King County voters will, almost surely, decide this November whether to spend $1.74 billion to expand and modernize Harborview Medical Center in Seattle.

A committee of the Metropolitan King County Council on Tuesday unanimously approved sending a bond measure to the November ballot, which would allow the county-owned hospital to build a new, 10-story, 360-bed tower on its First Hill campus.

The measure still needs to be approved by the whole County Council before it is sent to voters, but it was approved by the Committee of the Whole on Tuesday, which has the same nine members as the full council.

The committee passed the measure Tuesday with little discussion and no debate. County Executive Dow Constantine has said he would like the Harborview bond to be the only tax measure on the November ballot, where it would need 60% of the vote for passage.

“I’m obviously concerned about the economic environment and the multiple crises that are part of our world suddenly, but the COVID crisis has only served to underscore how important Harborview is for the community,” Constantine said Tuesday. “I’m very hopeful folks will be able to understand the importance of us making this generational investment.”

It authorizes a property-tax increase averaging 8 cents per $1,000 of assessed home value over up to 20 years, which equates to an average tax increase of $75 a year for the median homeowner.


A planning group, which convened in 2018 to study proposed improvements at Harborview, recommended the bond measure earlier this year.

“The medical center’s facilities are aging and outdated in terms of modern medical best practice standards for infection control and privacy,” the group, which included County Councilmembers Joe McDermott and Rod Dembowski among its members, wrote in its recommendation. “The hospital operates at almost 100 percent capacity on a daily basis.”

Harborview, which is operated by University of Washington Medicine, dates back to 1877.

It is the only Level 1 trauma center for Washington, Idaho, Montana and Alaska. The hospital has 413 beds, but only 40 are in single-bed rooms, and 20 of those are reserved for psychiatric patients.

Most rooms contain two or more beds, separated by curtains, and many of those beds are often unusable as patients must be separated for infection control. Patients are doubled up in Harborview’s intensive care unit and burn unit, which lack special sections for children. They share bathrooms and hear each other as they undergo medical treatments.

Some emergency department patients are assigned to gurney bays, while others must make do with beds in hallways.

The bond would provide $952 million for the new tower, $79 million for a new behavioral health building and more than $700 million for renovations and seismic upgrades for other buildings.

Voters have previously approved bond measures for the hospital, most recently in 2000. That 20-year, $200 million measure is about to expire.

If voters approve the new measure, construction could begin by 2023.