HomeMy WebLinkAbout4252 Resolution - AGs Distributor's Settlement Agreement - Opioid Litigation SettlementRESOLUTION NO. 4252
A RESOLUTION OF THE CITY OF PASCO, WASHINGTON,
APPROVING THE ATTORNEY GENERAL'S DISTRIBUTORS WASHINGTON
SETTLEMENT AGREEMENT; AND FURTHER AUTHORIZING THE CITY
MANAGER TO EXECUTE THE PARTICIPATION FORM AND ALLOCATION
AGREEMENT.
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; and
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; and
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 principles 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 other cities, such as the
City of Pasco and counties in Washington, wish to become "Participating Local Governments" by
agreeing on a form of allocation for Opioid Funds they receive from entities within the
Pharmaceutical Supply Chain; and
WHEREAS, the City Council of the City of Pasco is vested with the authority to sue and
be sued in courts and all proceedings and is also vested with authority to contract pursuant to RCW
35A.11; and
WHEREAS, the City of Pasco entered into the One MOU on May 27, 2022, as a
Participating Local Government bound by the distribution allocation as described in Exhibit A of
the One MOU; and
WHEREAS, the Washington State Attorney General is involved in litigation with
AmerisourceBergen Corp., Cardinal Health Inc., and McKesson Corp., ("Settling Distributors");
and
WHEREAS, the Attorney General's Distributors Washington Settlement Agreement has
added additional funds to the Global Settlement including the previously negotiated One MOU
with Keller Rohrback; and
WHEREAS, the total Washington Abatement Amount is $430,249,769.02; and
Resolution — Attorney General's Distributor Settlement Agreement
Opiate Litigation Settlement - I
WHEREAS, by entering into the Attorney General's negotiated Distributors Washington
Settlement Agreement, the Local Governments and State Government agree to split 50150 the
Washington Abatement Amount with the Local Governments share being distributed in
accordance with the Allocation Agreement previously negotiated with Keller Rohrback in the One
MOU; and
WHEREAS, by entering into this Agreement, the Settling Distributors admit no fault or
wrong -doing and the Local Governments agree to dismiss with prejudice the current litigation
against them.
NOW, THEREFORE, BE IT RESOLVED BY THE CITY COUNCIL OF THE CITY
OF PASCO, WASHINGTON:
That the City Council of the City of Pasco approves the terms and conditions of the
Distributors Washington Settlement Agreement between Washington State, the Participating
Local Jurisdictions and the Settling Distributors; a copy of which is attached hereto and
incorporated herein by reference as Exhibit B, and
Be It Further Resolved that in order to fully execute this Agreement, the City Council of
the City of Pasco further resolves to authorize the City Manager to sign all necessary documents
for that purpose including the Participation Form and the Allocation Agreement, copies of which
are attached hereto and incorporated herein by reference as Exhibit C and Exhibit D, respectively,
and
Be It Further Resolved, that this Resolution shall take effect immediately.
PASSED by the City Council of the City of Pasco, Washington this 10 day of September,
2022.
f✓���o�,s Blanche Barajas
0// Mayor
ATTEST:
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Debra Barham, CMC
City Clerk
APPROVED AS TO FORM:
Resolution — Attorney General's Distributor Settlement Agreement
Opiate Litigation Settlement - 2
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
("MOV') 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.
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 1.46813-1(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.
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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
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, Lewis, 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 CA.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 CA.
3. King County's Regional Agreement is reflected in Exhibit C to this
EvCili1
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
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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 CA.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
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redistributed to Participating Counties in the manner directed
in CAa 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.
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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.
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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 (2 1) 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
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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.
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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: 1 7-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
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shall be governed by the Uniform Electronic Transactions Act, C.R.S. §§ 24-71.3-
101, et seq. 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]
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This One Washington Memorandum of Understanding Behveen Washington
Municipalities is signed this day of ` ' = 2022 by:
-y
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On behalf of ^f
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OPIOID ABATEMENT STRATEGIES
PART ONE: TREATMENT
A. TREAT OPIOID USE DISORDER QUDI
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
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_
K
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
(COl\INEGTIONS 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
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.
n
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 CREVMAL-JUSTICE-IlWOLVED 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 Pius" 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
4. Provide evidence -informed treatment, including MAT, recovery support, or other
appropriate services to individuals with OUD and any co-occurring SUMAH
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.
1.1
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
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 AUSUSE 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
0
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
fust 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/Iv H conditions, co -usage, and/or co -addiction.
12. Support screening for fentanyl in routine clinical toxicology testing.
9
PART THREE: OTHER STRATEGIES
I. FIRST RESPONDERS
In addition to items C8, D1 through D7, Hl, 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. LEADERSHILP, 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 staffing for collaborative cross -system coordination to
prevent opioid misuse, prevent overdoses, and treat those with OUD and any co-
occurring SLID/MH conditions, co -usage, and/or co -addiction, or implement other
10
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 2417).
6. Research on expanded modalities such as prescription methadone that can expand
access to MAT.
11
EXHIBIT B
County Government `96111ccation ,
Adams County
Adams County 0.1638732475%
Hatton
Lind
Othello
Ritzvilie
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
EXHIBIT B
Clark Countv
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 Coun
Columbia County 0.0561699537%
Dayton
Starbuck
County Total: 0.0561699537%
Cowlitz County
Cowlitz County 1.722694S990%
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
EXHIBIT B
Franklin County
Franklin County
Connell
Kahlotus
Mesa
Pasco
0.3361237144%
0.4278056066%
County Total: 0.7639293210%
Garfield County
Garfield County 0.0321982209%
Pomeroy
County Total: 0.0321982209%
I .... ......
Grant County
Grant County
Coulee City
Coulee Dam***
Electric City
Ephrata
George
Grand Coulee
Hartline
Krupp
Mattawa
Moses Lake
Quincy
Royal City
Soap Lake
Warden
Wilson Creek
0.9932572167%
0.2078293909%
County Total: 1.2010866076%
*** -Local Government appears In multiple counties B-3
EXHIBIT B
Grays Harbor County
Grays Harbor County
Aberdeen
Cosmopolis
Elma
Hoquiam
McCleary
Montesano
Oakville
Ocean Shores
V-1
, M.."A i
0.9992429138%
0.2491525333%
------ -- --- ...... .
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 8-4
EXHIBIT B
� r �. 4 � 1 1 ]yi Jir �,,� a.. i ♦, ` � � i 4 C`'J +a j L t.
Kine County
0.0537768326%
King County
13.9743722662%
Algona
Auburn** *
0.2622774917%
Beaux Arts Village
0.0204441024%
Bellevue
1.1300592573%._
Black Diamond
0.5453525246%
Bothell***
0.1821602716%
Burien
0.0270962921%
Carnation
Clyde Hill
0.17517.97481%
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
0.17517.97481%
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
EXHIBIT B
'S is - • � i.
Kitsap County
KitsapCounty 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%
Cie Elum
Ellensburg
0.0955824915%
Kittitas
Roslyn
South Cie Elum
County Total:
0.4811529598%
Kiickitat 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
EXHIBIT B
_ ■WwwY�o T
COIIIl' ; 'G011,@�Il�iletlt °
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%
Okanoean Coun
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%
Ilwaco
Long Beach
Raymond
South Bend
County Total: 0.4895416466%
*** - Local Government appears in multiple counties B-7
EXHIBIT B
C� �`ir't^ �4 �'�r` a♦y��°���/,���' .�+i"'F r, � ._ 5.'� 7�.v `{44 }�ti�'�t� ..
�..�li9>� V -. J_..>..��n _.. ..a,sd 1. ...d.`•..Yia % i1. f- �1 od 7s,.
Pend Oreille County
Pend Oreille County
Cusick
Ione
Metaline
Metaline Falls
0.2566374940%
Newport
County Total: 0.2566374940%
Pierce County
0.0859963345%
Pierce County
7.2310164020%
Auburn***
0.0628522112%
Bonney Lake
0.1190773864%
Buckley
Carbonado
0.3845704814%
-
DuPont
Eatonville
Edgewood
0.0048016791%
Enumclaw***
0.0000000000%
Fife
0.1955185481_%
Fircrest
3.2816374617%
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
EXHIBIT B
Coy'�%tocatn`
Skaeit County
Skagit County
1.0526023961%
Anacortes
0.1774962906%
Burlington
0.1146861661%
Concrete
Hamilton
La Conner
0.1385202891%
Lyman
0.7704629214%
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
1.925.836324.1%
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
EXHIBIT B
U.
Qk
L lA.il WIS1 'NFYiS"'ldffi7. r} tl S ) h
Cour:.,.....
Sookane Coun
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 0.7479240.179%
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
EXHIBIT B
a t
Cau �t . -� ovetnme
Walla Walla County
Walla Walla County 0.5543870294%
College Place
Prescott_
Waitsburg
Walla Walla 0.3140768654%
County Total: 0.8684638948%
Whatcom Coun
Whatcom County
1.3452637306%
Bellingham
0.8978614577%
Blaine
Everson
Ferndale
0.0646101891%
Lynden
0.08271.1561.2%
Nooksack
Sumas
County Total: 2.3904469386%
Whitman County
Whitman County 0.2626805837%
Albion
Colfax
Colton
Endicott
Farmington
Garfield
LaCrosse
Lamont
Malden
Oakesdale
Palouse
Pullman 0.22148.37491%
Rosalia
St. John
Tekoa
Uniontown
County Total: 0.4841643328%
*** - Local Government appears in multiple counties B-11
EXHIBIT B
y,$ar
COltl1� s�ti n N=y
n4. ts +e�oc,}�
Yakima County
Yakima County 1.9388392959%
Grandview 0.0530606109%
Granger
Harrah
Mabton
Moxee
Naches
Selah
Sunnyside 0.121347.8384%
Tieton
Toppenish
Union Gap
Wapato
Yakima 0.6060410539%
Zillah
County Total.: 2.7192887991%
*** - Local Government appears in multiple counties B-12
Exhibit F
Subdivision Settlement Participation Form
Governmental Entity: State:
Authorized Official:
Address 1:
Address 2:
City, State, Zip:
Phone:
Email:
The governmental entity identified above ("Governmental Entity"), in order to obtain and in
consideration for the benefits provided to the Governmental Entity pursuant to the Settlement
Agreement dated May 2, 2022 ("Distributors Washington Settlement"), and acting through the
undersigned authorized official, hereby elects to participate in the Distributors Washington
Settlement, release all Released Claims against all Released Entities, and agrees as follows.
1. The Governmental Entity is aware of and has reviewed the Distributors Washington
Settlement, including the Distributor Global Settlement Agreement dated July 21, 2021
("Global Settlement") attached to the Distributors Washington Settlement as Exhibit H,
understands that all terms in this Participation Form have the meanings defined therein,
and agrees that by signing this Participation Form, the Governmental Entity elects to
participate in the Distributors Washington Settlement and become a Participating
Subdivision as provided therein.
2. The Governmental Entity shall, within 14 days of October 1, 2022 and prior to the filing
of the Consent Judgment, secure the dismissal with prejudice of any Released Claims that
it has filed.
4. The Governmental Entity agrees to the terms of the Distributors Washington Settlement
pertaining to Subdivisions as defined therein.
5. By agreeing to the terms of the Distributors Washington Settlement and becoming a
Releasor, the Governmental Entity is entitled to the benefits provided therein, including,
if applicable, monetary payments beginning after December 1, 2022.
6. The Governmental Entity agrees to use any monies it receives through the Distributors
Washington Settlement solely for the purposes provided therein.
7. The Governmental Entity submits to the jurisdiction of the Washington Consent
Judgment Court for purposes limited to that court's role as provided in, and for resolving
disputes to the extent provided in, the Distributors Washington Settlement. The
Governmental Entity likewise agrees to arbitrate before the National Arbitration Panel as
provided in, and for resolving disputes to the extent otherwise provided in the
Distributors Washington Settlement.
F-1
8. The Governmental Entity has the right to enforce the Distributors Washington Settlement
as provided therein.
9. The Governmental Entity, as a Participating Subdivision, hereby becomes a Releasor for
all purposes in the Distributors Washington Settlement, including, but not limited to, all
provisions of Section XI of the Global Settlement, and along with all departments,
agencies, divisions, boards, commissions, districts, instrumentalities of any kind and
attorneys, and any person in their official capacity elected or appointed to serve any of
the foregoing and any agency, person, or other entity claiming by or through any of the
foregoing, and any other entity identified in the definition of Releasor, provides for a
release to the fullest extent of its authority. As a Releasor, the Governmental Entity
hereby absolutely, unconditionally, and irrevocably covenants not to bring, file, or claim,
or to cause, assist or permit to be brought, filed, or claimed, or to otherwise seek to
establish liability for any Released Claims against any Released Entity in any forum
whatsoever. The releases provided for in the Distributors Washington Settlement are
intended by the Agreement Parties to be broad and shall be interpreted so as to give the
Released Entities the broadest possible bar against any liability relating in any way to
Released Claims and extend to the full extent of the power of the Governmental Entity to
release claims. The Distributors Washington Settlement shall be a complete bar to any
Released Claim.
10. The Governmental Entity hereby takes on all rights and obligations of a Participating
Subdivision as set forth in the Distributors Washington Settlement.
11. In connection with the releases provided for in the Distributors Washington Settlement,
each Governmental Entity expressly waives, releases, and forever discharges any and all
provisions, rights, and benefits conferred by any law of any state or territory of the
United States or other jurisdiction, or principle of common law, which is similar,
comparable, or equivalent to § 1542 of the California Civil Code, which reads:
General Release; extent. A general release does not extend to claims that
the creditor or releasing party does not know or suspect to exist in his or
her favor at the time of executing the release, and that if known by him or
her would have materially affected his or her settlement with the debtor or
released party.
A Releasor may hereafter discover facts other than or different from those which it
knows, believes, or assumes to be true with respect to the Released Claims, but each
Governmental Entity hereby expressly waives and fully, finally, and forever settles,
releases and discharges, upon the date the Distributors Washington Settlement becomes
effective pursuant to Section II.B of the Distributors Washington Settlement, any and all
Released Claims that may exist as of such date but which Releasors do not know or
suspect to exist, whether through ignorance, oversight, error, negligence or through no
fault whatsoever, and which, if known, would materially affect the Governmental
Entities' decision to participate in the Distributors Washington Settlement.
F-2
12. Nothing herein is intended to modify in any way the terms of the Distributors
Washington Settlement, to which Governmental Entity hereby agrees. To the extent this
Participation Form is worded differently from Exhibit F to the Distributors Washington
Settlement or interpreted differently from the Distributors Washington Settlement in any
respect, the Distributors Washington Settlement controls.
I have all necessary power and authorization to execute this Participation Form on behalf of the
Governmental Entity.
Signature:
Name:
Title:
Date:
F-3
ALLOCATION AGREEMENT GOVERNING THE ALLOCATION OF FUNDS PAID
BY THE SETTLING OPIOID DISTRIBUTORS IN WASHINGTON STATE
AUGUST 8, 2022
This Allocation Agreement Governing the Allocation of Funds Paid by the Settling
Opioid Distributors in Washington State (the "Allocation Agreement') governs the distribution
of funds obtained from AmerisourceBergen Corporation, Cardinal Health, Inc., and McKesson
Corporation (the "Settling Distributors") in connection with its resolution of any and all claims
by the State of Washington and the counties, cities, and towns in Washington State ("Local
Governments") against the Settling Distributors (the "Distributors Settlement'). The Distributors
Settlement including any amendments are attached hereto as Exhibit 1.
1. This Allocation Agreement is intended to be a State -Subdivision Agreement as
defined in Section I.VVV of the Global Settlement (the "Global Settlement'),
which is Exhibit H of the Distributors Settlement. This Allocation Agreement
shall be interpreted to be consistent with the requirements of a State -Subdivision
Agreement in the Global Settlement.
2. This Allocation Agreement shall become effective only if all of the following
occur:
A. All Litigating Subdivisions in Washington and 90% of Non -Litigating
Primary Subdivisions in Washington as the terms are used in Section
II.C.1 of the Distributors Settlement must execute and return the
Subdivision Settlement Participation Form, Exhibit F of the Distributors
Settlement (the "Participation Form") by September 23, 2022. This form
is also attached hereto as Exhibit 2.
B. The Consent Judgment and Stipulation of Dismissal with Prejudice,
Exhibit G of the Distributors Settlement, is filed and approved by the
Court.
C. The number of Local Governments that execute and return this Allocation
Agreement satisfies the participation requirements for a State -Subdivision
Agreement as specified in Exhibit O of the Global Settlement.
3. Requirements to become a Participating Local Government. To become a
Participating Local Government that can participate in this Allocation Agreement,
a Local Government must do all of the following:
A. The Local Government must execute and return this Allocation
Agreement.
B. The Local Government must release their claims against the Settling
Distributors and agree to by bound by the terms of the Distributors
Settlement by timely executing and returning the Participation Form. This
form is attached hereto as Exhibit 2.
C. Litigating Subdivisions must dismiss the Settling Distributors with
prejudice from their lawsuits. The Litigating Subdivisions are listed on
Exhibit B of the Distributors Settlement.
D. The Local Government must execute and return the One Washington
Memorandum of Understanding Between Washington Municipalities
("MOU") agreed to by the Participating Local Governments in
Washington State, which is attached hereto as Exhibit 3. As specified in
Paragraph 10.A of this Allocation Agreement, the Local Government may
elect in its discretion to execute the MOU for purposes of this Allocation
Agreement only.
A Local Government that meets all of the conditions in this paragraph shall be
deemed a "Participating Local Government." Alternatively, if the requirements of
Paragraphs 2(A), 2(B), and 2(C) of this Allocation Agreement are satisfied and
this Allocation Agreement becomes effective, then all Local Governments that
comply with Paragraph 3(B) of this Allocation Agreement shall be deemed a
"Participating Local Government."
4. This Allocation Agreement applies to the Washington Abatement Amount as
defined in Section IV.A of the Distributors Settlement. The maximum possible
Washington Abatement Amount for the Distributors Settlement is
$430,249,769.02. As specified in the Global Settlement, the Washington
Abatement Amount varies dependent on the percentage of Primary Subdivisions
that choose to become Participating Local Governments and whether there are
any Later Litigating Subdivisions as defined in Section I.EE of the Global
Settlement.
5. This Allocation Agreement does not apply to the Washington Fees and Costs as
defined in Section V of the Distributors Settlement. After satisfying its obligations
to its outside counsel for attorneys' fees and costs, the State estimates that it will
receive approximately $46 million for its own attorneys' fees and costs pursuant
to Section V.B.1 of the Distributors Settlement. The State shall utilize any and all
amounts it receives for its own attorneys' fees and costs pursuant to Section V.B.1
of the Distributors Settlement to provide statewide programs and services for
Opioid Remediation as defined in Section I.SS of the Global Settlement.
6. While this Allocation Agreement does not apply to the Washington Fees and
Costs as defined in Section V of the Distributors Settlement, Section V.B.2 of the
Distributors Settlement estimates that the Settling Distributors shall pay
$10,920,914.70 to Participating Litigating Subdivisions' attorneys for fees and
costs. The actual amount may be greater or less. This Allocation Agreement and
the MOU are a State Back -Stop Agreement. The total contingent fees an attorney
receives from the Contingency Fee Fund pursuant to Section II. D in Exhibit R
the Global Settlement, the MOU, and this Allocation Agreement combined cannot
exceed 15% of the portion of the LG Share paid to the Litigating Local
Government that retained that firm (i.e., if City X filed suit with outside counsel
2
on a contingency fee contract and City X receives $1,000,000 from the
Distributors Settlement, then the maximum that the firm can receive is $150,000
for fees.)
7. No portion of the Washington Fees and Costs as defined in Section V of the
Distributors Settlement and/or the State Share as defined in Paragraph 8.A of this
Allocation Agreement shall be used to fund the Government Fee Fund ("GFF")
referred to in Paragraph 10 of this Allocation Agreement and Section D of the
MOU, or in any other way to fund any Participating Local Government's
attorneys' fees, costs, or common benefit tax other than the aforementioned
payment by the Settling Distributors to Participating Litigating Subdivisions'
attorneys for fees and costs in Section V.13.2 of the Distributors Settlement.
8. The Washington Abatement Amount shall and must be used by the State and
Participating Local Governments for Opioid Remediation as defined in Section
I.SS of the Global Settlement, except as allowed by Section V of the Global
Settlement. Exhibit 4 is a non -exhaustive list of expenditures that qualify as
Opioid Remediation. Further, the Washington Abatement Amount shall and must
be used by the State and Participating Local Governments as provided for in the
Distributors Settlement.
9. The State and the Participating Local Governments agree to divide the
Washington Abatement Amount as follows:
A. Fifty percent (50%) to the State of Washington ("State Share").
B. Fifty percent (50%) to the Participating Local Governments ("LG Share").
10. The LG Share shall be distributed pursuant to the MOU attached hereto as Exhibit
3 as amended and modified in this Allocation Agreement.
11. For purposes of this Allocation Agreement only, the MOU is modified as follows
and any contrary provisions in the MOU are struck:
A. The MOU is amended to add new Section E.6, which provides as follows:
A Local Government may elect in its discretion to execute the
MOU for purposes of this Allocation Agreement only. If a Local
Governments executes the MOU for purposes of this Allocation
Agreement only, then the MOU will only bind such Local
Government and be effective with respect to this Allocation
Agreement and the Distributors Settlement, and not any other
Settlement as that term is defined in Section A.14 of the MOU. To
execute the MOU for purposes of this Allocation Agreement only,
the Local Government may either (a) check the applicable box on
its signature page of this Allocation Agreement that is returned or
(b) add language below its signature lines in the MOU that is
returned indicating that the Local Government is executing or has
executed the MOU only for purposes of the Allocation Agreement
Governing the Allocation of Funds Paid by the Settling Opioid
Distributors in Washington State.
B. Exhibit A of the MOU is replaced by Exhibit E of the Global Settlement,
which is attached as Exhibit 4 to this Agreement.
C. The definition of "Litigating Local Governments" in Section A.4 of the
MOU shall mean Local Governments that filed suit against one or more of
the Settling Defendants prior to May 3, 2022. The Litigating Local
Governments are listed on Exhibit B of the Distributors Settlement, and
are referred to as Litigating Subdivisions in the Distributors Settlement.
D. The definition of "National Settlement Agreement' in Section A.6 of the
MOU shall mean the Global Settlement.
E. The definition of "Settlement' in Section A.14 of the MOU shall mean the
Distributors Settlement.
F. The MOU is amended to add new Section C.4.g.vii, which provides as
follows:
"If a Participating Local Government receiving a direct payment
(a) uses Opioid Funds other than as provided for in the Distributors
Settlement, (b) does not comply with conditions for receiving
direct payments under the MOU, or (c) does not promptly submit
necessary reporting and compliance information to its Regional
Opioid Abatement Counsel ("Regional OAC") as defined at
Section CA.h of the MOU, then the Regional OAC may suspend
direct payments to the Participating Local Government after
notice, an opportunity to cure, and sufficient due process. If direct
payments to Participating Local Government are suspended, the
payments shall be treated as if the Participating Local Government
is foregoing their allocation of Opioid Funds pursuant to Section
C.4.d and C.4.j.iii of the MOU. In the event of a suspension, the
Regional OAC shall give prompt notice to the suspended
Participating Local Government and the Settlement Fund
Administrator specifying the reasons for the suspension, the
process for reinstatement, the factors that will be considered for
reinstatement, and the due process that will be provided. A
suspended Participating Local Government may apply to the
Regional OAC to be reinstated for direct payments no earlier than
five years after the suspension."
G. Consistent with how attorney fee funds for outside counsel for
Participating Local Subdivisions are being administered in most states
across the country, the Government Fee Fund ("GFF") set forth in the
ii
MOU shall be overseen by the MDL Fee Panel (David R. Cohen, Randi S.
Ellis and Hon. David R. Herndon (ret.)). The Fee Panel will preside over
allocation and disbursement of attorney's fees in a manner consistent with
the Motion to Appoint the Fee Panel to Allocate and Disburse Attorney's
Fees Provided for in State Back -Stop Agreements and the Order
Appointing the Fee Panel to Allocate and Disburse Attorneys Fees
Provided for in State Back -Stop Agreements, Case No. 1:17-md-02804-
DAP Doc #: 4543 (June 17, 2022).
H. The GFF set forth in the MOU shall be funded by the LG Share of the
Washington Abatement Amount only. To the extent the common benefit
tax is not already payable by the Settling Distributors as contemplated by
Section D.8 of the MOU, the GFF shall be used to pay Litigating Local
Government contingency fee agreements and any common benefit tax
referred to in Section D of the MOU, which shall be paid on a pro rata
basis to eligible law firms as determined by the Fee Panel.
I. To fund the GFF, fifteen percent (15%) of the LG Share shall be deposited
in the GFF from each LG Share settlement payment until the Litigating
Subdivisions contingency fee agreements and common benefit tax (if any)
referred to in Section D of the MOU are satisfied. Under no circumstances
will any Non -Litigating Primary Subdivision -or Litigating Local
Government be required to contribute to the GFF more than 15% of the
portion of the LG Share allocated to such Non -Litigating Primary
Subdivision or Litigating Local Government. In addition, under no
circumstances will any portion of the LG Share allocated to a Litigating
Local Government be used to pay the contingency fees or litigation
expenses of counsel for some other Litigating Local Government.
J. The maximum amount of any Litigating Local Government contingency
fee agreement (from the Contingency Fee Fund pursuant to Section II. D
in Exhibit R the Global Settlement) payable to a law firm permitted for
compensation shall be fifteen percent (15%) of the portion of the LG
Share paid to the Litigating Local Government that retained that firm (i.e.,
if City X filed suit with outside counsel on a contingency fee contract and
City X receives $1,000,000 from the Distributors Settlement, then the
maximum that the firm can receive is $150,000 for fees.) The firms also
shall be paid documented expenses due under their contingency fee
agreements that have been paid by the law firm attributable to that
Litigating Local Government. Consistent with the Distributors Settlement
and Exhibit R of the Global Settlement, amounts due to Participating
Litigating Subdivisions' attorneys under this Allocation Agreement shall
not impact (i) costs paid by the subdivisions to their attorneys pursuant to
a State Back -Stop agreement, (ii) fees paid to subdivision attorneys from
the Common Benefit Fund for common benefit work performed by the
attorneys pursuant to Section II.0 of Exhibit R of the Global Settlement,
or (iii) costs paid to subdivision attorneys from the MDL Expense Fund
5
for expenses incurred by the attorneys pursuant to Section II.E of the
Global Settlement.
K. Under no circumstances may counsel receive more for its work on behalf
of a Litigating Local Government than it would under its contingency
agreement with that Litigating Local Government. To the extent a law
firm was retained by a Litigating Local Government on a contingency fee
agreement that provides for compensation at a rate that is less than fifteen
percent (15%) of that Litigating Local Government's recovery, the
maximum amount payable to that law firm referred to in Section D.3 of
the MOU shall be the percentage set forth in that contingency fee
agreement.
L. For the avoidance of doubt, both payments from the GFF and the payment
to the Participating Litigating Local Governments' attorneys for fees and
costs referred to in Paragraph 6 of this Allocation Agreement and Section
V.13.2 Distributors Settlement shall be included when calculating whether
the aforementioned fifteen percent (15%) maximum percentage (or less if
the provisions of Paragraph 10X of this Allocation Agreement apply) of
any Litigating Local Government contingency fee agreement referred to
above has been met.
M. To the extent there are any excess funds in the GFF, the Fee Panel and the
Settlement Administrator shall facilitate the return of those funds to the
Participating Local Governments as provided for in Section D.6 of the
MOU.
12. In connection with the execution and administration of this Allocation
Agreement, the State and the Participating Local Governments agree to abide by
the Public Records Act, RCW 42.56 eq seq.
13. All Participating Local Governments, Regional OACs, and the State shall
maintain all non -transitory records related to this Allocation Agreement as well as
the receipt and expenditure of the funds from the Distributors Settlement for no
less than five (5) years.
14. If any party to this Allocation Agreement believes that a Participating Local
Government, Regional OAC, the State, an entity, or individual involved in the
receipt, distribution, or administration of the funds from the Distributors
Settlement has violated any applicable ethics codes or rules, a complaint shall be
lodged with the appropriate forum for handling such matters, with a copy of the
complaint promptly sent to the Washington Attorney General, Complex Litigation
Division, Division Chief, 800 Fifth Avenue, Suite 2000, Seattle, Washington
98104.
15. To the extent (i) a region utilizes a pre-existing regional body to establish its
Opioid Abatement Council pursuant to the Section 4.h of the MOU, and (ii) that
n
pre-existing regional body is subject to the requirements of the Community
Behavioral Health Services Act, RCW 71.24 et seq., the State and the
Participating Local Governments agree that the Opioid Funds paid by the Settling
Distributors are subject to the requirements of the MOU and this Allocation
Agreement.
16. Upon request by the Settling Distributors, the Participating Local Governments
must comply with the Tax Cooperation and Reporting provisions of the
Distributors Settlement and the Global Settlement.
17. Venue for any legal action related to this Allocation Agreement (separate and
apart from the MOU, the Distributors Settlement, or the Global Settlement) shall
be in King County, Washington.
18. Each party represents that all procedures necessary to authorize such party's
execution of this Allocation Agreement have been performed and that such person
signing for such party has been authorized to execute this Allocation Agreement.
7
FOR THE STATE OF WASHINGTON:
ROBERT W. FERGUSON
Attorney General
JEFFREY G. RUPERT
Division Chief
Date:
FOR THE PARTICIPATING LOCAL GOVERNMENT:
Name of Participating Local Government:
Authorized signature:
Name:
Title:
Date:
A Local Government may elect in its discretion to execute the MOU for purposes of this
Allocation Agreement only by checking this box (see Paragraph 10.A of this Allocation
Agreement):
❑ Local Government is executing the MOU in the form attached hereto as Exhibit 3, but
which is further amended and modified as set forth in this Allocation Agreement, only for
purposes of this Allocation Agreement.
7
EXHIBIT 1
Distributors Settlement
DISTRIBUTORS WASHINGTON
SETTLEMENT AGREEMENT
Table of Contents
I. Overview..............................................................................................................................1
II. Conditions to Effectiveness of Agreement..........................................................................1
III. Participation by Subdivisions..............................................................................................3
IV. Settlement Payments............................................................................................................3
V. Plaintiffs' Attorneys' Fees and Costs..................................................................................4
VI. Release.................................................................................................................................6
VII. Miscellaneous......................................................................................................................6
Exhibit A Primary Subdivisions................................................................................................. A-1
Exhibit B Litigating Subdivisions................................................................................................B-1
Exhibit C ABC IRS Form 1098-F...............................................................................................0-1
Exhibit D Cardinal Health IRS Form 1098-F............................................................................. D-1
Exhibit E McKesson IRS Form 1098-F.......................................................................................E-1
Exhibit F Subdivision Settlement Participation Form................................................................. F-1
Exhibit G Consent Judgment and Stipulation of Dismissal with Prejudice ................................ G-1
Exhibit H Distributor Global Settlement Agreement.................................................................. H-1
DISTRIBUTORS — WASHINGTON SETTLEMENT AGREEMENT
I. Overview
This Distributors Washington Settlement Agreement ("Agreement") sets forth the terms
and conditions of a settlement agreement between and among the State of Washington,
McKesson Corporation ("McKesson"), Cardinal Health, Inc. ("Cardinal") and
AmerisourceBergen Corporation ("Amerisource") (collectively, the "Agreement Parties") to
resolve opioid -related Claims against McKesson, Cardinal, and/or Amerisource (collectively,
"Settling Distributors").
By entering into this Agreement, the State of Washington and its Participating
Subdivisions agree to be bound by all terms and conditions of the Distributor Global Settlement
Agreement dated July 21, 2021 (including its exhibits) ("Global Settlement'), which (including
its exhibits) is incorporated into this Agreement as Exhibit H.1 By entering this Agreement, and
upon execution of an Agreement Regarding the State of Washington and the Distributor Global
Settlement Agreement ("Enforcement Committee Agreement'), unless otherwise set forth in this
Agreement, the Settling Distributors agree to treat the State of Washington for all purposes as if
it were a Settling State under the Global Settlement and its Participating Subdivisions for all
purposes as if they were Participating Subdivisions under the Global Settlement. Unless stated
otherwise in this Agreement, the terms of this Agreement are intended to be consistent with the
terms of the Global Settlement and shall be construed accordingly. Unless otherwise defined in
this Agreement, all capitalized terms in this Agreement shall be defined as they are in the, Global
Settlement.
The Settling Distributors have agreed to the below terms for the sole purpose of
settlement, and nothing herein, including in any exhibit to this Agreement, may be taken as or
construed to be an admission or concession of any violation of law, rule, or regulation, or of any
other matter of fact or law, or of any liability or wrongdoing, or any misfeasance, nonfeasance,
or malfeasance, all of which the Settling Distributors expressly deny. No part of this Agreement,
including its statements and commitments, and its exhibits, shall constitute or be used as
evidence of any liability, fault, or wrongdoing by the Settling Distributors. Unless the contrary is
expressly stated, this Agreement is not intended for use by any third party for any purpose,
including submission to any court for any purpose.
II. Conditions to Effectiveness of Agreement
A. Global Settlement Conditions to Effectiveness.
1. The Agreement Parties acknowledge that certain deadlines set forth in
Section VIII of the Global Settlement passed before the execution of this Agreement. For
' The version of the Global Settlement as updated on March 25, 2022 is attached to this
Agreement as Exhibit H. Further updates to the Global Settlement shall be deemed incorporated
into this Agreement and shall supersede all earlier versions of the updated provisions.
that reason, (i) Settling Distributors agree to treat the State of Washington as satisfying the
deadlines set forth in Section VIII of the Global Settlement provided that the State of
Washington satisfies its obligations set forth in this Section II and (ii) the State of
Washington agrees to treat Settling Distributors as having satisfied all notice obligations
under Section VIII.B of the Global Settlement as to the State of Washington.
2. The State of Washington shall deliver all signatures and releases required
by the Agreement to be provided by the Settling States to the Settling Distributors by
September 30, 2022. This Section II.A.2 supersedes the deadline for delivering those
signatures and releases set forth in Section VIII.A.1 of the Global Settlement.
B. Agreement with Enforcement Committee. This Agreement shall not become
effective unless the Enforcement Committee and the Settling Distributors execute the Enforcement
Committee Agreement. If the Enforcement Committee Agreement is not executed by June 1, 2022,
the State of Washington and Settling Distributors will promptly negotiate an agreement that mirrors
the Global Settlement to the extent possible and with a credit of $1,000,000 to Settling Distributors
to account for possible credits the Settling Distributors would have received under Section V of this
Agreement from the State Cost Fund and the Litigating Subdivision Cost Fund of the Global
Settlement and to be deducted from the Year 7 payment described in Section V.B.1 and Section
V.C.g of this Agreement.
C. Participation by Subdivisions. If the condition in Section II.B has been satisfied,
this Agreement shall become effective upon one of the following conditions being satisfied:
1. All Litigating Subdivisions in the State of Washington and ninety percent
(90%) of Non -Litigating Primary Subdivisions (calculated by population pursuant to the
Global Settlement) in the State of Washington must become Participating Subdivisions by
September 23, 2022.
2. If the condition set forth in Section II. C.1 is not met, the Settling
Distributors shall have sole discretion to accept the terms of this Agreement, which shall
become effective upon notice provided by the Settling Distributors to the State of
Washington. If the condition set forth by Section II.C.1 is not met and Settling Distributors
do not exercise discretion to accept this Agreement, this Agreement will have no further
effect and all releases and other commitments or obligations contained herein will be void.
D. Dismissal of Claims. Provided that the conditions in Sections II.B and II_C have
been satisfied, the State of Washington shall file the Consent Judgment described in Section I.N of
the Global Settlement and attached hereto as Exhibit G ("Washington Consent Judgment") with the
King County Superior Court ("Washington Consent Judgment Court") on or before November 1,
2022. This Section II.C.2 supersedes the deadline for submitting a Consent Judgment set forth in
Section VIII.B of the Global Settlement. In the event that the Court declines to enter the
Washington Consent Judgment, each Settling Distributor shall be entitled to terminate the
Agreement as to itself and shall be excused from all obligations under the Agreement, and if a
Settling Distributor terminates the Agreement as to itself, all releases and other commitments or
obligations contained herein with respect to that Settling Distributor will be null and void. The date
of the entry of the Washington Consent Judgment shall be the effective date of this Agreement
2
("Washington Effective Date"). Within the later of forty-five (45) days after the Washington
Effective Date or December 31, 2022, each Settling Distributor will certify to the State that all
medical claims data provided to it during the litigation (including Medicaid, PMP, LNI claims, and
PEBB data) has been destroyed by the party and its agents, including all retained experts.
III. Participation by Subdivisions
A. Notice. The Office of the State of Washington Attorney General in consultation
with the Settling Distributors shall send individual notice of the opportunity to participate in this
Agreement and the requirements for participation to all Subdivisions eligible to participate who
have not returned an executed Subdivision Settlement Participation Form within fifteen (15) days of
the execution of this Agreement. The Office of the State of Washington Attorney General may also
provide general notice reasonably calculated to alert Subdivisions, including publication and other
standard forms of notification. Nothing contained herein shall preclude the State of Washington
from providing further notice to, or from contacting any of its Subdivision(s) about, becoming a
Participating Subdivision.
B. Trigger Date for Later Litigating Subdivisions. Notwithstanding Sections I.EE and
I.GGGG of the Global Settlement, as to the State of Washington, Settling Distributors and the State
of Washington agree to treat the Trigger Date for Primary Subdivisions as September 23, 2022 and
the Trigger Date for all other Subdivisions as May 3, 2022.
C. Initial and Later Participating Subdivisions. Notwithstanding Sections I.BB, I.CC,
I.FF and Section VII.D and E of the Global Settlement, any Participating Subdivision in
Washington that meets the applicable requirements for becoming a Participating Subdivision set
forth in Section VII.B or Section VII.0 of the Global Settlement on or before September 23, 2022
shall be considered an Initial Participating Subdivision. Participating Subdivisions that are not
Initial Participating Subdivisions but meet the applicable requirements for becoming Participating
Subdivisions set forth in Section VII.B or Section VII.0 of the Global Settlement after September
23, 2022 shall be considered Later Participating Subdivisions.
D. Subdivision Settlement Participation Forms. Each Subdivision Settlement
Participation Form submitted by a Participating Subdivision from the State of Washington shall be
materially identical to Exhibit F to this Agreement. Nothing in Exhibit F is intended to modify in
any way either the terms of this Agreement or the terms of the Global Settlement, both of which the
State of Washington and Participating Subdivisions agree to be bound. To the extent that any
Subdivision Settlement Participation Form submitted by any Participating Subdivision is worded
differently from Exhibit F to this Agreement or interpreted differently from the Global Agreement
and this Agreement in any respect, the Global Agreement and this Agreement control.
IV. Settlement Payments
A. Schedule. Annual Payments under this Agreement shall be calculated as if the
State of Washington were a Settling State under the Global Settlement and shall be made pursuant
to the terms of Section IV of the Global Settlement except that, as to the State of Washington, the
Payment Date for Payment Year 1 shall be December 1, 2022 and the Payment Date for Payment
3
Year 2 shall be December 1, 2022. For the avoidance of doubt, the sole component of the State of
Washington's Annual Payment is the portion of the Net Abatement Amount allocated to the State
of Washington under the Global Settlement ("Washington Abatement Amount"). The maximum
possible Washington Abatement Amount is $430,249,769.02.
B. Use of Payment. The Washington Abatement Amount paid under this Agreement
shall be used as provided for in Section V of the Global Settlement.
C. Nature of Payment. The State of Washington and its Participating Subdivisions
agree that payments made to the State of Washington and its Participating Subdivisions under this
Agreement are properly characterized as described in Section V.F of the Global Settlement.
V. Plaintiffs' Attorneys' Fees and Costs
A. Interaction with Global Settlement. Notwithstanding any contrary provision in the
Global Settlement, payments to cover attorneys' fees and costs under this Agreement ("Washington
Fees and Costs") shall be made pursuant to this Section V.
B. Amounts. The total amount to cover of all Washington Fees and Costs is
$87,750,230.98. That total consists of the categories of attorneys' fees and costs set forth in this
Section V.B and shall be paid on the schedule set forth in Section V.C.
1. State Outside and Inside Counsel Fees and Costs. Settling Distributors shall
pay $76,829,316.21 to cover in-house fees and costs and outside counsel fees and costs to
the Washington Attorney General's Office, which shall be used for any lawful purpose in
the discharge of the Attorney General's duties at the sole discretion of the Attorney General.
The amount shall be paid in increments as specified in Section V.0 (Payment Year 1 — 20%,
Payment Year 2 — 20%, Payment Year 3 — 15%, Payment Year 4 — 15%, Payment Year 5 —
15%, Payment Year 6 —10%, Payment Year 7— 5%.)
2. Fees and Costs for Participating Litigating Subdivisions' Attorney.
Settling Distributors shall pay $10,920,914.70 to Participating Litigating Subdivisions'
attorneys for fees and costs into a single account as directed by the Washington Attorney
General's Office, which then shall be paid as agreed between the State of Washington and
attorneys for Participating Litigating Subdivisions. Participating Litigating Subdivisions'
attorneys shall be paid in accordance with the schedule in Section V.0 and V.D.5 of this
Agreement.
C. Schedule. Washington Fees and Costs shall be paid according to the following
schedule:
a. Payment Year 1: Twenty percent (20%) of the total Washington
Fees and Costs amount ($17,550,046.20), to be paid on or before December 1,
2022.
4
b. Payment Year 2: Twenty percent (20%) of the total Washington
Fees and Costs amount ($17,550,046.20), to be paid on or before December 1,
2022.
C. Payment Year 3: Fifteen percent (15%) of the total Washington
Fees and Costs amount ($13,162,534.65), to be paid on or before July 15, 2023.
d. Payment Year 4: Fifteen percent (15%) of the total Washington
Fees and Costs amount ($13,162,534.65), to be paid on or before July 15, 2024.
e. Payment Year 5: Fifteen percent (15%) of the total Washington
Fees and Costs amount ($13,162,534.65), to be paid on or before July 15, 2025.
f. Payment Year 6: Ten percent (10%) of the total Washington Fees
and Costs amount ($8,775,023.10), to be paid on or before July 15, 2026.
g. Payment Year 7: Five percent (5%) of the total Washington Fees
and Costs amount ($4,387,511.55), to be paid on or before July 15, 2027.
D. Remittance. So that Settling Distributors do not pay the same fees and costs under
both the Global Settlement and this Agreement, Washington and its Participating Litigating
Subdivisions and their respective counsel shall do as follows:
1. Participating Litigating Subdivisions in Washington and their counsel shall
apply to the Attorney Fee Fund and the Litigating Subdivision Cost Fund created pursuant
to Exhibit R of the Global Settlement for all fees, costs and expenses for which they may be
eligible and shall instruct the Fee Panel and the Cost and Expense Fund Administrator to
remit to Settling Distributors the full amount awarded to such Participating Litigating
Subdivision, with each Settling Distributor receiving the percentage of that amount
corresponding to the allocation set forth in Section IV.I of the Global Settlement.
2. Counsel for Participating Subdivisions shall instruct the Fee Panel created
by the MDL Court pursuant to Exhibit R of the Global Settlement to remit to Settling
Distributors the Contingency Fee Amount for their Participating Subdivisions in the State of
Washington, with each Settling Distributor receiving the percentage of that amount
corresponding to the allocation set forth in Section IV.I of the Global Settlement.
3. The State of Washington shall instruct the Fee Fund Administrator selected
pursuant to Exhibit S of the Global Settlement that the Settling Distributors shall not pay the
Fixed Amount for the State of Washington, and the State of Washington will not be eligible
to receive funds from the State Outside Counsel Fee Fund under the Global Settlement.
4. The State of Washington shall submit documented costs, as provided for in
Exhibit T of the Global Settlement, to the Global Settlement State Cost Fund created
pursuant to Exhibit T of the Global Settlement for all costs and expenses for which it may
be eligible and shall instruct the State Cost Fund Administrator to remit to Settling
Distributors the full amount awarded to the State of Washington, with each Settling
M
Distributor receiving the percentage of that amount corresponding to the allocation set forth
in Section IV.I of the Global Settlement.
5. No Participating Litigating Subdivision shall receive any payment due
under this Agreement, including but not limited to the portion of the Washington Abatement
Amount allocable to the Participating Subdivision, until it and/or its outside counsel, as
applicable, fulfill their obligations under Sections V.D. 1-2.
VI. Release
A. Scope. As of the Washington Effective Date, Section XI of the Global Settlement
is fully binding on, and effective with respect to, all Releasors under this Agreement. Accordingly,
as of the Washington Effective Date, the Released Entities are hereby released and forever
discharged from all Released Claims of Releasors, including the State of Washington and its
Participating Subdivisions.
VII. Miscellaneous
A. No Admission. The Settling Distributors do not admit liability, fault, or
wrongdoing. Neither this Agreement nor the Washington Consent Judgment shall be considered,
construed or represented to be (1) an admission, concession or evidence of liability or wrongdoing
or (2) a waiver or any limitation of any defense otherwise available to the Settling Distributors. It is
the understanding and intent of the Agreement Parties that no portion of the Agreement shall be
entered into evidence in any other action against the Settling Distributors, among other reasons,
because it is not relevant to such action. For the avoidance of any doubt, nothing herein shall
prohibit a Settling Distributor from entering this Agreement into evidence in any litigation or
arbitration concerning a Settling Distributor's right to coverage under an insurance contract.
B. Tax Cooperation and Reporting. The State of Washington and its Participating
Subdivisions will be bound by Section V.F and Section XIV.F of the Global Settlement, except
(i) as set forth in the final sentence of this Section VII.B and (ii) that the State of Washington shall
be its own Designated State and shall designate its own "appropriate official" within the meaning of
Treasury Regulations Section 1.6050X-l(f)(1)(ii)(B) (the "Appropriate Official"). The IRS Forms
1098-F to be filed with respect to this Agreement are attached as Exhibit C, Exhibit D, and Exhibit
E. The State of Washington and its Participating Subdivisions agree that any return, amended
return, or written statement filed or provided pursuant to Section XIV.F.4 of the Global Settlement
with respect to this Agreement, and any similar document, shall be prepared and filed in a manner
consistent with reporting each Settling Distributor's portion of the aggregate amount of payments
paid or incurred by the Settling Distributors hereunder as the "Total amount to be paid" pursuant to
this Agreement in Box 1 of IRS Form 1098-F, each Settling Distributor's portion of the amount
equal to the aggregate amount of payments paid or incurred by the Settling Distributors hereunder
less the Compensatory Restitution Amount as the "Amount to be paid for violation or potential
violation" in Box 2 of IRS Form 1098-F and each Settling Distributor's portion of the
Compensatory Restitution Amount as "Restitution/remediation amount" in Box 3 of IRS Form
1098-F, as reflected in Exhibit C. Exhibit D, and Exhibit E.
0
C. No Third -Party Beneficiaries. Except as expressly provided in this Agreement, no
portion of this Agreement shall provide any rights to, or be enforceable by, any person or entity that
is not the State of Washington or a Released Entity. The State of Washington may not assign or
otherwise convey any right to enforce any provision of this Agreement.
D. Cooperation. Each Agreement Party and each Participating Subdivision agrees to
use its best efforts and to cooperate with the other Agreement Parties and Participating Subdivisions
to cause this Agreement to become effective, to obtain all necessary approvals, consents and
authorizations, if any, and to execute all documents and to take such other action as may be
appropriate in connection herewith. Consistent with the foregoing, each Agreement Party and each
Participating Subdivision agrees that it will not directly or indirectly assist or encourage any
challenge to this Agreement or the Washington Consent Judgment by any other person, and will
support the integrity and enforcement of the terms of this Agreement and the Washington Consent
Judgment.
E. Enforcement. All disputes between Settling Distributors and the State of
Washington and/or the Participating Subdivisions in the State of Washington shall be handled as
specified in Section VI of the Global Settlement, including the referral of relevant disputes to the
National Arbitration Panel.
F. No Violations of Applicable Law. Nothing in this Agreement shall be construed to
authorize or require any action by Settling Distributors in violation of applicable federal, state, or
other laws.
G. Modification. This Agreement may be modified by a written agreement of the
Agreement Parties. For purposes of modifying this Agreement or the Washington Consent
Judgment, Settling Distributors may contact the Washington Attorney General for purposes of
coordinating this process. The dates and deadlines in this Agreement may be extended by written
agreement of the Agreement Parties, which consent shall not be unreasonably withheld.
H. No Waiver. Any failure by any Agreement Party to insist upon the strict
performance by any other party of any of the provisions of this Agreement shall not be deemed a
waiver of any of the provisions of this Agreement, and such party, notwithstanding such failure,
shall have the right thereafter to insist upon the specific performance of any and all of the
provisions of this Agreement.
I. Entire Agreement. This Agreement, including the Global Settlement (and its
exhibits), represents the full and complete terms of the settlement entered into by the Agreement
Parties, except as provided herein. In any action undertaken by the Agreement Parties, no prior
versions of this Agreement and no prior versions of any of its terms may be introduced for any
purpose whatsoever.
J. Counterparts. This Agreement may be executed in counterparts, and a facsimile or
.pdf signature shall be deemed to be, and shall have the same force and effect as, an original
signature.
K. Notice. All notices or other communications under this Agreement shall be
provided to the following via email and overnight delivery to:
7
Copy to AmerisourceBergen Corporation's attorneys at:
Michael T. Reynolds
Cravath, Swaine & Moore LLP
825 8th Avenue
New York, NY 10019
mreynolds@cravath.com
Copy to Cardinal Health, Inc. 's attorneys at:
Elaine Golin
Wachtell, Lipton, Rosen & Katz
51 West 52"d Street
New York, NY 10019
epgolin@wlrk.com
Copy to McKesson Corporation's attorneys at:
Thomas J. Perrelli
Jenner & Block LLP
1099 New York Avenue, NW, Suite 900
Washington, DC 20001-4412
TPerrelli@jenner.com
Copy to the State of Washington at:
Shane Esquibel
Jeffrey Rupert
Laura Clinton
Washington Attorney General's Office
1125 Washington Street SE
PO Box 40100
Olympia, WA 98504-0100
Shane.Esquibel@atg.wa.gov
Jeffrey.Rupert@atg.wa.gov
Laura. Clinton@atg.wa.gov
[Signatures begin on next page.]
Authorized and agreed to by:
Dated:
ROBERT W. FERGUSON
AM
Title: Division Chief
Authorized and agreed to by:
Dated: May 2, 2022 AMERISOURCEBERGEN CORPORATION
By:
Elizabeth Campbell
Executive Vice President and Chief Legal Officer
Authorized and agreed to by:
Dated: 04/29/2022 CARDINAL HEALTH, INC.
Y1— - X -
By:— /4
Name: Jessica Mayer
Title: Chief Legal and Compliance Officer
Authorized and agreed to by:
Dated: ' 7.'1 Z' -L- MCKESSON CORPORATION
By:
Name: Sckf-OL A C- ►3�a u
Title: Cl
Exhibit A
Primary Subdivisions2
No. Subdivision Name
1.
Aberdeen city
2.
Adams County
3.
Anacortes City
4.
Arlington City
5.
Asotin County
6.
Auburn City*
7.
Bainbridge Island City
8.
Battle Ground City
9.
Bellevue City*
10.
Bellingham City*
11.
Benton County*
12.
Bonney Lake City
13.
Bothell City*
14.
Bremerton City*
15.
Burien City*
16.
Camas City
17.
Centralia City
18.
Chelan County*
19.
Cheney City
20.
Clallam County*
21.
Clark County*
22.
Covington City
23.
Cowlitz County*
24.
Des Moines City*
25.
Douglas County*
26.
East Wenatchee City
27.
Edgewood City
28.
Edmonds City*
29.
Ellensburg City
30.
Enumclaw City
31.
Everett City*
32.
Federal Way City*
33.
Ferndale City
34.
Fife City
35.
Franklin County*
36.
Gig Harbor City
37.
Grandview City
38.
Grant County*
2 Entities denoted with an asterisk (*) indicate a population of greater than 30,000 for purposes of the definition of
Primary Subdivision as it relates to Incentive Payment C.
A-1
39.
Grays Harbor County*
40.
Island County*
41.
Issaquah City*
42.
Jefferson County*
43.
Kelso City
44.
Kenmore City
45.
Kennewick City*
46.
Kent City*
47.
King County*
48.
Kirkland City*
49.
Kitsap County*
50.
Kittitas County*
51.
Klickitat County
52.
Lacey City*
53.
Lake Forest Park City
54.
Lake Stevens City*
55.
Lakewood City*
56.
Lewis County*
57.
Liberty Lake City
58.
Lincoln County
59.
Longview City*
60.
Lynden City
61.
Lynnwood City*
62.
Maple Valley City
63.
Marysville City*
64.
Mason County*
65.
Mercer Island City
66.
Mill Creek City
67.
Monroe City
68.
Moses Lake City
69.
Mount Vernon City*
70.
Mountlake Terrace City
71.
Mukilteo City
72.
Newcastle City
73.
Oak Harbor City
74.
Okanogan County*
75.
Olympia City*
76.
Pacific County
77.
Pasco City*
78.
Pend Oreille County
79.
Pierce County*
80.
Port Angeles City
81.
Port Orchard City
82.
Poulsbo City
83.
Pullman City*
84.
Puyallup City*
A-2
85.
Redmond City*
86.
Renton City*
87.
Richland City*
88.
Sammamish City*
89.
San Juan County
90.
Seatac City
91.
Seattle City*
92.
Sedro-Woolley City
93.
Shelton City
94.
Shoreline City*
95.
Skagit County*
96.
Skamania County
97.
Snohomish City
98.
Snohomish County*
99.
Snoqualmie City
100.
Spokane City*
101.
Spokane County*
102.
Spokane Valley City*
103.
Stevens County*
104.
Sumner City
105.
Sunnyside City
106.
Tacoma City*
107.
Thurston County*
108.
Tukwila City
109.
Tumwater City
110.
University Place City*
111.
Vancouver City*
112.
Walla Walla City*
113.
Walla Walla County*
114.
Washougal City
115.
Wenatchee City*
116.
West Richland City
117.
Whatcom County*
118.
Whitman County*
119.
Woodinville City
120.
Yakima City*
121.
Yakima County*
A-3
Exhibit B
Litigating Subdivisions
No. Subdivision Name
1.
Anacortes City
2.
Bainbridge Island City
3.
Burlington City
4.
Chelan County
5.
Clallam County
6.
Clark County
7.
Everett City
8.
Franklin County
9.
Island County
10.
Jefferson County
11.
Kent City
12.
King County
13.
Kirkland City
14.
Kitsap County
15.
Kittitas County
16.
La Conner School District
17.
Lakewood City
18.
Lewis County
19.
Lincoln County
20.
Mount Vernon City
21.
Mount Vernon School District
22.
Olympia City
23.
Pierce County
24.
San Juan County
25.
Seattle City
26.
Sedro-Woolley City
27.
Sedro-Woolley School District
28.
Skagit County
29.
Snohomish County
30.
Spokane City
31.
Spokane County
32.
Tacoma City
33.
Thurston County
34.
Vancouver City
35.
Walla Walla County
36.
Whatcom County
37.
Whitman County
RN
Exhibit C
ABC IRS Form 1098-F
This Exhibit C will be appended to the Agreement prior to the Effective Date pursuant to Section
VII.B.
C-1
Exhibit D
Cardinal Health IRS Form 1098-F
This Exhibit D will be appended to the Agreement prior to the Effective Date pursuant to Section
VII.B.
D-1
Exhibit E
McKesson IRS Form 1098-F
This Exhibit E will be appended to the Agreement prior to the Effective Date pursuant to Section
VII.B.
E-1
Exhibit F
Subdivision Settlement Participation Form
Governmental Entity: State:
Authorized Official:
Address 1:
Address 2:
City, State, Zip:
Phone:
Email:
The governmental entity identified above ("Governmental Entity"), in order to obtain and in
consideration for the benefits provided to the Governmental Entity pursuant to the Settlement
Agreement dated May 2, 2022 ("Distributors Washington Settlement"), and acting through the
undersigned authorized official, hereby elects to participate in the Distributors Washington
Settlement, release all Released Claims against all Released Entities, and agrees as follows.
The Governmental Entity is aware of and has reviewed the Distributors Washington
Settlement, including the Distributor Global Settlement Agreement dated July 21, 2021
("Global Settlement") attached to the Distributors Washington Settlement as Exhibit H,
understands that all terms in this Participation Form have the meanings defined therein,
and agrees that by signing this Participation Form, the Governmental Entity elects to
participate in the Distributors Washington Settlement and become a Participating
Subdivision as provided therein.
2. The Governmental Entity shall, within 14 days of October 1, 2022 and prior to the filing
of the Consent Judgment, secure the dismissal with prejudice of any Released Claims that
it has filed.
4. The Governmental Entity agrees to the terms of the Distributors Washington Settlement
pertaining to Subdivisions as defined therein.
5. By agreeing to the terms of the Distributors Washington Settlement and becoming a
Releasor, the Governmental Entity is entitled to the benefits provided therein, including,
if applicable, monetary payments beginning after December 1, 2022.
6. The Governmental Entity agrees to use any monies it receives through the Distributors
Washington Settlement solely for the purposes provided therein.
7. The Governmental Entity submits to the jurisdiction of the Washington Consent
Judgment Court for purposes limited to that court's role as provided in, and for resolving
disputes to the extent provided in, the Distributors Washington Settlement. The
Governmental Entity likewise agrees to arbitrate before the National Arbitration Panel as
provided in, and for resolving disputes to the extent otherwise provided in the
Distributors Washington Settlement.
F-1
8. The Governmental Entity has the right to enforce the Distributors Washington Settlement
as provided therein.
9. The Governmental Entity, as a Participating Subdivision, hereby becomes a Releasor for
all purposes in the Distributors Washington Settlement, including, but not limited to, all
provisions of Section XI of the Global Settlement, and along with all departments,
agencies, divisions, boards, commissions, districts, instrumentalities of any kind and
attorneys, and any person in their official capacity elected or appointed to serve any of
the foregoing and any agency, person, or other entity claiming by or through any of the
foregoing, and any other entity identified in the definition of Releasor, provides for a
release to the fullest extent of its authority. As a Releasor, the Governmental Entity
hereby absolutely, unconditionally, and irrevocably covenants not to bring, file, or claim,
or to cause, assist or permit to be brought, filed, or claimed, or to otherwise seek to
establish liability for any Released Claims against any Released Entity in any forum
whatsoever. The releases provided for in the Distributors Washington Settlement are
intended by the Agreement Parties to be broad and shall be interpreted so as to give the
Released Entities the broadest possible bar against any liability relating in any way to
Released Claims and extend to the full extent of the power of the Governmental Entity to
release claims. The Distributors Washington Settlement shall be a complete bar to any
Released Claim.
10. The Governmental Entity hereby takes on all rights and obligations of a Participating
Subdivision as set forth in the Distributors Washington Settlement.
11. In connection with the releases provided for in the Distributors Washington Settlement,
each Governmental Entity expressly waives, releases, and forever discharges any and all
provisions, rights, and benefits conferred by any law of any state or territory of the
United States or other jurisdiction, or principle of common law, which is similar,
comparable, or equivalent to § 1542 of the California Civil Code, which reads:
General Release; extent. A general release does not extend to claims that
the creditor or releasing party does not know or suspect to exist in his or
her favor at the time of executing the release, and that if known by him or
her would have materially affected his or her settlement with the debtor or
released party.
A Releasor may hereafter discover facts other than or different from those which it
knows, believes, or assumes to be true with respect to the Released Claims, but each
Governmental Entity hereby expressly waives and fully, finally, and forever settles,
releases and discharges, upon the date the Distributors Washington Settlement becomes
effective pursuant to Section II.B of the Distributors Washington Settlement, any and all
Released Claims that may exist as of such date but which Releasors do not know or
suspect to exist, whether through ignorance, oversight, error, negligence or through no
fault whatsoever, and which, if known, would materially affect the Governmental
Entities' decision to participate in the Distributors Washington Settlement.
F-2
12. Nothing herein is intended to modify in any way the terms of the Distributors
Washington Settlement, to which Governmental Entity hereby agrees. To the extent this
Participation Form is worded differently from Exhibit F to the Distributors Washington
Settlement or interpreted differently from the Distributors Washington Settlement in any
respect, the Distributors Washington Settlement controls.
I have all necessary power and authorization to execute this Participation Form on behalf of the
Governmental Entity.
Signature:
Name:
Title:
Date:
F-3
Exhibit G
Consent Judgment and Stipulation of Dismissal with Preiudice
The Honorable Michael Ramsey Scott
Trial Date: November 15, 2021
STATE OF WASHINGTON
KING COUNTY SUPERIOR COURT
STATE OF WASHINGTON, I NO. 19-2-06975-9 SEA
Plaintiff,
V.
MCKESSON CORPORATION,
CARDINAL HEALTH INC., and
AMERISOURCEBERGEN DRUG
CORPORATION,
Defendants.
FINAL CONSENT JUDGMENT AND
DISMISSAL WITH PREJUDICE
FINAL CONSENT JUDGMENT AND DISMISSAL WITH PREJUDICE
The State of Washington ("State") and McKesson Corporation, Cardinal Health, Inc.,
AmerisourceBergen Drug Corporation and AmerisourceBergen Corporation, together with the
subsidiaries thereof (collectively, the "Settling Distributors," and each a "Settling Distributor")
(together with the State, the "Parties," and each a "Party") have entered into a consensual
resolution of the above -captioned litigation (the "Action") pursuant to a settlement agreement
entitled Distributors Washington Settlement Agreement, dated as of May 2, 2022 (the
"Washington Agreement'), a copy of which is attached hereto as Exhibit A. The Washington
Agreement shall become effective by its terms upon the entry of this Final Consent Judgment
(the "Judgment") by the Court without adjudication of any contested issue of fact or law, and
without finding or admission of wrongdoing or liability of any kind. By entering into the
Washington Agreement, the State of Washington agrees to be bound by all terms and conditions
G-1
of the Distributor Settlement Agreement, dated as of July 21, 2021 (as subsequently updated)
(the "Global Agreement"), a copy of which is attached hereto as Exhibit B (together with the
Washington Agreement, the "Agreements") unless stated otherwise in the Washington
Agreement. Unless stated otherwise in the Washington Agreement, the terms of the Washington
Agreement are intended to be consistent with the terms of the Global Settlement and shall be
construed accordingly.
I. RECITALS:
1. Each Party warrants and represents that it engaged in arm's-length negotiations in good
faith. In hereby executing the Agreements, the Parties intend to effect a good -faith settlement.
2. The State has determined that the Agreements are in the public interest.
3. The Settling Distributors deny the allegations against them and that they have any
liability whatsoever to the State, its Subdivisions, and/or (a) any of the State's or Subdivisions'
departments, agencies, divisions, boards, commissions, districts, instrumentalities of any kind and
attorneys, including its Attorney General, and any person in his or her official capacity whether
elected or appointed to serve any of the foregoing and any agency, person, or other entity claiming
by or through any of the foregoing, (b) any public entities, public instrumentalities, public
educational institutions, unincorporated districts, fire districts, irrigation districts, and other
Special Districts, and (c) any person or entity acting in a parens patriae, sovereign, quasi -
sovereign, private attorney general, qui tam, taxpayer, or other capacity seeking relief on behalf of
or generally applicable to the general public.
4. The Parties recognize that the outcome of the Action is uncertain and a final resolution
through the adversarial process likely will require protracted litigation.
5. The Parties agree to the entry of the injunctive relief terms pursuant to Exhibit P of the
Global Agreement.
6. Therefore, without any admission of liability or wrongdoing by the Settling Distributors
or any other Released Entities (as defined in the Global Agreement), the Parties now mutually
consent to the entry of this Judgment and agree to dismissal of the claims with prejudice pursuant
G-2
to the terms of the Agreements to avoid the delay, expense, inconvenience, and uncertainty of
protracted litigation.
NOW THEREFORE, IT IS HEREBY ORDERED, ADJUDGED AND DECREED THAT:
In consideration of the mutual promises, terms, and conditions set forth in the
Agreements, the adequacy of which is hereby acknowledged by all Parties, it is agreed by and
between the Settling Distributors and the State, and adjudicated by the Court, as follows:
1. The foregoing Recitals are incorporated herein and constitute an express term of this
Judgment.
2. The Parties have entered into a full and final settlement of all Released Claims of
Releasors against the Settling Distributors (including but not limited to the State) and the Released
Entities pursuant to the terms and conditions set forth in the Agreements.
3. The "Definitions" set forth in Section I of the Global Agreement are incorporated by
reference into this Judgment. The State is a "Settling State" within the meaning of the Global
Agreement. Unless otherwise defined herein, capitalized terms in this Judgment shall have the
same meaning given to them in the Global Agreement, or, if not defined in the Global Agreement,
the same meaning given to them in the Washington Agreement.
4. The Parties agree that the Court has jurisdiction over the subject matter of the Action
and over the Parties with respect to the Action and this Judgment. This Judgment shall not be
construed or used as a waiver of any jurisdictional defense the Settling Distributors or any other
Released Entity may raise in any other proceeding.
5. The Court finds that the Agreements were entered into in good faith.
6. The Court finds that entry of this Judgment is in the public interest and reflects a
negotiated settlement agreed to by the Parties. The Action is dismissed with prejudice, subject to
a retention of jurisdiction by the Court as provided herein and in the Agreements.
G-3
7. By this Judgment, the Agreements are hereby approved by the Court, and the Court
hereby adopts their terms as its own determination of this matter and the Parties' respective rights
and obligations.
8. The Court shall have authority to resolve disputes identified in Section VI.F.1 of the
Global Agreement, governed by the rules and procedures of the Court.
9. The Parties have satisfied the Conditions to Effectiveness of Agreement set forth in
Section II.B of the Washington Agreement as follows:
a. The Enforcement Committee and the Settling Distributors executed the
Enforcement Committee Agreement by June 1, 2022.
b. All Litigating Subdivisions in the State of Washington and ninety percent (90%)
of Non -Litigating Primary Subdivisions (calculated by population pursuant to the
Global Settlement) in the State of Washington became Participating Subdivisions
by September 23, 2022.
10. The Parties have satisfied the Condition to Effectiveness of Agreement set forth in
Section VIII of the Global Agreement and the Release set forth in Sections XI.A, F, and G of the
Global Agreement, as follows:
a. The Attorney General of the State exercised the fullest extent of his or her powers
to release the Settling Distributors and all other Released Entities from all
Released Claims pursuant to the release attached hereto as Exhibit C (the "AG
Release")
b. The Settling Distributors have determined that there is sufficient State
participation and sufficient resolution of the Claims of the Litigating Subdivisions
in the Settling States to proceed with the Agreements.
C. The Participation Form for each Initial Participating Subdivision in the State has
been delivered to the Settling Distributors. As stated in the Participation Form,
and for the avoidance of doubt, nothing in the Participation Form executed by the
Participating Subdivisions is intended to modify in any way the terms of the
G-4
Agreements to which the Participating Subdivisions agree. As stated in the
Participation Form, to the extent the executed version of the Participation Form
differs from the Global Agreement in any respect, the Global Agreement controls.
d. Pursuant to Section VIII.B of the Global Agreement, each Participating
Subdivision in the State is dismissing with prejudice any Released Claims that it
has filed against the Settling Distributors and the Released Entities.
11. Release. The Parties acknowledge that the AG Release, which is incorporated by
reference herein, is an integral part of this Judgment. Pursuant to the Agreements and the AG
Release and without limitation and to the maximum extent of the power of the State's Attorney
General, the Settling Distributors and the other Released Entities are, as of the Effective Date,
hereby released from any and all Released Claims of (a) the State and its Participating Subdivisions
and any of their departments, agencies, divisions, boards, commissions, Subdivisions, districts,
instrumentalities of any kind and attorneys, including the State's Attorney General, and any person
in his or her official capacity whether elected or appointed to serve any of the foregoing, and any
agency, person, or other entity claiming by or through any of the foregoing, (b) any public entities,
public instrumentalities, public educational institutions, unincorporated districts, fire districts,
irrigation districts, and other Special Districts in the State, and (c) any person or entity acting in a
parens patriae, sovereign, quasi -sovereign, private attorney general, qui tam, taxpayer, or other
capacity seeking relief on behalf of or generally applicable to the general public with respect to
the State or any Subdivision in the State, whether or not any of them participate in the Agreements.
Pursuant to the Agreements and the AG Release and to the maximum extent of the State's power,
the Settling Distributors and the other Released Entities are, as of the Effective Date, hereby
released from any and all Released Claims of (1) the State, (2) all past and present executive
departments, state agencies, divisions, boards, commissions and instrumentalities with the
regulatory authority to enforce state and federal controlled substances acts, and (3) any of the
State's past and present executive departments, agencies, divisions, boards, commissions and
instrumentalities that have the authority to bring Claims related to Covered Conduct seeking
G-5
money (including abatement and/or remediation) or revocation of a pharmaceutical distribution
license. For the purposes of clause (3) above, executive departments, agencies, divisions, boards,
commissions, and instrumentalities are those that are under the executive authority or direct control
of the State's Governor. Further, the provisions set forth in Section XI of the Global Agreement
are incorporated by reference into this Judgment as if fully set forth herein. The Parties
acknowledge, and the Court finds, that those provisions are an integral part of the Agreements and
this Judgment, and shall govern the rights and obligations of all participants in the settlement. Any
modification of those rights and obligations may be made based only on a writing signed by all
affected parties and approved by the Court.
12. Release of Unknown Claims. The State expressly waives, releases, and forever
discharges any and all provisions, rights, and benefits conferred by any law of any state or territory
of the United States or other jurisdiction, or principle of common law, which is similar,
comparable, or equivalent to § 1542 of the California Civil Code, which reads:
General Release; extent. A general release does not extend to
claims that the creditor or releasing party does not know or suspect
to exist in his or her favor at the time of executing the release that,
if known by him or her, would have materially affected his or her
settlement with the debtor or released party.
13. The State may hereafter discover facts other than or different from those which it
knows, believes, or assumes to be true with respect to the Released Claims, but the State expressly
waived and fully, finally, and forever settled, released and discharged, through the Agreements
and AG Release, any and all Released Claims that may exist as of the Effective Date but which
the State does not know or suspect to exist, whether through ignorance, oversight, error, negligence
or through no fault whatsoever, and which, if known, would have materially affected the State's
decision to enter into the Agreements.
14. Costs and Fees. The Parties will bear their own costs and attorneys' fees except as
otherwise provided in the Agreements.
Cel
15. No Admission of Liability. The Settling Distributors are consenting to this Judgment
solely for the purpose of effectuating the Agreements, and nothing contained herein may be taken
as or construed to be an admission or concession of any violation of law, rule, or regulation, or of
any other matter of fact or law, or of any liability or wrongdoing, all of which the Settling
Distributors expressly deny. None of the Settling Distributors or any other Released Entity admits
that it caused or contributed to any public nuisance, and none of the Settling Distributors or any
other Released Entity admits any wrongdoing that was or could have been alleged by the State, its
Participating Subdivisions, or any other person or entity. No part of this Judgment shall constitute
evidence of any liability, fault, or wrongdoing by the Settling Distributors or any other Released
Entity. The Parties acknowledge that payments made under the Agreements are not a fine, penalty,
or payment in lieu thereof and are properly characterized as described in Section VX of the Global
Agreement.
16. No Waiver. This Judgment is entered based on the Agreements without adjudication
of any contested issue of fact or law or finding of liability of any kind. This Judgment shall not be
construed or used as a waiver of any Settling Distributor's right, or any other Released Entity's
right, to defend itself from, or make any arguments in, any other regulatory, governmental, private
individual, or class claims or suits relating to the subject matter or terms of this Judgment.
Notwithstanding the foregoing, the State may enforce the terms of this Judgment as expressly
provided in the Agreements.
17. No Private Right of Action. This Judgment is not intended for use by any third party
for any purpose, including submission to any court for any purpose, except pursuant to Section
VI.A of the Global Agreement. Except as expressly provided in the Agreements, no portion of the
Agreements or this Judgment shall provide any rights to, or be enforceable by, any person or entity
that is not a Settling State or Released Entity. The State shall allow Participating Subdivisions in
the State to notify it of any perceived violations of the Agreements or this Judgment. No Settling
State, including the State of Washington, may assign or otherwise convey any right to enforce any
provision of the Agreements.
G-7
18. Admissibility. It is the intent of the Parties that this Judgment not be admissible in
other cases against the Settling Distributors or binding on the Settling Distributors in any respect
other than in connection with the enforcement of this Judgment or the Agreements. For the
avoidance of doubt, nothing herein shall prohibit a Settling Distributor from entering this Judgment
or the Agreements into evidence in any litigation or arbitration concerning (1) a Settling
Distributor's right to coverage under an insurance contract or (2) the enforcement of the releases
provided for by the Agreements and this Judgment.
19. Preservation of Privilege. Nothing contained in the Agreements or this Judgment, and
no act required to be performed pursuant to the Agreements or this Judgment, is intended to
constitute, cause, or effect any waiver (in whole or in part) of any attorney-client privilege, work
product protection, or common interest/joint defense privilege, and each Party agrees that it shall
not make or cause to be made in any forum any assertion to the contrary.
20. Mutual Interpretation. The Parties agree and stipulate that the Agreements were
negotiated on an arm's-length basis between parties of equal bargaining power and was drafted
jointly by counsel for each Party. Accordingly, the Agreements are incorporated herein by
reference and shall be mutually interpreted and not construed in favor of or against any Party,
except as expressly provided for in the Agreements.
21. Retention of Jurisdiction. The Court shall retain jurisdiction of the Parties for the
limited purpose of the resolution of disputes identified in Section VI.F.1 of the Global Agreement.
The Court shall have jurisdiction over Participating Subdivisions in the State for the limited
purposes identified in the Agreements.
22. Successors and Assigns. This Judgment is binding on each of the Settling Distributor's
successors and assigns.
23. Modification. This Judgment shall not be modified (by the Court, by any other court,
or by any other means) without the consent of the State and the Settling Distributors, or as provided
for in Section XIV.0 of the Global Agreement.
G-8
So ORDERED this day of
2022.
THE HONORABLE JUDGE MICHAEL. R. SCOTT
APPROVED, AGREED TO AND PRESENTED BY:
ROBERT W. FERGUSON
Attorney General
S/
MARTHA RODRIGUEZ LOPEZ,
WSBA No. 35466
ANDREW R.W. HUGHES, WSBA No. 49515
NATHAN K. BAYS, WSBA No. 43025
BRIAN H. ROWE, WSBA No. 56817
SPENCER W. COATES, WSBA No. 49683
KELSEY E. ENDRES, WSBA No. 39409
LAURA K. CLINTON, WSBA No. 29846
JONATHAN J. GUSS, WSBA No. 57663
SUSAN E. LLORENS, WSBA No. 38049
LIRE. PERNELL, WSBA No. 50208
MOTLEY RICE LLC
LINDA SINGER, pro hac vice
ELIZABETH SMITH, pro hac vice
DAVID I. ACKERMAN, pro hac vice
JAMES LEDLIE, pro hac vice
DON MIGLIORI, pro hac vice
REBECCA FONSECA, pro hac vice
MICHAEL J. QUIRK, pro hac vice
ANNIE KOUBA, pro hac vice
MICHAEL J. PENDELL, pro hac vice
CHRISTOPHER MORIARTY, pro hac vice
LISA M. SALTZBURG, pro hac vice
NATALIA DEYNEKA, pro hac vice
MICHAEL E. ELSNER, pro hac vice
ANDREW P. ARNOLD, pro hac vice
MIMI LIU, pro hac vice
STOEL RIVES LLP
VANESSA SORIANO POWER,
WSBA No. 30777
JENNA M. POLIGO, WSBA No. 54466
RACHEL C. LEE, WSBA No. 48245
S. JULIA LITTELL, WSBA No. 54106
PER RAMFJORD, pro hac vice
CHRIS C. RIFER, pro hac vice
WILLIAMS & CONNOLLY LLP
LORYN HELFMANN, pro hac vice
A. JOSHUA PODOLL, pro hac vice
SUZANNE SALGADO, pro hac vice
NEELUM J. WADHWANI, pro hac vice
PAUL E. BOEHM, pro hac vice
ELEANOR J.G. WASSERMAN, pro hac vice
DAVID J. PARK, pro hac vice
JOSHUA D. TULLY, pro hac vice
STEVEN PYSER, pro hac vice
ENU A. MAINIGI, pro hac vice
JENNIFER G. WICHT, pro hac vice
JOSEPH S. BUSHUR, pro hac vice
COLLEEN MCNAMARA, pro hac vice
MATTHEW P. MOONEY, pro hac vice
ASHLEY W. HARDIN, pro hac vice
J. ANDREW KEYES, pro hac vice
EMILY R. PISTILLI, pro hac vice
BRAD MASTERS, pro hac vice
AW
ANN RITTER, pro hac vice
SARA AGUINGUA, pro hac vice
DAVID BURNETT, pro hac vice
VINCENT GREENE, pro hac vice
Attorneys for Plaintiff State of Washington
WILLIAM F. HAWKINS, pro hac vice
Attorneys for Defendant Cardinal Health Inc.
GORDON TILDEN THOMAS & CORDELL
LLP
S/
FRANKLIN D. CORDELL,
WSBA No. 26392
JEFFREY M. THOMAS,
WSBA No. 21175
KASEY HUEBNER,
WSBA No. 32890
COVINGTON & BURLING
CHISTOPHER EPPICH, pro hac vice
ANDREW STANNER, pro hac vice
KEVIN KELLY, pro hac vice
AMBER CHARLES, pro hac vice
MEGHAN MONAGHAN, pro hac vice
ISAAC CHAPUT, pro hac vice
DANIEL EAGLES, pro hac vice
MEGAN MCLAUGHLIN, pro hac vice
DEVON L. MOBLEY RITTER, pro hac vice
MEGAN RODGERS, pro hac vice
SONYA D. WINNER, pro hac vice
CLAYTON L. BAILEY, pro hac vice
JAMES A. GOOLD, pro hac vice
EMILY KVESELIS, pro hac vice
PAUL W. SCHMIDT, pro hac vice
ALEXANDER SETZEPFANDT, pro hac vice
CHRISTIAN J. PISTILLI, pro hac vice
LAUREN DORRIS, pro hac vice
NICHOLAS GRIEPSMA, pro hac vice
ALISON DICIURCIO, pro hac vice
SARA J. DENNIS, pro hac vice
PHYLLIS A. JONES, pro hac vice
DALE A. RICE, pro hac vice
Attorneys for Defendant McKesson Corp.
LANE POWELL PC
S/
JOHN S. DEVLIN III, WSBA No. 23988
PILAR FRENCH, WSBA No. 33300
REED SMITH LLP
G-10
ROBERT A. NICHOLAS, pro hac vice
KIM M. WATTERSON, pro hac vice
STEVEN BORANIAN, pro hac vice
ELIZABETH BRANDON, pro hac vice
Attorneys for Defendant AmerisourceBergen
Drug Corporation and AmerisourceBergen
Corporation
G-11
DECLARATION OF SERVICE
I declare that I caused a copy of the foregoing document to be electronically served using
the Court's Electronic Filing System, which will serve a copy of this document upon all counsel
of record.
G-12
CARDINAL
Vanessa S. Power, Atty
vanessa. ower stoel.com
Jenna Poli o, Atty
jenna.poligo@stoel.com
Per A. Ram ord, Atty
per.ramfjord@stoel.com
Rachel C. Lee, Atty
rachel.lee@stoel.com
Christopher C. Rifer, Atty
christopher.rifer@stoel.com
Loryn Helfmann, Atty
lhelftnann@wc.com
A. Joshua Podoll, Atty
a odoll wc.com
Suzanne Salgado, Atty
ssal ado wc.com
Neelum J. Wadhwani, Atty
nwadhwani wc.com
Paul E. Boehm, Atty
pboehm@wc.corn
Eleanor J. G. Wasserman, Atty
ewasserman@,wc.com
David J. Park, Atty
d ark wc.com
Joshua D. Tully, Atty
jtully@,wc.com.
Steven P ser, Atty
spyser@wc.com
Enu A. Maini i, Atty
emaini i wc.com
Jennifer G. Wicht, Atty
jwicht,wc.corn
Joseph S. Bushur, Atty
jbushur@wc.corn
Colleen McNamara, Atty
cmcnamara wc.com
Ashley W. Hardin, Atty
ahardin@wc.com
J. Andrew Keyes, Atty
ake es wc.com
Emily R. Pistilli, Atty
e istilli wc.com
William F. Hawkins, Atty
whawkins@wc.com.
Stoel Docketing
docketclerk stoel.com
Leslie Lomax, Legal Assistant
leslie.lomax stoel.com
WA Action
cardinalwashin onaction wc.com
G-12
MCKESSON
Franklin D. Cordell
fcordell ordontilden.com
Jeffrey M. Thomas
Thomas ordontilden.com
Kasey Huebner
khuebner ordontilden.com
Christopher Eppich, Atty
ce ich cov.com
Andrew Stanner, Atty
astanner cov.com
Kevin Kelly, Atty
kkelly@,cov.com.
Amber Charles, Atty
acharles@)cov.com.
Me han Monaghan, Atty
mmona han cov.com
Isaac Chaput, Atty
icha ut cov.com
Daniel Eagles, Atty
deagles@,cov.com
Megan McLaughlin, Atty
mmclaughlin@cov.com
Devon L. Mobley -Ritter, Atty
dmobleyritter@cov.com
Megan Rodgers, Atty
mrod ers cov.com
Sonya D. Winner, Atty
swinner@,cov.com
Clayton L. Bailey,Atty
cbaile cov.com
G-12
James A. Goold, Atty
jgoold(&,cov.com
Emily Kveselis, Atty
ekveselis@cov.com
Paul W. Schmidt Atty
pschmidt(&,cov.com
Alexander Setze fandt, Atty
asetze fandt cov.com
Christian J. Pistilli, Atty
c istilli cov.com
Lauren Dorris Atty
Idorris@cov.com
Nicholas G ie sma, Atty
n ie sma cov.com
Alison DiCiurcio Atty
adiciurcio cov.com
Sara J. Dennis Atty
sdennis cov.com
Phyllis A. Jones Atty
pajones4,cov.com
Dale A. Rice, Atty
drice cov.com
Nicole Antoine, Atty
nantoine cov.com
Timothy Hester, Atty
thester@cov.com
Gregory L. Halperin, Atty
halperin@cov.com
Stephen Petkis, Atty
spetkis@cov.com
Alice Phillips Atty
a hilli s cov.com
Ellen Evans, Legal Assistant
eevans ordontilden.com
Jacqueline Lucien Legal Assistant
'lucien ordontilden.com
Courtney Caryl Garth, Paralegal
ccaryl@gordontilden.com
Electronic Mailing Inbox
mckessonwa cov.com
G-13
AMERISOURCEBERGEN
Pilar French, Atty
french lane owell.com
John S. Devlin III, Atty
devlin' lane owell.com
Katie Bass, Atty
bassk lane owell.com
Elizabeth Brandon, Atty
ebrandon@reedsmith.com
Sarah Johansen Atty
s'ohansen reedsmith.com
Rachel B. Weil, Atty
rweil reedsmith.com
Steven Boranian, Aft
sboranian reedsmith.com
Adam D. Brownrout, Atty
abrownrout reedsmith.com
Nicole S. Soussan, Atty
nsoussan reedsmith.com
Brian T. Himmel, Atty
bhimmel reedsmith.com
Shannon E. McClure Atty
smcclure reedsmith.com
Michael J. Salimbene, Atty
msalimbene reedsmith.com
Robert A. Nicholas, Atty
rnicholas reedsmith.com
Thomas H. Suddath, Jr., Atty
tsuddath reedsmith.com
Thomas J. McGarrile Atty
tmc arri le reedsmith.com
Courtland C. Chillingworth, Atty
cchillin orth reedsmith.com
Christina M. Vitale, Atty
cvitale reedsmith.com
Brian T. Kiolbasa, Atty
kiolbasab lane owell.com
Abigail M. Pierce, Atty
abi ail. fierce reedsmith.com
Joseph Mahad , Atty
jmahady(&,reedsmith.com
Jeffrey R. Melton, Atty
jmelton@,reedsmith.com
Anne E. Rollins, Atty
arollins reedsmith.com
Eric J. Buhr, Atty
ebuhr reedsmith.com
Brent R. Gary,Atty
bgary@reedsmith.com
Kim M. Watterson, Atty
KWatterson@reedsmith.com
Jeffrey M. Weimer, Atty
JWeimer reedsmith.com
E -Mailbox
Docketin -SEA lane owell.com
E -Mailbox
Docketin -PDX lane owell.com
E -Mailbox
ABDCWA LanePowell.com
G-13
DATED _ day of 2022, at Seattle, Washington.
S/
ANDREW R.W. HUGHES, WSBA No. 49515
G-14
Exhibit H Distributor Global Settlement Agreement
This document is not attached due to its size. The document can be found here: https://agportal-
s3bucket. s3 . amazonaws. com/Distributors S ettlement/National%2ODistributor%20 Settlement.pdf
EXHIBIT 2
Subdivision Settlement Participation Form
(Exhibit F of the Distributors Settlement)
Exhibit F
Subdivision Settlement Participation Form
Governmental Entity: State:
Authorized Official:
Address 1:
Address 2:
City, State, Zip:
Phone:
Email:
The governmental entity identified above ("Governmental Entity"), in order to obtain and in
consideration for the benefits provided to the Governmental Entity pursuant to the Settlement
Agreement dated May 2, 2022 ("Distributors Washington Settlement"), and acting through the
undersigned authorized official, hereby elects to participate in the Distributors Washington
Settlement, release all Released Claims against all Released Entities, and agrees as follows.
1. The Governmental Entity is aware of and has reviewed the Distributors Washington
Settlement, including the Distributor Global Settlement Agreement dated July 21, 2021
("Global Settlement") attached to the Distributors Washington Settlement as Exhibit H,
understands that all terms in this Participation Form have the meanings defined therein,
and agrees that by signing this Participation Form, the Governmental Entity elects to
participate in the Distributors Washington Settlement and become a Participating
Subdivision as provided therein.
2. The Governmental Entity shall, within 14 days of October 1, 2022 and prior to the filing
of the Consent Judgment, secure the dismissal with prejudice of any Released Claims that
it has filed.
4. The Governmental Entity agrees to the terms of the Distributors Washington Settlement
pertaining to Subdivisions as defined therein.
5. By agreeing to the terms of the Distributors Washington Settlement and becoming a
Releasor, the Governmental Entity is entitled to the benefits provided therein, including,
if applicable, monetary payments beginning after December 1, 2022.
6. The Governmental Entity agrees to use any monies it receives through the Distributors
Washington Settlement solely for the purposes provided therein.
7. The Governmental Entity submits to the jurisdiction of the Washington Consent
Judgment Court for purposes limited to that court's role as provided in, and for resolving
disputes to the extent provided in, the Distributors Washington Settlement. The
Governmental Entity likewise agrees to arbitrate before the National Arbitration Panel as
provided in, and for resolving disputes to the extent otherwise provided in the
Distributors Washington Settlement.
F-1
8. The Governmental Entity has the right to enforce the Distributors Washington Settlement
as provided therein.
9. The Governmental Entity, as a Participating Subdivision, hereby becomes a Releasor for
all purposes in the Distributors Washington Settlement, including, but not limited to, all
provisions of Section XI of the Global Settlement, and along with all departments,
agencies, divisions, boards, commissions, districts, instrumentalities of any kind and
attorneys, and any person in their official capacity elected or appointed to serve any of
the foregoing and any agency, person, or other entity claiming by or through any of the
foregoing, and any other entity identified in the definition of Releasor, provides for a
release to the fullest extent of its authority. As a Releasor, the Governmental Entity
hereby absolutely, unconditionally, and irrevocably covenants not to bring, file, or claim,
or to cause, assist or permit to be brought, filed, or claimed, or to otherwise seek to
establish liability for any Released Claims against any Released Entity in any forum
whatsoever. The releases provided for in the Distributors Washington Settlement are
intended by the Agreement Parties to be broad and shall be interpreted so as to give the
Released Entities the broadest possible bar against any liability relating in any way to
Released Claims and extend to the full extent of the power of the Governmental Entity to
release claims. The Distributors Washington Settlement shall be a complete bar to any
Released Claim.
10. The Governmental Entity hereby takes on all rights and obligations of a Participating
Subdivision as set forth in the Distributors Washington Settlement.
11. In connection with the releases provided for in the Distributors Washington Settlement,
each Governmental Entity expressly waives, releases, and forever discharges any and all
provisions, rights, and benefits conferred by any law of any state or territory of the
United States or other jurisdiction, or principle of common law, which is similar,
comparable, or equivalent to § 1542 of the California Civil Code, which reads:
General Release; extent. A general release does not extend to claims that
the creditor or releasing party does not know or suspect to exist in his or
her favor at the time of executing the release, and that if known by him or
her would have materially affected his or her settlement with the debtor or
released party.
A Releasor may hereafter discover facts other than or different from those which it
knows, believes, or assumes to be true with respect to the Released Claims, but each
Governmental Entity hereby expressly waives and fully, finally, and forever settles,
releases and discharges, upon the date the Distributors Washington Settlement becomes
effective pursuant to Section II.B of the Distributors Washington Settlement, any and all
Released Claims that may exist as of such date but which Releasors do not know or
suspect to exist, whether through ignorance, oversight, error, negligence or through no
fault whatsoever, and which, if known, would materially affect the Governmental
Entities' decision to participate in the Distributors Washington Settlement.
F-2
12. Nothing herein is intended to modify in any way the terms of the Distributors
Washington Settlement, to which Governmental Entity hereby agrees. To the extent this
Participation Form is worded differently from Exhibit F to the Distributors Washington
Settlement or interpreted differently from the Distributors Washington Settlement in any
respect, the Distributors Washington Settlement controls.
I have all necessary power and authorization to execute this Participation Form on behalf of the
Governmental Entity.
Signature:
Name:
Title:
Date:
F-3
EXHIBIT 3
One Washington Memorandum of Understanding Between Washington Municipalities
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.
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 11 of the United States Code, irrespective of the extent to
which Participating Local Governments vote in favor of or otherwise support such
plan of reorganization.
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
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 CA.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 CA.
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
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 CA.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 fixture 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
redistributed to Participating Counties in the manner directed
in CA.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.
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.
9
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
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 (2 1) 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
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.
�i
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
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
This One Washington Memorandum of Understanding Between Washington
Municipalities is signed this day of , 2022 by:
Name & Title
On behalf of
4894-0031-1574, v. 2
12
EXHIBIT A
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
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
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
(CONNECITONS TO CARET
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.
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
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.
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.
Z
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
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
3
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.
6
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 staffing 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
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
EXHIBIT B
Local
County Government % Allocation
Adams Count
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 Count
Clallam County 1.3076983401%
Forks
Port Angeles 0.4598370527%
Sequim
County Total: 1.7675353928%
*** - Local Government appears in multiple counties B-1
EXHIBIT B
Local
:County Government % Allocation
Clark Count
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 Count
Columbia County 0.0561699537%
Dayton
Starbuck
County Total: 0.0561699537%
Cowlitz County
Cowlitz County
Castle Rock
Kalama
Kelso
Longview
Woodland***
County Total:
Douglas County
Douglas County
Bridgeport
Coulee Dam***
East Wenatchee
Mansfield
Rock Island
Waterville
1.7226945990%
0.1331145270%
0.6162736905%
2.4720828165%
0.3932175175%
0.0799810865%
County Total: 0.4731986040%
Ferry County
Ferry County 0.1153487994%
Republic
County Total: 0.1153487994%
*** - Local Government appears in multiple counties B-2
EXHIBIT B
Local
County Government % Allocation
Franklin Count
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
Coulee City
Coulee Dam***
Electric City
Ephrata
George
Grand Coulee
Hartline
Krupp
Mattawa
Moses Lake
Quincy
Royal City
Soap Lake
Warden
Wilson Creek
0.9932572167%
0.2078293909%
County Total: 1.2010866076%
*** - Local Government appears in multiple counties B-3
EXHIBIT B
Local
County Government % Allocation
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 Count
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
EXHIBIT B
Local
!County Government % Allocation
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
EXHIBIT B
Local
'County Government
Kitsap County
Kitsap County
Bainbridge Island
Bremerton
Port Orchard
Poulsbo
County Total:
Kittitas County
Kittitas County
Cle Elum
Ellensburg
Kittitas
Roslyn
South Cle Elum
County Total:
Klickitat County
Klickitat County
Bingen
Goldendale
White Salmon
% Allocation
2.6294133668%
0.1364686014%
0.6193374389%
0.1009497162%
0.0773748246%
3.5635439479%
0.3855704683%
0.0955824915%
0.4811529598%
0.2211673457%
County Total: 0.2211673457%
Lewis County
Lewis County
Centralia
Chehalis
Morton
Mossyrock
Napavine
Pe Ell
Toledo
Vader
Winlock
1.0777377479%
0.1909990353%
County Total: 1.2687367832%
*** - Local Government appears in multiple counties B-6
EXHIBIT B
Local
County Government
Lincoln Countv
Lincoln County
Almira
Creston
Davenport
Harrington
Odessa
Reardan
Sprague
Wilbur
% Allocation
0.1712669645%
County Total: 0.1712669645%
Mason Countv
Mason County 0.8089918012%
Shelton 0.1239179888%
County Total: 0.9329097900%
Okanogan County
Okanogan County
Brewster
Conconully
Coulee Dam***
Elmer City
Nespelem
Okanogan
Omak
Oroville
Pateros
Riverside
Tonasket
Twisp
Winthrop
0.6145043345%
County Total: 0.6145043345%
Pacific County
Pacific County
Ilwaco
Long Beach
Raymond
South Bend
0.4895416466%
County Total: 0.4895416466%
*** - Local Government appears in multiple counties B-7
EXHIBIT B
Local
County Government % Allocation
Pend Oreille County
Pend Oreille County 0.2566374940%
Cusick
Ione
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
EXHIBIT B
Local
County Government % Allocation
Skaeit Count
Skagit County
1.0526023961%
Anacortes
0.1774962906%
Burlington
0.1146861661%
Concrete
0.2654558588%
Hamilton
La Conner
Lyman
0.3058936009%
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
EXHIBIT B
Local
County Government % Allocation
Saokane Count
Spokane County
5.5623859292%
Airway Heights
Cheney
0.1238454349%
Deer Park
0.6039423385%
Fairfield
Latah
Liberty Lake
0.0389636519%
Medical Lake
Millwood
3.3712525050%
Rockford
Spangle
0.0596582197%
Spokane
3.0872078287%
Spokane Valley
0.0684217500%
Waverly
County Total: 8.8808245947%
Stevens Count
Stevens County 0.7479240179%
Chewelah
Colville
Kettle Falls
Marcus
Northport
Springdale
County Total: 0.7479240179%
Thurston Count
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
EXHIBIT B
Local
County Government % Allocation
Walla Walla Count
Walla Walla County 0.5543870294%
College Place
Prescott
Waitsburg
Walla Walla 0.3140768654%
County Total: 0.8684638948%
Whatcom Count
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
EXHIBIT B
Local
County Government % Allocation
Yakima Count
Yakima County
1.9388392959%
Grandview
0.0530606109%
Granger
Harrah
Mabton
Moxee
Naches
Selah
Sunnyside
0.1213478384%
Tieton
Toppenish
Union Gap
Wapato
Yakima
0.6060410539%
Zillah
County Total: 2.7192887991%
*** - Local Government appears in multiple counties B-12
Exhibit C
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 CA of the MOU shall apply.
EXHIBIT 4
Non -Exhaustive List of Expenditures that Oualify as Opioid Remediation
(Exhibit E of the Global Settlement)
FINAL AGREEMENT 3.25.22
F,XHiRIT R
List of Opioid Remediation Uses
Schedule A
Core Strategies
States and Qualifying Block Grantees shall choose from among the abatement strategies listed in
Schedule B. However, priority shall be given to the following core abatement strategies ("Core
Strategies").14
A. NALOXONE OR OTHER FDA -APPROVED DRUG TO
REVERSE OPIOID OVERDOSES
1. Expand training for first responders, schools, community
support groups and families; and
2. Increase distribution to individuals who are uninsured or
whose insurance does not cover the needed service.
B. MEDICATION -ASSISTED TREATMENT ("MAT")
DISTRIBUTION AND OTHER OPIOID -RELATED
TREATMENT
1. Increase distribution of MAT to individuals who are
uninsured or whose insurance does not cover the needed
service;
2. Provide education to school-based and youth -focused
programs that discourage or prevent misuse;
3. Provide MAT education and awareness training to
healthcare providers, EMTs, law enforcement, and other
first responders; and
4. Provide treatment and recovery support services such as
residential and inpatient treatment, intensive outpatient
treatment, outpatient therapy or counseling, and recovery
housing that allow or integrate medication and with other
support services.
14 As used in this Schedule A, words like "expand," "fund," "provide" or the like shall not indicate a preference for
new or existing programs.
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FINAL AGREEMENT 3.25.22
C. PREGNANT & POSTPARTUM WOMEN
1. Expand Screening, Brief Intervention, and Referral to
Treatment ("SBIRT') services to non -Medicaid eligible or
uninsured pregnant women;
2. Expand comprehensive evidence -based treatment and
recovery services, including MAT, for women with co-
occurring Opioid Use Disorder ("OUD") and other
Substance Use Disorder ("SUD")/Mental Health disorders
for uninsured individuals for up to 12 months postpartum;
and
3. Provide comprehensive wrap-around services to individuals
with OUD, including housing, transportation, job
placement/training, and childcare.
D. EXPANDING TREATMENT FOR NEONATAL
ABSTINENCE SYNDROME ("NAS")
1. Expand comprehensive evidence -based and recovery
support for NAS babies;
2. Expand services for better continuum of care with infant -
need dyad; and
3. Expand long-term treatment and services for medical
monitoring of NAS babies and their families.
E. EXPANSION OF WARM HAND-OFF PROGRAMS AND
RECOVERY SERVICES
1. Expand services such as navigators and on-call teams to
begin MAT in hospital emergency departments;
2. Expand warm hand-off services to transition to recovery
services;
3. Broaden scope of recovery services to include co-occurring
SUD or mental health conditions;
4. Provide comprehensive wrap-around services to individuals
in recovery, including housing, transportation, job
placement/training, and childcare; and
5. Hire additional social workers or other behavioral health
workers to facilitate expansions above.
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FINAL AGREEMENT 3.25.22
F. TREATMENT FOR INCARCERATED POPULATION
Provide evidence -based treatment and recovery support,
including MAT for persons with OUD and co-occurring
SUD/MH disorders within and transitioning out of the
criminal justice system; and
2. Increase funding for jails to provide treatment to inmates
with OUD.
G. PREVENTION PROGRAMS
Funding for media campaigns to prevent opioid use (similar
to the FDA's "Real Cost" campaign to prevent youth from
misusing tobacco);
2. Funding for evidence -based prevention programs in
schools;
3. Funding for medical provider education and outreach
regarding best prescribing practices for opioids consistent
with the 2016 CDC guidelines, including providers at
hospitals (academic detailing);
4. Funding for community drug disposal programs; and
5. Funding and training for first responders to participate in
pre -arrest diversion programs, post -overdose response
teams, or similar strategies that connect at -risk individuals
to behavioral health services and supports.
H. EXPANDING SYRINGE SERVICE PROGRAMS
1. Provide comprehensive syringe services programs with
more wrap-around services, including linkage to OUD
treatment, access to sterile syringes and linkage to care and
treatment of infectious diseases.
I. EVIDENCE -BASED DATA COLLECTION AND
RESEARCH ANALYZING THE EFFECTIVENESS OF THE
ABATEMENT STRATEGIES WITHIN THE STATE
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FINAL AGREEMENT 3.25.22
Schedule B
Approved Uses
Support treatment of Opioid Use Disorder (OUD) and any co-occurring Substance Use Disorder
or Mental Health (SUD/MH) conditions through evidence -based or evidence -informed programs
or strategies that may include, but are not limited to, the following:
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 through evidence -based or evidence -
informed programs or strategies that may include, but are not limited to, those that:"
Expand availability of treatment for OUD and any co-occurring SUD/MH
conditions, including all forms of Medication -Assisted Treatment ("MV")
approved by the U.S. Food and Drug Administration.
2. Support and reimburse evidence -based services that adhere to the American
Society of Addiction Medicine ("ASAM") continuum of care for OUD and any co-
occurring SUD/MH conditions.
3. Expand telehealth to increase access to treatment for OUD and any co-occurring
SUD/MH conditions, 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 or evidence -informed practices such as adequate methadone dosing and low
threshold approaches to treatment.
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 and for persons
who have experienced an opioid overdose.
6. Provide treatment of trauma for individuals with OUD (e.g., violence, sexual
assault, human trafficking, or adverse childhood experiences) and family
members (e.g., surviving family members after an overdose or overdose fatality),
and training of health care personnel to identify and address such trauma.
7. Support evidence -based withdrawal management services for people with OUD
and any co-occurring mental health conditions.
15 As used in this Schedule B, words like "expand," "fund," "provide" or the like shall not indicate a preference for
new or existing programs.
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FINAL AGREEMENT 3.25.22
8. Provide training on MAT for health care providers, first responders, 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.
10. Offer fellowships for addiction medicine specialists for direct patient care,
instructors, and clinical research for treatments.
11. Offer scholarships and supports for behavioral health practitioners or workers
involved in addressing OUD and any co-occurring SUD/MH or mental health
conditions, including, but not limited to, training, scholarships, fellowships, loan
repayment programs, or other incentives for providers to work in rural or
underserved areas.
12. 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.
13. Disseminate 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.
14. Develop and disseminate 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 recovery from OUD and any co-occurring SUD/MH conditions
through evidence -based or evidence -informed programs or strategies that may include,
but are not limited to, the programs or strategies that:
Provide comprehensive wrap-around services to individuals with OUD and any
co-occurring SUD/MH conditions, including housing, transportation, education,
job placement, job training, or childcare.
2. Provide the full continuum of care of treatment and recovery services for OUD
and any co-occurring SUD/MH conditions, including supportive housing, peer
support services and counseling, community navigators, case management, and
connections to community-based services.
3. 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.
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FINAL AGREEMENT 3.25.22
4. Provide access to housing for people with OUD and any co-occurring SUD/MH
conditions, including supportive housing, recovery housing, housing assistance
programs, training for housing providers, or recovery housing programs that allow
or integrate FDA -approved mediation with other support services.
5. Provide community support services, including social and legal services, to assist
in deinstitutionalizing persons with OUD and any co-occurring SUD/MH
conditions.
6. 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.
7. Provide or support transportation to treatment or recovery programs or services
for persons with OUD and any co-occurring SUD/MH conditions.
8. Provide employment training or educational services for persons in treatment for
or recovery from OUD and any co-occurring SUD/MH conditions.
9. 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.
10. 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 support the person with OUD in the family.
11. Provide training and development of procedures for government staff to
appropriately interact and provide social and other services to individuals with or
in recovery from OUD, including reducing stigma.
12. Support stigma reduction efforts regarding treatment and support for persons with
OUD, including reducing the stigma on effective treatment. .
13. Create or support culturally appropriate services and programs for persons with
OUD and any co-occurring SUD/MH conditions, including new Americans.
14. Create and/or support recovery high schools.
15. Hire or train behavioral health workers to provide or expand any of the services or
supports listed above.
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 through evidence -based or evidence -informed
programs or strategies that may include, but are not limited to, those that:
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FINAL AGREEMENT 3.25.22
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. Fund SBIRT programs to reduce the transition from use to disorders, including
SBIRT services to pregnant women who are uninsured or not eligible for
Medicaid.
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.
4. Purchase automated versions of SBIRT and support ongoing costs of the
technology.
5. Expand services such as navigators and on-call teams to begin MAT, in hospital
emergency departments.
6. Provide training for emergency room personnel treating opioid overdose patients
on post -discharge planning, including community referrals for MAT, recovery
case management or support services.
7. Support hospital programs that transition persons with OUD and any co-occurring
SUD/MH conditions, or persons who have experienced an opioid overdose, into
clinically appropriate follow-up care through a bridge clinic or similar approach.
8. Support crisis stabilization centers that serve as an alternative to hospital
emergency departments for persons with OUD and any co-occurring SUD/MH
conditions or persons that have experienced an opioid overdose.
9. 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.
10. 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 or to persons who have experienced an
opioid overdose.
11. Expand warm hand-off services to transition to recovery services.
12. 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.
13. Develop and support best practices on addressing OUD in the workplace.
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FINAL AGREEMENT 3.25.22
14. Support assistance programs for health care providers with OUD.
15. Engage non -profits and the faith community as a system to support outreach for
treatment.
16. 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.
D. ADDRESS THE NEEDS OF CRIMINAL JUSTICE -INVOLVED PERSONS
Address the needs of persons with OUD and any co-occurring SUD/MH conditions who
are involved in, are at risk of becoming involved in, or are transitioning out of the
criminal justice system through evidence -based or evidence -informed programs or
strategies that may include, but are not limited to, those that:
1. Support pre -arrest or pre -arraignment diversion and deflection strategies for
persons with OUD and any co-occurring SUD/MH conditions, including
established strategies such as:
1. Self -referral strategies such as the Angel Programs or the Police Assisted
Addiction Recovery Initiative ("PAARI");
2. Active outreach strategies such as the Drug Abuse Response Team
("DART') model;
3. "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;
4. Officer prevention strategies, such as the Law Enforcement Assisted
Diversion ("LEAD") model;
5. Officer intervention strategies such as the Leon County, Florida Adult
Civil Citation Network or the Chicago Westside Narcotics Diversion to
Treatment Initiative; or
6. Co -responder and/or alternative responder models to address OUD-related
911 calls with greater SUD expertise.
2. Support pre-trial services that connect individuals with OUD and any co-
occurring SUD/MH conditions to evidence -informed treatment, including MAT,
and related services.
3. Support treatment and recovery courts that provide evidence -based options for
persons with OUD and any co-occurring SUD/MH conditions.
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FINAL AGREEMENT 3.25.22
4. Provide evidence -informed treatment, including MAT, recovery support, harm
reduction, or other appropriate services to individuals with OUD and any co-
occurring SUD/MH conditions who are incarcerated in jail or prison.
5. Provide evidence -informed treatment, including MAT, recovery support, harm
reduction, or other appropriate services to individuals with OUD and any co-
occurring SUD/MH conditions who are leaving jail or prison or 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 to law
enforcement, correctional, or judicial personnel or to providers of treatment,
recovery, harm reduction, 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, and the needs of their families, including babies with neonatal
abstinence syndrome ("NAS"), through evidence -based or evidence -informed programs
or strategies that may include, but are not limited to, those that:
1. Support evidence -based or evidence -informed 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, and other measures to educate and provide support to
families affected by Neonatal Abstinence Syndrome.
2. Expand comprehensive evidence -based treatment and recovery services, including
MAT, for uninsured women with OUD and any co-occurring SUD/MH
conditions for up to 12 months postpartum.
3. Provide training for obstetricians or other healthcare personnel who work with
pregnant women and their families regarding treatment of OUD and any co-
occurring SUD/MH conditions.
4. Expand comprehensive evidence -based treatment and recovery support for NAS
babies; expand services for better continuum of care with infant -need dyad; and
expand long-term treatment and services for medical monitoring of NAS babies
and their families.
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FINAL AGREEMENT 3.25.22
5. 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 NAS get referred to appropriate services and receive a plan of safe care.
6. Provide child and family supports for parenting women with OUD and any co-
occurring SUD/MH conditions.
7. Provide enhanced family support and child care services for parents with OUD
and any co-occurring SUD/MH conditions.
8. 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.
9. Offer home-based wrap-around services to persons with OUD and any co-
occurring SUD/MH conditions, including, but not limited to, parent skills
training.
10. Provide 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 or evidence -informed programs or
strategies that may include, but are not limited to, the following:
1. Funding medical provider education and outreach regarding best prescribing
practices for opioids consistent with the Guidelines for Prescribing Opioids for
Chronic Pain from the U.S. Centers for Disease Control and Prevention, including
providers at hospitals (academic detailing).
2. Training for health care providers regarding safe and responsible opioid
prescribing, dosing, and tapering patients off opioids.
3. Continuing Medical Education (CME) on appropriate prescribing of opioids.
4. Providing Support for non -opioid pain treatment alternatives, including training
providers to offer or refer to multi -modal, evidence -informed treatment of pain.
5. Supporting enhancements or improvements to Prescription Drug Monitoring
Programs ("PDMPs"), including, but not limited to, improvements that:
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FINAL AGREEMENT 3.25.22
Increase the number of prescribers using PDMPs;
2. Improve point -of -care decision-making by increasing the quantity, quality,
or format of data available to prescribers using PDMPs, by improving the
interface that prescribers use to access PDMP data, or both; or
3. 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 in a manner that
complies with all relevant privacy and security laws and rules.
6. Ensuring PDMPs incorporate available overdose/naloxone deployment data,
including the United States Department of Transportation's Emergency Medical
Technician overdose database in a manner that complies with all relevant privacy
and security laws and rules.
7. Increasing electronic prescribing to prevent diversion or forgery.
8. Educating dispensers on appropriate opioid dispensing.
G. PREVENT MISUSE OF OPIOIDS
Support efforts to discourage or prevent misuse of opioids through evidence -based or
evidence -informed programs or strategies that may include, but are not limited to, the
following:
1. Funding media campaigns to prevent opioid misuse.
2. Corrective advertising or affirmative public education campaigns based on
evidence.
3. Public education relating to drug disposal.
4. Drug take -back disposal or destruction programs.
5. Funding community anti-drug coalitions that engage in drug prevention efforts.
6. Supporting 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").
7. Engaging non -profits and faith -based communities as systems to support
prevention.
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FINAL AGREEMENT 3.25.22
8. Funding evidence -based prevention programs in schools or evidence -informed
school and community education programs and campaigns for students, families,
school employees, school athletic programs, parent -teacher and student
associations, and others.
9. 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.
10. Create or support community-based education or intervention services for
families, youth, and adolescents at risk for OUD and any co-occurring SUD/MH
conditions.
11. 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.
12. Support greater access to mental health services and supports for young people,
including services and supports provided by school nurses, behavioral health
workers or other school staff, to address mental health needs in young people that
(when not properly addressed) increase the risk of opioid or another drug misuse.
H. PREVENT OVERDOSE DEATHS AND OTHER HARMS (HARM REDUCTION)
Support efforts to prevent or reduce overdose deaths or other opioid -related harms
through evidence -based or evidence -informed programs or strategies that may include,
but are not limited to, the following:
1. Increased availability and distribution of naloxone and other drugs that treat
overdoses for first responders, overdose patients, individuals with OUD and their
friends and family members, schools, community navigators and outreach
workers, persons being released from jail or prison, or other members of the
general public.
2. Public health entities providing free naloxone to anyone in the community.
3. Training and education regarding naloxone and other drugs that treat overdoses
for first responders, overdose patients, patients taking opioids, families, schools,
community support groups, and other members of the general public.
4. Enabling school nurses and other school staff to respond to opioid overdoses, and
provide them with naloxone, training, and support.
5. Expanding, improving, or developing data tracking software and applications for
overdoses/naloxone revivals.
6. Public education relating to emergency responses to overdoses.
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FINAL AGREEMENT 3.25.22
7. Public education relating to immunity and Good Samaritan laws.
8. Educating first responders regarding the existence and operation of immunity and
Good Samaritan laws.
9. Syringe service programs and other evidence -informed programs to reduce harms
associated with intravenous drug use, including supplies, staffing, space, peer
support services, referrals to treatment, fentanyl checking, connections to care,
and the full range of harm reduction and treatment services provided by these
programs.
10. Expanding access to testing and treatment for infectious diseases such as HIV and
Hepatitis C resulting from intravenous opioid use.
11. Supporting mobile units that offer or provide referrals to harm reduction services,
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.
12. Providing training in harm reduction 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.
13. Supporting screening for fentanyl in routine clinical toxicology testing.
PART THREE: OTHER STRATEGIES
I. FIRST RESPONDERS
In addition to items in section C, D and H relating to first responders, support the
following:
1. Education of law enforcement or other first responders regarding appropriate
practices and precautions when dealing with fentanyl or other drugs.
2. Provision of wellness and support services for first responders and others who
experience secondary trauma associated with opioid -related emergency events.
J. LEADERSHIP, PLANNING AND COORDINATION
Support efforts to provide leadership, planning, coordination, facilitations, training and
technical assistance to abate the opioid epidemic through activities, programs, or
strategies that may include, but are not limited to, the following:
Statewide, regional, local or community regional planning to identify root causes
of addiction and overdose, goals for reducing harms related to the opioid
epidemic, and areas and populations with the greatest needs for treatment
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FINAL AGREEMENT 3.25.22
intervention services, and to support training and technical assistance and other
strategies to abate the opioid epidemic described in this opioid abatement strategy
list.
2. A dashboard to (a) share reports, recommendations, or plans to spend opioid
settlement funds; (b) to show how opioid settlement funds have been spent; (c) to
report program or strategy outcomes; or (d) to track, share or visualize key opioid -
or health-related indicators and supports as identified through collaborative
statewide, regional, local or 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, 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 throughout this document, support training to abate
the opioid epidemic through activities, programs, or strategies that may include, but are
not limited to, those that:
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. Support infrastructure and staffing for collaborative cross -system coordination to
prevent opioid misuse, prevent overdoses, and treat those with OUD and any co-
occurring SUD/MH conditions, or implement other 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, data collection 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.
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FINAL AGREEMENT 3.25.22
4. Research on novel harm reduction and prevention efforts such as the
provision of fentanyl test strips.
5. Research on innovative supply-side enforcement efforts such as improved
detection of mail -based delivery of synthetic opioids.
6. 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).
7. Epidemiological surveillance of OUD-related behaviors in critical
populations, including individuals entering the criminal justice system,
including, but not limited to approaches modeled on the Arrestee Drug
Abuse Monitoring ("ADAM") system.
8. Qualitative and quantitative research regarding public health risks and
harm reduction opportunities within illicit drug markets, including surveys
of market participants who sell or distribute illicit opioids.
9. Geospatial analysis of access barriers to MAT and their association with
treatment engagement and treatment outcomes.
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