We should be celebrating passage of mental health tax. Instead, we’re holding our breath
They always needed five.
For as long as the Pierce County Council has been debating the potential passage of a one-tenth of 1 percent sales tax increase to fund behavioral health services — which dates back years and several iterations of the elected body — that’s always been the magic number.
Five has always been the sticking point.
Until Tuesday evening.
That’s when — at long last — a solid, across-the-aisle agreement was finally reached. Generously, it wasn’t a Christmas miracle as much as it was the overdue culmination of too many studies, too much talking and too much wasted time.
Still, particularly with the recent example of just how dysfunctional and unpredictable the Pierce County Council can be, any decision to approve the collection of the long-needed behavioral health sales tax was noteworthy for one key reason.
Co-sponsored and championed by Republican Dave Morell, the effort finally cleared the hurdle that’s tripped the county up so many times before:
It secured five votes, the bipartisan supermajority necessary to pass.
Morell lined up with fellow Republican Doug Richardson and Democrats Connie Ladenburg, Derek Young and Marty Campbell and got it done.
Given the history, that’s nothing to sneeze at.
“It gets us to five (votes), which is the most important thing,” said Young, who co-sponsored the ordinance along with Ladenburg, who is wrapping up her eight years on the Council. “Would I do it this way? No, probably not. … But, again, it gets us to five.”
While there’s often been reason to believe such a thing no longer exists in the year 2020, Young’s comments underscore what the County Council’s behavioral health sale tax decision represents: a compromise.
It’s also a difficult one.
After calling for further planning back in March, Morell’s support of the tax ultimately was contingent on tying it to the launch of a pilot project that would completely re-imagine the way Pierce County serves Medicaid recipients.
The creation of a county overseen accountable care organization — or ACO — was something recommended by the county’s volunteer Regional System of Care Committee back in October, in response to Morell’s request.
Many, including Young and Ladenburg, believe it’s a good idea worth serious consideration.
Both also warn that the ordinance passed Tuesday — which makes state approval of the pilot program mandatory before a single cent is collected — carries significant risks.
Even if it is a good idea, an ACO pilot program would be a first in Washington, Ladenburg noted, and there’s no guarantee that the Washington State Health Care Authority will give us the go-ahead.
If that happens, Pierce County would be back to square one, she said.
“I think it’s going to be an uphill battle to get this passed through the state,” Ladenburg said Monday afternoon, prior to the vote, arguing — like some in the provider community — that she would personally favor splitting the two decisions.
“I do want to say that I’m very much in favor of (the ACO). … I think it’s a very good idea, but I think it’s going to be hard to get it done that way,” Ladenburg added.
Like Young, Ladenburg noted she was committed to pushing the state to OK the proposed Pierce County pilot project, despite her reservations.
According to Morell, the launch of an ACO overseen by the county has the potential to get at the root of many of Pierce County’s long standing behavioral health deficiencies.
If Council Democrats prefer taking on the two issues separately, he sees them as one-in-the-same
Passing a tax alone — which is estimated to bring in roughly $12 million a year for behavioral health services — would be like spreading peanut butter over the problem, Morell said
Conversely, he hopes that combining the tax with a new system that keeps more Medicaid dollars in Pierce County and provides local control over how money is spent will allow us to achieve the seismic shift that is necessary.
As The News Tribune’s Josephine Peterson has reported, under a new ACO the county estimates savings could reach as much as $1 billion dollars over the next 10 years.
Morell said it’s important to not just pass a new tax but leverage it into something more than a modest new revenue stream.
“The ACO drives the whole behavioral health change, system wide,” Morell told The News Tribune last week. “I felt that the (behavioral health sales tax) has to be part of a bigger answer to how we deliver behavioral health services in Pierce County.”
Although Tuesday’s vote wasn’t the finish line many hoped for, it did mark a new starting point — which is particularly meaningful for the thousands of Pierce County residents who stand to benefit from additional behavioral health services a new tax would fund.
Since the days of yore, we’ve been stuck in a feedback loop. Council Democrats have lobbied for the tax, routinely pointing to the overwhelming need and the fact that it’s already collected in every other major county in the state, red and blue, while key Pierce County Republicans have demanded a detailed plan for just how the new revenue would be spent.
On Tuesday, at least in theory, we got an ordinance that can satisfy both.
In the end, hopefully that’s what happens.
At the very least, it marked an important step in the right direction.
This story was originally published December 23, 2020 at 5:00 AM.
