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King County Executive Shannon Braddock today transmitted a proposal to renew the Behavioral Health Sales Tax Fund, known as MIDD. By renewing MIDD, King County will continue to have a reliable local funding source that makes behavioral health treatment more available, accessible, and effective. MIDD serves over 20,000 people across the region each year.
Today, Executive Braddock announced her proposal to renew MIDD, a local 0.1% behavioral health tax that funds vital mental health and substance use treatment. In 2025, MIDD is estimated to generate $97 million for programs that support health, wellness, recovery, and connection to community for people throughout King County.
For nearly two decades, MIDD has helped bolster treatment and crisis response programs that have experienced years of divestment at the federal and state levels, providing services to many low-income residents who lack access to care or who do not qualify for Medicaid.
“At a time when the federal government is slashing social safety net services for those most in need and enacting the largest program cuts in decades, King County remains committed to maintaining investments that provide access to vital mental health and substance use treatment and services,” said Executive Braddock. “Renewing MIDD ensures that adults, children, and families can continue to receive the behavioral health care they need from a robust workforce that can deliver those services.”
In 2016, the King County Council voted unanimously to extend MIDD from 2017 through 2025. Executive Braddock’s proposal would allow critical investments in behavioral health programming through 2034.
From 2017-2024, MIDD served over 100,000 people and infused more than $380 million into King County’s community-based behavioral health providers. These investments also allowed for the implementation of more than 54 initiatives that fund a range of services, including next-day appointments for substance use disorder assessments, mobile crisis teams in south King County, and school-based screening programs for youth.
“MIDD investments make behavioral health care more effective and responsive to King County’s needs,” said Kelly Rider, director of King County’s Department of Community and Human Services. “Accessible behavioral health care is essential to communities’ resilience and eases the strain on our region’s emergency response.
Recent reporting shows that MIDD’s investments make care more available, giving more people access to medications like buprenorphine for opioid use disorder.
“The MIDD behavioral health sales tax is a proven resource for addressing chronic underinvestment in mental health and substance use care in King County — ensuring people have access to the right support at the right time, so they can recover, remain stable, and avoid crisis and deeper system involvement,” said Steve Larsen, MIDD Advisory Committee co-chair and deputy director of the King County Department of Adult and Juvenile Detention.
King County data shows that MIDD has a positive impact on the people it serves. Three years after enrollment, participants in relevant programs experienced:
- 33% fewer emergency department visits.
- 62% fewer bookings into King County jails.
- 36% fewer involuntary psychiatric hospitalizations.
- 67% fewer engagements with crisis programs for adults.
In 2024, MIDD investments:
- Screened 14,400 youth in schools, connecting over 1,100 students to services.
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Provided direct services to 3,100 youth, including prevention and wellness strategies and recovery programs.
- Supported 120 behavioral health providers with funds for direct services like treatment, outreach, and engagement, as well as workforce training, recruitment, and retention.
- Ensured 3,500 low-income people received outpatient treatment.
- Connected 1,300 people to opioid addiction treatment.
- Helped 1,400 people maintain housing through supportive services, connecting 55% of these individuals to behavioral health treatment.
- Secured next-day appointments with a clinician for 1,341 people experiencing a behavioral health crisis.
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