## Meeting Overview The Whatcom County Council convened as the Health Board on Tuesday morning, February 4th, 2025, alongside the Public Health Advisory Board (PHAB) for their monthly joint meeting. With six of seven council members present in the hybrid meeting at County Courthouse chambers, the session tackled weighty issues from the front lines of the fentanyl crisis to the ongoing struggle of emergency winter sheltering. What distinguished this particular meeting was its focus on collaborative healthcare responses and structural governance questions. The morning featured detailed presentations from hospital and EMS partners on their evolving approach to treating opioid use disorder, followed by discussions about PHAB's statutory duties and a significant leadership transition for the Health Board itself. The session exemplified the complex coordination required between elected officials, health professionals, and community advocates in addressing public health crises. ## Frontline Medicine: Fighting Fentanyl with Suboxone and Trust The morning's centerpiece was a comprehensive briefing on medication for opioid use disorder (MOUD) programs now operating in both hospital emergency departments and EMS field responses. Dr. Lorna Gober, Chief Medical Officer for PeaceHealth Northwest Network, opened by describing their internal transformation: "As a physician, I thought, I want to be sure that every physician in that ER feels competent, comfortable in addressing the needs of these human beings." The initiative emerged from PeaceHealth joining the multi-agency coordination group in June 2023, three months after Dr. Gober started her position. Rather than accepting the sense of hopelessness that can pervade emergency departments treating overdose patients, the hospital formed an internal task force asking: "What can we do? What is in our control that we can actively work toward?" Their answer was comprehensive: train every emergency room physician to prescribe Suboxone (buprenorphine), create trauma-informed care protocols, and establish reliable connections to outpatient services. They brought in Dr. Thomas Robey from Providence Everett, who had successfully implemented similar programs, to train their emergency physicians. Dr. Shannon Boustead, a family medicine and addiction specialist who serves as medical advisor for the county's opioid response, provided the clinical foundation: "Medications for the treatment of opioid use disorder …