DATE: November 16, 2021
TO: Board of Supervisors
SUBMITTED BY: Kirk Haynes, Chief Probation Officer
SUBJECT: Retroactive Application with the California
Department of Public Health for a Naloxone Standing Order
RECOMMENDED ACTION(S):
TITLE
Approve and authorize the Chairman to ratify the Chief Probation Officer’s previous execution and submission of an application to the California Department of Public Health for a Standing Order for administration of Naloxone, effective July 8, 2021 through July 8, 2023.
REPORT
There is no increase in Net County Cost associated with the recommended action, which will ratify the Chief Probation Officer’s previous execution, and approve the retroactive submission of the Naloxone Standing Order to the California Department of Public Health (CDPH). Approval of the recommended action will allow the Probation Department to distribute and administer Naloxone to individuals to aid in opioid overdose prevention and treatment, as long as the Probation Department complies with the terms and conditions of the Standing Order. This item is countywide.
ALTERNATIVE ACTION(S):
If the recommended action is not approved, the Probation Department will rescind the Application.
FISCAL IMPACT:
There is no additional Net County Cost associated with the recommended action, as there is sufficient funding in Probation’s FY 2021-22 Adopted Budget for Org 3430 to cover costs associated with implementing the Standing Order in the County.
DISCUSSION:
Naloxone is a prescription drug medication approved by the Food and Drug Administration designed to rapidly reverse opioid overdose. It is administered when a patient is showing signs of opioid overdose and is a temporary treatment. Most opioid overdoses are accidental, and as a result from taking inappropriate doses of opioids or mixing opioid drugs with other substances. These poisonings typically are reported as taking 45-90 minutes to turn fatal, creating a critical window of opportunity for lifesaving intervention.
Naloxone is a prescription drug, but it is not a controlled substance. Naloxone has few known adverse effects, no known potential for abuse, and can be rapidly administered through intramuscular injection or nasal spray. Furthermore, Naloxone has no known effect on someone who does not have opioids in their system.
State law provides that a licensed health care provider who is authorized by law to prescribe an opioid antagonist, such as Naloxone, may issue standing orders for the administration of an opioid antagonist to a person at risk of an opioid-related overdose by a family member, friend, or other person in a position to assist a person experiencing or reasonably suspected of experiencing an opioid overdose.
The CDPH, as a licensed healthcare provider, has issued a statewide Standing Order to allow community organizations and other entities that are not currently working with a physician to allow for the administration of Naloxone to a person reasonably suspected of experiencing an opioid overdose, to help reduce morbidity and mortality associated with opioid overdose by facilitating the distribution and administration of Naloxone in California. The Standing Order requires the name, type of entity, and contact information for each entity applying for the Standing Order. It also requires that by submitting the online application, the entity:
1. Certifies that its information listed on the application is correct;
2. The CDPH may contact the entity;
3. The entity agrees to allow the CDPH to use the information provided on the application form to track the use of the Standing Order and conduct other public health and epidemiological surveillance activities;
4. Acknowledges that the Standing Order cannot be used to purchase or sell Naloxone;
5. Agrees to ensure that entities and people receiving and administering Naloxone receive opioid overdose prevention and treatment training, as described in Civil Code section 1714.22;
6. Agrees to maintain and report, at the time of renewal, information regarding the number of doses of Naloxone distributed under this Standing Order;
7. If known/available, agrees to maintain and report information, upon renewal, regarding the number of reversals that occurred using Naloxone distributed under this Standing Order;
8. Agrees to re-register for the Standing Order if there is a change in the information required on the application form; and
9. Agrees to maintain a copy of the Standing Order, which will include these terms and conditions.
In order for peace officers in the Probation Department to administer Naloxone to a person suspected of experiencing an overdose, officers are required to receive the Standing Order training.
Fresno County Emergency Medical Services, a division of the County Department of Health, will provide this training to the officers.
It should be noted, the Department submitted the application and received approval for the Standing Order on October 7, 2021, contingent upon your Board’s approval. The Standing Order is effective July 8, 2021 through July 8, 2023. The Department will move forward with the required Standing Order training once your Board approves the recommended action.
ATTACHMENTS INCLUDED AND/OR ON FILE:
On file with Clerk - Naloxone Standing Order
CAO ANALYST:
Greg Reinke