
“Governing Body” means (1) for a county, the county commissioners of the county, and (2) for
a municipality, the elected city council, town council, board of commissioners, or board of
aldermen for the municipality.
“Incentive Eligible Local Government” is defined in Section G below.
“Local Abatement Funds” are defined in Section B.2 below.
“Local Government” means all counties and municipalities located within the geographic
boundaries of the State of North Carolina that have chosen to sign on to this MOA.
“MDL Matter” means the matter captioned In re: National Prescription Opiate Litigation,
MDL 2804 pending in the United States District Court for the Northern District of Ohio.
“MDL Parties” means all parties who participated in the matter captioned In re: National
Prescription Opiate Litigation, MDL 2804 pending in the United States District Court for the
Northern District of Ohio as Plaintiffs.
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“National Settlement Agreement” means a national opioid settlement agreement with the
Parties and one or all of the Settling Defendants concerning alleged misconduct in manufacture,
marketing, promotion, distribution, or dispensing of an opioid analgesic.
“Opioid Settlement Funds” shall mean all funds allocated by the National Settlement
Agreement and any Bankruptcy Resolutions to the State or Local Governments for purposes of
opioid remediation activities or restitution, as well as any repayment of those funds and any
interest or investment earnings that may accrue as those funds are temporarily held before being
expended on opioid remediation strategies. Not included are funds made available in the
National Settlement Agreement or any Bankruptcy Resolutions for the payment of the Parties’
litigation expenses or the reimbursement of the United States Government.
“Parties” means the State of North Carolina and the Local Governments.
“Settling Defendants” means Johnson & Johnson, AmerisourceBergen, Cardinal Health, and
McKesson, as well as their subsidiaries, affiliates, officers, and directors named in a National
Settlement Agreement.
“State Abatement Fund” is defined in Section B.2 below.
B. Allocation of Settlement Proceeds
1. Method of distribution. Pursuant to the National Settlement Agreement and any
Bankruptcy Resolutions, Opioid Settlement Funds shall be distributed directly to the State
and to Local Governments in such proportions and for such uses as set forth in this MOA,
provided Opioid Settlement Funds shall not be considered funds of the State or any Local
Government unless and until such time as each annual distribution is made.
2. Overall allocation of funds. Opioid Settlement Funds shall be allocated as follows: (i)
15% directly to the State (“State Abatement Fund”), (ii) 80% to abatement funds
established by Local Governments (“Local Abatement Funds”), and (iii) 5% to a County
Incentive Fund described in Section G below.
3. Allocation of funds between Local Governments. The Local Abatement Funds shall be
allocated to counties and municipalities in such proportions as set forth in Exhibit G,
attached hereto and incorporated herein by reference, which is based upon the MDL
Matter’s Opioid Negotiation Class Model. The proportions shall not change based on
population changes during the term of the MOA. However, to the extent required by the
terms of the National Settlement Agreement, the proportions set forth in Exhibit G shall
be adjusted: (i) to provide no payment from the National Settlement Agreement to any
listed county or municipality that does not participate in the National Settlement
Agreement; and (ii) to provide a reduced payment from the National Settlement
Agreement to any listed county or municipality that signs onto the National Settlement
Agreement after the initial participation deadline.
4. Municipal allocations. Within counties and municipalities:
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a. Local Governments receiving payments. The proportions set forth in Exhibit G
provide for payments directly to (i) all North Carolina counties, (ii) North Carolina
municipalities with populations over 75,000 based on the United States Census
Bureau’s Vintage 2019 population totals, and (iii) North Carolina municipalities
who are also MDL Parties as of January 1, 2021.
b. Municipality may direct payments to county. Any municipality allocated a share
in Exhibit G may elect to have its share of current or future annual distributions of
Local Abatement Funds instead directed to the county or counties in which it is
located. Such an election may be made by January 1 each year to apply to the
following fiscal year. If a municipality is located in more than one county, the
municipality’s funds will be directed based on the MDL Matter’s Opioid
Negotiation Class Model.
5. Use of funds for opioid remediation activities. This MOA requires that except as related
to the payment of the Parties’ litigation expenses and the reimbursement of the United
States Government, all Opioid Settlement Funds, regardless of allocation, shall be utilized
only for opioid remediation activities.
6. Relationship of this MOA to other agreements and resolutions. All Parties acknowledge
and agree the National Settlement Agreement will require a Local Government to release
all its claims against the Settling Defendants to receive Opioid Settlement Funds. All
Parties further acknowledge and agree based on the terms of the National Settlement
Agreement, a Local Government may receive funds through this MOA only after
complying with all requirements set forth in the National Settlement Agreement to release
its claims. This MOA is not a promise from any Party that any National Settlement
Agreement or Bankruptcy Resolution will be finalized or executed.
C. Payment of Litigating and Non-Litigating Parties
No Party engaged in litigating the MDL Matter shall receive a smaller payment than a
similarly situated non-litigating Party, other than as based on the Allocation Proportions in
Exhibit G or based on the eligibility criteria for payments from the County Incentive Fund
as provided by Section G below.
D. Special Revenue Fund
1. Creation of special revenue fund. Every Local Government receiving Opioid Settlement
Funds shall create a separate special revenue fund, as described below, that is designated
for the receipt and expenditure of the Opioid Settlement Funds.
2. Procedures for special revenue fund. Funds in this special revenue fund shall not be
commingled with any other money or funds of the Local Government. The funds in the
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special revenue fund shall not be used for any loans or pledge of assets, unless the loan or
pledge is for an opioid remediation purpose consistent with the terms of this MOA and
adopted under the process described in Section E.6 below. Although counties or
municipalities may make contracts with or grants to a nonprofit, charity, or other entity,
counties or municipalities may not assign to another entity their rights to receive payments
from the national settlement or their responsibilities for funding decisions.
3. Interest earned on special revenue fund. The funds in the special revenue fund may be
invested, consistent with the investment limitations for local governments, and may be
placed in an interest-bearing bank account. Any interest earned on the special revenue
fund must be used in a way that is consistent with this MOA.
E. Opioid Remediation Activities.
1. Limitation on use of funds. Local Governments shall expend Opioid Settlement Funds
only for opioid-related expenditures consistent with the terms of this MOA and incurred
after the date of the Local Government’s execution of this MOA, unless execution of the
National Settlement Agreement requires a later date.
2. Opportunity to cure inconsistent expenditures. If a Local Government spends any Opioid
Settlement Funds on an expenditure inconsistent with the terms of this MOA, the Local
Government shall have 60 days after discovery of the expenditure to cure the inconsistent
expenditure through payment of such amount for opioid remediation activities through
budget amendment or repayment.
3. Consequences of failure to cure inconsistent expenditures. If a Local Government does
not make the cure required by Section E.2 above within 60 days, (i) future Opioid Fund
payments to that Local Government shall be reduced by an amount equal to the
inconsistent expenditure, and (ii) to the extent the inconsistent expenditure is greater than
the expected future stream of payments to the Local Government, the Attorney General
may initiate a process up to and including litigation to recover and redistribute the overage
among all eligible Local Governments. The Attorney General may recover any litigation
expenses incurred to recover the funds. Any recovery or redistribution shall be distributed
consistent with Sections B.3 and B.4 above.
4. Annual meeting of counties and municipalities within each county. Each county receiving
Opioid Settlement Funds shall hold at least one annual meeting with all municipalities in
the Local Government’s county invited in order to receive input as to proposed uses of the
Opioid Settlement Funds and to encourage collaboration between local governments both
within and beyond the county. These meetings shall be open to the public.
5. Use of settlement funds under Option A and Option B. Local Governments shall spend
Opioid Settlement Funds from the Local Abatement Funds on opioid remediation activities
using either or both of the processes described as Option A and Option B below, unless
the relevant National Settlement Agreement or Bankruptcy Resolution further limit the
spending.
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a. Option A.
i. Without any additional strategic planning beyond the meeting described in
Section E.4 above, Local Governments may spend Opioid Settlement
Funds from the list of High-Impact Opioid Abatement Strategies attached
as Exhibit A. This list is a subset of the initial opioid remediation strategies
listed in the National Settlement Agreement.
ii. Exhibit A may be modified as set forth in Exhibit D below; provided,
however, that any strategy listed on Exhibit A must be within the list of
opioid remediation activities for the then-current National Settlement
Agreement. Opioid remediation activities undertaken under a previously
authorized strategy list may continue if they were authorized at the time of
the Local Government’s commitment to spend funds on that activity.
b. Option B.
i. A Local Government that chooses to participate in additional voluntary,
collaborative, strategic planning may spend Opioid Settlement Funds from
the broader list of categories found in Exhibit B. This list contains all the
initial opioid remediation strategies listed in the National Settlement
Agreement.
ii. Before spending any funds on any activity listed in Exhibit B, but not listed
on Exhibit A, a Local Government must first engage in the collaborative
strategic planning process described in Exhibit C. This process shall result
in a report and non-binding recommendations to the Local Government’s
Governing Body described in Exhibit C (right-hand column).
iii. A Local Government that has previously undertaken the collaborative
strategic planning process described in Exhibit C and wishes to continue
implementing a strategy listed in Exhibit B, but not listed in Exhibit A,
shall undertake a new collaborative strategic planning process every four
years (or more often if desired).
iv. A Local Government that has previously undertaken the collaborative
strategic planning process described in Exhibit C that wishes to implement
a new strategy listed in Exhibit B but not listed in Exhibit A, shall
undertake a new collaborative strategic planning process.
v. Two or more Local Governments may undertake a single collaborative
strategic planning process resulting in a report and recommendations to all
of the Local Governments involved.
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6. Process for drawing from special revenue funds.
a. Budget item or resolution required. Opioid Settlement Funds can be used for a
purpose when the Governing Body includes in its budget or passes a separate
resolution authorizing the expenditure of a stated amount of Opioid Settlement
Funds for that purpose or those purposes during a specified period of time.
b. Budget item or resolution details. The budget or resolution should (i) indicate that
it is an authorization for expenditure of opioid settlement funds; (ii) state the
specific strategy or strategies the county or municipality intends to fund pursuant
to Option A or Option B, using the item letter and/or number in Exhibit A or
Exhibit B to identify each funded strategy, and (iii) state the amount dedicated to
each strategy for a stated period of time.
7. Coordination group. A coordination group with the composition and responsibilities
described in Exhibit D shall meet at least once a year during the first three years that this
MOA is in effect. Thereafter, the coordination group shall meet at least once every three
years until such time as Opioid Settlement Funds are no longer being spent by Local
Governments.
F. Auditing, Compliance, Reporting, and Accountability
1. Audits under Local Government Budget and Fiscal Control Act. Local Governments’
Opioid Settlement Funds are subject to financial audit by an independent certified public
accountant in a manner no less than what is required under G.S. 159-34. Each Local
Government must file an annual financial audit of the Opioid Settlement Funds with the
Local Government Commission. If any such audit reveals an expenditure inconsistent with
the terms of this MOA, the Local Government shall immediately report the finding to the
Attorney General.
2. Audits under other acts and requirements. The expenditure of Opioid Settlement Funds
is subject to the requirements of the Local Government Budget and Fiscal Control Act,
Chapter 159 of the North Carolina General Statutes; Local Government Commission rules;
the Federal Single Audit Act of 1984 (as if the Opioid Settlement Funds were federal
funds); the State Single Audit Implementation Act; Generally Accepted Government
Auditing Standards; and all other applicable laws, rules, and accounting standards. For
expenditures for which no compliance audit is required under the Federal Single Audit Act
of 1984, a compliance audit shall be required under a compliance supplement approved by
the coordination group.
3. Audit costs. Reasonable audit costs that would not be required except for this Section F
may be paid by the Local Government from Opioid Settlement Funds..
4. Access to persons and records. During and after the term of this MOA, the State Auditor
and Department of Justice shall have access to persons and records related to this MOA
and expenditures of Opioid Settlement Funds to verify accounts and data affecting fees or
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performance. The Local Government manager/administrator is the point of contact for
questions that arise under this MOA.
5. Preservation of records. The Local Government must maintain, for a period of at least five
years, records of Opioid Settlement Fund 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 National Settlement Agreement, any Bankruptcy Resolutions, and this
MOA.
6. Reporting.
a. Annual financial report required. In order to ensure compliance with the opioid
remediation provisions of the National Settlement Agreement, any Bankruptcy
Resolutions, and this MOA, for every fiscal year in which a Local Government
receives, holds, or spends Opioid Settlement Funds, the county or municipality
must submit an annual financial report specifying the activities and amounts it has
funded.
b. Annual financial report timing and contents. The annual financial report shall be
provided to the North Carolina Attorney General by emailing the report to
opioiddocs@ncdoj.gov, within 90 days of the last day of the state fiscal year
covered by the report. Each annual financial report must include the information
described on Exhibit E.
c. Reporting to statewide opioid settlement dashboard. Each Local Government must
provide the following information to the statewide opioid settlement dashboard
within the stated timeframes:
i. The budget or resolution authorizing the expenditure of a stated amount of
Opioid Settlement Funds for a specific purpose or purposes during a
specified period of time as described in Section E.6.b above (within 90
days of the passage of any such budget or resolution);
ii. If the Local Government is using Option B, the report(s) and non-binding
recommendations from collaborative strategic planning described in
Section E.5.b.ii above and Exhibit C (right hand column) (within 90 days
of the date the report and recommendations are submitted to the local
governing body for consideration);
iii. The annual financial reports described in Section F.6.a and Exhibit E
(within 90 days of the end of the fiscal year covered by the report); and
iv. The impact information described in Exhibit F (within 90 days of the end
of the fiscal year covered by the report).
The State will create an online portal with instructions for Local Governments to
report or upload each of these four items by electronic means.
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d. Copy to NCDOJ of any additional reporting. If the National Settlement Agreement
or any Bankruptcy Resolutions require that a Local Government file, post, or
provide a report or other document beyond those described in this MOA, or if any
Local Government communicates in writing with any national administrator or
other entity created or authorized by the National Settlement Agreement or any
Bankruptcy Resolutions regarding the Local Government’s compliance with the
National Settlement Agreement or Bankruptcy Resolutions, the Local Government
shall email a copy of any such report, document, or communication to the North
Carolina Department of Justice at opioiddocs@ncdoj.gov.
e. Compliance and non-compliance.
i. Every Local Government shall make a good faith effort to comply with all
of its reporting obligations under this MOA, including the obligations
described in Section F.6.c above.
ii. A Local Government that engages in a good faith effort to comply with its
reporting obligations under Section F.6.c but fails in some way to report
information in an accurate, timely, or complete manner shall be given an
opportunity to remedy this failure within a reasonable time.
iii. A Local Government that does not engage in a good faith effort to comply
with its reporting obligations under this MOA, or that fails to remedy
reporting issues within a reasonable time, may be subject to action for
breach of contract.
iv. Notwithstanding anything to the contrary herein, a Local Government that
is in substantial compliance with the reporting obligations in this MOA shall
not be considered in breach of this MOA or in breach of contract.
7. Collaboration. The State and Local Governments must collaborate to promote effective
use of Opioid Settlement Funds, including through the sharing of expertise, training,
technical assistance. They will also coordinate with trusted partners to collect and share
information about successful regional and other high-impact strategies and opioid
treatment programs.
G. County Incentive Fund
A Local Government receiving Settlement Proceeds pursuant to Section B.4.a shall be an
Incentive Eligible Local Government if every municipality in the Local Government's
county with population of at least 30,000 has executed this MOA by October 1, 2021, but
no later than any such deadline set in the National Settlement Agreement for the highest
possible participation in incentive structures for North Carolina. Each Incentive Eligible
Local Government shall receive a share of the 5% County Incentive Fund set forth in
Section B.2.iii, distributed pro rata among only Incentive Eligible Local Governments as
set forth in Exhibit G. For purposes of the calculations required by this Section,
populations will be based on United States Census Bureau's Vintage 2019 population
totals, and a municipality with populations in multiple counties will be counted only toward
the county which has the largest share of that municipality’s population.
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H. Effectiveness
1. When MOA takes effect. This MOA shall become effective at the time a sufficient number
of Local Governments have joined the MOA to qualify this MOA as a State-Subdivision
Agreement under the National Settlement Agreement or any Bankruptcy Resolution. If
this MOA does not thereby qualify as a State-Subdivision Agreement, this MOA will have
no effect.
2. Amendments to MOA.
a. Amendments to conform to final national documents. The Attorney General,
with the consent of a majority vote from a group of Local Government attorneys
appointed by the Association of County Commissioners, may initiate a process
to amend this MOA to make any changes required by the final provisions of the
National Settlement Agreement or any Bankruptcy Resolution. The Attorney
General’s Office will provide written notice of the necessary amendments to all
the previously joining parties. Any previously joining party will have a two-
week opportunity to withdraw from the MOA. The amendments will be
effective to any party that does not withdraw.
b. Coordination group. The coordination group may make the changes authorized
in Exhibit D.
c. No amendments to allocation between Local Governments. Notwithstanding
any other provision of this MOA, the allocation proportions set forth in Exhibit
G may not be amended.
d. General amendment power. After execution, the coordination group may
propose other amendments to the MOA, subject to the limitation in
Section H.2.c above. Such amendments will take effect only if approved in
writing by the Attorney General and at least two-thirds of the Local
Governments who are Parties to this MOA. In the vote, each Local Government
Party will have a number of votes measured by the allocation proportions set
forth in Exhibit G.
3. Acknowledgement. The Parties acknowledge that this MOA is an effective and fair way to
address the needs arising from the public health crisis due to the misconduct committed by
the Pharmaceutical Supply Chain Participants.
4. When MOA is no longer in effect. This MOA is effective until one year after the last date
on which any Opioid Settlement Funds are being spent by Local Governments pursuant to
the National Settlement Agreement and any Bankruptcy Resolution.
5. Application of MOA to settlements and bankruptcy resolutions. This MOA applies to all
settlements under the National Settlement Agreement with the Settling Defendants and any
Bankruptcy Resolutions. The Parties agree to discuss the use, as the Parties may deem
appropriate in the future, of the settlement terms set out herein (after any necessary
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amendments) for resolutions with Pharmaceutical Supply Chain Participants not covered
by the National Settlement Agreement or a Bankruptcy Resolution.
6. Applicable law and venue. Unless required otherwise by the National Settlement
Agreement or a Bankruptcy Resolution, this MOA shall be interpreted using North
Carolina law and any action related to the provisions of this MOA must be adjudicated by
the Superior Court of Wake County. If any provision of this MOA is held invalid by any
court of competent jurisdiction, this invalidity does not affect any other provision which
can be given effect without the invalid provision.
7. Scope of MOA. The Parties acknowledge that this MOA does not excuse any requirements
placed upon them by the terms of the National Settlement Agreement or any Bankruptcy
Resolution, except to the extent those terms allow for a State-Subdivision Agreement to do
so.
8. No third party beneficiaries. No person or entity is intended to be a third party beneficiary
of this MOA.
9. No effect on authority of parties. Nothing in this MOA shall be construed to affect or
constrain the authority of the Parties under law.
10. Signing and execution of MOA. This MOA may be signed and executed simultaneously
in any number of counterparts, each of which shall be deemed an original, but all of which
together shall constitute one and the same agreement. A signature transmitted by facsimile
or electronic image shall be deemed an original signature for purposes of executing this
MOA. Each person signing this MOA represents that he or she is fully authorized to enter
into the terms and conditions of, and to execute, this MOA, and that all necessary approvals
and conditions precedent to his or her execution have been satisfied.
(Signature pages follow.)
25
Signature pages will be structured as one page for the State of North Carolina,
followed by separate signature pages for each county.
These signature pages will also include blanks for the county’s municipalities.
To avoid having 101 signature pages in the middle of this file,
the signature pages are in a separate document.
26
Exhibits, page 1
EXHIBIT A TO NC MOA:
HIGH-IMPACT OPIOID ABATEMENT STRATEGIES (“OPTION A” List)
In keeping with the National Settlement Agreement, opioid settlement funds may support
programs or services listed below that serve persons with Opioid Use Disorder (OUD) or any
co-occurring Substance Use Disorder (SUD) or mental health condition.
As used in this list, the words “fund” and “support” are used interchangeably and mean to
create, expand, or sustain a program, service, or activity.
1. Collaborative strategic planning. Support collaborative strategic planning to address
opioid misuse, addiction, overdose, or related issues, including staff support, facilitation
services, or any activity or combination of activities listed in Exhibit C to the MOA
(collaborative strategic planning).
2. Evidence-based addiction treatment. Support evidence-based addiction treatment
consistent with the American Society of Addiction Medicine’s national practice
guidelines for the treatment of opioid use disorder – including Medication-Assisted
Treatment (MAT) with any medication approved for this purpose by the U.S. Food and
Drug Administration – through Opioid Treatment Programs, qualified providers of
Office-Based Opioid Treatment, Federally Qualified Health Centers, treatment offered in
conjunction with justice system programs, or other community-based programs offering
evidence-based addiction treatment. This may include capital expenditures for facilities
that offer evidence-based treatment for OUD. (If only a portion of a facility offers such
treatment, then only that portion qualifies for funding, on a pro rata basis.)
3. Recovery support services. Fund evidence-based recovery support services, including
peer support specialists or care navigators based in local health departments, social
service offices, detention facilities, community-based organizations, or other settings that
support people in treatment or recovery, or people who use drugs, in accessing addiction
treatment, recovery support, harm reduction services, primary healthcare, or other
services or supports they need to improve their health or well-being.
4. Recovery housing support. Fund programs offering recovery housing support to people
in treatment or recovery, or people who use drugs, such as assistance with rent, move-in
deposits, or utilities; or fund recovery housing programs that provide housing to
individuals receiving Medication-Assisted Treatment for opioid use disorder.
5. Employment-related services. Fund programs offering employment support services to
people in treatment or recovery, or people who use drugs, such as job training, job skills,
job placement, interview coaching, resume review, professional attire, relevant courses at
community colleges or vocational schools, transportation services or transportation
vouchers to facilitate any of these activities, or similar services or supports.
6. Early intervention. Fund programs, services, or training to encourage early
identification and intervention for children or adolescents who may be struggling with
problematic use of drugs or mental health conditions, including Youth Mental Health
27
Exhibits, page 2
First Aid, peer-based programs, or similar approaches. Training programs may target
parents, family members, caregivers, teachers, school staff, peers, neighbors, health or
human services professionals, or others in contact with children or adolescents.
7. Naloxone distribution. Support programs or organizations that distribute naloxone to
persons at risk of overdose or their social networks, such as Syringe Service Programs,
post-overdose response teams, programs that provide naloxone to persons upon release
from jail or prison, emergency medical service providers or hospital emergency
departments that provide naloxone to persons at risk of overdose, or community-based
organizations that provide services to people who use drugs. Programs or organizations
involved in community distribution of naloxone may, in addition, provide naloxone to
first responders.
8. Post-overdose response team. Support post-overdose response teams that connect
persons who have experienced non-fatal drug overdoses to addiction treatment, recovery
support, harm reduction services, primary healthcare, or other services or supports they
need to improve their health or well-being.
9. Syringe Service Program. Support Syringe Service Programs operated by any
governmental or nongovernmental organization authorized by section 90-113.27 of the
North Carolina General Statutes that provide syringes, naloxone, or other harm reduction
supplies; that dispose of used syringes; that connect clients to prevention, treatment,
recovery support, behavioral healthcare, primary healthcare, or other services or supports
they need; or that provide any of these services or supports.
10. Criminal justice diversion programs. Support pre-arrest or post-arrest diversion
programs, or pre-trial service programs, that connect individuals involved or at risk of
becoming involved in the criminal justice system to addiction treatment, recovery
support, harm reduction services, primary healthcare, prevention, or other services or
supports they need, or that provide any of these services or supports.
11. Addiction treatment for incarcerated persons. Support evidence-based addiction
treatment, including Medication-Assisted Treatment with at least one FDA-approved
opioid agonist, to persons who are incarcerated in jail or prison.
12. Reentry Programs. Support programs that connect incarcerated persons to addiction
treatment, recovery support, harm reduction services, primary healthcare, or other
services or supports they need upon release from jail or prison, or that provide any of
these services or supports.
28
Exhibits, page 3
EXHIBIT B TO NC MOA:
Additional Opioid Remediation Activities (“OPTION B” List)
This list shall be automatically updated to match the list of approved strategies in the most
recent National Settlement Agreement.
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 through evidence-based or evidence-informed programs
or strategies that may include, but are not limited to, the following:1
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.
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.
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
recovery support services.
4. Improve oversight of Opioid Treatment Programs (OTPs) to assure evidence-based or evidence-
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 service providers, such as peer recovery coaches, for persons with OUD and any co-occurring
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.
7. Support evidence-based withdrawal management services for people with OUD and any co-
occurring mental health conditions.
1 As used in this Exhibit B, words like “expand,” “fund,” “provide” or the like shall not indicate a preference
for new or existing programs.
29
Exhibits, page 4
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.
10. Fellowships for addiction medicine specialists for direct patient care, instructors, and clinical
research for treatments.
11. Scholarships and supports for behavioral health practitioners or workers involved in addressing
OUD and any co-occurring SUD or mental health conditions, including but not limited to training,
scholarships, fellowships, loan repayment programs, or other incentives for providers to work in
rural or underserved areas.
12. 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.
13. 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.
14. 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 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-occurring
SUD/MH conditions, including housing, transportation, education, job placement, job training, or
childcare.
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.
3. 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.
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 support services.
30
Exhibits, page 5
5. Provide community support services, including social and legal services, to assist in
deinstitutionalizing persons with OUD and any co-occurring SUD/MH conditions.
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.
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.
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.
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.
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.
14. Create and/or support recovery high schools.
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-
occurring SUD/MH conditions through evidence-based or evidence-informed 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. 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.
31
Exhibits, page 6
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. Expand services such as navigators and on-call teams to begin MAT in hospital emergency
departments.
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.
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.
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.
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
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 on young people.
13. Develop and support best practices on addressing OUD in the workplace.
14. Support assistance programs for health care providers with OUD.
15. Engage non-profits and the faith community as a system to support outreach for treatment.
16. 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.
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 in, are at risk of becoming involved in, or are transitioning out of the criminal justice
32
Exhibits, page 7
system through evidence-based or evidence-informed programs or strategies that may include, but
are not limited to, 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:
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; or
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 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.
33
Exhibits, page 8
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, 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 limited to, the following:
1. Support evidence-based or evidence-informed 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, and other measures to educate and
provide support to families affected by Neonatal Abstinence Syndrome.
2. Expand comprehensive evidence-based treatment and recovery services, including MAT, for
uninsured women with OUD and any co-occurring SUD/MH conditions for up to 12 months
postpartum.
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.
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.
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.
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.
34
Exhibits, page 9
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 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 Control and Prevention, including providers at hospitals (academic detailing).
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.
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, 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 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.
8. Educate Dispensers on appropriate opioid dispensing.
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:
35
Exhibits, page 10
1. Fund media campaigns to prevent opioid misuse.
2. Corrective advertising or affirmative public education campaigns based on evidence.
3. Public education relating to drug disposal.
4. Drug take-back disposal or destruction programs.
5. Fund community anti-drug coalitions that engage in drug prevention efforts.
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, including the Strategic Prevention Framework developed by the U.S. Substance
Abuse and Mental Health Services Administration (SAMHSA).
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.
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 or support community-based education or intervention services for families, youth, and
adolescents at risk for OUD and any co-occurring SUD/MH conditions.
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 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 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 first
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 that provide free naloxone to anyone in the community.
36
Exhibits, page 11
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 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. 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 provided by these programs.
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.
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
opioids or persons with OUD and any co-occurring SUD/MH conditions.
13. Support screening for fentanyl in routine clinical toxicology testing.
PART THREE: OTHER STRATEGIES
I. FIRST RESPONDERS
In addition to items in sections C, D, and H of this Exhibit 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.
37
Exhibits, page 12
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:
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.
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 through 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.
4. Provide resources to staff government oversight and management of opioid abatement
programs.
K. TRAINING
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.
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 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, data collection, and evaluation of programs and strategies described
in this opioid abatement strategy list.
2. Research non-opioid treatment of chronic pain.
38
Exhibits, page 13
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.
5. Research on innovative supply-side enforcement efforts such as improved detection of mail-
based delivery of synthetic opioids.
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).
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.
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 treatment outcomes.
39
Exhibits, page 14
EXHIBIT C to NC MOA:
COLLABORATIVE STRATEGIC PLANNING PROCESS UNDER OPTION B
ACTIVITY
NAME
ACTIVITY
DETAIL
CONTENT OF
REPORT &
RECOMMENDATIONS
A
Engage
diverse
stakeholders
Engage diverse stakeholders, per "ITEM A DETAIL" below,
throughout the collaborative strategic planning process
Report on stakeholder
engagement per "ITEM A
DETAIL" below
B Designate
facilitator
Designate a person or entity to facilitate the strategic collaborative
planning process. Consider a trained, neutral facilitator. Identify the facilitator
C
Build upon
any related
planning
Build upon or coordinate with prior or concurrent planning efforts
that address addiction, drug misuse, overdose, or related issues,
including but not limited to community health assessments.
Report any related
planning efforts you will
build upon or coordinate
with
D Agree on
shared vision
Agree on a shared vision for positive community change, considering
how strategic investments of Opioid Settlement Funds have the
potential to improve community health and well-being and address
root causes of addiction, drug misuse, overdose, and related issues
Report on shared vision
for positive community
change
E Identify key
indicator(s)
Identify one or more population-level measures to monitor in order to
gauge progress towards the shared vision. (The NC Opioid Action
Plan Data Dashboard contains several such measures.)
Report on the key
indicators selected
F
Identify and
explore root
causes
Explore root causes of addiction, drug misuse, overdose, and related
issues in the community, using quantitative data as well as
stakeholder narratives, community voices, the stories of those with
lived experience, or similar qualitative information
Report on root causes as
described
G
Identify and
evaluate
potential
strategies
Identify potential strategies to address root causes or other aspects of
the opioid epidemic; identify these strategies (by letter or number) on
EXHIBIT A or EXHIBIT B, and consider the effectiveness of each
strategy based on available evidence
Identify and evaluate
potential strategies
H
Identify gaps
in existing
efforts
For each potential strategy identified (or for favored strategies),
survey existing programs, services, or supports that address the same
or similar issues; and identify gaps or shortcomings
Report on survey of and
gaps in existing efforts
I Prioritize
strategies
Prioritize strategies, taking into account your shared vision, analysis
of root causes, evaluation of each strategy, and analysis of gaps in
existing efforts
Report on prioritization of
strategies
J
Identify
goals,
measures,
and
evaluation
plan
For each strategy (or favored strategy), develop goals and an
evaluation plan that includes at least one process measure (How
much did you do?), at least one quality measure (How well did you
do it?), and at least one outcome measure (Is anyone better off?)
Report on goals, measures,
and evaluation plan for
each chosen strategy
K
Consider
ways to align
strategies
For each potential strategy identified (or for favored strategies),
consider opportunities to braid Opioid Settlement Funds with other
funding streams; develop regional solutions; form strategic
partnerships; or to pursue other creative solutions
Report on opportunities to
align strategies as
described
L Identify
organizations
Identify organizations and agencies with responsibility to implement
each strategy; and identify the human, material, and capital resources
to implement each strategy
Identify organizations and
needs to implement each
strategy
40
Exhibits, page 15
M
Develop
budgets and
timelines
Develop a detailed global budget for each strategy with anticipated
expenditures, along with timelines for completing components of
each strategy
Report budgets and
timelines for each strategy
N
Offer
recommen-
dations
Offer recommendations to local governing body (e.g., the county
board, city council, or other local governing body)
Report recommendations
to governing body
ITEM A DETAIL: STAKEHOLDER INVOLVEMENT
STAKE-
HOLDERS DESCRIPTION
CONTENT OF
REPORT &
RECOMMENDATIONS
A-
1
Local
officials
County and municipal officials, such as those with responsibility over
public health, social services, and emergency services
Report stakeholder
involvement (who and
how involved in process)
A-
2
Healthcare
providers
Hospitals and health systems, addiction professionals and other
providers of behavioral health services, medical professionals,
pharmacists, community health centers, medical safety net providers,
and other healthcare providers
same as above
A-
3
Social service
providers
Providers of human services, social services, housing services, and
community health services such as harm reduction, peer support, and
recovery support services
same
A-
4
Education
and
employment
service
providers
Educators, such as representatives of K-12 schools, community
colleges, and universities; and those providing vocational education,
job skills training, or related employment services
same
A-
5
Payers and
funders
Health care payers and funders, such as managed care organizations,
prepaid health plans, LME-MCOs, private insurers, and foundations same
A-
6
Law
enforcement Law enforcement and corrections officials same
A-
7 Employers Employers and business leaders same
A-
8
Community
groups
Community groups, such as faith communities, community coalitions
that address drug misuse, groups supporting people in recovery,
youth leadership organizations, and grassroots community
organizations
same
A-
9
Stakeholders
with "lived
experience"
Stakeholders with "lived experience," such as people with addiction,
people who use drugs, people in medication-assisted or other
treatment, people in recovery, people with criminal justice
involvement, and family members or loved ones of the individuals
just listed
same
A-
10
Stakeholders
reflecting
diversity of
community
Stakeholders who represent the racial, ethnic, economic, and cultural
diversity of the community, such as people of color, Native
Americans, members of the LGBTQ community, and members of
traditionally unrepresented or underrepresented groups
same
41
Exhibits, page 16
EXHIBIT D TO NC MOA:
COORDINATION GROUP
COMPOSITION
The Coordination Group shall consist of the following twelve members:
Five Local Government Representatives
• Four appointed by the North Carolina Association of County Commissioners including:
• One county commissioner
• One county manager
• One county attorney
• One county local health director or consolidated human services director
• One municipal manager appointed by the North Carolina League of Municipalities
Four Experts Appointed by the Department of Health and Human Services
• Four appointed by the Secretary of the Department of Health and Human Services, having
relevant experience or expertise with programs or policies to address the opioid epidemic,
or with behavioral health, public health, health care, harm reduction, social services, or
emergency services.
One Expert Appointed by the Attorney General
• One appointed by the Attorney General of North Carolina from the North Carolina
Department of Justice or another state agency, having drug policy or behavioral health
experience or expertise.
Two Experts Appointed by Legislative Leaders
• One representative from the University of North Carolina School of Government with
relevant expertise appointed by the Speaker of the North Carolina House of
Representatives.
• One representative from the board or staff of the North Carolina Institute of Medicine with
relevant expertise appointed by the President Pro Tem of the North Carolina Senate.
The coordination group may appoint a non-voting administrator to convene meetings and facilitate
the work of the coordination group. The administrator will not be paid from the Opioid Settlement
Funds distributed under this MOA.
Appointees shall have relevant experience or expertise with programs or policies to address the
opioid epidemic, behavioral health, public health, health care, social services, emergency services,
harm reduction, management of local government, or other relevant areas.
Those responsible for making appointments to the coordination group are encouraged to appoint
individuals who reflect the diversity of North Carolina, taking into consideration the need for
geographic diversity; urban and rural perspectives; representation of people of color and
42
Exhibits, page 17
traditionally underrepresented groups; and the experience and perspective of persons with “lived
experience.” Those responsible for making appointments may appoint a successor or replace a
member at any time. Members of the coordination group serve until they resign or are replaced
by the appointer. Eight members of the coordination group constitutes a quorum.
RESPONSIBILITIES
a. As provided in Section F.2 of the MOA, where no compliance audit would be required
under the Federal Single Audit Act of 1984 for expenditures of Opioid Settlement Funds,
a compliance audit shall be required under a compliance supplement established by a
vote of at least 8 members of the coordination group. The compliance supplement shall
address, at least, procedures for determining:
i. Whether the Local Government followed the procedural requirements of the
MOA in ordering the expenditures.
ii. Whether the Local Government’s expenditures matched one of the types of
opioid-related expenditures listed in Exhibit A of the MOA (if the Local
Government selected Option A) or Exhibit B of the MOA (if the Local
Government selected Option B).
iii. Whether the Local Government followed the reporting requirements in the MOA.
iv. Whether the Local Government (or sub-recipient of any grant or loan, if
applicable) utilized the awarded funds for their stated purpose, consistent with this
MOA and other relevant standards.
v. Which processes (such as sampling) shall be used:
i. To keep the costs of the audit at reasonable levels; and
ii. Tailor audit requirements for differing levels of expenditures among
different counties.
b. The coordination group may, by a vote of at least 8 members, propose amendments to the
MOA as discussed in Section H of the MOA or modify any of the following:
i. The high-impact strategies discussed in Section E.5 of the MOA and described in
Exhibit A to the MOA;
ii. The collaborative strategic planning process discussed in Section E.5 of the MOA
and described in Exhibit C to the MOA;
iii. The annual financial report discussed in Section F.4 of the MOA and described in
Exhibit E to the MOA;
iv. The impact information discussed in Section F.4 of the MOA and described in
Exhibit F to the MOA; or
v. Other information reported to the statewide opioid dashboard.
43
Exhibits, page 18
c. The coordination group may, by consensus or by vote of a majority of members present
and voting, work with the parties to this MOA, the North Carolina Association of County
Commissioners, the North Carolina League of Municipalities, other associations,
foundations, non-profits, and other government or nongovernment entities to provide
support to Local Governments in their efforts to effectuate the goals and implement the
terms of this MOA. Among other activities, the coordination group may coordinate,
facilitate, support, or participate in any of the following activities:
i. Providing assistance to Local Governments in identifying, locating, collecting,
analyzing, or reporting data used to help address the opioid epidemic or related
challenges, including data referred to in Exhibit F;
ii. Developing resources or providing training or technical assistance to support
Local Governments in addressing the opioid epidemic and carrying out the terms
of this MOA;
iii. Developing pilot programs, trained facilitators, or other resources to support the
collaborative strategic planning process described in this MOA;
iv. Developing and implementing a voluntary learning collaborative among Local
Governments and others to share best practices in carrying out the terms of this
MOA and addressing the opioid epidemic, including in-person or virtual
convenings or connections;
v. Developing voluntary leadership training programs for local officials on strategies
to address the opioid epidemic, opportunities for Local Governments to harness
the ongoing transition to value-based healthcare, and other relevant topics;
vi. Taking other actions that support Local Governments in their efforts to effectuate
the goals and implement the terms of this MOA but do not in any way change the
terms of this MOA or the rights or obligations of parties to this MOA.
44
Exhibits, page 19
EXHIBIT E TO NC MOA:
ANNUAL FINANCIAL REPORT
Each annual financial report must include the following financial information:
1. The amount of Opioid Settlement Funds in the special revenue fund at the beginning
of the fiscal year (July 1).
2. The amount of Opioid Settlement Funds received during the fiscal year.
3. The amount of Opioid Settlement Funds disbursed or applied during the fiscal year,
broken down by funded strategy (with any permissible common costs prorated among
strategies).
4. The amount of Opioid Settlement Funds used to cover audit costs as provided in
Section F.3 of this MOA.
5. The amount of Opioid Settlement Funds in the special revenue fund at the end of the
fiscal year (June 30).
All Local Governments that receive two-tenths of one percent (0.2 percent) or more of the total
Local Government Allocation as listed in Exhibit G shall provide the following additional
information:
6. For all Opioid Settlement Funds disbursed or applied during the fiscal year as
reported in item 3 above, a single breakdown of the total amount disbursed or applied
for all funded strategies during the fiscal year into the following categories:
a. Human resource expenditures.
b. Subcontracts, grants, or other payments to sub-recipients involved in
implementing of the funded strategies listed item 4 above.
c. Operational expenditures.
d. Capital expenditures.
e. Other expenditures.
7. With respect to item 6.b above, the Local Government shall provide the following
information for any sub-recipient that receives ten percent or more of the total amount
that the Local Government disbursed or applied during the fiscal year:
a. The name of the sub-recipient.
b. The amount received by the sub-recipient during the fiscal year.
c. A very brief description of the goods, services, or other value provided by the
sub-recipient (for example, “addiction treatment services” or “peer-support
services” or “syringe service program” or “naloxone purchase”).
The coordination group may clarify or modify specifications for this annual financial report as
provided in Exhibit D.
45
Exhibits, page 20
EXHIBIT F TO NC MOA:
IMPACT INFORMATION
Within 90 days of the end of any fiscal year in which a Local Government expends Opioid
Settlement Funds, the Local Government shall report impact information for each strategy that it
funded with Opioid Settlement Funds during that fiscal year (“funded strategy”), using the
STANDARD FORM or the SHORT FORM for each funded strategy.
The STANDARD FORM is recommended to all Local Governments for all funded strategies.
However, Local Governments may use the SHORT FORM as follows:
• All Local Governments that receive less than 0.2 percent (two-tenths of one percent) of the
total Local Government Allocation as shown on Exhibit G may use the SHORT FORM
for all funded strategies.
• All Local Governments that receive 0.2 percent (two-tenths of one percent) or more but
less than 0.3 percent (three-tenths of one percent) of the total Local Government Allocation
as shown on Exhibit G must use the STANDARD FORM for the funded strategy that
received the largest amount of settlement funds during the fiscal year and may use the
SHORT FORM for all other funded strategies.
• All Local Governments that receive 0.3 percent (three-tenths of one percent) or more but
less than 0.4 percent (four-tenths of one percent) of the total Local Government Allocation
as shown on Exhibit G must use the STANDARD FORM for the two funded strategies
that received the largest amount of settlement funds during the fiscal year and may use the
SHORT FORM for all other funded strategies.
STANDARD FORM
1. County or municipality and fiscal year covered by this report.
2. Name, title, and organization of person completing this report.
3. Name of funded strategy, letter and/or number of funded strategy on Exhibit A or Exhibit B
to the MOA, and number and date of resolution(s) authorizing expenditure of settlement
funds on funded strategy.
4. Brief progress report describing the funded strategy and progress made during the fiscal
year. Recommended length: approximately one page (250 words).
5. Brief success story from a person who has benefitted from the strategy (de-identified unless
the person has agreed in writing to be identified). Recommended length: approximately one
page (250 words).
6. One or more process measures, addressing the question, “How much did you do?”
Examples: number of persons enrolled, treated, or served; number of participants trained;
units of naloxone or number of syringes distributed.
7. One or more quality measures, addressing the question, “How well did you do it?”
Examples: percentage of clients referred to care or engaged in care; percentage of staff with
46
Exhibits, page 21
certification, qualification, or lived experience; level of client or participant satisfaction
shown in survey data.
8. One or more outcome measures, addressing the question, “Is anyone better off?”
Examples: number or percentage of clients with stable housing or employment; self-reported
measures of client recovery capital, such as overall well-being, healthy relationships, or
ability to manage affairs; number or percentage of formerly incarcerated clients receiving
community services or supports within X days of leaving jail or prison.
9. In connection with items 6, 7, and 8 above, demographic information on the participation
or performance of people of color and other historically marginalized groups.
The State will provide counties and municipalities with recommended measures and sources of
data for common opioid remediation strategies such as those listed in Exhibit A.
Counties or municipalities that have engaged in collaborative strategic planning are encouraged to
use the measures for items 6 through 8 above identified through that process.
SHORT FORM
1. County or municipality and fiscal year covered by this report.
2. Name, title, and organization of person completing this report.
3. Name of funded strategy, letter and/or number of funded strategy on Exhibit A or Exhibit B
to the MOA, and number and date of resolution(s) authorizing expenditure of settlement
funds on strategy.
4. Brief progress report describing the funded strategy and progress made on the funded
strategy during the fiscal year. Recommended length: approximately one-half to one page
(125-250 words).
47
Exhibits, page 22
EXHIBIT G TO NC MOA:
LOCAL GOVERNMENT ALLOCATION PROPORTIONS
Counties:
Alamance 1.378028967612490%
Alexander 0.510007879580514%
Alleghany 0.149090598929352%
Anson 0.182192960366522%
Ashe 0.338639188321974%
Avery 0.265996766935006%
Beaufort 0.477888434887858%
Bertie 0.139468575095652%
Bladen 0.429217809476617%
Brunswick 2.113238507591200%
Buncombe 2.511587857322730%
Burke 2.090196827047270%
Cabarrus 1.669573446626000%
Caldwell 1.276301146194650%
Camden 0.073036400412663%
Carteret 1.128465593852300%
Caswell 0.172920237524674%
Catawba 2.072695222699690%
Chatham 0.449814383077585%
Cherokee 0.782759152904478%
Chowan 0.113705596126821%
Clay 0.224429948904576%
Cleveland 1.119928027749120%
Columbus 1.220936938986050%
Craven 1.336860190247190%
Cumberland 2.637299659634610%
Currituck 0.186778551294444%
Dare 0.533126731273811%
Davidson 1.940269530393250%
Davie 0.513147526867745%
Duplin 0.382785147396895%
Durham 1.797994362444460%
Edgecombe 0.417101939026669%
Forsyth 3.068450809484740%
Franklin 0.500503643290578%
Gaston 3.098173886907710%
Gates 0.079567516632414%
Graham 0.183484561708488%
Granville 0.590103409340146%
48
Exhibits, page 23
Greene 0.123274818647799%
Guilford 3.375015231147900%
Halifax 0.453161173976264%
Harnett 0.988980772198890%
Haywood 0.803315110111045%
Henderson 1.381595087040930%
Hertford 0.206843050128754%
Hoke 0.332485804570157%
Hyde 0.027237354085603%
Iredell 2.115931374540020%
Jackson 0.507757731330674%
Johnston 1.250887468217670%
Jones 0.087966986994631%
Lee 0.653115683614534%
Lenoir 0.604282592625687%
Lincoln 0.926833627125253%
Macon 0.466767666100745%
Madison 0.237776496104888%
Martin 0.232882220579515%
McDowell 0.587544576492856%
Mecklenburg 5.038301259920550%
Mitchell 0.309314151564137%
Montgomery 0.226050543041193%
Moore 0.971739112775481%
Nash 0.845653639635102%
New Hanover 2.897264892001010%
Northampton 0.120996238921878%
Onslow 1.644001364710850%
Orange 1.055839419023090%
Pamlico 0.119936151028001%
Pasquotank 0.374816210815334%
Pender 0.585749331860312%
Perquimans 0.111833180344914%
Person 0.403024296727131%
Pitt 1.369008066415930%
Polk 0.266142985954851%
Randolph 1.525433986174180%
Richmond 0.749132839979529%
Robeson 1.359735343574080%
Rockingham 1.365368837477560%
Rowan 2.335219287913370%
Rutherford 0.928941617994687%
Sampson 0.619513740526226%
Scotland 0.449148274209402%
49
Exhibits, page 24
Stanly 0.724974208589555%
Stokes 0.623953112434303%
Surry 1.410826706091650%
Swain 0.281162928604502%
Transylvania 0.497595509451435%
Tyrrell 0.041440907207785%
Union 1.466702679869700%
Vance 0.536258255282162%
Wake 4.902455667205510%
Warren 0.106390583495122%
Washington 0.074770720453604%
Watauga 0.469675799939888%
Wayne 0.970699333078804%
Wilkes 1.997177160589100%
Wilson 0.646470841490459%
Yadkin 0.562147145073638%
Yancey 0.382114976889272%
Municipalities:
Asheville 0.235814724255298%
Canton 0.011453823221205%
Cary 0.144151645370137%
Charlotte 1.247483814366830%
Concord 0.227455870287483%
Durham 0.380405026684971%
Fayetteville 0.309769055181433%
Gastonia 0.257763823789835%
Greensboro 0.527391696384329%
Greenville 0.162656474659432%
Henderson 0.032253478794181%
Hickory 0.094875835682315%
High Point 0.206428762905859%
Jacksonville 0.095009869783840%
Raleigh 0.566724612722679%
Wilmington 0.119497493968465%
Winston-Salem 0.494459923803644%
50
Opioid Litigation SettlementOverview
51
2
Issue and Litigation Background
Counties are on the frontlines of the opioid epidemic, which has imposed significant and ongoing devastation throughout
North Carolina. More than 16,000 lives have been lost and local governments have spent an untold amount of money
on opioid-related costs for healthcare, criminal justice, and social services.
Given the far-reaching impact of the opioid crisis, 76 counties and eight municipalities have filed lawsuits in federal court
to hold accountable several companies involved in manufacturing, marketing, promoting, and distributing prescription
opioid drugs. The federal cases, which include roughly 3,000 lawsuits from nearly every state have been consolidated
into Multi-District Litigation (MDL).
Local governments and the state are hopeful that a National Settlement Agreement with some of the companies
involved in the MDL may be forthcoming, along with additional potential proceeds from a bankruptcy resolution
involving opioid manufacturer Purdue Pharma. Under the national settlement and bankruptcy resolution (taken
together), up to $850 million could be allocated to North Carolina to address the opioid epidemic.
Settlement Fund Allocation Model
The potential settlement money would be allocated among states based on population and the local impact of the
opioid crisis, as determined by public health statistics related to opioid misuse. The potential payments would occur
over an 18-year period. The allocation formula also includes an incentive that increases the payment amounts as more
North Carolina counties and municipalities join the settlement.
In anticipation of potential opioid settlement funds, the North Carolina Association of County Commissioners
(NCACC) and the North Carolina Department of Justice (DOJ) have been working closely together over the past
18 months on a plan to maximize North Carolina’s share to ensure that resources reach communities as quickly,
effectively, and directly as possible.
Executive Summary
52
3
Memorandum of Agreement
NCACC formed a Working Group comprised of five county commissioners, five county managers, five county
attorneys and NCACC staff to collaborate with DOJ on a model to distribute potential settlement funds to all 100
counties to use on programs, services, and strategies to address the epidemic. The culmination of this collaborative
work is the North Carolina Memorandum of Agreement (NC MOA), which governs how North Carolina would use
its share of opioid settlement funds. Under the NC MOA, all opioid settlement funds would be directed as follows:
• 15% to the state (which the General Assembly would have authority to appropriate on a wide range of strategies
to address the epidemic)
• 80% to local governments, including all 100 counties plus 17 municipalities, allocated among those counties and
municipalities through a formula developed by attorneys representing local governments in national litigation
• An additional 5% percent into an incentive fund for any county (and any municipality in that county slated to
receive settlement funds) in which the county itself and every municipality with at least 30,000 residents (based
on 2019 population totals) in the county signs the NC MOA
The NC MOA also includes transparency and accountability measures for the use of opioid settlement funds by
local governments, including special revenue funds subject to audit, annual financial and impact reports, and a public
dashboard showing how they are using settlement funds to address the epidemic.
Executive Summary
November 2017
Summer 2017 2018-2019
September 2019
January 2020
March 2020
March - Present
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4
Counties are on the front lines of the opioid epidemic
The opioid epidemic has taken the lives of more than 16,000 North Carolinians, torn families apart, and ravaged
communities from the mountains to the coast. Just as we began to make progress in combatting the epidemic, the
COVID-19 pandemic caused a new wave of isolation, despair, drug misuse and overdose death. Individuals, families,
and entire communities continue to suffer.
Counties are on the front lines of the opioid crisis, which has imposed significant and continuing costs on our
healthcare, criminal justice, and social service systems. To respond to opioid related public health and safety needs,
North Carolina counties and the State have had to draw mostly on taxpayer funds.
76 counties are part of national litigation to hold opioid drug companies accountable
Given the far-reaching impact of the opioid crisis, the State along with 76 counties and 8 municipalities in North
Carolina have filed lawsuits in federal court and launched investigations to hold accountable several companies
involved in manufacturing, marketing, promoting, and distributing prescription opioid drugs. The federal cases have
been consolidated for pretrial proceedings into a Multi-District Litigation (MDL) in Cleveland, Ohio. The opioid MDL
consolidated roughly 3,000 lawsuits from nearly every state.
The lawsuits allege that opioid manufacturers “grossly misrepresented the risks of long-term use of those drugs for
persons with chronic pain,” and that pharmaceutical distribution companies “failed to properly monitor suspicious
orders of those prescription drugs — all of which contributed to the current opioid epidemic.” Four companies,
Johnson & Johnson, AmerisourceBergen, Cardinal Health, and McKesson, have announced their willingness to enter
into a global settlement of the cases filed against them for a combined $26 billion.
In preparation for a National Settlement Agreement, NCACC and DOJ joined forces to maximize funds to North Carolina
Local governments and the State are hopeful that a National Settlement Agreement with these four companies may
be forthcoming, with potentially more to follow. Importantly, the terms of the National Settlement Agreement will
require, among other things, that most settlement funds received by the State and Local Governments be devoted
to opioid remediation activities to the maximum extent possible.
Additionally, local governments and the State anticipate that the ongoing bankruptcy proceedings of opioid
manufacturer Purdue Pharma may be resolved before the end of the year with a settlement providing $4-5 billion
from Purdue and the Sackler family to state and local governments nationwide. The bankruptcy court is expected to
NCACC and NCDOJ Partnership
54
5
order these funds be used for opioid remediation activities.
Under the national settlement and bankruptcy resolution (taken together), up to $850 million could be allocated to
North Carolina for opioid remediation. The money will be allocated among states based on population and the local
impact of the opioid crisis, based on several public health statistics related to opioid misuse. The precise amount will
depend not only on the final terms of the National Settlement Agreement and bankruptcy resolutions, but also on
whether North Carolina qualifies for incentive structures that increase the payment amounts as more counties and
municipalities join the settlement.
The expected settlements and bankruptcy resolution would involve this money being paid out over an 18-year period.
The settlement payments would be front-loaded, so that more money is available sooner to local governments to
remedy the opioid problems in their communities. As a result, payments in the first three years would be higher than
the average annual payment.
In anticipation of a National Settlement Agreement and Purdue bankruptcy resolution, the North Carolina
Association of County Commissioners (NCACC) and the North Carolina Department of Justice (DOJ) have been
working closely together over the past 18 months on a plan to maximize North Carolina’s share of settlement funds
to ensure the resources reach communities as quickly, effectively, and directly as possible.
To assist with this effort, NCACC formed a Working Group to collaborate with DOJ on an allocation model to
distribute settlement funds to all 100 counties. NCACC Past President and Yadkin County Commissioner Kevin
Austin appointed a special NCACC Opioid Settlement Committee to help craft settlement options in conjunction
with NCACC staff. That committee, also known as the 5-5-5 Committee, consists of five County Commissioners,
five County Managers, and five County Attorneys.
NCACC and NCDOJ Partnership
North Carolina Department of JusticeRepresentatives:
• Swain Wood, First Assistant Attorney General and
General Counsel
• Kevin Anderson, Senior Deputy Attorney General
and Director, Consumer Protection Division
• Daniel Mosteller, Special Deputy Attorney General
• Blake Thomas, Deputy General Counsel
• Steve Mange, Senior Policy Counsel
North Carolina Association of County CommissionersRepresentatives:
• Kevin Leonard, Executive Director
• kevin.leonard@ncacc.org
• (919) 715-4369
• Amy Bason, Deputy Director and General Counsel
• amy.bason@ncacc.org
• (919) 715-1430
• Paige Worsham, Associate General Counsel
• paige.worsham@ncacc.org
• (919) 715-6245
55
6
NCACC, 5-5-5 Committee, and DOJ devised a pathbreaking MOA to bring opioid settlement funds directly to communities
Working closely together, NCACC staff, the 5-5-5 Committee and representatives from DOJ developed the
Memorandum of Agreement (MOA), which all counties and municipalities are urged to sign.
This pathbreaking agreement recognizes the critical role of North Carolina counties in delivering human and social
services to county residents. It directs substantial resources to local governments on the front lines of the opioid
epidemic while ensuring that these resources are used in an effective way to address the epidemic.
Opioid settlement funds will be distributed among local governments according to the National MDL Opioid Allocation
Class Model, which is a formula developed by local governments’ attorneys that allocates funds in proportion to
5-5-5 Committee and North Carolina MOA
County Commissioner Members
• Jasmine Beach-Ferrara,
Buncombe County Commissioner
• Johnnie Carswell,
Burke County Commissioner
• Sally Greene,
Orange County Commissioner
• Reece Pyrtle,
Rockingham County
Commissioner
• Ronnie Smith,
Martin County Commissioner
County Attorney Members
• Ron Aycock,
Special Counsel - Person County
• Debra Bechtel,
Catawba County Attorney
• Misty Leland,
Moore County Attorney
• Mark Payne,
Guilford County Attorney
• Gordon Watkins,
Forsyth County Attorney
County Manager Members
• Chris Coudriet,
New Hanover County Manager
• Dena Diorio,
Mecklenburg County Manager
• Becky Garland,
Graham County Manager
• Zee Lamb,
Nash County Manager
• Bobby Outten,
Dare County Manager
Graham
Martin Dare
Nash
NewHanoverPerson
Or
an
ge
Moore
Guilford
Rockingham
Forsyth
MecklenburgCatawbaBuncombeBurke
56
7
where the opioid crisis is the most severe. The model accounts for the number of pills dispensed, number of opioid
overdose deaths, and number of people suffering from opioid use disorder. A county’s allocation percentage will not
change over the term of the MOA.
Opioid settlement funds received in North Carolina from the national settlement will be allocated as follows:
• 80% will go to Local Governments listed in the MOA to address the opioid epidemic,
• 15% will go to the State of North Carolina,
• and the remaining 5% will be used for a County Incentive Fund for any county (and any municipality in that
county slated to receive settlement funds) in which the county itself and every municipality of a certain size
signs the NC MOA.
As explained in more detail below, all of these funds must be used only on opioid remediation activities.
The North Carolina MOA requires collaboration among localities and stakeholder engagement to maximize community impact
The MOA prescribes collaborative strategic planning and stakeholder involvement required for certain activities.
Counties are required to hold annual meetings with municipalities within their borders to encourage collaboration
and plan for permissible expenditures in the upcoming year. Local governments are also encouraged to engage in a
strategic planning process to access additional expenditure options.
The MOA also establishes a Coordination Group composed of local government representatives, state government
representatives, and others with relevant expertise will meet periodically to help coordinate and guide Local Governments
with their work under the MOA. The Coordination Group includes twelve total representatives as follows:
• Five Local Government Representatives
Four appointed by the North Carolina Association of County Commissioners including:
• One county commissioner
• One county manager
• One county attorney
• One county local health director or consolidated human services director
One municipal manager appointed by the North Carolina League of Municipalities
• Four Experts Appointed by the Department of Health and Human Services
• Four appointed by the Secretary of the Department of Health and Human Services
• One Expert Appointed by the Attorney General
• One appointed by the Attorney General of North Carolina from the North Carolina Department of
5-5-5 Committee and North Carolina MOA
57
8
Justice or another state agency
• Two Experts Appointed by Legislative Leaders
• One representative from the University of North Carolina School of Government with relevant expertise
appointed by the Speaker of the North Carolina House of Representatives
• One representative from the board or staff of the North Carolina Institute of Medicine with relevant
expertise appointed by the President Pro Tem of the North Carolina Senate
The North Carolina MOA helps ensure opioid-related strategies are effective and consistent with the National Settlement Agreement
Under the MOA, local governments are required to deposit opioid settlement funds received in a special restricted
revenue fund to account separately for the monies. The local government must include in its budget or pass a resolution
authorizing the expenditure of opioid settlement funds, indicating the specific strategy it chose from the options
outlined in the MOA.
Local governments may expend funds only on opioid remediation activities, as consistent with strategies outlined in
the National Settlement Agreement.
The NC MOA offers local governments two options:
• Under Option A, a local government may fund one or more strategies from a shorter list of evidence-based,
high-impact strategies to address the epidemic, including many strategies already deployed at the county level.
The Option A strategies include:
• evidence-based addiction treatment
• recovery support services
• recovery housing
• employment-related services
• early intervention programs
• naloxone distribution
• post-overdose response teams
• syringe service programs
• criminal justice diversion programs
• addiction treatment for incarcerated persons
• reentry programs
5-5-5 Committee and North Carolina MOA
58
9
• Under Option B, a local government may fund one or more strategies from a longer list of strategies after
engaging in a collaborative strategic planning process involving a diverse array of stakeholders at the local level
(as detailed in Exhibit C to the MOA). The longer list of Option B strategies – the full range of strategies that
will be allowed under a national settlement or bankruptcy resolution – involve multiple strategies falling into
these broad categories:
• Provide treatment for Opioid Use Disorder (OUD)
• Support people in treatment and recovery and provide connections to care
• Address the needs of criminal-justice-involved persons with OUD
• Address the needs of pregnant or parenting women and their families
• Prevent over-prescribing of opioids and misuse of opioids
• Prevent overdose deaths and other harms (harm reduction)
The North Carolina MOA includes measures to ensure transparency and track performance
Local governments have annual financial and impact reporting and audit requirements under the MOA to ensure
opioid settlement funds are spent consistent with permissible purposes:
• Certain reports and resolutions from the local government’s governing body will be available for public access
on a statewide opioid settlement dashboard.
• For every fiscal year in which a local government receives, holds, or spends opioid settlement funds, the county or
municipality must submit annual financial and impact reports specifying the activities and amounts it has funded.
• The local government must maintain records of opioid settlement Fund expenditures and related documents
for at least five years.
• The State Auditor and Department of Justice shall have access to persons and records related to the MOA and
expenditures of Opioid Settlement Fund to verify accounts and data affecting fees for performance.
• The Local Government manager/administrator is the point of contact for questions that arise under the MOA.
Please Act by Signing MOA
In order to maximize North Carolina’s share of the national settlement and ensure that the funding continues, all
counties and all municipalities above 10,000 in population need to sign the MOA between the State of North Carolina
and Local Governments on proceeds relating to the Settlement of Opioid Litigation, as well as the eventual National
Settlement Agreement.
All North Carolina counties that sign on will receive a portion of opioid settlement funds, regardless of whether they
5-5-5 Committee and North Carolina MOA
59
10
are litigants in the national opioid litigation or filed a proof of claim in Purdue Pharma’s bankruptcy. Municipalities
above 75,000 in population, and municipalities that previously filed litigation, will also receive funds directly. Smaller
municipalities will benefit from the maximum possible level of funds being directed into their counties, and their
counties are required by the agreement to work closely with all of their municipalities in making decisions about
where to direct the funds.
The national settlement agreement is expected to provide the highest benefits to state and local governments that
have 100% participation in signing on to their state agreements and the National Settlement Agreement. Therefore, it
is important that all counties and referenced municipalities sign on to this proposed agreement.
It is advantageous to all North Carolinians for all local governments to sign onto the MOA and demonstrate solidarity
in response to the opioid epidemic, and to maximize the share of opioid settlement funds received in the state to help
abate the harm.
5-5-5 Committee and North Carolina MOA
Kevin Leonard
ExecutiveDirector
kevin.leonard@ncacc.org
(919) 715-4369
Amy Bason
Deputy Director and General Counsel
amy.bason@ncacc.org
(919) 715-1430
Paige Worsham
Associate General Counsel
paige.worsham@ncacc.org
(919) 715-6245
60
AGENDA ABSTRACT
Meeting Date: May 17, 2021
Agenda Title: Falls Watershed Regulations – Interim Alternative Implementation Approach (IAIA)
Possible Projects
Summary of Information:
In the summer of 2012, Person County adopted the Falls Watershed Stormwater Ordinance for New
Development in the southern portion of Person County in order to comply with state watershed regulations.
The regulations require adherence to two stages of nutrient reductions – Stage 1 and Stage 2.
Since 2018, the Upper Neuse River Basin Association (UNRBA) has been exploring an alternative option
for achieving compliance with Stage I Existing Development nutrient load reductions required by the Falls
rules for watershed requirements and in early 2021, the Interim Alternative Implementation Approach
(IAIA) was approved by the state. The IAIA does not utilize the traditional individual nutrient load (pounds
of nitrogen and phosphorus) reduction based tracking system, but rather proposes an investment based
compliance system focused on the entire watershed as an avenue to meet the required standards. In other
words, rather than counting pounds reduced in individual jurisdictions the IAIA counts dollars invested into
the overall health of the watershed.
In November 2020, Person County Board of Commissioners voted to participate in the IAIA program,
which includes an annual financial commitment of $114,394 over a 5-year period totaling $571,970. The
start date for qualified projects or investments for the IAIA is July 1, 2021.
Several county staff members from different departments recently met and identified three potential sites
to meet the IAIA requirements, which include:
“County Farm” site located off of Onnie Burton Road (Parcel A76-15)
Land adjacent to the Rock Athletic Complex, formerly known as the “Sportsplex” (Parcels 118-18
and 118-10)
Land adjacent to Hurdle Mills Park (Parcel A32-54)
Each of these sites represent unique opportunities for the county to meet the IAIA requirements through the
following eligible IAIA activities:
Creation of parks, trails and paths with water quality benefits and a focus on environmental
education
Floodplain restoration and reconnection
Stream and riparian buffer restoration and enhancement
Pet waste pickup education and waste management stations
61
Benefits to the community from eligible IAIA projects include increased community involvement,
improved community health and wellbeing and increased tourism levels and economic development
opportunities that the proposed trails and greenspace would generate for the community.
Staff is requesting that the Board select a site (or multiple sites) for FY 2021/2022 in order for staff to begin
working on fulfilling the requirements of participation in the IAIA program. Staff recommends the
selection of the “County Farm” site based on the number of eligible IAIA activities and the benefits that it
will provide to the County.
Recommended Action: Vote to select a site(s) in order to fulfill the County’s participation requirement in
the IAIA program.
Submitted by: Lori Oakley, Planning Director and John Hill, Recreation, Arts and Parks Director
62
Person County’s Stormwater Obligation•In the summer of 2012, Person County adopted the Falls Watershed Stormwater Ordinance for New Developmentin the southern portion of Person County. •In 2018, the Upper Neuse River Basin Association (UNRBA) begin exploring alternative options for meeting the Stage 1 requirements of the stormwater regulations. The Interim Alternative Implementation Approach (IAIA) was adopted earlier this year by the UNRBA and approved by the state. It is the goal of Person County Government to satisfy it’s obligation to the North Carolina State Division of Water Quality’s Stormwater regulation requirements under the IAIA.•Person County is obligated to spend $114,394 per year for the next 5 years totaling $571,970.63
Person County’s Stormwater Team Goals•Develop and implement IAIA project elements that will not only satisfy NCDWQ requirements but will also result in the following benefits for Person County and its citizens through the following eligible IAIA projects:•Development of ‘Green Space’ and recreational natural areas•Creation of trails and park amenities with a focus on environmental education•Creation of wildlife and natural environmental observation areas •Floodplain and riparian buffer restoration and enhancement•Land acquisition for public recreation and conservation•All expenses associated with the development, administration, and maintenance of these projects will be attributed to the IAIA program.64
Person County’s Stormwater Team Goals•Positive outcomes from establishing creative IAIA eligible activities:•Increase community involvement while building the park infrastructure •Improve community health and wellness through increased greenspace •Increase tourism to capitalize on economic impact•Increase opportunities for economic development by improving community attractiveness and livability •“Have a little fun” while building relationships and creating a natural, experientialist culture while adding exposure to Person County65
Project option 1: County Farm site•More project opportunities to fulfill IAIA requirement.•Acquire access to the site.•Expenses associated with acquisition qualify for the IAIA.•Land will be future site of recreational green space and trail.•Fulfill IAIA elements with environmental education programs.•Fulfills elements and action items of the Person County Recreation Comprehensive Master Plan that was adopted by commissions.66
Project option 2: Land Acquisition adjacent to the Rock Athletic Complex and Southern Middle School•Acquire approximately 7 acres of land adjacent to the Rock Athletic Complex and Southern Middle School.•Expenses associated with acquisition qualify for the IAIA.•Land will be future site of recreational green space and trail.•Fulfill IAIA elements with environmental education programs.•Fulfills elements and action items of the Person County Recreation Comprehensive Master Plan that was adopted by commissions.67
Project option 3: Hurdle Mills Land Acquisition•Acquire one acre of land adjacent to the Hurdle Mills Park.•Expenses associated with acquisition qualify for the IAIA.•Land will be future site of recreational green space and trail.•Fulfill IAIA elements with environmental education programs.•Fulfills elements and action items of the Person County Recreation Comprehensive Master Plan that was adopted by commissions.68
Health and Wellness , Community, Tourism, Economic Development and Fun “All In One”69
Goal #1: Build Park Infrastructure through Community Involvement to Accomplish IAIA Requirement•Development of a multi‐use trail system, campsites, green space and environmental education amenities through partnerships with citizens, civic organizations, schools, scouts, and outdoor enthusiast groups, including:•Boy and Girls Scouts of Person County •Public School: projects, volunteer hours, environmental education, biology classes•Schools: athletic events•Eagle Scout and Gold Projects•Recreation, Arts, and Park Department events •Location for fundraising events for community civic organizations: Kiwanis, Rotary, Chamber of Commerce, Masons, Lions Club, Sertoma, Churches, and many more Person County clubs.•Sappony Tribal Council •Triangle Off‐Road Cyclist70
Goal #1: Build Park Infrastructure through Community Involvement to Accomplish IAIA Requirement71
Goal #2: Improve Community Health and Wellness through Increased Greenspace•Developing trails and other greenspace area improve community health by:•Encouraging individuals and groups to exercise and lead a healthy lifestyle•Helps to prevent chronic health issues such as high blood pressure, high cholesterol and diabetes, etc.•Improves general mood and attitude while increasing individual and community morale•Improves mental health and function•Helps to build social capital, sense of community worth and interpersonal relationships•Improves community mindfulness and creativity72
Goal #3: Increase Tourism to Capitalize on Economic Impact•Create amenities with low environmental impact and large tourism impact•Create a trail system that is multi purpose including: mountain biking, hiking, disc golf, etc. •Primitive camping areas along the Flat River•Areas for public river access support fishing, canoeing, kayaking, and paddle boarding•Create paddle trail to promote environmental and stormwater education •Construct a state registered site for Birding and Wildlife observation to promote ecotourism •Host Recreation, Arts, and Park Department tourism events that attract visitors to come spend their money through daytrips and overnight stays. Examples: professional/amateur mountain bike events, trail races, biathlons, paddle tours, fishing tournaments, professional disc golf tournaments •Maintain open field support areas to host festivals and other public events•Promote Person County as an outdoor experientialist tourism destination73
Tourism taking place around Person County Lets Not Miss Out on the opportunity!74
Tourism taking place around Person County Lets not miss out on the opportunity!75
Goal #4: Increase Opportunities for Economic Development by Improving Community Attractivenessand Livability •Create a Greenspace and Outdoor Recreation Culture that is the “In thing”•Before the pandemic, outdoor recreation was already growing in popularity. Covid‐19 made it huge!•Studies show that more recreational infrastructure increase the livability of a community.•Green space, parks, and recreational amenities increase property values to communities. •Economic Impact: Day Tripper Average Spending ‐$203, Overnight Average Spending ‐$721 •Economic Development: Green Space and outdoor recreation attract companies and their workforce.•Building an outdoor recreational culture that attracts all generations of families and workers.•Surrounding community trends show a need for more greenspace and outdoor recreation.76
Goal 5: “Have a little Fun” while building relationships and creating a natural, experientialist culture while adding exposure to Person County Opportunities for exposure to Person County is vital for future growth.•Greenspace and outdoor events increase exposure to prospective residents and companies looking to relocate.•There is a growing need for greenspace and outdoor recreation as the trend increases.•Location of the park is the perfect opportunity to attract people from Durham and Raleigh.•Building key relationships will increase exposure and opportunities for growth.•The locations are perfect opportunities to partner with nearby universities.77
Video Clips of Potential Tourism Programs Kayaking the Flat River below the ParkAnglers Ridge Trail, Danville VA78
AGENDA ABSTRACT
Meeting Date: May 17, 2021
Agenda Title: Presentation of the Fiscal Year 2021-2022 Proposed Budget
Summary of Information: North Carolina General Statutes require that on or before June 1,
the manager present her recommended budget for the next fiscal year to the Board of
Commissioners. An overview of the proposed budget will be given, along with copies of the
budget document for Commissioners’ review. The schedule of the budget worksessions will also
be presented based on the Board’s feedback. A Public Hearing on the budget is scheduled for
June 7th with adoption of the budget planned for June 21st.
Recommended Action: Receive the manager’s proposed budget.
Submitted By: Heidi York, County Manager
79