By Jose E. Navarro | The Navarro Report | September 24, 2026
SAN DIEGO, Calif. In August 2024, a $50,000 check from a county-funded nonprofit to one of its subcontractors bounced. That same month, according to the District Attorney’s timeline, San Diego County awarded the nonprofit a second contract. Nine months later, in June 2025, the county terminated both. Prosecutors now allege the nonprofit’s former chief operating officer spent public opioid-settlement money on cosmetic surgery, vacations and utility bills.
Amy Knox, formerly of the Harm Reduction Coalition of San Diego, faces nine felony counts, including misappropriating public money and embezzlement. Prosecutors allege more than $130,000 in improper spending: $30,000 for cosmetic surgery, over $90,000 in credit card payments and more than $10,000 in utilities. A later count alleges a falsified $105,000 invoice to the county. Knox has pleaded not guilty, and the allegations are unproven. She was previously convicted of stealing more than $500,000 from an employer and went to prison in 2015.
The warning signs
The DA’s timeline shows a county with repeated chances to intervene. In January 2023, a citizen alerted the county to improper medication storage. In April 2023, a financial audit revealed control weaknesses. The second contract followed in August 2024, after the prior conviction had surfaced. In September 2024, a subcontractor met with a county contract administrator about the bounced check. Early in 2025, another subcontractor flagged missed payments. Twenty-nine months separate the first alert from the terminations.
The contracts were substantial: about $2.2 million a year combined, drawn from $4.2 million in county opioid-settlement funds meant to reduce fentanyl deaths and distribute the overdose-reversal drug naloxone.
District Attorney Summer Stephan called it “deeply concerning” that checks and balances failed. County Chief Administrative Officer Ebony Shelton said the county wants to understand where they “may have broken down.”
Who paid the price
Small community groups absorbed the losses. A New Path, which trains people to use naloxone, says it is owed $98,820 for five months of work plus $4,400 from the bounced 2024 check. With an annual budget under $500,000, it cut staff hours by 25 percent. SAY San Diego is owed $92,500 and absorbed the loss. Project AWARE is owed about $2,000, and two of its workers left over the missed pay. One individual contractor reports being owed roughly $36,000. Meanwhile, months passed between the bounced check and the terminations, and unpaid groups kept delivering naloxone training that residents relied on.
The county’s contract makes the nonprofit solely responsible for paying subcontractors. Even so, in April the county agreed to pay nearly $150,000 to six unpaid organizations, and it continues distributing naloxone through other providers.
The review that skipped the question
The county hired the firm Eide Bailly, for up to $68,000, to examine its contracting practices. Its June 24 report found sound procurement procedures but weak monitoring after awards. It found that the county applies uniform oversight regardless of a contract’s risk, lacks countywide documentation standards and leans on invoice audits rather than compliance reviews. Recommendations include fraud-detection checklists, risk-based oversight, monitoring standards and staff training.
What the report did not do, as Voice of San Diego noted, is examine how insufficient county oversight may have contributed to the scandal. Officials said the review was meant to improve oversight rather than make findings in an active criminal case. The county’s chief administrative officer says the recommendations are under evaluation, with no timeline announced.
The arithmetic
The alleged $130,000 equals about three cents of every dollar in the $4.2 million grant. Small percentages hide easily inside large contracts, which is precisely why invoice review alone falls short. An invoice shows that a bill was submitted. It cannot show who was paid, who was not, or who was steering the money.
Three questions for the Board of Supervisors
First, will the county publish the audit in full and commission a review of its own decisions between 2023 and 2025? Second, will high-risk contracts receive tiered monitoring and background checks on the people who control the money? Third, will the county verify that subcontractors are paid before it pays the prime contractor?
The Board has shown it understands the problem. In November 2025, supervisors voted 4-0 to advance a regional homelessness funding audit, citing a state auditor’s finding that more than $24 billion in state homelessness money was spent from 2018 to 2023 with little consistent tracking. The same rigor belongs on the county’s own contracts.
Opioid-settlement dollars were meant to save lives. Residents are entitled to see that they do.
Sources: San Diego County District Attorney news release (Feb. 18, 2026); Voice of San Diego (Mar. 6, Apr. 21 and Jul. 14, 2026); San Diego County News Center (Apr. 27 and Jul. 13, 2026); Times of San Diego and KPBS (Feb.-Mar. 2026).
Human-Directed AI Journalism: Jose E. Navarro selected the topic, directed the research and framing, edited, and approved this article. AI assisted with research and drafting.