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 city’s 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 committee’s executive staff. The MIDD’s 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 plan’s success, seeking further review of the strategies used and a more unbiased evaluation. “I’m kind of suspicious. You’re 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 don’t 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 committee’s 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 plan’s oversight board. Currently in its fourth year, the MIDD program was established with the goal of assisting those with mental illnesses and drug dependencies. “It’s counselling, preventative work, trying to provide early intervention,” Joe McDermott, the legislation’s prime sponsor, said. “The earlier we can help someone the better - both for them, and for cost in treatment.”

The MIDD program’s 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 committee’s 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, it’s 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-down-psychiatric.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