Spokane County, City outline expanded crisis services and use of opioid‑settlement funds

Spokane County Community Services and the City of Spokane presented coordinated plans to expand regional behavioral‑health crisis capacity and to direct opioid‑settlement dollars toward immediate treatment, long‑term housing and data improvements, county and city officials said during a community briefing.

Justin Johnson, Spokane County director of community services, said the county’s regional role includes contracting crisis care across six counties and paying for involuntary evaluation and detention services when state or Medicaid funding does not cover them. “For the purposes of Spokane County’s coverage for non‑involuntary treatment services, we cover the 5% [uninsured],” Johnson said, adding that the county also covers crisis services for everyone regardless of insurance.

The county and city emphasized that Medicaid and Medicare remain the primary funders of most services, and that local funds target gaps the state and commercial insurers do not cover. Maggie Yates, deputy city administrator for community safety, said Spokane recorded about 324 opioid‑related deaths last year and described the city’s emergency declaration and initial allocations to expand outreach and care.

Officials said the county has prioritized three tiers of work: build a 23‑hour crisis relief and sobering center; expand immediate treatment and transition programs; and invest in housing and prevention. Johnson said the planned crisis relief and sobering center is a multi‑year build; the county received a $3,000,000 state grant to support the project and is pursuing federal funds. “That’s a five‑year project,” Johnson said of the buildout.

Shorter‑term investments already under way or funded by opioid settlement and local sales tax include: - An expansion of CARES (fire‑department outreach clinicians): the city allocated $500,000 to add clinicians to a team that follows up after emergency responses, a change Yates said has produced a roughly 70% reduction in 911 utilization for people served by the team. - A high‑utilizer/“hot spotters” complex‑care program (contract with Consistent Care): $500,000 to identify people cycling among ERs, jails and shelters and provide intensive case management. - Embedding a provider with the city’s homeless outreach team to engage people in encampments before abatement. - Support for STARS (sobering, triage and transition) and expanded medication‑assisted treatment (MAT) partnerships with providers including MultiCare and Spokane Regional Health District. - Support for Maddie’s Place and housing supports for families affected by neonatal abstinence syndrome.

Johnson said county appropriations for opioid‑related projects have exceeded $10,000,000 and noted the county also distributes roughly $11–12 million annually in mental‑health sales tax funding to community programs. He said opioid‑settlement dollars are finite and the county is prioritizing investments that can be sustained beyond the settlement period.

Both city and county officials described efforts to improve data and analytics. Yates said the city will post a position for a data analyst focused on opioid overdoses and program evaluation to track whether funded interventions reduce harm and should be sustained.

Officials also described regional coordination: Spokane County runs an Opiate Abatement Council and the county and nine municipalities operate under a 1 Washington memorandum of understanding (MOU) to allocate state settlement distributions; the Attorney General’s Office oversees the MOU, officials said.

On eligibility and coverage, Johnson explained the county’s voluntary service coverage threshold: voluntary services for uninsured clients are available up to 220% of the federal poverty level under state/federal rules. He said the county has increased financial access for some adults; Johnson said the county’s adult eligibility has been expanded to 330% of FPL, while a later city presentation referenced a 350% figure for expanded center coverage—an inconsistency officials acknowledged in discussion that will be clarified in published materials.

Officials noted gaps in regional inpatient care for youth, especially secure withdrawal‑management and long‑term beds in Eastern Washington, and said limited bed availability means voluntary placements can escalate to involuntary care when acuity rises.

The county urged patience as multi‑year projects are built and said it will continue posting funding details, minutes and program reports on the county website. Johnson and Yates said next steps include finalizing city‑county agreements to deploy jointly funded services and providing build updates on the sobering center.