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King County to expand access to outpatient mental health, addiction treatment

Renton Reporter - 11/21/2017

From a King County press release:

As many as 22,000 low-income people in King County will be eligible for same-day outpatient treatment for mental health and addiction services under an innovative new program announced today by King County, Ballmer Group and Third Sector Capital Partners, a San Francisco-based nonprofit advisory firm that collaborates with communities on how to contract for social services.

The "Pay for Success" model will allocate $1.4 million a year in incentive payments to mental health and substance use treatment agencies that provide outpatient treatment on demand for people in need.

"We are combining County resources with local philanthropy to open the door for King County residents to have access to outpatient treatment on demand," said Executive Constantine. "We are committed to delivering on our promise to make treatment available where and when people need it, and we will continue to work with our partners at the state and federal governments to ensure that mental health and addiction services are adequately funded for those we bring in the front door."

Currently, only five out of 29 local treatment agencies are able to consistently provide on-demand outpatient treatment for low-income clients. King County has set aside incentive payments for mental health and substance use treatment agencies that meet the targets and milestones, such that 80 percent of all new clients will receive timely access to care.

Ballmer Group hired the national organization Third Sector Capital Partners to work with King County to design the outpatient treatment on demand system pilot and a structure for rigid evaluation.

Third Sector Capital Partners was one of the first national organizations to design and promote "Pay for Success" as an innovative contracting model that drives government resources toward high-performing social programs in areas such as poverty, education, child welfare, recidivism, homelessness and wellness.

Ballmer Group co-founder Connie Ballmer said, "Ballmer Group is proud to partner with King County to address two very difficult problems: improving access to better mental health services and helping government spend tax dollars in the most impactful, efficient way. Our most difficult community problems can only be addressed when all sectors work together. Here in King County, innovative leaders like Dow Constantine champion collaboration among philanthropy, government, business, and nonprofits so that we accomplish more together."

Funding to support the effort will come from King County's Mental Illness and Drug Dependency (MIDD) sales tax revenues dedicated to behavioral health and specialty courts. The program will be structured as a two percent bonus payment when the agency achieves benchmarks. Total estimated expenditure from the MIDD is approximately $1.4 million a year.

King County is moving toward treatment on demand throughout the entire behavioral health treatment system. Developing this model for outpatient care is a significant first step. When people are able to get treatment when and where they need it, they are less likely to cycle into crisis. Treatment before a crisis occurs benefits the individual, their family and the whole community.

Additional investments to boost treatment access

In addition to the new outpatient program, King County announced that it will partner with Pioneer Human Services (PHS) to provide additional substance abuse residential treatment. King County will provide approximately $1 million to re-open a currently moth-balled facility owned by PHS in Seattle that will provide 20 more treatment beds by early 2018.

King County will also provide funding to Evergreen Treatment Services to expand their current mobile opiate treatment program. This would increase access to treatment services, particularly in rural areas where there are no treatment facilities. It also eliminates the time and expense needed to site and build a permanent facility. Total cost is approximately $150,000.

Addressing root causes of homelessness

According to the National Coalition for the Homeless, untreated mental illness and addiction remains one of the leading underlying causes for people to become homelessness. Serious mental illnesses disrupt a person's ability to carry out essential aspects of daily life, such as self-care and household management. Mental illnesses may also prevent people from forming and maintaining stable relationships, often pushing away caregivers, family, and friends. As a result of these factors and the stresses of living with a mental disorder, people with mentally illnesses are much more likely to become homeless than the general population, according to the National Coalition for the Homeless.

The local "Count Us In" homelessness point in time conducted in January 2017 found that fully half of the respondents reported at least one disabling condition, and 66 percent of those respondents reported living with two or more disabling conditions. Behavioral health conditions were the most frequently reported disabling conditions, with 45 percent experiencing psychiatric or emotional conditions, 36 percent reporting drug or alcohol abuse, and 34 percent living with post-traumatic stress disorder.

Next steps

These are important steps forward for the region and will directly increase access to treatment services for individuals and families in need. King County will work with Mayor-elect Jenny Durkan and other city, county and community leaders across the region to seek additional collaborative ideas and solutions to addressing the root causes of homelessness.