Min CC 3/14/2023 Resolution 1605City of Cibolo, Texas
City Council Regular Meeting
March 14, 2023
SUBJECT:
Discussion/Action for the City of Cibolo to submitted four (4) new 2023 Opioid Settlement — Subdivision
Participation and Release Form through the Attorney General of the State of Texas -- Wayne Reed, City Manager
ITEM SUMMARY:
In 2021, the Honorable Ken Paxton, Attorney General of the State of Texas, is requested local jurisdictions to
consider joining the Texas Settlement concerning litigation settlement with corporations involved in the illicit
opioid use and distribution within the State of Texas for damages caused. The State of Texas, through its
Attorney General and its Political Subdivisions, share a common desire to abate and alleviate the impacts of the
opioid epidemic throughout the State of Texas. Council selected on September 28, 2021, to join the Texas
Settlement by approving the Texas Term Sheet by resolution in the form approved by the Attorney General of
the State of Texas.
In February 2023, the Attorney General's Office announced the 2023 New Opioid Settlements— Participation
Information for Subdivisions. This announcement included four (4) new settlements. Those being with, Allergan,
CVS, Walgreens, and Walmart. With the approval of Resolution 1604 the City of Cibolo does not need to adopt
an additional resolution to readopt the Texas Term Sheet. Should Council support participate in the 2023 Opioid
Settlements, the City Manager's office will need to submit all four (4) Subdivision Participation Forms signed by Mayor
Allen no later than April 18, 2023.
MORE INFORMATION: Go to www.texasattorneygeneral.goy/globalopioidsettlement
FINANCIAL IMPACT:
It is estimated that the City of Cibolo will receive $12,900.66 (this is an approximate) for funding education, prevention,
and treatment of opioid abuse.
County/City
Allocation %
Allergan
CVS
Walgreens
Walmart
Total
Cibilo
0.009126667%
$1,837.71
$4,130.50
$4,621.82
$2,310.63
$12,900.66
Region 6-
9.845317027%
$7,863,592.06
17,674,436.49
$19,776,804.26
$9,887,210.07
$55,202,042.88
Atascosa, Sandera, Bexar, Comal, Dimmit,
Edwards, Frio, Gillespie, Guadalupe, Kendall,
Kerr, Kinney, to Salle, McMullen, Medina,
Real, Uvalde, Val Verde, Wilson, Zavala
SUBMITTED BY:
Wayne Reed
ATTACHMENTS:
1. Resolution 1605—September 28, 2021
2. Global Opioids Settlement PowerPoint 2021-08
4. List of Opioid Remediation Uses
5. Exhibit K—Subdivision Participation and Release Forms (4)
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"City0f Choice
RESOLUTION
NO: /605
City of Cibolo
STATE OF TEXAS
COUNTY OF GUADALUPE
CITY OF CIBOLO, TEXAS
BE IT REMEMBERED, at a regular meeting of the City Council of City of Cibolo, Guadalupe
County,Texas, was held on the, 28fh day of September, 2021, on motion made by
'go el i4i r—ka Councilmember of District 7 and seconded by
FIM bjO hO r"r Councilmember of Districtthe following Resolution was adopted:
WHEREAS, the City of Cibolo, Guadalupe County; Texas obtained information indicating that
certain drug companies and their corporate affiliates, parents, subsidiaries, and such other
defendants as may be added to the litigation (collectively, "Defendants") have engaged in
fraudulent and/or reckless marketing and/ordistribution of opioids that have resulted in addictions
and overdoses; and
WHEREAS, these actions, conduct and misconduct -have resulted in significant financial costs to
the City and County; and
WHEREAS, on May 13; 2020, the State of Texas, through the Office of the Attorney General, and
a negotiation group for Texas political subdivisions entered into an Agreement entitled Texas
Opioid Abatement Fund Council and Settlement Allocation Term Sheet (hereafter, the Texas Term
Sheet) approving the allocation of any and all opioid settlement funds within the State of Texas.
The Texas Term Sheet is attached hereto as Exhibit "A"; and
R
WHEREAS, Special Counsel and the State of Texas have recommended that the City of Cibolo,
Guadalupe County, Texas support the adoption and approval the Texas Term Sheet in its entirety.
NOW, THEREFORE, BE IT RESOLVED that we, the City Council of the City of Cibolo,
Guadalupe County, Texas:
1. Support the adoption and approval the Texas Term Sheet in its entirety; and
2. Find as follows:
a. There is a substantial need for repayment of opioid -related expenditures and payment
to abate opioid -related harms in and about City of Cibolo, Guadalupe County, Texas; and
b. The City Council supports in its entirety and hereby adopts the -allocation method for
opioid settlement proceeds as set forth in the STATE OF TEXAS AND TEXAS
POLITICAL SUBDIVISIONS' OPIOID ABATEMENT FUND COUNCIL AND
SETTLEMENT ALLOCATION TERM SHEET, attached hereto as Exhibit A. The City
Council understands that the purpose of this Texas Term Sheet is to permit collaboration
between the State of Texas and Political Subdivisions to explore and potentially
effectuate resolution of the Opioid Litigation against Pharmaceutical Supply Chain
Participants as defined therein. We also understand that an additional purpose is to create
an effective means of distributing any potential settlement funds obtained under this
Texas Term Sheet between the State of Texas and Political Subdivisions in a manner and
means that would promote an effective and meaningful use of the funds in abating the,
opioid epidemic in the City, County and throughout Texas.
PASSED AND APPROVED THIS 28T11 DAY OF SEPTEMBER, 2021
Stosh Boyle, Mayor
ATTEST
h�
Peggy Cimics, TRMS, City Secretary
2
EXHIBIT K
Subdivision Settlement Participation Form
Govemmental Enti
: Gi or i o a State: CX45'
Authorized Official:
5-1,0.4t, ,DAl iq Ya,—
Address 1: 2o o .5.
Address 2: T?o. T�ox S16
City, State, Zip:
-7g/a s
Phone: --ale-
-aio-Email:
Email:5130
;6ola� - oV
The governmental entity identified above ("Governmental Entity."), in order to obtain and
in consideration for'ihe benefits provided to the Governmental Entity pursuant to the Settlement
Agreement dated July 21, 2021 {"Distributor Settlement'), and acting through the undersigned
authorized offidial, hereby elects to participate in the Distributor Settlement, release all Released
Claims against all Released Entities, and agrees as follows.
1. The Governmental Entity is aware of and has reviewed the Distributor Settlement,
understands that all terms in this Participation Form have the meanings defined therein,
and agrees that by signing this Participation Form,.the Governmental Entity elects to
participate in the Distributor Settlement and become, a Participating Subdivision as
provided therein.
2. The Governmental Entity shall, within 14 days of the Reference Date and prior to the
filing of the Consent Judgment, secure the dismissal with prejudice of any Released
Claims that it has filed.
3. The Governmental Entity agrees to the terms of the Distributor Settlement pertaining to
Subdivisions as definedtherein.
4. By agreeing to the terms of the Distributor Settlement and becoming a Releasor, the
Governmental Entity is entitled to the benefits provided therein, including, if applicable,
monetary payments beginning after the Effective Date.'
5. The Governmental Entity agrees to use any monies it receives through the Distributor
Settlement solely for the purposes provided therein.
6. The -Governmental Entity submits to thejurisdicfion of the court in the Governmental
Entity's state where the Consent Judgment is filed.for purposes limited to that court's role
as provided in, and for resolving disputes to the extent provided in, the Distributor
Settlement. The Governmental Entity likewise agrees to arbitrate before the National
Arbitration Panel as provided in, and for resolving disputes to the extent otherwise
provided in, the.Distributor Settlement:
7. The Governmental Entity has the right to enforce the Distributor Settlement as provided
therein.
8. The Governmental Entity, as a Participating Subdivision, hereby becomes a Releasor for
all purposes in the Distributor Settlement, including, but not limited to, all provisions of
Part XI, and along with all departments, agencies, divisions, boards, commissions,
districts, instrumentalities of any kind and attorneys, and any person in their official
capacity elected or appointed to serve any of the foregoing and any agency, person, or
other entity claiming by or through any of the foregoing, and any other entity identified in
the definition of Releasor, provides for a release to the fullest extent of its authority. As a
Releasor, the Governmental Entity hereby absolutely, unconditionally, and irrevocably
covenants not to bring, file, or claim, or to cause, assist or permit to be brought, filed, or
claimed, or to otherwise seek to establish liability for any Released Claims against any
Released Entity in any forum whatsoever. The releases provided for in the Distributor
Settlement are intended by the Pal -ties to be broad and shall be interpreted so as to give
the Released Entities the broadest possible bar against any liability relating in any way to
Released Claims and extend to the full extent of the power of the Governmental Entity to
release claims. The Distributor Settlement shall be a complete bar to any Released
Claim.
9. The Governmental Entity hereby takes on all rights and obligations of a Participating
Subdivision as set forth in the Distributor Settlement.
10. In connection with the releases provided for in the Distributor Settlement, each
Governmental Entity expressly waives, releases, and forever discharges any and all
provisions, rights, and benefits conferred by any law of any state or territory of the
United States or other jurisdiction, or principle of common law, which is similar,
comparable, or equivalent to § 1542 of the California Civil Code, which reads:
General Release; extent. A general release does not extend to claims that
the creditor or releasing party does not know or suspect to exist in his or
her favor at the time of executing the release, and that if known by him or
her would have materially affected his or Iyer settlement with the debtor or
released party.
A Releasor may hereafter discover facts other than or different from those which it
knows, believes, or assumes to be true with respect to the Released Claims, but each
Governmental Entity hereby expressly waives and fully, finally, and forever settles,
releases and discharges, upon the Effective Date, any and all Released Claims that may
exist as of such date but which Releasors do not know or suspect to exist, whether
through ignorance, oversight, error, negligence or through no fault whatsoever, and
which, if known, would materially affect the Governmental Entities' decision to
participate in the Distributor Settlement.
K-2
11. Nothing herein is intended to modify in any way the terms of the Distributor Settlement,
to which Governmental Entity hereby agrees. To the extent this Participation Form is
interpreted differently from the Distributor Settlement in any respect, the Distributor
Settlement controls.
I have all necessary power and authorization to execute this Participation Form on behalf of the
Governmental Entity,
Signature:
Name: Q
Title: ztxl fel`
Date: `� I IZO/S I
K-3
EXIIIBIT K
Settlement Participation Form
Governmental Entity:
(moi o -P C%
d 10 State: -7'e)r4s
Authorized. Official:
544.5A ?30
/e Mw
Address 1: ---pO
5. irla%n Ct-%o
?x -77/o
Address 2: po• �/oY c"a�
Ci State, Zi
, [COAD %'Gr 5
6
Phone: -2/zv -.
G�
Email: 540
e ;A0 104X .
av
The governmental entity identified above ("Governmental Entity"), in order to obtain and in
consideration for the benefits provided to the Governmental Entity pursuant to the Settlement
Agreement dated July 21, 2021 ("Janssen Settlement"), and acting through the undersigned
authorized official, hereby elects to participate in the Janssen Settlement, release all Released
Claims against all Released Entities, and agrees as follows.
1. The Governmental Entity is aware of and has reviewed the Janssen Settlement,
understands that all terms in this Election and Release have the meanings defined therein,
and agrees that by this Election, the Governmental Entity elects to participate in the
Janssen Settlement and become a Participating Subdivision as provided therein.
2. The Governmental Entity shall, within 14 days of the Reference Date and prior to the
filing of the Consent Judgment, dismiss with prejudice any Released Claims that it has
filed.
3. The Governmental Entity agrees to the terns of the Janssen Settlement pertaining to
Subdivisions as defined therein.
4. By agreeing to the terms of the Janssen Settlement and becoming a Releasor, the
Governmental Entity is entitled to the benefits provided therein, including, if applicable,
monetary payments beginning after the Effective Date.
5. The Governmental Entity agrees to use any monies it receives through the Janssen
Settlement solely for the purposes provided therein. -
6. The Governmental Entity submits to the jurisdiction of the court in the Governmental
Entity's state where the Consent Judgment is filed for purposes limited to that coma's role
as provided in, and for resolving disputes to the extent provided in, the Janssen
Settlement.
7. The Governmental Entity has the right to enforce the Janssen Settlement as provided
therein.
8. The Governmental Entity, as a Participating Subdivision, hereby becomes a Releasor for
all purposes in the Janssen Settlement, including but not limited to all provisions of
86
Section IV (Release), and along with all departments, agencies, divisions, boards,
commissions, districts, instrumentalities of any kind and attorneys, and any person in
their official capacity elected or appointed to serve any of the foregoing and any agency,
person, or other entity claiming by or through any of the foregoing, and any other entity
identified in the definition of Releasor, provides for a release to the fullest extent of its
authority. As a Releasor, the Governmental Entity hereby absolutely, unconditionally,
and irrevocably covenants not to bring, file, or claim, or to cause, assist or permit to be
brought, filed, or claimed, or to otherwise seek to establish liability for any Released
Claims against any Released Entity in any forum whatsoever. The releases provided for
in the Janssen Settlement are intended by the Parties to be broad and shall be interpreted
so as to give the Released Entities the broadest possible bar against any liability relating
in any way to Released Claims and extend to the full extent of the power of the
Governmental Entity to release claims. The Janssen Settlement shall be a complete bar to
any Released Claim.
9. In connection with the releases provided for in the Janssen Settlement, each
Governmental Entity expressly waives, releases, and forever discharges any and all
provisions, rights, and benefits conferred by any law of any state or territory of the
United States or other jurisdiction, or principle of common law, which is similar,
comparable, or equivalent to § 1542 of the California Civil Code, which reads:
General Release; extent. A general release does not extend to claims that
the creditor or releasing party does not know or suspect to exist in his or
her favor at the time of executing the release that, if known by him or her,
would have materially affected his or her settlement with the debtor or
released party.
A Releasor may hereafter discover facts other than or different from those which it
knows, believes, or assumes to be true with respect to the Released Claims, but each
Governmental Entity hereby expressly waives and fully, finally, and forever settles,
releases and discharges, upon the Effective Date, any and all Released Claims that may
exist as of such date but which Releasors do not know or suspect to exist, whether
through ignorance, oversight, error, negligence or through no fault whatsoever, and
which, if known, would materially affect the Governmental Entities' decision to
participate in the Janssen Settlement.
10. Nothing herein is intended to modify in any way the terms of the Janssen Settlement, to
which Governmental Entity hereby agrees. To the extent this Election and Release is
interpreted differently from the Janssen Settlement in any respect, the Janssen Settlement
controls.
87
I have all necessary power and authorization to execute this Election and Release on behalf of
the Governmental Entity.
Signature:
Name:
Title: Mh4an
Date:
M
0�,..N E Y
e KEN PAXTON
z -
ATTORNEY GENERAL of TEXAS
♦ �'FXA`'r
Global Opioids Settlement
What it means for Texas
This presentation is for informational purposes and does not constitute legal advice.
Opioids Crisis Update
• In 2020, drug overdose deaths
rose nearly 30% in the United
States to a record high of 93,000.
• Opioid overdose deaths hit a
record 69,000 in the United
States.
• In Texas, drug
also increased
primarily by
deaths.
overdose deaths
by 31.9%, driven
opioid overdose
• The opioid overdose death
increase was driven by fentanyl and
other synthetic opioids.
• Attorney General Paxton's website
has information to protect Texans
from the nation's opioid crisis by
educating them about the dangers
of misusing prescription opioids.
Sources:
"Provisional Drug Overdose Death Counts" Centers for Disease Control: National
Center for Health Statistics (last accessed July 23, 2021),
https7//www.cdc.aov/nchs/nvss/vsrr/druo-overdose-data.htm
'U.S. Drug -Overdose Deaths Soared Nearly 30% in 2020, Driven by Synthetic
Opioids° Betsy McKay, Wall Street Journal (July 14, 2021),
vww.wsi.com/articles/u-s-drug-overdose-deaths-soared-nearly-30-in-
2020-11626271200 2
Opioids Settlements
• On July 23, 2021, Attorney General Paxton announced global
settlements had been reached with the three major opioid
distributors McKesson, Cardinal Health, and Amerisource Bergen
(ABDC), and opioid manufacturer Johnson & Johnson (J&J).
• Both settlements are a combined historic $26 billion.
• The distributors' settlement is for $21 billion.
• J&J's settlement is for $5 billion.
• The settlements include injunctive relief that changes the industry.
3
Opioids Settlements
• Texas could receive as much as $1.17 billion from the distributors
and $268 million from AJ for almost $1.5 billion, most of which is
targeted for opioid abatement.
• The actual amount Texas receives will depend upon the participation of cities,
counties, and other political subdivisions in the state.
• Texas has 30 days to decide to join both settlements.
Opioids Settlements
• Injunctive Relief in the Settlements:
• AJ is enjoined from manufacturing, selling, and promoting
opioids for 10 years.
• Distributors must establish a centralized clearinghouse
jointly overseen by states and distributors.
• Distributors will be required to take certain measures to
detect suspicious orders.
Opioids Settlements
• Mechanics of the Monetary Settlement:
• Texas's overall allocation is 6.29% of the Global Amount —
potentially almost $1.5 billion over 18 years from:
• Distributors - $1.17 billion over 18 years.
• J&J - over $268 million over 9 years.
• Annual payments are split into base and incentive
payments as follows:
• Distributors - 55% base, 45% incentive
• J&1 - 45% base, 55% incentive
• All incentive payments deal with preventing future
litigation by subdivisions and incentivizing subdivision sign
on.
6
Offsets and Suspension of Payments
• If a subdivision who hasn't sued decides to sue later, there is a suspension of payments
and a potential offset of those payments.
• Size of the suspension and a potential offset depend on several factors, but the
distributors' deal applies a maximum offset in the amount of 67% against the
suspension and/or future payments.
• If that lawsuit is resolved, suspended payments resume. If the lawsuit requires
payment, the amounts held are used to offset the amount paid.
Goal: Bring the Most Money to Texas
• There are a combination of approaches that Texas could take to maximize funds with the participation of
litigating subdivisions and nonlitigating subdivisions.
• This can be obtained by getting releases for past and future claims from all litigating subdivisions and
special districts, all general-purpose subdivisions over 10,000 population, and covered special districts.
• Texas has 128 litigating subdivisions:
• 110 Counties.
• 5 Cities.
• 10 Hospital Districts.
• 3 School Districts.
• Texas has 406 general purpose subdivisions with a population of over 10,000 (309 nonlitigating and 97
litigating).
• Currently, the best option for Texas to maximize incentive funds is through a partnership with political
subdivisions, where a large percentage agree to release claims.
R
How Settlement Dollars Flow into Texas
• By signing on to the Settlement and executing a release, you increase the funds coming into
Texas and will be entitled to a portion of the funds that Texas receives.
• Texas and Participating Subdivisions alike get direct payments under the settlement.
• Cities and Counties will also get funding for abatement programs from the Opioid Council.
• Question: If my county signs up and executes a release, how do I get dollars to my county?
• Answer: SB 1827 (87R) and the Texas Term Sheet
9
Texas Term Sheet and SB 1827
• Goal of the Texas Term Sheet: Provide Texans in all 254 counties with the opportunity for
funding for education, prevention, and treatment of opioid abuse.
• SB 1827 (87R) codifies the Texas Term Sheet and establishes the Texas Opioid Council (Council)
to ensure that the funds recovered by Texas are allocated fairly and spent to remediate the
opioid crisis in Texas, using efficient and cost-effective methods that are directed to the hardest
hit regions in Texas while also ensuring that all Texans benefit from prevention and recovery
efforts.
• 85% of the funds under the Settlement will be deposited into the Opioids Abatement Trust
Fund:
• 15% to directly to subdivisions.
• 70% share to abatement programs.
Example Opioid Fund Allocations
These amounts are estimates only based on maximum recoveries
• Assuming (1) your
subdivision
executes a release
and signs on to
the Texas Term
Sheet, and (2)
Texas receives
maximum funds
from the
distributors and
J&J, what kind of
funding does that
mean for my
subdivision?
• Example 1— direct payments to
cities and counties:
..
Brazoria County $1,013,429.26 $232,935.37
City of Edinburg
City of Houston
League City
City of Longview
City of McKinney
City of Odessa
City of Round Rock
Starr County
City of Waxahachie
$119,977.07 $27,576.57
$6,969,111.93 $1,601,841.11
$300,149.11
$478,635.88
$447,004.00
$554,967.87
$472,420.87
$99,146.53
$150,952.91
$68,988.87
$110,013.82
$102,743.27
$127,558.63
$108,585.31
$22,788.70
$34,696.33
$1,246,364.63
$147,553.64
$8,570,953.04
$369,137.98
$588,649.71
$549,747.27
$682,526.50
$581,006.17
$121,935.23
$185,649.24
Example Opioid Fund Allocations
These amounts are estimates only based on maximum recoveries
• Assuming (1) your
subdivision
executes a release
and signs on to
the Texas Term
Sheet, and (2)
Texas receives
maximum funds
from the
distributors and
J&J, what kind of
funding does that
mean for my
subdivision?
• Example 2 — Abatement allocations by
Regions for Treatment Programs
Region 3 (Austin,
Calhoun, Chambers,
Colorado, Fort Bend,
Harris, Matagorda,
Waller, Wharton)
Region 5 (Cameron,
Hidalgo, Starr, Willacy)
Region 9 (Dallas,
Kaufman)
Region 15 (EI Paso,
Hudspeth)
$121,270,842.23 $27,873,941.89 $149,144,784.13
$17,664,324.97
$66,659,834.77
$18,039,679.50
$4,060,121.61 $21,724,446.58
$15,321,674 $81,981,509.18
$4,146,396.35 $22,186,075.85
Opioid Lawsuits Timeline (1 of 3)
• In September 2017, Attorney General Paxton and a bipartisan coalition of 40 other states
served investigative subpoenas and additional requests on eight companies that
manufacture or distribute highly addictive opioids to evaluate whether manufacturers and
distributors engaged in unlawful practices in the marketing, sale, and distribution of
opioids.
• May 15, 2018, Texas filed a lawsuit against Purdue Pharma for violating state laws against
deceptive trade practices and misrepresenting the risk of addiction to patients and doctors.
• On September 4, 2019, Attorney General Paxton announced that a civil Medicaid fraud
lawsuit had been filed against pharmaceutical manufacturer Johnson & Johnson for
misrepresentations made to the Texas Medicaid program about their dangerous opioid
drug, Duragesic.
• Purdue Pharma files for Chapter 11 Bankruptcy in September 2019.
,3
Opioid Lawsuits Timeline (2 of 3)
• In February 2020, Attorney General Paxton announced a global settlement
framework between state attorneys general, local subdivisions, and Mallinckrodt
(MKN). MKN is currently the largest generic opioid manufacturer in the United
States. In the agreement, MKN agreed to pay $1.6 billion in cash to a trust that will
cover the costs of opioid addiction treatment and related efforts, with the potential
for increased payment to the trust.
• On May 13, 2020, Attorney General Paxton reached a bipartisan agreement with
Texas Counties and Cities in preparation for settlement with opioid defendants:
McKesson, Cardinal Health, ABDC, and Johnson & Johnson. Texas is one of the lead
states currently negotiating financial settlements with the nation's largest companies
in the opioid supply chain.
14
Opioid Lawsuits Timeline (3 of 3)
• In February 2021, Attorney General Paxton and 46 states entered into a settlement
with McKinsey, a consulting firm that assisted Purdue and others with their
marketing of prescription opioids, for $583 million and injunctive relief. The funds
are earmarked to remediate the harms caused by the opioid epidemic and to recover
the costs incurred in investigating and pursuing these claims.
• On July 23, 2021, Attorney General Paxton announced the global settlement had
been reached with opioid defendants McKesson, Cardinal Health, ABDC, and
Johnson & Johnson.
E
Next Steps
• To join the Settlement, Subdivisions need to:
• Sign on the to settlement and execute releases; and
• Execute the Texas Term Sheet.
• The deadline to sign on is approximately 120 days after the state sign -on period,
estimated January 2, 2022.
16
0,,NtNEy�
. KEN PAXTON
a ATTORNEY GENERAL of TEXAS
+Th x 1
For more information, visit
www.texasattorneVgeneraI.gov/globalopioidsettIement
Questions? Email opioids@oag.texas.gov
17
EXHIBIT E
List of Opioid Remediation Uses
Schedule A
Core Strategies
States and Qualifying Block Grantees shall choose from among the abatement strategies listed in
Schedule B. However, priority shall be given to the following core abatement strategies ("Core
Strategies")- 14
A. NALOXONE OR OTHER FDA -APPROVED DRUG TO
REVERSE OPIOID OVERDOSES
1. Expand training for first responders, schools, community
support groups and families; and
2. Increase distribution to individuals who are uninsured or
whose insurance does not cover the needed service.
B. MEDICATION -ASSISTED TREATMENT ("MA 7")
DISTRIBUTION AND OTHER OPIOID -RELATED
TREATMENT
Increase distribution of MAT to individuals who are
uninsured or whose insurance does not cover the needed
service;
2. Provide education to school-based and youth -focused
programs that discourage or prevent misuse;
3. Provide MAT education and awareness training to
healthcare providers, EMTs, law enforcement, and other
first responders; and
4. Provide treatment and recovery support services such as
residential and inpatient treatment, intensive outpatient
treatment, outpatient therapy or counseling, and recovery
housing that allow or integrate medication and with other
support services.
10 As used in this Schedule A, words like "expand," "fund," "provide" or the like shall not indicate a preference for
new or existing programs.
E-1
C. PREGNANT & POSTPARTUM WOMEN
1. Expand Screening, Brief Intervention, and Referral to
Treatment ("SBIRT') services to non -Medicaid eligible or
uninsured pregnant women;
2. Expand comprehensive evidence -based treatment and
recovery services, including MAT, for women with co-
occurring Opioid Use Disorder ("OUD") and other
Substance Use Disorder ("SUD")/Mental Health disorders
for uninsured individuals for up to 12 months postpartum;
and
3. Provide comprehensive wrap-around services to individuals
with OUD, including housing, transportation, job
placement/training, and childcare.
D. EXPANDING TREATMENT FOR NEONATAL
ABSTINENCE SYNDROME ("NAS")
Expand comprehensive evidence -based and recovery
support for NAS babies;
2. Expand services for better continuum of care with infant -
need dyad; and
3. Expand long-term treatment and services for medical
monitoring of NAS babies and their families.
E. EXPANSION OF WARM HAND-OFF PROGRAMS AND
1. Expand services such as navigators and on-call teams to
begin MAT in hospital emergency departments;
2. Expand warm hand-off services to transition to recovery
services;
3. Broaden scope of recovery services to include co-occurring
SUD or mental health conditions;
4. Provide comprehensive wrap-around services to individuals
in recovery, including housing, transportation, job
placement/training, and childcare; and
5. Hire additional social workers or other behavioral health
workers to facilitate expansions above.
E-2
F. TREATMENT FOR INCARCERATED POPULATION
Provide evidence -based treatment and recovery support,
including MAT for persons with OUD and co-occurring
SUD/MH disorders within and transitioning out of the
criminal justice system; and
2. Increase funding for jails to provide treatment to inmates
with OUD.
G. PREVENTION PROGRAMS
1. Funding for media campaigns to prevent opioid use (similar
to the FDA's "Real Cost" campaign to prevent youth from
misusing tobacco);
2. Funding for evidence -based prevention programs in
schools;
3. Funding for medical provider education and outreach
regarding best prescribing practices for opioids consistent
with the 2016 CDC guidelines, including providers at
hospitals (academic detailing);
4. Funding for community drug disposal programs; and
5. Funding and training for first responders to participate in
pre -arrest diversion programs, post -overdose response
teams, or similar strategies that connect at -risk individuals
to behavioral health services and supports.
H. EXPANDING SYRINGE SERVICE PROGRAMS
1. Provide comprehensive syringe services programs with
more wrap-around services, including linkage to OUD
treatment, access to sterile syringes and linkage to care and
treatment of infectious diseases.
I. EVIDENCE -BASED DATA COLLECTION AND
RESEARCH ANALYZING THE EFFECTIVENESS OF THE
ABATEMENT STRATEGIES WITHIN THE STATE
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Schedule B
Approved Uses
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:
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, those that:15
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. Provide 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.
Support evidence -based withdrawal management services for people with OUD
and any co-occurring mental health conditions.
15 As used in this Schedule B, words like "expand," "fund," "provide" or the like shall not indicate a preference for
new or existing programs.
E-4
8. Provide 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. Offer fellowships for addiction medicine specialists for direct patient care,
instructors, and clinical research for treatments.
11. Offer scholarships and supports for behavioral health practitioners or workers
involved in addressing OUD and any co-occurring SUD/MH 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. Disseminate 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. Develop and disseminate 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 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 programs or strategies that:
I. 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.
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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 mediation with other support services.
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. Provide 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 are 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, those that:
E-6
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 SBIRT programs to reduce the transition from use to disorders, including
SBIRT services to pregnant women who are uninsured or not eligible for
Medicaid.
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. Provide 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/MI-I
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.
E-7
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 system through evidence -based or evidence -informed programs or
strategies that may include, but are not limited to, those that:
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:
Self -referral strategies such as the Angel Programs or the Police Assisted
Addiction Recovery Initiative ("PAART');
2. Active outreach strategies such as the Drug Abuse Response Team
("DART') model;
"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;
4. Officer prevention strategies, such as the Law Enforcement Assisted
Diversion ("LEAD") model;
5. Officer intervention strategies such as the Leon County, Florida Adult
Civil Citation Network or the Chicago Westside Narcotics Diversion to
Treatment Initiative; or
6. 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.
E-8
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 or 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 ("CTP'), 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.
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.
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, those that:
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.
Provide training for obstetricians or other healthcare personnel who 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; and
expand long-term treatment and services for medical monitoring of NAS babies
and their families.
E-9
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 NAS get referred to appropriate services and receive a plan of safe care.
6. Provide child and family supports for parenting women with OUD and any co-
occurring SUD/MH conditions.
7. Provide enhanced family support 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/M11 conditions, including, but not limited to, parent skills
training.
10. Provide support for Children's Services—Fund additional positions and services,
including supportive housing and other residential services, relating to children
being removed from the home and/or placed in foster care due to custodial opioid
use.
PART TWO: PREVENTION
F. PREVENT OVER -PRESCRIBING AND ENSURE APPROPRIATE
PRESCRIBING AND DISPENSING OF OPIOIDS
Support efforts to prevent over -prescribing and ensure appropriate prescribing and
dispensing of opioids through evidence -based or evidence -informed programs or
strategies that may include, but are not limited to, the following:
Funding medical provider education and outreach regarding best prescribing
practices for opioids consistent with the 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. Providing Support for non -opioid pain treatment alternatives, including training
providers to offer or refer to multi -modal, evidence -informed treatment of pain.
5. Supporting enhancements or improvements to Prescription Drug Monitoring
Programs ("PDMPs"), including, but not limited to, improvements that:
E-10
1. Increase the number of prescribers using PDMPs;
2. 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
3. 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. Increasing electronic prescribing to prevent diversion or forgery.
8. Educating 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:
1. Funding 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. Funding community anti-drug coalitions that engage in drug prevention efforts.
6. Supporting 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").
Engaging non -profits and faith -based communities as systems to support
prevention.
E-11
8. Funding 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/M1I
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 another 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:
Increased 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, schools, community navigators and outreach
workers, persons being released from jail or prison, or other members of the
general public.
2. Public health entities providing free naloxone to anyone in the community.
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. Enabling school nurses and other school staff to respond to opioid overdoses, and
provide them with naloxone, training, and support.
5. Expanding, improving, or developing data tracking software and applications for
overdoses/naloxone revivals.
6. Public education relating to emergency responses to overdoses.
E-12
Public education relating to immunity and Good Samaritan laws.
8. Educating 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. Expanding access to testing and treatment for infectious diseases such as HIV and
Hepatitis C resulting from intravenous opioid use.
11. Supporting 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. Providing 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. Supporting screening for fentanyl in routine clinical toxicology testing.
PART THREE: OTHER STRATEGIES
I. MIRST RESPONDERS
In addition to items in section C, D and H relating to first responders, support the
following:
1. Education of 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.
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:
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
E-13
intervention services, and to support training and technical assistance and other
strategies to abate the opioid epidemic described in this opioid abatement strategy
list.
2. A dashboard to (a) share reports, recommendations, or plans to spend opioid
settlement funds; (b) to show how opioid settlement funds have been spent; (c) to
report program or strategy outcomes; or (d) to track, share or visualize key opioid -
or health-related indicators and supports as identified through collaborative
statewide, regional, local or community processes.
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, those that:
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:
I. 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.
3. Research on improved service delivery for modalities such as SBIRT that
demonstrate promising but mixed results in populations vulnerable to
opioid use disorders.
E-14
4. Research on novel harm reduction and prevention efforts such as the
provision of fentanyl test strips.
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.
E-15
EXHIBIT K
Subdivision farticination and Release Form
Governmental Entity: cityoratboto State: Texas
Authorized Signatory: Mayor Mark Allen
Address 1:200S Main street
Address 2: P.O. Box 826
City, State, Zip: Cibolo, Texas 7810B
Phone: 210-658-9900
Email: mallen@cibolotx.gov
The governmental entity identified above ("Governmental Enliq,"), in order to obtain and in
consideration for the benefits provided to the Governmental Entity pursuant to the Settlement
Agreement dated December 9, 2022 ("Walgreens Settlement"), and acting through the undersigned
authorized official, hereby elects to participate in the Walgreens Settlement, release all Released
Claims against all Released Entities, and agrees as follows.
L The Governmental Entity is aware of and has reviewed the Walgreens Settlement, understands
that all tennis in this Participation and Release Form have the meanings defined therein, and
agrees that by executing this Participation and Release Form, the Governmental Entity elects to
participate in the Walgreens Settlement and become a Participating Subdivision as provided
therein.
2. The Governmental Entity shall promptly, and in any event no later than 14 days after the
Reference Date and prior to the filing of the Consent Judgment, dismiss with prejudice any
Released Claims that it has filed. With respect to any Released Claims pending in /n re
Naliotml Prescription Opiate Litigation, MDL No. 2804, the Governmental Entity authorizes
the Plaintiffs' Executive Committee to execute and file on behalf of the Governmental Entity a
Stipulation of Dismissal with Prejudice substantially in the form found at
Mins://nationalopioidsettlemcnt.com.
3. The Governmental Entity agrees to the terms of the Walgreens Settlement pertaining to
Participating Subdivisions as defined therein.
4. By agreeing to the terms of the Walgreens Settlement and becoming a Releasor, the
Governmental Entity is entitled to the benefits provided therein, including, if applicable,
monetary payments beginning after the Effective Date.
5. The Governmental Entity agrees to use any monies it receives through the Walgreens
Settlement solely for the purposes provided therein.
WIN
6. The Governmental Entity submits to the jurisdiction of the court in the Governmental Entity's
state where the Consent Judgment is filed for purposes limited to that court's role as provided in,
and for resolving disputes to the extent provided in, the Walgreens Settlement. The
Governmental Entity likewise agrees to arbitrate before the National Arbitration Panel as
provided in, and for resolving disputes to the extent otherwise provided in, the Walgreens
Settlement.
7. The Govermnental Entity has the right to enforce tine Walgreens Settlement as provided therein.
8. The Governmental Entity, as a Participating Subdivision, hereby becomes a Releasor for all
purposes in the Walgreens Settlement, including without limitation all provisions of Section XI
(Release), and along with all departments, agencies, divisions, boards, commissions, districts,
instrumentalities of any kind and attorneys, and any person in their official capacity elected or
appointed to serve any of the foregoing and any agency, person, or other entity claiming by or
through any of the foregoing, and any other entity identified in the definition of Releasor,
provides for a release to the fullest extent of its authority. As a Releasor, the Governmental
Entity hereby absolutely, unconditionally, and irrevocably covenants not to bring, file, or
claim, or to cause, assist or permit to be brought, filed, or claimed, or to otherwise seek to
establish liability for any Released Claims against any Released Entity in any forum
whatsoever. The releases provided for in the Walgreens Settlement are intended by the Parties
to be broad and shall be interpreted so as to give the Released Entities the broadest possible bar
against any liability relating in any way to Released Claims and extend to the full extent of the
power of the Governmental Entity to release claims. The Walgreens Settlement shall be a
complete bar to any Released Claim.
9. The Governmental Entity hereby takes on all rights and obligations of a Participating
Subdivision as set forth in the Walgreens Settlement.
10. In connection with the releases provided for in the Walgreens Settlement, each Governmental
Entity expressly waives, releases, and forever discharges any and all provisions, rights, and
benefits conferred by any law of any state or territory of the United States or other jurisdiction,
or principle of common law, which is similar, comparable, or equivalent to § 1542 of the
California Civil Code, which reads:
General Release; extent. A general release does not extend to claims that the
creditor or releasing party does not know or suspect to exist in his or her favor
at the time of executing the release that, if known by him or her would have
materially affected his or her settlement with the debtor or released party.
A Releasor may hereafter discover facts other than or different from those which it knows,
believes, or assumes to be true with respect to the Released Claims, but each Governmental
Entity hereby expressly waives and fully, finally, and forever settles, releases and discharges,
upon the Effective Date, any and all Released Claims that may exist as of such date but which
Releasors do not know or suspect to exist, whether through ignorance, oversight, error,
negligence or through no fault whatsoever, and which, if known, would materially affect the
Governmental Entities' decision to participate in the Walgreens Settlement.
11. Nothing herein is intended to modify in any way the terms of the Walgreens Settlement, to
which Governmental Entity hereby agrees. To the extent this Participation and Release Form
is interpreted differently from the Walgreens Settlement in any respect, the Walgreens
Settlement controls.
I have all necessary power and authorization to execute this Participation and Release Form on
behalf of the Governmental Entity.
Signature:
Name: Mark Allen
Title: Mayor
Date:
FW.Tffrljm
Subdivision Particinatiou Form
Governmental Entity: city ofCibolo State: Texas
Authorized Official: Mayor Mark Allen
Address 1:200 S. Main Street
Address 2: P.O. Box 826
City, State, Zip: Cibolo, Texas 78108
Ph0ne: 210-658-9900
Emai I: mallenecibolotx.gov
The governmental entity identified above ("Governmental Entity"), in order to obtain and in
consideration for the benefits provided to the Governmental Entity pursuant to the Settlement
Agreement dated November 14, 2022 ("Walmart Settlement"), and acting through the undersigned
authorized official, hereby elects to participate in the Walnlart Settlement, release all Released Claims
against all Released Entities, and agrees as follows.
1. The Governmental Entity is aware of and has reviewed the Walnlart Settlement, understands
that all terms in this Election and Release have the meanings defined therein, and agrees that
by this Election, the Governmental Entity elects to participate in the Walmart Settlement and
become a Participating Subdivision as provided therein.
2. The Governmental Entity shall promptly, and in any event within 14 days of the Effective
Date and prior to the filing of the Consent Judgment, dismiss with prejudice any Released
Claims that it has filed. With respect to any Released Claims pending in In re National
Prescription Opiate Litigation, MDL No. 2804, the Governmental Entity authorizes the
Plaintiffs' Executive Committee to execute and file on behalf of the Governmental Entity a
Stipulation of Dismissal With Prejudice substantially in the form found at
httns://nat ionalopioidsettlenlent.com/.
3. The Governmental Entity agrees to the terms of the Walmart Settlement pertaining to
Subdivisions as defined therein.
4. By agreeing to the terms of the Walmart Settlement and becoming a Releasor, the
Governmental Entity is entitled to the benefits provided therein, including, if applicable,
monetary payments beginning after the Effective Date.
5. The Governmental Entity agrees to use any monies it receives through the Walnlart
Settlement solely for the purposes provided therein.
6. The Governmental Entity submits to the jurisdiction of the court in the Governmental
Entity's state where the Consent Judgment is filed for purposes limited to that court's role
as provided in, and for resolving disputes to the extent provided in, the Walmart
Settlement,
7. The Governmental Entity has the right to enforce the Walmart Settlement as provided
therein.
8. The Governmental Entity, as a Participating Subdivision, hereby becomes a Releasor for all
purposes in the Walmart Settlement, including but not limited to all provisions of Section X
(Release), and along with all departments, agencies, divisions, boards, commissions, districts,
instrumentalities of any kind and attorneys, and any person in their official capacity elected
or appointed to serve any of the foregoing and any agency, person, or other entity claiming
by or through any of tite foregoing, and any other entity identified in the definition of
Releasor, provides for a release to the fullest extent of its authority. As a Releasor, the
Governmental Entity hereby absolutely, unconditionally, and irrevocably covenants not to
bring, file, or claim, or to cause, assist or permit to be brought filed, or claimed, or to
otherwise seek to establish liability for any Released Claims against any Released Entity in
any forum whatsoever. The releases provided for in tine Walmart Settlement are intended by
the Parties to be broad and shall be interpreted so as to give the Released Entities the broadest
possible bar against any liability relating in any way to Released Claims and extend to the
full extent of the power of the Governmental Entity to release claims. The Walmart
Settlement shall be a complete bar to any Released Claim.
9. In connection with the releases provided for in the Walmart Settlement, each
Governmental Entity expressly waives, releases, and forever discharges any and all
provisions, rights, and benefits conferred by any late of any state or territory of the
United States or otherjurisdiction, or principle of common law, which is similar,
comparable, or equivalent to § 1542 of the California Civil Code, which reads:
General Release; extent. A general release does not extend to claims that the
creditor or releasing party does not know or suspect to exist in his or her favor at tine
time of executing the release that, if known by him or her, would have materially
affected his or her settlement with the debtor or released party.
A Releasor may hereafter discover facts other than or different from those which it knows,
believes, or assumes to be true with respect to the Released Clahns, but each Governmental
Entity hereby expressly waives and fully, finally, and forever settles, releases and discharges,
upon the Effective Date, any and all Released Claims that may exist as of such date but which
Releasors do not know or suspect to exist, whether through ignorance, oversight, error,
negligence or through no fault whatsoever, and which, if known, would materially affect the
Governmental Entities' decision to participate in the Walmart Settlement.
10. Nothing herein is intended to modify in any way the terms of the Walmart Settlement, to
which Governmental Entity hereby agrees. To the extent this Election and Release is
interpreted differently from the Walmart Settlement in any respect, the Walmart Settlement
controls.
I have all necessary power and authorization to execute this Election and Release on behalf of the
Governmental Entity.
Signature:
Nance: Mark Man
Title:
Date:
EXHIBIT K
Subdivision and Special District Settlement Participation Fmvn
Governmental Entity: Cityotcibolo State: Texas
Authorized Signatory: Mayor Mark Allen
Address 1:200 S. Main Street
Address 2: P.O. Box 826
City, State, Zip: Cibolo, Texas 78108
Phone: 210-658-9900
Entail: mallen@cibolotx.gov
The governmental entity identified above ("Governmental Lntilp"), in order to obtain and in
consideration for the benefits provided to the Governmental Entity pursuant to the Agreement dated
November 22, 2022 ("Allergan Settlement'), and acting through the undersigned authorized official,
hereby elects to participate in the Allergan Settlement, release all Released Claims against all Released
Entities, and agrees as follows.
1. The Governmental Entity is aware of and has reviewed the Allergan Settlement, understands
that all terms in this Election and Release have the meanings defined therein, and agrees that
by this Election, the Governmental Entity elects to participate in the Allergan Settlement as
provided therein.
2. Following the execution of this Settlement Participation Form, the Governmental Entity shall
comply with Section IILB of the Allergan Settlement regarding Cessation of Litigation
Activities.
3. The Governmental Entity shall, within fourteen (14) days of the Reference Date and prior to
the filing of the Consent Judgment, file a request to dismiss with prejudice any Released
Claims that it has filed. With respect to any Released Claims pending in In re National
Prescription Opiate Litigation, MDL No. 2804, the Governmental Entity authorizes the MDL
Plaintiffs' Executive Committee to execute and file on behalf of the Governmental Entity a
Stipulation of Dismissal With Prejudice substantially in the form found at
httos:Hnationalopioidsett lem ent.cont.
4. The Governmental Entity agrees to the terms of the Allergan Settlement pertaining to
Subdivisions and Special Districts as defined therein.
5. By agreeing to the terms of the Allergan Settlement and becoming a Releasor, the
Governmental Entity is entitled to the benefits provided therein, including, if applicable,
monetary payments beginning atter the Effective Date.
6. The Governmental Entity agrees to use any monies it receives through the Allergan Settlement
solely for the purposes provided therein.
o
7. The Governmental Entity submits to the jurisdiction of the court in the Governmental Entity's
state where the Consent Judgment is filed for purposes limited to that court's role as provided
in, and for resolving disputes to the extent provided in, the Allergan Settlement.
8. The Governmental Entity has tite right to enforce the Allergan Settlement as provided therein.
9. The Governmental Entity, as a Participating Subdivision or Participating Special District,
hereby becomes a Releaser for all purposes in the Allergan Settlement, including, but not
limited to, all provisions of Section V (Release), and along with all departments, agencies,
divisions, boards, commissions, Subdivisions, districts, instrumentalities of any kind and
attorneys, and any person in their official capacity whether elected or appointed to serve any of
the foregoing and any agency, person, or other entity claiming by or through any of the
foregoing, and any other entity identified in the definition of Releasor, provides for a release to
the fullest extent of its authority. As a Releasor, the Governmental Entity hereby absolutely,
unconditionally, and irrevocably covenants not to bring, file, or claim, or to cause, assist in
bringing, or permit to be brought, filed, or claimed, or to otherwise seek to establish liability
for any Released Claims against any Released Entity in any forum whatsoever. The releases
provided for in the Allergan Settlement are intended to be broad and shall be interpreted so as
to give tine Released Entities the broadest possible bar against any liability relating in any way
to Released Claims and extend to the full extent of the power of the Governmental Entity to
release claims. The Allergan Settlement shall be a complete bar to any Released Claim.
10. The Governmental Entity hereby takes on all rights and obligations of a Participating
Subdivision or Participating Special District as set forth in the Allergan Settlement.
11. In connection with the releases provided for in the Allergan Settlement, each Governmental
Entity expressly waives, releases, and forever discharges any and all provisions, rights, and
benefits conferred by any law of any state or territory of the United States or other jurisdiction,
or principle of common law, which is similar, comparable, or equivalent to § 1542 of tine
California Civil Code, which reads:
General Release; extent. A general release does not extend to claims that the
creditor or releasing party does not know or suspect to exist in his or her favor
at tine time of executing the release that, if known by him or her, would have
materially affected his or her settlement with the debtor or released party.
A Releasor may hereafter discover facts other than or different from those which it knows,
believes, or assumes to be true with respect to the Released Claims, but each Governmental
Entity hereby expressly waives and fully, finally, and forever settles, releases and discharges,
upon the Effective Date, any and all Released Claims that may exist as of such date but which
Releasors do not know or suspect to exist, whether through ignorance, oversight, error,
negligence or through no fault whatsoever, and which, if known, would materially affect the
Governmental Entities' decision to participate in the Allergan Settlement.
12, Nothing herein is intended to modify in any way the terms of the Allergan Settlement, to
which the Governmental Entity hereby agrees. To the extent this Settlement Participation
Form is interpreted differently from the Allergan Settlement in any respect, the Allergan
Settlement controls.
2 e
0
I have all necessary power and authorization to execute this Settlement Participation Form on behalf
of the Governmental Entity.
Signature:
Name: Mark Allen
Title: Mayor
Date:
RXHIBIT K
Subdivision Participation and Release Form
Governmental Entity: City ofCibolo State: Texas
Authorized Signatory: Mayor Mark Allen
Address 1:200 S. Main street
Address 2: P.G. Box 826
City, State, Zip: Cibolo, Texas 78108
Phone: 210-658-9900
Entail: mallen@cibolotx.gov
The governmental entity identified above ("Governmental Entity"), in order to obtain and in
consideration for the benefits provided to the Governmental Entity pursuant to the Settlement
Agreement dated December 9, 2022 ("CVS Setllemeni"), and acting through the undersigned authorized
official, hereby elects to participate in the CVS Settlement, release all Released Claims against all
Released Entities, and agrees as follows.
I. The Governmental Entity is aware of and has reviewed the CVS Settlement, understands that all
terms in this Participation and Release Form have the meanings defined therein, and agrees that
by executing this Participation and Release Form, the Governmental Entity elects to participate
in the CVS Settlement and become a Participating Subdivision as provided therein.
2. The Governmental Entity shall promptly, and in any event no later than 14 days after the
Reference Date and prior to the filing of (lie Consent Judgment, dismiss with prejudice any
Released Claims that it has filed. With respect to any Released Claims pending in /n re
National Prescription Opiate Litigation, MDL No. 2804, the Governmental Entity authorizes
the Plaintiffs' Executive Committee to execute and file on behalf of the Governmental Entity a
Stipulation of Dismissal with Prejudice substantially in the form found at
lilt ps://nationalopioidsettlennent conn.
3. The Governmental Entity agrees to the terms of the CVS Settlement pertaining to Participating
Subdivisions as defined therein.
4. By agreeing to the terms of the CVS Settlement and becoming a Releasor, the Governmental
Entity is entitled to the benefits provided therein, including, if applicable, monetary payments
beginning after the Effective Date.
5. The Governmental Entity agrees to use any monies it receives through the CVS Settlement
solely for the purposes provided therein.
6. The Governmental Entity submits to the jurisdiction of the court in the Governmental Entity's
state where the Consent Judgment is filed for purposes limited to that court's role as provided in,
and for resolving disputes to the extent provided in, the CVS Settlement. The Governmental
Entity likewise agrees to arbitrate before the National Arbitration Panel as provided in, and for
resolving disputes to the extent otherwise provided in, the CVS Settlement.
7. The Governmental Entity has the right to enforce the CVS Settlement as provided therein.
8. The Governmental Entity, as a Participating Subdivision, hereby becomes a Releasor for all
purposes in the CVS Settlement, including without limitation all provisions of Section XI
(Release), and along with all departments, agencies, divisions, boards, commissions, districts,
instrumentalities of any kind and attorneys, and any person in their official capacity elected or
appointed to serve any of the foregoing and any agency, person, or other entity claiming by or
through any of the foregoing, and any other entity identified in the definition of Releasor,
provides for a release to the tallest extent of its authority. As a Releasor, the Governmental
Entity hereby absolutely, unconditionally, and irrevocably covenants not to bring, file, or
claim, or to cause, assist or permit to be brought, filed, or claimed, or to otherwise seek to
establish liability for any Released Claims against any Released Entity in any forum
whatsoever. The releases provided for in the CVS Settlement are intended by the Patties to be
broad and shall be interpreted so as to give the Released Entities the broadest possible bar
against any liability relating in any way to Released Claims and extend to the full extent of the
power of the Governmental Entity to release claims. The CVS Settlement shall be a complete
bar to any Released Claim.
9. The Governmental Entity hereby takes on all rights and obligations of a Participating
Subdivision asset foth in the CVS Settlement.
10. In connection with the releases provided for in the CVS Settlement, each Governmental Entity
expressly waives, releases, and forever discharges any and all provisions, rights, and benefits
conferred by any law of any state or territory of the United States or other jurisdiction, or
principle of common law, which is similar, comparable, or equivalent to § 1542 of the
California Civil Code, which reads:
General Release; extent. A general release does not extend to claims that
the creditor or releasing party does not know or suspect to exist in his or her
favor at the time of executing the release that, if known by him or her would
have materially affected his or her settlement with the debtor or released
ply.
A Releasor may hereafter discover facts other than or different from those which it knows,
believes, or assumes to be true with respect to the Released Claims, but each Governmental Entity
hereby expressly waives and fully, finally, and forever settles, releases and discharges, upon the
Effective Date, any and all Released Claims that may exist as of such date but which Releasors do
not know or suspect to exist, whether through ignorance, oversight, error, negligence or through no
fault whatsoever, and which, if known, would materially affect the Governmental Entities'
decision to participate in the CVS Settlement.
l 1. Nothing herein is intended to modify in any way the terms of the CVS Settlement, to which
Governmental Entity hereby agrees. To the extent this Participation and Release Form is
interpreted differently from the CVS Settlement in any respect, the CVS Settlement controls.
I have all necessary power and authorization to execute this Participation and Release Form on
behalf of the Govermuental Entity.
Signature:
Name: Mark Allen
Title: Mayor
Date: