HomeMy WebLinkAboutPacket Health Board Oct 28 2025Whatcom County
Council as the Health Board
COUNTY COURTHOUSE
311 Grand Avenue, Ste #105
Bellingham, WA 98225-4038
(360) 778-5010
Meeting Agenda
Tuesday, October 28, 2025
10 AM
Hybrid Meeting - Council Chambers
JOINT HEALTH BOARD / PUBLIC HEALTH ADVISORY BOARD (PHAB)
MEETING - HYBRID MEETING (PARTICIPATE IN -PERSON, SEE REMOTE JOIN
INSTRUCTIONS AT www.whatcomcounty.us/joinvirtualcouncil, OR CALL
360.778.5010)
COUNCILMEMBERS
Barry Buchanan
Tyler Byrd
Todd Donovan
Ben Elenbaas
Kaylee Galloway
Jon Scanlon
Mark Stremler
CLERK OF THE COUNCIL
Cathy Halka, AICP, CMC
Council as the Health Board Meeting Agenda October 28, 2025
Call To Order
Roll Call - Health Board
Roll Call - PHAB
Announcements
Individuals who require special assistance to participate in the Council's meetings are asked to contact
the Council Office at 360.778.5010 at least 96 hours in advance. This committee meeting is also noticed
as a meeting of the Whatcom County Council, with the agenda limited to committee business.
The Council is currently testing a new live captioning feature to increase the accessibility and
transparency of its meetings. If you are watching the meeting remotely via Zoom, captions can be
turned on by clicking the Show Captions (CC) icon. Open captions will also appear in meetings
streamed live or watched later through the Legislative Information Center. Please contact the Council
Office at 360-778-5010 if you have questions or concerns.
Public Comment
Special Presentation
1. AB2025-734
2. AB2025-736
3. AB2025-735
4. AB2025-693
Other Business
Adjournment
Update from the Health Director
Update from the Public Health Advisory Board Chair and Vice Chair
Update from the Health Officers on the Opioid Response Plan
Presentation on locally -led health initiatives
Whatcom County Page 2 Printed on 11712026
• Whatcom County COUNTY COURTHOUSE
311 Grand Avenue, Ste #105
Bellingham, WA 98225-4038
(360) 778-5010
• Agenda Bill Master Report
File Number: AB2025-734
File ID: AB2025-734 Version: 1 Status: Presented
File Created: 10/14/2025 Entered by: nervin@co.whatcom.wa.us
Department: Health Department File Type: Presentation
Assigned to: Council as the Health Board Final Action: 10/28/2025
Agenda Date: 10/28/2025 Enactment #:
Primary Contact Email: nervin@co.whatcom.wa.us
TITLE FOR AGENDA ITEM:
Update from the Health Director
SUMMARY STATEMENT OR LEGAL NOTICE LANGUAGE:
None
HISTORY OF LEGISLATIVE FILE
Date: Acting Body: Action: Sent To:
10/28/2025 Council as the Health Board PRESENTED
Attachments: Report
Whatcom County Page 1 Printed on 11712026
W HATCO M COUNTY Charlene Ramont, MPH, Interim Director
AL Amy Harley, MD, MPH, Co -Health Officer
Health and Community Services Meghan Lelonek, MD, Co -Health Officer
Department Report October, 2025
Equity — Collaboration — Compassion — Transparency — Innovation - Service
Leadership:
Health Director
• Department participated in the September 3 County Open House
• Personnel Updates: Financial Services Manager, Greg Iturria, started with the
department September 2. Department Director, Champ Thomaskutty, started yesterday,
October 27.
Health Officer
• Monitoring vaccine policy, availability, and coverage, and sharing evidence -based best
practices with the local healthcare community.
• Collaborating with partners to assess local healthcare access and to anticipate impacts
of changes to Medicaid and the WA Health Benefit Exchange on our population.
Financial Services:
• Mid -biennium budget adjustments were prepared and submitted to the County Executive
in October. The proposed adjustments reduce the general fund contribution to the
department by more than $1 million per year. Reductions to achieve this net savings to
the general fund include cutting vacant positions, reducing non -personnel operating
expenditures, and maximizing the use of restricted revenue to support core department
services.
• The business office is in the process of onboarding an Accounting Supervisor who is
scheduled to start on November 10.
Communicable Disease and Epidemiology (CD&E):
• Honoring Ann Lund's Retirement: After 19.5 years of dedicated service, we celebrate
Ann Lund's retirement and the tremendous impact she has made in public health. Ann's
pivotal leadership in the Tuberculosis (TB) Program has helped position Whatcom
County as a statewide model for TB care and community support. Her expertise,
compassion, and commitment have touched countless lives, and her legacy will continue
to inspire our teams and community for years to come.
509 Girard Street
Bellingham, WA 98225-4005
WHATCOM COUNTY
fLHEALTH AND
COMMUNITY
SERVICES
Main Line: (360) 778-6000
wwwwhatcomcounty.us/health
• Tuberculosis (TB) Program: The TB team continues to provide intensive case
management for newly arrived individuals with medically complex TB conditions who
face significant barriers to care. In partnership with Dr. Harley (Health Officer), the team
has also delivered several Latent TB Infection (LTBI) trainings for local healthcare
providers —strengthening prevention, early intervention, and community -wide TB
response capacity.
• Safety and Support Program (SSP): The Safety and Support Program is expanding
access to overdose prevention resources by partnering with supportive and transitional
housing organizations to install Naloxone distribution boxes, ensuring 24/7 access to
lifesaving medication. The team also organized and hosted the Overdose Awareness
Day event at Bellingham City Hall, in collaboration with Lummi and Nooksack Tribal
organizations. The event offered free Narcan kits, hands-on training, and public
education, raising awareness and fostering community connection. In addition, the SSP
team is collaborating with the University of Washington to conduct the annual SSP
survey. This research provides essential, up-to-date insights that help SSP staff,
policymakers, and service providers better understand the complex needs of the
individuals we serve.
• Refugee Health Navigation, Promotion & Immigration Support: From January to
August 2025, we supported 147 refugee clients with health system navigation,
immunization education, and assistance with the 1-693 form to support green card
applications. Demand for these services continues to grow, thanks to strong
partnerships with local refugee resettlement agencies and word-of-mouth referrals within
client communities.
• Immunization Program Highlights: A pilot project with local schools is also underway,
allowing students to receive vaccinations during school hours. This partnership supports
record management and helps ensure families stay informed about recommended
vaccines and community resources.
• MPDX Vaccination Clinic: In response to increased community concern and growing
MPDX cases nationwide, we are hosting a MPDX-specific vaccine clinic on October 28.
This clinic reflects our commitment to rapid, responsive public health action.
Community and Organizational Development (COD):
• The Epidemiology & Assessment team is activating weekly updates for the Respiratory
Illness Dashboard as we head into respiratory illness season.
• The Informatics team launched the Healthy Children's Fund Doula Project electronic
data collection and referral system- this will allow HIPAA-secure automation of referrals
and enable the program to have participant data and outcome data available
electronically.
• The Informatics Team, along with our Quality Improvement Specialist, completed an
audit of RSD data to improve client electronic medical records data entry and accuracy.
• Staff presented at WSALPHO's Fall Learning Symposium: Inclusive Approaches to
Public Health Practices.
• Danielle Humphreys (Equity Specialist) participated on a panel with other equity -
focused LHJ staff called "Strategies for Advancing Equity in Local Public Health"
and discussed how we are putting equity into practice.
• Amy Rydel (Healthy Planning Specialist), Aly Robinson (Community Health
Specialist), Danielle Humphreys (Equity Specialist), and Christine Espina (PHAB
member) facilitated an interactive breakout session called "Centering Equity in
Community Health Improvement: Strategies, Stories, and Shared Learning".
They shared experiences with Community Health Improvement (CHI) in
Whatcom County, and presented strategies and tools for keeping equity centered
during the CHI process.
• COD is in the process of hiring a Public Health Emergency Preparedness and Resiliency
(PHEPR) Specialist, and we hope to make an offer shortly. We have been without a
PHEPR Specialist since May.
• Heather McGuinness (Partnerships & Strategy Supervisor) attended the first annual
Northwest Preparedness & Resilience Conference, hosted by the University of
Washington's Northwest Center for Evidence -Based Public Health Emergency
Preparedness and Response (NWPHEPR) and the Center for Disaster Resilient
Communities (CDRC). The event brought together public health practitioners from
across Oregon, Washington, Idaho, and Alaska to learn and share best practices related
to emergency preparedness and response.
• Division staff moved into the expanded Unity building, a big thanks to Facilities and IT for
getting the space ready!
Community Health and Human Services (CH&HS):
• Feedback on the Healthy Children's Fund 2025-26 Implementation plan is open from
10/1-10/17. You can find more information on the HCF webpage.
• The Healthy Children's Funding closed the Childcare Capital RFP and has been
reviewing the nearly $6 million in funding requests they received. The Childcare subsidy
RFP closes on 10/21.
• Whatcom County's next Homeless Housing Plan for 2026-2030 has been released for
public comment. This draft plan can be found here.
• Hiring for the severe weather shelter is moving along! With nearly 30 positions being
temporarily hired, the housing team is busy with interviews and training to prepare to
take on this big lift.
• The Developmental Disabilities Program has an open RFP to build community capacity
for individuals with developmental disabilities. The anticipated outcomes of this RFP
include increasing the number of public sector and large employers hiring or providing
youth internships to people with developmental disabilities in Whatcom County.
Increasing the diversity and number of job candidates in the developmental disability
field. As well as building the capacity of the community to welcome and include people
with developmental disabilities. The RFP will be open until 10/28/25.
• The Nurse Family Partnership supervisor stepped into her role in July, after nearly half a
year without a supervisor. She has jumped right in and is happy to report some
highlights from the program. The NFP team is currently serving 43 families and, in the
past 12 months, has completed 761 home visits! 100% of the families being served have
initiated breastfeeding last year, and smoking rates last year decreased from 9% at
enrollment to 0% at 36 weeks of pregnancy!
• The Community Health & Human Services team has moved from their Civic Building
location to the new building at 110 Unity. The team is settling in well and looks forward
to stronger collaboration with colleagues in the same building!
Environmental Health (EH):
• The Solid Waste and Food Teams supported Bellingham SeaFeast from Sept. 27-28.
Bellingham SeaFeast 2025 makes history as Whatcom County's first festival to
implement 100% reusable dishware. HCS awarded the Innovative Waste Reduction
grant to a team of local partners to implement a full-scale reusable dishware system in
the main food court. SeaFeast draws over 15,000 attendees annually. Festivals of that
size often generate thousands of pounds of garbage, much of it from single -use to -go
ware, which accounts for up to 70% of food service waste at public events.
• The resolution to adopt the updated Coordinated Water System Plan was passed by
Council on September 23. The WA State Department of Health is now reviewing the
plan, and we anticipate approval by December 31.
• The division has started its implementation of a new system called Enterprise Permitting
and Licensing. This system will replace aging technology and streamline processes
related to permitting, licensing, and complaint response. Our Go -Live date is expected
towards the end of the 1 st Quarter 2026.
• The On -site sewage team will be offering a free education course for the industry,
educating on best practices and new tools for applying code requirements. A CEU will
be granted after participation, and this will help industry professionals with their licensure
requirements.
• The water recreation team is back up to pre-COVID inspection activity levels. In 2025,
they have seen every seasonal facility.
Response Systems (RS):
• Mental Health Court is celebrating its 10th Anniversary. Over the past decade, the
program has enrolled 155 participants between the Bellingham Municipal Court and the
Whatcom County District Court. We have witnessed inspiring transformations,
celebrated graduates, and navigated the real challenges and barriers to recovery. The
program is a testament to the compassion and collaboration that uplift our community
and its members in their most challenging times.
• Hannah Fisk, Special Programs Manager, presented across multiple community
meetings, highlighting the progress around developing a Behavioral Care Center (BCC),
a key component of the Justice Project Implementation Plan. Hannah provided
presentations to: County Council, Behavioral Health and Crisis Provider meeting,
Incarceration, Prevention and Reduction Taskforce, Whatcom County Outreach provider
meeting, and Whatcom Racial Equity Commission.
• Alternative Response Team (ART) is in the process of expanding staff by one position.
We hope to have this position filled and fully onboarded by the beginning of 2026. This
additional staff will allow ART to respond to additional 911 calls in the Bellingham area
and support the efforts to work with additional law enforcement agencies in the County.
• Response Systems has started an internship/practicum program for the 2025/2026
calendar year. We have seven interns, three graduate students, and four undergrad
students, placed in Mental Health Court, Alternative Response Team, and GRACE. We
are especially excited to be hosting two students from the new Bachelor's of Social Work
program at Whatcom Community College.
• Law Enforcement Assisted Diversion/Let Everyone Advance with Dignity (LEAD)
celebrated their 5th Anniversary this September! We highlighted the work of this
transformational program through some social media posts (see below).
5 YEARS OF LEAD
Wv, Enlor[emerri Rsars LFxrtnn ILe[ Everyone ldvence wAh ngnily
as
Many LEAD Clients
struggle with addiction of
one kind Or another.
cyften, we're the first ones
to take clients to detox,
help there apply for a
recovery bed at a rehab
facIIity,or help them Flnd a
clean and sober house after
graduation from rehab.
c�S Im
LEAD Imens Cnie M... ger
HEALTH 1R"r..
f COMMUNITY
• SERVICES
5 YEARS OF LEAD
Law rntdeemera Ape M Diermn ILei Emyona AQraree wah )Kyv '
166
Five yea rs ago, a &mail group
interested in bringing change
to Whatcom County brought
in a program known as Law
Enforcement Assisted Diversion
(LEAD). At that time, no one
knew the LEAD program would
develop into what it is today.
nor did they realize how much
effect it -Ovid have on our
Community.
Chief Dopupr ]peg Cum
Whatcom [,.rw 9-1fft ORkc
DNFALTN AND
. COMMUNITY
SErnnCES
5 YEARS OF LEAD
Lirrc [rrlorowneri! Re�levl Clrrertnn ILe[ En•i �xare IuH�rx:e rnllr Drcprnf
041
working for LEAD over the
past five years has been an
immense privilege —
witnessing the healing of
individuals, families, and
the community. I've been
deeply honored to be
welcomed into such
i ntimate and personal parts
of people's IIves,
fdalfq "l
LEAD IMensra Case Manage,
Fee yea" vnf h LEAD
HEALTH 1.....
5i1 ■IIl� COMMi1 NITY
SERVICES
5 YEARS OF LEAD
L, Enfvttrtvw'tt Psss�p6 aiwrcim Lq E.w,p�o Ativarkn mm DTjtity
fi
LEAD Is an invaluable and
critical service for our
Community. At any given
Lime, there are over IOU
people receiving vital
services with the help of
I ntensive case ma nagem
eh+w Rvt.eraM .Is
rlvll:rgham pdko Dopartmcn,
COMM
HnAND
7 iL SERVICES
• Whatcom County COUNTY COURTHOUSE
311 Grand Avenue, Ste #105
Bellingham, WA 98225-4038
(360) 778-5010
• Agenda Bill Master Report
File Number: AB2025-736
File ID: AB2025-736 Version: 1 Status: Presented
File Created: 10/14/2025 Entered by: nervin@co.whatcom.wa.us
Department: Health Department File Type: Presentation
Assigned to: Council as the Health Board Final Action: 10/28/2025
Agenda Date: 10/28/2025 Enactment #:
Primary Contact Email: nervin@co.whatcom.w.us
TITLE FOR AGENDA ITEM:
Update from the Public Health Advisory Board Chair and Vice Chair
SUMMARY STATEMENT OR LEGAL NOTICE LANGUAGE:
None
HISTORY OF LEGISLATIVE FILE
Date: Acting Body: Action: Sent To:
10/28/2025 Council as the Health Board PRESENTED
Attachments:
Whatcom County Page 1 Printed on 11712026
• Whatcom County COUNTY COURTHOUSE
311 Grand Avenue, Ste #105
Bellingham, WA 98225-4038
(360) 778-5010
• Agenda Bill Master Report
File Number: AB2025-735
File ID: AB2025-735 Version: 1 Status: Presented
File Created: 10/14/2025 Entered by: nervin@co.whatcom.wa.us
Department: Health Department File Type: Presentation
Assigned to: Council as the Health Board Final Action: 10/28/2025
Agenda Date: 10/28/2025 Enactment #:
Primary Contact Email: nervin@co.whatcom.wa.us
TITLE FOR AGENDA ITEM:
Update from the Health Officers on the Opioid Response Plan
SUMMARY STATEMENT OR LEGAL NOTICE LANGUAGE:
None
HISTORY OF LEGISLATIVE FILE
Date: Acting Body: Action: Sent To:
10/28/2025 Council as the Health Board PRESENTED
Attachments: Presentation - Lelonek, Presentation - Holley, Opioid Spending Plan 2026, Settlement Fact Sheet
Whatcom County Page 1 Printed on 11712026
OP810'Id update
Meg Lelonek, MD Co -Health Officer
October 28, 2025
Joint Board of Health Public Health Advisory Board
WHATCOM COUNTY
'LLHEALTH AND
COMMUNITY
SERVICES
OUR PURPOSE: We serve Whatcom County by
to:
PRESERVE
a healthy
environment
where everyone
can thrive
PREPARE
for and respond
to emergencies
Objectives
■ Review the data landscape in Whatcom county, Washington state, and
nationally
• Give a snapshot of local programs supporting opioid use disorder
prevention and response
• Update on local Opioid Settlement Funds- Kari Holley
� � Ilvalt4 knouln
Narcan
saveslive5
�6H
PS
WHATCOM COUNTY
HEALTH AND
COMMUNITY
SERVICES
By the numbers
a,
4f
Y
Figure 1b. Percent Change in Predicted 12 Month -ending Count of Drug Overdose Deaths, by
Jurisdiction: April 2024 to April 2025
Jetu `'ark City
of CaLumbia
•
Legend for Percent Change in Drug Overd-ose Deaths Between 72-Month Ending Periods
-39-9% s-a%
WHATCOM COUNTY
SERVICES
National,, state,, county comparis
12-month Drug Overdose Death Rates (by end of 12-month period
*US OWA *King •Whatcom
160
3fl
120
0
2019
20: 2021 2022 2023
Dale Month
....................................................................................... ....................
2024
2025
fjo
e
on •
WHATCOM COUNTY
y g 21 HEALTH AND
COMMUNITY
SERVICES
King
WA
Whatcom
US
Whatcom County Drug related death
Monthly Dwerdose-related Deaths {and m1ling average over previous 365 days}
az
20
1s
12 '
�0
' 7r4
S-8
4,7
4.6 8
3 3 3
0
Jen 2022 Jul 2022 Jan m0
10.7
� O.a
Jul 2023 Jan M4
Qiate Month
19
s ijiL
WHATCOM COUNTY
HEALTH AND
COMMUNITY
SERVICES
11.2 1 i
1'
.. 7S
a
3
J%d 2024
•�
What type of dru . National data WHATCfLNTV
HEALTH AND
COMMUNITY
SERVICES
Figure Z. 12 Month -ending Provisional Number of Drug Overdose Deaths by Drug or Drug Class: United States
80.000
Ln
r
v 60,000
fl
Q
L
E 40.000
3
z
20.000
0
12-Month Ending Period
-egend for Drug or Drug Ctass
i'—i— rrAn 5•.1 AcvruAfl, �h.--fanfi�l lTdR R1Reported
Valto
0 Predicted Value
What type of drug? State data
W HATCOM COUNTY
HEALTH AND
COMMUNITY
SERVICES
Figure 2. 12 Month -ending Provisional Number of Drug Overdose Deaths by Drug or Drug Class: Washington
3.�00
3 000
2-500
Ln
IS 2,000
ra
m
d
° 1,500
a
E
z 1,000
500
0- ------ -- ----------
Jan 2015 Jan 2016 Jan 2017 Jan 2018 Jan 2019 Jan 2020 Jan 2021 Jan 2022 Jan 2023 Jan 2024 Jan 2025
12-Month Ending Period
egend for Drug or Drug Class
f 'nraina IAn Ni Pavrhncfimr dank umh nhrrca nw4anfi2i ITdA RX ---- Reported Value
0 Predicted Value
Monthly EMS Suspected Overdose Incidents (count by
month and rolling monthly count over previous 365
days)
140
120
E 100
1
E 80
8t
60
44
20
0
2,023 .2024. 2025
Monthly Drug -Related ED visits {count by month and
rolling monthly count over previous 365 days)
80
6❑
40
20.
0
74
60
1 1.-_. 59
2023 2024
2025
WNATCOM COUNTY
HEALTH AND
COMMUNITY
SERVICES
Program Highlights
MOUD Treatmo%nt Highlights 0 000
WHATCOM COUNTY
HEALTH AND
COMMUNITY
SERVICES
■ Co -organized and presented with local healthcare and first
response providers
• Opioid Advisor work with EMS to encourage
Buprenorphine in the field, ED initiation of buprenorphine,
and increase support for hospitalized patients
• Continuing to partner with MOUD treatment clinics,
encouraging use of tele-buprenorphine line through UW
Low barrier access and care coordination at the
sites of care with the Street Medicine Team
WHATCOM COUNTY
HEALTH AND
COMMUNITY
SERVICES
Overdose Response Pilot Program ill
WHATCOM COUNTY
HEALTH AND
COMMUNITY
SERVICES
• Initial positive response
• Planned for 6 months through 12/2025, now partnering with UW with plans to
continue and have 50% funding for the position through grants
• Specialist works with EMS, RSD, and community partners
Strategy
Initiative
Action Steps
Operational
Period Cost
Funding
Source
Department/
Division
Responsible
Timeline for
Completion*
Budget
Supplemental
required?
2e
Partner with fire and
-Convene partners via MAC
S75.000/
Multiple,
EMS, WCHCS/
Medium -term
Yes
emergency medical
workgroup
year
including
RSI Health
systems and other
-Identify challenges/ barriers and
outside
Officers/CD&E.
jurisdictions to support
opportunities
funding
Fire Districts.
an Overdose
-Develop a budget and staffing
Providers.
Response Team to
plan
PeaceHealth
connect people to
-Execute a plan and systems to
follow up care and
ensure communication
services
Naloxone Distribution and Training
• Naloxone out via
boxes since start of
program (Sept 2024):
3,559
• Naloxone out via
boxes in 2025 alone:
2,490
• Naloxone out via SSP
this year (2025): 2,990
ill
WHATCOM COUNTY
HEALTH AND
COMMUNITY
SERVICES
Strategy
Initiative
Action Steps
Operational
Funding
Department!
Timeline for
Budget
Period Cost
Source
Division
Completion"
Supplemental
Responsible
required?
1.g
Install and promote
-Installed vending machine at
$ 5,000!
Council-
WCHC 1
Short-te•rn
No
the use of at least one
Girard on 561 J 4_
year
directed
CD&E
naloxone vending
-Promoted on all public facing HCS
ARPA
Division
machine at a central
websites and communications
funds for
location
naloone
_purchase
lob.
`� f [) COMMUNFTy
J SERVIC65
1
SNOW
- m
oil
x 4
WMATCOM COUNTY
HEALTH AND
COMMUNITY
SERVICES
I
Thank you !
Washington State
Opioid Settlements &
Spend Plan
Kari Holley, Program Specialist
WHATCOM COUNTY
HEALTH AND
COMMUNITY
flifb
SERVICES
Opioid Settlement Funds
$0 M $200 M $400 M $600 M
Distributors Resolution: $518 M
May 2022
Purdue Resolution: $183 M
March 2022
Mallinckrodt Resolution: $24.8 M
May 2022
J
$800 M $1 B $1.2 $
McKinsey Resolution: $13.5 M
Feb. 2021
Pharmacies & Manufacturers
Resolution: $434.4 M
Dec. 2022
WHATCOM COUNTY
HEALTH AND
COMMUNITY
SERVICES
Region 10 Opioid Settlement fllfflLi
Settlement
involvement
Settlement amount
Over 18 years
Staggered
distribution
Who's receiving the
settlement?
J&J, McKesson,
Amerisource Bergen,
Cardinal Health
$58 million
85 % state
5% political
subdivisions
..Idah
J&J, McKesson,
Amerisource Bergen,
Cardinal Health
$119 million
40% state
40% participating
cities and counties
20% participating
health districts
•
J&J, McKesson,
Amerisource Bergen,
Cardinal Health,
Purdue
$97 million (Purdue)
$329 million (J&J,
McKesson,
Amerisource, Cardina
Health)
45% state
55% participating
subdivisions
W"ATCOM COUNTY
HEALTH AND
COMMUNITY
SERVICES
McKesson,
Amerisource Bergen,
Cardinal Health
CVS, Walgreens,
Walmart, Teva,
Allergan
$518 million
(McKesson,
Amerisource, Cardinal
Health)
$434 million (CVS,
Walgreens, Walmart,
Teva, Allergan)
50% state
50% counties/cities
-,5215million
-$217 million
Settlements & WA State
McKesson/Amerisouce- Berge n/Cardinal Health
CVS
Walgreens
Walmart
Teva
Allergan
Johnson & Johnson
Kroger
Mallincrodt
McKinsey
Publicis
Purdue
Pending: Albertson, Rite Aid, Endo, Hikma, Amneal
518 Million
18 yrs.
110.6
10 yrs.
120.3
15 yrs.
62.6
1st yr. 97%
90.7
13 yrs.
50
7 yrs.
123.3 (local 740k est.)
1 time payout
47.5 (local 319k est.)
11 yrs.
7.7
TBD
13.5
TBD
' 9
TBD
183 (in mediation)
TBD
Pending
Pending
WHATCOM COUNTY
HEALTH AND
COMMUNITY
SERVICES
Allocation of Settlement Funds
WHATCOM COUNTY
HEALTH AND
COMMUNITY
SERVICES
Local governments will determine how to spend their share, and the Legislature will
determine how the state share is allocated in communities around the state. In the 2023
legislative session, the Legislature allocated $64.1 million from the opioid payments.
Examples of legislative support included:
9$18,168,000 for prevention, treatment and recovery
support services to address and remediate the opioid
epidemic.
9$15,447,000 to tribes and urban Indian health programs for
opioid and overdose response activities.
9$5,000,000 for the Department of Health to expand the
distribution of naloxone through overdose education and a
distribution program.
•$4,000,000 for the authority to provide short-term housing
vouchers for individuals with substance use disorders.
http://www.vitaIstrategies.org/wp-content/uploads/Washington-opioid-Settlement-Fact-Sheet.pdf
50%
Local Share
p0ufL
Statewide Workgroups
WHATCOM COUNTY
HEALTH AND
Goal 1— Prevention COMMUNITY
SERVICES
Alicia Hughes — HCA alicia.hughes@hca.wa.gov
Erika Jenkins — HCA erika.ienkins@hca.wa.gov
Jaymie Mai — LNI MAIJ235@LNI.WA.GOV
Criminal Justice
Michelle Gayle —HCA michele.gayle@hca.wa.gov
Goal 2 —Treatment
Patricia Dean — HCA Patty.dean@hca.wa.gov Pregnant and Parenting
Jessica Blose — HCA iessica.blose@hca.wa.gov Tiffani Buck — DOH tiffani.buck@doh.wa.gov
Goal 3 — Opioid and Overdose
Emalie Huriaux— DOH emalie.huriauxPdoh.wa.Rov
Alison Newman — UW — alison26CcDuw.edu
Sean Hemmerle- DOH sean.Hemmerle@doh.wa.gov
Goal 4 - Data
Cathy Wasserman — DOH
Cathy.Wasserman@doh.wa.gov
Goal 5 — Recovery
Meta Hogan — HCA meta.hogan@hca.wa.gov
Malika Lamont — Public Defender's Office/Vocal WA -
malika.lamont(@defender.o
American Indian/Alaskan Native
Lucy Mendoza — HCA lucilla.mendoza@hca.wa.gov
Vicki Lowe — vicki.lowe.aihc@outlook.com
Lisa Rey Thomas — lisarey5l@gmail.com
General auestions or comments about
settlement process, contact:
Kris Shera-HCA- kris.shera@hca.wa.gov
Mary Beth Brown-DOH-
marybeth.brown@doh.wa.gov
local Settlement Allocations
W HATCOM COUNTY
HEALTH AND
COMMUNITY
SERVICES
Includes "Distributor Settlement" of $215 million with McKesson, Amerisource
Bergen, & Cardinal Health and $217 million settlement with CVS, Walgreens,
Walmart, Teva, & Allergan
18 Year Dist Staggered Dist. Total
Local Government Allocation % 215,0001000 217,000,000 432,000,000
Whatcom County
1.3452637306%
$2,893,997.05
$219191222.30
$5,813,219.34
Bellingham
0.8978614577%
$1,931,523.42
$1,948,359.36
$3,879,882.79
Ferndale
0.0646101891%
$138,992.59
$1401204.11
$279,196.71
Lynden
0.0827115612%
$177,933.15
$1791484.09
$357,417.24
County total
2.39044693s6/
$5,142,446.22
$5,187,269.86
$10,329,716.07
Blaine, Everson, Nooksack, & Sumas below 10k population
local Settlement Allocations
Walgraans US
2025
2026
351440.19
2027
351440.19
2028
361106.29
2029
361106.29
2030
520682.69
2031
521682.69
2032
520682.69
2033
520682.69
2034
520682.69
2035
520682.69
2D36
521682.69
2037
521682.69
2038
-
By -Entity total
5640554.48
Allargan Teva Distributor
720177.73
410 68.38
720971.45
410 68.38
720971.45
400400.13
71054 .75
400400.13
670968.45
400400.13
640394.15
-
640337.43
-
640337.43
-
5500700.84 031737.15
37,553.5
371553.5
370553.5
370553.5
360515.03
360515.03
360515.03
360515.03
360515.03
360515.03
360515.03
4050819.29
1380230.17
1380230.17
1130507.37
1850433.78
191,265.09
191,265,09
1600777.61
1601777.61
1600777.61
1600777.61
1600777.61
1600777.61
1600777.61
1K777,61
WHATCOM COUNTY
HEALTH AND
COMMUNITY
SERVICES
Yearly total
890 9.80
3250463.71
99,87,66
3710036.47
3720254.99
3440856.96
314031 .76
314031 .76
490975.33
490975.33
490975.33
130460.30
130460.30
1600777.61
Opioid Abatement Strategies
PART ONE: TREATMENT
a. Treat Opioid Use Disorder (OUD)
b. Support People in Treatment and Recovery
c. Connect People Who Need Help to the Help They Need (Connections to Care)
d. Address the Needs of Criminal Justice -Involved Persons
e. Address Needs of Pregnant/Parenting Women & their Families, including Babies
w/ Neonatal Abstinence Syndrome 6
PART TWO: PREVENTION
f. Prevent Over -Prescribing and Ensure Appropriate Prescribing and Dispensing of
Opioids
g. Prevent Misuse of Opioid
h. Prevent Overdose Deaths and Other Harms
PART THREE: OTHER STRATEGIES
i. First Responders
j. Leadership, Planning, and Coordination
k. Training
I. Research
WHATCOM COUNTY
HEALTH AND
COMMUNITY
SERVICES
Shy le[ 111 11 'forts & fanning
Year 1: 2024
ill
WHATCOM COUNTY
HEALTH AND
COMMUNITY
SERVICES
• Continued supporting existing goals and objectives while conducting long-
term planning
• Formation of required Regional Opioid Abatement Council (10% of $$$)
• Built Capacity (Foundational Public Health Services Fund)
• Hired Opioid Response Program Specialist
• Increased data access and utilization (feedback for statewide data
dashboards)
• Participated in statewide efforts
• Increased representation in State Opioid Planning Workgroups
• Participated in update of WA State Opioid & Overdose Response Plan
• Ensured alignment with state plan (identify additional local needs)
Long -Term Planning
Phase 1: Needs & Gaps
Susta Ina bi lily
and
-Collect information on needs and gaps Cultural
Competence
-Utilize existing plans to avoid duplication
Phase 2: Strategies & Services
-Determine programs, services, and strategies that meet identified needs
-Inclusion of non-professional interventions
Phase 3: Priorities
-Assess strategies for impact, capacity & readiness to implement
ill
WHATCOM COUNTY
HEALTH AND
COMMUNITY
SERVICES
(Is it evidence -based? Is it a new or expanded service? What level of resource is needed?)
-Determine state investments addressing local needs
-Identify appropriate fund sources including grants and alternative sources
2025 Spend Plan
WHATCOM COUNTY
HEALTH AND
COMMUNITY
SERVICES
Priorities from the Opioid Task Force, the Fentanyl Operations Plan,
and from All Hands Whatcom provided a broad range of potential
services and strategies to support. Many of these concurrently align
with the WA State Opioid & Overdose Response Plan.
WCHCS requested expenditure authority from Whatcom County
Council in July of 2025 to provide opioid prevention and mitigation
strategies in accordance with Opioid Settlement funding. Services
focus on Whatcom County youth, families, individuals, and
populations at higher risk for substance use or mental health
concerns, and the broader public.
Settlement Fund Spending - 2025 ASR
Whatcom County Examples
$10,000
$25,000
$30,000
$40,000
$45,000
$25,000
$25,000
$200,000
ill
WHATCOM COUNTY
HEALTH AND
COMMUNITY
SERVICES
In Fentanyl Operations Plan +Priority of Opioid Task Force
There will likely be $300k-$350k available per year, tapering at intervals as settlements reach their conclusion
Settlement Fund Spending — 2025 Actual
Whatcom County Examples
$10,000
$0
$18,500
$20,000
$500
$0
$12,000
$61,000
ill
WHATCOM COUNTY
HEALTH AND
COMMUNITY
SERVICES
In Fentanyl Operations Plan +Priority of Opioid Task Force
There will likely be $300k-$350k available per year, tapering at intervals as settlements reach their conclusion
Allowable Use of
Settlement Fund
Coalition prevention strategies
Youth Substance Use & Mental
Health Services
Public Education and Marketing
Naloxone
Medication lock bags
Supported employment services
Community Supported training and
programming
Personnel (Opioid Response)
•
Whatcom County Fentanyl
Operations Plan alignment
Subtotal
10% admin
10% OAC
TOTAL
Recommended
Amount
Quo mr;t6ionso.?
Kari Holley, M.Ed
Opioid Prevention Specialist
360-303-5237
Kholley@co. whotcom. wo. us
ijp
WHATCOUNTY
HEALTH AND
CSERV CESY V4=97
.,:-
2026 Spend Plan
for Opioid Settlement Funds
Background
Opioid misuse has been a concern in Whatcom County for many years and strains many public and
social services. While misuse of prescription opioids has trended downward for the past several years,
other synthetic opioids (e.g. Fentanyl) have experienced significant growth. With high potency opioids
more available and poly drug use on the rise, overdose incidences and overdose deaths have been a
concern. Whatcom County fatal overdoses increased nearly 50% from 2022 to 2023, and non -fatal
overdoses have increased significantly, as well. Without proper interventions and expanded supports,
these concerns increase the need for more expensive and intensive supports (treatment, emergency
room visits, jail, etc.).
Overview
Opioid settlement funding will be received by eligible government entities over a multi -year period. In
preparation, extensive engagement of key stakeholders and the broader community took place in
Whatcom County to assess local needs and gaps and to identify priorities for potential services and
strategies. Planning relied on a comprehensive review of needs and services across the Prevention,
Intervention, Treatment, and Aftercare (PITA) continuum of care.
The Whatcom County Opioid Task Force was convened in 2016 and supported ongoing opioid mitigation
work, and in the past couple of years local efforts have grown to include a Multi -Agency Coordination
(MAC) Group and large scale community planning events, such as All Hands Whatcom. All of these
efforts continue to provide opportunities for public engagement in opioid response efforts.
Planning
Frameworks
Whatcom County has provided substance use disorder initiatives for decades. Some of these efforts
have included a direct focus on opioids and others have targeted the reduction of key risk factors
related to the use of all substances. Throughout this work, Whatcom County has relied on frameworks
based in science to ensure services are well planned, meet local needs, and demonstrate effectiveness
in their delivery. The overarching planning framework has been the Strategic Planning Framework,
adopted from the Substance Abuse & Mental Health Service
Administration's (SAMHSA), which is a continual process and ensures
ongoing community needs are supported through an collaborative,
data -driven, and comprehensive approach.
SusteinaGffllrtp
and
Planning and assessment has aligned with other critical research, such
as Risk & Protective Factors and Adverse Childhood Experiences
(ACE'S). Planning around strategy selection also relied on the
Substance Use Continuum of Care, originally developed by the Institute
of Medicine and adapted by the substance use field, which includes a
focus on Prevention, Intervention, Treatment, and Aftercare (PITA). A focus across this "PITA
Continuum" is used to ensure a comprehensive approach to supports is considered.
Community Process
Opioid settlement funding requires that communities ensure "there is opportunity for community -
based input on priorities for Opioid Fund programs and services." Whatcom County has excelled at
engaging community stakeholders in strategic planning. Feedback has been, and continues to be,
collected from groups and stakeholders that help identify needs, gaps, and potential strategies that are
necessary to continue to address opioid and other substance misuse. Involvement of the community in
opioid response planning and prioritizing has been a cornerstone of local efforts. This has come in the
form of participation in the Opioid Task Force, Opioid MAC (Multi -Agency Coordination) Groups, All
Hands Whatcom community events, Fentanyl Operations Plan development, local coalition meetings,
and various county board and community meetings.
A number of local, regional, and state plans were also reviewed and considered to ensure efforts were
not duplicated and that strategies could align as much as possible. Alignment with these plans ensured
efforts were coordinated, built upon existing services, and provided maximum opportunity to leverage
additional resources.
State Plan
The Washington State Health Care Authority leads statewide substance use prevention and response
efforts and utilizes the frameworks described earlier. Whatcom County currently participates in
statewide meetings to ensure local efforts align with the Washington State Opioid & Overdose Response
Plan (SOOR). Goals of the SOOR currently include:
1. Prevent opioid misuse
2. Identify and treat substance use disorder
3. Ensure and improve the health and wellness of individuals that use drugs
4. Use data to detect opioid misuse/abuse, monitor illness, injury and death, and evaluate
interventions
5. Support individuals in recovery
Washington State receives 50% of all opioid settlement funds coming into the state, allowing them to
coordinate a more robust set of strategies than can be delivered by smaller jurisdictions. Whatcom
County continually identifies opportunities to align and support these strategies, and considers how
state priorities impact local needs and gaps.
Strategies
A comprehensive set of strategies is necessary to
address the broad needs created from the opioid crisis
and from other related substance misuse. Priorities m 5 4
from the Opioid Task Force, the Fentanyl Operations
Plan, and from All Hands Whatcom have provided key
guidance on potential services and strategies across i p
Sodorao '-- Lp•--.. .. ..
AM F m
the Prevention, Intervention, Treatment, and Aftercare
(PITA) Continuum. Many of these concurrently align V""TION
with the state plan.
Community assessment and strategic planning builds on work that has been done for decades in
Whatcom County. Many longstanding services have relied on a variety of federal, state, and local
resources. While a review of these efforts was essential in establishing priorities, this plan will directly
focus on the use of opioid funds and is not intended to reflect services supported through alternative
sources. It is also important to recognize that even with expanded resources, many gaps and needs still
exist.
Requirements & Selection Criteria
Use of opioid settlement funding must follow requirements established in the One Washington
Memorandum of Understanding Between Washington Municipalities. A Regional Opioid Abatement
Council (OAC) has been formed to provide oversight and ensure funds only support allowable uses and
meet settlement requirements. Some essential requirements include:
• Ensuring there is opportunity for community -based input on priorities for Opioid Fund
programs and services
• Reporting and making publicly available all decisions on Opioid Fund allocation applications,
distributions, and expenditures
• Developing a methodology for obtaining proposals for use of Opioid Funds
• Using funds only for approved purposes. "Approved Purpose(s)" shall mean the strategies
specified and set forth in the Opioid Abatement Strategies attached as Exhibit A.
Community needs exceed the resources available to address them. In addition to settlement
requirements, a variety of factors were used to help identify initial community priorities ripe for positive
outcomes. Through the application of additional selection criteria, local efforts have been strategically
selected to ensure positive local impact. Some considerations proposed by the Opioid Task Force and
county staff include, but is not limited to:
• Ensuring strategies address identified need(s) that were data -driven
• Providing balance across the Prevention, Intervention, Treatment, and Aftercare (PITA)
continuum
• Considering impact vs. effort
• Determining if strategies are short, medium, or long-term strategies
• Assessing if it is a one-time expense or needs ongoing support
• Determining readiness and capacity of the community to implement (is this new or expanded
service?)
• Building infrastructure and capacity that can be sustained
• Addressing equity in its selection and implementation (populations, geographies, etc.) and
considers populations at higher risk for substance use
• Identifying if this is a best -practice or demonstrates effectiveness through research or data
• Integrating program evaluation (has evaluation tool and identified metrics to be addressed)
• Showing cost -benefit or cost -savings
• Determining funds are sufficient to address the identified needs or gaps
• Considering if the strategy is funded by another source (state, federal, grant, etc.) or if an
alternative source is more appropriate
• Assessing if these funds can leverage other funds or resources to maximize impact
Strategies by PITA Continuum
Strategies
Coalition prevention strategies
Prevention
✓
intervention
Treatment
Aftercare
Youth substance use & mental health
services
✓
Public education and marketing
✓
✓
✓
✓
Naloxone
✓
✓
✓
✓
Medication lock bags
✓
✓
✓
✓
Supported employment services
✓
Community supported training and
programming
✓
✓
✓
✓
Personnel (Opioid Response)
✓
✓
✓
✓
23-hour Crisis Center
✓
✓
Outcomes and Evaluation
A Fentanyl Evaluation Plan was published in April of 2025 and identifies process evaluation, strategy
evaluation, and population -level monitoring efforts. The plan details a range of strategies, indicators,
and data sources that will be used to determine progress and success. The strategies identified in this
spend plan are reflected in the evaluation plan. Though long-term efforts focus on the prevention and
reduction of substance use, short-term efforts will immediately impact service access and utilization.
Efforts will ultimately create a positive impact on families, the healthcare systems, schools, emergency
medical services, and the criminal justice system, including law enforcement, courts, and jails. Each
program, service, or strategy will track metrics unique to their area of service. Service and outcome
summaries will be made publicly available.
Cost Savings
Research -based strategies will be employed when available. An analysis by Washington State Institute
for Public Policy details cost savings unique to individual programs and can be found at
https://www.wsipp.wa.gov/. Some evidence -based strategies already operating in Whatcom County, for
example, show a cost benefit of $5,805 for each participant. Other interventions show a savings of an
estimated $18 per $1 invested.
Budget
The strategies listed below were determined to be allowable uses of settlement funds and were directly
connected to a locally identified priority.
Coalition prevention strategies
Allowable Use.
Settlement Fund
G4, G5
Fentanyl Operations
Plan alignment
113
Amount
100,000
Youth Substance Use & Mental
Health Services
G10, G11
OTF
40,000
Public Education and
Marketing
G1, G2, G7, H6, H7
1A
45,000
Naloxone
H1, H2, H4
1G, 2F
25,000
Medication lock bags
G5
1F
5,000
Supported employment
services
136
4d
25,000
Community Supported training
and programming
K1, H3
1C
80,000
Personnel (Opioid Response)
Multiple
Multiple
223,494
Subtotal
10% admin
10% OAC
TOTAL
543,494
54,349
54,349
652,192
Through previous budgeting processes, $1 million of opioid settlement funds was set -aside to support
treatment services through the 23-hour crisis -facility. Those funds are not included in this budget but
have already been approved by County Council.
Proposals
Service contracts, agreements, or purchases generated from these funds will follow county purchasing
policies and procedures. Settlement funds require there is a process in place for "receiving and
reviewing proposals" for use of opioid funds. In Whatcom County, this may come in the form of a
Purchasing Bid, Request for Proposal (RFP) or Request for Qualification (RFQ) solicitation, or through the
MRSC roster. Entities are able to sign up to receive a text message or email when new bids are added at
https://www.whatcomcounty.us/Bids.aspx. Once posted, agencies can submit proposals responding to
a solicitation. Whatcom County Government is a member of MRSC Rosters and it is an efficient way to
publish contract opportunities for services using a competitive roster process. Join the MRSC Roster at
https://members.mrscrosters.org/register.
The focus of solicitations will continue to be based on community feedback. Consider participating in
some of the community planning processes detailed earlier to help guide future work.
Next Steps
Engage in continuous collaboration with county department leadership and the executive office to
identify needs, establish priorities, and ensure alignment with organizational goals. Opioid settlement
funds will continue to be distributed to eligible government entities over the course of many years. The
strategies listed in this plan are the first steps to utilizing funds to meet locally identified needs.
Ongoing planning will help determine the feasibility of expanding or adding new strategies, identify new
or emerging needs or gaps over time, and provide ongoing assessment of any shifts in capacity,
readiness, and resources. In 2026, Whatcom County will:
1. Collect service and/or purchase bids or proposals (as appropriate)
2. Finalize program or service evaluation plans
3. Execute service agreements or purchases
4. Initiate and conduct full implementation of proposed strategies
5. Perform service and strategy evaluation
6. Determine if services have achieved outcomes and are appropriate for renewal or extension
The Strategic Planning Framework will continue to be utilized to provide essential structure for this
multi -year process.
Prepared by Whatcom County Health and Community Services on October 22, 2025
GUIDE FOR COMMUNITY ADVOCATES
ON THE OPIOID SETTLEMENT
Vital
Washington Strategies
Total Funds Allocation Mechanism
Allocation agreements
between the state and local
governments (One Washington
Memorandum of Understanding
50%to the state and 50%to Between Washington
$518 million' participating local governments Municipalities+ Allocation
Agreement Governing the
Allocation of Funds Paid by the
Settling Opioid Distributors in
Washington State), legislation
(Laws of 2023, ch. 435, § 5)
Key Takeaways
Patchwork participation in national settlements. As of publication, Washington has settled with the "big three"
distributors McKesson, AmerisourceBergen, and Cardinal Health, but not with Johnson & Johnson.2 Its Allocation
Agreement applies to settlements from the "big three" only.'
50-50 allocation. Washington splits its opioid settlement funds evenly
between the state and participating local governments
Public reporting. Participating localities must annually report their expenditures to their regional Opioid Abatement
Councils (OACs).4 The OACs must then make these and their own expenditures public on regional dashboards.' The
state's 50%share, however, is not subject to similar reporting requirements.'
Background Washington's August 2022 Allocation Agreement establishes a 50-50 split of
settlement funds between the state and local governments.' The One Washington
Memorandum of Understanding Between Washington Municipalities (MOU)
establishes the regional allocation structure governingthe participating local
governments' use of funds.' State law establishes the Opioid Abatement
This resource is current as of
Settlement Account (Abatement Account) to hold the state's share of settlement
6/5/2023. For the most up-to-date funds s Both the state and participating local governments must spend their funds
information, please visit httpson "Approved Purposes" such as to expand prevention, harm reduction, treatment,
:// and recovery services.10 The state is further required to spend Abatement Account
www.opioidsettlementtracker.com/
monies on future opioid remediation, as defined by state law and applicable
settlementspending settlement agreements"
vita lstrategies.org Vital Strategies, in collaboration with OpioidSettlementTracker.com ® christineminhee
GUIDE FOR COMMUNITY ADVOCATES
ON THE OPIOID SETTLEMENT
Washington
Decision -
Making Process
Vital
VA * Strategies
ALLOCATION OF SETTLEMENT FUNDS
50%
Local Share
50% STATE SHARE
The state's 50% share of settlement funds are held in the Opioid Abatement
Settlement Account (Abatement Account) established by state law.12 Abatement
Account monies must be appropriated by the state legislature and used for future
opioid remediation 13 The legislature is informed by input from a chain of key
stakeholders:
1. The State Opioid and Overdose Response Plan (SOORP) workgroup provides
recommendations to the SOORP "executive sponsors" (representatives from
key state agencies and academia).
2. The SOORP executive sponsors use the workgroup's recommendations to
develop their own funding recommendations, which are then provided to the
governor's office."
3. The SOORP executive sponsors' recommendations may be integrated into
the Governor's budget, which contains funding proposals for the legislature's
consideration and approval.","
50% LOCAL SHARE
The local governments' 'LG Share" of funds is held in a Qualified Settlement Fund"
and distributed to participating local governments by county accordingto the
MOU's Exhibit B.18 The distribution of funds within each participating county will be
determined by regional decisionmaking structures based on the nine predefined
Washington State Accountable Communities of Health (ACH) regions.19 Each region
is responsible for determiningthe sub -allocation of funds among its counties, cities,
and towns based on regional agreements.20 In regions without a regional agreement,
the MOU provides a default formula for allocating funds within the region(s) based
on Exhibit B.21 Additionally, each region must establish an Opioid Abatement
vita Istrategies.org Vital Strategies, in collaboration with OpioidSettlementTracker.com ® christineminhee
GUIDE FOR COMMUNITY ADVOCATES
ON THE OPIOID SETTLEMENT
Vital
Washington Strategies
Decision- Council (OAC) to oversee regional distributions and review the expenditures of
Making Process participating local governments in the region 22 Ten percent (10%) of each region's
(Continued) funds are reserved for the OAC's administrative costs 23 Although membership
selection and terms are left up to the OAC's themselves, lalll persons who serve
on an OAC must have work or educational experience pertainingto one or more
Approved Uses."24
Regardless of whether funds are sub -allocated via a regional agreement or
the default formula, only participating local governments may receive direct
distributions of sub -allocated funds;25 non -participating local governments'
portions will be reabsorbed by participating counties 26 Participating local
governments must comply with a set of conditions to receive direct payment"
These conditions include, for example, creating processes to collect proposals
on the use of funds, gathering community feedback on funding priorities, and
reporting their expenditures to the OAC and the public" Participating local
governments that comply with these conditions may decide for themselves how
to allocate their direct funds on approved uses such as to expand harm reduction
and treatment services.29 If participating local governments choose to forego their
direct allocation of settlement funds, the OAC is responsible for directing and
administering the distribution of those funds, including by approving or denying
funding proposals from participating local governments or community groups.30
Tracking Funds
• Participating localities must annually report their expenditures to their regional
and Accountability
Opioid Abatement Councils (0ACs).32 The OACs must then make these and their
own expenditures public on regional dashboards."
• Regional OACs may suspend participating local governments' direct payments
if they use funds for non -approved uses, fail to satisfy the MOU's reporting
requirements, or fail to meet the conditions for direct payment described
above 34
• Neither state law, Washington's MOU, nor its Allocation Agreement contain
explicit promises to publicly report the state's 50% share."
• Both the state and participating local governments are subject to Washington's
Public Records Act 36
vita lstrategies.org
Vital Strategies, in collaboration with OpioidSettlementTracker.com ® christineminhee
GUIDE FOR COMMUNITY ADVOCATES
ON THE OPIOID SETTLEMENT
Vital
Washington� Strategies �
Engaging in • Participating local governments' direct receipt of funds is conditioned on a few
the Process factors, including gathering community input on funding decisions 37 Watch for
opportunities to provide that input!
• Look out for the regional dashboards that describe spending, which OACs must
make public and update annually.38 Track how expenditures match up against the
community input provided to participating local governments.
• Attend monthly meetings of the Substance Use Recovery Services Advisory
Committee (SURSAC), also known as the Blake Committee — a legislatively
created body which must include people with lived experience and that was
tasked with developing a plan to help people with substance use disorders
access care.31,41 Public comment is encouraged at committee meetings.
• Monitor meeting materials form the State Opioid and Overdose Response Plan
(SOORP) Workgroup. Subscribe to e-mail updates from the Workgroup here.
Additional WASHINGTON STATE HEALTH CARE AUTHORITY
Resources State Opioid and Overdose Response Plan +
Workgroup Materials
Washington State Opioid Settlements
Washington Opioid Settlement Frequently Asked
Questions
WASHINGTON ATTORNEY GENERAL
Distributors Washington Settlement
vita Istrategies.org Vital Strategies, in collaboration with OpioidSettlementTracker.com ® christineminhee
GUIDE FOR COMMUNITY ADVOCATES
ON THE OPIOID SETTLEMENT
Washington VA
References Last updated June 5, 2023.
Vital
Strategies
1. From settlements with distributors McKesson, AmerisourceBergen, and Cardinal Health only.
Washington is also participating in several settlements that are likely to be finalized later this
year, e.g., CVS, Walgreens, Walmart, Allergan, and Teva. See KHN's "The Right to Know: Where
Does Your State Stand on Public Reporting of Opioid Settlement Cash?" interactive transparency
map (located mid -article; click "Washington" for state -specific participation information) and
OpioidSettlementTracker.com's Global Settlement Trackerfor more information.
2. See, e.g., AG's December 2022 press.
3. Alloc. Agrmt.4. Washington's Allocation Agreement is limited by its definitions to the Distributor
Settlements (see Alloc. Agrmt.1). Its MOU, however, contains no such specificity to Distributors
but explicitly excludes bankruptcy settlements. MOU A.14. Note that many states' mechanisms
for opioid settlement spendingwere designed to comply with the requirements of the Distributor
and Janssen settlement agreements, which require (among other provisions) that a minimum of
85% of settlement funds be spent on opioid remediation expenditures. Section V.B.I. Subsequent
settlements require varying thresholds of opioid remediation spend; the CVS and Walgreens
agreements, for instance, require a minimum of 95.5%and 95%opioid remediation spending,
respectively. Section V.B.I. Keep an eye out for the ways states will amend their spending
mechanisms, if at all, to comply with subsequent settlement terms.
4. MOU CA(g)(vi).
5. MOU C.4(j)(ii),(iv),(v).
6. See OpioidSettlementTracker.com's "States' Initial Promises to Publicly Report Their Opioid
Settlement Expenditures."
7. Alloc. Agrmt. 9.
8. Alloc. Agrmt.10. The MOU is also attached to Washington's Allocation Agreement as its Exhibit 3.
9. Laws of 2023, ch. 435, § 5(1).
10. Approved Purposes is defined by reference to Exhibit E of the Distributor and Janssen Settlement
Agreements. "Approved Purpose(s)'shall mean the strategies specified and set forth in the Opioid
Abatement Strategies attached as Exhibit A." MOU A.2. "Exhibit A of the MOU is replaced by Exhibit
E of the Global Settlement, which is attached as Exhibit 4 to this Agreement." Alloc. Agrmt.11.B.
11. Laws of 2023, ch. 435, § 50) (opioid remediation is defined as "the care, treatment, and other
programs and expenditures, designed to: (a) [a)ddress the use and abuse of opioid products; (b) treat
or mitigate opioid use or related disorders; or (c) mitigate other alleged effects of, includingthose
injured as a result of, the opioid epidemic.")
12. Laws of 2023, ch. 435, § 5(1). See also Laws of 2023, ch. 435, § 5(2) (transferring all remaining money
in the state opioid settlement account established under RCW 43.88.195 to the opioid abatement
settlement account).
13. Laws of 2023, ch. 435, § 50) (opioid remediation is defined as "the care, treatment, and other
programs and expenditures, designed to: (a) [a)ddress the use and abuse of opioid products; (b) treat
or mitigate opioid use or related disorders; or (c) mitigate other alleged effects of, includingthose
injured as a result of, the opioid epidemic.")
14. See, e.g., 2021-22 Opioid Overdose and Response Plan.
15. https://waportal.org/partners/home/washington-state-opioid-settlements/frequently-asked-
questions. See also Gov's 2023-25 Budget and Policy Highlights; 2023-2025 Proposed Budget
- Washington State Health Care Authority (HCA) ("In the HCA agency recommendation summary,
opioid settlement uses are marked'DS,"' per this FAQ); and 2023-2025 Proposed Budget -
Department of Health (DOH) ("in the DOH agency recommendation summary, opioid settlement
uses are marked with 'Settlement,"' per this FAQ).
16. Laws of 2023, Chapter 475, which contains appropriations from the Opioid Abatement Settlement
Account, provides an example of the process' final product.
17. MOU B.1.
vita lstrategies.org Vital Strategies, in collaboration with OpioidSettlementTracker.com 0 christineminhee
GUIDE FOR COMMUNITY ADVOCATES
ON THE OPIOID SETTLEMENT
Vital
Washington� Strategies �
References 18. MOU B.3 and Alloc. Agrmt.10. The Allocation Agreement amends and adds to the MOU and may
(Continued) be treated as its amendment.
19. MOU BA, CA
20. MOU C.2. Regional agreements may allow for the pooling of funds per MOU C.5, and participating
localities may reallocate their shares to their regional OACs per MOU CAW).
21. See MOU CA(a).
22. MOU CA(h).
23. MOU CA(b).
24. MOU CA(i).
25. MOU CA(f). "Cities and towns with a population of less than 10,000 shall be excluded from
the allocation, with the exception of cities and towns that are Litigating Participating Local
Governments." MOU CA(c).
26. MOU CA(f).
27. MOU CA(g).
28. MOU CA(g)(i)-(vi).
29. "Participating Local Governments that receive a direct payment maintain full discretion over the
use and distribution of their allocation of Opioid Funds, provided the Opioid Funds are used solely
for Approved Purposes." MOU CA(e).
30. MOU C.4(j)(iii).
31. See also, https://www.peninsuladailynews.com/news/claIlam-county-approves-creating-opioid-
abatement-council/.
32. "As a condition of receiving a direct payment, each participating local government that receives
a direct payment agrees to undertake the following actions:... Reporting to the OAC and
making publicly available all decisions on Opioid Fund allocation applications, distributions and
expenditures." MOU CA(g)(vi).
33. 'The Regional OAC will be responsible for the following actions:... Annual review of expenditure
reports from [PLJs] within the Allocation Region for compliance with Approved Purposes
and the terms of this MOU and any Settlement," "Reporting and making publicly available all
decisions on Opioid Fund allocation applications, distributions and expenditures by the OAC
or directly by [PLGsl," and "Developing and maintaining a centralized public dashboard or
other repository for the publication of expenditure data from any [PLG) that receives Opioid
Funds, and for expenditures by the OAC in that Allocation Region, which it shall update at least
annually." MOU C.4Q)(ii),(iv),(v). Regional OACs must also collect outcome -related data from PLGs
"if necessary." MOU CA(j)(vi).
34. Alloc. Agrmt.11.F.
35. See OpioidSettlementTracker.com's "States' Initial Promises to Publicly Report Their Opioid
Settlement Expenditures."
36. RCW 42.56 et seq. Alloc. Agrmt.12.
37. MOU CA(g)(ii).
38. MOU C.4(j)(v).
39. RCW 71.24.546. See also SB 5476 State v. Blake Behavioral Health Expansion Fact Sheet.
40. The SURSAC may propose ways to expend opioid settlement funds. See, e.g., the group's plan,
which was submitted to the Governor in December 2022, proposes funding some strategies with
opioid settlement funds, including capital construction costs for new opioid treatment programs
(OTPs) and expanding the reach of existing OTPs.
vita Istrategies.org Vital Strategies, in collaboration with OpioidSettlementTracker.com ® christineminhee
• Whatcom County COUNTY COURTHOUSE
311 Grand Avenue, Ste #105
Bellingham, WA 98225-4038
(360) 778-5010
• Agenda Bill Master Report
File Number: AB2025-693
File ID: AB2025-693 Version: 1 Status: Presented
File Created: 09/26/2025 Entered by: KSmith@co.whatcom.wa.us
Department: Council Office File Type: Presentation
Assigned to: Council as the Health Board Final Action: 10/28/2025
Agenda Date: 10/28/2025 Enactment #:
Primary Contact Email• ksmith@co.whatcom.wa.us
TITLE FOR AGENDA ITEM:
Presentation on locally -led health initiatives
SUMMARY STATEMENT OR LEGAL NOTICE LANGUAGE:
None
HISTORY OF LEGISLATIVE FILE
Date: Acting Body: Action: Sent To:
10/28/2025 Council as the Health Board PRESENTED
Attachments: Presentation - Lummi Island Health & Wellness, Presentation - United General District 304,
Presentation - East Whatcom County Health Equity Zone
Whatcom County Page 1 Printed on 11712026
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Where we live
should not determine
how well we live.
Medical Access
Residents of Lummi Island struggle
with limited access to healthcare,
especially for emergency and routine
services.
Aging Population
The average age on Lummi Island is MIA
62.2 years compared to 38 for the E
county. w _ 6�-wai a
Limited Supply of Caregivers
With a population of 1000, the island
lacks caregivers due to the cost of
29 living and ferry access.
Healthcare Equality
The situation highlights the need for
equitable healthcare access, regardless
of geographic location.
Expanding Telehealth Services
Telehealth capabilities are being
enhanced to improve access to quality
care for community members,
regardless of location.
Support for Aging in Place
Efforts focus on enabling older adults
to live safely and comfortably in their
own homes, supported by community
programs.
Community and Social Connections
Building strong social networks
encourages mental health and fosters
a sense of belonging among
community members.
Preventive Health and Wellness
The survey emphasized the
importance of preventive health and
wellness services to improve overall
community well-being.
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Health Support for All Ages
Lummi Island Health & Wellness was launched in 2024 to
serve residents of every age group with inclusive
support.
Building Resilience and Adaptability
The mission fosters resilience and adaptability, helping
residents face changes and challenges throughout life.
Programs and Wellness Activities
Programs include education, support networks, and
community activities that strengthen overall health and
well-being.
Health Resource Center Launch —
The new resource center offers health
information and support to community
members for improved wellness.
Active Lifestyle Initiatives
Fitness classes and wellness events
promote active lifestyles and foster
• stronger community engagement.
Accessible Health Services
Telehealth services and a foot care clinic
provide essential, accessible care for
diverse community health needs.
Telehealth
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Health Support
from Home.
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Training and Education Initiatives
We empower our community by providing targeted
training and educational opportunities that boost skills
and confidence for lasting success.
Expanding Through Partnerships
Strategic partnerships have allowed us to pool resources,
broaden our reach, and maximize positive community
outcomes.
Model of Sustainable Empowerment
Our commitment to self -belief and measurable results
has made us a model for sustainable community growth
and empowerment.
Active Stakeholder Listening
Listening to stakeholders helps us
identify needs and address them
effectively for better outcomes.
Fostering Collaboration
Engaging with teams and partners
builds trust and encourages
collaborative problem solving.
Leveraging Tools and Resources
Using modern communication tools
and available resources streamlines
workflows and ensures clear, efficient
information sharing.
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Early Success Achieved
Programs have demonstrated effectiveness and impact
without the need for public funding, showcasing initial
success.
Long-term Sustainability Challenges
Maintaining momentum overtime is difficult, especially
with limited resources and growing needs.
Expanding and Seeking Support
There is a desire to share our model more widely and
secure financial backing for continued growth.
Celebrating Impact:
Sincere Thank
1 national and 5 local foundations, and
2 island organizations have supported
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North Sound ACH
CHUCKANUT
HEALTH FOUNDATION
Investina todav for a healthier tomorrow.
Mount Baker
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Questions
and
Comments
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Hospital District -*304
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NA1113NAL FOREST
History of the Hospital District
PIP' Hospital District was
1965 formed from consolidation
of hospital districts 3 and 4.
• Boundaries cover 2000 square miles
• Cities include Burlington.
Sedro-Woolley. Clear Lake,
Hamilton, Lyman, Concrete.
Rockport & Marblemount
United was a
standalone hospital
during this time.
1991
United affiliated with Skagit
Valley Hospital under the name
Affiliated Health Services.
Affiliation with
Skagit Valley
Hospital ended.
United signed a
t014 long-term agreement
with PeaceHealth to
manage clinical
services.
• United retains most of the
hospital assets
United was once
again a standalone
hospital.
UNITED
GENERAL
DISTRICT 304
By}lding Hgalthier
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' DID YOU KNOW?
Hospital districts can provide any service
that helps people stay healthy - physically,
socially, and mentally. We make sure
hospital and medical care is there when
you need it and go beyond to help keep
people healthy and thriving every day.
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Tobacco Drug &
Excercise Use Alcohol Use
20% Medical Care
Access to
Medical Care
Stress/
Mental Health
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Quality of
Medical Care
10% Physical Housing &
Environment Environmental Factors
Public Health
Prevention Model
Tertiary
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Board of
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Superintendent / CFO
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Carol Hawk Suzanne Carr
Mar V55 ------------- Visual Communications
------ Chief Operating Officer &or
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Human Resources Mgr.
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Elizabeth Ruth
Kenny Tuckerman Nicole Dewey Communications &
Fiscal Analyst Senior Accountant Resource Development
Vanessa Rnitlan ArnY Wilcox
Grant Writer &
Office Supervisor Resource Development
Mark Pearson Rdcttel Nluia
Lyndie Simmonds Jill Sprouse Stephanie Mvrgareidge
Manager Supervisor Supervisor 1 Supervisor Supervisor
Thriving Children 4I Engaged Youth & Community Att'lve Living Healthy faking &Families � Y &
Communirieg Professional Education
Children's
Durlington Healthy
CGUndl
Comm. Coalition
Early Childhood
Concrete Resource
Programs
Coalition ! CPP
Help Me Grow
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WIC Clinics
Sedro-Woolley
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Health Equity Zones:
Born from Policy, Built by People
• In 2021, the Washington State Legislature passed Senate Bill 5052, which
officially authorized DOH to identify and support "health equity zones", geographic
areas where communities face significant barriers to health.
• DOH launched the initiative with a core belief: the people who are most impacted
by health inequities are also the best positioned to design solutions.
• Beginning in July 2021, DOH worked alongside agency and community partners to
build the HEZ model, focusing first on partnerships, community engagement, and
designing a process where residents would help pick priorities, lead decision -
making, and build sustainable systems. ==A
Overview
• The Health Equity Zone in East Whatcom, which encompasses the entire Mt
Baker School District,
has been focused on one big goal
this
past year;
building a transparent,
resident -led system for identifying
and
prioritizing
community needs.
• Instead of outside agencies deciding what's best for East County, we've built a
process where local residents, through our Community Advisory Board (CAB),
set the agenda, design the decision -making tools, and lead the work.
How It Started
We've spent the year building relationships and testing ways to make
government processes actually accessible.
• Engagement: Over 1,150 residents connected through workshops, focus groups, tabling events,
and community gatherings.
• Supports: Events include, childcare, translation (Spanish, Ukrainian, Russian, Punjabi), and are
held in accessible locations. Attendees are also compensated with Visa gift cards for their time
and expertise.
• Trusted Messengers: 29 local residents helped share information, reaching another 1,000
households through the Foothills Connection HUB.
Key Take=Aways
• East Whatcorn communities carry real hesitation, years of being promised
help with little follow-through.
• Trust wasn't built through words; it came from consistency, transparency,
and showing up.
• Each small action, a conversation, an event, a visible result, helps build
credibility.
• Lesson: Lasting change will only happen when community sees that this
time, their voice truiy matters.
How It's Going
The CAB: The Heart of the Work
• Formed intentionally —
byJune 2025.
11 Ile
22 applications, 15 one -on -ones, 11 dedicated members
• i ne UHb isnt dust aavisory." They decide now i
the ballot, and which projects move forward.
deas are scored, what goes on
• Rarely seen before, East Whatcom residents are governing their own investment
pipeline.
• Their leadership transformed HEZ from a program into aresident-run process
that reflects lived experience, not outside assumptions.
What That Looks Like
We developed a new framework called the Community Priorities Pipeline, our version of
participatory budgeting adapted for our current process.
• Here's how it works:
• Community Ideas: Anyone can submit a proposal (simple form — no grant writing required).
• CAB Scoring: The CAB evaluates each idea for impact, feasibility, and sustainability.
• Community Voting: In January 2026, everyone 14+ who lives, works, or learns in the Mount
Baker School District can vote online, on paper, or at events.
o Funding Prep: In February -March, top priorities will move into the funding pipeline for grants,
partnerships, or advocacy support.
Currently we have six proposals on hand ranging from local transportation options to a community
farmers' market and youth mentorship programs.
Where We Are Headed'.
The next phase is about growing local leadership — identifying and supporting a
team of Mount Baker community members to carry this work forward.
• The goal: aself-sustaining, ad -hoc community council that keeps this
momentum alive long after HEZ funding ends.
• East Whatcom's lack of consistent representation has had real
consequences. This is our moment to change that — by helping the
community build the structure to speak for itself.
• Every step we've taken has been about giving this community the one thing
it's always deserved: a clear, collective voice that's heard and respected.
IC) CHUCKANUT
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