Spokane County announces plans for initial $7.2 million in opioid settlement disbursements

Spokane County is poised to pour $5.2 million into hands-on medical treatment to detox and treat drug addicts as elected officials try to slow the deepening fentanyl crisis.

The treatment spending, approved by Spokane County commissioners on Tuesday, accounts for most of the $7.2 million made available from initial disbursements of money won from state lawsuits against opioid manufacturers and distributors.

“I think that we all know that this epidemic has caused so much damage in our community and all over the nation,” Commissioner Chris Jordan said ahead of the vote. “The scale of pain for families of victims is immense. The settlement dollars, I believe, are our chance to bring some solutions to the table to promote public health and safety here in Spokane County.”

In recent years, Washington state has been awarded more than $1.1 billion in opioid court judgments and settlements. Roughly half of it will be dispersed to local jurisdictions, and Spokane County expects to receive around $17.5 million in installments until 2038.

Spokane County has identified four areas of investment for the initial settlement disbursements, which are all intended to fill existing gaps in the regional treatment network, community services director Justin Johnson said.

“We looked at all of these areas, medium treatment, long-term treatment, comprehensive engagement, gap areas and supportive housing,” Johnson said. “The county has looked at a wide swath of areas that hit everything that the community is looking for, but more effectively addresses areas where the largest gaps are, where insurance or other providers are not covering.”

The county commissioners have agreed to put the $5.2 million toward a proposed expansion of services at the Spokane Regional Stabilization Center; $1.2 million toward the more immediate expansion of services provided by community partners; $600,000 toward housing and treatment support for parents of infants with Neonatal Abstinence Syndrome; and $200,000 to improve overdose and substance use data.

“That’s where people are falling through, and that’s where the county said we need to step in and be a leader in it,” Johnson said.

The 45-bed Spokane Regional Stabilization Center opened in 2021 to offer medical and mental health services to those who often cycle through stays at the jail and local emergency rooms without receiving treatment.

At present, only prebooked individuals escorted to the facility by a law enforcement officer, and who meet certain requirements necessitating care, are able to access the facility. Ashley Magee, an integrated behavioral health care manager for the county, told the Spokane Valley City Council in March that 1,563 people were served by the facility in 2023.

Johnson said $5 million of the county’s settlement funds will go toward capital improvements at the facility, with the intent of expanding services to include crisis relief and stabilization for walk-ins and referrals, bolstered mental health and substance use treatment, and more extensive withdrawal and detox management care.

The latter is one of those gaps in the treatment system Johnson hopes the investment will help fill. Those who go through detox or receive withdrawal treatment may not always go on to an inpatient facility, and there is a need for more detox and inpatient facilities in the region. Having those services in one location would be beneficial in getting those already at the facility into a treatment plan.

“That is the biggest challenge we have with individuals,” Johnson said, “is finding a place that provides a comprehensive and safe environment so that they can be encouraged to remain in care longer.

“So I’m reducing that car ride, that cab ride, that, ‘Please walk here,’ to being literally walked, with someone who is a peer, saying, ‘I’ve been through this before,’ over to the facility, in a safe environment.”

The remaining $200,000 allocated to the center will help cover its ongoing annual operation costs.

County CEO Scott Simmons said the proposed plans for the facility are projected to cost $15 to $18 million.

The commissioners have asked Congresswoman Cathy McMorris Rodgers and Senators Patty Murray and Maria Cantwell to advocate for an additional $5 million in federal backing, and local hospitals, the Spokane Regional Health District and the cities of Spokane and Spokane Valley have all contributed letters of support.

Simmons said the county will likely need to ask for additional funding from the state to achieve their vision for the center, and it will likely be a few years before it becomes a reality.

In the meantime, the county has devoted $1.2 million toward helping community partners build up their existing treatment networks. Johnson said the county will issue a request for proposals in the coming weeks to see where those funds could best be used.

“We have immediate investment of funds to support the current need, as well as long-term funding and investment to support the ongoing need in the community,” Johnson said.

Having access to secure housing while receiving treatment is one of the challenges parents struggling with addiction face after having a child, he said.

There are facilities in the area like Maddie’s Place that provide care for infants with Neonatal Abstinence Syndrome, and help parents receive treatment themselves, but those families often go back to environments where they can slip back into old habits.

“When you put in a mom with a new baby, with various challenges dealing with behavioral health and trauma, and you put them back in an environment where there may be other drug use there, factors remain,” Johnson said.

Around $600,000 in settlement funding will go toward housing and supportive services for those families, in the hopes that more integrated care in a stable environment will have lasting impacts on the family’s health.

The county will also issue a request for proposals from care providers for this project in the coming weeks, Johnson said.

The remaining $200,000 in initial settlement allocations will go toward improving data collection related to the opioid crisis, to better inform the county’s approach to shoring up existing gaps.

Johnson said there’s no single way to track the impacts of the opioid crisis in the region. They gather data on fatal overdoses, interactions with local law enforcement and information from providers and hospitals, but there is nothing that provides the full picture.

The funds will cover, in part, the work that needs to happen to build that system, as well as a devoted staff member to manage it.

“So part of the challenge that we find is how can we better track and understand the trends within the community and respond effectively to the services,” Johnson said.

“So the board has also approved the use of dollars to be provided for a data tracking and engagement analyst to be able to collect all that data from areas, and then coordinate that with regional health districts’ current data tracking, so there’s a greater depth of understanding and knowledge in the system.”

Johnson said the county was thorough in determining how to spend its settlement disbursements, using a community survey with more than 200 responses, internal reviews of the existing network and a panel composed of local experts, tribal and community members, providers and in-house staff members to help narrow the focus to these projects.

The settlements have provided initial funding, but Simmons said all of the projects will be sustainable through funding sources Johnson and his team have identified during the months of work leading to the commissioners’ vote Tuesday. Those sources include the county’s Mental Health Sales Tax, Medicaid, and federal and state grants.

Johnson said there’s more than enough funding available to keep the projects going, and part of the initial investments is to build up the infrastructure and network needed to qualify for some of those funding sources.

All four commissioners at the meeting Tuesday tipped their cap to Johnson and county staff members for their months of work to identify where the funding would be used best.

Commissioner Amber Waldref said she’s excited about the opportunity to expand the stabilization center, and to assist vulnerable families with the challenge of turning over a new leaf.

Commissioners Josh Kerns and Al French noted Spokane County was one of the first jurisdictions in the state to join in the legal fight and said they look forward to seeing how the settlements will benefit the community.

“We were at the cutting edge, one of the first counties to join in the litigation,” French said. “Now we have the benefit of reaping the rewards, of having financial resources to help deal with the addiction and presence of it in our community.”