File #: 2022-498   
Type: Administrative Item Status: Passed
In control: Board of Commissioners
On agenda: 9/27/2022 Final action: 9/27/2022
Title: Minnesota Opioid Overdose Prevention Settlement Funds and Personnel Complement Increase in Public Health
Sponsors: Public Health
Attachments: 1. Resolution


Sponsor: Public Health




Minnesota Opioid Overdose Prevention Settlement Funds and Personnel Complement Increase in Public Health





1.                     Accept Ramsey County’s share of the Minnesota opioid overdose prevention settlement funds in the amount of $15,780,977, payable in installments over the course of an 18-year period.

2.                     Authorize the County Manager to establish a project budget for the Minnesota opioid overdose prevention settlement funds in the Public Health department.

3.                     Approve an increase in the personnel complement of Public Health or supporting departments by 6.0 Full Time Equivalent positions.



Background and Rationale


On December 14, 2021, the Ramsey County Board of Commissioners agreed to the Minnesota Opioids State-Subdivision Memorandum of Agreement and opted into the multistate settlements with pharmaceutical distributors McKesson, Cardinal Health, Amerisource Bergen, and opioid manufacturer Johnson & Johnson. On February 25, 2022, the settlement agreements were approved by the companies listed above. Minnesota’s share of the settlements is more than $300,000,000.


On June 15, 2022, Governor Tim Walz held a ceremonial bill signing with Lieutenant Governor Peggy Flanagan, Attorney General Keith Ellison, legislators, and advocates for a bipartisan $300 million opioid response bill. Of the $300 million, 75% has been allocated to all Minnesota counties and 33 cities that signed on to the lawsuit and 25% has been allocated to the state. Ramsey County’s share of this settlement is $15,780,977, which is approximately 7% of the total amount allocated to Minnesota counties and cities.


Payments from the settlement will be distributed over the course of an 18-year period. Ramsey County expects to receive five payments this year: three from the settlement with Johnson & Johnson and two from the distributor settlement. The Memorandum of Agreement requires counties to use their public health department as chief strategists in deciding how to expend the funds and consult with municipalities on plans. The funding will be used for opioid response, education, treatment, prevention and recovery. Public Health will have flexibility to modify their opioid abatement approach as needed and as new uses are discovered. The settlement distributions do not have spending deadlines and should not be commingled with any other money or funds. Because of this, a project budget needs to be created to accurately account for these funds.


Public Health also seeks to increase the personnel complement by 6.0 Full Time Equivalent positions to support the opioid overdose prevention program. These positions would work across the Health and Wellness Service Team or supporting departments to best meet the needs of clients and residents. The anticipated classifications and explanation of each position’s duties are as follows:


                     Planning Specialist 1 or 2: oversee the coordination and planning of community engagement and partnerships with county municipalities to determine funding allocation of the settlement dollars, implementation and evaluation of activities.

                     Health Educator and Health Education Program Assistant: help facilitate education and prevention activities.

                     Contract Manager: manage contract and procurement process to secure agreements with community agencies and manage financial reporting.

                     Planning & Evaluation Analyst: oversee program evaluation and assist with the compilation of data and development of narrative reports.

                     Communications Associate: create and develop promotional content and reports for both electronic media and print.



County Goals (Check those advanced by Action)

       Well-being             Prosperity                 Opportunity                 Accountability


Racial Equity Impact

Counties are uniquely impacted by the opioid overdose epidemic and substance use disorder. According to the Minnesota Attorney General's office, in 2020, opioid overdose deaths nationally rose to a record 93,000, a nearly 30 percent increase over the prior year. According to the Minnesota Department of Health drug overdose dashboard, there have been over 6,300 opioid related deaths statewide since 2000. Unfortunately, the crisis continues with increasing deaths and emergency room visits for opioid involved overdoses, and the impact these events have on individuals, children and families. 

American Indians in Minnesota are seven times more likely and African Americans are two times more likely to die from an opioid overdose than white individuals. Statewide in 2020,131 per 100,000 American Indians and 49 per 100,000 African Americans experienced opioid overdose deaths compared to 16 per 100,000 white residents. Opioid-related deaths among Ramsey County residents increased from 34 in 2016 to 130 in 2021 - an almost 300% increase in five years. Forty-six percent of opioid-related deaths in 2021 occurred among Ramsey County racially and ethnically diverse residents. Additionally, injection of drugs accounts for one in 10 of cases of HIV and is also a major factor in the spread of hepatitis C.


Community Participation Level and Impact

Public Health provided an opioid prevention community update session on May 26, 2022 and launched the Opioid Prevention and Response Survey in May 2022. To date, over 200 surveys have been received by community residents, partners and internal key stakeholders. The Opioid Prevention Coordinator has also hosted a listening session at Peoples Incorporated and Recover Café Frogtown providing an additional opportunity for community to provide input. Public Health plans to continue engagement with Ramsey County cities and other key stakeholders through the month of November 2022.

  Inform              Consult                                 Involve                      Collaborate        Empower                     


Fiscal Impact

Public Health expects to receive $15,780,977 in settlement payments over the course of an 18-year period. Public Health is building their strategy with input from both internal and external key stakeholders to further determine the internal capacity needs of Public Health and other departments to support this response. It is anticipated that the estimated annual cost of $587,000, including salaries and fringe benefits, of the identified positions will be fully covered by the settlement payments, the public health operating budget and/or other federal, state, local public health and human services funding.



Last Previous Action

On December 14, 2021, the Ramsey County Board supported and agreed to the Minnesota Opioids State-Subdivision Memorandum of Agreement and opted into the multistate settlements with McKesson, Cardinal Health, AmerisourceBergen and Johnson & Johnson (Resolution B2021-273).