By SDCN Staff
San Diego, CA–San Diego County officials say a comprehensive system of internal controls helped identify and address concerns involving the Harm Reduction Coalition of San Diego and one of its employees, leading to a criminal referral and termination of county contracts.
According to the County, its safeguards are designed to prevent, detect, and report fraud, waste, and abuse by both internal and external actors. Officials said those controls — combined with vigilant county employees — played a central role in identifying issues involving the Harm Reduction Coalition of San Diego and employee Amy Knox and referring the matter to law enforcement.
To date, the County said, no information has surfaced indicating a failure in its internal control environment. Instead, officials pointed to a series of actions — including contract monitoring, corrective directives, audits, site visits, contract suspension, termination, and a referral to the Public Integrity Unit within the San Diego County District Attorney’s Office — as evidence that oversight systems operated as intended.
County officials emphasized that the focus remains on the individuals accused of embezzling funds intended to provide potentially life-saving services.
When overseeing contracts, the County follows federal and state requirements. It adheres to the Committee of Sponsoring Organizations of the Treadway Commission’s framework, a globally recognized model for internal controls.
The Harm Reduction Coalition of San Diego was selected in July 2022 following Board direction to conduct a competitive solicitation for naloxone distribution services. The effort aimed to address rising accidental drug overdose deaths as powerful opioids, including fentanyl, became increasingly prevalent in the region. Naloxone is an FDA-approved medication used to rapidly reverse opioid overdoses.
In March 2023, during routine contract monitoring, County staff issued corrective actions after identifying improper naloxone storage and inventory processes. Officials later confirmed the corrective measures were completed.
A month later, in April 2023, a financial audit identified nine findings related to internal controls, including segregation of duties, bank reconciliations, tax filings, invoice approvals and payments. The contractor implemented corrective actions in response to the audit findings, according to the County.
In August 2024, the organization expanded its services to include the coordination of a drug-checking program, allowing individuals to test substances for dangerous contaminants to reduce overdose risk.
In mid-June 2025, County staff conducted an unannounced site visit following reports of potential issues. The visit led to suspension of the contracts and, on June 30, 2025, termination of both agreements. Later that month, the matter was formally referred to the Public Integrity Unit of the District Attorney’s Office.
County officials said they are fully cooperating with prosecutors and will provide any information necessary to support the investigation and potential prosecution. If vulnerabilities or immediate risks are identified, the County said it will implement additional safeguards as needed.
In coordination with an outside auditor, the County is conducting a comprehensive review of its processes to ensure continued improvement and protection of public funds.
Officials are urging employees and members of the public to report concerns through the County’s Ethics Hotline or directly to the District Attorney’s Public Integrity Unit. Reports can be made 24 hours a day.
Despite the contract termination, naloxone distribution efforts have continued without interruption. Since ending its agreement with the Harm Reduction Coalition of San Diego, the County reports that nearly 48,000 naloxone kits have been distributed through its network, maintaining access to life-saving resources throughout the community.
