County begins independent audit after ex-con COO charged with embezzlement

San Diego County Chief Administrative Officer Ebony Shelton announced Monday the county is formally reviewing its internal contracting processes following embezzlement charges against a nonprofit executive.

In February, Amy Knox, the former chief operating officer of Harm Reduction Coalition of San Diego, which contracted with the county to distribute the anti-overdose medication Narcan, was charged with embezzling funds from the organization.

Knox is accused of taking more than $130,000 in public funds to pay for personal expenses such as plastic surgery procedures, trips to Hawaii and Disneyland, and payments for her SDG&E and credit card bills.

As a result of the charges, the county has started work with an independent auditor to conduct a targeted review of contracting processes. The auditor is expected to deliver a report with findings and recommendations by the end of May, a county statement read.

Shelton said the county was committed to transparency and constant improvement.

“The Board of Supervisors has made clear that they want a full understanding of what occurred and how we can strengthen our oversight,” Shelton said. “We take stewardship of public funds seriously, and we want to understand where the checks and balances may have broken down and what improvements may be needed. We look forward to the independent auditor’s report.”

Once the independent audit is complete, county staff will evaluate the findings and determine any additional steps needed to strengthen contracting practices and protect public resources.

Waste, fraud or abuse reports can be made through the county’s Ethics Hotline at 866-549-0004 and online and the District Attorney’s Office Public Integrity Unit.

According to the county, it continues to cooperate with the district attorney’s investigation into fraud and embezzlement allegations related to the Harm Reduction Coalition and is also coordinating with Harm Reduction Coalition subcontractors that did not receive anticipated payments from the contractor to examine options for providing payment.

San Diego County’s naloxone distribution efforts have continued without interruption, with nearly 48,000 kits distributed through its network.

According to the DA’s Office, the funds Knox is accused of taking were part of over $4 million awarded to the nonprofit for its efforts to prevent and reduce fentanyl deaths within San Diego County.

Knox, 45, “controlled the nonprofit’s finances and was designated as the contract administrator for the county contracts,” the D.A.’s Office said.

She faces up to seven years in state prison if convicted of charges that include felony counts of misappropriating public funds and embezzlement.

Knox was arrested in February and after pleading not guilty to the charges, was given a $200,000 bail.

In a news conference announcing the charges, San Diego County District Attorney Summer Stephan said Knox was previously charged in San Diego County with taking over $500,000 from a prior employer. Court records show she pleaded guilty to felony grand theft charges in that case and was sentenced to prison in 2015.

Despite her criminal history, Stephan said Knox was able to attain her position in the organization without a background check.

After concerns were raised by county staff, a background check was ultimately conducted and revealed the conviction, yet around a year later, the nonprofit was awarded another contract from the county in August of 2024, Stephan said.

Stephan said Wednesday that it was “deeply concerning that the checks and balances that are supposed to safeguard the county’s large budget and trust funds failed in this case.”

Harm Reduction Coalition’s CEO, Tara Stamos-Buesig, reported suspicions regarding Knox to the District Attorney’s Office last May, Stephan said. The county canceled its contracts for Narcan distribution and drug testing with the nonprofit the following month.

Stephan said an investigation remained ongoing into “aspects in the county as to why and how this happened,” as well as whether anyone else was involved in the fraud.

She also alleged there has “been an effort to remove checks and balances when it comes to contracts” and that employees have recently left the county “with agreements to be silent.”

The D.A.’s Office urged any county employees with information of suspected malfeasance to report concerns to prosecutors and said anyone making reports would be protected under whistleblower laws.

Stephan said in a statement, “Whistleblowing is an important part of public safety. It is often the first line of defense against corruption an misuse of public funds.”