By Jose E. Navarro, MBA | The Navarro Report | October 15, 2026
SAN DIEGO. Fentanyl deaths in San Diego County fell from 802 in 2022 to 340 in 2025, a drop of about 58%, according to county data. County health officials credit more treatment, less stigma and widespread naloxone. San Diego has made recovery a public priority and has leaned on public money spread across nonprofit contractors to deliver it. On November 3, voters will decide Measure A, a charter package that would reshape who oversees those contractors, and a single embezzlement case shows why the question matters.
The case
In February, prosecutors charged Amy Knox, former chief operating officer of the Harm Reduction Coalition of San Diego, with taking more than $130,000 in public funds for personal expenses, including plastic surgery and utility bills. Prosecutors later alleged at least $210,000 may have been misappropriated, according to Voice of San Diego. The nonprofit held county contracts to distribute naloxone and test street drugs for fentanyl, part of more than $4 million awarded to prevent overdose deaths. Knox pleaded not guilty.
The oversight record is the harder part. Knox had a 2015 prison sentence for stealing more than $500,000 from a previous employer. NBC 7 reported she was hired without a background check, and when a check was later run, the nonprofit still received another county contract in August 2024. Voice of San Diego reported that the county signed that second contract after a 2023 audit raised concerns, and that the county relied on providers to run their own criminal background checks. The county canceled the contracts in June 2025.
The arithmetic
By my arithmetic, the alleged $130,000 equals about 3% of the $4 million awarded, and the $210,000 figure about 5%. The share is small. The lesson is the control gap: the checks the county did not run were basic, and the person at the center managed both the nonprofit’s finances and its county contracts.
There was also a disclosure problem. County spokespeople first said opioid settlement money had not gone to the nonprofit, but the District Attorney said it had, and the county later confirmed $102,000 in settlement funds bought fentanyl test strips. A county spokesperson said that purchase involved no wrongdoing. The county had planned to spend about $100 million in opioid settlement money on treatment, housing and drug disposal, so the stakes of tracking each dollar are substantial.
What the county did
On March 23, the county announced a targeted review of its contracting processes with an independent auditor, with findings expected by the end of May. I could not locate published findings. The county said naloxone distribution continued without interruption, with nearly 48,000 kits distributed after the contracts ended. Supervisor Jim Desmond called the episode “embarrassing for the county,” and Supervisor Terra Lawson-Remer asked for much more robust background checks. Other contractors carry the load: A New PATH, a county-contracted nonprofit, reports training more than 39,000 people and 3,508 overdose reversals, and says deaths are still rising in Black and Brown communities.
What Measure A would do
The Board of Supervisors voted 3-2 in May to place the package on the ballot. According to KPBS, it would let supervisors hire and fire some senior county staff, a power that now rests with the chief administrative officer. It would create a budget analyst, a program auditor and an ethics commission, with the auditor and analyst reporting to the Board, and it would require added public disclosure of some county spending. Lawson-Remer’s office calls the package cost neutral and says it could prevent fraud and waste.
The measure also lets supervisors serve three four-year terms instead of two. Supervisors Desmond and Joel Anderson backed some oversight reforms but opposed extending term limits through a measure the Board itself placed on the ballot, arguing supervisors should not pass a reform that benefits themselves.
The question voters face
Supporters have a plausible case that independent auditing, an ethics commission and more disclosure are essential after a failure like this one. Critics have a plausible case that bundling those safeguards with longer terms asks voters to accept both or neither. The coverage I reviewed does not describe contracting rules or background-check requirements, so voters should read the measure text for them. An auditor who reports to the Board also raises an independence question the ballot language does not answer.
What to watch
Three markers will show whether oversight improves: whether the independent audit is released and what it recommends, the outcome of the Knox case, and whether the county adopts explicit contractor vetting rules whatever the vote on Measure A. Recovery depends on trust that public money reaches patients. The deaths data show the work is succeeding, which makes protecting the funding more urgent.
Jose E. Navarro, MBA, is a financial and operations professional and the publisher of The Navarro Report, which examines government spending and institutional accountability.
Human-Directed AI Journalism: Jose E. Navarro selected the topic, directed the research and framing, and edited and approved this article. AI assisted with research and drafting.