At the August Board meeting, Ms. Fraley-Monillas reported that the Edmonds police chief recently received an email from the County stating that as of Dec. 31 there will no longer be funding to provide police departments with Narcan/naloxone. Ms. Fraley-Monillas and Chair Stephanie Wright asked for staff to bring additional information forward at the next meeting for further discussion.

Staff reached out to Snohomish County Human Services for more background. Snohomish County Human Services collaborated with law enforcement to develop the Opiate Overdose Prevention Project. In April 2015, the first naloxone/Narcan training began and naloxone was distributed to trained officers. The County provided a breakdown of Narcan distributed to agencies since 2015, including total cost per year (Exhibit A).

Human Services staff notified law enforcement partners in an email on June 28 that there will no longer be funding for the Opiate Overdose Prevention Project beginning in January 2020. For the remainder of 2019, expired Narcan will be replaced, and Narcan deployed for a suspected overdose will also be replaced. After December 31, 2019, each law enforcement agency will be responsible for continuing to supply their personnel if they choose to continue.

At the September meeting, the Board asked staff to reach out to the cities to see what their plan is for supplying Narcan to law enforcement after the end of the year. Staff was also asked to come back to the October meeting with options of what the Health District can do, including training and coordination, and options for funding it.

The District is hosting an AmeriCorps VISTA member, who is a federal employee in partnership with Housing Hope and Hope Works. The District’s cost for Mr. Wansing position is $5,000, which is funded through our opioid grant. Mr. Wansing is providing opioid outreach and working with community partners. There’s a possibility he could provide data tracking and coordination with Narcan distribution, should the Board decide to move forward. He is also in the process of becoming an ACT trainer, where he could work with business and community groups to offer Antidote (Narcan), CPR and Tourniquet trainings.

Staff reached out to the cities and their police departments to inquire what their future plans are for Narcan supplied to their law enforcement. Information gathered is included in Exhibit B.  Staff also reached out to the fire districts and departments to get a better sense of their usage and funding mechanisms, which is included in Exhibit C. Lastly, staff at Snohomish County Human Services provided more detail on the law enforcement Narcan deployments for apparent opioid overdoses (Exhibit D).

At the September meetings with the Executive and Administration Committees, options for funding were discussed. The cost has been approximately $45-50K/year for the county to supply Narcan to law enforcement. Staff noted to the committees that expiration dates for current Narcan kits deployed in the field need to be researched and inventoried to get a better sense for immediate costs.

The executive committee requested that staff bring this item, with options, forward to the full Board for discussion and potential action. At the Oct. 8 Board meeting, the Board remanded this item to the Program Policy Committee for further review and to bring back to the full Board a recommendation for Naloxone distribution in the county.

The Program Policy Committee discussed the options at its Oct. 11 meeting. The recommendations from that committee include the following:

1. Municipalities that contribute per capita dollars will have their naloxone supplies paid for with their contribution, and the Health District will partner with them for expanded naloxone training and opioid outreach in their communities.

2. Municipalities that don’t contribute per capita dollars will be invoiced for the cost of the requested kits and an administrative fee.

3. The Health District will actively seek additional funding opportunities to help defray expenses, including applying for MAC Group funding if approved by the County Council and other local, state, and national grant opportunities.

4. The AmeriCorps VISTA member currently housed with the Health District will assist with tracking and other administrative duties of the program.

5. The program will remain in place in 2020, and the Board of Health will evaluate the program in one year and make a determination about continuing beyond December 2020.

The Program Policy Committee asked for this to be placed on the full Board agenda under Action at the Nov. 12 meeting. At the Admin Committee on Oct. 23, it was requested that a minimum threshold of $1.00 per resident be established for per capita contributions in order to qualify for the naloxone purchases and enhanced services.

The anticipated indirect/overhead rate for the opioid program in 2020 is 32.63%. Staff are recommending that this rate be used for the administrative fee assessed to cities that do not contribute per capita funding in 2020 but still request that the Health District coordinate the purchasing, deployment and data tracking of naloxone in their police department.

For the Board’s consideration, attached is a draft resolution (Exhibit E) declaring the Board’s intent for the Health District to take responsibility for coordination and tracking of naloxone distribution in the county with additional direction provided by the Program Policy Committee.

RCW 70.05.060 – Powers and duties of local board of health.

MOVE TO adopt Res. 19-25 regarding intent to take on the responsibility for naloxone distribution and tracking in the county, and tying the program to per capita contributions of at least $1.00 per resident or direct invoicing to participating cities that do not contribute per capita funding.