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HomeMy WebLinkAbout5722 RESOLUTION NO. 5722 A RESOLUTION OF THE CITY COUNCIL OF THE CITY OF AUBURN, WASHINGTON, AUTHORIZING THE MAYOR TO SIGN THE KING COUNTY REGIONAL INTERLOCAL AGREEMENT ENABLING THE CITY TO RECEIVE ITS SHARE OF THE OPIOID SETTLEMENT FUNDS WHEREAS, by resolutions 5708 and 5682, the Auburn City Council accepted a share of the funds awarded to Washington through the opioid distributor and manufacturer settlements; and WHEREAS, the settlement funds are allocated according to an agreement that Auburn and other cities and counties entered into with the state; and WHEREAS; the state allocation agreement requires that the settlement funds be distributed through opioid abatement councils, which are regional groups of governments that will receive a share of the settlements; and WHEREAS, the opioid abatement council for King County will be governed by an interlocal agreement; and WHEREAS, the King County interlocal agreement closely mirrors the provisions of the state allocation agreement concerning the operations of a council, payment of its costs, and the distribution of the settlement funds; and WHEREAS, the City desires to participate in the King County Opioid Abatement Council to address the need for additional funding to support opioid treatment and prevention. NOW, THEREFORE, THE CITY COUNCIL OF THE CITY OF AUBURN, WASHINGTON, RESOLVES as follows: Resolution No. 5722 June 14, 2023 Page 1 of 2 Rev.2019 Section 1. The Mayor is authorized to sign the King County Regional Agreement, attached as Exhibit A. Section 2. The Mayor is authorized to implement those administrative procedures necessary to carry out the directives of this legislation. Section 3. This Resolution will take effect and be in full force on passage and signatures. Dated and Signed this 26th day of June, 2023. CITY OF AUBURN N NCY B US, MAYOR ATTEST: APPROVED AS TO FORM: s �►%- (2 -40V Shawn Campbe I, MMC, City Clerk p,,Kenurra Comeau, City Attorney Resolution No. 5722 June 14, 2023 Page 2 of 2 Rev.2019 DocuSign Envelope ID:809CFC7E-057D-4479-8E3C-52905A1E349D KING COUNTY REGIONAL AGREEMENT OPIOID ABATEMENT COUNCIL This regional agreement for an opioid abatement council is entered into among King County and the cities of Auburn, Bellevue, Bothell, Burien,Covington, Des Moines, Enumclaw, Federal Way, Issaquah, Kenmore, Kent, Kirkland, Lake Forest Park, Maple Valley, Mercer Island, Newcastle, Redmond, Renton, Sammamish,SeaTac,Seattle,Shoreline,Snoqualmie,Tukwila and Woodinville,each a"Party" and jointly "Parties." SECTION 1. RECITALS WHEREAS,the State of Washington and other local governments have engaged in litigation with entities who manufacture,distribute,and dispense prescription opioids;and WHEREAS,the opioid litigation has resulted in various settlements and/or judgments with direct money payments to be made to the state and its eligible political subdivisions;and WHEREAS,the One Washington Memorandum of Understanding Between Washington Municipalities ("the MOU"),attached hereto with Exhibits A,B,and C,and incorporated by reference,which has been previously approved and executed by the Parties, requires the formation of an opioid abatement council;and WHEREAS,the undersigned Parties do hereby adopt and implement this Agreement for the creation of the King County Regional Opioid Abatement Council("OAC"),to be bound by the terms of this Agreement,the MOU and exhibits thereto,the settlement agreement provisions,and any applicable state statute(s). NOW,THEREFORE, it is hereby agreed by the Parties: SECTION 2. DEFINITIONS 1. "Approved Purposes" refers to the strategies specified and set forth in Exhibit A to the MOU. 2. "OAC Administrator"shall mean King County,the Party who shall perform the duties assigned to the OAC Administrator in Section 4.C. 3. "Opioid Funds"shall mean monetary amounts obtained through a settlement,judgment or any other manner from the Opioid Litigation. 4. "Opioid Litigation"shall mean the litigation between state and/or local jurisdictions and Johnson&Johnson,and distributors AmerisourceBergen,Cardinal Health,and McKesson;and the national opioid settlement agreements involving Teva Pharmaceutical Industries,Allergan,Walgreens, Walmart,and CVS. 5. "National Settlement Agreement(s)"or"Settlement(s)" means the national opioid settlement agreements involving Johnson &Johnson,and distributors AmerisourceBergen,Cardinal Health,and McKesson; and the national opioid settlement agreements involving Teva Pharmaceutical Industries, Allergan,Walgreens,Walmart,and CVS. Page[1 King County Regional Agreement For Opioid Abatement Council DocuSign Envelope ID:809CFC7E-057D-4479-8E3C-52905A1E349D SECTION 3. PARTICIPATING ENTITIES The Parties to this Agreement are the political subdivisions in King County entitled to direct payment of Opioid Funds pursuant to the National Settlement Agreements derived from the Opioid Litigation. SECTION 4. CREATION OF THE KING COUNTY REGIONAL OAC Consistent with the MOU Exhibits A, B and C,the Parties create and establish the OAC to perform the duties and functions set forth in the MOU and herein. A. OAC Members 1. Membership—Representation on the OAC shall be roughly proportional to Opioid Fund distribution with a total of four party representatives:two from King County,one from the City of Seattle,and one chosen by the Sound Cities Association (SCA).All persons who serve on the OAC must have prior work or educational experience pertaining to one or more of the Approved Purposes. 2. Chair—As the OAC Administrator,one of the King County representatives to the OAC shall be the chairperson to preside at and lead all meetings of the OAC and to act as the representative of the OAC in any matters contemplated by the MOU.The chairperson is entitled to vote on all OAC business and at King County's discretion,the role of the chairperson may alternate between the two King County OAC representatives. 3. OAC Vacancies—In the event the OAC has a vacancy,the Party or Parties whose representative vacated the position shall select a new member for the OAC. 4. Alternates—Parties may designate alternate representatives to serve on the OAC in the absence of the Party or Parties' primary representative.Alternates must meet the same work/educational experience requirements as primary representatives. B. Duties of the OAC 1. Oversight—As provided in this Agreement,the OAC shall monitor distribution, expenditure,re-allocation,and dispute resolution related to the Parties'allocations of Opioid Funds for Approved Purposes within the King County Region. 2. Data Requirements—The OAC shall determine what data and in what form and under what timelines the Parties must provide to the OAC Administrator regarding the Parties' Opioid Fund allocation expenditures. 3. Reports—The OAC shall annually review reports prepared by the OAC Administrator of the Parties'Opioid Funds allocation expenditures for compliance with the Approved Purposes and the terms of the MOU and any Settlement. 4. Re-Allocation of Opioid Funds—If the OAC is notified that a Party will forego some or all of its allocation of Opioid Funds,the OAC shall: (i) Request and then approve or deny proposals from other Parties and/or community groups for use of the allocation within the King County Region;and (ii) Direct the trustee responsible for releasing Opioid Funds to distribute the allocation to the Party(ies)and/or community group(s)whose proposals were approved by the OAC. Page E2 King County Regional Agreement For Opioid Abatement Council DocuSign Envelope ID:809CFC7E-057D-4479-8E3C-52905A1 E349D 5. Reporting—The OAC shall report and make publicly available all decisions on Opioid Fund allocation and re-allocation applications, proposals,distributions, and expenditures by the OAC and the Parties. 6. Dashboard—The OAC shall develop and maintain a centralized public dashboard or other repository for the publication of expenditure data from the OAC and the Parties that receive Opioid Funds.The dashboard or repository shall be updated at least annually. 7. Outcome Data—If necessary,the OAC shall require and collect additional outcome- related data from the Parties to evaluate the use of the Opioid Funds.The OAC shall work with the Parties to determine the type of outcome data to be collected. 8. Complaints—The OAC shall establish a process for hearing complaints and resolving disputes by Parties regarding the alleged failure of the OAC or a Party to(1) use Opioid Funds for Approved Purposes or(2)comply with reporting requirements. 9. Noncompliance—If the OAC finds that a Party's expenditure of its allocation of Opioid Funds did not comply with the Approved Purposes of the MOU, or that the Party otherwise misused its allocation of Opioid Funds,the OAC may take remedial action against the alleged offending Party.Such remedial action is left to the discretion of the OAC and may include notifying the Settlement Fund Administrator of the noncompliant expenditure(s) and requesting suspension of direct payments to the offending Party and re-allocation by the OAC consistent with Section B.4. C. Duties of the OAC Administrator 1. Receipt of Expenditure Reports—The OAC Administrator shall receive and maintain the expenditure reports provided by the Parties pursuant to Section D.8 and shall provide them to the members of the OAC for the annual review required under Section B.3. 2. Re-Allocation—The OAC Administrator shall be responsible for requesting proposals, notifying the Settlement trustee as required,and maintaining records of distribution decisions for Opioid Funds subject to re-allocation under Section B.4. 3. Reporting— (i) The OAC Administrator shall fulfill the OAC's responsibilities for collecting data, preparing reports,and making information publicly available,including through the development, maintenance,and annual updating of a centralized public dashboard or other repository. (ii) The OAC Administrator shall set deadlines for the Parties to submit data to the OAC and the OAC shall not be responsible for any deficiencies in data or reports due to the failure of a Party to meet those deadlines or the reporting requirements under Section D. (iii) Nothing in this Section C shall relieve a Party of its responsibilities to maintain, report,and produce data or records as required by Section D,the MOU, and/or any Settlement Agreement. 4. Outcome Data—If the OAC determines that outcome-related data will be collected,the OAC Administrator will receive such data from the Parties and prepare any related reports as directed by the OAC. Page A King County Regional Agreement For Opioid Abatement Council DocuSign Envelope ID:809CFC7E-057D-4479-8E3C-52905A1E349D 5. Records Retention—The OAC Administrator shall maintain OAC records for no less than five (5)years and shall make such records available for review by other Parties or the public. Records requested by the public shall be produced in accordance with the Washington Public Records Act,chapter 42.56 RCW. Nothing in this section supplants any Party's obligations to retain and produce its own records as provided in this Agreement. 6. Accounting of Administrative Expenses—The OAC Administrator shall prepare the annual accounting of OAC administrative expenses. D. Duties of the Parties 1. Notice of OAC Representative—Parties shall notify the OAC Administrator of its OAC representative and alternate, if any,and shall timely fill vacancies. 2. Use and Distribution of Opioid Funds—Parties shall maintain full discretion over the use and distribution of their allocation of Opioid Funds, provided the Opioid Funds are used solely for Approved Purposes. 3. Notice to Forego Allocation—If a Party chooses to forego its allocation of Opioid Funds, it will notify the OAC so the funds can be re-allocated as provided in Section B.4.A Party's notice that it will forego its allocation of Opioid Funds shall apply to all future allocations unless the Party notifies the OAC otherwise.A Party is excused from the reporting requirements set forth in this Agreement for any allocation of Opioid Funds it foregoes. 4. Allocation Amount—If a Party disputes the amount it receives from its allocation of Opioid Funds,the Party shall resolve the dispute with the Settlement Fund Administrator. However,the Party shall alert the OAC within sixty(60) days of discovering the information underlying the dispute. Failure to alert the OAC within this timeframe shall not constitute a waiver of the Party's right to seek recoupment of any deficiency in its allocation. 5. Collaboration—Parties may agree and elect to share, pool,or collaborate with their respective allocation of Opioid Funds as long as such sharing, pooling,or collaboration is used for Approved Purposes and complies with the MOU and the Settlements. 6. Proposal Methodology—Parties shall develop and implement a methodology for obtaining, receiving,and reviewing proposals for use of their allocation of Opioid Funds. 7. Community-Based Input—Parties shall ensure an opportunity for community-based input on priorities for Opioid Fund allocation strategies. 8. Reporting—Parties shall report to the OAC Administrator on all expenditures of Opioid Fund allocations.The specific data to be provided shall be determined by the OAC. 9. OAC Administrative Payment—As further described in Section 6,beginning in 2023 each Party shall contribute 10%of its annual Opioid Funds allocation to pay for OAC Administrative Costs. 10. Party's Administrative Costs—After the 10%OAC Administrative Costs contribution,the administrative costs for a Party to administer its allocation of Opioid Funds shall not exceed 10%of the remaining allocation or actual costs,whichever is less. Page King County Regional Agreement For Opioid Abatement Council DocuSign Envelope ID:809CFC7E-057D-4479-8E3C-52905A1 E349D 11. Records Retention—Parties shall maintain all records related to the receipt and expenditure of Opioid Funds for no less than five(5)years and shall make such records available for review by other Parties,the OAC,or the public. Records requested by the public shall be produced in accordance with the Washington Public Records Act,chapter 42.56 RCW. Records requested by another Party or the OAC shall be produced within twenty-one(21)days of the date the record request was received. Nothing in this Agreement supplants any Party's obligations under the Washington Public Records Act. SECTION 5. OAC ACTION A. The OAC shall take action by way of motion and such motions shall be adopted if approved by a favorable majority vote. B. Any action by the OAC shall not be effective unless approved by a quorum of the members.The OAC quorum shall be a simple majority of its members. SECTION 6. FINANCING OF OAC ADMINISTRATIVE COSTS A. The OAC Administrator shall act as the fiscal agent for the OAC and shall hold funds and pay, either directly or through reimbursement, administrative costs related to the OAC("OAC Administrative Costs"). B. Beginning in 2023,each Party shall contribute 10%of its allocation of Opioid Funds to an appropriate fund held by King County Treasury to pay for OAC Administrative Costs. The OAC Administrator shall annually calculate and notify each Party and King County Treasury of the amount of each Party's required contribution.Within 90(ninety)days of receiving notification, King County Treasury shall transfer the appropriate amounts from each Party's Real Estate Excise Tax(REET) account to the OAC Administrative Costs fund. King County Treasury and a Party may agree on a procedure other than REET transfer for accepting a Party's contribution. C. Each Party's share of responsibility for annual OAC Administrative Costs shall be proportionate to the number of Opioid Funds the Party received in that year as compared to the amount received by other Parties. D. OAC administrative expenses shall not exceed 10%of the Parties'combined annual Opioid Funds received or actual costs,whichever is less.This does not preclude a Party from using 10% of its remaining allocation of Opioid Funds,after it's OAC Administrative Cost contribution,for its own administrative costs as outlined in the MOU and in Section 4.D.10. E. Beginning in 2024,the OAC Administrator shall provide the Parties with an annual accounting for the prior year(July 1 to June 30)of all actual OAC Administrative Costs along with the allocation showing each Party's proportionate share of the costs. F. If the amount contributed by a Party to the OAC Administrative Costs fund under Section 6.B in a year exceeds that Party's proportionate share of the OAC Administrative Costs for that year, Page 5 King County Regional Agreement For Opioid Abatement Council DocuSign Envelope ID:809CFC7E-057D-4479-8E3C-52905A1E349D King County Treasury shall retain the excess amount in the OAC Administrative Costs fund and reduce that Party's required contribution for the following year by that same amount.Any excess contributions remaining in the fund after termination and payment of all OAC Administrative Costs will be returned to the contributing Party for use as authorized by the MOU. SECTION 7. DURATION This Agreement shall be effective for the time period that the political subdivisions receive payments under any of the Opioid Litigation claims and shall continue to be effective until one year after the final payment of such funds. SECTION 8.TERMINATION This Agreement shall be self-terminating one year after the final distribution of funds and all reporting finalized through or by the Parties to the MOU. SECTION 9. MODIFICATIONS OR AMENDMENTS This Agreement may be modified or amended upon written agreement by all participating Parties, except that the OAC may amend the definitions of Opioid Litigation and National Settlement Agreements in order to make this Agreement applicable to future opioid litigation settlements.Any modifications or amendments to the Agreement must be consistent with the terms of the MOU and the Settlements. SECTION 10. HEADINGS The article headings in this Agreement have been inserted solely for the purpose of convenience and ready reference. In no way do they purport to,and shall not be deemed to,define, limit,or extend the scope or intent of the articles to which they appertain. SECTION 11. ENTIRE AGREEMENT This Agreement may be executed in any number of counterparts,each of which,when so executed and delivered,shall be an original, but such counterparts shall together constitute but one and the same. This Agreement sets forth the entire agreement between the Parties with respect to the subject matter hereof and supersedes all previous discussions and agreements. Understandings, representations,or warranties not contained in this Agreement or a written amendment hereto shall not be binding on any Party. SECTION 12. SEVERABILITY In the event any term or condition of this Agreement or application thereof to any person or circumstances is held invalid,such invalidity shall not affect other terms, conditions,or applications of this Agreement which can be given effect without the invalid term,condition,or application.To this end the terms and conditions of this Agreement are declared severable. Page 6 King County Regional Agreement For Opioid Abatement Council DocuSign Envelope ID:809CFC7E-057D-4479-8E3C-52905A1 E349D In the event any portion of this Agreement should become invalid or unenforceable,the remainder of the Agreement shall remain in full force and effect. SECTION 13. NON-DISCRIMINATION The Parties,their employees,and agents shall not discriminate against any person based on any reason prohibited by Washington state or federal law as adopted or subsequently amended. SECTION 14. COMPLIANCE WITH LAWS The Parties shall observe all federal,state,and local laws,ordinances,and regulations,to the extent that they may be applicable to the terms of this Agreement. SECTION 15. GOVERNING LAW;VENUE This Agreement has and shall be construed as having been made and delivered in the State of Washington,and the laws of the State of Washington shall be applicable to its construction and enforcement. Any action at law,suit in equity,or judicial proceeding for the enforcement of this Agreement or any provisions hereto shall be instituted only in courts of competent jurisdiction within King County,Washington,unless relocation or commencement elsewhere is required by law. WHEREFORE,the undersigned executive authorities do hereby approve and adopt the Agreement as set forth herein. Done on this 17'0@ay of July ,2023. DocuSI a ned by: A� m s4,-ikrztAr ICCO MDD17C947C... Name and Title Nancy Backus Mayor On Behalf Of The City of Auburn CDocuSlgned by: atIA.t, 9F865DF92888462... Nadine Chan Interim Chief, APDE and CDIP, PHSKC Chronic Disease and Injury Prevention Section of Public Health-Seattle and King County Page 7 King County Regional Agreement For Opioid Abatement Council DocuSign Envelope ID:809CFC7E-057D-4479-8E3C-52905A1E349D ONE WASHINGTON MEMORANDUM OF UNDERSTANDING BETWEEN WASHINGTON MUNICIPALITIES Whereas,the people of the State of Washington and its communities have been harmed by entities within the Pharmaceutical Supply Chain who manufacture, distribute, and dispense prescription opioids; Whereas, certain Local Governments, through their elected representatives and counsel, are engaged in litigation seeking to hold these entities within the Pharmaceutical Supply Chain of prescription opioids accountable for the damage they have caused to the Local Governments; Whereas,Local Governments and elected officials share a common desire to abate and alleviate the impacts of harms caused by these entities within the Pharmaceutical Supply Chain throughout the State of Washington, and strive to ensure that principals of equity and equitable service delivery are factors considered in the allocation and use of Opioid Funds; and Whereas, certain Local Governments engaged in litigation and the other cities and counties in Washington desire to agree on a form of allocation for Opioid Funds they receive from entities within the Pharmaceutical Supply Chain. Now therefore, the Local Governments enter into this Memorandum of Understanding ("MOU")relating to the allocation and use of the proceeds of Settlements described. A. Definitions As used in this MOU: 1. "Allocation Regions"are the same geographic areas as the existing nine(9)Washington State Accountable Community of Health(ACH)Regions and have the purpose described in Section C below. 2. "Approved Purpose(s)" shall mean the strategies specified and set forth in the Opioid Abatement Strategies attached as Exhibit A. 3. "Effective Date"shall mean the date on which a court of competent jurisdiction enters the first Settlement by order or consent decree.The Parties anticipate that more than one Settlement will be administered according to the terms of this MOU,but that the first entered Settlement will trigger allocation of Opioid Funds in accordance with Section B herein, and the formation of the Opioid Abatement Councils in Section C. 4. "Litigating Local Government(s)" shall mean Local Governments that filed suit against any Pharmaceutical Supply Chain Participant pertaining to the Opioid epidemic prior to September 1, 2020. 1 DocuSign Envelope ID:809CFC7E-057D-4479-8E3C-52905A1E349D 5. "Local Government(s)" shall mean all counties, cities, and towns within the geographic boundaries of the State of Washington. 6. "National Settlement Agreements"means the national opioid settlement agreements dated July 21, 2021 involving Johnson&Johnson, and distributors AmerisourceBergen, Cardinal Health and McKesson as well as their subsidiaries, affiliates, officers, and directors named in the National Settlement Agreements, including all amendments thereto. 7. "Opioid Funds" shall mean monetary amounts obtained through a Settlement as defined in this MOU. 8. "Opioid Abatement Council" shall have the meaning described in Section C below. 9. "Participating Local Government(s)" shall mean all counties, cities, and towns within the geographic boundaries of the State that have chosen to sign on to this MOU. The Participating Local Governments may be referred to separately in this MOU as"Participating Counties"and"Participating Cities and Towns" (or"Participating Cities or Towns,"as appropriate) or"Parties." 10. "Pharmaceutical Supply Chain"shall mean the process and channels through which controlled substances are manufactured,marketed, promoted, distributed, and/or dispensed, including prescription opioids. 11. "Pharmaceutical Supply Chain Participant" shall mean any entity that engages in or has engaged in the manufacture,marketing,promotion, distribution, and/or dispensing of a prescription opioid, including any entity that has assisted in any of the above. 12. "Qualified Settlement Fund Account,"or"QSF Account,"shall mean an account set up as a qualified settlement fund, 468b fund, as authorized by Treasury Regulations 1.468B-1(c) (26 CFR§1.468B-1). 13. "Regional Agreements"shall mean the understanding reached by the Participating Local Counties and Cities within an Allocation Region governing the allocation,management, distribution of Opioid Funds within that Allocation Region. 14. "Settlement"shall mean the future negotiated resolution of legal or equitable claims against a Pharmaceutical Supply Chain Participant when that resolution has been jointly entered into by the Participating Local Governments. "Settlement" expressly does not include a plan of reorganization confirmed under Title l lof the United States Code, irrespective of the extent to which Participating Local Governments vote in favor of or otherwise support such plan of reorganization. 2 DocuSign Envelope ID:809CFC7E-057D-4479-8E3C-52905A1E349D 15. "Trustee"shall mean an independent trustee who shall be responsible for the ministerial task of releasing Opioid Funds from a QSF account to Participating Local Governments as authorized herein and accounting for all payments into or out of the trust. 16. The"Washington State Accountable Communities of Health"or "ACH"shall mean the nine(9)regions described in Section C below. B. Allocation of Settlement Proceeds for Approved Purposes 1. All Opioid Funds shall be held in a QSF and distributed by the Trustee, for the benefit of the Participating Local Governments, only in a manner consistent with this MOU. Distribution of Opioid Funds will be subject to the mechanisms for auditing and reporting set forth below to provide public accountability and transparency. 2. All Opioid Funds,regardless of allocation, shall be utilized pursuant to Approved Purposes as defined herein and set forth in Exhibit A. Compliance with this requirement shall be verified through reporting, as set out in this MOU. 3. The division of Opioid Funds shall first be allocated to Participating Counties based on the methodology utilized for the Negotiation Class in In Re:National Prescription Opiate Litigation,United States District Court for the Northern District of Ohio,Case No. 1:17-md-02804-DAP. The allocation model uses three equally weighted factors: (1)the amount of opioids shipped to the county; (2)the number of opioid deaths that occurred in that county; and(3)the number of people who suffer opioid use disorder in that county. The allocation percentages that result from application of this methodology are set forth in the "County Total"line item in Exhibit B.In the event any county does not participate in this MOU,that county's percentage share shall be reallocated proportionally amongst the Participating Counties by applying this same methodology to only the Participating Counties. 4. Allocation and distribution of Opioid Funds within each Participating County will be based on regional agreements as described in Section C. C. Regional Agreements 1. For the purpose of this MOU,the regional structure for decision- making related to opioid fund allocation will be based upon the nine(9)pre- defined Washington State Accountable Community of Health Regions (Allocation Regions). Reference to these pre-defined regions is solely for the purpose of 3 DocuSign Envelope ID:809CFC7E-057D-4479-8E3C-52905A1E349D drawing geographic boundaries to facilitate regional agreements for use of Opioid Funds. The Allocation Regions are as follows: • King County(Single County Region) • Pierce County(Single County Region) • Olympic Community of Health Region (Clallam, Jefferson, and Kitsap Counties) • Cascade Pacific Action Alliance Region (Cowlitz, Grays Harbor, Lewis, Mason,Pacific,Thurston, and Wahkiakum Counties) • North Sound Region (Island, San Juan, Skagit, Snohomish, and Whatcom Counties) • SouthWest Region(Clark, Klickitat, and Skamania Counties) • Greater Columbia Region (Asotin, Benton, Columbia, Franklin, Garfield, Kittitas, Walla Walla,Whitman,and Yakima Counties) • Spokane Region (Adams, Ferry, Lincoln, Pend Oreille, Spokane, and Stevens Counties) • North Central Region(Chelan,Douglas, Grant, and Okanogan Counties) 2. Opioid Funds will be allocated,distributed and managed within each Allocation Region, as determined by its Regional Agreement as set forth below. If an Allocation Region does not have a Regional Agreement enumerated in this MOU, and does not subsequently adopt a Regional Agreement per Section C.5, the default mechanism for allocation, distribution and management of Opioid Funds described in Section C.4.a will apply. Each Allocation Region must have an OAC whose composition and responsibilities shall be defined by Regional Agreement or as set forth in Section C.4. 3. King County's Regional Agreement is reflected in Exhibit C to this MOU. 4. All other Allocation Regions that have not specified a Regional Agreement for allocating, distributing and managing Opioid Funds,will apply the following default methodology: a. Opioid Funds shall be allocated within each Allocation Region by taking the allocation for a Participating County from Exhibit B and apportioning those funds between that Participating County and its Participating Cities and Towns. Exhibit B also sets forth the allocation to the Participating Counties and the Participating Cities or Towns within the Counties based on a default allocation formula. As set forth above in Section B.3,to determine the allocation to a county,this formula utilizes: (1)the amount of opioids shipped to the county; (2)the number of opioid deaths that occurred in that county; and(3)the number of people who suffer opioid use disorder in that county.To determine the allocation within a county,the formula utilizes historical federal data showing how the specific Counties and the Cities and Towns within the Counties have 4 DocuSign Envelope ID:809CFC7E-057D-4479-8E3C-52905A1 E349D made opioids epidemic-related expenditures in the past. This is the same methodology used in the National Settlement Agreements for county and intra-county allocations. A Participating County, and the Cities and Towns within it may enter into a separate intra-county allocation agreement to modify how the Opioid Funds are allocated amongst themselves,provided the modification is in writing and agreed to by all Participating Local Governments in the County. Such an agreement shall not modify any of the other terms or requirements of this MOU. b. 10% of the Opioid Funds received by the Region will be reserved, on an annual basis, for administrative costs related to the OAC. The OAC will provide an annual accounting for actual costs and any reserved funds that exceed actual costs will be reallocated to Participating Local • Governments within the Region. c. Cities and towns with a population of less than 10,000 shall be excluded from the allocation,with the exception of cities and towns that are Litigating Participating Local Governments.The portion of the Opioid Funds that would have been allocated to a city or town with a population of less than 10,000 that is not a Litigating Participating Local Government shall be redistributed to Participating Counties in the manner directed in C.4.a above. d. Each Participating County, City, or Town may elect to have its share re-allocated to the OAC in which it is located. The OAC will then utilize this share for the benefit of Participating Local Governments within that Allocation Region,consistent with the Approved Purposes set forth in Exhibit A. A Participating Local Government's election to forego its allocation of Opioid Funds shall apply to all future allocations unless the Participating Local Government notifies its respective OAC otherwise. If a Participating Local Government elects to forego its allocation of the Opioid Funds,the Participating Local Government shall be excused from the reporting requirements set forth in this Agreement. e. Participating Local Governments that receive a direct payment maintain full discretion over the use and distribution of their allocation of Opioid Funds,provided the Opioid Funds are used solely for Approved Purposes. Reasonable administrative costs for a Participating Local Government to administer its allocation of Opioid Funds shall not exceed actual costs or 10% of the Participating Local Government's allocation of Opioid Funds,whichever is less. f. A Local Government that chooses not to become a Participating Local Government will not receive a direct allocation of Opioid Funds. The portion of the Opioid Funds that would have been allocated to a Local Government that is not a Participating Local Government shall be 5 DocuSign Envelope ID:809CFC7E-057D-4479-8E3C-52905A1 E349D redistributed to Participating Counties in the manner directed in C.4.a above. g. As a condition of receiving a direct payment, each Participating Local Government that receives a direct payment agrees to undertake the following actions: i. Developing a methodology for obtaining proposals for use of Opioid Funds. ii. Ensuring there is opportunity for community-based input on priorities for Opioid Fund programs and services. iii. Receiving and reviewing proposals for use of Opioid Funds for Approved Purposes. iv. Approving or denying proposals for use of Opioid Funds for Approved Purposes. v. Receiving funds from the Trustee for approved proposals and distributing the Opioid Funds to the recipient. vi. Reporting to the OAC and making publicly available all decisions on Opioid Fund allocation applications, distributions and expenditures. h. Prior to any distribution of Opioid Funds within the Allocation Region, The Participating Local Governments must establish an Opioid Abatement Council(OAC)to oversee Opioid Fund allocation, distribution, expenditures and dispute resolution. The OAC may be a preexisting regional body or may be a new body created for purposes of executing the obligations of this MOU. i. The OAC for each Allocation Region shall be composed of representation from both Participating Counties and Participating Towns or Cities within the Region. The method of selecting members, and the terms for which they will serve will be determined by the Allocation Region's Participating Local Governments.All persons who serve on the OAC must have work or educational experience pertaining to one or more Approved Uses. j. The Regional OAC will be responsible for the following actions: i. Overseeing distribution of Opioid Funds from Participating Local Governments to programs and services within the Allocation Region for Approved Purposes. 6 DocuSign Envelope ID:809CFC7E-057D-4479-8E3C-52905A1E349D ii. Annual review of expenditure reports from Participating Local Jurisdictions within the Allocation Region for compliance with Approved Purposes and the terms of this MOU and any Settlement. iii. In the case where Participating Local Governments chose to forego their allocation of Opioid Funds: (i) Approving or denying proposals by Participating Local Governments or community groups to the OAC for use of Opioid Funds within the Allocation Region. (ii) Directing the Trustee to distribute Opioid Funds for use by Participating Local Governments or community groups whose proposals are approved by the OAC. (iii) Administrating and maintaining records of all OAC decisions and distributions of Opioid Funds. iv. Reporting and making publicly available all decisions on Opioid Fund allocation applications, distributions and expenditures by the OAC or directly by Participating Local Governments. v. Developing and maintaining a centralized public dashboard or other repository for the publication of expenditure data from any Participating Local Government that receives Opioid Funds, and for expenditures by the OAC in that Allocation Region,which it shall update at least annually. vi. If necessary,requiring and collecting additional outcome- related data from Participating Local Governments to evaluate the use of Opioid Funds, and all Participating Local Governments shall comply with such requirements. vii. Hearing complaints by Participating Local Governments within the Allocation Region regarding alleged failure to (1)use Opioid Funds for Approved Purposes or(2) comply with reporting requirements. 5. Participating Local Governments may agree and elect to share, pool, or collaborate with their respective allocation of Opioid Funds in any manner they choose by adopting a Regional Agreement, so long as such sharing,pooling, or collaboration is used for Approved Purposes and complies with the terms of this MOU and any Settlement. 7 DocuSign Envelope ID:809CFC7E-057D-4479-8E3C-52905A1E349D 6. Nothing in this MOU should alter or change any Participating Local Government's rights to pursue its own claim. Rather,the intent of this MOU is to join all parties who wish to be Participating Local Governments to agree upon an allocation formula for any Opioid Funds from any future binding Settlement with one or more Pharmaceutical Supply Chain Participants for all Local Governments in the State of Washington. 7. If any Participating Local Government disputes the amount it receives from its allocation of Opioid Funds,the Participating Local Government shall alert its respective OAC within sixty(60) days of discovering the information underlying the dispute. Failure to alert its OAC within this time frame shall not constitute a waiver of the Participating Local Government's right to seek recoupment of any deficiency in its allocation of Opioid Funds. 8. If any OAC concludes that a Participating Local Government's expenditure of its allocation of Opioid Funds did not comply with the Approved Purposes listed in Exhibit A, or the terms of this MOU, or that the Participating Local Government otherwise misused its allocation of Opioid Funds,the OAC may take remedial action against the alleged offending Participating Local Government. Such remedial action is left to the discretion of the OAC and may include withholding future Opioid Funds owed to the offending Participating Local Government or requiring the offending Participating Local Government to reimburse improperly expended Opioid Funds back to the OAC to be re-allocated to the remaining Participating Local Governments within that Region. 9. All Participating Local Governments and OAC shall maintain all records related to the receipt and expenditure of Opioid Funds for no less than five(5)years and shall make such records available for review by any other Participating Local Government or OAC, or the public. Records requested by the public shall be produced in accordance with Washington's Public Records Act RCW 42.56.001 et seq.Records requested by another Participating Local Government or an OAC shall be produced within twenty-one(21) days of the date the record request was received. This requirement does not supplant any Participating Local Government or OAC's obligations under Washington's Public Records Act RCW 42.56.001 et seq. D. Payment of Counsel and Litigation Expenses 1. The Litigating Local Governments have incurred attorneys' fees and litigation expenses relating to their prosecution of claims against the Pharmaceutical Supply Chain Participants, and this prosecution has inured to the benefit of all Participating Local Governments.Accordingly, a Washington 8 DocuSign Envelope ID:809CFC7E-057D-4479-8E3C-52905A1E349D Government Fee Fund("GFF")shall be established that ensures that all Parties that receive Opioid Funds contribute to the payment of fees and expenses incurred to prosecute the claims against the Pharmaceutical Supply Chain Participants, regardless of whether they are litigating or non-litigating entities. 2. The amount of the GFF shall be based as follows: the funds to be deposited in the GFF shall be equal to 15%of the total cash value of the Opioid Funds. 3. The maximum percentage of any contingency fee agreement permitted for compensation shall be 15%of the portion of the Opioid Funds allocated to the Litigating Local Government that is a party to the contingency fee agreement,plus expenses attributable to that Litigating Local Government. Under no circumstances may counsel collect more for its work on behalf of a Litigating Local Government than it would under its contingency agreement with that Litigating Local Government. 4. Payments from the GFF shall be overseen by a committee (the "Opioid Fee and Expense Committee")consisting of one representative of the following law firms: (a)Keller Rohrback L.LP.; (b)Hagens Berman Sobol Shapiro LLP; (c) Goldfarb&Huck Roth Riojas,PLLC; and(d)Napoli Shkolnik PLLC. The role of the Opioid Fee and Expense Committee shall be limited to ensuring that the GFF is administered in accordance with this Section. 5. In the event that settling Pharmaceutical Supply Chain Participants do not pay the fees and expenses of the Participating Local Governments directly at the time settlement is achieved,payments to counsel for Participating Local Governments shall be made from the GFF over not more than three years, with 50%paid within 12 months of the date of Settlement and 25%paid in each subsequent year, or at the time the total Settlement amount is paid to the Trustee by the Defendants,whichever is sooner. 6. Any funds remaining in the GFF in excess of: (i)the amounts needed to cover Litigating Local Governments'private counsel's representation agreements, and(ii)the amounts needed to cover the common benefit tax discussed in Section C.8 below(if not paid directly by the Defendants in connection with future settlement(s), shall revert to the Participating Local Governments pro rata according to the percentages set forth in Exhibits B,to be used for Approved Purposes as set forth herein and in Exhibit A. 7. In the event that funds in the GFF are not sufficient to pay all fees and expenses owed under this Section,payments to counsel for all Litigating Local Governments shall be reduced on a pro rata basis. The Litigating Local Governments will not be responsible for any of these reduced amounts. 9 DocuSign Envelope ID:809CFC7E-057D-4479-8E3C-52905A1 E349D 8. The Parties anticipate that any Opioid Funds they receive will be subject to a common benefit"tax"imposed by the court in In Re:National Prescription Opiate Litigation,United States District Court for the Northern District of Ohio, Case No. 1:17-md-02804-DAP ("Common Benefit Tax"). If this occurs, the Participating Local Governments shall first seek to have the settling defendants pay the Common Benefit Tax. If the settling defendants do not agree to pay the Common Benefit Tax,then the Common Benefit Tax shall be paid from the Opioid Funds and by both litigating and non-litigating Local Governments. This payment shall occur prior to allocation and distribution of funds to the Participating Local Governments. In the event that GFF is not fully exhausted to pay the Litigating Local Governments' private counsel's representation agreements, excess funds in the GFF shall be applied to pay the Common Benefit Tax(if any). E. General Terms 1. If any Participating Local Government believes another Participating Local Government,not including the Regional Abatement Advisory Councils,violated the terms of this MOU,the alleging Participating Local Government may seek to enforce the terms of this MOU in the court in which any applicable Settlement(s)was entered,provided the alleging Participating Local Government first provides the alleged offending Participating Local Government notice of the alleged violation(s)and a reasonable opportunity to cure the alleged violation(s). In such an enforcement action, any alleging Participating Local Government or alleged offending Participating Local Government may be represented by their respective public entity in accordance with Washington law. 2. Nothing in this MOU shall be interpreted to waive the right of any Participating Local Government to seek judicial relief for conduct occurring outside the scope of this MOU that violates any Washington law. In such an action,the alleged offending Participating Local Government, including the Regional Abatement Advisory Councils,may be represented by their respective public entities in accordance with Washington law. In the event of a conflict, any Participating Local Government, including the Regional Abatement Advisory Councils and its Members,may seek outside representation to defend itself against such an action. 3. Venue for any legal action related to this MOU shall be in the court in which the Participating Local Government is located or in accordance with the court rules on venue in that jurisdiction. This provision is not intended to expand the court rules on venue. 4. This MOU may be executed in two or more counterparts, each of which shall be deemed an original,but all of which shall constitute one and the same instrument. The Participating Local Governments approve the use of electronic signatures for execution of this MOU.All use of electronic signatures 10 DocuSign Envelope ID:809CFC7E-057D-4479-8E3C-52905A1 E349D shall be governed by the Uniform Electronic Transactions Act. The Parties agree not to deny the legal effect or enforceability of the MOU solely because it is in electronic form or because an electronic record was used in its formation. The Participating Local Government agree not to object to the admissibility of the MOU in the form of an electronic record, or a paper copy of an electronic document, or a paper copy of a document bearing an electronic signature, on the grounds that it is an electronic record or electronic signature or that it is not in its original form or is not an original. 5. Each Participating Local Government represents that all procedures necessary to authorize such Participating Local Government's execution of this MOU have been performed and that the person signing for such Party has been authorized to execute the MOU. [Remainder of Page Intentionally Left Blank—Signature Pages Follow] 11 DocuSign Envelope ID:809CFC7E-C57D-4479-8E3C-52905A1 E349D This One Washington Memorandum of Understanding Between Washington Municipalities is signed this day of , 2022 by: —DocuS( nerd by: F.CG27ZC'Kb17,.. Name& Title Nancy Backus Mayor On behalf of The City of Auburn p—DocuSlgned by: Na�Qiln t, 044A, NadF865o 2888462... ine Chan Interim Chief, APDE and CDIP, PHSKC Chronic Disease and Injury Prevention Section of Public Health-Seattle and King County 4894-0031-1574,v.2 12 DocuSign Envelope ID:809CFC7E-057D-4479-8E3C-52905A1E349D EXHIBIT A DocuSign Envelope ID:809CFC7E-057D-4479-8E3C-52905A1E349D OPIOID ABATEMENT STRATEGIES PART ONE: TREATMENT A. TREAT OPIOID USE DISORDER(OUD) Support treatment of Opioid Use Disorder (OUD) and any co-occurring Substance Use Disorder or Mental Health (SUD/MH) conditions, co-usage, and/or co-addiction through evidence-based, evidence-informed, or promising programs or strategies that may include, but are not limited to,the following: 1. Expand availability of treatment for OUD and any co-occurring SUD/MH conditions, co-usage, and/or co-addiction, including all forms of Medication-Assisted Treatment (MAT) approved by the U.S. Food and Drug Administration. 2. Support and reimburse services that include the full American Society of Addiction Medicine (ASAM) continuum of care for OUD and any co-occurring SUD/MH conditions, co-usage, and/or co-addiction, including but not limited to: a. Medication-Assisted Treatment(MAT); b. Abstinence-based treatment; c. Treatment, recovery, or other services provided by states, subdivisions, community health centers;non-for-profit providers; or for-profit providers; d. Treatment by providers that focus on OUD treatment as well as treatment by providers that offer OUD treatment along with treatment for other SUD/MH conditions, co-usage, and/or co-addiction; or e. Evidence-informed residential services programs,as noted below. 3. Expand telehealth to increase access to treatment for OUD and any co-occurring SUD/MH conditions, co-usage, and/or co-addiction, including MAT, as well as counseling,psychiatric support, and other treatment and recovery support services. 4. Improve oversight of Opioid Treatment Programs (OTPs) to assure evidence-based, evidence-informed, or promising practices such as adequate methadone dosing. 5. Support mobile intervention, treatment, and recovery services, offered by qualified professionals and service providers, such as peer recovery coaches, for persons with OUD and any co-occurring SUD/MH conditions, co-usage, and/or co-addiction and for persons who have experienced an opioid overdose. 6. Support treatment of mental health trauma resulting from the traumatic experiences of the opioid user(e.g.,violence, sexual assault, human trafficking, or adverse childhood experiences) and family members (e.g., surviving family members after an overdose 1 DocuSign Envelope ID:809CFC7E-057D-4479-8E3C-52905A1E3490 or overdose fatality), and training of health care personnel to identify and address such trauma. 7. Support detoxification (detox) and withdrawal management services for persons with OUD and any co-occurring SUD/MH conditions, co-usage, and/or co-addiction, including medical detox, referral to treatment, or connections to other services or supports. 8. Support training on MAT for health care providers, students, or other supporting professionals, such as peer recovery coaches or recovery outreach specialists, including telementoring to assist community-based providers in rural or underserved areas. 9. Support workforce development for addiction professionals who work with persons with OUD and any co-occurring SUD/MH conditions, co-usage, and/or co-addiction. 10. Provide fellowships for addiction medicine specialists for direct patient care, instructors, and clinical research for treatments. 11. Provide funding and training for clinicians to obtain a waiver under the federal Drug Addiction Treatment Act of 2000 (DATA 2000) to prescribe MAT for OUD, and provide technical assistance and professional support to clinicians who have obtained a DATA 2000 waiver. 12. Support the dissemination of web-based training curricula, such as the American Academy of Addiction Psychiatry's Provider Clinical Support Service-Opioids web- based training curriculum and motivational interviewing. 13. Support the development and dissemination of new curricula, such as the American Academy of Addiction Psychiatry's Provider Clinical Support Service for Medication-Assisted Treatment. B. SUPPORT PEOPLE IN TREATMENT AND RECOVERY Support people in treatment for and recovery from OUD and any co-occurring SUD/MH conditions, co-usage, and/or co-addiction through evidence-based, evidence-informed, or promising programs or strategies that may include,but are not limited to,the following: 1. Provide the full continuum of care of recovery services for OUD and any co-occurring SUD/MH conditions, co-usage, and/or co-addiction, including supportive housing, residential treatment, medical detox services, peer support services and counseling, community navigators, case management, and connections to community-based services. 2. Provide counseling, peer-support, recovery case management and residential treatment with access to medications for those who need it to persons with OUD and any co-occurring SUD/MH conditions, co-usage, and/or co-addiction. 2 DocuSign Envelope ID:809CFC7E-057D-4479-8E3C-52905A1 E349D 3. Provide access to housing for people with OUD and any co-occurring SUD/MH conditions, co-usage, and/or co-addiction, including supportive housing, recovery housing,housing assistance programs, or training for housing providers. 4. Provide community support services, including social and legal services, to assist in deinstitutionalizing persons with OUD and any co-occurring SUD/MH conditions, co- usage, and/or co-addiction. 5. Support or expand peer-recovery centers, which may include support groups, social events, computer access, or other services for persons with OUD and any co-occurring SUD/MH conditions, co-usage, and/or co-addiction. 6. Provide employment training or educational services for persons in treatment for or recovery from OUD and any co-occurring SUD/MH conditions, co-usage, and/or co- addiction. 7. Identify successful recovery programs such as physician, pilot, and college recovery programs, and provide support and technical assistance to increase the number and capacity of high-quality programs to help those in recovery. 8. Engage non-profits, faith-based communities, and community coalitions to support people in treatment and recovery and to support family members in their efforts to manage the opioid user in the family. 9. Provide training and development of procedures for government staff to appropriately interact and provide social and other services to current and recovering opioid users, including reducing stigma. 10. Support stigma reduction efforts regarding treatment and support for persons with OUD, including reducing the stigma on effective treatment. C. CONNECT PEOPLE WHO NEED HELP TO THE HELP THEY NEED (CONNECTIONS TO CARE) Provide connections to care for people who have — or are at risk of developing — OUD and any co-occurring SUD/MH conditions, co-usage, and/or co-addiction through evidence- based, evidence-informed, or promising programs or strategies that may include, but are not limited to,the following: 1. Ensure that health care providers are screening for OUD and other risk factors and know how to appropriately counsel and treat (or refer if necessary) a patient for OUD treatment. 2. Support Screening,Brief Intervention and Referral to Treatment(SBIRT)programs to reduce the transition from use to disorders. 3. Provide training and long-term implementation of SBIRT in key systems (health, schools, colleges, criminal justice, and probation), with a focus on youth and young adults when transition from misuse to opioid disorder is common. 3 DocuSign Envelope ID:809CFC7E-057D-4479-8E3C-52905A1E349D 4. Purchase automated versions of SBIRT and support ongoing costs of the technology. 5. Support training for emergency room personnel treating opioid overdose patients on post-discharge planning, including community referrals for MAT, recovery case management or support services. 6. Support hospital programs that transition persons with OUD and any co-occurring SUD/MH conditions, co-usage, and/or co-addiction, or persons who have experienced an opioid overdose, into community treatment or recovery services through a bridge clinic or similar approach. 7. Support crisis stabilization centers that serve as an alternative to hospital emergency departments for persons with OUD and any co-occurring SUD/MH conditions, co- usage, and/or co-addiction or persons that have experienced an opioid overdose. 8. Support the work of Emergency Medical Systems, including peer support specialists, to connect individuals to treatment or other appropriate services following an opioid overdose or other opioid-related adverse event. 9. Provide funding for peer support specialists or recovery coaches in emergency departments, detox facilities, recovery centers, recovery housing, or similar settings; offer services, supports, or connections to care to persons with OUD and any co- occurring SUD/MH conditions, co-usage, and/or co-addiction or to persons who have experienced an opioid overdose. 10.Provide funding for peer navigators, recovery coaches, care coordinators, or care managers that offer assistance to persons with OUD and any co-occurring SUD/MH conditions, co-usage, and/or co-addiction or to persons who have experienced on opioid overdose. 11. Create or support school-based contacts that parents can engage with to seek immediate treatment services for their child; and support prevention, intervention, treatment, and recovery programs focused on young people. 12.Develop and support best practices on addressing OUD in the workplace. 13. Support assistance programs for health care providers with OUD. 14.Engage non-profits and the faith community as a system to support outreach for treatment. 15. Support centralized call centers that provide information and connections to appropriate services and supports for persons with OUD and any co-occurring SUD/MH conditions, co-usage, and/or co-addiction. 16. Create or support intake and call centers to facilitate education and access to treatment, prevention, and recovery services for persons with OUD and any co- occurring SUD/MH conditions, co-usage, and/or co-addiction. 4 DocuSign Envelope ID:809CFC7E-057D-4479-8E3C-52905A1E349D 17. Develop or support a National Treatment Availability Clearinghouse — a multistate/nationally accessible database whereby health care providers can list locations for currently available in-patient and out-patient OUD treatment services that are accessible on a real-time basis by persons who seek treatment. D. ADDRESS THE NEEDS OF CRIMINAL-JUSTICE-INVOLVED PERSONS Address the needs of persons with OUD and any co-occurring SUD/MH conditions, co- usage, and/or co-addiction who are involved — or are at risk of becoming involved— in the criminal justice system through evidence-based, evidence-informed, or promising programs or strategies that may include,but are not limited to,the following: 1. Support pre-arrest or post-arrest diversion and deflection strategies for persons with OUD and any co-occurring SUD/MH conditions, co-usage, and/or co-addiction, including established strategies such as: a. Self-referral strategies such as the Angel Programs or the Police Assisted Addiction Recovery Initiative(PAARI); b. Active outreach strategies such as the Drug Abuse Response Team (DART) model; c. "Naloxone Plus" strategies, which work to ensure that individuals who have received naloxone to reverse the effects of an overdose are then linked to treatment programs or other appropriate services; d. Officer prevention strategies, such as the Law Enforcement Assisted Diversion (LEAD)model; e. Officer intervention strategies such as the Leon County, Florida Adult Civil Citation Network or the Chicago Westside Narcotics Diversion to Treatment Initiative; f. Co-responder and/or alternative responder models to address OUD-related 911 calls with greater SUD expertise and to reduce perceived barriers associated with law enforcement 911 responses; or g. County prosecution diversion programs, including diversion officer salary, only for counties with a population of 50,000 or less. Any diversion services in matters involving opioids must include drug testing,monitoring, or treatment. 2. Support pre-trial services that connect individuals with OUD and any co-occurring SUD/MH conditions, co-usage, and/or co-addiction to evidence-informed treatment, including MAT, and related services. 3. Support treatment and recovery courts for persons with OUD and any co-occurring SUD/MH conditions, co-usage, and/or co-addiction, but only if these courts provide referrals to evidence-informed treatment, including MAT. 5 DocuSign Envelope ID:809CFC7E-057D-4479-8E3C-52905A1E349D 4. Provide evidence-informed treatment, including MAT, recovery support, or other appropriate services to individuals with OUD and any co-occurring SUD/MH conditions, co-usage, and/or co-addiction who are incarcerated in jail or prison. 5. Provide evidence-informed treatment, including MAT, recovery support, or other appropriate services to individuals with OUD and any co-occurring SUD/MH conditions, co-usage, and/or co-addiction who are leaving jail or prison have recently left jail or prison, are on probation or parole, are under community corrections supervision, or are in re-entry programs or facilities. 6. Support critical time interventions (CTI),particularly for individuals living with dual- diagnosis OUD/serious mental illness, and services for individuals who face immediate risks and service needs and risks upon release from correctional settings. 7. Provide training on best practices for addressing the needs of criminal-justice- involved persons with OUD and any co-occurring SUD/MH conditions, co-usage, and/or co-addiction to law enforcement, correctional, or judicial personnel or to providers of treatment, recovery, case management, or other services offered in connection with any of the strategies described in this section. E. ADDRESS THE NEEDS OF PREGNANT OR PARENTING WOMEN AND THEIR FAMILIES, INCLUDING BABIES WITH NEONATAL ABSTINENCE SYNDROME Address the needs of pregnant or parenting women with OUD and any co-occurring SUD/MH conditions, co-usage, and/or co-addiction, and the needs of their families, including babies with neonatal abstinence syndrome, through evidence-based, evidence-informed, or promising programs or strategies that may include,but are not limited to,the following: 1. Support evidence-based, evidence-informed, or promising treatment, including MAT, recovery services and supports, and prevention services for pregnant women — or women who could become pregnant—who have OUD and any co-occurring SUD/MH conditions, co-usage, and/or co-addiction, and other measures to educate and provide support to families affected by Neonatal Abstinence Syndrome. 2. Provide training for obstetricians or other healthcare personnel that work with pregnant women and their families regarding treatment of OUD and any co-occurring SUD/MH conditions, co-usage, and/or co-addiction. 3. Provide training to health care providers who work with pregnant or parenting women on best practices for compliance with federal requirements that children born with Neonatal Abstinence Syndrome get referred to appropriate services and receive a plan of safe care. 4. Provide enhanced support for children and family members suffering trauma as a result of addiction in the family; and offer trauma-informed behavioral health treatment for adverse childhood events. 6 DocuSign Envelope ID:809CFC7E-057D-4479-8E3C-52905A1E349D 5. Offer enhanced family supports and home-based wrap-around services to persons with OUD and any co-occurring SUD/MH conditions, co-usage, and/or co-addiction, including but not limited to parent skills training. 6. Support for Children's Services — Fund additional positions and services, including supportive housing and other residential services, relating to children being removed from the home and/or placed in foster care due to custodial opioid use. PART TWO: PREVENTION F. PREVENT OVER-PRESCRIBING AND ENSURE APPROPRIATE PRESCRIBING AND DISPENSING OF OPIOIDS Support efforts to prevent over-prescribing and ensure appropriate prescribing and dispensing of opioids through evidence-based, evidence-informed, or promising programs or strategies that may include,but are not limited to,the following: 1. Training for health care providers regarding safe and responsible opioid prescribing, dosing, and tapering patients off opioids. 2. Academic counter-detailing to educate prescribers on appropriate opioid prescribing. 3. Continuing Medical Education(CME) on appropriate prescribing of opioids. 4. Support for non-opioid pain treatment alternatives, including training providers to offer or refer to multi-modal,evidence-informed treatment of pain. 5. Support enhancements or improvements to Prescription Drug Monitoring Programs (PDMPs), including but not limited to improvements that: a. Increase the number of prescribers using PDMPs; b. Improve point-of-care decision-making by increasing the quantity, quality, or format of data available to prescribers using PDMPs or by improving the interface that prescribers use to access PDMP data, or both; or c. Enable states to use PDMP data in support of surveillance or intervention strategies, including MAT referrals and follow-up for individuals identified within PDMP data as likely to experience OUD. 6. Development and implementation of a national PDMP — Fund development of a multistate/national PDMP that permits information sharing while providing appropriate safeguards on sharing of private health information, including but not limited to: a. Integration of PDMP data with electronic health records, overdose episodes, and decision support tools for health care providers relating to OUD. 7 DocuSign Envelope ID:809CFC7E-057D-4479-8E3C-52905A1E349D b. Ensuring PDMPs incorporate available overdose/naloxone deployment data, including the United States Department of Transportation's Emergency Medical Technician overdose database. 7. Increase electronic prescribing to prevent diversion or forgery. 8. Educate Dispensers on appropriate opioid dispensing. G. PREVENT MISUSE OF OPIOIDS Support efforts to discourage or prevent misuse of opioids through evidence-based, evidence- informed, or promising programs or strategies that may include, but are not limited to, the following: 1. Corrective advertising or affirmative public education campaigns based on evidence. 2. Public education relating to drug disposal. 3. Drug take-back disposal or destruction programs. 4. Fund community anti-drug coalitions that engage in drug prevention efforts. 5. Support community coalitions in implementing evidence-informed prevention, such as reduced social access and physical access, stigma reduction — including staffing, educational campaigns, support for people in treatment or recovery, or training of coalitions in evidence-informed implementation, including the Strategic Prevention Framework developed by the U.S. Substance Abuse and Mental Health Services Administration(SAMHSA). 6. Engage non-profits and faith-based communities as systems to support prevention. 7. Support evidence-informed school and community education programs and campaigns for students, families, school employees, school athletic programs, parent- teacher and student associations, and others. 8. School-based or youth-focused programs or strategies that have demonstrated effectiveness in preventing drug misuse and seem likely to be effective in preventing the uptake and use of opioids. 9. Support community-based education or intervention services for families, youth, and adolescents at risk for OUD and any co-occurring SUD/MH conditions, co-usage, and/or co-addiction. 10. Support evidence-informed programs or curricula to address mental health needs of young people who may be at risk of misusing opioids or other drugs, including emotional modulation and resilience skills. 11. Support greater access to mental health services and supports for young people, including services and supports provided by school nurses or other school staff, to 8 DocuSign Envelope ID:809CFC7E-057D-4479-8E3C-52905A1E349D address mental health needs in young people that (when not properly addressed) increase the risk of opioid or other drug misuse. H. PREVENT OVERDOSE DEATHS AND OTHER HARMS Support efforts to prevent or reduce overdose deaths or other opioid-related harms through evidence-based, evidence-informed, or promising programs or strategies that may include, but are not limited to,the following: 1. Increase availability and distribution of naloxone and other drugs that treat overdoses for first responders, overdose patients, opioid users, families and friends of opioid users, schools, community navigators and outreach workers, drug offenders upon release from jail/prison, or other members of the general public. 2. Provision by public health entities of free naloxone to anyone in the community, including but not limited to provision of intra-nasal naloxone in settings where other options are not available or allowed. 3. Training and education regarding naloxone and other drugs that treat overdoses for first responders, overdose patients, patients taking opioids, families, schools, and other members of the general public. 4. Enable school nurses and other school staff to respond to opioid overdoses, and provide them with naloxone,training, and support. 5. Expand, improve, or develop data tracking software and applications for overdoses/naloxone revivals. 6. Public education relating to emergency responses to overdoses. 7. Public education relating to immunity and Good Samaritan laws. 8. Educate first responders regarding the existence and operation of immunity and Good Samaritan laws. 9. Expand access to testing and treatment for infectious diseases such as HIV and Hepatitis C resulting from intravenous opioid use. 10. Support mobile units that offer or provide referrals to treatment, recovery supports, health care, or other appropriate services to persons that use opioids or persons with OUD and any co-occurring SUD/MH conditions, co-usage, and/or co-addiction. 11.Provide training in treatment and recovery strategies to health care providers, students, peer recovery coaches, recovery outreach specialists, or other professionals that provide care to persons who use opioids or persons with OUD and any co- occurring SUD/MH conditions, co-usage, and/or co-addiction. 12. Support screening for fentanyl in routine clinical toxicology testing. 9 DocuSign Envelope ID:809CFC7E-057D-4479-8E3C-52905A1 E349D PART THREE: OTHER STRATEGIES I. FIRST RESPONDERS In addition to items C8,D1 through D7, H1,H3, and H8, support the following: 1. Current and future law enforcement expenditures relating to the opioid epidemic. 2. Educate law enforcement or other first responders regarding appropriate practices and precautions when dealing with fentanyl or other drugs. J. LEADERSHIP, PLANNING AND COORDINATION Support efforts to provide leadership,planning, and coordination to abate the opioid epidemic through activities, programs, or strategies that may include, but are not limited to, the following: 1. Community regional planning to identify goals for reducing harms related to the opioid epidemic, to identify areas and populations with the greatest needs for treatment intervention services, or to support other strategies to abate the opioid epidemic described in this opioid abatement strategy list. 2. A government dashboard to track key opioid-related indicators and supports as identified through collaborative community processes. 3. Invest in infrastructure or staffing at government or not-for-profit agencies to support collaborative, cross-system coordination with the purpose of preventing overprescribing, opioid misuse, or opioid overdoses, treating those with OUD and any co-occurring SUD/MH conditions, co-usage, and/or co-addiction, supporting them in treatment or recovery, connecting them to care, or implementing other strategies to abate the opioid epidemic described in this opioid abatement strategy list. 4. Provide resources to staff government oversight and management of opioid abatement programs. K. TRAINING In addition to the training referred to in various items above, support training to abate the opioid epidemic through activities, programs, or strategies that may include, but are not limited to,the following: 1. Provide funding for staff training or networking programs and services to improve the capability of government, community, and not-for-profit entities to abate the opioid crisis. 2. Invest in infrastructure and staffmg for collaborative cross-system coordination to prevent opioid misuse, prevent overdoses, and treat those with OUD and any co- occurring SUD/MH conditions, co-usage, and/or co-addiction, or implement other 10 DocuSign Envelope ID:809CFC7E-057D-4479-8E3C-52905A1E349D strategies to abate the opioid epidemic described in this opioid abatement strategy list (e.g.,health care,primary care,pharmacies,PDMPs, etc.). L. RESEARCH Support opioid abatement research that may include,but is not limited to, the following: 1. Monitoring, surveillance, and evaluation of programs and strategies described in this opioid abatement strategy list. 2. Research non-opioid treatment of chronic pain. 3. Research on improved service delivery for modalities such as SBIRT that demonstrate promising but mixed results in populations vulnerable to opioid use disorders. 4. Research on innovative supply-side enforcement efforts such as improved detection of mail-based delivery of synthetic opioids. 5. Expanded research on swift/certain/fair models to reduce and deter opioid misuse within criminal justice populations that build upon promising approaches used to address other substances(e.g. Hawaii HOPE and Dakota 24/7). 6. Research on expanded modalities such as prescription methadone that can expand access to MAT. 11 DocuSign Envelope ID:809CFC7E-057D-4479-8E3C-52905A1E349D EXHIBIT B "t. a yy z�1 F «s CountyP :!Government=" J %F Attocatfoni f, Adams County Adams County 0.1638732475% Hatton Lind Othello Ritzville Washtucna County Total: 0.1638732475% Asotin County Asotin County 0.4694498386% Asotin Clarkston County Total: 0.4694498386% Benton County Benton County 1.4848831892% Benton City Kennewick 0.5415650564% Prosser Richland 0.4756779517% West Richland 0.0459360490% County Total: 2.5480622463% Chelan County Chelan County 0.7434914485% Cashmere Chelan Entiat Leavenworth Wenatchee 0.2968333494% County Total: 1.0403247979% Clallam County Clallam County 1.3076983401% Forks Port Angeles 0.4598370527% Sequim County Total: 1.7675353928% ***-Local Government appears in multiple counties B-1 DocuSign Envelope ID:809CFC7E-057D-4479-8E3C-52905A1E349D EXHIBIT B m� Locale County:j :r-n-:. .Governmnt %�Alloca iofl Clark County Clark County 4.5149775326% Battle Ground 0.1384729857% Camas 0.2691592724% La Center Ridgefield Vancouver 1.7306605325% Washougal 0.1279328220% Woodland*** Yacolt County Total: 6.7812031452% Columbia County Columbia County 0.0561699537% Dayton Starbuck County Total: 0.0561699537% Cowlitz County Cowlitz County 1.7226945990% Castle Rock Kalama Kelso 0.1331145270% Longview 0.6162736905% Woodland*** County Total: 2.4720828165% Douglas County Douglas County 0.3932175175% Bridgeport Coulee Dam*** East Wenatchee 0.0799810865% Mansfield Rock Island Waterville County Total: 0.4731986040% Ferry County Ferry County 0.1153487994% Republic County Total: 0.1153487994% ***-Local Government appears in multiple counties B-2 DocuSign Envelope ID:809CFC7E-057D-4479-8E3C-52905A1E349D EXHIBIT B mkh'"' County Government s % Hocation: Franklin County Franklin County 0.3361237144% Connell Kahlotus Mesa Pasco 0.4278056066% County Total: 0.7639293210% Garfield County Garfield County 0.0321982209% Pomeroy County Total: 0.0321982209% Grant County Grant County 0.9932572167% Coulee City Coulee Dam*** Electric City Ephrata George Grand Coulee Hartline Krupp Mattawa Moses Lake 0.2078293909% Quincy Royal City Soap Lake Warden Wilson Creek County Total: 1.2010866076% *** -Local Government appears in multiple counties B-3 DocuSign Envelope ID:809CFC7E-057D-4479-8E3C-52905A1E349D EXHIBIT B -,7,,.. ,,.-,-,.,.,,:..,7..';.,,')ocal -z.. -:ou fr=,- ; , :,7, County G,'000 ent= " : yoAtjoc04:9;,,,,.7: Grays Harbor County Grays Harbor County 0.9992429138% Aberdeen 0.2491525333% Cosmopolis Elma Hoquiam McCleary Montesano Oakville Ocean Shores Westport County Total: 1.2483954471% Island County Island County 0.6820422610% Coupeville Langley • Oak Harbor 0.2511550431% County Total: 0.9331973041% Jefferson County Jefferson County 0.4417137380% Port Townsend County Total: 0.4417137380% ***-Local Government appears in multiple counties B-4 DocuSign Envelope ID:809CFC7E-057D-4479-8E3C-52905A1E349D EXHIBIT B z8 " County GoVerhinient> � N�%=Ailocation King County King County 13.9743722662% Algona Auburn*** 0.2622774917% Beaux Arts Village Bellevue 1.1300592573% Black Diamond Bothell*** 0.1821602716% Burien 0.0270962921% Carnation Clyde Hill Covington 0.0118134406% Des Moines 0.1179764526% Duvall Enumclaw*** 0.0537768326% Federal Way 0.3061452240% Hunts Point Issaquah 0.1876240107% Kenmore 0.0204441024% Kent 0.5377397676% Kirkland 0.5453525246% Lake Forest Park 0.0525439124% Maple Valley 0.0093761587% Medina Mercer Island 0.1751797481% Milton*** Newcastle 0.0033117880% Normandy Park North Bend Pacific*** Redmond 0.4839486007% Renton 0.7652626920% Sammamish 0.0224369090% SeaTac 0.1481551278% Seattle 6.6032403816% Shoreline 0.0435834501% Skykomish Snoqualmie 0.0649164481% Tukwila 0.3032205739% Woodinville 0.0185516364% Yarrow Point County Total: 26.0505653608% ***-Local Government appears in multiple counties B-5 DocuSign Envelope ID:809CFC7E-057D-4479-8E3C-52905A1E349D EXHIBIT B County' " Government� _ , �%Allocation' Kitsap County Kitsap County 2.6294133668% Bainbridge Island 0.1364686014% Bremerton 0.6193374389% Port Orchard 0.1009497162% Poulsbo 0.0773748246% County Total: 3.5635439479% Kittitas County Kittitas County 0.3855704683% Cle Elum Ellensburg 0.0955824915% Kittitas Roslyn South Cle Elum County Total: 0.4811529598% Klickitat County Klickitat County 0.2211673457% Bingen Goldendale White Salmon County Total: 0.2211673457% ....................._..._.._........... Lewis County Lewis County 1.0777377479% Centralia 0.1909990353% Chehalis Morton Mossyrock Napavine Pe Ell Toledo Vader Winlock County Total: 1.2687367832% ***-Local Government appears in multiple counties B-6 DocuSign Envelope ID:809CFC7E-057D-4479-8E3C-52905A1E349D EXHIBIT B j , 1.0ca1 ; C01Ynty%? i s, GOV2CtY111@rit; ��AI�t}CBtIOn; Lincoln County Lincoln County 0.1712669645% Almira Creston Davenport Harrington Odessa Reardan Sprague Wilbur County Total: 0.1712669645% Mason County Mason County 0.8089918012% Shelton 0.1239179888% County Total: 0.9329097900% Okanogan County Okanogan County 0.6145043345% Brewster Conconully Coulee Dam*** Elmer City Nespelem Okanogan Omak Oroville Pateros Riverside Tonasket Twisp Winthrop County Total: 0.6145043345% Pacific County Pacific County 0.4895416466% I lwaco Long Beach Raymond South Bend County Total: 0.4895416466% *** -Local Government appears in multiple counties B-7 DocuSign Envelope ID:809CFC7E-057D-4479-8E3C-52905A1E349D EXHIBIT B �. ., ; , ,. County .Government• %.Allocation W,, Pend Oreille County Pend Oreille County 0.2566374940% Cusick lone Metaline Metaline Falls Newport County Total: 0.2566374940% Pierce County Pierce County 7.2310164020% Auburn*** 0.0628522112% Bonney Lake 0.1190773864% Buckley Carbonado DuPont Eatonville Edgewood 0.0048016791% Enumclaw*** 0.0000000000% Fife 0.1955185481% Fircrest Gig Harbor 0.0859963345% Lakewood 0.5253640894% Milton*** Orting Pacific*** Puyallup 0.3845704814% Roy Ruston South Prairie Steilacoom Sumner 0.1083157569% Tacoma 3.2816374617% University Place 0.0353733363% Wilkeson County Total: 12.0345236870% San Juan County San Juan County 0.2101495171% Friday Harbor County Total: 0.2101495171% ***-Local Government appears in multiple counties B-8 DocuSign Envelope ID:809CFC7E-057D-4479-8E3C-52905A1E349D EXHIBIT B �•i$ fe County /Government;,ATM`' '%Allocation's':: Skagit County Skagit County 1.0526023961% Anacortes 0.1774962906% Burlington 0.1146861661% Concrete Hamilton La Conner Lyman Mount Vernon 0.2801063665% Sedro-Woolley 0.0661146351% County Total: 1.6910058544% Skamania County Skamania County 0.1631931925% North Bonneville Stevenson County Total: 0.1631931925% Snohomish County Snohomish County 6.9054415622% ................ ....... .. Arlington 0.2620524080% Bothell*** 0.2654558588% Brier Darrington Edmonds 0.3058936009% Everett 1.9258363241% Gold Bar Granite Falls Index Lake Stevens 0.1385202891% Lynnwood 0.7704629214% Marysville 0.3945067827% Mill Creek 0.1227939546% Monroe 0.1771621898% Mountlake Terrace 0.2108935805% Mukilteo 0.2561790702% Snohomish 0.0861097964% Stanwood Sultan Woodway County Total: 11.8213083387% .......................... .......... ***-Local Government appears in multiple counties B-9 DocuSign Envelope ID:809CFC7E-057D-4479-8E3C-52905A1E349D EXHIBIT B yz yb %a:AtI. , n : county , .,� , YGoverrimiit , . iocatil`o -,_d Spokane County Spokane County 5.5623859292% Airway Heights Cheney 0.1238454349% Deer Park Fairfield Latah Liberty Lake 0.0389636519% Medical Lake • Millwood Rockford Spangle Spokane 3.0872078287% Spokane Valley 0.0684217500% Waverly County Total: 8.8808245947% Stevens County Stevens County 0.7479240179% Chewelah Colville Kettle Falls Marcus Northport Springdale County Total: 0.7479240179% Thurston County Thurston County 2.3258492094% Bucoda Lacey 0.2348627221% Olympia 0.6039423385% Rainier Tenino Tumwater 0.2065982350% Yelm County Total: 3.3712525050% Wahkiakum County Wahkiakum County 0.0596582197% Cathlamet County Total: 0.0596582197% ***-Local Government appears in multiple counties B-10 DocuSign Envelope ID:809CFC7E-057D-4479-8E3C-52905A1E349D EXHIBIT B • • Cnun �f� Gnv rnment . .,I` o%Allb�cation,,:; Walla Walla County Walla Walla County 0.5543870294% College Place Prescott Waitsburg Walla Walla 0.3140768654% County Total: 0.8684638948% Whatcom County Whatcom County 1.3452637306% Bellingham 0.8978614577% Blaine Everson Ferndale 0.0646101891% Lynden 0.0827115612% Nooksack Sumas County Total: 2.3904469386% Whitman County Whitman County 0.2626805837% Albion Colfax Colton Endicott Farmington Garfield LaCrosse Lamont Malden Oakesdale Palouse Pullman 0.2214837491% Rosalia St.John Tekoa Uniontown County Total: 0.4841643328% ***-Local Government appears in multiple counties B-11 DocuSign Envelope ID: e349D EXHIBIT B Yakima County Yakima County 1.9308392959V6 Grandview 0.0530606108% Granger Harrah Mabton Moxee � Naches Selah Sunnyside 0.1213478384% Tieton Toppenish Union Gap Wapato Yakima 0.6060410539S6 Zillah County Total: 2.719388799196 *** -Local Government appears in multiple counties 13-13 DocuSign Envelope ID:809CFC7E-057D-4479-8E3C-52905A1E349D DocuSign Envelope ID:809CFC7E-057D-4479-8E3C-52905A1E349D KING COUNTY REGIONAL AGREEMENT King County intends to explore coordination with its cities and towns to facilitate a Regional Agreement for Opioid Fund allocation. Should some cities and towns choose not to participate in a Regional Agreement, this shall not preclude coordinated allocation for programs and services between the County and those cities and towns who elect to pursue a Regional Agreement. As contemplated in C.5 of the MOU, any Regional Agreement shall comply with the terms of the MOU and any Settlement. If no Regional Agreement is achieved, the default methodology for allocation in C.4 of the MOU shall apply.