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MIDD Renewal

About the MIDD Behavioral Health Sales Tax

The MIDD Behavioral Health Sales Tax is a countywide 0.1% sales tax that generates about $180 million per biennium. MIDD currently serves over 20,000 people each year through its funding of programs and services for people living with or at risk of developing behavioral health conditions. King County’s MIDD is managed and operated by the King County Department of Community and Human Services' (DCHS) Behavioral Health and Recovery Division (BHRD).

Since 2008, MIDD has funded high-quality programs and services that, collectively, work to reduce reliance on jails, emergency rooms, and hospitals, and create connections to the community for King County residents most in need. Broad support exists in King County for continuing and modernizing the behavioral health sales tax, and the MIDD Renewal Team is working closely with leadership from DCHS and the Executive’s Office to prepare an implementation plan for the next iteration of the MIDD behavioral health sales tax. 

The MIDD Renewal Team is currently working to imagine and realize the community vision for the next implementation of King County’s local behavioral health fund.

Learn more about MIDD here.

Updates About King County’s Behavioral Health Sales Tax Renewal

The MIDD Behavioral Health Sales Tax funds programs and services for over 20,000 King County residents each year. MIDD is scheduled to expire at the end of 2034.  

Broad support exists in King County for continuing and modernizing the MIDD Behavioral Health Sales Tax, and the Department of Community & Human Services’ (DCHS) MIDD Renewal Team is working to prepare an implementation plan for its next iteration.

What to Expect—MIDD Renewal Timeline

In 2025, the King County Council approved a proposed ordinance to extend MIDD for an additional nine years through 2034. DCHS and the Executive Office are now working to finalize the remaining steps and the implementation timeline. The Executive is expected to send a new plan to Council in 2026. DCHS’s Behavioral Health & Recovery Division will begin procuring programs in 2027 that will be launched the following year. These dates are subject to change. 

About MIDD Renewal community engagement (July 2024-October 2025)

The MIDD Renewal Team has been engaging providers, community-based organizations, and community members across King County to identify strengths and opportunities in the behavioral health system. Below is the updated community engagement report that provides more detailed findings. 

To learn more about the findings of the MIDD Renewal community engagement, click on the following link: Read the MIDD Renewal community engagement report.  

Frequently Asked Questions (FAQs) about MIDD Renewal

MIDD is a countywide behavioral health sales tax fund that plays an integral role in community behavioral health and serves to augment chronically insufficient federal and state investments in behavioral health. MIDD supports 54 initiatives, partners with 170+ community partners, and serves around 20,000 people annually. MIDD invests around $90 million each year in communities across King County.
MIDD was first introduced in 2008 and is up for renewal every eight years. In 2016, the King County Council voted unanimously to extend sales tax collection for MIDD through 2025. The MIDD Renewal is a process King County’s Department of Community and Human Services is undertaking to renew the sales tax collection and continue funding of behavioral health programs and services for King County residents.
The MIDD tax is a 0.1% sales tax, generating approximately $180 million every two years.
The MIDD fund supports programs and services that provide over 20,000 residents annually with behavioral health services. MIDD revenues represent 15% of the Behavioral Health and Recovery Division’s budget and pay for services not covered by Medicaid or that serve populations that are uninsured or underinsured. Renewing the tax ensures that these critical services continue and adapt to better meet community needs. Learn more about MIDD here and dig into MIDD Annual Reports here to see MIDD results over the years.
The Renewal Team is part of the Behavioral Health and Recovery Division in DCHS. The team is working with the department, division and the Executive’s Office, as well as community behavioral health partners, members of the community, and those most impacted by the services.
Community behavioral health providers in King County serve residents at a level above and beyond the national standard. MIDD was first created because too many people were ending up in jail or hospital emergency rooms or other costly and traumatic parts of the system because they didn’t get the care they need. MIDD Renewal is looking to expand access to care and get people the care they need before reaching a crisis.
King County is engaging with community and focusing on identifying needs, system gaps, and opportunities by listening to community members who work in and use public behavioral health services to ensure those voices are considered in the renewal process. This engagement helps gather valuable insights and feedback to shape the future use of local behavioral health funding. Phase One focused on gathering insights into the needs, gaps, and opportunities within the behavioral health system. It included virtual and in-person listening sessions, online surveys, and culturally specific community-based organization sessions. Phase Two will gather additional input from community members, especially from priority populations such as people with lived experience in behavioral health, youth, and people of color. It will also include reporting back to the community on what was heard in Phase One.
Details will be posted here on the website soon. The Renewal Team will be seeking additional input especially from people with lived experience in behavioral health, youth, BIPOC community members, and behavioral health service providers.
You can visit the King County MIDD Renewal webpage for updates and information on upcoming community engagement sessions. You can also learn more about upcoming opportunities to engage on Instagram. Follow @KingCountyDCHS.