Skagit officials ask Anacortes to back regional North Star plan using opioid settlement funds

Skagit County officials asked the Anacortes City Council on Sept. 15 to support a regional plan to spend opioid settlement funds on behavioral-health infrastructure, including startup costs for the Skagit STAR Center, short-term ‘‘bridge’’ housing and expanded recovery housing.

“We are here tonight, because we are seeking your direction, on a North Star initiative,” Skagit County Director of Strategic Initiatives Monica Nacrillo told council members. The county and the four cities formed the North Star collaborative to coordinate responses to behavioral health and homelessness; presenters said settlement funds must be used for opioid abatement and recovery services.

The county presented numbers current to June 30 showing the jurisdictional region is scheduled to receive about $8.6 million from opioid settlement agreements, of which roughly $2.6 million had already been delivered and remained in local accounts. The county’s proposal would allocate roughly 80 percent of locally apportioned settlement money to regional projects and 20 percent to city-level priorities. Proposed regional investments shown to council included $1.5 million toward startup costs for the Skagit STAR Center, $150,000 for short-term bridge housing pilots and $650,000 to expand recovery-housing beds over a two-year pilot period.

George Kosovich, community services manager for Public Health, said the STAR Center start-up funding is intended to cover hiring, training and operations until the center can bill Medicaid and other payors. ‘‘By working together, we can make some things happen that individually, our cities and our county wouldn't be able to to make happen on our own,’’ Kosovich said, describing the county’s view that pooled funds could create capacity beyond what any single jurisdiction could achieve.

Council members asked for more detail about long-term sustainability. Councilmember Walters stressed that the council should avoid supplanting current county or provider commitments and recommended written agreements clarifying that settlement money would not replace existing funding streams. Nacrillo and Kosovich said the two-year housing pilots would be followed by searches for ongoing revenue, including Medicaid billing, BHASO (Behavioral Health Administrative Services Organization) support and other grants; they acknowledged risk if Medicaid eligibility or reimbursement rates change.

Councilmember Fantini asked whether the STAR Center model depended on Medicaid reimbursements; Kosovich said the providers expect to bill Medicaid but that contingency plans must manage care for uninsured patients and ensure law-enforcement drop-offs are not conditioned on insurance status. Multiple council members urged a formal governance or interlocal agreement to record responsibilities before checks are distributed. Nacrillo said a draft interlocal agreement has been circulated to a work group and will be on a joint meeting agenda Sept. 30, with further review planned ahead of a Nov. 6 joint meeting.

Commissioner Ron Wiesen and other North Star partners attended the meeting. Nacrillo closed by noting a tentative ribbon-cutting date for the STAR Center in December and asking council members to bring feedback to the Sept. 30 joint meeting.

Council action: council did not vote on a funding commitment at the Sept. 15 meeting; staff asked for direction and said they would return with a draft interlocal agreement and more detailed budget/mechanism options for council consideration.

Why it matters: settlement funds are restricted to opioid-abatement uses; the county’s plan would concentrate a majority of those locally available dollars on treatment capacity and housing supports intended to reduce overdoses, emergency-room admissions and jail diversions.