“George” was an 18-year-old college freshman when he had his first episode of psychosis. Sharing with no one that he had voices inside his head and unable to focus on his studies, George left school without telling his parents.

Frightened, isolated and living on the streets, George’s future was unclear. Then he found help at Harborview Medical Center’s Behavioral Health Institute, where providers met George on his terms and helped him take incremental steps toward recovery.

George is among the countless King County residents profoundly impacted by Harborview Medical Center. Whether it is care at the region’s only Level 1 adult and pediatric trauma and burn center, psychiatric emergency services, infectious disease treatment, vascular surgery, stroke care or numerous other specialty disciplines, Harborview has delivered world-class, comprehensive medical care for all King County residents since 1877.

Regrettably, the aging and outdated facilities do not match the outstanding care offered by the dedicated and compassionate medical providers. Harborview’s resourceful health care workers have found ways to deal with this misalignment of architecture and medical care. But these workarounds are wildly inefficient and fall short of modern care standards.

Harborview has outgrown its space and the potential of its workforce to serve the health needs of our community. For example, every day in the emergency department, patients wait on gurneys in the hallway for a room.

King County voters have an opportunity to correct this challenge and safeguard Harborview’s ability to provide first-rate care by voting to approve King County Proposition 1 on their ballots.


King County Prop. 1 is a 20-year, $1.74 billion capital improvement bond that would help pay for critical upgrades to modernize Harborview’s facilities. These investments would allow the county-owned medical center to apply the latest infection control and privacy standards in its care with 360 new single-patient rooms to replace the two- and three-person rooms and wards currently in use. In addition, the bond measure would provide a much-needed emergency department expansion, increase behavioral health program capacity, renovate existing hospital buildings to adhere to the latest seismic building codes, and create space for 150 respite beds for patients who no longer require acute medical care but don’t have a safe home to go to.

Harborview operates at near 100% capacity at this time, impacting its ability to respond to a major medical event. The COVID-19 pandemic has further exacerbated the situation due to the need for patient isolation procedures. Just imagine how additional emergency department space would increase surge capacity to accommodate the anticipated influx of patients during a catastrophic event or accident, natural disaster or outbreak.

Prop. 1 would allow the county-owned public hospital to continue its mission to serve King County by providing quality care for its residents. Envision a new medical tower dedicated to delivering leading edge medicine for patients. Its 360 single-patient rooms would give patients and their visiting family members privacy, dignity, and meet modern-day infection-control and care standards. Imagine a building dedicated to cutting-edge and accessible psychiatric care, including a 24/7 psychiatric crisis treatment unit. Prop 1 can make these a reality.

King County Prop 1 will keep this important community investment strong by ensuring that the Harborview facilities match the staff’s commitment to providing excellent care for patients like George.

Today, George is in permanent housing. He has reconnected with family and friends, and has hopes of returning to school.

Let’s support Harborview so it can continue to treat patients who, like George, will arrive at Harborview at their most vulnerable moments, seeking healing and comfort from a health care institution that has dedicated itself to caring for King County residents for more than 140 years.