King County to vote this month on a levy for crisis care centers

A $1.25 billion proposal on the special election ballot would open five on-demand mental health and addiction facilities and increase worker wages.

a man in an orange safety jacket hands out socks to a person on the street in downtown seattle

Shawn Pimpleton, community safety ambassador with “We Deliver Care,” hands over socks while doing outreach along Third Avenue in downtown Seattle on Wednesday, Feb. 15, 2023. If passed, the King County Crisis Care Centers Levy would fund construction of five new behavioral health facilities around the region. (Amanda Snyder/Crosscut)

On April 25, King County voters will decide whether to adopt a new property tax levy that will fund the construction and operations of five walk-in crisis care centers around the region. The tax revenue would also help bring back the region’s lost supply of long-term residential treatment beds and bolster wages for workers in the behavioral health sector.

The measure’s proponents say it’s necessary to combat the region’s pervasive mental health and substance-use crises.

If passed, the levy would tax King County homeowners $0.145 per $1,000 of home value. For the median King County homeowner, it’s expected to cost $121 per year. The levy is projected to generate $1.25 billion over the nine years it would be collected, ending in 2032.

That money would fund the construction and operations of five walk-in behavioral health facilities that would be open 24 hours a day, seven days a week. Individuals could check themselves in or be dropped off by family members or police and fire first responders.

Each facility would have three levels of services available: immediate screening and triage services for people experiencing mental health or substance-use disorder crises; space for people to stay for up to 23 hours under observation; and beds for people to stay for up to 14 days before discharge or referral to other services. The exact locations of the sites are still to be determined, but will be distributed north, south, east and west across the county, with one facility serving just youth.

“We see the results of this lack of care in overcrowding in our jails and court system, overcrowding in hospitals and emergency systems, on the street,” said King County Executive Dow Constantine. “This is really a crisis that touches every community. There is a quiet suffering happening across the entirety of our county and country, in neighborhoods of every description, and we have to respond.”

King County currently does not have walk-in, on-demand behavioral health treatment facilities. Downtown Emergency Service Center’s Crisis Solutions Center in Seattle operates on a model similar to the proposed centers. But the nonprofit provider has only 46 beds and requires a referral from police, a mental health professional or mobile crisis responder. As such, people in crisis often end up in hospitals or jail.

The levy has been endorsed by elected officials throughout King County, eight firefighters’ unions, 15 behavioral health service providers and coalitions, labor representatives, and chambers of commerce and business groups in Seattle, Bellevue and Kenmore. The Yes campaign has raised $310,000.

There is not an opposing campaign registered with the state Public Disclosure Commission, but Tim Eyman, Suzie Burke and Jim Coombes wrote the statement of opposition that's part of the official election materials. In it, they argue the county needs to prioritize how to spend the tax revenue it already has. The opponents did not respond to a request for comment for this article.  

“Nobody likes paying taxes, but this is a modest price to meet a glaring, unmet need,” said Constantine when asked about opposition to the levy. “I have yet to talk to anyone, as I’ve called around seeking support for this, who does not have a personal story about an addiction or mental health challenge in their family or among friends and co-workers where someone needed help and couldn’t get it.”

Supporters agree with Constantine that the levy will help fill a serious gap in the county’s treatment options.

“We will save lives. We will connect people with care when they actually need it. And we will be providing this care close to where they live, which is another very important thing,” said Heather Venegas, director of King County Recovery Coalition, a nonprofit that does advocacy and public-awareness work on substance-use disorder and mental health issues.

Venegas said having treatment options that don’t require referrals is essential for helping people in crisis, especially those experiencing substance-use disorders who often have a “window of willingness” for seeking care.  

“The return on investment will be greater because we will be connecting people with care and resilience and recovery sooner,” she said, explaining that on-demand care will help keep people from cycling in and out of hospitals and jails without receiving help. “Recovery is possible. We can and do recover, especially when we are met with the services and care we need.”

County data shows that demand for treatment services grew during the pandemic. Call volume to King County’s behavioral health crisis line increased from 82,523 calls in 2019 to 102,754 calls in 2021. Mobile Crisis outreach referrals in the county increased 15% in the same period. Between 2019 and 2022, the wait time for involuntary treatment evaluation increased from four days to 12 for King County residents.

First responders such as firefighters and EMTs have increasingly dealt with the region’s mental health and addiction crises, often with few options for addressing the problems in meaningful ways.

“We see the impact of the mental health crisis and opiate crisis 24 hours a day,” said Kenny Stuart, president of IAFF Local 27, the Seattle firefighters union. “The biggest problem we encounter is where to take people to get help. We respond to a call [of someone in crisis], do outreach and assessment, build a rapport with them. And often times there just is no place to take folks.”

Stuart said dealing with the crisis without the resources to really help people has been demoralizing for firefighters.

“We want to be part of the bigger picture of providing the best, most effective response possible,” he said. “We’re caught in this washing-machine cycle and not actually fixing the problem. Over time it’s debilitating to firefighters. It’s creating a mental health crisis for firefighters, to be honest.”

In addition to building the crisis care centers, the tax revenue will help replace long-term treatment facilities that have been lost to budget cuts in recent decades and help bolster the workforce necessary to operate all parts of the behavioral health system.

In the 1970s, Washington’s Northern State Hospital psychiatric facility closed and other state institutions downsized, leaving counties and nonprofit organizations to try to make up for the loss of thousands of long-term residential beds for people experiencing behavioral health issues.

Research by The Seattle Times found that as of the 1990s, King County had 548 residential beds. But after years of mergers and budget cuts and lost leases, that number is down to 261 beds today. If passed, the levy would help expand the supply of long-term residential beds in King County where people can stay as long as they need to recover.

The levy also seeks to address the workforce crisis the human-services sector is experiencing. The largely nonprofit workforce has always earned low wages for challenging work. But in recent years, the mismatch between pay, working conditions and required credentialing has led to significant turnover and high vacancies. The tax revenue would help pay for higher wages and fund an apprenticeship program and other workforce retention efforts.

“In implementation, we will look at what people will need in order to choose this noble calling and stick with it in a place where cost of living is very, very high,” said Constantine. “You can build all the buildings and beds you want, but you have to have trained, educated caregivers to help people recover.”

King County Elections began mailing ballots on April 5. Ballots must be returned no later than 8 p.m. on Election Day, April 25.

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