Mental Illness and Drug Dependency
King County's Mental Illness and Drug Dependency (MIDD) is a countywide 0.1% sales tax generating an about $134 million per two-year biennium, specifically for programs and services for people living with or at risk of behavioral health conditions. King County’s MIDD is managed and operated by the King County Department of Community and Human Services' Behavioral Health and Recovery Division.
2005: The Washington State Legislature created an option for counties to support behavioral health services locally by increasing the local sales tax by 0.1 percent to augment state funding for behavioral health services and therapeutic courts. As required by state law (Revised Code of Washington 82.14.460), revenue raised under the MIDD must be used for new and expanded mental health and substance use disorder services, including King County’s therapeutic courts.
2006: The King County Council began exploring of the possibility of utilizing the tax option in response to shrinking state investment in community-based behavioral health services and corresponding escalation in the use of jails and hospitals for people living with behavioral health conditions.
2007: After significant work in partnership with communities and the Executive, the Council authorized the sales tax levy collection to begin in 2008 and extend through 2016. King County is one of 23 counties (along with one city) in Washington State that have authorized the tax revenue.
2016: King County Council voted unanimously to extend sales tax collection for MIDD through 2025. The nine-year extension of the tax is expected to generate an estimated $134 million per biennium (two-year budget cycle), and is known as MIDD 2. Also, the Service Improvement Plan for MIDD 2 was approved by King County Council, updating policy goals for MIDD 2.
2018: Both MIDD 2 Plans were approved by the Council.
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King County's MIDD is guided by adopted policy goals (King County Ordinance 18407) and the Service Improvement Plan (Ordinance 18406). The forthcoming Implementation and Evaluation Plans, due to the Council in August 2017, will further detail operations and assessment components for MIDD initiatives.
As required by the Council annual MIDD reports are provided to the Council. Find MIDD reports
The MIDD Advisory Committee is an advisory body to the County Executive and Council on matters related to King County's MIDD, as described in Ordinance 18452. The MIDD Advisory Committee is a unique partnership of representatives from the health and human services and criminal justice communities, including providers and other stakeholders. MIDD Advisory Committee meetings are open to the public and comments are welcome.
Find a schedule of meetings and meeting notes from past meetings on the MIDD Advisory Committee page.
As adopted by King County Council, MIDD’s five policy goals updated for MIDD 2 are as follows:
- Divert individuals with behavioral health needs from costly interventions, such as jail, emergency rooms, and hospitals.
- Reduce the number, length, and frequency of behavioral health crisis events.
- Increase culturally appropriate, trauma-informed behavioral health services.
- Improve health and wellness of individuals living with behavioral health conditions.
- Explicit linkage with and furthering the work of King County and community initiatives.
The 2017 MIDD Annual Report was transmitted to King County Council in July 2018, summarizing key outcomes from MIDD-funded services in 2017, including continued significant long-term reductions in psychiatric hospitalizations, jail utilization, and emergency department admissions for MIDD service participants. It also describes implementation progress for MIDD's various initiatives in 2017.
The 2017 MIDD Annual Report is accompanied by a companion Technical Supplement that provides further discussion of detailed evaluation results.
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