Category: Addiction

Addiction, Crime, King County, Opinion

“High Utilizers” Report Embraces Jail as Solution to Addiction and Crime

By Erica C. Barnett

When City Attorney Ann Davison announced her “high utilizers initiative” last year, she said it would go beyond previous attempts to punish people who commit misdemeanors by connecting them to case management, treatment, and other services. In reality, according to a report from Davison’s office, the initiative has only managed to temporarily incapacitate some people by locking them in the understaffed downtown jail, a “solution” to crimes like shoplifting and trespassing that does nothing to address the root causes that lead people to use drugs, steal from stores, and act out in public.

The report appears to feature a lot of hard numbers, but a closer look reveals that many are based on assumptions about how individual people would behave—assumptions that would undoubtedly be altered by effective interventions like housing, mental health care, and addiction treatment focused on harm reduction rather than coercion.

According to the report, the high utilizers list included 168 people over the last year—all individuals who have had at least 12 misdemeanor referrals to the city attorney’s office over the prior year, and at least one in the most recent eight months. Of those, 142 were booked into the downtown jail for misdemeanors or warrants, under a special exception to jail rules that have eliminating booking for most misdemeanors. On average, each “high utilizer” served 117 days in jail in jail last year—nearly four months per person.

In January and February 2022, before the high utilizer initiative went into effect,  the average daily population at the downtown jail was 910; for the same period this year, it was 1,220. The increase is the result of a complex mix of factors, but jailing 142 people for low-level misdemeanors is undoubtedly among them.

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Because most of the people on the high utilizers list ended up incarcerated, the report notes, they ended up fewer crimes than they had in previous years, averaging 2.7 misdemeanor referrals per year compared to a pre-initiative average of 6.3. This, the report says, is proof the initiative is working: “The principal reason for the significant drop in high utilizer criminal activity was that they were quickly held accountable and booked into jail for their criminal activity,” the report says. “Holding high utilizers accountable for repeat criminal conduct is the game-changer that reduced their impact on the City.”

Already, these numbers are speculative—who can say, for example, whether a “high utilizer” who received housing and case management, rather than blunt-force punishment, would have gone on to commit their own “average” number of misdemeanors? The report veers further into extrapolation and guesswork with an “estimate” that locking people on the list up for misdemeanors has prevented “over 750 criminal police referrals reflecting many thousands of criminal acts.” If this is true (and if “high utilizers” are really superpredators who deserve harsher treatment, including exclusion from community court), the city’s overall misdemeanor rate should have declined appreciably. Yet according to the Seattle Police Department’s 2022 crime report, misdemeanor theft (which includes shoplifting and theft from buildings) went up 5 percent last year.

The report includes “examples of reduced public safety impact” identifying some of the high utilizers by first name and last initial, making them easily identifiable—something PubliCola has not done when writing about the initiative in an effort to avoid re-traumatizing people who may have been targets of negative media attention. It also lists people, by name, who “absconded” from mandatory treatment for their addictions or died during the period covered by the report.

Not surprisingly, the report also concludes that people “failed” to follow through with coercive residential treatment, which has an extremely low success rate, particularly for people with co-occurring mental illness and those experiencing homelessness. Even people who voluntarily enter residential treatment for opiate use disorder are likely to leave against medical advice, and the vast majority of people who enter traditional residential treatment relapse—facts that ought to argue in favor of different solutions, rather than more of the same.

According to Davison’s report, though, the problem is that the people on her list just aren’t “ready” to accept the treatment they’re offered.

Image from original high utilizers initiative announcement

“While there were a small handful of success stories, the great majority of times in which out-of-custody addiction treatment services were offered and accepted, the defendant fled within the first 24 hours,” the report says. “At least five high utilizers absconded on more than one occasion when they were given a chance to address their substance use disorders with treatment. … That leads us to the conclusion that most high utilizers are not ready to go direct to out-of-custody, voluntary addiction treatment programs.”

“If individuals stabilize during in-custody time, there is an opportunity to successfully graduate the individual to out-of-custody residential treatment after they had demonstrated active participation,” the report concludes.

King County does offer medication for opiate dependency behind bars—an evidence-based solution that, unfortunately, doesn’t work long-term if a person doesn’t have immediate access to equivalent treatment when they’re released. As we’ve reported, the county’s jail-based treatment programs suffer from the same lack of staffing that has led the ACLU to sue the county over inmates’ lack of access to basic physical and mental health care; jail-based treatment also has the best chance of succeeding if people can immediately access housing and health care when they’re released, something the jail system is poorly equipped to provide.

Addiction, criminal justice, Drugs, legislature

New Drug Possession Bill Emphasizes Coercive Treatment

State. Sen. June RobinsonBy Andrew Engelson

Democrats in the legislature are making procedural moves that will decide what the state’s new drug possession law will look like—an exercise that became necessary after the state supreme court’s 2021 ruling Blake v. State of Washington invalidated existing law. 

Whatever bill emerges will correct the element of current law the court found unconstitutional:  that someone who “unknowingly” possesses drugs could still be convicted. But the legislature is also taking the opportunity to debate what the state’s approach to drug use, and an unprecedented overdose crisis, will be. Various camps in this debate favor a criminal justice approach; a coercive treatment approach; or a public health approach focused on decriminalization.

The bill that has emerged from committee in the senate favors the “middle” option—coercive treatment—and amendments added in the past few days double down on that strategy.

Sen. Manka Dhingra (D-45, Redmond), who chairs the Law & Justice committee, is a strong supporter of decriminalization and safe supply. But her bill moving things in that direction,  which would implement recommendations in a report issued in December by the Substance Use Recovery Services Advisory Committee (SURSAC), didn’t have the votes to pass the Senate and never made it out of committee.

What did survive is a bill sponsored by Sen. June Robinson (D-38, Everett), that would make possession of a “small amount” of schedule 2 drugs (which include cocaine, fentanyl, and methamphetamine) a gross misdemeanor and require prosecutors to offer defendants diversion to treatment instead of jail time. 

“We’re basically saying: Upon conviction, you’re auto-enrolled in a substance abuse treatment program. But if for whatever reason you fail, if you choose to exit the program because you don’t feel like doing it—now there’s going to be consequences.”—Sen. Mark Mullet (D-5, Issaquah)

Last Friday, when the bill was in the Ways and Means committee, vice chair Sen. Mark Mullet (D-5, Issaquah) succeeded in adding a major amendment to the bill empowering (and in some cases requiring) judges to impose jail sentences on defendants who fail to complete treatment.

Mullet told PubliCola he filed the amendment with input from Sen. Jesse Salomon (D-32, Shoreline), whose own drug possession bill, which is more punitive than either Dhingra’s or Robinson’s, failed to make it out of committee.

“We’re basically saying: Upon conviction, you’re auto-enrolled in a substance abuse treatment program,” Mullet told PubliCola. “But if for whatever reason you fail, if you choose to exit the program because you don’t feel like doing it—now there’s going to be consequences.”

This sort of language, focused on pushing drug users into treatment and demanding results, mirrors testimony that Salomon, who works as a public defender, gave during a committee hearing for his bill on Feb 6. Introducing that bill, Salomon expressed concerns about an “unacceptable level of public, open drug use,” and then told a story about seeing people using fentanyl outside his child’s day care, lamenting what he called  “a high level of public disorder and a decrease in public safety.” 

“Our current referral system… “ Salomon said in his testimony, “effectively only asks people to get help, but has no consequences when those folks don’t get help.”

Caleb Banta-Green, a researcher on substance use disorder at the University of Washington— and a member of the SURSAC committee that recommended decriminalization—says this approach ignores the realities of opioid and stimulant use. 

“You don’t treat substance use disorder,” Banta-Green said, “You manage it as a chronic relapsing condition. One of the challenges when the criminal legal system is involved is that if you have a return to use, you’re a failure and you’re committing a crime. Rather than: you’re showing symptoms of your disease and we’re going to continue to provide you care.”

Mullet’s amendment would give judges discretion on the first offense, but on the second offense, those who fail to complete treatment will face a minimum of 21 days in jail, and for a third offense a minimum of 45 days—sentences Mullet said are often be knocked down, with good behavior, to 14 days and 30 days, respectively.

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“Our hope is that in those 14 days, people can go through that kind of challenging withdrawal process where they don’t have access to substances,” Mullet said. “Then hopefully, at the end of those 14 days, now they’re in a better spot to realize: oh, maybe I should get treatment.”

Banta-Green says this is the approach the state has used for decades, and he believes it’s ineffective and harmful. “Incarceration is not innocuous,” he said. “I think legislators think it’s like having to go to a Motel 6 for the weekend and miss out on some parties.” A drug conviction and jail time can be a “scarlet letter” that limits a person’s future opportunities; it also “dramatically increases [the] risk of overdose,” Banta-Green said.

Two academic studies of people released from Washington state prisons have shown that the majority of deaths among those recently released from prison were overdoses and that within two weeks of release, inmates were 129 times more likely to overdose than the general population. 

Michelle Conley, director of integrated care at REACH, which serves unhoused Seattle residents with substance abuse disorders, says that for many of her clients who end up incarcerated, jail is detrimental to recovery. “People are traumatized by jail,” Conley said. “And then we’re 15 steps back from where they were. As providers we have to engage with them and rebuild trust… to make sure they see us as a provider and not just a part of the system.”

Even the bill’s seeming compromise between criminalization and decriminalization—coercive treatment—is problematic, Conley said.

Conley said the expectation that someone can be pushed into recovery with one session of 30 to 90-day inpatient treatment is unrealistic, especially if they’re released from treatment without ongoing support. “Churning people through this kind of treatment mill, and then sending them back on the streets, really serves as little more than a moment of respite,” Conley said. “Especially when people are released back to the same circumstances that drove them, oftentimes, to aggressive use.”

Not everyone who uses drugs needs to go to treatment, Banta-Green said, and people who would benefit from services “don’t want the treatment we have,” which often takes an all-or-nothing approach to sobriety. Instead of coercing people into conventional treatment with the threat of jail time, Banta-Green believes the state should implement one of the SURSAC committee’s recommendations: aggressively funding “health engagement hubs” that offer a range of services and treatment options to people who use drugs, including comprehensive harm reduction, health care, mental health care, addiction treatment, and medications.

“I absolutely believe that the criminal justice system is not the right place to deal with addiction. It’s just—this is where we are. And we need to move to provide alternatives, to provide other systems, and to fund and destigmatize other ways of helping people through addiction.”—Sen. June Robinson (D-38, Everett)

Banta-Green’s research team has worked with local public health agencies to establish pilot hubs in Seattle, Kennewick, and Walla Walla. He says the state would ideally have one of these hubs for every 200,000 residents, for a total of about 38 such facilities statewide.

Robinson’s bill directs the Washington Health Care Authority to “make sufficient funding available” to create health hubs within a 2-hour drive of all residents at the ratio to population Banta Green recommends. The bill also appropriates a $51 million—much of it from the state’s legal settlement with prescription opioid manufacturers—to fund opioid use disorder medications, crisis relief centers, and grants to LEAD and other programs that offer alternatives to arrest or jail time.  

Among other provisions, the bill legalizes handing out drug paraphernalia (such as smoking supplies) statewide, but an amendment added in the Ways and Means committee by Sen. Keith Wagoner (R-19, Sedro Woolley) would allow cities to opt out of that provision.

Dhingra added language to the bill that would set up a working group to study the creation of a safer drug supply system. Canada has incrementally started to experiment with prescribing pharmaceutical-grade drugs such as fentanyl to drug users to reduce the risk of overdose from street drugs, whose contents are unpredictable. However, that language also got stripped out of the bill in Ways and Means.

Following a year when King County had a record 998 fatal drug overdoses, all options should be on the table, Dhingra said.

 “If you want to help people get to recovery,” she said, “you have to make sure they’re alive in order to do that.”

Sen. Robinson, who sponsored the bill now moving forward, told PubliCola she believes her legislation offers a politically viable balance between restoring some criminal penalties and providing options for treatment.

Robinson, who has a masters in public health, said, “I truly believe all the research” about the need for a variety of approaches to drug use and addiction. “I absolutely believe that the criminal justice system is not the right place to deal with addiction,” she said. “It’s just—this is where we are. And we need to move to provide alternatives, to provide other systems, and to fund and destigmatize other ways of helping people through addiction.”

Robinson’s bill will likely get a floor vote this week, and it’s also likely that supporters of each competing approach to drug policy will offer a frenzy of competing floor amendments to shape the final bill. 

Addiction, City Council, legislature, Morning Fizz, Transportation

State Could Eliminate Jaywalking Law; Right-Wing Group Attacks Seattle Council for Addiction Program They Had Nothing to Do With

1. If you’ve ever lived outside the Pacific Northwest, or spent time in virtually any big city elsewhere, you may wonder why the state of Washington still has, and enforces, laws against “jaywalking”—the practice of crossing the street midblock or while the light is green but the road is clear. (“Jay-walking” is an antique slur for a rube who doesn’t know enough to keep out of the road). Crossing the street in an area other than an intersection or against a signal can set you back $68, and you’re far more likely to be targeted if you’re Black; according to a 2017 analysis, more than a quarter of jaywalking tickets issued between 2010 and 2016 went to Black pedestrians, even though just 7 percent of Seattle residents are Black.

This year, legislators plan to propose a bill that would eliminate the specific law against jaywalking—or “crossing not at a crosswalk,” as the state’s 57-year-old jaywalking law describes it—which would make it legal to cross the street as long as it’s safe to do so. During a recent Transportation Choices Coalition-sponsored forum, state Sens. Javier Valdez (D-46) and Marko Liias (D-21), the head of the Senate Transportation Committee, noted that legislators laid the groundwork for getting rid of the jaywalking ban by specifying that pedestrians, like drivers, must exercise “due care” when using roads and sidewalks.

Now, Liias said,  “I don’t think we need a specific violation for jaywalking, because if law enforcement sees someone that’s violating that duty of care, just like if they see any other user [doing so], they already have tools to hold that person accountable. When you look at the history of how these laws were used, it’s clear that there’s been disproportionate enforcement against low-income and BIPOC communities.” Basically, Valdez added, the change would give people the ability to use common sense when crossing the street without risking an automatic penalty. In areas where stoplights are far apart, the rational choice is often to cross midblock rather than walking a quarter-mile or more each way just to get to the other side of the road.

TCC, along with Commute Seattle, the King County Department of Public Defense, and other groups have started a coalition called Free to Walk Washington to support the elimination of jaywalking laws, which would follow similar changes in California, Virginia, Nevada, and Kansas City, MO.

2. Change Washington, a “strategic communications organization” funded by the right-wing organization Project 42, often makes and promotes some pretty outrageous claims about the city of Seattle on its website, which includes cross-posts from Project 42-funded ventures like the podcast of a well-known former local FOX reporter. Last week, though, they got the attention of a Seattle City Council member with a post that not only mischaracterized a well-established addiction management technique called contingency management, but accused the whole city council of proposing a “giveaway to drug addicts”—a claim without even a passing connection to reality. (The post uses the sneering slur “addict” no fewer than seven times.)

Contingency management is a method of helping a person reduce their drug consumption by offering them small rewards, such as money, a gift card, or a small prize, for a negative drug test. In numerous studies, contingency management has been found to be one of the most effective methods for reducing or eliminating drug use, particularly among people whose main drug of choice is stimulants, for which there are no broadly effective medications. There is longstanding, research-backed scientific consensus that contingency management works. Even so, the city council has never proposed funding it.

“The budget that City Council passed last month does not include funding for a contingency management program,” Herbold wrote Change Washington in an email. “I am unaware of any City Councilmember that has a proposal for a contingency management program,” she added, since the city doesn’t fund public health care programs—the county does. King County’s DCHS Behavioral Health and Recovery Division got approval last year to fund a contingency management pilot project.

After mischaracterizing contingency management as a frivolous “giveaway to addicts” that will just give them money to buy drugs and mocking its proponents for supposedly thinking “gift cards cure mental illness,” the conservative group also trashed needle exchanges, which prevent the spread of diseases like HIV and hepatitis, and said a better solution would be to force addicted people into (presumably locked) mental health facilities where they could be “monitored” to make sure they changed their ways. The post ends with a warning to council members about next year’s elections. But it looks like the election disinformation has already started.

Addiction, City Council, Development, Morning Fizz, Police

Diaz Almost Permanent Chief; Sawant Wants Impact Fees; Another Residential Treatment Center Shuts Down

1. Members of the city council’s public safety committee, which voted unanimously to appoint interim police chief Adrian Diaz to the permanent police chief position on Tuesday, were mostly effusive about Diaz’ performance at the final public hearing on his appointment, praising him for his efforts to recruit new officers, reinstate the community service officer program, and work collaboratively with the council. Council members did have a few pointed questions, though, about Diaz’ commitment to replacing police with civilian responders.

Like many other cities across the country, Seattle committed to creating new community-based alternatives to traditional policing amid protests against police violence in 2020; since then, other cities have moved forward with new strategies while Seattle has bogged down in process.

“Around the same time that members of this council were talking about creating a third public safety department and civilian alternatives to police, Albuquerque also started their journey. The difference between them and us is that we have two years of resolutions, workgroups, promises, talking, [and] misrepresentations [from the previous administration].”—Councilmember Andrew Lewis

“Around the same time that members of this council were talking about creating a third public safety department and civilian alternatives to police, Albuquerque also started their journey,” Councilmember Andrew Lewis said. Albuquerque, Lewis noted, has a similar budget to Seattle’s and has also seen its police department shrink from around 1,400 to fewer than 1,000 officers.

“The difference between them and us is that we have two years of resolutions, workgroups, promises, talking, [and] misrepresentations” from the previous mayoral administration, while Albuquerque stood up its new public safety department in 2021 and has diverted thousands of calls from the police department.

As we’ve reported, SPD is still in the middle of a lengthy risk analysis that is supposed to determine which kind of 911 calls are safe enough for a civilian response. That process is expected to stretch into 2024. Meanwhile, according to SPD’s latest hiring projections, the department will only grow by 18 fully trained officers in the next two years.

While transferring some low-risk work to trained civilian responders would be one way to free up SPD officers for police work and investigations, another option could be reducing the amount of overtime police burn through directing traffic and providing security for sports events, which added up to more than 91,000 hours through October of this year. Diaz didn’t seem particularly open to this suggestion, either, noting that there is always a risk of violence at large events, such as someone trying to drive through a barricade.

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2.  Also on Tuesday, the city council voted unanimously to move forward with a plan to exempt many affordable housing projects from the design review process for another year—effectively signing off on the once-controversial view that design review leads to unnecessary delays that makes housing more expensive.

However, one of those “yes” votes, Councilmember Kshama Sawant, voted “no” on a separate package of amendments to the city’s comprehensive plan because they did not include “developer impact fees,” which some cities levy on housing developers to offset the toll new residents create on urban infrastructure like roads and sewers. One reason such fees are controversial is that they imply that new housing has a negative impact on the city, without considering the positive impacts (such as reduced traffic congestion, less sprawl, and more customers for local businesses) of dense, vibrant neighborhoods.

Since the city can’t pass developer impact fees until they’re included in the comprehensive plan, Sawant said, the vote to approve the amendments “means that we need to wait another year to make big developers pay for the impacts they have on our city infrastructure and for the profits they make without paying even this minimum of compensation for the city’s working people.” During the 2020 budget deliberations, Sawant joined her colleague Councilmember Alex Pedersen in seeking $350,000 for a study of impact fees; although Pedersen is generally far to the right of socialist Sawant, a shared opposition to most development frequently puts them on the same side of housing-related issues.

Low-income people and people experiencing homelessness often have to wait weeks or months before getting into residential treatment—a fact that flies in the face of calls to force more people in crisis into treatment under the state’s involuntary treatment law.

3. Pioneer Human Services, which offers treatment to low-income people with substance use disorder, is closing its 50-bed Pioneer Center North facility in Skagit County next month amid an acute regional shortage of residential treatment beds for low-income people and people seeking treatment during or after serving time in jail.

According to agency spokeswoman Nanette Sorich, there were a number of reasons for the “difficult decision,” including the fact that “the building has been operating on a short-term lease and the facility is past its useful life. Additionally, like many behavioral health providers, we have faced significant challenges with staffing and these labor force shortages have become more acute over time,” Sorich said.

The Sedro-Wooley inpatient clinic had 77 beds before the pandemic. Pioneer Human Services will now refer potential clients to its other clinics in Everett and Spokane, Sorich said.

Low-income people and people experiencing homelessness often have to wait weeks or months before getting into residential treatment—a fact that flies in the face of calls to force more people in crisis into treatment under the state’s involuntary treatment law. Since 2018, King County has lost more than 110 residential treatment beds and is now down to 244 beds countywide. A countywide levy, on the ballot next April, would restore the number of residential beds in King County to 2018 levels; the bulk of the $1.25 billion proposal would go toward five new walk-in crisis stabilization centers across the county.

Addiction, City Council, homelessness, Mayor Harrell, Police

Nelson, Pedersen Vote to Reject City Budget Because It Doesn’t Fund Everything They Want
Councilmember Alex Pedersen and Sara Nelson
Seattle City Councilmembers Alex Pedersen and Sara Nelson

By Erica C. Barnett

Seattle City Councilmembers Sara Nelson and Alex Pedersen voted against the city council’s amended 2023-2024 budget proposal at a council budget committee meeting Monday, joining socialist Kshama Sawant—who votes against the budget every year—in an ideologically split three-vote minority. The budget, which goes to the full council for a final vote tomorrow, requires a six-vote majority to pass; if even one more council member sided with Nelson, Pedersen, and Sawant, the entire budget would fail.

Nelson and Pedersen, who frequently formed a two-vote mini-bloc during the council’s budget deliberations, explained their decision in similar terms: They couldn’t vote for a budget that doesn’t fully fund Harrell’s public safety priorities. “I cannot in good conscience endorse a final budget that, I believe, fails to learn from recent public policy mistakes on public safety and fall short on public safety for a third year in a row,” Pedersen said.

That argument would hold more water if the council had proposed actually cutting SPD’s budget. Instead, the council fully funded SPD’s (and Mayor Bruce Harrell’s) entire hiring plan, and used savings from vacant SPD positions to provide the department with an additional $17 million a year to pay for, among other things, the recruitment and retention proposals Nelson and Pedersen have supported. No other department received this kind of kid-gloves treatment; in fact, many departments face dramatic cuts next year.

The council’s budget also returns the city’s parking enforcement division to SPD, another one of Harrell’s top budget priorities.

“Minor reductions [to proposed new SPD programs] are being emphasized and exaggerated. This is the harmful rhetoric that is likely to continue to negatively impact hiring and retention.”—City Councilmember Lisa Herbold

In contrast to previous years, such as 2020, it’s virtually impossible to make the argument that the council didn’t work with the mayor to craft a budget that retains most of what he wanted—a point Councilmember Lisa Herbold made when she accused her two colleagues of contributing to a “false narrative” about public safety.

“It’s normal to debate budget issues,” Herbold said. “But these false narratives don’t make us safer.”

“Ninety-nine percent of the mayor’s proposed budget is included in this balancing package,” Herbold continued. “SPD hiring is fully funded, and they’ve begun to show some promising trends. Minor reductions to the remaining 1 percent of the budget”—the elimination of new programs, such as a gunfire surveillance system and a marketing consultant—”are being emphasized and exaggerated. This is the harmful rhetoric that is likely to continue to negatively impact hiring and retention.”

Eliminating these new programs from next year’s budget helped the council close a late-breaking general-fund budget shortfall of $4.5 million, on top of the $141 million shortfall announced earlier this year.

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Nelson and Pedersen also objected to the council’s decision to eliminate, or abrogate, 80 of the 240 SPD positions that are currently sitting vacant; these vacant positions, which the city will use to augment the budget and fund new SPD spending next year, receive funding every budget cycle. The council’s budget will retain funding for at least 160 of these “ghost” positions going forward, and can add more positions in the future if SPD hiring suddenly skyrockets past the department’s own rather optimistic projections. Nonetheless, both Pedersen and Nelson have characterized this as an example of “defunding” the police. 

Nelson also criticized the council for failing to fund an expansion of the city’s graffiti abatement program and for moving homeless outreach workers out of Harrell’s new Unified Care Team (which the council fully funded) and into the King County Regional Homelessness Authority.

The two council members’ votes against the budget seem even less justified when you consider the concessions the rest of the council made to fund their priorities. 

Nelson, for example, got unanimous approval for a last-minute amendment that commits the city to spend some of the proceeds from a recent settlement with opioid distributors on abstinence-based rehab, marking the city’s first foray into the kind of public health decisions that are usually made by King County’s public health department.

Nelson was elected last year, and is staking out a position on the budget every bit as absolutist as Sawant’s: If the rest of the council doesn’t support her specific priorities, she’ll vote to reject the city’s budget wholesale.

In an op/ed earlier this year, Nelson expressed her view that medication-assisted treatment, such as the use of suboxone (an opioid) to treat opiate addiction, is “not aimed at long-term recovery.” This is the opposite of scientific consensus (the federal government’s substance abuse agency, for example, has a far more expansive definition of recovery that embraces long-term medication), but in line with Nelson’s general opposition to harm reduction programs— like the Public Defender Association’s LEAD and Co-LEAD programs, which provide case management and housing to people with addiction and other behavioral health issues.

Pedersen, meanwhile, managed to wrangle $3.5 million a year for bridge maintenance out of the Seattle Transportation Benefit District tax, which is supposed to fund transit, by arguing that because buses and bikes also use bridges, funding for bridges is a transit investment. That amendment passed 5-4—a major win for Pedersen at the expense of future transit projects.

Nelson was elected last year, and is staking out a position on the budget every bit as absolutist as Sawant’s: If the rest of the council doesn’t support her specific priorities, she’ll vote to reject the city’s budget wholesale. Time will tell if she continues down this all-or-nothing path.

Pedersen, in contrast, has apparently had a dramatic change of heart. Just two years ago, Pedersen wrote in a Seattle Times op/ed that it would be irresponsible for him to vote against the 2020 budget—which included far more dramatic changes than this year’s plan—just because he didn’t like everything that was in it.

“People are yearning for functional government. If the budget does not pass, nothing gets done,” Pedersen wrote. “No budget is perfect. Our constituents have diverse and conflicting views. A budget with positives and negatives is a natural result.”

“And to my constituents who ask, ‘Why did you vote the same way as Kshama Sawant?,” Pedersen concluded,
“I didn’t. She voted No.” This year, so did Pedersen.

Addiction, City Council, Economy, homelessness, human services, Mayor Harrell, Police, Taxes

Council Budget Eliminates 80 Vacant Police Positions, Preserves Human Service Pay, Moves Parking Officers Back to SPD
City Council budget chair Teresa Mosqueda

By Erica C. Barnett

The Seattle City Council’s budget committee, which includes all nine council members, moved forward on a 2023-2024 budget yesterday that will move the city’s parking enforcement division back to the police department, preserve inflationary wage increases for human service workers, and increase the city’s funding for the King County Regional Homelessness Authority—all while closing a late-breaking budget hole of almost $80 million over the next two years.

Every fall, the mayor proposes a budget and the council “rebalances” it, adding spending for their own priorities and removing items to keep the budget balanced. In November, after many council members had already proposed substantial changes to Mayor Bruces Harrell’s initial budget proposal, the city received news that tax revenues would be even lower than previously anticipated. The biggest unanticipated shortfall came from a decline in real-estate taxes, which pay for long-term capital projects, but other revenues, including parking taxes and money from the sweetened beverage tax, also declined.

Last week, council budget chair Teresa Mosqueda proposed a balancing package that saved money by declining to fund most of the new programs and program expansions Harrell proposed in his budget, while making several substantive policy changes. Among the most controversial: A proposal to eliminate 80 vacant positions in the police department, and a related plan to to keep the city’s parking enforcement officers at the Seattle Department of Transportation (SDOT), rather than moving them back to SPD, while the city decides on a permanent home for the unit.

“Our mayor’s budget did not delete these 80 [vacant police] positions, and if we trust in what the mayor asks for regarding public safety and the budgeting knowledge and skills and best practices of the city budget office, I don’t think we should do anything different here.”—Councilmember Alex Pedersen

The budget the committee adopted Monday night, nearly 12 hours into a meeting that began at 9:30 that morning, will eliminate the 80 vacant positions, while preserving another 160 vacant positions in future years. Vacant positions continue to be funded year after year unless the mayor or council takes action to defund them temporarily and use the money for other purposes, as Harrell’s budget does this year. Both the proposed budget and the one adopted by the committee on Monday use money  that would have gone to the 80 vacant positions to augment the city’s general fund, while using the savings from another 120 positions to pay for new spending within the police department. This week, the council got word that SPD had identified another 40 vacant positions, for a total of 240.

Council member Alex Pedersen opposed eliminating the 80 unfilled police positions, arguing that it would be wrong for the council to go against the “wisdom” of the City Budget Office, the mayor, and police chief Adrian Diaz, who want to keep as many positions vacant but funded as possible.

“Our mayor’s budget … did not delete these 80 positions, and if we trust in what the mayor asks for regarding public safety and the budgeting knowledge and skills and best practices of the city budget office, I don’t think we should do anything different here by abrogating or deleting these 80 positions,” Pedersen said.

Council member Sara Nelson added that eliminating vacant positions as a recurring budget line item could discourage people from applying for jobs at SPD and send a message to existing officers that the city did not support police hiring.

In response, council public safety chair Lisa Herbold pointed out that the budget fully funds the mayor and SPD’s hiring plan, which would increase the department by a net total of 30 officers in the next two years. (This hiring plan assumes a complete reversal, and then some, of current SPD hiring trends). It also keeps the remaining 160 vacant positions on the books, where they will be funded again automatically in 2025. For the city to need the 80 positions the council eliminated Monday, it would have to hire at least 190 net new officers, not counting new recruits who replace officers who leave the department. If that very unlikely scenario came to pass, the council could add funding for more officers—as it has many times in the past.

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“It’s really disappointing that … some people seem unwilling to say that the hiring budget is fully funded for the next biennium for the council to act on,” Herbold said. “That would send a positive factual message, rather than … distort what an abrogation of positions would do for the budget.”

Nelson and Pedersen also cast the only votes against a Herbold-sponsored proviso, or spending restriction, requiring the police department to get council approval if they want to use their staffing budget for anything other than salaries and benefits, arguing it was important to give SPD special flexibility to spend their budget how they want to.

“I believe we should stop micromanaging the use of salary savings and exercise some humility going forward because we simply don’t know what needs will need to be met,” Nelson said. “[Extra] overtime, for example, if there’s an earthquake or a mass shooting or something.”

In a last-minute compromise with Harrell’s office, the council agreed to move parking enforcement from SDOT to SPD, as PubliCola reported Monday. The compromise amendment uses administrative savings from the move (almost $9 million a year) to pay for several council spending priorities, including $1 million in one-time funds to support the Public Defender Association’s LEAD and Co-LEAD programs, which Harrell’s budget partially defunded; $1 million to “activate” City Hall Park in Pioneer Square, which has been fenced off since the summer of 2021; and $1 million for RV parking and storage “associated with non-congregate shelter,” among other new spending.

In a separate amendment, the council provided an additional $2 million a year for LEAD and Co-LEAD, which the PDA says still leaves them $5.3 million a year short of what it needs to fully fund both programs. The two programs provide case management and (in the case of Co-LEAD) hotel-based shelter for people involved in the criminal legal system, including many with behavioral health conditions that make it harder to find housing.

Morales had more success with another amendment that would place a budget proviso, or restriction, on $1 million in 2023 spending from the city’s transportation levy, requiring SDOT to spend it replacing plastic bollards that do not actually “protect” bike lanes with concrete barriers that do.

Here are some more highlights from Monday’s meeting, which was the last chance for council members to make substantive changes to the budget; for budget changes the council agreed on prior to Monday’s meeting, check out our coverage of those changes from last week.

• The council turned down proposals to place extra scrutiny on two programs that the council’s more conservative faction, led by Pedersen and Nelson, generally oppose. For example, they voted to remove $1.2 million in funding (all numbers are two-year figures) that Nelson wanted to spend on two full-time city staffers who would evaluate the JumpStart tax, which was just implemented last year.

The council also rejected two proposals by Nelson to apply extra scrutiny to LEAD and Co-LEAD, which take a harm reduction approach to addiction and low-level criminal activity rather than the abstinence-only approach Nelson favors (more on that in a moment). Specifically, Nelson wanted detailed information about the PDA’s subcontracts with REACH, the homeless outreach provider, and the basic details of both programs.

“What services are provided to the clients of LEAD?” Nelson asked Monday. “Which contractors do what for which program?”  because they do receive so much funding?” Additionally, Nelson proposed an amendment that would require quarterly reports on LEAD and Co-LEAD clients’ shelter and housing “acceptance” rates. Continue reading “Council Budget Eliminates 80 Vacant Police Positions, Preserves Human Service Pay, Moves Parking Officers Back to SPD” →

Addiction, Drugs, Health

King County is on Pace for a Record Year of Overdose Deaths
Overdoses in King County, 2012 (L) and 2021 (R)
Overdoses in King County, 2012 (L) and 2021 (R)

By Andrew Engelson

Tricia Howe, who directs an outreach program for drug users at REACH, Evergreen Treatment Services’ homeless outreach program, had firsthand experience of King County’s overdose crisis earlier this summer. In a matter of weeks, there were two overdoses outside REACH’s Belltown office.

“One of our case managers came into my office and said, “I think there’s somebody outside who doesn’t look like they’re breathing,” Howe said. “I grabbed a whole bunch of Narcan out of my drawer and ran outside.”

The man’s lips were blue, Howe said, and he wasn’t breathing, though he did have a pulse. She gave him a standard dose of naloxone nasal spray (Narcan), which can reverse the effect of opioids and restore a person’s breathing, but he failed to revive. So Howe gave him a second dose. “He took one deep breath, but was still not responsive,” she said. As Howe was preparing to administer a third dose, first responders arrived, put the man on oxygen, and he finally started breathing.

Based on the man’s response, fentanyl was almost certainly involved. The drug, which is up to 50 times more potent than heroin, can cause overdoses even among frequent opioid users. According to Howe, because fentanyl is cheaper to manufacture, it is quickly replacing heroin and oxycontin as the primary drug available to people who use opioids.

Data from the Washington State Patrol shows that the share of fentanyl in King County drug seizures has climbed dramatically, from around 10 instances in 2018 to more than 100 in 2021. Howe said that all of the counterfeit oxycodone (OxyContin) pills her staff have recently tested have been positive for fentanyl.

“It’s so available now and people are actually seeking it out at this point, where that was not the case before.” According to Howe, because fentanyl is cheaper to manufacture, it is quickly replacing heroin and oxy, and is making overdoses more common and more difficult to reverse. 

Though former mayor Ed Murray expressed early support for what would have been the first such sanctioned site in the US, Jenny Durkan’s administration showed little enthusiasm for supervised consumption. Durkan downgraded the plan in 2019 to a single site in a mobile van, citing concerns about the Trump administration’s legal action against a proposed consumption site in Philadelphia. 

A 2017 study showed that 83 percent of fentanyl overdoses in Massachusetts required a second dose of naloxone. Howe notes that overdoses of heroin or oxy were easier to reverse than fentanyl. “In the past, you could definitely expect the person to wake up and almost walk away,” says Howe.

Seattle and King County are in the midst of a severe overdose death crisis that began to spike during the pandemic and shows no sign of abating. People without shelter are particularly at risk. A ten-year study published in September by the King County Medical Examiner’s Office and Public Health Seattle-King County found that that accidental deaths nearly quadrupled  between 2012 and 2021 among people living unsheltered, and that overdoses now account for 71 percent of such deaths. 

As of last week, according to King County Public Health, there had been at least 710 fatal overdoses in the county this year. Of those, at least 473 involved fentanyl. That number has already eclipsed last year’s 708 overdose deaths, including 385 caused by fentanyl.

“When we first started our heroin and opioid task force in 2015, there were three fentanyl overdose deaths,” said Brad Finegood, a strategic advisor at the public health department. “The numbers have grown exponentially.”

Drug users tried to avoid fentanyl when it first arrived on the West Coast, Finegood said, but that attitude has dramatically shifted, and now people are actively seeking out fentanyl. According to a Pew study published in 2019 on drug use in San Francisco, more than half of opioid drug users now actively seek it, despite the dangers. Complicating matters, fentanyl is either smoked or vaporized and then inhaled, so traditional initiation barriers have fallen away.

“For younger people who are experimenting with drugs,” Finegood said, “that makes it much more feasible because they don’t have to use a needle.” Public Health and REACH have had to counter the misinformed belief that fentanyl is safer because it’s smoked rather than injected.

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According to the US Department of Justice, most fentanyl originates in China and is made into pills or powders by cartels based in Mexico. Batches of fentanyl that are poorly blended can result in what Finegood calls the “chocolate chip cookie effect,” in which pockets of higher concentrations cause accidental overdose.

A young man named Ian who was living in an encampment near the Home Depot in the Bitter Lake neighborhood said in August that he had no choice but to start using fentanyl. Originally from Wasilla, Alaska, Ian said he first became addicted to opioids while taking Oxycontin for pain. “Then oxy disappeared,” he said. In 2016, the CDC advised doctors to lower prescription levels of oxycodone and this, combined with the Drug Enforcement Agency’s recent crackdown on illegal and fraudulent prescriptions, has made medical-grade pills rare.

Ian said that in the absence of oxy, he did heroin for a while. “Then that disappeared. Now it’s all fetty.”

Half a dozen people at the encampment told me they use fentanyl and know many others who do. Nearly everyone had witnessed overdoses and several said they knew people who’d died.

“Everyone’s doing fetty,” said Jessie, who’s 26 and has been using drugs, including meth, since she was 11 years old. She didn’t live in the Bitter Lake camp, but was helping a friend pack up their belongings before the city came to sweep the site. “I’ve been sober, but it didn’t last,” she said. When asked if she’d seen friends overdose, Jessie said, “Yeah, of course.”

The transformation of fentanyl from risky outlier to the opioid of choice in King County mirrors national trends. In 2021, fentanyl accounted for the majority of overdose deaths in the U.S, though methamphetamine continues to be a close second, both nationally and locally. 

Although Seattle, King County, and the cities of Renton and Auburn formed an opiate overdose task force in 2015, local leaders have shelved a key recommendation from the task force’s report: establishing two supervised consumption sites in King County. 

Seattle could have been home to the first such sanctioned site in the U.S., following the lead of Vancouver, B.C. and 200 other sites currently operating elsewhere in Canada, Europe and Australia.

Though former mayor Ed Murray expressed early support for what would have been the first such sanctioned site in the US, Jenny Durkan’s administration showed little enthusiasm for supervised consumption. Durkan downgraded the plan in 2019 to a single site in a mobile van, citing concerns about the Trump administration’s legal action against a proposed consumption site in Philadelphia. 

“It’s a no-brainer. If you don’t want people to use right in front of you and you don’t want needles all over your parks, then you’ve got to give people a place where they can go.”—Tricia Howe, REACH

Even as the Biden administration changed course and said it would consider allowing sites, neither Durkan nor Mayor Bruce Harrell followed through on the scaled-back plan. Earlier this year, New York City moved past Seattle and opened two safe consumption sites that have already succeeded in preventing 500 deaths.

Kris Nyrop, who spent two decades working on HIV prevention among drug users in Seattle and helped design Seattle’s Law Enforcement Assisted Diversion (LEAD) program, says the window for action in King County is quickly closing.

“We have two years,” Nyrop said. “Biden is not going to prosecute if Seattle moves forward. So how do we get Mayor Harrell and a majority of the council behind this?”

In fact, Councilmember Lisa Herbold added $1.1 million to the 2021 Human Services Department budget to create safe consumption spaces in existing social services facilities. The city did not move forward on that approach and Harrell’s proposed 2023-2024 budget does not fund it. 

Instead, Mayor Harrell has vowed to crack down on people who sell and use drugs, in a highly publicized effort to target “hot spots” such as the intersection of 12th and Jackson in Little Saigon. Anyone walking through the area today can see that this short-term strategy was ineffective at reducing public drug use and sales in the area.

Howe said that the only effective way to reduce visible drug use on the street isn’t more policing, but sanctioned consumption sites. “It’s a no-brainer. … If you don’t want people to use right in front of you and you don’t want needles all over your parks, then you’ve got to give people a place where they can go.”

In the absence of sanctioned sites, Public Health has been quietly moving forward on other, lower-profile strategies aimed at empowering drug users to consume drugs as safely as possible. 

In addition to social media campaigns to educate young people about the extremely high risks of fentanyl pills (“blues”), Finegood says Public Health is doing more targeted educational outreach to users about safer consumption practices. 

This includes training drug users to recognize the symptoms of overdose, encouraging people not to use alone, and making the overdose reversal medication naloxone widely available. Finegood said Public Health has set up the first mail-order naloxone program in the country, and is working extensively with local pharmacies to offer the drug free, without a doctor’s prescription. “We’ve also set up a couple naloxone and fentanyl tester vending machines,” Finegood said. Continue reading “King County is on Pace for a Record Year of Overdose Deaths” →

Addiction, Drugs

Opioid Settlement Payouts to King County Cities Range from a Few Thousand Dollars to Millions
Map of fatal overdoses in King County, 2021; data available on King County’s overdose information site.

By Erica C. Barnett

Today is the deadline for cities and counties across the state to sign on as participants in the state’s $518 million settlement with the nation’s three largest opioid distributors, and it now appears all but certain that enough jurisdictions will sign agreements that the state will be able to keep the funds. As we reported earlier this week, the settlement—the result of a case Attorney General Bob Ferguson brought against the big pill distributors for their role in fueling opiate addiction—won’t be finalized unless all of Washington’s counties, and most of its cities, agree to participate.

The settlement will be split evenly between the state and local jurisdictions, with cities and counties receiving payouts worth a total of up to $203 million over the next 17 years based on a calculation that considers three factors—the number of deaths from opioid overdoses, the prevalence of opioid use disorder, and the quantity of opioids shipped to each jurisdiction—equally. Cities and counties have to spend the money on treatment, prevention, harm reduction, and other programs designed to reduce the harm of opiate addiction.

At a meeting of the Burien City Council this past Monday, council members expressed disappointment in both the size of the city’s allocation and the fact that cities won’t be able to receive their funds in a lump sum, which would provide more spending flexibility.

Some cities have been disappointed by the amount they’re set to receive. Burien, where there several dozen overdoses (from all causes) in 2021, stands to receive around $55,000 from the settlement, paid out in chunks of $2,700 per year after a first-year lump sum of around $5,400.

According to Attorney General’s Office spokeswoman Brionna Aho, the distribution of funds was “negotiated by the local governments. The state was not a party to those negotiations and had no part in deciding how much each city or county would receive.”

At a meeting of the Burien City Council this past Monday, council members expressed disappointment in both the size of the city’s allocation and the fact that cities won’t be able to receive their funds in a lump sum, which would provide more spending flexibility.

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“I do know that this is not much allocation to our city, and honestly I was disappointed that there was not more information shared from the Attorney General’s Office,” Councilmember Jimmy Matta said at the meeting. “At the same time, I know that the attorney general [fulfilled] his obligation as the attorney for the state.” Council members suggested that they might use the money to buy more doses of the opioid-reversal drug Narcan, or pool it with other jurisdictions to get more bang for the buck.

According to Burien City Manager Adolfo Bailon, there was never any question that the city would sign on to the settlement. “I think they were just interested in learning how the money can be distributed in a different way,” Bailon told PubliCola.

“We’re just grateful that something’s being done,” he added. “I am sure that we can put it to use some way or another.”

Other cities in King County will receive larger or smaller amounts based the formulas in a memorandum of understanding between the cities. Issaquah, for example, will receive about $380,000; Kent, around $1.1 million; and Seattle a little over $12 million. The smallest payout in King County will go to the city of Newcastle, which will receive a total of around $6,700. King County, which directly funds treatment and other services, will receive just over $28 million.

Addiction, Crime, homelessness, human services, Mental Health

Seattle’s “High Utilizers Initiative” Targets Frequent Offenders for Prosecution. Could It Be Put to Better Use?

By Erica C. Barnett

Six months ago, City Attorney Ann Davison announced a new initiative that would target so-called high utilizers of the criminal justice system—people with more than 12 misdemeanor referrals in the last five years—by subjecting their actions to greater scrutiny, excluding them from community court, and keeping them in jail for months, much longer than current misdemeanor booking restrictions allow.

Since launching the High Utilizers Initiative in February, the city attorney’s office has filed charges against people on the list 82 percent of the time, compared to a 63 percent charging rate for all misdemeanor cases so far this year. In 2021, under former city attorney Pete Holmes, the office charged people meeting the new “high utilizer” standard just 58 percent of the time. The initiative was also supposed prioritize this group for mental health services and treatment.

So far, the initiative has resulted mostly in more charges for people on the list, although the city attorney’s office says additional policy proposals are coming.

“We are declining fewer cases for this population than for the overall population,” deputy city attorney Scott Lindsay said. “I think it tells us that this effort is doing exactly what Ann said it would do: For individuals who are repeatedly having a significant disruptive impact on their neighborhood, we are trying to make sure that they are not slipping through the cracks.”

The initiative also allows the city to keep people on the list in jail for longer, bypassing rules that have prohibiting most misdemeanor bookings. “When somebody has a record of 35, 40 criminal cases and then they have a new property destruction case in Ballard and they’re saying you can’t do anything about that, that doesn’t make sense,” Lindsay said.

Critics of the high utilizers initiative argue, citing considerable research, that repeatedly jailing people who are homeless and suffer from significant behavioral health conditions does not reduce crime and makes the people being incarcerated sicker and less likely to be able to thrive in their communities. Anita Khandelwal, director of the King County Department of Public Defense, said the people on the high utilizers list “should not be subject to jail booking or prosecution for misdemeanor offenses; instead, they should be introduced to service providers who can develop community support and housing options without the hindrance and destabilization caused by repeated jailing and prosecution.”

“It’s hard to overstate the cruelty—and futility—of incarcerating a person who is not able to understand what is happening or to assist their attorney. What’s more, incarceration is destabilizing and leads to an increased risk of a person dying by suicide—as we have repeatedly seen happen at the King County Jail over the past year.”—Anita Khandelwal, director, King County Department of Public Defense

Lisa Daugaard, co-director of the Public Defender Association, whose programs serve people involved in the criminal legal system, said creating a list of people who are frequently arrested for misdemeanors isn’t a “good thing nor a bad thing by itself. It could be helpful if it caused local authorities to come up with a plan for these people’s situation, which is highly likely in need of a plan or support or intervention.”

So far, Daugaard acknowledges, the focus has been on the enforcement side.

“If they are choosing to file against people on the list more often, to me, that means we’re not getting busy making plans proactively for people who we already know are in difficult situations,” she said. “There should be a lot of energy pushing for programming and placement options that just don’t exist for this population right now—and they would have a lot of allies.”

PubliCola obtained a copy of the most recent high utilizers roster, from July, and reviewed the recent criminal and legal histories of each of the 111 people on the list. Two things stand out right away. First, the vast majority of people on the list are either homeless or show signs of housing instability; fewer than 10 had consistent residential addresses in the Seattle area. Second, most “high utilizers” show signs of major behavioral conditions, including addiction and mental illness.

In many cases, people’s behavioral health issues were so severe that a Seattle Municipal Court judge has recently questioned their ability to understand the charges against them and participate in their own defense, a process used to determine, among other things, if a case can proceed. Nearly half, or about 54, have been ordered to undergo a competency evaluation within the last year, and 30 have been found incompetent multiple times—a high bar that requires not just a transient lack of understanding (which might be caused by drug use) but a profound underlying mental health condition.

Prosecuting such people, Khadelwal says, is pointless and counterproductive. “It’s hard to overstate the cruelty—and futility—of incarcerating a person who is not able to understand what is happening or to assist their attorney,” Khandelwal said. “What’s more, incarceration is destabilizing and leads to an increased risk of a person dying by suicide—as we have repeatedly seen happen at the King County Jail over the past year.”

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Katie landed on the high utilizers list after racking up more than two dozen separate charges in the last five years—everything from tampering with a fire alarm to vehicle prowling to pedestrian interference, for walking in the middle of busy Rainier Avenue South. She spends most of her time in Ballard, despite restraining orders and arrests and people warning her, over and over, to stay out of the area. She has a connection to the neighborhood—it’s where her family once lived, she has told officers and court officials and anyone who will listen, and where her “street family” lives now.

Mostly, Katie’s charges involve stealing from, screaming at, and harassing employees and patrons of businesses and institutions in Ballard’s commercial core, including retail stores, a car dealership, and the Seattle Public Library. Typically, she will enter a business, yell and knock things down, and run off with random items, such as pile of Starbucks paper cups a barista set outside one day. For just one person, people familiar with Katie say, her impact is tremendous; she might enter a single business multiple times a day, causing havoc and running out only to return a few hours later.

Katie has also assaulted people directly—pulling an earring off a waitress who told her to go away, attacking an employee at St. Luke’s Presbyterian Church, which offers daily meals from its building across from the Ballard Commons. St. Luke’s is among at least half a dozen Ballard businesses that have a no-contact order barring Katie from coming within 1,000 feet of their property—an almost unprecedented move for a church whose institutional mission includes serving Ballard’s homeless population. Earlier this year, because of her status as a “high utilizer,” she was detained for nearly five months at the King County Jail; when she got out, she went straight back to Ballard, where she was promptly arrested—not for harming anyone, but for simply being there.

This time, the city attorney’s office didn’t seek to keep Katie in jail , and she was released two days after her arrest. But her months-long stay in jail had consequences she was still living through. During that period, her name had come up on a waiting list for housing, but no one noticed; as a result, she missed a crucial deadline and fell off the list. Now, after case conferencing that included representatives from the city attorney’s office, she’s staying in a tiny house in a neighborhood across town. But she’s still barred from most of Ballard, which will make it hard for her to avoid arrest in the future.

Despite her erratic behavior, Katie has been found competent at least once, after two previous incompetency findings. Her most recent evaluation, in February, concluded that she was competent to stand trial as long as she stayed away from drugs—a conclusion that shows one of the limits of “competency” as a measure of behavioral health.

Peter, another “high utilizer” who has been found incompetent to stand trial repeatedly, most recently in July, frequents the University District, where his name is on a private list of high-impact individuals maintained by the University District Partnership (UDP), which represents businesses in the area.

“There may be a reason to incarcerate a person to keep them away from everybody else and stop them from doing that [behavior] for some period of time. But does state punishment itself cause a positive change in people? I think the answer is clearly, no, it does not.”—Daniel Malone, Director, Downtown Emergency Service Center

Peter—also a pseudonym—has been arrested repeatedly for walking into businesses, stealing small items—a can of Campbell’s chicken and dumpling soup, an Ace bandage, a bottle of A&W root beer—and threatening employees who catch him or tell him to leave. He says things like, “If you stop me, I have a gun and I will kill you,” and “fuck you, I’ll kick your ass,” and “if you call the police, I will murder you,” according to police reports. On occasion, he’s taken a swing or tried to “head butt” a clerk. Once, he grabbed a “small pink pen knife” from a homeless woman’s cart and pointing it toward a Safeway clerk, Other than the pen knife, which he returned to the woman who owned it, police reports do not indicate that has ever been caught carrying a weapon.

Peter is also, as his many incompetency findings make clear, profoundly disabled, to the point that he’s frequently incapable of carrying on a coherent conversation. He may be “terrorizing” a neighborhood, but he’s also lost in his own delusions of money, grandeur, and persecution; it’s hard to imagine him understanding the nature of the charges against him, much less sitting still in front of a judge and testifying in his own defense.

“We have a lot of clients who are just so gravely disabled that you’re not going to get the same result if you tell them to do something” the way you would with most people, said Ailene Richard, the North Seattle LEAD supervisor for the homeless outreach organization REACH. “They’re not internalizing information in the same way. You have to ask people, what is your motivator? Why do you keep stealing things? Even to do that takes relationship building and trust building.”

The UDP participates in case conferencing—a process that involves sitting down with representatives from Mayor Bruce Harrell’s office, neighborhood organizations, LEAD, REACH, and the city attorney’s office and figuring out how to address and assist people who are having a negative impact on local residents and businesses. But for cases like Peter’s, UDP president Don Blakeney says, they’re at a loss.

“What is the solution for someone who is having a negative impact on the neighborhood but is not really a great candidate for behavioral change?” Blakeney said. “Those kind of people on the list are going to be hard [to deal with]—they can’t keep impacting the neighborhood the way they do because it’s terrifying of folks who are stuck in one place,” such as behind the counter at a retail store. “If you get to a point in the neighborhood where people are doing that every day, it has a cumulative impact.”

The Downtown Seattle Association, which supported previous efforts to crack down on drug dealing and sales of stolen goods such as the short-lived Operation New Day, also supports the high utilizers initiative. But the group’s CEO, Jon Scholes, says simply arresting people and releasing them back into the community without health care and housing won’t address the impact high utilizers have on the neighborhood or help them access the services and housing they need. “There’s very few people in our constituency who want to lock up mentally ill people forever—they they want to reduce the impact [and] they want a better outcome.”

Unlike the University District and SoDo neighborhoods, which have access to case conferencing, Scholes said the city and service providers “haven’t set that kind of table with us and other [business] groups. We’ve never set aside the housing and other services that are really needed for this population. …A list is just a list if there’s no meaningful intervention that’s being offered.”

Both Katie and Peter, along with many others on the high utilizers list, are connected with case managers from groups like REACH and LEAD, which work with unhoused people facing charges and those who have co-occurring behavioral health conditions, including mental illness and addiction. But identifying appropriate housing and services for people with huge, sometimes lifelong, challenges takes time, even years, and in the meantime, the prescription from the city attorney’s office often prioritizes immediate neighborhood demands. 

And even some homeless service providers say there are times when jail is justified. Staffers for the Downtown Emergency Service Center, which has provided (or currently provides) shelter or housing for many of the people on the high utilizers list, call police when a client assaults another client or threatens guests or staff—as happened earlier this month, when a man on the list exposed himself to residents and staff at DESC’s Hobson Place apartments.

“When I first heard about the so-called high-utilizers program,” Municipal Court Judge Damon Shadid said, he hoped Davison’s office would “gather certain information on people who are having a high impact on the community” and “figure out how to address them in a useful way. That is not what happened. Instead, we were handed a list of people who we were told were not eligible for the primary diversion program at the court, and we were not offered a solution other than the primary solution of putting people in jail.”

“We’re supposed to [call police] not just when we’re upset at a lack of compliance or cooperation, but when it’s reached a point where we’re unable to manage the situation safely and effectively,” Malone said. “There may be a reason to incarcerate a person to keep them away from everybody else and stop them from doing that [behavior] for some period of time. But does state punishment itself cause a positive change in people? I think the answer is clearly, no, it does not.”

Richard said going in and out of jail all the time can cause “tremendous” harm—”jail is not a therapeutic place.” At the same time, jail can provide “a sort of break from everything they’re usually doing,” she added. “Sometimes if we’ve had trouble finding that client, that’s a way we can contact them. It is sometimes the only opportunity that we have to be able to meet with certain folks who we have not been able to find on outreach.”

Seattle Municipal Court Judge Damon Shadid oversees community court, an alternative to mainstream criminal court that offers access to services such as mental health and addiction treatment, occupational therapy, and life skills classes. He says the city attorney’s office needs to demonstrate, with clear evidence, that jail is helping not just businesses and neighborhood residents but the people who are being jailed over and over again with few visible results. “If they’re going to charge these people more, they need to prove that they’re having a positive impact.” So far, he said, they haven’t done so.

Instead, Davison took action early in her term to specifically deny access to community court to anyone on the list, arguing that people who commit the same offenses repeatedly need strict accountability, not treatment and classes. Davison, and Lindsay, especially objected to the fact that community court is a “release first” model, which gives people who enter the program the benefit of the doubt instead of, as Khandelwal put it recently, keeping people in jail “simply because they are too poor to post bail.” Continue reading “Seattle’s “High Utilizers Initiative” Targets Frequent Offenders for Prosecution. Could It Be Put to Better Use?” →

Addiction, King County, Mental Health

County Plans Emergency Walk-In Centers for Behavioral Health Crises
King County Executive Dow Constantine, flanked by Sheriff Patti Cole-Tindall and state Rep. Nicole Macri
King County Executive Dow Constantine, flanked by Sheriff Patti Cole-Tindall and state Rep. Nicole Macri

By Erica C. Barnett

On Thursday morning, King County Executive Dow Constantine announced his plan to introduce a plan to expand services for people experiencing behavioral health crisis as part of his 2023 budget proposal in September. The plan will attempt to address the worsening shortage of short- and long-term treatment for people with behavioral health conditions and substance use disorder. As of this year, Constantine said, the county has lost a third of its residential behavioral health care beds, “and it would have been more but for our intervention. And more facilities are potentially closing their doors in the months ahead.”

Currently, there is only one 16-bed crisis stabilization unit—the Downtown Emergency Service Center’s Crisis Solutions Center—in the entire county. A person in crisis who needs help right away can call 911 or the new 988 mental health crisis line, but people who need immediate, intensive intervention generally have nowhere to go but emergency rooms, which are ill-equipped to deal with behavioral health crises, or jail.

:I’m glad we’re here to be talking about potentially expanding [the crisis] system, but we can’t just expand it. We need to fix what is broken. And if I’m being honest with you, I am part of what’s broken, and every other behavioral health worker, because the system has put us in an impossible situation.” —DESC registered nurse Naomi Morris

Gesturing toward the King County Correctional Facility across the street from the county building where the press conference was taking place, Constantine noted that of about 1,530 people in the county jail, more than 600, or two in five, are in some kind of treatment for behavioral health conditions. Many of those have been jailed for crimes that are often related to mental health conditions and poverty, such as theft, trespassing, and assault.

“We cannot accept having the county jail as the main place for people to get behavioral health care. And right now, the fact is that the jail across the street is the second largest behavioral health facility in the state of Washington. We can’t accept relying on law enforcement to solve what is ultimately the health care challenge,” Constantine said.

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Constantine did not provide any details about the scope or cost of his plan, which the county is working on as part of a coalition with other elected officals—including state Rep. Nicole Macri (D-43), Seattle Mayor Bruce Harrell, and King County Councilmember Girmay Zahilay—and health care providers. However, he did indicate that in addition to new walk-in crisis centers, it will include better pay for behavioral health-care workers, such as Naomi Morris, a registered nurse who works for DESC.

“I’m glad we’re here to be talking about potentially expanding [the crisis] system,” Morris said, “but we can’t just expand it. We need to fix what is broken. And if I’m being honest with you, I am part of what’s broken, and every other behavioral health workerm because the system has put us in an impossible situation.” Morris said a coworker recently had to take unpaid leave to deal with the trauma caused by their job as a case manager and found themselves unable to meet their basic needs because “the amount of money they make [is] barely above what the clients we serve get.”

Earlier this year, the King County Regional Homelessness Authority asked the city to pay for salary increases for people who work for agencies like DESC; the KCRHA also funds its own in-house outreach team and pays them significantly more than nonprofit employees doing similar work.