Funding and Payment Case Study: King County Mental Illness and Drug Dependency Sales Tax (MIDD)

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Isaac Wheeler
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1 Funding and Payment Case Study: King County Mental Illness and Drug Dependency Sales Tax (MIDD) National Council for Behavioral Health National Conference Seattle, Washington April 4, 2017 Merril Cousin, M. Ed MIDD Advisory Committee Co-Chair Executive Director, Coalition Ending Gender-Based Violence Kelli Carroll, MPA Strategic Advisor, King County Behavioral Health and Recovery Division

2 Session Learning Goals Identify elements for success o Data o Leadership by a champion o Human Services and Criminal Justice partnership Steps to build political will o Involving providers, public, and cities o Creating public awareness and support o Communicate, negotiate, communicate

3 What is MIDD? A 1/10 th of one percent countywide sales mental health tax authority granted to counties by the Washington State Legislature in 2005 Enacted by Council vote, not ballot measure Known as the Mental Illness and Drug Dependency Sales Tax or MIDD in King County

4 What is MIDD? Revised Code of Washington (RCW) requires 1/10 th sales revenue to be used solely for: Providing of chemical dependency or mental health treatment programs and services (treatment, case management, and housing that are a component of a coordinated chemical dependency or mental health treatment program or service)

5 What is MIDD? To date 25 counties in Washington State have authorized the tax revenue which generated over $109 million statewide in 2015 King County s MIDD was first authorized in 2007; it was reauthorized in 2016 through 2025 For the biennium, King County s MIDD is projected to raise over $135 million

6 MIDD at Work How people does MIDD? o 42,398 unduplicated individuals were served by MIDD between October 1, 2015 and September 30, 2016 How are people served? o MIDD funds support a broad array of services behavioral health services provided by over 40 community based agencies and eight county agencies and departments What are MIDD Outcomes? Individual pre-post comparisons of those who were served by MIDD programs: o o o Jail bookings were cut in half and jail days were reduced by 44 percent Psychiatric hospital admissions were reduced by 46 percent and the number of days hospitalized was reduced by 27 percent Emergency department admissions at Harborview Medical Center were reduced by 60 percent

7 How Did King County Make MIDD Happen? Based on local data o Established that the King County Jail was the state s largest de facto mental health facility, with high recidivism rates and poor behavioral health outcomes Led by a King County Council champion who called for change o 2006 motion: develop a plan to prevent and reduce homelessness, unnecessary involvement in the criminal justice and emergency medical systems and promote recovery

8 How Did King County Make MIDD Happen? Motion launched a ground breaking partnership between human services and criminal justice sectors of the county that continues today Behavioral health and criminal justice partners worked together with community partners for nearly a year to develop the plan The plan gave the Council a basis to begin developing political will for the sales tax vote

9 How Did King County Make MIDD Happen? County external activities: o Organized outreach to communities and providers resulted widespread stakeholder backing o Notable media interest, driving public awareness and support o Key Conversations with city leaders o King County Council Committee briefings County internal activities o Developed councilmember support, resolved questions, created path to yes

10 Taking the Vote Ordinance authorizing King County s levying of the tax passed 6-3 along party lines in November, 2007 Included a sunset clause, ending the tax unless reauthorized on January 1, 2017 Subsequent legislation called for oversight, implementation, and evaluation plans

11 Taking the Vote, Part Deux County Legislation passed in 2015 calling for key information the King County Council needed to potentially consider reauthorizing MIDD Intensive analysis, stakeholder driven planning, and rigorous community engagement, led to key structural and service recommendations being made to Council for MIDD 2 MIDD was unanimously (9-0 vote) reauthorized on August 22, 2017, in place through 2025

12 Lessons Learned True partnership between criminal justice, behavioral health, and community groups takes work but pays off Developing political & public support essential Careful planning a must Transparency highly valued Focus on data and evidence, balance with field knowledge and qualitative Communities want meaningful input, especially from consumers and communities of color

13 Questions Kelli Carroll

AGENDA ITEM SUMMARY August 16, 2016 City Council

Agenda Item 21 AGENDA ITEM SUMMARY August 16, 2016 City Council STAFF Beth Sowder, Director of Social Sustainability Jackie Kozak-Thiel, Chief Sustainability Officer SUBJECT Resolution 2016-065 Expressing