Baltimore City Council Public Health and Environment Committee Chair Felicia Porter convened a legislative oversight hearing focused on the city's response to a series of mass overdose events centered in the Penn North neighborhood, asking city agencies for timelines, data-sharing updates and operational improvements after incidents in July and October.

The hearing opened with public comment from Darcy of the Baltimore Harm Reduction Coalition, who described outreach in Penn North and urged continued harm-reduction services and “acute rapid response” measures. "These events are traumatic," Darcy said, and she urged continued distribution of naloxone, testing and wraparound services.

Deputy Mayor for Health and Human Services Dr. Leticia DeRaza and Baltimore City Health Commissioner Dr. Michelle Taylor presented a timeline of three mass-overdose incidents that the city is treating as related: July 10, July 18 and Oct. 8. Officials said EMS received the first July 10 call about 9:20 a.m.; in that incident roughly 27 people were transported by EMS, five patients were triaged by an on-site mobile medical unit, three declined transport, seven were classified priority 1 (required ventilation after naloxone), about 15 were priority 2 (unconscious or semi-conscious after naloxone) and about five were priority 3 (regained consciousness after naloxone).

Toxicology results collected by the health department and Baltimore Police Department indicated a mix that included acetaminophen, caffeine, fentanyl, mannitol, methyl clonazepam (a benzodiazepine) and quinine. Officials said the presence of methyl clonazepam may explain why some people had atypical or poor responses to naloxone. "Methyl clonazepam ... can cause respiratory depression, which explains why some individuals were not so responsive to naloxone," DeRaza said.

The agencies described an immediate and sustained response after July 10. From July 10 to July 25 the city said it mobilized more than 500 volunteers from about 30 organizations and distributed more than 4,000 naloxone kits, roughly 2,500 fentanyl test strips and about 750 xylazine test strips, along with hygiene and wound-care kits and food and cooling buses. Officials also described field coordination sites established at the Enoch Pratt Library and use of the Health Care on the Spot mobile unit (a health department-Johns Hopkins partnership) to provide on-site care, triage and referral.

Dr. Taylor said a draft Mass Overdose Rapid Response Protocol is in development and summarized its planned components: an activation threshold under discussion (roughly five overdoses in a defined area and time frame, with local adjustments), coordinated incident command and partial Emergency Operations Center activation, medical monitoring, sustained canvassing and outreach (volunteers in shifts, roughly 9 a.m.–9 p.m.), real-time data collection and a public communications strategy that emphasizes harm reduction and Good Samaritan protections. She said OEM (the Office of Emergency Management) would lead logistics and that outreach would transition to a community partner called Monsey for longer-term engagement. Taylor described post-incident "hot washes" held to identify strengths and areas for improvement.

Officials detailed additional steps the city has taken or announced: a Naloxone Neighbors train-the-trainer program launched on Overdose Awareness Day; a pending partnership among the city, MTA and the Maryland Peer Advisory Council to expand naloxone access (to be announced by the mayor); and a Restitution Advisory Board (RAB) community-grants competitive process. RAB released an RFP planned for Oct. 23 focused on low-barrier mobile treatment, low-barrier harm reduction services and low-barrier social supports; initial proposals are due Nov. 23, with final applications due Jan. 23 or Jan. 26, according to officials.

Council members pressed health officials on several operational gaps. Chair Felicia Porter asked for an estimated completion date for the mass-overdose protocol; DeRaza said the draft existed and staff would provide a date to the committee, and Porter said she hoped the protocol would be completed and move to implementation by the end of the year. Porter also requested monthly status updates on negotiations to update data-use agreements with the Maryland Department of Health so the city can disseminate fatal and nonfatal overdose information more quickly.

Councilman Mark Conway and others asked about a public or community alert system. Officials said internal notifications to responding agencies and hospitals are routine; the city is exploring a public alert system carefully to avoid retraumatizing residents and to ensure messages are clear and harm-reduction oriented. Conway requested a 30-day follow-up on plans for a notification system; the committee asked staff to provide a status update.

Council members and attendees also discussed expanding low-barrier treatment access at overdoses. The Health Care on the Spot team said it provides telemedicine and on-site treatment options and that on Oct. 8 the Spot Van and telemedicine pathway were available for some people. Several council members asked whether buprenorphine could be offered immediately after naloxone reversal; Health Care on the Spot staff described telemedicine connections and said the van has provided on-the-spot treatment in some responses, but members noted existing constraints on EMS protocols and state approvals for administering buprenorphine immediately after naloxone.

Committee members also raised nonclinical drivers of risk: vacant property cleanup, housing availability for people completing treatment, neighborhood stabilization and the sustainability of multi-agency "blitzes." Council members pushed for stronger coordination with DHCD (housing) and with state partners to review prescribing and treatment-provider quality. Deputy Mayor DeRaza and other agency leads said they are engaging those partners and will provide more detail in follow-up briefings.

The committee recorded several formal staff-direction requests but no votes. Chair Porter asked for a date for the Mass Overdose Rapid Response Protocol and monthly updates on the MDH data-use agreements. Councilman Conway asked for a 30-day update on the public/peer notification system. Councilman Torrance requested month-over-month status reports on plans for 24/7 mobile outreach. Officials said they would return with timelines and monthly status updates where requested.

The meeting closed with a resident's testimony from Thelma Davis, who described running a licensed residential recovery program and urged more housing paths for people completing treatment. Committee members acknowledged housing as a central, long-term element of overdose-prevention strategy.

The oversight hearing produced an operational checklist for agencies rather than new ordinances: complete and share the Mass Overdose Rapid Response Protocol timeline; finalize data-use agreements with the state to support more timely information-sharing; evaluate public alert options that emphasize harm reduction and minimize trauma; and develop a plan for sustained, 24/7 outreach and permanent neighborhood stabilization rooted in housing and anti-displacement strategies.

A follow-up oversight hearing was requested to review measurable outcomes and the data supporting the overdose-response strategy.