Work Session Meeting October 28, 2024 MINUTES Work Session Monday, October 28, 2024 @ 1:00 PM City Council Chambers, City Hall PRESENT: Councilor Johana Bencomo, Councilor Yvonne Flores, Councilor Becki Graham, Councilor Becky Corran, Mayor Eric Enriquez, and Councilor Cassie McClure ABSENT: Councilor William Mattiace 1. JOBS OF THE WEEK 1.1 Sarah Raney, New Mexico Workforce Connection presented Jobs of the Week. 2. PETS OF THE WEEK 2.1 Carol Nielson, Animal Services Center of the Mesilla Valley presented Pets of the Week. 3. AGENDA ITEM 3.1 OVERDOSE PREVENTION CENTER. Monica Torres, Economist gave the overhead presentation. 3.2 CITY OF LAS CRUCES ECONOMIC OUTLOOK. Phillip Fiuty, Member of the Public introduced the topic. Kailin See, Homeless Health Team Los Angeles, gave the overhead presentation. Councilor Corran asked we are having ongoing opioid funding sort of conversations about what we are going to use for that, I am wondering what the next steps are for when we are going to hear some of those additional recommendations? It seems like it is alluded to in the documentation that we have received so far but not as specific in detail as to what this presentation was. I am curious as to when the next opioid conversation might be and if we can also consider this in connection with that conversation too? Athena Huckaby, Member of the Public said I am a public health professional here in Las Cruces and I also sit on the Opioid Settlement Advisory Council. Those meetings are ongoing. We have been meeting monthly for several months and we have a meeting coming up on November 4th where what we are trying to line out is both the programs that we would like to see funded and the ways that we would like to track the success of those programs. So, before we bring a full suite of recommendations to you, we want to understand how we are going to measure the success of those programs. We are hoping to line that out on November 4th and then be a little bit closer to having ironed out recommendations that everyone agrees on to bring. That being said, I am not sure that overdose prevention centers are necessarily, we are talking of course about harm reduction, recovery and many other things but I don’t think that we are talking specifically in that group about an overdose prevention center. That being said, I do of course envision that the opioid settlement funds could be very easily used to fund a pilot project of something of this nature. Councilor Corran said I was just wondering the context of all of those things. I interpret the documents that I read so far as being pretty open to this type of conversation too so I think I just want to elevate that I hope we can continue this conversation in that context as well. Councilor McClure asked what are some legality issues that we might have with something like this? Is there a state issue or city issues that we might have that we might need to overcome or would this work in the city? Brad Douglas, City Attorney said I don’t want to go too deeply into the issue in an open forum but of course the issue that I am always looking at are in regard to both liability and legality. What I can say here in the open forum today is that Chapter 24 of our State Code at least appears to contemplate the legality of these overdose prevention centers but it is also my understanding that the New Mexico State Legislature probably intends to introduce more robust legislation regarded to that especially with regard to limitation of liability. Kailin See said the City of New York had to in Court Council grapple with this issue and one of the concerns was being defunded at a federal level if the City of New York chose to support the sites. Especially given that the Governor was seeming to adopt a stance of noninterference but had no intention and wasn’t signaling that she intended to legislate now or in the future and if it is helpful Court Council at New York City is very willing to talk to other jurisdictions who are thinking this through in terms of risk and how they mitigated those risks and the thought exercise that they undertook. I would be very happy to connect you if that is an interest. You have probably already reached out to them but if you haven’t, they are very happy to speak to other jurisdictions to help with that if helpful. Mayor Pro Tem Bencomo said I don’t have questions necessarily, I just have a couple of comments. I am looking forward to the conversation with the Opioid Settlement Advisory Committee on why or why not something like this should be on the list of recommendations. I think harm reduction strategies are vitally important in this moment and more and more people are dying and so we have to interfere boldly and as best as possible. I think something like this bold would be best suited in coordination with our partners at the county of course. I think it would function best that way and of course with a bunch of other stakeholders. So, I do look forward to that conversation. I am happy to have all of this information as we move into potentially joint session with the county regarding opioid settlement recommendations. The last thing I will say is that there has been a couple of pieces of legislation that were introduced in the New Mexico State Legislature regarding these kind of harm reduction strategies and one in 2021 and one in 2023. Neither of them have made it out of one of the chambers from what I understand just lack of time but that there has been momentum around these and that there has been some other statewide advocates who have raised this conversation to state level so I also look forward to following any of that in the future and in the January 2025 Legislative Session to see if any of these pieces of legislation will be reintroduced. For now, for me I really appreciate having all of this information and understanding this especially as we go into the opioid settlement joint work session with the county and potentially in a few weeks or a couple of months, I am not sure. Juan Garcia, Member of the Public said this morning there was an article on KFox where various parks in Las Cruces were identified as drug havens for users, addicts and overdoses. Something has to change because citizens of this community don’t deserve this deplorable environment. You want more money to better our parks, but it shouldn’t be for criminal activity. Although my initial reaction to OPC is no and I did see the movie, Love in the Age of Fentanyl. If these centers can be used as a conduit to treatment forced through the judicial system or volunteer this may be an option to consider and I stress, may be. There has to be consequences and there has to be a center to facilitate illicit drug use and further enable the already horrible human destruction going on. We can’t have Las Cruces continue to be a haven magnet for homeless, criminals, but potentially now with OPC increase drug users in the city leading to even more criminal activity. Dr. Francine Feinberg, Member of the Public said I spent about 30 years working with women with substance use disorders and their children. I actually have some questions for Kailin. One is how are they funded? The other is, are they able to serve pregnant women and is there any kind of service for people who have children so that they can go into your facility and not have to worry about where their children are? Kailin See said for the first 18 months of our operation we could not use a single cent of public money for the operation of the site and then the New York City Department of Health and the City of New York figured out following our recommendation a Time and Effort Budgeting System and that is how the sites continue to be funded. A Time and Effort Budget is a federally acknowledged budgeting system that separates activities of a program into eligible and ineligible activities against federal regulation and federal law. So when we look at the scope of work and the percentage of staff time in an overdose prevention center under this Time and Effort structure we see that 98% roughly, 98% of staff labor is spent doing activities that are eligible under federal law and according to federal regulations, 2% of staff time or less are spent doing activities that are ineligible under federal law and that really comes down to the act of observing consumption itself. Everything else is an evidence based widely accepted public health intervention for people who use drugs, even the observation of consumption is divided into passive and indirect observation but when you think about it if you only have to come up with discretionary money to fund 2% of staff time as opposed to 100% of staff time suddenly your funding options for a site like this becomes much broader. Rhode Island as you know is using opioid settlement funds. Now New York is using public money to fund the sites with the exception of the 2% which is funded by discretionary or foundation money. So that is the funding piece. The budget for On Point by the way is $17 million for the entire organization. That is everything that I showed you. The OPC themselves come in around $4 million. In terms of pregnant people, or pregnant and parenting, people who use drugs and people with dependents, yes, we have policies in place for both. I don’t know that we have a ton of time to get into that but know that policies do exist for both pregnant people who use drugs and pregnant and parenting people who use drugs. The OPCs in New York have successfully seen the birth of three children to parents who did their pregnancies through the OPC and two of those parents still have full custody of their children and for both this is the first baby that was not apprehended by social services. So, a huge testament to the role, the healthcare role that these sites can play in interrupting addiction patterns for pregnant and parenting people who use drugs. Sarah Smith, Member of the Public said I have some serious concerns about this and the message that it sends to the public. It is basically saying, okay drugs are illegal, but you can come and do them right here and I think that creates a very interesting dynamic that says drugs aren’t really illegal anymore because we will give you a place where you can come and do them. I am very concerned that this potentially increases the number of people that are doing drugs in the community as well as what kind of real metrics are used for this besides how many people didn’t overdose. What impact does it have on the neighborhood? What impact does it have on the city? How many of these people actually become sober and rehabilitated versus just continuing on because now they have comfortable dignified place to do it? You may have heard that San Francisco is being sued right now for a very similar situation looking at the case which is in Federal Court right now which the city tried to shut down the case and the judge said nope, the case can proceed. They are specifically having a lawsuit filed by residents and businesses that says, “lawmakers created a lawless living environment by enabling drug addicts and dealers” and they go on to say “the city’s enabling of drug use has increased petty and violent crime in the neighborhood, addicts support their habit by stealing, car break ins, robberies, burglaries, etcetera along with all the other things that we often see with these types of neighborhoods”, and it sounds very familiar to Desert Hope when it first opened also increasing crime. So, we have seen that happen. I am very concerned about anything else that the city might be funding that is going to have similar consequences for the people who live nearby and then having to deal with drug addicts in their neighborhood very regularly. Drug addicts basically as a magnet for them to that neighborhood and all of the things that go with that in terms of their public safety, their rights to having a safe neighborhood for their children and a place to live. Andrew Thomas, Member of the Public said I am going to speak as an expert in addiction being that I am in recovery. I won’t speak for any of the recovery of the facilities that I have worked for but for the community that I take part in. Most of the addicts and alcoholics that I speak with don’t want to be addicts or alcoholics. It is not something they strive for. There is a severe fear of detox and a severe fear of getting sober. One of the things that medication assisted treatment helps with is reducing that fear. If we can get people unafraid of detoxing from the pain and sometimes death then what we can offer them is a chance and that is what we are talking about here, is offering people a chance. They are not going to get it if they are just on the streets. They are not going to get it if they are just hanging out in parks. Where they have the opportunity to get it is when they enter a facility where the alternatives offered to them and that is really what we are talking about here, opportunity and for me sobriety is opportunity. It is the opportunity to do all the things that I want to do in life instead of chasing after drugs and alcohol. I am very passionate about this, and I know Athena and other members of this community are too. We are passionate about it for a reason because we have seen it work. That may sound anecdotal but if anecdote is all I have, and my testimony is that then that is what I am going to go by. I am going to go by all the people that I have seen it worked for and I think we need to really look into providing opportunities to people that they don’t otherwise get. Fred Miller, Member of the Public said it seems to me that people who end up in these overdose prevention centers they are not people who are going to be trying to encourage other people to join them in doing drugs. If anything, they are people who are addressing it at a level. They are not people who want to share it with new friends. That doesn’t make sense to me. So, I don’t think that these will promote wider drug use, it seems prima facie it should cut down on drug use with people being treated and such. In the presentation Kailin See mentioned the use of small doses of naloxone instead of large doses so that gets away from the problem of people getting treated out on the street and running off and refusing treatment and then the naloxone wears off and the overdose comes back. I glanced over at Chief Smith when she brought that up and that looked like that really hit home for him. That is worthwhile, that is something worth having and in terms of parks and streets that is part of what these reduction centers are taking care of. They are diverting the needles from the parks and streets, so it sounds like a good thing to me. Liz Liano, Member of the Public said I am a person in recovery as well and I came late so I missed a little bit of the presentation but overdose prevention centers, I was just looking at the National Institute of Health and in their twenty years of data they have zero deaths and that is really important because having that method of not just prevention but like assertive action for people who are dealing with such a pervasive addiction. New Mexico ranks really high in our statistics nationally for deaths of disappear which is alcohol, drug addiction, and suicide. It shows that nationally we rank sixth for opioid use deaths or drug addiction deaths and we rank four nationally for deaths by alcohol use and as well number four for death by suicide. We are also very heavy in ACEs which is Adverse Childhood Experiences and research has shown that folks who rank high in ACEs score which it’s a ten question questionnaire that has had decades of studies in it actually so folks who answer yes for four or more of those questions have a significant higher propensity for drug and alcohol addiction and this is really important to note because studies in ACEs have also shown that traditional methods may not always scratch the surface. Everything from bariatrics to therapy much more sort of treatment is definitely needed. Tenika Sosa-Gonzalez, Member of the Public said I am a Board Certified Psychiatric Mental Health Nurse. I also have extensive lived experiences so I would like to start this discussion by saying I appreciate the fact that we are bringing science into this and facts into this because the reality is that this is a medical condition that affects D2 dopamine receptors and other receptors. So, I think we should have a discussion about this like it is an illness. I also would say to my fellow Las Crucens and council that we stop using words that are pejorative like addict. Three years ago, I lost my father who had returned to substance use after he lost his sister who was murdered at the hands of her son with schizophrenia. My dad died because he didn’t know how to take his drugs, so he is not an addict, he is my dad. There are faces to this and there are people to this, and I will just say that when we had our discussion about shopping carts, Sarah Smith said, “overall these strategies aren’t working, and people need treatment and a safe space to go”. And Chief Story encourages us to not be all or nothing but to have a balanced approach and so I think that we use and have this discussion using science and compassion and stop feeding into stigma because really what stigma does is gives people who feel insecure and insufficient the opportunities to otherwise people in their communities, they feel better about themselves. So, the next time you walk past someone, and you want to look at them as just a junkie or just an addict, they belong to somebody. They have a family who loves them so I would just encourage us to elevate this discussion and to really look at the science behind it and to be open to talking about how to do new and different things. Mayor Pro Tem Bencomo said thank you very much to our three presenters. I appreciate very much and continue to look forward to continued conversations on this. 4. ADJOURNMENT 4.1 Councilor Becki Graham moved, seconded by Councilor Becky Corran, to adjourn at 2:18 p.m. RESULT: Carried MOVER: Councilor Becki Graham SECONDER: Councilor Becky Corran AYES: Councilor Johana Bencomo, Councilor Yvonne Flores, Councilor Becki Graham, Councilor Becky Corran, and Councilor Cassie McClure ABSENT: Mayor Eric Enriquez and Councilor William Mattiace Mayor City Clerk