County Review Finds Oversight Gaps After Harm Reduction Coalition Subcontractors Reported Months of Unpaid Work

Unpaid bills surfaced as county reviewed a high-dollar overdose-prevention contract

San Diego County’s internal review of a contracting breakdown found that reports of unpaid subcontractors and other operational problems underscored gaps in how the county monitored vendor finances under a public health program tied to naloxone distribution and drug-checking services.

The review centered on the Harm Reduction Coalition of San Diego, a nonprofit that held county contracts intended to expand access to overdose reversal medication and related services. County records described concerns that some subcontractors were not compensated on time and that several remained unpaid for work performed under the county-funded contract scope.

Timeline: complaints, internal review, and contract termination

The review traced events beginning in mid-2025, when a key worker associated with the nonprofit filed a complaint with the county and separately reported she had not been paid for work performed in May 2025. County staff then sought guidance from the Health and Human Services Agency’s business assurance and compliance leadership as managers raised concerns about invoicing documentation and day-to-day operational information.

In subsequent weeks, at least one nonprofit partner involved in distributing naloxone reported it had not been paid for earlier work, including services performed in February and March 2025. The internal review framed these payment problems as a risk area for county contracts that rely on smaller vendors and layered subcontracting arrangements.

What the county said went wrong

The internal review documented multiple allegations and county findings involving financial controls and contract management. County staff reviewed bank statements, accounting ledgers and invoices submitted for reimbursement and noted the appearance of numerous charges that seemed personal in nature, alongside deposits from entities other than the county. The review stated it did not identify personal expenses being directly billed to the county through the invoices it examined, while still flagging concerns about commingled spending and limited segregation of duties.

Separately, the review highlighted oversight issues connected to subcontracting and potential conflicts of interest, including circumstances in which a person with operational authority also had responsibility for administering a subcontract linked to the same organization.

• County staff recommended closer monitoring of contractor accounts payable on county-funded work, particularly when subcontractors deliver significant portions of services.
• The review urged refining contract structures to allow easier validation of deliverables and more accurate tracking of spending and inventory.
• County auditors had previously identified internal-control concerns at the nonprofit in 2023 and sought corrective steps; the later review suggested some risks persisted.

Criminal case and ongoing questions

After the county ended its contracts with the organization in 2025, the San Diego County District Attorney’s Office later filed felony charges against Amy Knox, a former executive associated with the nonprofit. Prosecutors alleged misappropriation of public money and embezzlement tied to funds intended for overdose-prevention work.

The county review characterized unpaid subcontractor reports as a warning sign that routine monitoring of vendor payables can be critical when public services are delivered through multiple layers of contracting.

As of early March 2026, the county’s internal review indicated some subcontractors were still awaiting payment for work performed under the county-funded contract. The county has also signaled that responsibility for specific expenses and ultimate accountability would be informed by investigative and audit outcomes.