Public Safety Committee Special Meeting - April 21, 2023

The San Diego City Council Public Safety Committee held a special meeting on April 21, 2023, at 9:00 a.m. (PDT) to discuss two agenda items: an amendment to the city's emergency ambulance service contract with Falk Mobile Health, and a report from the Independent Budget Analyst (IBA) on options to combat the illicit fentanyl crisis using opioid settlement funds. The meeting was chaired by Councilmember von Wilpert, with Councilmembers Campbell, Campillo, and Vice Chair Montgomery Steppe present. The committee approved the consent calendar (minutes of March 15, 2023) unanimously.

Consent Calendar

• Approval of the committee actions from March 15, 2023, passed unanimously.

Public Comments & Testimony

Non-Agenda Public Comment:

• Barbara Gordon, a public health educator, expressed concern about marijuana products appealing to children, citing a surge in marijuana poisoning at Rady Children's Hospital. She urged the committee to consider regulations prohibiting sales of products resembling conventional candy or foods.
• Blair Beekman commented on unhoused issues, federal funding for sewer projects, and smart meters for water utilities, advocating for open communication and trust in government processes.
• Judy Strang, a parent advocate and social worker, highlighted a National Safety Council study on marijuana-impaired driving and employer responsibilities regarding marijuana addiction treatment.

Public Comment on Agenda Item 1 (Falk Amendment):

• Tony Sorcy, president of the Association of Pre-Hospital Professionals (STAP), expressed support for the amendment, noting it enables a three-year successor contract with competitive wages and benefits for EMS workers.
• Josue Castro, from Casa Familiar, supported Falk, citing their community engagement in San Ysidro, including CPR training and scholarships for EMTs.
• Troy Hagen, Chief Commercial Officer for Falk USA, committed to improving service, acknowledged staffing shortages, and submitted letters of support from the American Red Cross, Casa Familiar, the American Lung Association, and San Diego Pride.
• Bob Ilko, from the Scripps Ranch Civic Association, supported the amendment, noting the need for compromise and flexibility in the contract.
• A virtual caller, Jason Yata, thanked the committee and praised the amendment for increasing city oversight.
• Blair Beekman noted Falk's operations in San Jose as a potential model.

Public Comment on Agenda Item 2 (Fentanyl Crisis):

• Blair Beekman raised concerns about possible fentanyl distribution by police officers and urged review and better access to fentanyl test strips.
• A public health educator (unnamed) argued that marijuana is a gateway to opioid use, citing experts and urging potency caps as a low-cost abatement measure.

Discussion Items

Item 1: Amendment to the Contract with Falk Mobile Health Fire Chief Colin Stowell and Deputy Chief Jody Pierce presented the first amendment to the city's emergency ambulance service contract. The amendment allows subcontracting with another accredited provider to increase ambulance staffing hours up to the contracted median of 900 advanced life support hours per day, requires Falk to maintain a minimum of 780 hours per day (5,460 per week) or face penalties, and provides temporary relief from response-time penalties to offset subcontracting costs. The city aims to move toward an alliance model with multiple providers. Discussion included:

• Chair von Wilpert emphasized the need for rapid implementation and continued monthly monitoring.
• Councilmember Campbell expressed frustration with the contract's shortfalls but supported the amendment due to benefits for STAP workers and the need for additional hours.
• Councilmember Campillo questioned the penalty abatement structure: penalties are held in abeyance if Falk meets the 780-hour floor and subcontracts for as many additional hours as possible, even if the 900-hour target is not reached. He stressed the importance of realistic contracting and oversight.
• Vice Chair Montgomery Steppe sought clarity on past penalties and their use, noting concerns about setting a precedent for penalty abatement and budget impacts.
• The committee approved the motion to send the amendment to full city council (unanimous).

Item 2: IBA Response to Options to Combat the Illicit Fentanyl Crisis IBA analysts Baku Patel and Amy Lee presented report 23-06, summarizing the fentanyl crisis: 383 overdose deaths in San Diego City in 2021 (27.1 per 100,000), with African Americans disproportionately affected (66.9 per 100,000) and homeless individuals comprising 30% of fatalities. The city expects up to $40 million over 18 years from opioid settlements, with $4.4 million already received. The IBA reviewed existing programs (PLEDS, RAP, low-barrier shelters, naloxone distribution) and stakeholder input, identifying five key findings: adequate naloxone access, improved data tracking, but also limited timely access to drug treatment (no residential detox beds within city), barriers from state law changes (Prop 47, AB 3234), and secondary impacts like staff burnout. Recommendations fell into three levers: prevention, treatment, and law enforcement, each with trade-offs. The IBA advised adhering to Johns Hopkins principles, spending funds as collected, complementing county efforts, and using data to inform decisions. Committee members discussed:

• Chair von Wilpert announced a community listening session on May 10, 2023, and emphasized using funds for new programs rather than offsetting existing costs.
• Councilmember Campillo agreed that settlement funds should be used for enhanced services, not just plugging budget holes.
• Vice Chair Montgomery Steppe highlighted youth prevention and racial equity, noting the high rate of Black overdose deaths.
• Councilmember Campbell emphasized treatment access and the success of the harm reduction shelter, also stressing law enforcement partnerships and broader societal uplift.

Key Outcomes

• Item 1 (Falk Amendment): The committee voted unanimously (4-0) to approve the staff recommendation and forward the amendment to the full city council for consideration. The implementation timeline targets mid-May 2023 for council approval, with subcontracting to begin immediately thereafter. A second amendment to transition to an alliance model is expected by July or August 2023.
• Item 2 (Fentanyl Crisis): The item was informational only; no vote was taken. The committee will continue discussions during the budget process and the upcoming community listening session. The IBA will review the mayor's proposed opioid settlement fund expenditures in its FY24 budget review.
• The next regular public safety committee meeting is scheduled for May 17, 2023, at 2:00 p.m.