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CDPH Naloxone Grant Program Distribution Plan

Naloxone Distribution Plan

California Department of Public Health
Safe and Active Communities Branch
Naloxone Grant Program
 
REQUEST FOR APPLICATIONS (RFA #16-10967):
Naloxone Distribution Projects

Naloxone Distribution Plan
 

As a condition of the Naloxone Distribution Projects grant agreement, grantees are required to submit a Naloxone Distribution Plan within 60 days of receiving CDPH final approval of the grant agreement. Completing and submitting this online form fulfills this grant requirement.

This plan should be completed after conducting outreach to identify local entities within your health jurisdiction that already have a naloxone distribution system in place and have the capacity to efficiently and effectively provide naloxone and training to first responders (e.g., harm reduction/syringe exchange programs, substance use disorder treatment providers, homeless programs, jails, emergency services providers, law enforcement, and others), assessing the level of risk of overdose among the populations they serve, and the need for naloxone (Narcan) product.
 

Please send questions to ngp@cdph.ca.gov.

Please provide the following information as requested for each entity that has been identified to receive Narcan in your local health jurisdiction.
This form should only be filled out by local health department officials.
2. Information for person entering information *This question is required.
3.

Will you distribute Narcan nasal spray to a Syringe Exchange Program (SEP)?

*This question is required.
Please give reasons for not distributing to SEPs *This question is required.
  • * This question is required.