Governance — the RACC
Five overlapping command structures run today’s response. The fix is one accountable table: the Regional Accountability & Coordination Council.
Today — the patchwork
Before: the City runs shelter and outreach; the County runs crisis and the jail; the State runs Medicaid and the hospital; private and faith organizations run most of the treatment and housing; and the seams between them are where people fall. No one can be held responsible for the outcome, because no one owns it.
TODAY — THE PATCHWORK. Every tinted box is publicly governed, but by different governments: ■ city, ■ county, ■ state/federal, ■ shared seams, ■ private partners. Five colors, five command structures, no shared data, no single accountable owner. This is the system that produced America's #2 overdose death rate.
The five stewards — who leads each box
"Who leads?" — Who do we hold accountable for each piece? Every box is tagged with its steward. City of Spokane: the HUD Continuum of Care collaborative applicant — federal homelessness dollars, shelter contracts, coordinated entry, outreach. Spokane County: the regional behavioral health authority (SCRBH BH-ASO — the crisis system and involuntary-treatment gatekeeping), the jail, therapeutic courts, the 0.1% behavioral health tax, the opioid settlement, and co-governance of the Regional Health District. State/Federal: Medicaid — the single biggest payer on this map — plus Eastern State Hospital, DOC, and the Housing Authority's vouchers. Private & Faith: UGM, the meal circuit, the hospitals, most treatment and PSH operators — capacity that answers to donors and boards, not voters. And Shared/Blended marks the seams where two or more must act together. Look at Shared and you are looking at exactly where the city-county silo failure does its damage. This breakdown exists because accountability is impossible when nobody knows who owns what — and because "the city should fix it" is wrong about half of this map, and "the county should fix it" is wrong about the other half.
City of Spokane
CITY-LED. The City of Spokane is the HUD Continuum of Care collaborative applicant — federal homelessness dollars (CoC $6.3M, CDBG, HOME, ESG) flow through City Hall, along with shelter contracts, street outreach, and coordinated entry. But the city cannot treat addiction or psychiatric illness: those levers belong to the county and state.
Spokane County
COUNTY-LED. Spokane County runs the regional behavioral health system (the SCRBH BH-ASO — crisis line, DCRs, E&T placements), the jail, therapeutic courts, the 0.1% behavioral health sales tax, the opioid settlement council, and co-governs the Spokane Regional Health District (harm reduction, opioid treatment program). But the county cannot house people: the housing levers are the city's and SHA's.
State / Federal
STATE & FEDERAL. Medicaid — the single largest payer on this entire map — flows from the state Health Care Authority; Eastern State Hospital, DOC reentry, secure-withdrawal beds, and SHA's 5,749 federal vouchers are all set in Olympia and Washington DC. Local leaders influence these; they do not control them.
Private & Faith
PRIVATE & FAITH-LED. UGM, the meal circuit, the hospitals, most treatment providers, and the PSH operators — enormous capacity that answers to boards, donors, and congregations, not to voters. Government cannot command it; it can only partner with it.
Shared / Blended — the seams
SHARED / BLENDED — THE SEAMS. These boxes only work when city AND county (and often state) act together — and they are exactly where silos fail: co-response, courts, MAT, PSH, prevention, police contact. Houston's three-term Mayor Annise Parker said the only thing Houston did differently was work across jurisdictional and political lines. When Spokane's city and county aren't talking, these are the boxes that break.
After — the RACC
After: a Regional Accountability & Coordination Council — one table where the governments and major providers commit to shared outcomes, shared data, and dated results. Not a new bureaucracy: an accountability structure over the $120–150M already being spent.
WITH THE ROADMAP — ONE SYSTEM. Under recommendation A1, everything gold answers to one Regional Accountability & Coordination Council — one by-name data system, one intake standard, warm handoffs at every seam, one facilities plan, one funding measure. Private (teal) and state/federal (violet) boxes stay distinct but plug into the council as formal partners. As Houston's Mayor Parker said: the only thing done differently was working across jurisdictional lines.
A1 — the Cross-Sector Accountability & Coordination Council
Three functions: cross-system coordination; accountability for completion (a "named accountability pathway, independent of any single ballot measure or election cycle," public reporting on a defined cadence, "standing to escalate when implementation stalls"); and continued cross-sector convening. It must sit outside any single government and survive election cycles; formal authority stays with jurisdictions via intergovernmental agreements, including data-sharing. Composition pairs expertise with "power and authority to make decisions" — public, private, nonprofit, philanthropic, Tribal, victims'-rights, and lived-experience members. Timeline: design 3–6 months, stand-up 6–12 months — operational within a year.
Judge Tony Hazel on why past efforts failed: coordination was "always temporary… key stakeholders are missing… focus goes away."
The politics around this recommendation — the letters, the rollout exchange, the 2024 Regional Homeless Authority precedent — are documented in full on the Roadmap page: Governance & the politics →
🤝 Collaboration · Integration · Regionalization
The holy grail: collaboration, integration, regionalization
Every feature of this map ultimately points at one conclusion, so it should be stated plainly at the top: the answer to Spokane’s crisis is not primarily more money, more buildings, or more programs — it is making the parts we already have work together. That is not a hometown theory; it is the consistent testimony of the leaders of the American cities that actually turned their crises around. Houston’s three-term Mayor Annise Parker, whose region cut homelessness by nearly two-thirds, says the only thing Houston did differently was find a way to work across jurisdictional and political lines — a blue city and red counties, one system, one database, rowing together. Dave Bieter, Boise’s four-term mayor — whom the Spokane Business Association brought to Spokane as its keynote speaker last year — tells the same story from a city Spokane’s size: Boise’s results came from a by-name, university-refereed, genuinely regional partnership, not from outspending anyone. Collaboration, integration, and regionalization are the holy grail of this work. Everything else on this map — the gaps, the loops, the receipts — is what their absence looks like.
What collaboration actually asks of us
The politics of this moment pull everything toward the binary — left or right, right or wrong, my approach or yours. Collaboration is the deliberate breaking of that habit, and a city like Spokane is exactly the place it can be done. We are not Washington, D.C.; we are a community with a long record of coming together — across parties, neighborhoods, and faiths — to solve hard problems, and of genuinely caring for one another while we do it. That civic muscle is the real asset under everything on this map.
But collaboration also means retiring some lines we’ve drawn inside the response system itself. The Housing First versus services-first fight now playing out in the federal NOFO is the loudest example — and as this map shows throughout, the honest answer has always been both, in combination. The same is true across every other divide we’re tempted to treat as a contest: nonprofit, for-profit, and faith-based providers; low-, medium-, and high-barrier services — each one serves people the others cannot reach, and all of them contribute to the whole. The faith-based programs deserve particular mention: they are an essential part of this community’s fabric, and while they will always — and should always — maintain their independence, they can be full partners in the planning and execution of a well-run system. None of that happens without the unglamorous thing underneath it all: constant communication. No box on this map has the right answers alone. The system does — but only when it talks to itself.
Spokane has known this for years — a short institutional memory
This is not a new discovery for our region; it is a repeatedly rediscovered one, and this project stands in a specific lineage. Its author served as the City of Spokane’s Chief Financial Officer for seventeen years, and many of the lessons in this map were learned inside City Hall during the Condon administration (2012–2020), working alongside City Administrator Theresa Sanders and Rick Romero — who championed collaboration and integration across city government for years before it was fashionable, proving on utilities, budgets, and capital projects that Spokane’s jurisdictions could act as one when leadership insisted on it.
In 2023, Cooley, Sanders, and Romero carried that conviction into the homelessness arena — entirely as volunteers, unpaid and unaffiliated — spending roughly eighteen months building the Spokane Regional Collaborative — a formal effort, joined by the region’s elected leadership, to regionalize, integrate, and coordinate the homelessness response. Its record is public at spokaneunite.com, and its six workstreams read like a prophecy: legal structure for a regional entity, shared funding, shared data, governance, staffing, and how success would be measured — explicitly modeled on Houston. Set that agenda beside the Safe & Healthy Task Force’s 2026 roadmap (the Roadmap) and the overlap is unmistakable: an independent regional accountability council, a shared data system, formalized cross-system coordination, unified investment. The same recommendations keep resurfacing, through different authors and different years, because they are correct — and each time the region has stopped short of adopting them, the crisis has compounded. This map exists partly so that the next time, the whole community can see what is being proposed, and what declining it costs.
The crossroads, now: one regional measure — or three fragments
A dated snapshot, written in early July 2026 while these decisions were live. If you are reading this later, the specifics may have resolved — the pattern they illustrate never has.
That “next time” is not hypothetical. It is right now. The Safe & Healthy Task Force did a marvelous thing: thirty-three leaders across business, government, courts, law enforcement, providers, philanthropy, and lived experience spent a year building one shared roadmap — precisely the cross-constituency convening this region has repeatedly failed to sustain. The recommendations are on the table. The region’s leadership now faces exactly the decision the Regional Collaborative posed in 2023: adopt them together, or fragment again.
The early signals are worrying, in two directions at once:
Fragment one — a city going it alone. City leadership has signaled interest in pursuing the task force’s goals separately, through a city-only one-tenth sales tax. The argument offered is that separate funding streams can still be integrated and collaborative. They cannot — because integration and collaboration follow the money. Whoever levies the tax appoints the board, writes the contracts, sets the priorities, and answers to its own electorate; a separately funded city program will drift toward city-only purposes as surely as water runs downhill. This is not speculation — it is the operating history this whole page documents. And the arithmetic makes going alone doubly costly: under state law the public-safety sales-tax stack is finite (a best reading of roughly 0.50% maximum inside the cities), the councilmanic window under RCW 82.14.345 closes June 30, 2028, and every tenth claimed unilaterally shrinks and complicates what remains for a unified regional measure. If the city takes its tenth alone, the realistic prospect of mobilizing a full two-tenths behind the Safe & Healthy roadmap likely dies with it — and with it, the integrated facilities-plus-treatment ecosystem the roadmap says must be funded as one package or not at all. (The full capacity analysis: Public Safety Tax Capacity memo.)
The region has already run this experiment. In November 2023, a 0.2% jail-centered measure went to voters without a unified regional plan behind it — and won barely more than a third of the vote. The Safe & Healthy Task Force was convened, in large part, to repair exactly that failure of collaboration and clarity of mission. To respond to its roadmap by fragmenting the funding again would be to reproduce, step for step, the mistake the task force was created to correct.
Fragment two — an agency crowding the till. Meanwhile the Spokane Transit Authority is asking voters this August to approve what it labels a “renewal” of its 0.2% sales tax — in substance a new twenty-year, roughly billion-dollar tax running to 2048, atop STA’s permanent 0.6%. An SBA analysis of STA’s own filings with the State Auditor found the expiring “temporary” tax was not needed to deliver its promised projects: between 2017 and 2024 the tax collected $169 million while STA’s reserves grew by $234 million — and over nine years STA’s actual results beat its own forecasts by roughly $320 million. Core transit service is not at risk either way. The relevance here is regional capacity: GSI’s Pulse surveys show the same public that ranks the health-and-safety crisis as its number-one concern is also acutely sensitive to affordability and total tax burden. A community will not absorb a billion-dollar transit tax in August and then layer additional tenths for Safe & Healthy behind it. If this region is serious about its own stated first priority, STA should stand down and let the Safe & Healthy measure go first.
The pattern in both fragments is the same one this page keeps naming: institutions optimizing their own silo at the expense of the region’s one shot at an integrated response. The task force built the plan. The capacity exists — barely, and only if it is husbanded. What remains is the leadership decision this map was built to inform: one region, one measure, one system — or another decade of well-funded fragments.