Well, good morning, everyone.
Thank you for coming out on this gorgeous day today.
And it's short notice I know must be we're getting into the long weekend.
So thank you very much for being here.
First, I want to thank our speakers, Dr. Mercy Wanaina, founder and CEO of Hope and Chance Integrated Health.
Daniel Malone, Executive Director of the Downtown Emergency Services Center, Brandy McNeil and Lisa Dugard, who couldn't be with us today, with Purpose, Dignity in Action, and Steve Woolworth, CEO of Evergreen Treatment Services.
Thank you all for being here.
And I also want to alert you to the fact that we've got other guests, including Uplift Northwest, Seattle Indian Health Board, The Salvation Army, We Heart Seattle, REACH, The More We Love, Battlefield Addiction, Soto BIA, Ballard Alliance, and the Alliance for Pioneer Square, and the City Attorney's Office, City Attorney.
Thank you all for standing here with me today.
All right.
You've heard me say this before, but I'll just say it again for good measure.
The fentanyl crisis and addiction in general is inextricably linked to our chronic homelessness and our public safety problems.
And you don't have to be in recovery to realize that expanding access to evidence-based treatment is a good way to help solve both problems or at least chip away at them.
For too long, for too long, we've watched people suffering from untreated addiction and mental illness deteriorate in our streets.
Well, our neighborhoods become less safe.
And there's a reason why we're right here.
This area, Pioneer Square Occidental Park, is one of the ground zeroes in this city for gun violence and for the heartbreak that is associated with addiction.
So that is why I put forward my pilot project a couple years ago that enables caseworkers to refer people to rehab at Lakeside Mylim Treatment Center.
It's over there in Kirkland, after which Lakeside, after 28 days of residential detox and treatment, they just build a city.
That's a simple way of getting people the help they need right now because The last thing we want is for Medicaid recipients to wait weeks to get into one of the exceedingly few spots because we know what can happen in the meantime.
It's working.
Caseworkers with co-lead We Heart Seattle, the more we love, have taken advantage of this resource because everyone, everyone deserves the same chance at recovery that I had almost five years ago.
People in Medicaid shouldn't have to wait, and the city shouldn't have to wait for better solutions.
What I'm fighting for is simple, and it's to put treatment at the heart and the center of the city's agenda, policy agenda.
We can't keep deferring investments in treatment while watching the same people cycle through homelessness, overdose, emergency rooms, and jail over and over and over again.
Bringing people together, putting forward a package of proposed investments isn't just fiscally responsible.
It's a break from what we've been doing in the past, deferring constantly, which is a moral failure.
The time is now for a zealous push for a righteous cause.
Using an opportunity the legislature gave us by authorizing local jurisdictions to increase the sales tax by 0.1% for public safety.
And the way that the legislature writes public safety in that bill does include behavioral health.
While Mayor Harrell has not yet announced implementing this new funding source, he has indicated interest in doing so because it will raise over $35 million for public safety.
And my resolution calls for allocating up to 25% of that to the pathway to recovery.
HB 2015 was sponsored by Representative Endman and pushed by the Black Caucus, likely because The black community is disproportionately impacted by violence, particularly the violence surrounding the drug trade, and overrepresented in fatal overdose statistics.
No one likes to increase regressive taxes, but I am suggesting to you a little bit of the background why it was put forward.
The legislature carved out this funding source.
Perhaps someone who needs treatment.
Anyway, the legislature carved out this funding source for public safety, specifically for this kind of intervention.
This is not about raising taxes on working families.
This is about helping working families because there isn't one working family, I would suggest, that has not been touched by addiction.
Many of you, people standing behind me as well.
When we invest in getting people off the streets and into treatment, we prevent crime, reduce emergency room responses, and make every neighborhood safer.
And that is smart public safety.
That is public safety.
So our speakers will talk today about sustaining the investments we're already making in treatment and bringing new interventions to fill in the gaps in what has been up to now a more limited set of options for people who are struggling with addiction.
Because take it from me, when someone struggling with a substance use disorder decides to take that step, we have got to give them somewhere to go.
And so that's what I'm trying to do here today.
I will now stop talking and turn the mic over to Dr. Mercy Wanaina, founder and CEO of Hope and Chance Integrated Health, which offers wraparound services for addiction and mental health, and they're located in Belltown.
Thank you.
Good morning.
My name is Dr. Mercy Wanaina.
I'm a board-certified psychiatric nurse practitioner.
I specialize in mental health and also substance use disorder.
I'm the CEO and founder of Hope and Chance Integrated Health, which is a nonprofit organization that provides wraparound services, mental health services, and also substance use services.
With over 15 years of direct experience working in correctional facilities, for example, King County Jail, Snohomish County Jail, Monroe Prison, Prady Women's Corrections, I've witnessed firsthand and heartbreaking cycle of recidivism.
Too often, individuals are arrested, they come to the jail whereby they get detox, they begin stabilization with medications, and then they are released back to the streets with no housing or follow-up care or support.
Many relapse within weeks or months and then they return into incarceration.
So there is that cycle that keeps going over and over and over.
This deeply broken system inspired me to create a model that addresses these gaps head on.
Each housing site that we have, we have five different housing in Seattle, five houses in Tacoma, and we provide transportation.
So we are covering all the barriers.
We provide transportation, we provide housing, we provide psychiatric services like medication management, peer support, case management, group, medical services and also job placement so we accept referrals from psychiatric hospitals inpatient facilities shelters and community-based organizations additionally our outreach professionals engage directly with unhoused individuals in the community to connect them with services What makes our model unique is our fierce commitment to remove the most common barriers for recovery, housing, transportation, and community reintegration.
One of the most impactful partnerships we've had is with We Heart Seattle, and we are working with Andrea Suarez.
She's the CEO and founder.
She did believe in our mission and helping our clients rediscover their purpose.
Many of our clients volunteer to help clean up the public spaces, reclaiming not just the environment, but their own dignity and help heal the environment they once struggled in.
Our program structure is in three phases.
So once they come into our program, we give them 90 days which is phase one so in phase one we focus on just giving the treatment focusing on our clients they are with us for 90 days and it's all individual based before they can transition to phase two so once they move to phase two the transition to phase two we start talking about continuing with the treatment and also we start talking about job placement We are currently working with a few apprenticeships, so we want to give them the skills while they are still in the program, still getting the treatment that they need.
So once they get the treatment that they need and they find jobs, they can go to jobs and still continue getting the treatment.
So we are preparing them for placement into housing.
because putting them into housing without a purpose without giving them something to look forward to it's not going to help them because they're going to go back to using the drugs or they're going to use the same same drugs in those housing so we have to prepare them and they have up to 90 days to be able to work, stay with us, continue getting the help that they need.
And then once they're stable, they're able to save up enough money to put down for housing.
And then they're able to transition.
And we have had a lot of success stories.
We have clients that have moved into housing, low income housing.
They're still working.
They still continue seeing our psychiatric nurse practitioners.
We have almost five psychiatric nurse practitioners.
We have a medical provider who provides medical services.
And we check in with these clients even after they move on.
And all I can say is we are getting good progress and we're getting good success stories.
At Hope and Chance Integrated Health, we are not just providing treatment.
We are restoring hope, rebuilding lives, and creating lasting change in our communities, one person at a time.
Thank you.
Next, I'd like to welcome Daniel Malone, who needs no introduction from Downtown Emergency Services.
Go ahead.
Thank you very much, Council President Nelson.
Good morning.
I'm with DESC, which is an organization that provides shelter, emergency housing, permanent supportive housing, and behavioral health services for people with really complicated and profound disabling conditions who have also been experiencing long-term homelessness.
And in short, we assist people with getting off the streets for good and giving them a chance to stabilize and better reconnect with the life of the community.
The things that make the biggest difference for people with serious mental illness and longtime substance use disorder to live healthier and happier lives include, first and foremost, a safe and stable place to live, as well as a range of care and support that's applicable to their individual needs.
For many people who we focus on helping at DESC, that includes tailored behavioral health services, including case management, psychiatric diagnosis and medication and treatment for a range of substance use disorder conditions.
We offer state licensed substance use disorder treatment that includes outpatient counseling and case management.
Assistance with accessing inpatient treatment and use of medications were indicated.
Over the past year, we've had markedly improved success in assisting people to start and stay on medications for opioid use disorder.
This success is attributable to bringing care to people where they're comfortable receiving it and to advances in the protocol for administering buprenorphine so that it's much more comfortable for people to take.
Hundreds of people are benefiting from this approach and they're staying off of fentanyl use as a result.
But many, many more people need this kind of treatment and existing programs are at capacity.
We also see many more people struggling with their use of other substances, including stimulants like methamphetamine.
And we need to, as a community, devise and implement a range of better interventions to help people who use methamphetamine achieve the same kind of success we're having with people who are using fentanyl and other opioids.
this funding that council president nelson is proposing ensures that the city's approach to the crisis on our streets will include evidence-based and innovative strategies that will produce lasting change and i'm grateful to see these proposed investments thank you next i'd like to call up brandy mcneil of of purpose dignity action
Thank you.
I want to begin by expressing deep admiration for Council President Nelson.
She has been a consistent and vocal champion of recovery services, and she has never wavered in her commitment to making these issues a top priority for our city.
Her leadership is one of the reasons we're able to stand here today and talk not only about the challenges we face, but also the progress we've made.
Let's be clear, any serious public safety system must prioritize how we respond to individuals with complex behavioral health needs, especially when those needs are contributing to harm or distress in neighborhoods and business districts.
Ignoring that reality only prolongs the cycle.
Confronting it head on is how we build safer, healthier communities.
Over the last several years, we've seen measurable progress through initiatives that take this approach seriously.
Our partnership with SPD on drug possession and public use diversions required by both the possession and public use ordinance adopted in the fall of 2023 and by SPD policy has been a standout success.
Now, instead of jail or prosecution, individuals contacted by SPD have access to a warm handoff 24-7 within 30 minutes to a field response team that can connect them to services immediately.
We're also in the process of critical data integration with SPD systems so that officers can make diversions directly within their information system, get credit for those decisions, and have greater visibility into who's already in the program.
That means officers can directly contact case managers instead of cycling people through jail or emergency rooms.
That's, as Council President Nelson said, that's smart public safety policy, and smart public safety policy works.
Other efforts have seen similar success.
The Just Care program, originally focused on encampment resolution, has evolved into a robust model that inform the state transportation right of way encampment resolution program.
Co-lead continues to show remarkable outcomes.
Over 95% of participants accept services, more than 70% transition to permanent housing, 100% are enrolled in Medicaid, and we've had zero co-lead participant overdose deaths in co-lead lodging.
The Third Avenue Project is another example.
Business owners and residents alike have reported a high level of satisfaction with We Deliver Care's rapid street-level response.
And we've seen successful shelter and housing placements through lead case management for chronically unsheltered people with high neighborhood impact.
Because of these interventions, we're seeing tangible results.
Declining crime rates, a growing sentiment among residents and businesses that disorder is decreasing, and reduced overdose deaths.
But I wanna be honest, we still have a long way to go.
And what's even more pressing is that all the programs I've mentioned have suffered major setbacks due to state and local funding reductions over the last three years.
We cannot afford to let what's working fall apart.
We have to stabilize these programs and add new pieces to address the gaps that remain.
One such effort was Council President Nelson's idea to sponsor a low friction pathway for immediate placement into private pay inpatient treatment programs like Lakeside Milam.
She understood that low barrier programs like LEAD and Co-LEAD don't require sobriety at entry, but they do support people making as much progress as possible on the path to recovery.
Co-LEAD nominated the largest group to use this option so far, and nearly all of them completed treatment and are still doing well today.
But that experience also revealed another gap.
When participants finished treatment, they shouldn't have to return to housing where active use is prevalent.
Council President Nelson was absolutely right to push for recovery housing, rent subsidies, to help people maintain the progress they've worked so hard to achieve.
And perhaps most fundamentally, none of this works without long term, high quality case management.
That's the heart of what LEAD and Co-LEAD provide.
And yet those programs are very much in jeopardy due to millions of dollars in lost local and state funding over the last few years.
We strongly support the full range of investments called for in the resolution under discussion today.
This work belongs at the center of our city's public safety agenda, not on the margins, and it must be funded accordingly.
Once again, I want to thank Council President Nelson for her leadership in advancing this work.
We have proof that these approaches work.
Now we must ensure that these efforts have the funding needed to continue delivering results.
Thank you.
Last but certainly not least is Steve Woolworth of Evergreen Treatment Services.
Good morning.
We at Evergreen Treatment Services have been providing substance use disorder treatment in Seattle for 52 years.
We find ourselves right now in the nonprofit community-based behavioral health and social service sector in very challenging and uncertain times for those organizations who serve individuals with severe substance use disorder, especially those living unsheltered.
Because it's a struggle for much of our workforce to actually afford to live in Seattle, lending support for a sales tax increase is not something that I take lightly.
However, if this tax to support public safety is adopted, I strongly support dedicating a portion of the revenue to funding, low barrier shelter services, jail diversion and alternative response, and the coupling of behavioral health and permanent supportive housing in addition to needed capital improvement projects.
We continue to find ourselves in a perilous situation with poisonous drug supply and persistent preventable drug overdose deaths that disproportionately affect those living unsheltered.
To date, even if we had tighter system coordination, I would argue the resources have never been adequate to address the scale and scope of the problem that we face.
Unfortunately, the irresponsible and draconian Medicaid cuts that the Senate just passed moments ago by one vote will further compound the devastation and the consequences for the most vulnerable here in western Washington will be severe.
I see the opportunity to invest this sales tax generated revenue in recovery-oriented services as one step we can take to fund evidence-based services at the local level in response to the federal government's abandonment of vulnerable and sick people.
As is often said during times of crisis, every little bit helps.
I want to acknowledge and thank Councilmember President Nelson for her leadership and foresight in recognizing that public health and public safety are inextricably linked.
Healthy communities are safer communities, and given what we are up against, directing some public safety funding towards pathways to recoveries is the right and responsible thing to do.
Thank you all.
I'll just briefly close us out here by saying out loud what you might be thinking.
This is an eclectic mix of service providers.
They represent different methodologies, different philosophies, different approaches to addiction and treatment.
But it takes all of us.
Really, we can't pick and choose.
I believe, when I stumbled into the politics of treatment and recovery, I didn't know about harm reduction versus, not harm reduction, housing first, et cetera.
I was just thinking about the fastest way to get people help.
And so that's the spirit that we have to go forward with.
I want to recognize that City Attorney Ann Davison is here today because in a few weeks her drug prosecution alternative will start up as the next layer that we need in the fight for people winning over addictions and where they will have more accountability leading to the doorway to recovery treatment.
I mangled that quote, but I just want to say that it takes every branch of government to do their job as well.
Policy, the courts.
and the executive.
And so what I'm calling for is a critical shift in how we think about treatment and recovery and substance use disorder and all come together because as I've said before, addiction is expensive for us to deal with the impacts and I'm not even touching on the sorrow and the heartache and the desperation.
that people around us in this town feel every day.
The next steps in this process is that I do have a resolution that has been cleared by law and will be on the introduction and referral calendar next week.
It's a resolution that lists a series of investments and if somebody has their paper, can I read some of them?
Thank you.
This is not a complete list of all the things that I'm calling for because our needs are great.
Expanding access to on-demand residential and intensive outpatient substance use disorder treatment.
Enhancing access to recovery housing and recovery-based services within already existing housing, permanent supportive housing.
Innovative approaches to addressing stimulant use disorder and expanding the provision of long-lasting buprenorphine injections.
That's what Daniel Malone was just talking about.
And on and on and on.
It's a really long list.
Stabilizing, diversion, and our co-lead model.
Funding capital investments in the facilities where people go for treatment and also our drop-in centers for people that are living outside unhoused.
And this is one thing that I haven't mentioned and hasn't come up in conversation, is we need to coordinate with the King County to increase the number of designated crisis responders, otherwise known as DCRs, that operate within Seattle to facilitate referrals to secure withdrawal management and stabilization facilities, such as the one operated by Valley Cities Behavioral Healthcare.
And what we're talking about is involuntary commitment.
We've heard more and more acceptance and recognition of the need for that, for people who are in danger of harming themselves and others.
The problem is there aren't enough DCRs to really help us take that next step.
So the list goes on and on.
I'm not going to bore you with everything that we need to do.
My point is that we have to start now and focus on treatment.
as a public safety response.
So thank you very much for all being here today.
I can take a couple questions.
Yeah.
Your announcement says that this is going to be low barrier treatment.
Some of the folks that are gathered here might do not offer low barrier treatment or support it.
So how in the legislation will it be guaranteed that this is low barrier rather than treatment that, you know, for example, picks people out on the program for relaxation?
Most treatment is short term that I'm talking about.
When I'm talking about treatment, obviously we've got opioid use disorder treatment that is ongoing for a long time.
Then you've got your rehab, which is simply, you know, you go to a facility, you detox, and then you spend some time trying to get your mind straight.
The point is that it takes everything and it's not up to us to define what people should do and what is the right path to recovery for them.
What I am trying to do is I'm trying to add more pavers on that roadway to recovery, simply.
As I've studied this topic more deeply over the past year, I was really unaware of the schism between low barrier and recovery.
I find it hard to believe the two sides are necessarily going to come together on this.
One of the things I found most interesting as I study about this is Addict upon addict I have spoken to has said they aren't asked about getting into recovery.
They aren't asked about getting into detox until they proactively ask them.
Why aren't we proactively asking people in crisis immediately and often to get into treatment?
That's a very good question.
And first of all, what I would have to say is that the new HSD contracts for our outreach services do require that the outreach workers do employ motivational interviewing, which is a way of centering the conversation on the client and surfacing their goals, short-term and long-term goals, and leading folks to a decision to take care of themselves.
So what I think I would like to tell you is that, yeah, the schisms that you talk about, I truly believe, because I wouldn't be standing here with all sides of the schism if we all didn't recognize that it takes all kinds of treatment, because there is not one cookie cutter, there's not one path only to recovery.
And that is why every single service that the organizations represented here provide are important.
Because, you know, I chose one thing when I made that decision, but somebody else might choose another.
Your announcement says up to 25% of the revenue generated goes to these folks, service providers, treatment options.
Do you have an idea what the other 75% would go to?
Well, I think that's for the mayor to say.
What I will say is that there are vastly more services.
The need is tremendously greater than 20%, 5%, 25% of $35 million, right?
I'm talking about starting.
I'm talking about starting a conversation toward focusing on the need for treatment and shoring up the services that we already have and filling in the gaps.
I just wanted to go back to the designated crisis responders.
My understanding is that there's a problem...
Oh, Gina, I'm sorry, can you come up here?
I didn't...
My understanding is that there's a problem...
Gina with Uplift Northwest, go ahead.
Is that a situation where, you know, you can have more people trying to get people into involuntary...
Yep, good.
But there's not necessarily anywhere to put them that is secure, you know, when you're talking about involuntary treatment, why focus on DCRs, I guess is the question.
Sorry, I got distracted by that.
Yeah, focusing on DCRs simply because when I am told why it's difficult to get people who, from a professional perspective, should be in such a facility, The people that actually make that call are very difficult to reach or just simply unavailable for too long.
So that is why I'm focusing on it.
And obviously they're designated by King County, correct?
And so we're not the boss of the county, clearly.
But if we were to provide some additional funding for some additional FTEs, let's say, that could serve specifically Seattle residents, then I think that would go a long way toward breaking through that bottleneck.
Yeah.
To that point, does this sort of reflect the lack of faith that King County is going to increase its investments in the school and the services?
I'm not going to speak for the county.
I do serve on the Board of Health and the governance board of the King County Regional Homelessness Authority.
So I do hear of their budget challenges as well.
It's not a lack of faith.
It is simply that we have to do more.
And I think that we can all agree that what the county offers is insufficient to meet the need we've got right here in Seattle, let alone the rest of the county.
So that's why we're trying to pitch in here.
What I want to mention is that we expanded the care team from seven to, I believe, 27 responders.
But where do they send people when they're dealing with somebody in crisis?
If a care team member were right here, what would that person say or do with the gentleman who is just passing by?
The same goes for our reach.
I want to recognize Andrew Constantino.
He took me on a walk in Little Saigon and explained the work that he does.
But what does one tell someone if, when Andrew's in conversation with them, if they say, yeah, I really want to stop using, where do they go?
And so this is what I'm talking about is our resources that are immediately available and also meet many other needs.
I funded an additional mobile medication unit for Evergreen Treatment Services because we can't just arrest people for using drugs downtown.
We should be also offering them treatment right where...
right in the hot spots.
Third Avenue, Pike and Pine, Little Saigon.
That's just one, however.
And so I am calling for a pivot, a critical shift in the way we think about the importance of treatment and its centrality in advancing public safety and also public health.
So
Well, I recognize that SPD is hiring at unprecedented rates.
you know, thanks to many of the policies that council put into action.
So we will likely have a shortfall this year in that department.
But it is not up to 35 million.
And I'm sure that the mayor has other plans for this resource when and if he puts it forward with the other budget legislation.
But what could be more important?
That's simply the point I'm trying to make.
Okay, one more question.
Okay.
Hi.
I came up with a crew today.
We've been getting sober about women for a lot of years.
My kind of question to everyone up here, I've always wanted to know the answer to this.
I was an addict 17 years, 14 years of recovery.
I've always heard this word evidence-based.
Evidence of what?
Can anyone answer what that evidence means?
Evidence of what?
We talk about investing money in evidence-based solutions.
Evidence of what?
I'll answer.
I'm not going to go there.
A sober person that buys a home, does that mean a sober person that doesn't use drugs, or what does the evidence show?
What I will simply say is, I've never looked at that question the same way, but SAMHSA defines recovery basically as getting one's life back together.
And that is the goal that we're after, is helping, excuse me, sir.
But I'm just asking, because that's, no one's ever came and asked anyone from us about our evidence.
And that's, okay, so this is what, this is.
How do we get our evidence put forth?
Okay.
Let us talk about that later, but the reason why I also wanted people to recognize is that in addition to our existing large service providers, when we're talking about getting people off the street, there is a whole network of private or philanthropy-supported smaller shops that can also help relieve the shortage of space in our already existing transitional and permanent supportive housing.
And here's the reason that I wanted to just add one more thing.
I asked the directors of two of our business improvement areas here is because as a small business owner I know and I hear from small businesses all the time the the impacts of the fentanyl crisis on our neighborhood business districts.
And mind you, the game has changed completely with fentanyl.
And so we can't keep doing things in the same old way that we used to.
That is why I'm calling for a critical pivot toward a focus on treatment that offers a number of different modalities to help the people that we see struggling on our streets every day.
Thank you, everybody, for coming today.
Very quickly, is the mayor supporting your proposal?
The mayor has indicated support of the idea and it will have to wait until we get closer to the budget to figure out what the departments are proposing for some reductions before we get to any hard numbers.
Thank you.