Headline: Motion to renew program for mentally ill and drug dependent faces problems

By: Christopher Zeuthen

For: The Seattle Times
Date: 3/3/15
Meeting Date: 2/24/15

(Photo taken and edited by Christopher Zeuthen)

The Seattle City Council is facing the renewal and revision of a program for mentally ill and
drug dependent individuals that would likely impact tens of thousands across King County,
however, their discussion on the program has also sparked a number of problems and challenges
to be addressed.
The Law, Justice, Health and Human Services (LJHHS) Committee met this past Tuesday in
hopes of updating and renewing the citys Mental Illness and Drug Dependency (MIDD)
program to make its efforts more effective.
Originally developed in 2007 and beginning in 2011, the MIDD program places an additional 0.1
percent on sales tax for the delivery of mentally ill and chemical dependency services to stabilize
those with issues. The sales tax generates approximately $111.2 million per year, and funds
MIDD strategies aimed at diverting afflicted citizens from jails and emergency rooms by getting
them proper treatment.

While the program is set to expire in 2017, the LJHHS Committee has no intentions to allow it to
die, voting to bring it before the city council in a 4-0 vote. Although this meeting most directly
concerned the renewal of the program, the committee also hopes to update and revise the policies
currently in place to better assist those in need, and will first be taking a comprehensive review
of the program and the achievement of its goals.
So far, the outcomes of policy goals have been very successful, and in the majority of cases 80
percent of the outcomes in the evaluation plan for a particular strategy are being met, said Kelli
Carroll, a member of the committees executive staff.
The MIDDs Fifth Annual Report also showed signs of success, with MIDD programs serving
over 20,000 adults and 11,000 youths in 2012, along with a decrease in the average time spent in
both psychiatric hospitals and jail. The report cites a decrease of 14% in the total number of days
spent in the hospital, a decrease of 12% in the number of psychiatric hospitalizations, and a 60%
reduction in average jail days over a four-year period.
However, not all councilmembers are fully convinced of the MIDD plans success, seeking
further review of the strategies used and a more unbiased evaluation.
Im kind of suspicious. Youre dealing with people with underlying or major drug addiction
problems, and people with underlying or major mental health problems, councilmember Larry
Gossett said, questioning the validity of these results as they are evaluated by King County,
rather than an outside source. You got an 82 percent success rate? Come on man! No program
in the country gets that well cuz you servicing them with money. I dont buy that.
In addition to facing issues concerning the proper evaluation of the program during its review,
the committee also faces the problem of a changed landscape. Nearly a decade old, the landscape
for mental and substance abuse services and policy has changed significantly. Wendy Soo Hoo, a
member of the committees staff, noted that the US Affordable Care Act, reduced state funding,
and the 2014 Supreme Court decision on psychiatric boarding have all had significant impact on
the direction and efforts of the MIDD program.
Soo Hoo outlined three goals in the passing of the ordinance to discuss the renewal of the MIDD
program at City Council. First, Soo Hoo called for the review of the how the program is
evaluated. Second, she called for an improvement plan for the program to update its service
policies, and lastly, she acknowledged the need for the examination of MIDD processes, such as
the addition of new people to the plans oversight board.
Currently in its fourth year, the MIDD program was established with the goal of assisting those
with mental illnesses and drug dependencies.
Its counselling, preventative work, trying to provide early intervention, Joe McDermott, the
legislations prime sponsor, said. The earlier we can help someone the better - both for them,
and for cost in treatment.

The MIDD programs original goals were reductions in the number of mentally ill and
chemically dependent people using costly interventions, the number of people who recycle
through interventions, and the incidence and severity of chemical dependency and mental
disorders. Additionally, the program hoped to divert mentally ill and chemically dependent
people from justice system involvement.
Councilmember McDermott also expanded on the social and fiscal costs of the program, noting
that three-fourths of the committees general budget is spent on criminal justice. One key reason
why people are finding themselves in the criminal justice system are issues with drugs, and
alcohol, and mental health, McDermott said. If we could treat people for those items - mental
health and drug dependency - earlier and prevent them from getting into the criminal justice
system, its going to pay off.
While there are still the issues of proper evaluation and a new landscape to be addressed with the
renewal and revision of the program, committee chair, Kathy Lambert, showed hope for
improving situations surrounding the mentally ill and drug dependent population of Seattle.
When we can finally get to that place - with best practices and the kind of data we will soon
have - we will be in a lot better of a position, Lambert said.
Links:
For a brief summary of the US Affordable Care Act: http://www.hhs.gov/healthcare/rights/
For a brief summary of the 2014 Supreme Court Decision:
http://www.thenewstribune.com/2014/08/07/3320850/supreme-court-strikes-downpsychiatric.html
For more on MIDD:
http://www.kingcounty.gov/healthservices/MHSA/MIDDPlan.aspx
Sources:
Wendy Soo Hoo
Kathy Lambert
Larry Gossett
Joe McDermott
Kelly Carroll
Meeting agenda
Staff report
King County Website