Executive/Council Action Form (ECAF)
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Budget Motion 26-375, approving the Six-Year Opioid Settlement Dollars Spending Plan 2027-2032
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DEPARTMENT: Health Department
ORIGINATOR: Theresa Bengtson
EXECUTIVE RECOMMENDATION: Approved by Ken Patton 9/4/26
PURPOSE: Acceptance of the Health Department’s response to Budget Note 1 included in the mid-biennium review adopted in Amended Ordinance 25-065
BACKGROUND: On September 7, 2022, Snohomish County Council authorized the County Executive to join in the State of Washington’s settlement with McKesson Corp., Cardinal Health Inc., and AmerisourceBergen Drug Corp as a Participating Local Government pursuant to the One WA Memorandum of Understanding (MOU). Snohomish County is also a participant in the “Allocation Agreement Governing the Allocation of Funds Paid by the Settling Opioid Distributors in Washington State” with initial funds from this settlement distributed directly to Snohomish County in 2022. Snohomish County participates with Whatcom, Skagit, Island and San Juan Counties in the North Sound Behavioral Health Administrative Services Organization area (NSBH-ASO) established under RCW 74.09.870 and all five counties and certain cities within those five counties are Participating Local Governments pursuant to the One WA MOU and the Allocation Agreement. In late 2025, the Opioid Settlement Fund transitioned to the Health Department to provide oversight of the Fund on behalf of Snohomish County with the purpose of aligning with its existing body of work of substance use prevention and treatment. The department developed the Six-Year Opioid Settlement Dollars Spending Plan and proposed a six-year spend plan (from page 26 of the attached plan) in response to Amended Ordinance 25-065 Mid-Biennium Budget Note. The report outlines the community needs, strategic priorities, and recommended investments that will guide the use of settlement funds. The spending plan demonstrates how the proposed funding aligns with the plan's goals, is informed by stakeholder engagement and data, and supports evidence-based, coordinated strategies to prevent overdoses, expand treatment and recovery services, and address the broader impacts of the opioid crisis. As such, it serves as the foundation for the funding request and the proposed allocation of opioid settlement resources during the 2027-2028 biennium. This Six-Year Opioid Settlement Dollars Spending Plan (2027-2032) establishes Snohomish County's strategic direction for addressing the opioid epidemic. Building on a coordinated community response established in 2017, the plan is rooted in seven guiding principles developed by the Opioid Multi-Agency Coordination (MAC) Group under the 2023 Executive Directive - evidence-based, accountable, compassionate, legally grounded, fiscally responsible, collaborative, and nimble - and shaped by input from three community convenings and key informant interviews conducted in 2026. Snohomish County is a signatory to the One Washington Memorandum of Understanding (MOU), which governs how opioid settlement funds are allocated, managed, and spent statewide. The plan and all settlement spending are jointly overseen by the Snohomish County Health Department and the MAC Group, ensuring strategic, evidence-based investment and public accountability through annual reporting.
FISCAL IMPLICATIONS:
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DEPARTMENT FISCAL IMPACT NOTES: Note: Opioid Settlement Fund DACs reflect Department 39 for Department of Emergency Management (DEM) until updated for the 2027-2028 biennial budget and will reflect Department 15 for Health Department once fully transitioned. Oversight of the opioid settlement fund is supported by existing health department resources and budget that are aligned with this body of work and are currently sufficient to support this request projected through the end of the 2027-2028 biennium. A potential fiscal impact could occur if entities obligated to make payments into the opioid settlement funds file for bankruptcy and their payment obligations are legally extinguished.
CONTRACT INFORMATION:
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OTHER DEPARTMENTAL REVIEW/COMMENTS: Reviewed/approved by Finance (Nathan Kennedy 9/4/26)