In King County, Washington, a portion of all sales tax collected is dedicated to substance abuse, mental health and therapeutic court services. The Mental Illness and Drug Dependency Plan (MIDD), passed by the King County Council in 2007, has helped prevent and reduce the involvement of people with substance use disorders and mental illness in the criminal justice system, says the plan’s project manager.
“We are seeing people recovering from substance abuse and mental illness with the help of programs funded by MIDD,” says Andrea LaFazia-Geraghty, MSW, MPH, of the King County Mental Health, Chemical Abuse and Dependency Services Division. She spoke about the passage and implementation of the plan at the recent National Alliance on Mental Illness National Convention.
MIDD is funded through a one-tenth of one cent sales tax. Counties in Washington state have had the option to raise the sales tax by 0.1 percent since 2005. More than a dozen counties in the state have implemented the sales tax increase. King County, which includes Seattle, raises an estimated $45 million per year through the tax, LaFazia-Geraghty said. MIDD’s programs are designed to stabilize people suffering from mental illness and chemical dependency, diverting them from jails and emergency rooms by getting them proper treatment.
Before the plan was enacted, King County had several years of state budget cuts to its mental health programs. At the same time, inadequate state funding for substance abuse services limited needy county residents’ access to treatment. This meant that a large number of people with untreated substance abuse and mental health issues were arrested, jailed or hospitalized.
One service MIDD funds is crisis intervention training for law enforcement and other first responders. “It’s hard to get law enforcement to go through 40 hours of training, so we cover not only the cost of the training, but the overtime costs as well,” LaFazia-Geraghty says. The plan also pays for an eight-hour refresher course.
The county is creating a crisis diversion facility, where law enforcement and other first responders can bring persons experiencing a behavioral health crisis. It is designed to help 3,000 people a year. The facility, which is scheduled to open in August, will provide 24 to 72 hours of help for people with mental health and substance abuse issues who are in a crisis situation.
MIDD is also funding crisis respite beds for people who have been hospitalized and have nowhere to go afterwards, but who still need care. “If a person who is mentally ill or has substance abuse issues is homeless or doesn’t have safe housing, they can go into respite care for two to four weeks. They will receive treatment while they are there, and they will be linked with long-term treatment,” LaFazia-Geraghty notes. The respite facility plans to assist 350-500 people per year. Local hospitals provided seed money to help develop the facility. “They are being helped, because their hospital beds are being freed up,” she adds.
In an attempt to help youth with complex emotional and/or behavioral issues who have tried but have been unsuccessful in previous treatment attempts, MIDD is funding a “wraparound” program. Youth served by this program receive coordinated services from two or more systems that serve children: child welfare, developmental disabilities, juvenile justice, mental health, special education or substance abuse.
The program provides individual and family-based plans, wrapping around the whole family to achieve these goals. “Wraparound teams help pull kids out of those systems and keep them with their parents,” LaFazia-Geraghty says.
Other MIDD-funded programs include:
• Drug courts – one for youth and one for adults
• Connecting people with treatment if they screen positive for alcohol use in a hospital screening and brief intervention program
• Reimbursing continuing education fees for chemical dependency professionals, in an effort to increase the number of professionals in the county
• Providing clinical assessments by chemical dependency professionals in the juvenile justice system
• Connecting programs on domestic violence and sexual assault with providers of mental health and substance abuse treatment services.