Polk County outlines $9.9M on-hand opioid settlement plan and moves to adopt county naloxone policy

Polk County Behavioral Health staff presented the Board of Supervisors with an update on opioid settlement funds and proposed a county policy to make naloxone widely available in county buildings.

Gabby, a Polk County Behavioral Health & Disability Services (BHDS) staff member, told supervisors the county currently has $9,900,000 on hand in opioid settlement funds and is projected to receive $32,000,000 “by FY 40,” figures she said came from the auditor’s office. Gabby said Polk County’s settlement dollars are separate from any state-administered funds and must be spent on remediation strategies — i.e., evidence-based programs that help people with substance use disorders or co-occurring disorders.

Gabby outlined near-term and FY26 program proposals including:

- A temporary housing assistance program (stakeholder-recommended) proposed at $1,000,000 to pay short-term rent for people entering substance-use treatment; county staff estimated the fund would cover roughly 200 people if the assistance averaged two months’ rent per person, though the presenter did not provide a formal rent-average calculation at the meeting.

- An Overdose Response Team to coordinate post-overdose outreach across Polk County in partnership with the Des Moines Fire Department and Full Circle Recovery Community Center; the proposed team would go to residences after nonfatal overdoses to offer rapid connection to treatment and medications.

- A reentry kiosk pilot with St. Vincent de Paul to reach people released from jail (staff noted roughly half of the county jail population turns over within 24 hours), offering navigation to housing, treatment and employment services.

- Expansion of medication-assisted treatment (medications for opioid use disorder) in the jail to connect people to ongoing care after release; staff said this is considered an evidence-based treatment that reduces recidivism and saves lives.

- Grant cycles: a two-year ‘‘supports for people with lived experience’’ grant ($100,000 per year, $200,000 total per award) that, in the prior cycle, grantees reported reaching more than 1,300 people in their first three months; and a youth prevention grant focused on fourth- through eighth-grade programming, paired with technical assistance from the Prevention Science Collaborative at Iowa State University.

Gabby also described ongoing overdose prevention work supported with county funds: she said Steps of Hope Iowa has placed naloxone boxes around the county (18 boxes placed since August) and distributed about 3,000 doses of naloxone. The county is funding expansions of harm-reduction activities and a health-department vending machine pilot that would dispense naloxone and other supplies; successful models would be duplicated with settlement funds.

On funding cadence, Gabby said Polk County expects to receive at least $2,000,000 per year but that payments and totals depend on national settlements and court schedules: “We just have to wait and see what the courts decide there,” she said.

Naloxone policy proposal: separate from the settlement spending plan, BHDS proposed a county policy to make naloxone available in county workplaces. Key elements described at the meeting included:

- Voluntary administration: trained county employees would be allowed, but not required, to use naloxone on someone they believed was experiencing an opioid overdose.

- Reporting and stock management: if an employee uses naloxone, staff must report the event to the county locksmith coordinator (identified at the meeting as Rodney) to create a record. Naloxone kits would be housed with AED machines; General Services would visually check that kits are present during regular AED inspections and notify Rodney if supplies are missing.

- Training and public distribution: the county would offer optional lunch-and-learn sessions and online training for employees. The policy also includes a clause allowing county staff to distribute naloxone to the public for free through an HHS program (state-supplied naloxone is provided at no cost, per staff).

Staff estimated a one-time cost of about $1,500 for pouches, stickers and CPR masks to assemble the AED naloxone kits; ongoing replacement costs would be minimal (staff estimated under $50 per year). Gabby said the one-time and ongoing costs could be paid from opioid settlement dollars because naloxone is an approved use.

Legal and rollout questions: staff and a county attorney advisor referenced Iowa Code chapter 135 as providing liability protections for individuals and organizations administering naloxone. Rodney (identified in the presentation as the locksmith coordinator) and risk-management staff were present to discuss logistics. Gabby said the county has ordered state-provided naloxone and that distribution to buildings could begin once supplies arrive; she estimated a practical rollout window of about six weeks but noted the county is dependent on the state’s schedule for shipping supplies. The proposed naloxone policy will be brought to the board as a resolution for formal action in a forthcoming meeting.

No formal board votes on settlement spending allocations or the naloxone policy were recorded during the update. Supervisors asked about coordination with the Criminal Justice Coordinating Council and state funding streams; staff said they will present to CJCC stakeholders to avoid duplication and will continue to pursue federal and state grants to supplement settlement funds.

The county posted a strategic plan and grant updates on the Polk County BHDS opioid settlement web page; Gabby told supervisors that the county will continue to update the board and community stakeholders as programs are developed and funded.