Whatcom County LEAD expansion reports large drops in EMS and jail use, officials warn of funding squeeze

Vanessa Martin, a member of the Whatcom County LEAD management team, told the CSRSAC that the county's LEAD expansion has generated substantial reductions in system use while operating under constrained finances. The county reported more than 2,000 case-management events, about 950 outreach events and 306 clients served in calendar-year 2025; the program estimates per-participant costs at a little over $4,000.

"We had a 92% decrease in the utilization," Martin said of EMS transport among cohorts followed before enrollment and after graduation. She also reported an 83% decrease in jail bookings for the same cohorts and explained the county converts those utilization decreases into a cost-avoidance figure "over 7,500,000," excluding emergency-department, prosecution and defense time that would increase the estimate.

Martin said law-enforcement contacts remain the top referral source (about 49% in 2025 for one stakeholder sample and roughly 75% when combined with legal-system partners), and that the county has operational data-sharing interfaces with EMS and the jail. She described a county-run direct-service model in which county-employed intensive case managers provide transportation, legal advocacy and long-term caseload management until participants graduate from the program.

Committee members pressed Martin about funding. Brandy Flood asked how much of the program comes from Recovery Navigator Program dollars; Martin said the program's annual ASO contract is about $512,000, that funding is split between HCA and RNP sources, and that Whatcom took a 14% cut in HCA funding in the past year. "Any cut is hurting us," she said, noting the program relies on county behavioral-health sales tax to plug gaps and is maintaining a 3'to2-week wait list when referrals outpace capacity.

Martin emphasized tradeoffs: her team cannot implement law-enforcement-requested warm handoffs in the field without reducing caseloads substantially. "If we do warm handoffs, we have to make sure we have the staffing availability, which would mean our caseload max would probably be, anywhere from 80 to 90," she said, down from the usual 130'150 participants the program can serve.

Tony (meeting facilitator) and staff said Martin's slide deck and supporting materials would be posted on the CSRSAC web page and distributed to committee members.