Special Notice / Hearing: None__
Vote Required: Majority
To: Honorable Board of Supervisors
From: John L. Maltbie, County Manager
Subject: Board of Supervisors’ Response to the 2017-2018 Civil Grand Jury Report, “Law Enforcement Officers + Narcan = Lives Saved From Opioid Overdoses”
RECOMMENDATION:
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Approve the Board of Supervisors’ response to the 2017-2018 Grand Jury Report, “Law Enforcement Officers + Narcan = Lives Saved From Opioid Overdoses.”
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BACKGROUND:
On June 28, 2018, the 2017-2018 San Mateo County Civil Grand Jury issued a report titled “Law Enforcement Officers + Narcan = Lives Saved From Opioid Overdoses.” The Board of Supervisors is required to submit comments on the findings and recommendations pertaining to the matters over which it has some decision making authority within 90 days. The Board’s response to the report is due to the Honorable V. Raymond Swope no later than September 26, 2018.
DISCUSSION:
The Grand Jury made eight findings and four recommendations in its report. The Board responses follow each finding and the eight recommendations that the Grand Jury requested that the Board respond to within 90 days.
FINDINGS
Finding 1:
Untreated opioid overdose can cause brain damage and death.
Response:
The respondent agrees with the finding.
Finding 2:
Naloxone is a safe, nontoxic drug that can stop and reverse the effects of opioid
overdose.
Response:
The respondent agrees with the finding.
Finding 3:
Narcan® is a brand of intranasal naloxone, which can be successfully administered with no more than one hour of training.
Response:
The respondent agrees with the finding.
Finding 4:
Fire department and ambulance paramedics are the only emergency responders within
the County currently carrying naloxone.
Response:
The respondent disagrees with the finding. Law enforcement personnel assigned to the San Mateo County Narcotics Task Force, the Sheriff’s Crime Suppression Unit (gangs and street drugs) and the Vehicle Theft Task Force currently carry naloxone.
Finding 5:
Law enforcement officers may arrive at the scene of opioid overdose before paramedics.
Response:
The respondent agrees with the finding.
Finding 6:
Law enforcement officers’ risk of accidental exposure to fentanyl derivatives varies based on their roles and responsibilities. Narcotics units, crime suppression units, SWAT teams, K-9 units, and evidence-handling units are at a heightened risk of exposure.
Response:
The respondent agrees with the finding.
Finding 7:
Certain law enforcement officers and Sheriff’s Forensic Lab and Coroner’s Office personnel are at heightened risk of exposure to fentanyl derivatives.
Response:
The respondent agrees with the finding.
Finding 8:
Equipping and training officers with intranasal naloxone is inexpensive and the associated costs can be absorbed into existing programs and budgets.
Response:
The respondent partially disagrees with the finding. The preliminary estimate for equipping all law enforcement personnel in the San Mateo County Sheriff’s Office is $50,000.
RECOMMENDATIONS
Recommendation 1:
Train and equip law enforcement officers at heightened risk of exposure to fentanyl derivatives with intranasal naloxone as a minimum standard of practice.
Response:
The San Mateo County Sheriff’s Office has developed policy, trained, and equipped our personnel working assignments with a heightened risk of exposure to fentanyl derivatives with intranasal naloxone. These assignments include sworn personnel assigned to the San Mateo County Narcotics Task Force, the Sheriff’s Crime Suppression Unit (gangs and street drugs) and the Vehicle Theft Task Force.
Further, we have naloxone available to both staff and inmates through Correctional Health Services. Naloxone is currently deployed in three locations in Corrections.
1. The nurse’s station at Intake at the Maguire Correctional Facility
2. The medical “crash cart” at the Maguire Correctional Facility
3. The medical “crash cart” at the Maple Street Correctional Center
As a point in reference, a “crash cart” is a medical term used in hospitals for a cart containing various emergency medicine and equipment that nurses deploy during medical emergencies. Medical personnel are on duty 24 hours a day in both Correctional Facilities.
Recommendation 2:
Evaluate training and equipping all law enforcement officers with intranasal naloxone in order to protect themselves and the general public.
Response:
The San Mateo County Sheriff’s Office has completed its evaluation and will begin the process of training and equipping all law enforcement officers in the agency with intranasal naloxone.
Recommendation 3:
Train and equip Coroner’s Office personnel at a heightened risk of exposure to fentanyl derivatives with intranasal naloxone.
Response:
The recommendation has not yet been implemented, but will be implemented in the future. The Office of the Coroner agrees that personnel at a heightened risk of exposure to fentanyl derivatives should be equipped with intranasal naloxone; however, the response vehicles driven by personnel and the locations where they usually congregate and work would need to be additionally equipped with AED devices. The procurement of at least 8 AED devices to accompany at least 9 naloxone kits would burden the Office of the Coroner’s budget. As a result, the Office of the Coroner will research funding opportunities to alleviate the cost of acquiring the naloxone and AED devices.
Recommendation 4:
Train and equip Sheriff’s Forensic Lab personnel at a heightened risk of exposure to fentanyl derivatives with intranasal naloxone.
Response:
The San Mateo County Sheriff’s Office will train and equip Sheriff’s Forensic Lab personnel with intranasal naloxone by December 31, 2018.
Acceptance of the report contributes to the Shared Vision 2025 outcome of a Collaborative Community by ensuring that all Grand Jury findings and recommendations are thoroughly reviewed by the appropriate County departments and that, when appropriate, process improvements are made to improve the quality and efficiency of services provided to the public and other agencies.
FISCAL IMPACT:
There is no Net County Cost associated with accepting this report.