SNOHOMISH COUNTY, Wash., June 8, 2022 – The Snohomish County Council unanimously voted to integrate the Snohomish Health District (SHD) into the County during its General Legislative Session today. Some benefits of this integration include minimizing bureaucratic obstructions, streamlining permitting operations, and creating an overall unified effort in prioritizing public health. The integration process will begin immediately following today’s decision, and by January 2023, Snohomish County will join the 30 other counties in Washington state that have integrated health departments.

“I want to assure you and the public that our goal here is to really strengthen public health in the County and support the incredible work they do,” County Executive Dave Somers said during the session before the vote. 

“As we’ve seen over the pandemic, we really came together as health district and county to work together on many issues. A lot of the main public health issues we face today really require that integrated approach,” he said before listing homelessness, mental health, and opioid use as some of the top health issues in the County.

Repeating what he stated in a memo sent to County Council members last month, Executive Somers added, “By permanently unifying, we can make formal what has been merely informal the last two years.”

While the pandemic tightened the knitting between the County and District, the two have a historical working relationship dating back to the SHD’s incorporation in 1959. And according to last month’s memo, the integration has been a long time coming.

“There have been discussions for at least ten years to stabilize and prioritize public health by integrating the Snohomish Health District and Snohomish County, like most large counties in the state,” Somers wrote.

The vote to pass Motion 22-248, which indicates the county’s intent to withdraw from the Snohomish Health District at the end of the year and immediately establish a county health department as required by RCW 70.46.090, was motioned by County Councilmen Jared Meade, seconded by Councilwoman Stephanie Wright, and passed 5 – 0.

Snohomish County Council comments

“Our priority is to strengthen public and environmental health in Snohomish County,” said Snohomish County Council Chair and Board of Health Member Megan Dunn. “As Snohomish County grows, we must adapt to ensure we will be able to meet the needs of our residents. Today’s action ensures we are prepared for the future public health needs of our county.”

“While the COVID-19 pandemic is not completely over just yet, now is the time to start transitioning to prepare for whatever may be coming next,” said Snohomish County Council Vice Chair and Board of Health Member Jared Mead. “A unified public health effort will ensure we are being as efficient as possible and using every opportunity to leverage county and public health assets for the benefit of all residents.”

“Today’s action is another step towards providing more robust public health services to our residents,” said Snohomish County Councilmember and Board of Health Chair Stephanie Wright. “We will find every opportunity available to us to strengthen public health, working to reestablish and expand clinical services, while addressing today’s threats and preparing for those that may be coming tomorrow.”

“The Snohomish Health District and Snohomish County have always worked together closely, and today’s decision will ensure we are being as efficient as possible with resources,” said Snohomish County Councilmember and Board of Health Member Nate Nehring. “We want to ensure that Snohomish County’s residents have a dynamic and effective public health department.”

“This is another step in Snohomish County’s efforts to ensure we are making decisions today that will serve our growing community in the long term,” said Snohomish County Councilmember and Board of Health Member Sam Low. “We are committed to looking out for both our rural and urban communities. We will continue to collaborate with our cities and towns as they work to solve pressing public health issues.”

Public Comments on Snohomish Health District integration

Several local leaders voiced their support during the legislative session. The benefit most widely cited by public commenters revolved around how, with a county health department, cities won’t have to financially assist public health entities.

“I’m here to talk in favor of the public health moving over to the county because if we do, we’re going to have more money for public health in general,” said Mountlake Terrace Mayor Kyoko Matsumoto. 

“Also, all the cities will have access without being asked to contribute when funds are low, because in the past we were always asked to contribute when the health department was not doing well financially […] Now, this will be more of an equal across the board.”

Marysville Mayor John Nehring, attending virtually, said, “I believe the time is right to make this move. I’m optimistic that this move will allow for increased collaboration and increased resources being put towards many of our public health priorities, not the least of which is the twin crisis of mental health and substance abuse that are really among the most difficult issues we’ve faced in local government here in some time.”

The Director of Engagement with the City of Everett, Nichole Webber, commented on behalf of Mayor Cassie Franklin, saying, “We feel this transition will only strengthen the outstanding public health service in our communities that everyone has grown to appreciate and expect.”

One public commentator raised concern over the review process of the integration. Jeff Clarke, a chair of the Board of the Health District’s Public Health Advisory Council, said that the Board of Health was “not given a chance to discuss or take an action” on the subject, and had to make a decision on the same day the resolution was presented to them.

“I’m not here today to argue against the move,” Clarke concluded. “I’m simply saying that it is a complicated matter of great importance to public health in this county, and the county and Board of Health should give it the time and review necessary to make the right decision.”

The integration process into the new Public Health Snohomish County

The six-month integration process is now underway, and by January 2023, all Snohomish Health District employees will officially be designated as County employees. 

Despite the approximately 135 new employees the County is set to receive, the integration isn’t expected to impact the County’s general budget, according to County Executive Communications Manager Kent Patton. 

Since SHD is currently funded by the County and government grants, the Health District will transfer its entire budget to Snohomish County during this transition. 

“The specific mechanism for doing that will be determined in the next six months,” Patton explained. “Once the health department is launched on January 1, 2023, the Health District budget will become the health department’s budget. Of course, there may be an additional step in transferring grants, but that level of detail will be worked out later this year.”

Patton also noted how the Snohomish County Health Department will have a separate county budget, much like the County’s Human Services Department and Paine Field Airport.

While this integration is new for Snohomish County, county-operated health departments are more common than rare in Washington state, especially for larger counties like King, Pierce, and Clark. Out of Washington’s 39 counties, 30 have county health departments.

A change in public health leadership is also in Snohomish County’s future, but not necessarily because of the integration. The County’s soon-to-be public health department is still expected to have a Health Officer at the helm. But as SHD Health Officer Dr. Chris Spitters announced last December that he would be stepping down from his role at the end of this month, the Board of Health is currently searching for his replacement. 

The SHD’s Health Officer leads the District in partnership with its Administrative Officer. Shawn Fredrick, SHD’s current Administrative Officer, is expected to fill the Director role in the County’s public health department come 2023. 

With the health department coming under the County’s umbrella, the County Executive and Council will have the ultimate financial authority over the department, but Snohomish County’s Board of Health will continue to play an integral role in setting priorities for public health.

Snohomish County’s Board of Health is currently comprised of 15 County and city council members from the County’s five districts and is one of the largest health boards in Washington state. To see who currently sits on the board, click here.

How the integration will impact public health

As the Lynnwood Times recently reported, Executive Somers noted the integration’s array of benefits in his May 24 memo to Council members. Some of those benefits include:

• A more unified effort to the Fentanyl/Heroin/Opioids Crisis
• Better collaboration on Disease Prevention and Control
• Improved management of volunteers for sheltering issues
• Stronger leveraging position for acquiring competitive grants
• Streamlined Permitting process
• Integration of Diversity, Equity, and Inclusion efforts
• Additional leverage to address nuisance properties

During the legislative session, Executive Somers reiterated how this move will resolve the “inefficiencies and holes” that come from having a split system. “We really feel this will be able to provide those wraparound services in an integrated way,” he said, adding how the unified approach will help address the County’s “big issues,” including homelessness, mental health issues, and the opioid epidemic.  

One of the first priorities of the soon-to-be County Health Department, according to Executive Somers, is to restart direct service deliveries for public health. “There’s no formal proposal yet, but we will be looking at it over the next six months,” he said.

To view the agenda for the General Legislative Session, click here.

The Snohomish County Health District was first established in 1959 as an “independent special purpose district responsible for public health in Snohomish County,” according to snohd.org. Some of the SHD’s priorities this year have been focusing on Coronavirus, Housing and Health, Equity, Mental Health, Vapor Products, and Foundational Public Health Services, with its annual budget coming in at around $31.5 million.