City of Alexandria, Virginia
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MEMORANDUM
DATE: JUNE 20, 2018
TO: THE HONORABLE MAYOR AND MEMBERS OF CITY COUNCIL
FROM: MARK B. JINKS, CITY MANAGER /s/
DOCKET TITLE:
TITLE
Consideration of the Release of $100,000 from FY 2019 Contingent Reserves to Create an Opioid and Other Drugs Recovery Coordinator Position.
BODY
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ISSUE: Consideration of the release of $100,000 from the FY 2019 Contingent Reserves to create an Opioid and Other Drugs Recovery Coordinator position.
RECOMMENDATION: That City Council:
1. Authorize the release of $100,000 in Contingent Reserves for the creation of an Opioid and Other Drugs Recovery Coordinator position (1.0 FTE Grade 22/Supervisory Program Analyst); and
2. That staff continue to seek out alternative funding sources to support this work
BACKGROUND: In October 2017, the White House declared the opioid crisis a National Public Health Emergency. This followed a declaration by the Virginia State Health Commissioner who declared the epidemic a public health emergency in Virginia in 2016. Opioid overdose deaths are increasing throughout the country and since 2015 the City has been a leader in organizing to address the opioid epidemic. City staff have been focused on monitoring local trends and creating solutions to address the problem locally. In FY 2017, there were 59 overdoses in the City, nine of which resulted in death.
In July 2017, the City’s Opioid Work Group (OWG) drafted an initial list of priorities (see attached) necessary to address opioid misuse and overdose deaths in the City. Mirroring the President’s Commission on Combatting Drug Addiction and the Opioid Crisis plan, this initial plan is holistic, system-wide, and includes a focus on five key areas:
1. Opioid Addiction Prevention
2. Opioid Addiction Treatment
3. Overdose Response and Recovery
4. Diversion of Addicted Persons into Treatment
5. Supply Reduction and Law Enforcement Strategies
Initial work on the initiatives has begun, but adequate resources do not exist to implement and manage much of the work required to fully impact the opioid crisis locally. Staff from various City departments have been absorbing as much of these efforts as possible, but resources are not adequate to address this crisis in both the immediate and ongoing ways that are necessary.
DISCUSSION: The FY 2019 Approved Budget includes funding for two added permanent clinical positions in the Department of Community and Human Services (DCHS) Opioid Treatment Program. These positions will help ensure that based on current demand no person who needs opioid treatment will have to wait, which is critical to addressing the deadliness of the opioid crisis.
In addition and in response to a DCHS Supplemental Request to fund an “Opioid and Other Drugs Recovery Coordinator,” the FY 2019 budget also includes $100,000 in Contingent Reserves for Opioid Management. The budget notes “if potential Federal and State grants are not forthcoming, this contingent could provide funding for implementing priority initiatives identified by the City of Alexandria Opioid Work Group, as well as working with local healthcare providers to develop a coordinated and immediate response plan for individuals who have overdosed to ensure the immediate availability of addiction recovery services.”
Staff regularly reviews all State and Federal funding announcements related to the opioid crisis and it appears that no funding is currently available that could be used to create the Senior Manager (Grade 22/Supervisory Program Analyst) position at this time. The focus of most of the funding is direct treatment for areas of greatest need. Funding support for coordination and systems work has not been forthcoming.
The position is needed to lead and manage the significant amount of work and initiatives identified by the OWG as necessary to combat the Opioid Crisis. Without an Opioid Coordinator, many of the critical OWG initiatives will not be implemented due to lack of management capacity. The role of this position will be to lead the inter-departmental, multi-dimensional work with all affected City departments (DCHS, Alexandria Police Department, Sheriff’s Office, Health, Fire/EMS, Inova Alexandria Hospital, and Alexandria City Public Schools) and to develop and manage a multi-system approach to address the opioid crisis and other addictions which often lead to opioid use. This position will manage the direction and work of the OWG, implement strategies, analyze and track trends, represent the City on regional, State and National opioid initiatives, pursue funding and grant opportunities, and provide regular briefings to City Council and others. The position will also continue to search for alternative sources of funding to support the City’s opioid management work.
FISCAL IMPACT: The $100,000 in General Funds currently held in Contingent Reserves would be released to DCHS in order to move forward in the hiring of an Opioid and Other Drugs Recovery Coordinator position.
ATTACHMENT: Alexandria Opioid Work Group Priorities
STAFF:
Debra Collins, Deputy City Manager
Kate Garvey, Director, Department of Community and Human Services (DCHS)
Liz Wixson, Director of Clinical and Emergency Services, DCHS