Drafter
Clerk 09/06/2023
Title
A RESOLUTION supporting the framework, the funding focus, and the methodology for funding prioritization recommended in the 2023 Community Engagement Report and encouraging jurisdictions within King County to use the same framework as they develop spending plans; and further encouraging jurisdictions within King County to seek out and pursue cross-jurisdictional strategies when possible, to maximize the impact of available funding.
Body
WHEREAS opioids are a class of drugs that include heroin, pain relievers available by prescription such as oxycodone, hydrocodone, codeine, and morphine, and synthetic opioids such as fentanyl, all of which have pain-reducing effects and are highly addictive, even when they are prescribed appropriately and taken as directed, and
WHEREAS, the National Centers for Disease Control identifies three "waves" of increasing overdose deaths involving an opioid since the late 1990s, beginning with the increased prescription of these drugs earlier in that decade, and
WHEREAS, the majority of preventable overdose deaths nationally involve opioids, with synthetic opioids other than methadone being the fastest growing category of opioids involved in a death, and
WHEREAS, beginning in 2016 the national number of overdose deaths from fentanyl passed the number of overdose deaths from prescription opioids, and that gap has persisted and grown ever since, and
WHEREAS, in 2016 King County Executive Dow Constantine, Auburn Mayor Nancy Backus, Renton Mayor Denis Law, and Seattle Mayor Ed Murray convened the King County Heroin and Prescription Opiate Addiction Task Force with the participation of experts from a wide range of disciplines, resulting in a list of recommendations that emphasized addiction prevention, the expansion and enhancement of available treatment options, and the ongoing use of harm-reduction strategies, and
WHEREAS, the American Psychiatric Association recognizes opioid use disorder as a chronic disorder, with serious potential consequences including disability, relapses, and death, and in 2019 the Washington state Legislature passed Substitute Senate Bill 5380, which became Chapter 314, Laws of Washington 2019, recognizing opioid use disorder as a chronic medical condition and endorsing evidence-based treatment, and
WHEREAS, the number of deaths in King County that were attributed to opioid overdoses increased from 189 in 2012 to 802 in 2022, and 678 in 2023 through August 16, 2023, and the number of deaths in King County that were attributed to opioid and stimulant overdose increased from 45 to 529 over the same period, with 463 such overdoses through August 16, 2023, and
WHEREAS, in May 2022 Attorney General Ferguson announced the resolution in principle of the state's lawsuit against opioid distributors McKesson Corp., Cardinal Health, Inc., and AmeriSource Bergen Drug Corp., with these companies willing to pay a total of $518 million over 17 years, and
WHEREAS, all 125 eligible local governments signed a settlement of that lawsuit for $518 million, resulting in the One Washington Memorandum of Understanding ("the MOU") regarding the expenditure of settlement proceeds, which identified the permissible uses by municipalities of settlement proceeds, including: ensuring the appropriate prescribing and dispensing of opioids; preventing the misuse of opioids; treating opioid use disorder; providing support for people in treatment and recovery from opioid use disorder; providing connections to care for those who have or are at risk of developing opioid use disorder; addressing the needs of those who have or are affected by opioid use disorder and are at risk of becoming involved in the criminal justice system or are pregnant or parenting; preventing overdose deaths and other harms; and supporting research, training, coordination, and first-response investments relating to the opioid epidemic, and
WHEREAS, in December 2022, Attorney General Ferguson announced that Washington was joining multistate resolutions with the opiate producers and sellers CVS, Walgreens, Walmart, Teva, and Allergan, with these companies willing to pay a total of $434 million over varying periods of up to 15 years, and
WHEREAS, in 2023, all 125 eligible local governments signed the settlement with opiate producers and sellers CVS, Walgreens, Walmart, Teva, and Allergan, agreeing to expend settlement proceeds consistent with the MOU; and
WHEREAS, litigation and bankruptcy proceedings continue against other parties and may result in additional moneys for the state, county, and cities to expend in response to the opioid crisis, and
WHEREAS, as required by the MOU, Public Health - Seattle & King County and the city of Seattle engaged Research with Expert Advisors on Drug Use ("READU") at the University of Washington to design and lead a community engagement consultation process to understand community's experiences, needs, and goals to identify priorities for the use of settlement revenues arising from opioid resolutions, and
WHEREAS, in June 2023 the University of Washington School of Nursing, in partnership with READU, delivered a final draft of the results of this process, the Opioid Settlement Community Consultation Report, which recommends uplifting the voices of people who use opioids and including people with lived and living experience in decision-making around implementation of investments, and
WHEREAS, that community engagement report also recommended resource allocations should focus on funding low-barrier, flexible, easy-to-access services through peer-led and community organizations, prioritizing such organizations that are led by and that serve people who have been disproportionately impacted by opioid overdose, for instance LGBTQIA+ people, people experiencing homelessness, people who engage in sex work, and people from historically marginalized racial, ethnic, or racial and ethnic groups, and
WHEREAS, the recommendations of the report are consistent with the five principles set forth for spending settlement moneys developed by the Johns Hopkins, Bloomberg School of Public Health, which are: <https://opioidprinciples.jhsph.edu/the-principles/>1: Spend Money to Save Lives; 2: Use Evidence to Guide Spending; 3: Invest in Youth Prevention; 4: Focus on Racial Equity; and 5: Develop a Fair and Transparent Process for Deciding where to Spend the Funding, and
WHEREAS, the recommendations of that report are also consistent with the principles of overdose prevention and harm reduction, which is an evidence-based approach that is critical to engaging with people who use drugs and equipping them with tools and information to create positive change in their lives and possibly save their lives and which is also a key pillar in the Overdose Prevention Strategy of the U.S. Department of Health and Human Services, and
WHEREAS, throughout King County and the Puget Sound region, intragovernmental and cross-agency partnerships will be critical to mitigating the effects of opioid addiction on our shared community and on making help available to those who want it;
NOW, THEREFORE, BE IT RESOLVED by the Board of Health of King County:
A. The King County Board of Health supports the framework, the funding focus, and the methodology for funding prioritization recommended in the Community Engagement report and encourages jurisdictions within King County to use the same framework as they develop spending plans including facilities to provide services such as post overdose care, opioid medication delivery, health hub services, long-term care management, and drop-in support as well as treatment and overdose response services, access to mobile opioid medication delivery, and harm reduction services.
B. The King County Board of Health further encourages all jurisdictions within
King County to seek out and pursue cross-jurisdictional spending strategies to maximize the impact of available funding.