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      <Desc>OUTPATIENT: VALLEY CITIES COUNSELING AND CONSULTATION (VALLEY CITIES), A NOT-FOR-PROFIT COMMUNITY BEHAVIORAL HEALTH CENTER, HAS BEEN THE LOCAL SOURCE FOR QUALITY BEHAVIORAL HEALTH COUNSELING AND CHEMICAL DEPENDENCY SINCE 1965 IN WASHINGTON STATE WITH CLINICS IN AUBURN, FEDERAL WAY, KENT, RENTON, MERIDIAN AT NORTHGATE, RAINIER BEACH, ENUMCLAW, MIDWAY, PIKE PLACE, BITTER LAKE, AND THE COHEN VETERANS NETWORK IN LAKEWOOD. VALLEY CITIES SERVES APPROXIMATELY 20,000 INDIVIDUALS EACH YEAR. VALLEY CITIES IS ACCREDITED BY THE JOINT COMMISSION ON THE ACCREDITATION OF HEALTHCARE ORGANIZATIONS (JCAHO) AND COMMISSION ON ACCREDITATION OF REHABILITATION FACILITIES (CARF). VALLEY CITIES PROVIDES LICENSED MENTAL HEALTH AND CHEMICAL DEPENDENCY TREATMENT FOR YOUTH AND ADULTS; SUPPORTED EMPLOYMENT AND EDUCATION SERVICES; OUTREACH SERVICES AND HOUSING PROGRAMS FOR THE HOMELESS; FAMILY SUPPORT PROGRAMS OFFERING YOUTH AND FAMILY ACTIVITIES; AND SPECIALIZED VETERANS SERVICES THAT DELIVER COUNSELING AND FAMILY SUPPORT SERVICES TO VETERANS AND THEIR FAMILIES. THE DEVELOPMENT DEPARTMENT CONDUCTS FUNDRAISING, MARKETING, PUBLIC RELATIONS, GRANT WRITING, AND PUBLIC POLICY ADVOCACY. THE HUMAN RESOURCES DEPARTMENT OVERSEES PERSONNEL, STAFF TRAINING, STUDENT INTERN, AND VOLUNTEER FUNCTIONS, AND THE ADMINISTRATION AND FINANCE DEPARTMENTS OVERSEE THE REVENUE CYCLE TEAM, SUPPORT STAFF, ACCOUNTING AND PAYROLL OPERATIONS. VALLEY CITIES CONTINUES TO INTEGRATE TRAINED AND CERTIFIED PEER SUPPORT SPECIALISTS INTO ALL PROGRAMS, ALLOWING THEIR OWN RECOVERY, AND MOTIVATING OTHERS TO FIND HOPE AND GROWTH IN THEIR RECOVERY PROCESS. VALLEY CITIES CLINICS OFFER A UNIQUE MODEL OF CARE, TEAM-BASED CARE. ALL CLIENTS ARE ASSIGNED TO A CASE MANAGER WHO THEN ASSISTS THEM IN CONNECTING TO RESOURCES IN THE AGENCY AND IN THE COMMUNITY. CLINICIANS ARE TRAINED IN EVIDENCED BASED TREATMENT MODALITIES INCLUDING CBT+ (TRAUMA FOCUSED COGNITIVE BEHAVIORAL THERAPY FOR CHILDREN) AND LOVE AND LOGIC PARENTING SKILLS. THROUGH CARE COORDINATION, VALLEY CITIES STILL TREATS CHILDREN, ADULTS AND OLDER ADULTS, BUT AS A TEAM APPROACH SO EACH INDIVIDUAL GETS THE FOCUS THAT THEY NEED. SERVICES ARE PROVIDED TO MEET THE NEEDS OF CHILDREN, YOUTH AND THEIR FAMILIES WITH MENTAL ILLNESSES OR EMOTIONAL DISTURBANCES; CHILDREN, YOUTH AND FAMILIES WHO ARE IN CRISES; AND CHILDREN AND YOUTH WHO ARE VICTIMS OF TRAUMA OR FAMILY VIOLENCE. THESE SERVICES INCLUDE INDIVIDUAL AND FAMILY COUNSELING; IN HOME FAMILY SUPPORT AND ADVOCACY; SCHOOL-BASED COUNSELING; CRISES INTERVENTION; CASE MANAGEMENT; PSYCHIATRIC ASSESSMENT; CASE COORDINATION WITH OTHER SERVICE PROVIDERS; MEDICATION MANAGEMENT; SUPPORT GROUPS AND SKILLS FOR TRAINING PARENTS; OUTREACH CLINICAL TEAMS FOR HOMELESS FAMILIES; COMMUNITY CONSULTATION AND EDUCATION; AND SPECIALIZED TREATMENT FOR THOSE WITH CO-OCCURRING MENTAL HEALTH AND SUBSTANCE USE DISORDERS. SERVICES ARE ALSO PROVIDED TO ASSIST ADULTS AND THEIR FAMILIES WITH CHEMICAL DEPENDENCY TREATMENT SERVICES. SERVICES ARE TRAUMA-INFORMED AND DESIGNED WITH AN EMPHASIS ON RECOVERY AND HOPE. VALLEY CITIES PROVIDES EMPLOYMENT AND EDUCATIONAL SERVICES SO THAT CLIENTS CAN BE SUPPORTED TO RETURN TO WORK OR SCHOOL. THE CHEMICAL DEPENDENCY SERVICES INCLUDE INTENSIVE OUTPATIENT AND SPECIALIZED RELAPSE PREVENTION SERVICES AND ARE INTEGRATED WITH THE MENTAL HEALTH SERVICES FOR THOSE CLIENTS THAT HAVE CO- OCCURRING MENTAL HEALTH AND CHEMICAL DEPENDENCY PROBLEMS. VALLEY CITIES' PROGRAMS CONSIST OF: CASE MANAGER AT EACH OUTPATIENT CLINIC THE CASE MANAGER IS THE MAIN POINT OF CONTACT AT VALLEY CITIES. THEY HELP WALK THE CLIENT THROUGH HOW TO GET SERVICES AT VALLEY CITIES, ASK THEM ABOUT WHAT DIFFICULTIES THEY ARE HAVING AND TRY TO FIND WAYS TO HELP. THEY CONNECT THE CLIENT WITH THE APPROPRIATE LEVEL OF CARE THAT IS NEEDED, WHICH CAN INCLUDE COUNSELING, MEDICATIONS, PEER SUPPORT, OR GROUPS. THEY ALSO HELP CONNECT THEM TO SERVICES IN THE COMMUNITY, LIKE A PRIMARY CARE PHYSICIAN OR A DENTIST. THE CASE MANAGER HELPS MANAGE ALL THE EXPERTISE NEEDED TO PROVIDE THE BEST OUTCOMES FOR CLIENTS. PEER SUPPORT SERVICES PEERS ARE LIVING, WALKING EXAMPLES OF HOPE AND THAT RECOVERY IS POSSIBLE. VALLEY CITIES PROUDLY OFFERS A RANGE OF SUPPORT SERVICES PROVIDED BY CERTIFIED PEER COUNSELORS. PEERS ARE AN INTEGRAL PART OF THE CARE TEAM AT VALLEY CITIES, OFFERING INSIGHT, EMPOWERMENT, AND ENGAGEMENT FROM LIFE EXPERIENCE. PEER SUPPORT IS BASED ON THE PHILOSOPHY THAT SOMEONE WHO HAS FACED LIFE CIRCUMSTANCES SIMILAR TO YOURS MAY BE THE PERSON WHO CAN UNDERSTAND YOU THE MOST. PEER SUPPORT COUNSELORS HAVE BEEN TRAINED, TESTED, AND CERTIFIED TO INSPIRE HOPE AND PROVIDE UNIQUE SUPPORT TO PEOPLE RECEIVING MENTAL HEALTH AND CHEMICAL DEPENDENCY SERVICES. BECAUSE OF THEIR UNIQUE EXPERIENCE WITH MENTAL ILLNESS, MENTAL HEALTH SERVICES, AS WELL AS SUBSTANCE ABUSE EXPERIENCE AND SERVICES, PEER COUNSELORS PROVIDE EXPERTISE THAT PROFESSIONAL TRAINING CANNOT REPLICATE. PEER SUPPORT COUNSELORS HAVE BEEN TRAINED, TESTED, AND CERTIFIED TO INSPIRE HOPE AND PROVIDE UNIQUE SUPPORT TO PEOPLE RECEIVING MENTAL HEALTH AND CHEMICAL DEPENDENCY SERVICES. BECAUSE OF THEIR UNIQUE EXPERIENCE WITH MENTAL ILLNESS, MENTAL HEALTH SERVICES, AS WELL AS SUBSTANCE ABUSE EXPERIENCE AND SERVICES, PEER COUNSELORS PROVIDE EXPERTISE THAT PROFESSIONAL TRAINING CANNOT REPLICATE. CHILDREN'S WRAPAROUND SERVICES VALLEY CITIES WRAPAROUND SERVES HIGH NEEDS YOUTH THROUGHOUT KING COUNTY, WITH A PRIMARY FOCUS IN SOUTH KING COUNTY, WHO ARE ELIGIBLE FOR ONE OF TWO WRAPAROUND PROGRAMS OFFERED. 1) WRAPAROUND WITH INTENSIVE SERVICES - WISE (YOUTH UTILIZING MEDICAID FUNDED MENTAL HEALTH TREATMENT) OR 2) MIDD WRAPAROUND (YOUTH INVOLVED IN AT LEAST TWO OF THE FOLLOWING SYSTEMS: MENTAL HEALTH, SPECIAL EDUCATION, JUVENILE JUSTICE, CHILD WELFARE, DDA - DEVELOPMENT DISABILITIES, AND CHEMICAL DEPENDENCY.) WRAPAROUND FACILITATORS, CLINICIANS, PARENT PARTNERS AND YOUTH PEERS WORK COLLABORATIVELY WITH THE YOUTH, FAMILIES, PROVIDERS AND COMMUNITY MEMBERS TO DEVELOP A CROSS SYSTEM CARE PLAN DRIVEN BY THE YOUTH AND FAMILYS IDENTIFIED NEEDS AND GOALS. WRAPAROUND FACILITATORS, CLINICIANS, PARENT PARTNERS AND YOUTH PEERS WORK COLLABORATIVELY WITH THE YOUTH, FAMILIES, PROVIDERS AND COMMUNITY MEMBERS TO DEVELOP A CROSS SYSTEM CARE PLAN DRIVEN BY THE YOUTH AND FAMILY'S IDENTIFIED NEEDS AND GOALS. WRAPAROUND STAFF FOLLOW TEN GUIDING PRINCIPLES AS THEY SUPPORT THE TEAM PLANNING PROCESS. THESE PRINCIPLES ARE: FAMILY VOICE AND CHOICE, TEAM BASED, NATURAL SUPPORTS, COLLABORATION, COMMUNITY-BASED, CULTURALLY COMPETENT, INDIVIDUALIZED, STRENGTHS BASED, PERSISTENCE AND OUTCOMES BASED. IN 2022, THIS PROGRAM PROVIDED INTENSIVE SERVICES TO A TOTAL OF 83 YOUTH. THE AVERAGE YOUTH IS SERVED IN WRAPAROUND FOR 18 MONTHS, AND OUTCOMES INCLUDE FEWER HOSPITAL VISITS, INCREASED SCHOOL ATTENDANCE AND ACHIEVEMENT AND FEWER POLICE CONTACTS. FAMILIES LEAVE WRAPAROUND WITH INCREASED ONGOING SUPPORT AND IMPROVED SKILLS TO NAVIGATE THEIR YOUTHS RECOVERY MOVING FORWARD. FAMILY TREATMENT COURT WRAPAROUND FAMILY TREATMENT COURT IS AN ALTERNATIVE TO REGULAR DEPENDENCY COURT AND IS DESIGNED TO IMPROVE THE SAFETY AND WELL-BEING OF CHILDREN IN THE DEPENDENCY SYSTEM BY PROVIDING PARENTS ACCESS TO DRUG AND ALCOHOL TREATMENT, JUDICIAL MONITORING OF THEIR SOBRIETY AND INDIVIDUALIZED SERVICES TO SUPPORT THE ENTIRE FAMILY. VALLEY CITIES IS THE ONLY WRAPAROUND PROGRAM IN THE STATE OF WASHINGTON TO WORK WITH ADULTS AS THE IDENTIFIED CLIENT, TO AMPLIFY THE PARENT'S VOICE IN THE DEPENDENCY PROCESS. ONE FTE WRAPAROUND FACILITATOR WORKS WITH THE TEAM TO DISCOVER THE INDIVIDUAL'S STRENGTHS, SET GOALS, DETERMINE MAJOR NEEDS, AND DEVELOP STRENGTH-BASED OPTIONS TO MEET THOSE NEEDS. VALLEY CITIES FACILITATOR WORKS WITH UP TO 15 FAMILIES AT A TIME TO PROVIDE THIS CRITICAL RESOURCE TO KEEP FAMILIES TOGETHER IN A SAFE AND HEALTHY ENVIRONMENT. THIS PROGRAM IS CONTRACTED BY KING COUNTY AND FUNDED THROUGH THE MIDD TAX INITIATIVE. MENTAL HEALTH FIRST AID (MHFA) PROGRAM VALLEY CITIES CONTINUES ITS PARTNERSHIP WITH KING COUNTY TO MAINTAIN A PROGRAM DESIGNED TO INCREASE THE NUMBER OF PEOPLE IN THE COMMUNITY TRAINED IN MENTAL HEALTH FIRST AID (MHFA). THE FOCUS IS TO REDUCE THE STIGMA ASSOCIATED WITH BEHAVIORAL HEALTH DISORDERS, TEACH PARTICIPANTS THE SIGNS AND SYMPTOMS OF MENTAL HEALTH CHALLENGES, HOW TO TALK WITH SOMEONE EXPERIENCING A CHALLENGE AND HOW TO CONNECT THEM TO PROFESSIONAL RESOURCES. TRAINING IS PROVIDED TO THE PUBLIC, INCLUDING PARTNERSHIPS WITH MANY ORGANIZATIONS, WITH THE FOCUS ON INCLUSION FOR ALL REGARDLESS OF GEOGRAPHIC LOCATION, RACE, OR NATIONALITY. IN 2022, 793 INDIVIDUALS PARTICIPATED IN A MHFA TRAINING AND 85 MHFA TRAININGS WERE HELD; 39 OF THOSE WERE ON YOUTH MENTAL HEALTH AND 46 WERE ON ADULT MENTAL HEALTH, 3 WERE TAUGHT IN SPANISH. IN RESPONSE TO COVID-19, MHFA TRAININGS WERE HELD VIRTUALLY WITH DIRECTION AND TOOLS FROM THE NATIONAL COUNCIL OF BEHAVIORAL HEALTH. THE FIRST BOUNCE BACK TO IN-PERSON MHFA TRAINING OCCURRED IN NOVEMBER 2022 AND WAS A SUCCESS. SCHOOL BA</Desc>
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        <Desc>MEDICAL SERVICES MEDICAL SERVICES INCLUDES BOTH STAFF PSYCHIATRISTS AND NURSE PRACTITIONERS. THEY PROVIDE PSYCHIATRIC EVALUATIONS AND MEDICATION MANAGEMENT SERVICES TO ANY CLIENT WHO NEEDS PSYCHIATRIC CARE. IN ADDITION, THE MEDICAL STAFF PROVIDES PSYCHIATRIC CONSULTATION TO A RANGE OF COMMUNITY HEALTH CENTERS THROUGHOUT KING COUNTY, ADVISING THE PRIMARY CARE STAFF WITH DIAGNOSTIC INFORMATION AND RECOMMENDATIONS ON PSYCHOTROPIC MEDICATIONS THAT CAN BE PRESCRIBED IN THE PRIMARY CARE SETTING. ALL EXPENSES RELATED TO THESE STAFF ARE CAPTURED IN THIS PROGRAM. CLINICAL SUPPORT SERVICES CLINICAL SUPPORT SERVICES INCLUDES INFORMATION SYSTEMS, ACCESS SERVICES INCLUDING ALL TELEPHONE SCREENING AND INITIAL INTAKE SERVICES, AFTER-HOURS CRISES TEAM, FRONT DESK SUPPORT, MEDICAL RECORDS, CALL CENTER AND QUALITY MANAGEMENT SERVICES. THESE PROGRAMS DIRECTLY SUPPORT ALL CLINICAL PROGRAMS BY PROVIDING EITHER CLIENT ASSISTANCE AND/OR DATA COLLECTION AND REPORTING IN ORDER TO MANAGE CLIENT CARE. RECOVERY PLACE SEATTLE (RPS) RECOVERY PLACE SEATTLE (RPS) IS A RESIDENTIAL TREATMENT FACILITY AND HOUSES A LICENSED MEDICALLY MONITORED 33 BED DETOXIFICATION SERVICE WHICH PROVIDES MEDICAL DETOXIFICATION INPATIENT SERVICES FOR PEOPLE WHO NEED SUPPORT TO SAFELY WITHDRAW FROM DRUG OR ALCOHOL USE. THIS 33-BED SERVICE PROVIDES SERVICES FOR A 3-5 DAY TYPICAL STAY. RPS ALSO HOUSES A 42 BED 28-DAY INTENSIVE INPATIENT PROGRAM FOR INDIVIDUALS LIVING WITH SUBSTANCE USE DISORDER CONCERNS. THIS PROGRAM OFFERS STRUCTURED, HOLISTIC, AND EVIDENCE- BASED PRACTICES, INCLUDING RELAPSE PREVENTION, COPING MECHANISMS (BOTH ABSTINENCE-BASED AND HARM REDUCTION), AND RE-CONNECTION TO COMMUNITY AND RESOURCES. CLIENTS PARTICIPATE IN COUNSELING AND SUPPORT GROUPS. THE AVERAGE DAILY CENSUS FOR DETOX AND RESIDENTIAL FOR 2022 WAS 10 AND 25, RESPECTIVELY. RECOVERY PLACE KENT (RPK) RECOVERY PLACE KENT (RPK) OPENED IN DECEMBER 2019 WITH 32 BEDS AND IS WASHINGTON STATES FIRST DUALLY LICENSED CHEMICAL DEPENDENCY &amp; PSYCHIATRIC FACILITY. THE EVALUATION AND TREATMENT PROGRAM PROVIDES INPATIENT CRISIS STABILIZATION SERVICES TO INDIVIDUALS WHO HAVE BEEN DETAINED UNDER THE INVOLUNTARY TREATMENT ACT (ITA) FOR DANGER TO SELF, DANGER TO OTHERS, OR GRAVE DISABILITY RELATED TO A PSYCHIATRIC ILLNESS. THE INTERDISCIPLINARY TREATMENT TEAM PROVIDES PSYCHIATRIC EVALUATION, MEDICATION MANAGEMENT, INDIVIDUAL MENTAL HEALTH AND SUBSTANCE USE DISORDER COUNSELING, GROUP ACTIVITIES, PEER SUPPORT, COORDINATION WITH KING COUNTY ITA COURT, AND DISCHARGE PLANNING TO RE-CONNECT CLIENTS TO COMMUNITY SUPPORTS. THE SECURE WITHDRAWAL MANAGEMENT PROGRAM OPENED DECEMBER 2019 IN RESPONSE TO HOUSE BILL 1713 "RICKY'S LAW". THE SECURE WITHDRAWAL MANAGEMENT SERVICES PROVIDES BOTH MEDICAL MANAGEMENT OF WITHDRAWAL FROM ADDICTIVE SUBSTANCES, PSYCHIATRIC EVALUATION AND SUPPORT, SUBSTANCE USE ASSESSMENT AND COUNSELING, MEDICATION MANAGEMENT, GROUP ACTIVITIES, PEER SUPPORT, COORDINATION WITH KING COUNTY ITA COURT, AND DISCHARGE PLANNING TO COMMUNITY SUPPORTS.</Desc>
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        <Desc>HOUSING SUPPORT SERVICES VALLEY CITIES OPERATES PERMANENT SUPPORTIVE HOUSING PROGRAMS THAT PROVIDE RENTAL ASSISTANCE WITH HOME-BASED CASE MANAGEMENT SERVICES FOR HOMELESS INDIVIDUALS AND HOMELESS FAMILIES. SUPPORTIVE SERVICES IN THESE PROGRAMS ADDRESS EVENTS AND CIRCUMSTANCES THAT UNDERLIE OR CONTRIBUTE TO THE INABILITY TO OBTAIN AND MAINTAIN AFFORDABLE AND STABLE HOUSING. THIS INCLUDES PATHWAYS FIRST, HOMELESS SERVICE ENHANCEMENT, SHELTER PLUS CARE, VALLEY CITIES LANDING, VALLEY CITIES PLACE AND PHOENIX RISING PERMANENT SUPPORTIVE HOUSING PROJECTS DEDICATED TO SERVING INDIVIDUALS, AND FAMILIES. TWELVE UNITS AT VALLEY CITIES LANDING AND EIGHT UNITS IN THE HOMELESS SERVICE ENHANCEMENT PROGRAM ARE DEDICATED FOR HOMELESS VETERANS. RESIDENTS ENGAGE IN ONSITE AND COMMUNITY-BASED SERVICES THAT HELP THEM LIVE WITH STABILITY, AUTONOMY AND DIGNITY. IN 2022, THIS PROGRAM SERVED 149 CLIENTS. FUNDING SOURCES INCLUDED KING COUNTY, HUD, WA STATE DEPT. OF COMMERCE; PLYMOUTH HOUSING; AND KING COUNTY HOUSING AUTHORITY. FAMILIES FIRST WITH FUNDING FROM THE KING COUNTY HOUSING AUTHORITY (24 VOUCHERS), THE FAMILIES FIRST PROGRAM IS DESIGNED TO PROVIDE HOUSING PLACEMENT AND SUPPORTIVE SERVICES TO 24 HIGH NEEDS FAMILIES IN KING COUNTY WHO HAVE HAD AT LEAST ONE CHILD OR ARE IN IMMINENT DANGER OF HAVING A CHILD REMOVED FROM THE HOME BY CHILD PROTECTIVE SERVICES. THE GOAL OF THE PROJECT IS REUNIFICATION OF THE FAMILY AND INCREASING HOUSING STABILITY AND SELF- SUFFICIENCY. THIS IS ACCOMPLISHED THROUGH INDIVIDUALIZED, INTENSIVE SERVICES TO FAMILIES ALONG WITH A FAMILY UNIFICATION PROGRAM (FUP) SECTION 8 VOUCHER (TENANT-BASED VOUCHERS) THAT CAN BE USED IN THE PRIVATE HOUSING MARKET. IN 2022, THIS PROGRAM SERVED 34 INDIVIDUALS AND A SUCCESS RATE OF 82% OF FAMILIES REMAINING STABLY HOUSED FOR AT LEAST 1 OR MORE YEARS. COMING-UP YOUTH PROGRAM THE COMING UP PROGRAM (CUP) IS A SUPPORTIVE HOUSING PROGRAM SUBSIDIZED THROUGH KING COUNTY HOUSING AUTHORITY (KCHA) AND KING COUNTY. CUP PROVIDED HOUSING AND SUPPORT SERVICES TO UP TO 22 HOMELESS YOUNG ADULTS IN SOUTH KING COUNTY AGES 18-24. THE GOAL OF THE CUP PROGRAM WAS TO PROVIDE PROGRAM PARTICIPANTS WITH A WRAPAROUND APPROACH TO SERVICES AND SUPPORT THAT WOULD ENABLE THEM TO ACHIEVE SELF-SUFFICIENCY. IN 2022, VALLEY CITIES WORKED WITH THE KING COUNTY HOUSING AUTHORITY (KCHA) TO MOVE FROM MASTER LEASED UNITS TO TENANT-BASED SEC. 8 VOUCHERS. AFTER A YEAR OF WORKING CLOSELY WITH KCHA TO COMPLETE THIS TRANSITION, VALLEY CITIES SEARCHED FOR AN APARTMENT COMPLEX WITHIN THE SOUTH KING COUNTY COMMUNITY THAT COULD PROVIDE 22 SET- ASIDE UNITS THAT WOULD ACCEPT TENANT-BASED SEC. 8 VOUCHERS. UNFORTUNATELY, DUE TO THE CURRENT RENTAL MARKET, MANAGEMENT COMPANIES THAT IN THE PAST WERE WILLING TO PARTNER ARE NO LONGER WILLING TO PROVIDE SET-ASIDE UNITS FOR THE POPULATION VALLEY CITIES SERVES. VALLEY CITIES WAS UNABLE TO LOCATE A COMMUNITY APARTMENT COMPLEX THAT WOULD PROVIDE 22 SET-ASIDE UNITS TO MEET THE GRANT REQUIREMENTS. CONSEQUENTLY, IN 2022, VALLEY CITIES MADE THE DIFFICULT DECISION TO END THE CUP PROGRAM AS OF DECEMBER 30, 2022. ALL CURRENT CUP PARTICIPANTS WERE PROVIDED ADVOCACY TO LOCATE ALTERNATIVE HOUSING PROGRAMS OR WERE PROVIDED ASSISTANCE TO GRADUATE WITH A SEC. 8 MOVE-ON VOUCHER TO PERMANENT HOUSING. NEW JOURNEYS DEMONSTRATION PROJECT PROGRAM THE NEW JOURNEYS DEMONSTRATION PROJECTS GOAL IS TO DELIVER AND IMPLEMENT A MODEL FOR FIRST-EPISODE PSYCHOSIS (FEP) TREATMENT THAT CREATES A POSITIVE CLIMATE AND MAINTAINS FIDELITY TO THE CLINICAL CONCEPTS AND CORE ELEMENTS OF COORDINATED SPECIALTY CARE (CSC) VIA THE NAVIGATE MODEL. PARTICIPANTS ARE KING COUNTY RESIDENTS BETWEEN AGES 15-40 WHO HAVE A PRIMARY DIAGNOSIS ON THE SCHIZOPHRENIA SPECTRUM WITH SYMPTOMS FOR LESS THAN TWO YEARS. THE MENTAL HEALTH SYMPTOMS ARE NOT A DIRECT RESULT OF OR STRONGLY IMPACTED BY AN AUTISM SPECTRUM DISORDER, SIGNIFICANT DEVELOPMENTAL DELAYS, LEARNING DISABILITIES OR OTHER MEDICAL CONDITIONS. NEW JOURNEYS PLACES A STRONG EMPHASIS ON OUTREACH AND ENGAGEMENT. VALLEY CITIES STAFF DEDICATE THEIR TIME TO MEETING PARTICIPANTS WHERE THEY ARE AT. THEY ENSURE PARTICIPANT AND ENGAGEMENT OF SUPPORTS BY OFFERING MOBILE SERVICES TO MEET THE VARYING NEEDS WITHIN RECOVERY. NEW JOURNEYS PROVIDES INDIVIDUAL SKILLS TRAINING AND THERAPY, GROUP THERAPY, FAMILY EDUCATION AND SUPPORT, CASE MANAGEMENT, EMPLOYMENT AND EDUCATION SERVICES AND PEER SUPPORT IN COMMUNITY SETTINGS. THEY ALSO OFFER MEDICATION MANAGEMENT AT A CLINIC FOR ENROLLED PARTICIPANTS. THE MANAGER PROVIDES SCREENINGS FOR REFERRALS, CLINICAL SUPERVISION, CONTRACT MONITORING, RELATIONSHIP BUILDING WITH THE REFERRAL BASE AND COMMUNITY EDUCATION ABOUT BOTH THE SCHIZOPHRENIA SPECTRUM AND SERVICES OFFERED BY NEW JOURNEYS. IN ADDITION TO WORKING WITH ENROLLED PARTICIPANTS AND THEIR SUPPORTS, THE MANAGER ALSO EXPLORES RESOURCES AND TREATMENT OPTIONS FOR THOSE INDIVIDUALS WHO DO NOT MEET THE ELIGIBILITY CRITERIA FOR NEW JOURNEYS. IN 2022, NEW JOURNEYS PROVIDED 5,980 SERVICES AND TRAVELLED MORE THAN 9,000 MILES TO ENGAGE PARTICIPANTS AND THEIR SUPPORT SYSTEMS. HUB AND SPOKES SERVICES ALSO KNOWN AS MATCH (MEDICATION-ASSISTED TREATMENT &amp; COMMUNITY HEALTH) IN 2017, VALLEY CITIES BEHAVIORAL HEALTH ENTERED A CONTRACT WITH SAMHSA AND THE HEALTH CARE AUTHORITY TO BEGIN PROVIDING LOW-BARRIER, RAPID ACCESS TO MEDICATIONS FOR OPIATE USE DISORDER (MOUD) AND RELATED SUPPORT SERVICES IN RESPONSE TO THE OPIOID EPIDEMIC. THE PRIMARY FOCUS OF THE MATCH PROGRAM IS TO INDUCT AND STABILIZE INDIVIDUALS WITH MOUD, WHO MEET DIAGNOSTIC CRITERIA FOR AN OPIOID USE DISORDER, WITH THE OPTION OF ON-SITE ADMINISTRATION OF AN OPIOID AGONIST (BUPRENORPHINE) OR AN OPIOID ANTAGONIST (NALTREXONE, PRIMARILY IN THE FORM OF EXTENDED-RELEASE INJECTABLE). AN ADDITIONAL FOCUS OF MATCH IS REDUCING BARRIERS TO INCREASE THE EASE OF ACCESS TO MOUD, TREATMENT AND CARE NAVIGATION. MATCH SERVICES CAN BE ACCESSED IN THE COMMUNITY AT ONE OF VALLEY CITIES OUTPATIENT FACILITIES THROUGHOUT KING COUNTY OR AT ONE OF THE TWO INPATIENT PROGRAMS, RECOVERY PLACE SEATTLE (RPS) AND RECOVERY PLACE KENT (RPK). IN RESPONSE TO THE ONSET OF FENTANYL AND THE SUBSEQUENT SPIKE IN OVERDOSE, OVERDOSE DEATH AND ACCIDENTAL POISONING, THE MATCH PROGRAM IS WORKING ASSERTIVELY TO ENSURE CONSISTENT ACCESS TO NALOXONE AND FENTANYL TEST STRIPS. THESE LIFESAVING ITEMS ARE DISTRIBUTED AT ALL VALLEY CITIES LOCATIONS. THE MATCH PROGRAM WORKS CLOSELY WITH ITS COMMUNITY PARTNERS TO PROVIDE INDIVIDUALIZED, EQUITABLE SERVICES. VALLEY CITIES CARE NAVIGATORS, PEER SUPPORT SPECIALIST, DATA COORDINATOR AND NURSE CARE MANAGER ALL WORK DIRECTLY WITH THE CLIENT TO CONNECT THEM WITH THE SERVICES THEY ARE SEEKING TO INCLUDE (BUT NOT LIMITED TO), PRIMARY CARE, DENTAL, BEHAVIORAL HEALTH, HOUSING, EMPLOYMENT, AND RECOVERY SUPPORT SERVICES. TO PROVIDE EVIDENCE-BASED, TRAUMAINFORMED CARE, THE MATCH PROGRAM REGULARLY ATTENDS CONTINUING EDUCATION OPPORTUNITIES AND ENGAGES WITH OTHER MOUD PROVIDERS AS A COHORT, TO BETTER UNDERSTAND THE COMMUNITY VALLEY CITIES IS SERVING AND TO STAY UP TO DATE ON THE MOST EFFECTIVE TREATMENT STRATEGIES. IN THAT SPIRIT, MATCH PROVIDES QUANTITATIVE AND QUALITATIVE DATA TO THE WASHINGTON STATE HEALTHCARE AUTHORITY, DBHR AND SAMHSA TO FURTHER THE MUTUAL GOAL OF HELPING THOSE WHO CONTINUE TO STRUGGLE WITH OPIATE USE DISORDER. IN 2022, MATCH SERVED 467 CLIENTS AND 396 OF THOSE WERE NEW INDUCTIONS. LOW-BARRIER BUPRENORPHINE SERVICE EXPANSION PROGRAM IN 2018, VALLEY CITIES FACILITATED ACCESS TO BUPRENORPHINE INDUCTION AND TREATMENT SERVICES THAT PROVIDE A CONTINUUM OF MEDICATION ASSISTED TREATMENT AND RECOVERY SUPPORT SERVICES DESIGNED FROM A RECOVERY AND RESILIENCY PERSPECTIVE AND AVAILABLE TO ELIGIBLE INDIVIDUALS IN KING COUNTY. VALLEY CITIES WORKED COOPERATIVELY WITH BEHAVIORAL HEALTH RECOVERY DIVISION (BHRD) ON A MUTUALLY AGREED-UPON PROCESS TO QUALITATIVELY EVALUATE TREATMENT ACTIVITIES TO HELP ANSWER QUESTIONS RELATED TO BUPRENORPHINE PROGRAM SUCCESS AND TO CREATE AND IDENTIFY LEARNING OPPORTUNITIES WHILE AN EFFECTIVE LOW-BARRIER MAT NETWORK IS DEVELOPED IN KING COUNTY. ASSISTED OUTPATIENT SERVICES PROGRAM THE ASSISTED OUTPATIENT SERVICES PROGRAM (AOSP) WAS CREATED BY KING COUNTY IN ORDER TO REDUCE OR PREVENT DECOMPENSATION, RE-HOSPITALIZATION, AND OTHER EMERGENCY BEHAVIORAL HEALTH RESPONSES FOR CLIENTS WHO HAVE BEEN DISCHARGED FROM COMMUNITY HOSPITALS AND EVALUATION AND TREATMENT (E&amp;T) FACILITIES ON A LESS RESTRICTIVE ORDER (LRO), LESS RESTRICTIVE ALTERNATIVE (LRA), OR CONDITIONAL RELEASE (CR). THE GOAL OF AOSP IS TO SUCCESSFULLY TRANSITION CLIENTS FROM A HIGHER LEVEL OF CARE TO OUTPATIENT BEHAVIORAL HEALTH SERVICES AS WELL AS ENSURE THAT CLIENTS MAINTAIN A HIGH LEVEL OF ENGAGEMENT IN OUTPATIENT SERVICES FOR THE DURATION OF THEIR LRO, LRA OR CR. KING COUNTY PROVIDES AN INCENTIVE PAYMENT WHEN VALLEY CITIES ENGAGES AN AOSP ENROLLED CLIENT IN AT LEAST 12 CONTACTS PER MONTH. CLIENTS ARE ENROLLED IN AOSP FOR THE DURATION OF THEIR LRO, LRA OR CR WHICH IS TYPICALLY 3 MONTHS BUT CAN BE 6 MONTH</Desc>
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        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>ALYSON WRIGHT</PersonNm>
        <TitleTxt>DIRECTOR</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <TotalReportableCompFromOrgAmt>2073426</TotalReportableCompFromOrgAmt>
      <TotalOtherCompensationAmt>90559</TotalOtherCompensationAmt>
      <IndivRcvdGreaterThan100KCnt>44</IndivRcvdGreaterThan100KCnt>
      <FormerOfcrEmployeesListedInd>false</FormerOfcrEmployeesListedInd>
      <TotalCompGreaterThan150KInd>true</TotalCompGreaterThan150KInd>
      <CompensationFromOtherSrcsInd>false</CompensationFromOtherSrcsInd>
      <ContractorCompensationGrp>
        <ContractorName>
          <BusinessName>
            <BusinessNameLine1Txt>MAXIM STAFFING SERVICES</BusinessNameLine1Txt>
          </BusinessName>
        </ContractorName>
        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>6021 244TH ST SW 400</AddressLine1Txt>
            <CityNm>MOUNTLAKE TERRACE</CityNm>
            <StateAbbreviationCd>WA</StateAbbreviationCd>
            <ZIPCd>98043</ZIPCd>
          </USAddress>
        </ContractorAddress>
        <ServicesDesc>STAFFING</ServicesDesc>
        <CompensationAmt>451776</CompensationAmt>
      </ContractorCompensationGrp>
      <ContractorCompensationGrp>
        <ContractorName>
          <BusinessName>
            <BusinessNameLine1Txt>CREDIBLE BEHAVIORAL HEALTH</BusinessNameLine1Txt>
          </BusinessName>
        </ContractorName>
        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>PO BOX 34456</AddressLine1Txt>
            <CityNm>BETHESDA</CityNm>
            <StateAbbreviationCd>MD</StateAbbreviationCd>
            <ZIPCd>20817</ZIPCd>
          </USAddress>
        </ContractorAddress>
        <ServicesDesc>EHR CONSULTANT</ServicesDesc>
        <CompensationAmt>370453</CompensationAmt>
      </ContractorCompensationGrp>
      <ContractorCompensationGrp>
        <ContractorName>
          <BusinessName>
            <BusinessNameLine1Txt>VALLEY JANITORIAL SERVICE</BusinessNameLine1Txt>
          </BusinessName>
        </ContractorName>
        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>PO BOX 2102</AddressLine1Txt>
            <CityNm>AUBURN</CityNm>
            <StateAbbreviationCd>WA</StateAbbreviationCd>
            <ZIPCd>98071</ZIPCd>
          </USAddress>
        </ContractorAddress>
        <ServicesDesc>JANITORIAL</ServicesDesc>
        <CompensationAmt>360587</CompensationAmt>
      </ContractorCompensationGrp>
      <ContractorCompensationGrp>
        <ContractorName>
          <BusinessName>
            <BusinessNameLine1Txt>UKRANIAN COMMUNITY CENTER OF</BusinessNameLine1Txt>
            <BusinessNameLine2Txt>WASHINGTON</BusinessNameLine2Txt>
          </BusinessName>
        </ContractorName>
        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>17701 108TH AVE SE SUITE 336</AddressLine1Txt>
            <CityNm>RENTON</CityNm>
            <StateAbbreviationCd>WA</StateAbbreviationCd>
            <ZIPCd>98055</ZIPCd>
          </USAddress>
        </ContractorAddress>
        <ServicesDesc>SUB-CONTRACTOR</ServicesDesc>
        <CompensationAmt>341778</CompensationAmt>
      </ContractorCompensationGrp>
      <ContractorCompensationGrp>
        <ContractorName>
          <BusinessName>
            <BusinessNameLine1Txt>CERO'S LLC</BusinessNameLine1Txt>
            <BusinessNameLine2Txt>ALERT SECURITY</BusinessNameLine2Txt>
          </BusinessName>
        </ContractorName>
        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>3691 NE JOHN OLSEN AVE</AddressLine1Txt>
            <CityNm>HILLSBORO</CityNm>
            <StateAbbreviationCd>OR</StateAbbreviationCd>
            <ZIPCd>97124</ZIPCd>
          </USAddress>
        </ContractorAddress>
        <ServicesDesc>SECURITY</ServicesDesc>
        <CompensationAmt>295097</CompensationAmt>
      </ContractorCompensationGrp>
      <CntrctRcvdGreaterThan100KCnt>7</CntrctRcvdGreaterThan100KCnt>
      <AllOtherContributionsAmt>2025068</AllOtherContributionsAmt>
      <TotalContributionsAmt>2025068</TotalContributionsAmt>
      <ProgramServiceRevenueGrp>
        <Desc>KING COUNTY CONTRACTS</Desc>
        <BusinessCd>621400</BusinessCd>
        <TotalRevenueColumnAmt>39475492</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>39475492</RelatedOrExemptFuncIncomeAmt>
      </ProgramServiceRevenueGrp>
      <ProgramServiceRevenueGrp>
        <Desc>STATE OF WASHINGTON</Desc>
        <BusinessCd>621400</BusinessCd>
        <TotalRevenueColumnAmt>5673640</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>5673640</RelatedOrExemptFuncIncomeAmt>
      </ProgramServiceRevenueGrp>
      <ProgramServiceRevenueGrp>
        <Desc>MEDICAID</Desc>
        <BusinessCd>621400</BusinessCd>
        <TotalRevenueColumnAmt>3077419</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>3077419</RelatedOrExemptFuncIncomeAmt>
      </ProgramServiceRevenueGrp>
      <ProgramServiceRevenueGrp>
        <Desc>LOCAL CONTRACTS</Desc>
        <BusinessCd>621400</BusinessCd>
        <TotalRevenueColumnAmt>1705137</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>1705137</RelatedOrExemptFuncIncomeAmt>
      </ProgramServiceRevenueGrp>
      <ProgramServiceRevenueGrp>
        <Desc>SUPPORTED HOUSING INCOME</Desc>
        <BusinessCd>624200</BusinessCd>
        <TotalRevenueColumnAmt>601102</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>601102</RelatedOrExemptFuncIncomeAmt>
      </ProgramServiceRevenueGrp>
      <TotalOthProgramServiceRevGrp>
        <TotalRevenueColumnAmt>803250</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>803250</RelatedOrExemptFuncIncomeAmt>
      </TotalOthProgramServiceRevGrp>
      <TotalProgramServiceRevenueAmt>51336040</TotalProgramServiceRevenueAmt>
      <InvestmentIncomeGrp>
        <TotalRevenueColumnAmt>8064</TotalRevenueColumnAmt>
        <ExclusionAmt>8064</ExclusionAmt>
      </InvestmentIncomeGrp>
      <GrossAmountSalesAssetsGrp>
        <SecuritiesAmt>500</SecuritiesAmt>
      </GrossAmountSalesAssetsGrp>
      <GainOrLossGrp>
        <SecuritiesAmt>500</SecuritiesAmt>
      </GainOrLossGrp>
      <NetGainOrLossInvestmentsGrp>
        <TotalRevenueColumnAmt>500</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>500</RelatedOrExemptFuncIncomeAmt>
      </NetGainOrLossInvestmentsGrp>
      <TotalRevenueGrp>
        <TotalRevenueColumnAmt>53369672</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>51336540</RelatedOrExemptFuncIncomeAmt>
        <ExclusionAmt>8064</ExclusionAmt>
      </TotalRevenueGrp>
      <GrantsToDomesticOrgsGrp>
        <TotalAmt>32280</TotalAmt>
        <ProgramServicesAmt>32280</ProgramServicesAmt>
      </GrantsToDomesticOrgsGrp>
      <CompCurrentOfcrDirectorsGrp>
        <TotalAmt>977384</TotalAmt>
        <ProgramServicesAmt>599572</ProgramServicesAmt>
        <ManagementAndGeneralAmt>377812</ManagementAndGeneralAmt>
      </CompCurrentOfcrDirectorsGrp>
      <OtherSalariesAndWagesGrp>
        <TotalAmt>31508227</TotalAmt>
        <ProgramServicesAmt>29801391</ProgramServicesAmt>
        <ManagementAndGeneralAmt>1529260</ManagementAndGeneralAmt>
        <FundraisingAmt>177576</FundraisingAmt>
      </OtherSalariesAndWagesGrp>
      <PensionPlanContributionsGrp>
        <TotalAmt>825070</TotalAmt>
        <ProgramServicesAmt>753300</ProgramServicesAmt>
        <ManagementAndGeneralAmt>69968</ManagementAndGeneralAmt>
        <FundraisingAmt>1802</FundraisingAmt>
      </PensionPlanContributionsGrp>
      <OtherEmployeeBenefitsGrp>
        <TotalAmt>3249432</TotalAmt>
        <ProgramServicesAmt>3077582</ProgramServicesAmt>
        <ManagementAndGeneralAmt>157375</ManagementAndGeneralAmt>
        <FundraisingAmt>14475</FundraisingAmt>
      </OtherEmployeeBenefitsGrp>
      <PayrollTaxesGrp>
        <TotalAmt>2820959</TotalAmt>
        <ProgramServicesAmt>2650570</ProgramServicesAmt>
        <ManagementAndGeneralAmt>153941</ManagementAndGeneralAmt>
        <FundraisingAmt>16448</FundraisingAmt>
      </PayrollTaxesGrp>
      <FeesForServicesLegalGrp>
        <TotalAmt>23240</TotalAmt>
        <ProgramServicesAmt>23240</ProgramServicesAmt>
      </FeesForServicesLegalGrp>
      <FeesForServicesAccountingGrp>
        <TotalAmt>57250</TotalAmt>
        <ProgramServicesAmt>53931</ProgramServicesAmt>
        <ManagementAndGeneralAmt>2950</ManagementAndGeneralAmt>
        <FundraisingAmt>369</FundraisingAmt>
      </FeesForServicesAccountingGrp>
      <FeesForServicesOtherGrp>
        <TotalAmt>496889</TotalAmt>
        <ProgramServicesAmt>444224</ProgramServicesAmt>
        <ManagementAndGeneralAmt>52665</ManagementAndGeneralAmt>
      </FeesForServicesOtherGrp>
      <AdvertisingGrp>
        <TotalAmt>149733</TotalAmt>
        <ProgramServicesAmt>102503</ProgramServicesAmt>
        <ManagementAndGeneralAmt>46440</ManagementAndGeneralAmt>
        <FundraisingAmt>790</FundraisingAmt>
      </AdvertisingGrp>
      <OfficeExpensesGrp>
        <TotalAmt>2679647</TotalAmt>
        <ProgramServicesAmt>2591760</ProgramServicesAmt>
        <ManagementAndGeneralAmt>78629</ManagementAndGeneralAmt>
        <FundraisingAmt>9258</FundraisingAmt>
      </OfficeExpensesGrp>
      <InformationTechnologyGrp>
        <TotalAmt>695777</TotalAmt>
        <ProgramServicesAmt>664118</ProgramServicesAmt>
        <ManagementAndGeneralAmt>30056</ManagementAndGeneralAmt>
        <FundraisingAmt>1603</FundraisingAmt>
      </InformationTechnologyGrp>
      <OccupancyGrp>
        <TotalAmt>3285656</TotalAmt>
        <ProgramServicesAmt>3003094</ProgramServicesAmt>
        <ManagementAndGeneralAmt>251203</ManagementAndGeneralAmt>
        <FundraisingAmt>31359</FundraisingAmt>
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      <TravelGrp>
        <TotalAmt>105896</TotalAmt>
        <ProgramServicesAmt>98480</ProgramServicesAmt>
        <ManagementAndGeneralAmt>7136</ManagementAndGeneralAmt>
        <FundraisingAmt>280</FundraisingAmt>
      </TravelGrp>
      <ConferencesMeetingsGrp>
        <TotalAmt>271207</TotalAmt>
        <ProgramServicesAmt>197041</ProgramServicesAmt>
        <ManagementAndGeneralAmt>71580</ManagementAndGeneralAmt>
        <FundraisingAmt>2586</FundraisingAmt>
      </ConferencesMeetingsGrp>
      <InterestGrp>
        <TotalAmt>335279</TotalAmt>
        <ProgramServicesAmt>335279</ProgramServicesAmt>
      </InterestGrp>
      <DepreciationDepletionGrp>
        <TotalAmt>1506694</TotalAmt>
        <ProgramServicesAmt>1505011</ProgramServicesAmt>
        <ManagementAndGeneralAmt>1499</ManagementAndGeneralAmt>
        <FundraisingAmt>184</FundraisingAmt>
      </DepreciationDepletionGrp>
      <InsuranceGrp>
        <TotalAmt>519344</TotalAmt>
        <ProgramServicesAmt>493992</ProgramServicesAmt>
        <ManagementAndGeneralAmt>22535</ManagementAndGeneralAmt>
        <FundraisingAmt>2817</FundraisingAmt>
      </InsuranceGrp>
      <OtherExpensesGrp>
        <Desc>CLIENT ASSISTANCE</Desc>
        <TotalAmt>548119</TotalAmt>
        <ProgramServicesAmt>547119</ProgramServicesAmt>
        <FundraisingAmt>1000</FundraisingAmt>
      </OtherExpensesGrp>
      <OtherExpensesGrp>
        <Desc>CLIENTS-SPECIAL NEEDS</Desc>
        <TotalAmt>52693</TotalAmt>
        <ProgramServicesAmt>52693</ProgramServicesAmt>
      </OtherExpensesGrp>
      <OtherExpensesGrp>
        <Desc>OTHER EXPENSES</Desc>
        <TotalAmt>51657</TotalAmt>
        <ProgramServicesAmt>46307</ProgramServicesAmt>
        <ManagementAndGeneralAmt>5307</ManagementAndGeneralAmt>
        <FundraisingAmt>43</FundraisingAmt>
      </OtherExpensesGrp>
      <TotalFunctionalExpensesGrp>
        <TotalAmt>50192433</TotalAmt>
        <ProgramServicesAmt>47073487</ProgramServicesAmt>
        <ManagementAndGeneralAmt>2858356</ManagementAndGeneralAmt>
        <FundraisingAmt>260590</FundraisingAmt>
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      <CashNonInterestBearingGrp>
        <BOYAmt>1788401</BOYAmt>
        <EOYAmt>1001765</EOYAmt>
      </CashNonInterestBearingGrp>
      <SavingsAndTempCashInvstGrp>
        <BOYAmt>16222795</BOYAmt>
        <EOYAmt>21293850</EOYAmt>
      </SavingsAndTempCashInvstGrp>
      <AccountsReceivableGrp>
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        <EOYAmt>5304083</EOYAmt>
      </AccountsReceivableGrp>
      <PrepaidExpensesDefrdChargesGrp>
        <BOYAmt>515347</BOYAmt>
        <EOYAmt>269261</EOYAmt>
      </PrepaidExpensesDefrdChargesGrp>
      <LandBldgEquipCostOrOtherBssAmt>54773622</LandBldgEquipCostOrOtherBssAmt>
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      <LandBldgEquipBasisNetGrp>
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        <EOYAmt>43008491</EOYAmt>
      </LandBldgEquipBasisNetGrp>
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        <EOYAmt>2629732</EOYAmt>
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      <TotalAssetsGrp>
        <BOYAmt>68516464</BOYAmt>
        <EOYAmt>73507182</EOYAmt>
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      <AccountsPayableAccrExpnssGrp>
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        <EOYAmt>3894231</EOYAmt>
      </AccountsPayableAccrExpnssGrp>
      <TaxExemptBondLiabilitiesGrp>
        <BOYAmt>9193586</BOYAmt>
        <EOYAmt>8801387</EOYAmt>
      </TaxExemptBondLiabilitiesGrp>
      <MortgNotesPyblScrdInvstPropGrp>
        <BOYAmt>1495923</BOYAmt>
        <EOYAmt>1335235</EOYAmt>
      </MortgNotesPyblScrdInvstPropGrp>
      <OtherLiabilitiesGrp>
        <BOYAmt>19620992</BOYAmt>
        <EOYAmt>22131890</EOYAmt>
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      <TotalLiabilitiesGrp>
        <BOYAmt>34349264</BOYAmt>
        <EOYAmt>36162743</EOYAmt>
      </TotalLiabilitiesGrp>
      <OrganizationFollowsFASB117Ind>X</OrganizationFollowsFASB117Ind>
      <NoDonorRestrictionNetAssetsGrp>
        <BOYAmt>32462042</BOYAmt>
        <EOYAmt>35606551</EOYAmt>
      </NoDonorRestrictionNetAssetsGrp>
      <DonorRestrictionNetAssetsGrp>
        <BOYAmt>1705158</BOYAmt>
        <EOYAmt>1737888</EOYAmt>
      </DonorRestrictionNetAssetsGrp>
      <TotalNetAssetsFundBalanceGrp>
        <BOYAmt>34167200</BOYAmt>
        <EOYAmt>37344439</EOYAmt>
      </TotalNetAssetsFundBalanceGrp>
      <TotLiabNetAssetsFundBalanceGrp>
        <BOYAmt>68516464</BOYAmt>
        <EOYAmt>73507182</EOYAmt>
      </TotLiabNetAssetsFundBalanceGrp>
      <ReconcilationRevenueExpnssAmt>3177239</ReconcilationRevenueExpnssAmt>
      <MethodOfAccountingAccrualInd>X</MethodOfAccountingAccrualInd>
      <AccountantCompileOrReviewInd>false</AccountantCompileOrReviewInd>
      <FSAuditedInd>true</FSAuditedInd>
      <FSAuditedBasisGrp>
        <SeparateBasisFinclStmtInd>X</SeparateBasisFinclStmtInd>
      </FSAuditedBasisGrp>
      <AuditCommitteeInd>true</AuditCommitteeInd>
      <FederalGrantAuditRequiredInd>true</FederalGrantAuditRequiredInd>
      <FederalGrantAuditPerformedInd>true</FederalGrantAuditPerformedInd>
    </IRS990>
    <IRS990ScheduleA documentId="RetDoc8">
      <PubliclySupportedOrg509a2Ind>X</PubliclySupportedOrg509a2Ind>
      <GiftsGrantsContrisRcvd509Grp>
        <CurrentTaxYearMinus4YearsAmt>1078604</CurrentTaxYearMinus4YearsAmt>
        <CurrentTaxYearMinus3YearsAmt>1729714</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>2153345</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>2419989</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>2025068</CurrentTaxYearAmt>
        <TotalAmt>9406720</TotalAmt>
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      <GrossReceiptsAdmissionsGrp>
        <CurrentTaxYearMinus4YearsAmt>41092649</CurrentTaxYearMinus4YearsAmt>
        <CurrentTaxYearMinus3YearsAmt>44414062</CurrentTaxYearMinus3YearsAmt>
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        <CurrentTaxYearAmt>51336040</CurrentTaxYearAmt>
        <TotalAmt>244681840</TotalAmt>
      </GrossReceiptsAdmissionsGrp>
      <Total509Grp>
        <CurrentTaxYearMinus4YearsAmt>42171253</CurrentTaxYearMinus4YearsAmt>
        <CurrentTaxYearMinus3YearsAmt>46143776</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>59973203</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>52439220</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>53361108</CurrentTaxYearAmt>
        <TotalAmt>254088560</TotalAmt>
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      <PublicSupportTotal509Amt>254088560</PublicSupportTotal509Amt>
      <GrossInvestmentIncome509Grp>
        <CurrentTaxYearMinus4YearsAmt>275080</CurrentTaxYearMinus4YearsAmt>
        <CurrentTaxYearMinus3YearsAmt>31605</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>8274</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>2242</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>8064</CurrentTaxYearAmt>
        <TotalAmt>325265</TotalAmt>
      </GrossInvestmentIncome509Grp>
      <InvestmentIncomeAndUBTIGrp>
        <CurrentTaxYearMinus4YearsAmt>275080</CurrentTaxYearMinus4YearsAmt>
        <CurrentTaxYearMinus3YearsAmt>31605</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>8274</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>2242</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>8064</CurrentTaxYearAmt>
        <TotalAmt>325265</TotalAmt>
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      <TotalSupportCalendarYearGrp>
        <CurrentTaxYearMinus4YearsAmt>42446333</CurrentTaxYearMinus4YearsAmt>
        <CurrentTaxYearMinus3YearsAmt>46175381</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>59981477</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>52441462</CurrentTaxYearMinus1YearAmt>
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        <TotalAmt>254413825</TotalAmt>
      </TotalSupportCalendarYearGrp>
      <PublicSupportCY509Pct>0.99870</PublicSupportCY509Pct>
      <PublicSupportPY509Pct>0.99860</PublicSupportPY509Pct>
      <InvestmentIncomeCYPct>0.00000</InvestmentIncomeCYPct>
      <InvestmentIncomePYPct>0.00000</InvestmentIncomePYPct>
      <ThirtyThrPctSuprtTestsCY509Ind>X</ThirtyThrPctSuprtTestsCY509Ind>
      <Form990ScheduleAPartVIGrp>
        <FormAndLineReferenceDesc>SUPPLEMENTAL INFORMATION</FormAndLineReferenceDesc>
        <ExplanationTxt>PART I LINE 10 - REASON FOR PUBLIC CHARITY STATUS THE ORGANIZATION CONSIDERED ITSELF A 33 1/3% SUPPORTED ORGANIZATION, WHICH IS DIFFERENT THAN THE IRS DETERMINATION LETTER DATED APRIL 13, 1994 WHERE IT STATES THAT IT IS A HOSPITAL DESCRIBED IN SECTION 170(B)1(A)(III). ALTHOUGH IT STILL PROVIDES OUTPATIENT MENTAL HEALTH SERVICES, IT PROVIDES OTHER SERVICES AS WELL AND RECEIVES MORE THAN 33 1/3% OF ITS TOTAL SUPPORT FROM CONTRIBUTIONS AND GROSS RECEIPTS FROM ACTIVITIES RELATED TO ITS EXEMPT FUNCTIONS.</ExplanationTxt>
      </Form990ScheduleAPartVIGrp>
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    <IRS990ScheduleB documentId="RetDoc1">
      <ContributorInformationGrp>
        <ContributorNum>RESTRICTED</ContributorNum>
        <ContributorBusinessName>
          <BusinessNameLine1>RESTRICTED</BusinessNameLine1>
        </ContributorBusinessName>
        <ContributorUSAddress>
          <AddressLine1>RESTRICTED</AddressLine1>
          <AddressLine2>RESTRICTED</AddressLine2>
          <City>RESTRICTED</City>
          <State>RESTRICTED</State>
          <ZIPCode>RESTRICTED</ZIPCode>
        </ContributorUSAddress>
        <TotalContributionsAmt>RESTRICTED</TotalContributionsAmt>
      </ContributorInformationGrp>
    </IRS990ScheduleB>
    <IRS990ScheduleD documentId="RetDoc3">
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        <BookValueAmt>6138227</BookValueAmt>
      </LandGrp>
      <BuildingsGrp>
        <OtherCostOrOtherBasisAmt>45062774</OtherCostOrOtherBasisAmt>
        <DepreciationAmt>8979271</DepreciationAmt>
        <BookValueAmt>36083503</BookValueAmt>
      </BuildingsGrp>
      <LeaseholdImprovementsGrp>
        <OtherCostOrOtherBasisAmt>1399684</OtherCostOrOtherBasisAmt>
        <DepreciationAmt>902751</DepreciationAmt>
        <BookValueAmt>496933</BookValueAmt>
      </LeaseholdImprovementsGrp>
      <EquipmentGrp>
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        <DepreciationAmt>1883109</DepreciationAmt>
        <BookValueAmt>289828</BookValueAmt>
      </EquipmentGrp>
      <TotalBookValueLandBuildingsAmt>43008491</TotalBookValueLandBuildingsAmt>
      <OtherLiabilitiesOrgGrp>
        <Desc>REFUNDABLE ADVANCE</Desc>
        <Amt>19592443</Amt>
      </OtherLiabilitiesOrgGrp>
      <OtherLiabilitiesOrgGrp>
        <Desc>OPERATING LEASE LIABILITIES</Desc>
        <Amt>2447526</Amt>
      </OtherLiabilitiesOrgGrp>
      <OtherLiabilitiesOrgGrp>
        <Desc>FINANCE LEASE LIABILITIES</Desc>
        <Amt>63372</Amt>
      </OtherLiabilitiesOrgGrp>
      <OtherLiabilitiesOrgGrp>
        <Desc>SECURITY DEPOSITS</Desc>
        <Amt>28549</Amt>
      </OtherLiabilitiesOrgGrp>
      <TotalLiabilityAmt>22131890</TotalLiabilityAmt>
      <FootnoteTextInd>X</FootnoteTextInd>
      <TotalRevEtcAuditedFinclStmtAmt>53369672</TotalRevEtcAuditedFinclStmtAmt>
      <RevenueSubtotalAmt>53369672</RevenueSubtotalAmt>
      <TotalRevenuePerForm990Amt>53369672</TotalRevenuePerForm990Amt>
      <TotExpnsEtcAuditedFinclStmtAmt>50192433</TotExpnsEtcAuditedFinclStmtAmt>
      <ExpensesSubtotalAmt>50192433</ExpensesSubtotalAmt>
      <TotalExpensesPerForm990Amt>50192433</TotalExpensesPerForm990Amt>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>SCHEDULE D, PAGE 3, PART X</FormAndLineReferenceDesc>
        <ExplanationTxt>FASB ASC 740 REQUIRES NONPUBLIC ENTITIES TO DETERMINE AND EVALUATE UNCERTAIN TAX POSITIONS. THE STANDARD REQUIRES ENTITIES TO MEASURE, RECOGNIZE, AND DISCLOSE UNCERTAIN TAX POSITIONS. THE TERM TAX POSITION INCLUDES, BUT IS NOT LIMITED TO, A DECISION NOT TO FILE A RETURN, THE CHARACTERIZATION OF INCOME OR A DECISION TO EXCLUDE REPORTING TAXABLE INCOME ON A TAX RETURN, AND THE ENTITYS TAX-EXEMPT STATUS. MANAGEMENT BELIEVES VALLEY CITIES DOES NOT HAVE ANY UNCERTAIN TAX POSITIONS. VALLEY CITIES IS NO LONGER SUBJECT TO EXAMINATIONS BY THE INTERNAL REVENUE SERVICE FOR THE YEARS PRIOR TO 2019.</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleD>
    <IRS990ScheduleI documentId="RetDoc4">
      <GrantRecordsMaintainedInd>true</GrantRecordsMaintainedInd>
      <RecipientTable>
        <RecipientBusinessName>
          <BusinessNameLine1Txt>NEIGHBORCARE HEALTH</BusinessNameLine1Txt>
        </RecipientBusinessName>
        <USAddress>
          <AddressLine1Txt>1200 12TH AVENUE SOUTH NO 901</AddressLine1Txt>
          <CityNm>SEATTLE</CityNm>
          <StateAbbreviationCd>WA</StateAbbreviationCd>
          <ZIPCd>98144</ZIPCd>
        </USAddress>
        <RecipientEIN>910893287</RecipientEIN>
        <IRCSectionDesc>501(C)</IRCSectionDesc>
        <CashGrantAmt>32280</CashGrantAmt>
        <PurposeOfGrantTxt>SUPPORT</PurposeOfGrantTxt>
      </RecipientTable>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>SCHEDULE I, PAGE 1, PART I, LINE 2</FormAndLineReferenceDesc>
        <ExplanationTxt>THE ORGANIZATION ENTERED INTO A FORMAL AGREEMENT WITH NEIGHBORCARE OUTLINING THE RESPONSIBILITIES REGARDING ACCEPTABLE USE OF THE FUNDS AND REPORTING. THE AGREEMENT IS STRUCTURED AS A REIMBURSEMENT, REQUIRING NEIGHBORCARE TO EXPEND FUNDS AS INTENDED BEFORE PAYMENT. A BUDGET IS ESTABLISHED AND REPORTED ON QUARTERLY WITH THE REQUEST FOR PAYMENT FROM NEIGHBORCARE.</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleI>
    <IRS990ScheduleJ documentId="RetDoc5">
      <WrittenEmploymentContractInd>X</WrittenEmploymentContractInd>
      <CompensationSurveyInd>X</CompensationSurveyInd>
      <BoardOrCommitteeApprovalInd>X</BoardOrCommitteeApprovalInd>
      <SeverancePaymentInd>false</SeverancePaymentInd>
      <SupplementalNonqualRtrPlanInd>false</SupplementalNonqualRtrPlanInd>
      <EquityBasedCompArrngmInd>false</EquityBasedCompArrngmInd>
      <CompBasedOnRevenueOfFlngOrgInd>false</CompBasedOnRevenueOfFlngOrgInd>
      <CompBsdOnRevRelatedOrgsInd>false</CompBsdOnRevRelatedOrgsInd>
      <CompBsdNetEarnsFlngOrgInd>false</CompBsdNetEarnsFlngOrgInd>
      <CompBsdNetEarnsRltdOrgsInd>false</CompBsdNetEarnsRltdOrgsInd>
      <AnyNonFixedPaymentsInd>false</AnyNonFixedPaymentsInd>
      <InitialContractExceptionInd>false</InitialContractExceptionInd>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>SHEKH ALI</PersonNm>
        <TitleTxt>CEO</TitleTxt>
        <BaseCompensationFilingOrgAmt>358168</BaseCompensationFilingOrgAmt>
        <OtherCompensationFilingOrgAmt>19644</OtherCompensationFilingOrgAmt>
        <NontaxableBenefitsFilingOrgAmt>11141</NontaxableBenefitsFilingOrgAmt>
        <TotalCompensationFilingOrgAmt>388953</TotalCompensationFilingOrgAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>BRIAN ALLENDER</PersonNm>
        <TitleTxt>CHIEF MED. OFFICER</TitleTxt>
        <BaseCompensationFilingOrgAmt>250363</BaseCompensationFilingOrgAmt>
        <OtherCompensationFilingOrgAmt>14900</OtherCompensationFilingOrgAmt>
        <NontaxableBenefitsFilingOrgAmt>26109</NontaxableBenefitsFilingOrgAmt>
        <TotalCompensationFilingOrgAmt>291372</TotalCompensationFilingOrgAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>JOHN VASZARI</PersonNm>
        <TitleTxt>PSYCHIATRIST</TitleTxt>
        <BaseCompensationFilingOrgAmt>259132</BaseCompensationFilingOrgAmt>
        <OtherCompensationFilingOrgAmt>15739</OtherCompensationFilingOrgAmt>
        <NontaxableBenefitsFilingOrgAmt>12664</NontaxableBenefitsFilingOrgAmt>
        <TotalCompensationFilingOrgAmt>287535</TotalCompensationFilingOrgAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>MORGAN MALLORY</PersonNm>
        <TitleTxt>MEDICAL DOCTOR</TitleTxt>
        <BaseCompensationFilingOrgAmt>224488</BaseCompensationFilingOrgAmt>
        <OtherCompensationFilingOrgAmt>1084</OtherCompensationFilingOrgAmt>
        <NontaxableBenefitsFilingOrgAmt>11616</NontaxableBenefitsFilingOrgAmt>
        <TotalCompensationFilingOrgAmt>237188</TotalCompensationFilingOrgAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>STANFORD TRAN</PersonNm>
        <TitleTxt>ASSOC MED DIR</TitleTxt>
        <BaseCompensationFilingOrgAmt>217030</BaseCompensationFilingOrgAmt>
        <OtherCompensationFilingOrgAmt>3885</OtherCompensationFilingOrgAmt>
        <NontaxableBenefitsFilingOrgAmt>372</NontaxableBenefitsFilingOrgAmt>
        <TotalCompensationFilingOrgAmt>221287</TotalCompensationFilingOrgAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>STEPHANIE ARMSTRONG</PersonNm>
        <TitleTxt>PSYCHIATRIST</TitleTxt>
        <BaseCompensationFilingOrgAmt>181896</BaseCompensationFilingOrgAmt>
        <OtherCompensationFilingOrgAmt>6308</OtherCompensationFilingOrgAmt>
        <NontaxableBenefitsFilingOrgAmt>8982</NontaxableBenefitsFilingOrgAmt>
        <TotalCompensationFilingOrgAmt>197186</TotalCompensationFilingOrgAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>JEFFREY KENDALL</PersonNm>
        <TitleTxt>NURSE PRACTITIONER</TitleTxt>
        <BaseCompensationFilingOrgAmt>185966</BaseCompensationFilingOrgAmt>
        <OtherCompensationFilingOrgAmt>514</OtherCompensationFilingOrgAmt>
        <NontaxableBenefitsFilingOrgAmt>9127</NontaxableBenefitsFilingOrgAmt>
        <TotalCompensationFilingOrgAmt>195607</TotalCompensationFilingOrgAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>RICHARD GEIGER</PersonNm>
        <TitleTxt>CHIEF-INPATIENT/RES</TitleTxt>
        <BaseCompensationFilingOrgAmt>167337</BaseCompensationFilingOrgAmt>
        <OtherCompensationFilingOrgAmt>1630</OtherCompensationFilingOrgAmt>
        <NontaxableBenefitsFilingOrgAmt>10176</NontaxableBenefitsFilingOrgAmt>
        <TotalCompensationFilingOrgAmt>179143</TotalCompensationFilingOrgAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>JAMIE NORITAKE HENSON</PersonNm>
        <TitleTxt>CHIEF ADMIN OFFICER</TitleTxt>
        <BaseCompensationFilingOrgAmt>159040</BaseCompensationFilingOrgAmt>
        <OtherCompensationFilingOrgAmt>6302</OtherCompensationFilingOrgAmt>
        <NontaxableBenefitsFilingOrgAmt>372</NontaxableBenefitsFilingOrgAmt>
        <TotalCompensationFilingOrgAmt>165714</TotalCompensationFilingOrgAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
    </IRS990ScheduleJ>
    <IRS990ScheduleK documentId="RetDoc6">
      <TaxExemptBondsIssuesGrp>
        <BondReferenceCd>A</BondReferenceCd>
        <IssuerName>
          <BusinessNameLine1Txt>WASHINGTON HEALTH CARE FACILITIES</BusinessNameLine1Txt>
          <BusinessNameLine2Txt>AUTHORITY</BusinessNameLine2Txt>
        </IssuerName>
        <BondIssuerEIN>911108929</BondIssuerEIN>
        <BondIssuedDt>2019-09-20</BondIssuedDt>
        <IssuePriceAmt>10080000</IssuePriceAmt>
        <PurposeDesc>PROCEEDS OF THE LOAN WERE USED TO REFINANCE A BANK OF AMERICA, N.A. CREDIT LINE, HOUSING FINANCE COM</PurposeDesc>
        <DefeasedInd>false</DefeasedInd>
        <OnBehalfOfIssuerInd>false</OnBehalfOfIssuerInd>
        <PoolFinancingInd>false</PoolFinancingInd>
      </TaxExemptBondsIssuesGrp>
      <TaxExemptBondsProceedsGrp>
        <BondReferenceCd>A</BondReferenceCd>
        <RetiredAmt>2632487</RetiredAmt>
        <TotalProceedsAmt>10080000</TotalProceedsAmt>
        <IssuanceCostsFromProceedsAmt>131776</IssuanceCostsFromProceedsAmt>
        <CapitalExpendituresAmt>7315737</CapitalExpendituresAmt>
        <SubstantialCompletionYr>2019</SubstantialCompletionYr>
        <RefundingTaxExemptBondsInd>false</RefundingTaxExemptBondsInd>
        <RefundingTaxableBondsInd>true</RefundingTaxableBondsInd>
        <FinalAllocationMadeInd>true</FinalAllocationMadeInd>
        <AdequateBooksAndRecMaintInd>true</AdequateBooksAndRecMaintInd>
      </TaxExemptBondsProceedsGrp>
      <TaxExemptBondsPrivateBusUseGrp>
        <BondReferenceCd>A</BondReferenceCd>
        <OwningBondFinancedPropertyInd>false</OwningBondFinancedPropertyInd>
        <AnyLeaseArrangementsInd>false</AnyLeaseArrangementsInd>
        <MgmtContractBondFincdPropInd>false</MgmtContractBondFincdPropInd>
        <AnyResearchAgreementsInd>false</AnyResearchAgreementsInd>
        <BondIssMeetPrvtSecPymtTestInd>false</BondIssMeetPrvtSecPymtTestInd>
        <ChangeInUseBondFinancedPropInd>false</ChangeInUseBondFinancedPropInd>
        <ProcsNonqualifiedBondRemdtdInd>false</ProcsNonqualifiedBondRemdtdInd>
      </TaxExemptBondsPrivateBusUseGrp>
      <TaxExemptBondsArbitrageGrp>
        <BondReferenceCd>A</BondReferenceCd>
        <Form8038TFiledInd>false</Form8038TFiledInd>
        <RebateNotDueYetInd>false</RebateNotDueYetInd>
        <ExceptionToRebateInd>false</ExceptionToRebateInd>
        <NoRebateDueInd>false</NoRebateDueInd>
        <VariableRateIssueInd>false</VariableRateIssueInd>
        <HedgeIdentifiedInBksAndRecInd>false</HedgeIdentifiedInBksAndRecInd>
        <GrossProceedsInvestedInGICInd>false</GrossProceedsInvestedInGICInd>
        <GrossProceedsInvestedInd>false</GrossProceedsInvestedInd>
        <WrittenProcToMonitorReqsInd>false</WrittenProcToMonitorReqsInd>
      </TaxExemptBondsArbitrageGrp>
      <ProceduresCorrectiveActionGrp>
        <BondReferenceCd>A</BondReferenceCd>
        <ProceduresCorrectiveActionInd>false</ProceduresCorrectiveActionInd>
      </ProceduresCorrectiveActionGrp>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>PURPOSE OF ISSUE DESCRIPTION</FormAndLineReferenceDesc>
        <ExplanationTxt>WASHINGTON HEALTH CARE FACILITIES PROCEEDS OF THE LOAN WERE USED TO REFINANCE A BANK OF AMERICA, N.A. CREDIT LINE, HOUSING FINANCE COMMISSION LOAN, RAINIER COMMUNITY DEVELOPMENT FUNDS LOAN, WHCFA SERIES 2009 BOND, AND TO PAY COSTS OF ISSUANCE.</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleK>
    <IRS990ScheduleO documentId="RetDoc7">
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PAGE 1, PART I, LINE 6</FormAndLineReferenceDesc>
        <ExplanationTxt>VOLUNTEERS WORKED CLOSELY WITH THE DEVELOPMENT AND FUNDRAISING DEPARTMENT IN THE ADMINISTRATION BUILDING. THEY ASSISTED WITH SALESFORCE AND DATABASE MANAGEMENT, ASSISTED WITH GOOGLE AD WORDS FOR THE WEBSITE, TOOK PHOTOS AND VIDEO FOR VALLEY CITIES, HELPED FIND GRANT OPPORTUNITIES, AND HELPED WRITE GRANTS. ALL BOARD MEMBERS ARE UNPAID VOLUNTEERS WHO ASSIST IN OVERSIGHT OF THE ORGANIZATION THROUGH MONTHLY MEETINGS DISCUSSING FINANCIAL RESULTS, POLICIES, THE MISSION, AND OTHER GOVERNANCE ISSUES.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PAGE 2, PART III, LINE 4A</FormAndLineReferenceDesc>
        <ExplanationTxt>OUTPATIENT: VALLEY CITIES COUNSELING AND CONSULTATION (VALLEY CITIES), A NOT-FOR-PROFIT COMMUNITY BEHAVIORAL HEALTH CENTER, HAS BEEN THE LOCAL SOURCE FOR QUALITY BEHAVIORAL HEALTH COUNSELING AND CHEMICAL DEPENDENCY SINCE 1965 IN WASHINGTON STATE WITH CLINICS IN AUBURN, FEDERAL WAY, KENT, RENTON, MERIDIAN AT NORTHGATE, RAINIER BEACH, ENUMCLAW, MIDWAY, PIKE PLACE, BITTER LAKE, AND THE COHEN VETERANS NETWORK IN LAKEWOOD. VALLEY CITIES SERVES APPROXIMATELY 20,000 INDIVIDUALS EACH YEAR. VALLEY CITIES IS ACCREDITED BY THE JOINT COMMISSION ON THE ACCREDITATION OF HEALTHCARE ORGANIZATIONS (JCAHO) AND COMMISSION ON ACCREDITATION OF REHABILITATION FACILITIES (CARF). VALLEY CITIES PROVIDES LICENSED MENTAL HEALTH AND CHEMICAL DEPENDENCY TREATMENT FOR YOUTH AND ADULTS; SUPPORTED EMPLOYMENT AND EDUCATION SERVICES; OUTREACH SERVICES AND HOUSING PROGRAMS FOR THE HOMELESS; FAMILY SUPPORT PROGRAMS OFFERING YOUTH AND FAMILY ACTIVITIES; AND SPECIALIZED VETERANS SERVICES THAT DELIVER COUNSELING AND FAMILY SUPPORT SERVICES TO VETERANS AND THEIR FAMILIES. THE DEVELOPMENT DEPARTMENT CONDUCTS FUNDRAISING, MARKETING, PUBLIC RELATIONS, GRANT WRITING, AND PUBLIC POLICY ADVOCACY. THE HUMAN RESOURCES DEPARTMENT OVERSEES PERSONNEL, STAFF TRAINING, STUDENT INTERN, AND VOLUNTEER FUNCTIONS, AND THE ADMINISTRATION AND FINANCE DEPARTMENTS OVERSEE THE REVENUE CYCLE TEAM, SUPPORT STAFF, ACCOUNTING AND PAYROLL OPERATIONS. VALLEY CITIES CONTINUES TO INTEGRATE TRAINED AND CERTIFIED PEER SUPPORT SPECIALISTS INTO ALL PROGRAMS, ALLOWING THEIR OWN RECOVERY, AND MOTIVATING OTHERS TO FIND HOPE AND GROWTH IN THEIR RECOVERY PROCESS. VALLEY CITIES CLINICS OFFER A UNIQUE MODEL OF CARE, TEAM-BASED CARE. ALL CLIENTS ARE ASSIGNED TO A CASE MANAGER WHO THEN ASSISTS THEM IN CONNECTING TO RESOURCES IN THE AGENCY AND IN THE COMMUNITY. CLINICIANS ARE TRAINED IN EVIDENCED BASED TREATMENT MODALITIES INCLUDING CBT+ (TRAUMA FOCUSED COGNITIVE BEHAVIORAL THERAPY FOR CHILDREN) AND LOVE AND LOGIC PARENTING SKILLS. THROUGH CARE COORDINATION, VALLEY CITIES STILL TREATS CHILDREN, ADULTS AND OLDER ADULTS, BUT AS A TEAM APPROACH SO EACH INDIVIDUAL GETS THE FOCUS THAT THEY NEED. SERVICES ARE PROVIDED TO MEET THE NEEDS OF CHILDREN, YOUTH AND THEIR FAMILIES WITH MENTAL ILLNESSES OR EMOTIONAL DISTURBANCES; CHILDREN, YOUTH AND FAMILIES WHO ARE IN CRISES; AND CHILDREN AND YOUTH WHO ARE VICTIMS OF TRAUMA OR FAMILY VIOLENCE. THESE SERVICES INCLUDE INDIVIDUAL AND FAMILY COUNSELING; IN HOME FAMILY SUPPORT AND ADVOCACY; SCHOOL-BASED COUNSELING; CRISES INTERVENTION; CASE MANAGEMENT; PSYCHIATRIC ASSESSMENT; CASE COORDINATION WITH OTHER SERVICE PROVIDERS; MEDICATION MANAGEMENT; SUPPORT GROUPS AND SKILLS FOR TRAINING PARENTS; OUTREACH CLINICAL TEAMS FOR HOMELESS FAMILIES; COMMUNITY CONSULTATION AND EDUCATION; AND SPECIALIZED TREATMENT FOR THOSE WITH CO-OCCURRING MENTAL HEALTH AND SUBSTANCE USE DISORDERS. SERVICES ARE ALSO PROVIDED TO ASSIST ADULTS AND THEIR FAMILIES WITH CHEMICAL DEPENDENCY TREATMENT SERVICES. SERVICES ARE TRAUMA-INFORMED AND DESIGNED WITH AN EMPHASIS ON RECOVERY AND HOPE. VALLEY CITIES PROVIDES EMPLOYMENT AND EDUCATIONAL SERVICES SO THAT CLIENTS CAN BE SUPPORTED TO RETURN TO WORK OR SCHOOL. THE CHEMICAL DEPENDENCY SERVICES INCLUDE INTENSIVE OUTPATIENT AND SPECIALIZED RELAPSE PREVENTION SERVICES AND ARE INTEGRATED WITH THE MENTAL HEALTH SERVICES FOR THOSE CLIENTS THAT HAVE CO- OCCURRING MENTAL HEALTH AND CHEMICAL DEPENDENCY PROBLEMS. VALLEY CITIES' PROGRAMS CONSIST OF: CASE MANAGER AT EACH OUTPATIENT CLINIC THE CASE MANAGER IS THE MAIN POINT OF CONTACT AT VALLEY CITIES. THEY HELP WALK THE CLIENT THROUGH HOW TO GET SERVICES AT VALLEY CITIES, ASK THEM ABOUT WHAT DIFFICULTIES THEY ARE HAVING AND TRY TO FIND WAYS TO HELP. THEY CONNECT THE CLIENT WITH THE APPROPRIATE LEVEL OF CARE THAT IS NEEDED, WHICH CAN INCLUDE COUNSELING, MEDICATIONS, PEER SUPPORT, OR GROUPS. THEY ALSO HELP CONNECT THEM TO SERVICES IN THE COMMUNITY, LIKE A PRIMARY CARE PHYSICIAN OR A DENTIST. THE CASE MANAGER HELPS MANAGE ALL THE EXPERTISE NEEDED TO PROVIDE THE BEST OUTCOMES FOR CLIENTS. PEER SUPPORT SERVICES PEERS ARE LIVING, WALKING EXAMPLES OF HOPE AND THAT RECOVERY IS POSSIBLE. VALLEY CITIES PROUDLY OFFERS A RANGE OF SUPPORT SERVICES PROVIDED BY CERTIFIED PEER COUNSELORS. PEERS ARE AN INTEGRAL PART OF THE CARE TEAM AT VALLEY CITIES, OFFERING INSIGHT, EMPOWERMENT, AND ENGAGEMENT FROM LIFE EXPERIENCE. PEER SUPPORT IS BASED ON THE PHILOSOPHY THAT SOMEONE WHO HAS FACED LIFE CIRCUMSTANCES SIMILAR TO YOURS MAY BE THE PERSON WHO CAN UNDERSTAND YOU THE MOST. PEER SUPPORT COUNSELORS HAVE BEEN TRAINED, TESTED, AND CERTIFIED TO INSPIRE HOPE AND PROVIDE UNIQUE SUPPORT TO PEOPLE RECEIVING MENTAL HEALTH AND CHEMICAL DEPENDENCY SERVICES. BECAUSE OF THEIR UNIQUE EXPERIENCE WITH MENTAL ILLNESS, MENTAL HEALTH SERVICES, AS WELL AS SUBSTANCE ABUSE EXPERIENCE AND SERVICES, PEER COUNSELORS PROVIDE EXPERTISE THAT PROFESSIONAL TRAINING CANNOT REPLICATE. PEER SUPPORT COUNSELORS HAVE BEEN TRAINED, TESTED, AND CERTIFIED TO INSPIRE HOPE AND PROVIDE UNIQUE SUPPORT TO PEOPLE RECEIVING MENTAL HEALTH AND CHEMICAL DEPENDENCY SERVICES. BECAUSE OF THEIR UNIQUE EXPERIENCE WITH MENTAL ILLNESS, MENTAL HEALTH SERVICES, AS WELL AS SUBSTANCE ABUSE EXPERIENCE AND SERVICES, PEER COUNSELORS PROVIDE EXPERTISE THAT PROFESSIONAL TRAINING CANNOT REPLICATE. CHILDREN'S WRAPAROUND SERVICES VALLEY CITIES WRAPAROUND SERVES HIGH NEEDS YOUTH THROUGHOUT KING COUNTY, WITH A PRIMARY FOCUS IN SOUTH KING COUNTY, WHO ARE ELIGIBLE FOR ONE OF TWO WRAPAROUND PROGRAMS OFFERED. 1) WRAPAROUND WITH INTENSIVE SERVICES - WISE (YOUTH UTILIZING MEDICAID FUNDED MENTAL HEALTH TREATMENT) OR 2) MIDD WRAPAROUND (YOUTH INVOLVED IN AT LEAST TWO OF THE FOLLOWING SYSTEMS: MENTAL HEALTH, SPECIAL EDUCATION, JUVENILE JUSTICE, CHILD WELFARE, DDA - DEVELOPMENT DISABILITIES, AND CHEMICAL DEPENDENCY.) WRAPAROUND FACILITATORS, CLINICIANS, PARENT PARTNERS AND YOUTH PEERS WORK COLLABORATIVELY WITH THE YOUTH, FAMILIES, PROVIDERS AND COMMUNITY MEMBERS TO DEVELOP A CROSS SYSTEM CARE PLAN DRIVEN BY THE YOUTH AND FAMILYS IDENTIFIED NEEDS AND GOALS. WRAPAROUND FACILITATORS, CLINICIANS, PARENT PARTNERS AND YOUTH PEERS WORK COLLABORATIVELY WITH THE YOUTH, FAMILIES, PROVIDERS AND COMMUNITY MEMBERS TO DEVELOP A CROSS SYSTEM CARE PLAN DRIVEN BY THE YOUTH AND FAMILY'S IDENTIFIED NEEDS AND GOALS. WRAPAROUND STAFF FOLLOW TEN GUIDING PRINCIPLES AS THEY SUPPORT THE TEAM PLANNING PROCESS. THESE PRINCIPLES ARE: FAMILY VOICE AND CHOICE, TEAM BASED, NATURAL SUPPORTS, COLLABORATION, COMMUNITY-BASED, CULTURALLY COMPETENT, INDIVIDUALIZED, STRENGTHS BASED, PERSISTENCE AND OUTCOMES BASED. IN 2022, THIS PROGRAM PROVIDED INTENSIVE SERVICES TO A TOTAL OF 83 YOUTH. THE AVERAGE YOUTH IS SERVED IN WRAPAROUND FOR 18 MONTHS, AND OUTCOMES INCLUDE FEWER HOSPITAL VISITS, INCREASED SCHOOL ATTENDANCE AND ACHIEVEMENT AND FEWER POLICE CONTACTS. FAMILIES LEAVE WRAPAROUND WITH INCREASED ONGOING SUPPORT AND IMPROVED SKILLS TO NAVIGATE THEIR YOUTHS RECOVERY MOVING FORWARD. FAMILY TREATMENT COURT WRAPAROUND FAMILY TREATMENT COURT IS AN ALTERNATIVE TO REGULAR DEPENDENCY COURT AND IS DESIGNED TO IMPROVE THE SAFETY AND WELL-BEING OF CHILDREN IN THE DEPENDENCY SYSTEM BY PROVIDING PARENTS ACCESS TO DRUG AND ALCOHOL TREATMENT, JUDICIAL MONITORING OF THEIR SOBRIETY AND INDIVIDUALIZED SERVICES TO SUPPORT THE ENTIRE FAMILY. VALLEY CITIES IS THE ONLY WRAPAROUND PROGRAM IN THE STATE OF WASHINGTON TO WORK WITH ADULTS AS THE IDENTIFIED CLIENT, TO AMPLIFY THE PARENT'S VOICE IN THE DEPENDENCY PROCESS. ONE FTE WRAPAROUND FACILITATOR WORKS WITH THE TEAM TO DISCOVER THE INDIVIDUAL'S STRENGTHS, SET GOALS, DETERMINE MAJOR NEEDS, AND DEVELOP STRENGTH-BASED OPTIONS TO MEET THOSE NEEDS. VALLEY CITIES FACILITATOR WORKS WITH UP TO 15 FAMILIES AT A TIME TO PROVIDE THIS CRITICAL RESOURCE TO KEEP FAMILIES TOGETHER IN A SAFE AND HEALTHY ENVIRONMENT. THIS PROGRAM IS CONTRACTED BY KING COUNTY AND FUNDED THROUGH THE MIDD TAX INITIATIVE. MENTAL HEALTH FIRST AID (MHFA) PROGRAM VALLEY CITIES CONTINUES ITS PARTNERSHIP WITH KING COUNTY TO MAINTAIN A PROGRAM DESIGNED TO INCREASE THE NUMBER OF PEOPLE IN THE COMMUNITY TRAINED IN MENTAL HEALTH FIRST AID (MHFA). THE FOCUS IS TO REDUCE THE STIGMA ASSOCIATED WITH BEHAVIORAL HEALTH DISORDERS, TEACH PARTICIPANTS THE SIGNS AND SYMPTOMS OF MENTAL HEALTH CHALLENGES, HOW TO TALK WITH SOMEONE EXPERIENCING A CHALLENGE AND HOW TO CONNECT THEM TO PROFESSIONAL RESOURCES. TRAINING IS PROVIDED TO THE PUBLIC, INCLUDING PARTNERSHIPS WITH MANY ORGANIZATIONS, WITH THE FOCUS ON INCLUSION FOR ALL REGARDLESS OF GEOGRAPHIC LOCATION, RACE, OR NATIONALITY. IN 2022, 793 INDIVIDUALS PARTICIPATED IN A MHFA TRAINING AND 85 MHFA TRAININGS WERE HELD; 39 OF THOSE WERE ON YOUTH MENTAL HEALTH AND 46 WERE ON ADULT MENTAL HEALTH, 3 WERE TAUGHT IN SPANISH. IN RESPONSE TO COVID-19, MHFA TRAININGS WERE HELD VIRTUALLY WITH DIRECTION AND TOOLS FROM THE NATIONAL COUNCIL OF BEHAVIORAL HEALTH. THE FIRST BOUNCE BACK TO IN-PERSON MHFA TRAINING OCCURRED IN NOVEMBER 2022 AND WAS A SUCCESS. SCHOOL BA</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PAGE 2, PART III, LINE 4B</FormAndLineReferenceDesc>
        <ExplanationTxt>MEDICAL SERVICES MEDICAL SERVICES INCLUDES BOTH STAFF PSYCHIATRISTS AND NURSE PRACTITIONERS. THEY PROVIDE PSYCHIATRIC EVALUATIONS AND MEDICATION MANAGEMENT SERVICES TO ANY CLIENT WHO NEEDS PSYCHIATRIC CARE. IN ADDITION, THE MEDICAL STAFF PROVIDES PSYCHIATRIC CONSULTATION TO A RANGE OF COMMUNITY HEALTH CENTERS THROUGHOUT KING COUNTY, ADVISING THE PRIMARY CARE STAFF WITH DIAGNOSTIC INFORMATION AND RECOMMENDATIONS ON PSYCHOTROPIC MEDICATIONS THAT CAN BE PRESCRIBED IN THE PRIMARY CARE SETTING. ALL EXPENSES RELATED TO THESE STAFF ARE CAPTURED IN THIS PROGRAM. CLINICAL SUPPORT SERVICES CLINICAL SUPPORT SERVICES INCLUDES INFORMATION SYSTEMS, ACCESS SERVICES INCLUDING ALL TELEPHONE SCREENING AND INITIAL INTAKE SERVICES, AFTER-HOURS CRISES TEAM, FRONT DESK SUPPORT, MEDICAL RECORDS, CALL CENTER AND QUALITY MANAGEMENT SERVICES. THESE PROGRAMS DIRECTLY SUPPORT ALL CLINICAL PROGRAMS BY PROVIDING EITHER CLIENT ASSISTANCE AND/OR DATA COLLECTION AND REPORTING IN ORDER TO MANAGE CLIENT CARE. RECOVERY PLACE SEATTLE (RPS) RECOVERY PLACE SEATTLE (RPS) IS A RESIDENTIAL TREATMENT FACILITY AND HOUSES A LICENSED MEDICALLY MONITORED 33 BED DETOXIFICATION SERVICE WHICH PROVIDES MEDICAL DETOXIFICATION INPATIENT SERVICES FOR PEOPLE WHO NEED SUPPORT TO SAFELY WITHDRAW FROM DRUG OR ALCOHOL USE. THIS 33-BED SERVICE PROVIDES SERVICES FOR A 3-5 DAY TYPICAL STAY. RPS ALSO HOUSES A 42 BED 28-DAY INTENSIVE INPATIENT PROGRAM FOR INDIVIDUALS LIVING WITH SUBSTANCE USE DISORDER CONCERNS. THIS PROGRAM OFFERS STRUCTURED, HOLISTIC, AND EVIDENCE- BASED PRACTICES, INCLUDING RELAPSE PREVENTION, COPING MECHANISMS (BOTH ABSTINENCE-BASED AND HARM REDUCTION), AND RE-CONNECTION TO COMMUNITY AND RESOURCES. CLIENTS PARTICIPATE IN COUNSELING AND SUPPORT GROUPS. THE AVERAGE DAILY CENSUS FOR DETOX AND RESIDENTIAL FOR 2022 WAS 10 AND 25, RESPECTIVELY. RECOVERY PLACE KENT (RPK) RECOVERY PLACE KENT (RPK) OPENED IN DECEMBER 2019 WITH 32 BEDS AND IS WASHINGTON STATES FIRST DUALLY LICENSED CHEMICAL DEPENDENCY &amp; PSYCHIATRIC FACILITY. THE EVALUATION AND TREATMENT PROGRAM PROVIDES INPATIENT CRISIS STABILIZATION SERVICES TO INDIVIDUALS WHO HAVE BEEN DETAINED UNDER THE INVOLUNTARY TREATMENT ACT (ITA) FOR DANGER TO SELF, DANGER TO OTHERS, OR GRAVE DISABILITY RELATED TO A PSYCHIATRIC ILLNESS. THE INTERDISCIPLINARY TREATMENT TEAM PROVIDES PSYCHIATRIC EVALUATION, MEDICATION MANAGEMENT, INDIVIDUAL MENTAL HEALTH AND SUBSTANCE USE DISORDER COUNSELING, GROUP ACTIVITIES, PEER SUPPORT, COORDINATION WITH KING COUNTY ITA COURT, AND DISCHARGE PLANNING TO RE-CONNECT CLIENTS TO COMMUNITY SUPPORTS. THE SECURE WITHDRAWAL MANAGEMENT PROGRAM OPENED DECEMBER 2019 IN RESPONSE TO HOUSE BILL 1713 "RICKY'S LAW". THE SECURE WITHDRAWAL MANAGEMENT SERVICES PROVIDES BOTH MEDICAL MANAGEMENT OF WITHDRAWAL FROM ADDICTIVE SUBSTANCES, PSYCHIATRIC EVALUATION AND SUPPORT, SUBSTANCE USE ASSESSMENT AND COUNSELING, MEDICATION MANAGEMENT, GROUP ACTIVITIES, PEER SUPPORT, COORDINATION WITH KING COUNTY ITA COURT, AND DISCHARGE PLANNING TO COMMUNITY SUPPORTS.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PAGE 2, PART III, LINE 4C</FormAndLineReferenceDesc>
        <ExplanationTxt>HOUSING SUPPORT SERVICES VALLEY CITIES OPERATES PERMANENT SUPPORTIVE HOUSING PROGRAMS THAT PROVIDE RENTAL ASSISTANCE WITH HOME-BASED CASE MANAGEMENT SERVICES FOR HOMELESS INDIVIDUALS AND HOMELESS FAMILIES. SUPPORTIVE SERVICES IN THESE PROGRAMS ADDRESS EVENTS AND CIRCUMSTANCES THAT UNDERLIE OR CONTRIBUTE TO THE INABILITY TO OBTAIN AND MAINTAIN AFFORDABLE AND STABLE HOUSING. THIS INCLUDES PATHWAYS FIRST, HOMELESS SERVICE ENHANCEMENT, SHELTER PLUS CARE, VALLEY CITIES LANDING, VALLEY CITIES PLACE AND PHOENIX RISING PERMANENT SUPPORTIVE HOUSING PROJECTS DEDICATED TO SERVING INDIVIDUALS, AND FAMILIES. TWELVE UNITS AT VALLEY CITIES LANDING AND EIGHT UNITS IN THE HOMELESS SERVICE ENHANCEMENT PROGRAM ARE DEDICATED FOR HOMELESS VETERANS. RESIDENTS ENGAGE IN ONSITE AND COMMUNITY-BASED SERVICES THAT HELP THEM LIVE WITH STABILITY, AUTONOMY AND DIGNITY. IN 2022, THIS PROGRAM SERVED 149 CLIENTS. FUNDING SOURCES INCLUDED KING COUNTY, HUD, WA STATE DEPT. OF COMMERCE; PLYMOUTH HOUSING; AND KING COUNTY HOUSING AUTHORITY. FAMILIES FIRST WITH FUNDING FROM THE KING COUNTY HOUSING AUTHORITY (24 VOUCHERS), THE FAMILIES FIRST PROGRAM IS DESIGNED TO PROVIDE HOUSING PLACEMENT AND SUPPORTIVE SERVICES TO 24 HIGH NEEDS FAMILIES IN KING COUNTY WHO HAVE HAD AT LEAST ONE CHILD OR ARE IN IMMINENT DANGER OF HAVING A CHILD REMOVED FROM THE HOME BY CHILD PROTECTIVE SERVICES. THE GOAL OF THE PROJECT IS REUNIFICATION OF THE FAMILY AND INCREASING HOUSING STABILITY AND SELF- SUFFICIENCY. THIS IS ACCOMPLISHED THROUGH INDIVIDUALIZED, INTENSIVE SERVICES TO FAMILIES ALONG WITH A FAMILY UNIFICATION PROGRAM (FUP) SECTION 8 VOUCHER (TENANT-BASED VOUCHERS) THAT CAN BE USED IN THE PRIVATE HOUSING MARKET. IN 2022, THIS PROGRAM SERVED 34 INDIVIDUALS AND A SUCCESS RATE OF 82% OF FAMILIES REMAINING STABLY HOUSED FOR AT LEAST 1 OR MORE YEARS. COMING-UP YOUTH PROGRAM THE COMING UP PROGRAM (CUP) IS A SUPPORTIVE HOUSING PROGRAM SUBSIDIZED THROUGH KING COUNTY HOUSING AUTHORITY (KCHA) AND KING COUNTY. CUP PROVIDED HOUSING AND SUPPORT SERVICES TO UP TO 22 HOMELESS YOUNG ADULTS IN SOUTH KING COUNTY AGES 18-24. THE GOAL OF THE CUP PROGRAM WAS TO PROVIDE PROGRAM PARTICIPANTS WITH A WRAPAROUND APPROACH TO SERVICES AND SUPPORT THAT WOULD ENABLE THEM TO ACHIEVE SELF-SUFFICIENCY. IN 2022, VALLEY CITIES WORKED WITH THE KING COUNTY HOUSING AUTHORITY (KCHA) TO MOVE FROM MASTER LEASED UNITS TO TENANT-BASED SEC. 8 VOUCHERS. AFTER A YEAR OF WORKING CLOSELY WITH KCHA TO COMPLETE THIS TRANSITION, VALLEY CITIES SEARCHED FOR AN APARTMENT COMPLEX WITHIN THE SOUTH KING COUNTY COMMUNITY THAT COULD PROVIDE 22 SET- ASIDE UNITS THAT WOULD ACCEPT TENANT-BASED SEC. 8 VOUCHERS. UNFORTUNATELY, DUE TO THE CURRENT RENTAL MARKET, MANAGEMENT COMPANIES THAT IN THE PAST WERE WILLING TO PARTNER ARE NO LONGER WILLING TO PROVIDE SET-ASIDE UNITS FOR THE POPULATION VALLEY CITIES SERVES. VALLEY CITIES WAS UNABLE TO LOCATE A COMMUNITY APARTMENT COMPLEX THAT WOULD PROVIDE 22 SET-ASIDE UNITS TO MEET THE GRANT REQUIREMENTS. CONSEQUENTLY, IN 2022, VALLEY CITIES MADE THE DIFFICULT DECISION TO END THE CUP PROGRAM AS OF DECEMBER 30, 2022. ALL CURRENT CUP PARTICIPANTS WERE PROVIDED ADVOCACY TO LOCATE ALTERNATIVE HOUSING PROGRAMS OR WERE PROVIDED ASSISTANCE TO GRADUATE WITH A SEC. 8 MOVE-ON VOUCHER TO PERMANENT HOUSING. NEW JOURNEYS DEMONSTRATION PROJECT PROGRAM THE NEW JOURNEYS DEMONSTRATION PROJECTS GOAL IS TO DELIVER AND IMPLEMENT A MODEL FOR FIRST-EPISODE PSYCHOSIS (FEP) TREATMENT THAT CREATES A POSITIVE CLIMATE AND MAINTAINS FIDELITY TO THE CLINICAL CONCEPTS AND CORE ELEMENTS OF COORDINATED SPECIALTY CARE (CSC) VIA THE NAVIGATE MODEL. PARTICIPANTS ARE KING COUNTY RESIDENTS BETWEEN AGES 15-40 WHO HAVE A PRIMARY DIAGNOSIS ON THE SCHIZOPHRENIA SPECTRUM WITH SYMPTOMS FOR LESS THAN TWO YEARS. THE MENTAL HEALTH SYMPTOMS ARE NOT A DIRECT RESULT OF OR STRONGLY IMPACTED BY AN AUTISM SPECTRUM DISORDER, SIGNIFICANT DEVELOPMENTAL DELAYS, LEARNING DISABILITIES OR OTHER MEDICAL CONDITIONS. NEW JOURNEYS PLACES A STRONG EMPHASIS ON OUTREACH AND ENGAGEMENT. VALLEY CITIES STAFF DEDICATE THEIR TIME TO MEETING PARTICIPANTS WHERE THEY ARE AT. THEY ENSURE PARTICIPANT AND ENGAGEMENT OF SUPPORTS BY OFFERING MOBILE SERVICES TO MEET THE VARYING NEEDS WITHIN RECOVERY. NEW JOURNEYS PROVIDES INDIVIDUAL SKILLS TRAINING AND THERAPY, GROUP THERAPY, FAMILY EDUCATION AND SUPPORT, CASE MANAGEMENT, EMPLOYMENT AND EDUCATION SERVICES AND PEER SUPPORT IN COMMUNITY SETTINGS. THEY ALSO OFFER MEDICATION MANAGEMENT AT A CLINIC FOR ENROLLED PARTICIPANTS. THE MANAGER PROVIDES SCREENINGS FOR REFERRALS, CLINICAL SUPERVISION, CONTRACT MONITORING, RELATIONSHIP BUILDING WITH THE REFERRAL BASE AND COMMUNITY EDUCATION ABOUT BOTH THE SCHIZOPHRENIA SPECTRUM AND SERVICES OFFERED BY NEW JOURNEYS. IN ADDITION TO WORKING WITH ENROLLED PARTICIPANTS AND THEIR SUPPORTS, THE MANAGER ALSO EXPLORES RESOURCES AND TREATMENT OPTIONS FOR THOSE INDIVIDUALS WHO DO NOT MEET THE ELIGIBILITY CRITERIA FOR NEW JOURNEYS. IN 2022, NEW JOURNEYS PROVIDED 5,980 SERVICES AND TRAVELLED MORE THAN 9,000 MILES TO ENGAGE PARTICIPANTS AND THEIR SUPPORT SYSTEMS. HUB AND SPOKES SERVICES ALSO KNOWN AS MATCH (MEDICATION-ASSISTED TREATMENT &amp; COMMUNITY HEALTH) IN 2017, VALLEY CITIES BEHAVIORAL HEALTH ENTERED A CONTRACT WITH SAMHSA AND THE HEALTH CARE AUTHORITY TO BEGIN PROVIDING LOW-BARRIER, RAPID ACCESS TO MEDICATIONS FOR OPIATE USE DISORDER (MOUD) AND RELATED SUPPORT SERVICES IN RESPONSE TO THE OPIOID EPIDEMIC. THE PRIMARY FOCUS OF THE MATCH PROGRAM IS TO INDUCT AND STABILIZE INDIVIDUALS WITH MOUD, WHO MEET DIAGNOSTIC CRITERIA FOR AN OPIOID USE DISORDER, WITH THE OPTION OF ON-SITE ADMINISTRATION OF AN OPIOID AGONIST (BUPRENORPHINE) OR AN OPIOID ANTAGONIST (NALTREXONE, PRIMARILY IN THE FORM OF EXTENDED-RELEASE INJECTABLE). AN ADDITIONAL FOCUS OF MATCH IS REDUCING BARRIERS TO INCREASE THE EASE OF ACCESS TO MOUD, TREATMENT AND CARE NAVIGATION. MATCH SERVICES CAN BE ACCESSED IN THE COMMUNITY AT ONE OF VALLEY CITIES OUTPATIENT FACILITIES THROUGHOUT KING COUNTY OR AT ONE OF THE TWO INPATIENT PROGRAMS, RECOVERY PLACE SEATTLE (RPS) AND RECOVERY PLACE KENT (RPK). IN RESPONSE TO THE ONSET OF FENTANYL AND THE SUBSEQUENT SPIKE IN OVERDOSE, OVERDOSE DEATH AND ACCIDENTAL POISONING, THE MATCH PROGRAM IS WORKING ASSERTIVELY TO ENSURE CONSISTENT ACCESS TO NALOXONE AND FENTANYL TEST STRIPS. THESE LIFESAVING ITEMS ARE DISTRIBUTED AT ALL VALLEY CITIES LOCATIONS. THE MATCH PROGRAM WORKS CLOSELY WITH ITS COMMUNITY PARTNERS TO PROVIDE INDIVIDUALIZED, EQUITABLE SERVICES. VALLEY CITIES CARE NAVIGATORS, PEER SUPPORT SPECIALIST, DATA COORDINATOR AND NURSE CARE MANAGER ALL WORK DIRECTLY WITH THE CLIENT TO CONNECT THEM WITH THE SERVICES THEY ARE SEEKING TO INCLUDE (BUT NOT LIMITED TO), PRIMARY CARE, DENTAL, BEHAVIORAL HEALTH, HOUSING, EMPLOYMENT, AND RECOVERY SUPPORT SERVICES. TO PROVIDE EVIDENCE-BASED, TRAUMAINFORMED CARE, THE MATCH PROGRAM REGULARLY ATTENDS CONTINUING EDUCATION OPPORTUNITIES AND ENGAGES WITH OTHER MOUD PROVIDERS AS A COHORT, TO BETTER UNDERSTAND THE COMMUNITY VALLEY CITIES IS SERVING AND TO STAY UP TO DATE ON THE MOST EFFECTIVE TREATMENT STRATEGIES. IN THAT SPIRIT, MATCH PROVIDES QUANTITATIVE AND QUALITATIVE DATA TO THE WASHINGTON STATE HEALTHCARE AUTHORITY, DBHR AND SAMHSA TO FURTHER THE MUTUAL GOAL OF HELPING THOSE WHO CONTINUE TO STRUGGLE WITH OPIATE USE DISORDER. IN 2022, MATCH SERVED 467 CLIENTS AND 396 OF THOSE WERE NEW INDUCTIONS. LOW-BARRIER BUPRENORPHINE SERVICE EXPANSION PROGRAM IN 2018, VALLEY CITIES FACILITATED ACCESS TO BUPRENORPHINE INDUCTION AND TREATMENT SERVICES THAT PROVIDE A CONTINUUM OF MEDICATION ASSISTED TREATMENT AND RECOVERY SUPPORT SERVICES DESIGNED FROM A RECOVERY AND RESILIENCY PERSPECTIVE AND AVAILABLE TO ELIGIBLE INDIVIDUALS IN KING COUNTY. VALLEY CITIES WORKED COOPERATIVELY WITH BEHAVIORAL HEALTH RECOVERY DIVISION (BHRD) ON A MUTUALLY AGREED-UPON PROCESS TO QUALITATIVELY EVALUATE TREATMENT ACTIVITIES TO HELP ANSWER QUESTIONS RELATED TO BUPRENORPHINE PROGRAM SUCCESS AND TO CREATE AND IDENTIFY LEARNING OPPORTUNITIES WHILE AN EFFECTIVE LOW-BARRIER MAT NETWORK IS DEVELOPED IN KING COUNTY. ASSISTED OUTPATIENT SERVICES PROGRAM THE ASSISTED OUTPATIENT SERVICES PROGRAM (AOSP) WAS CREATED BY KING COUNTY IN ORDER TO REDUCE OR PREVENT DECOMPENSATION, RE-HOSPITALIZATION, AND OTHER EMERGENCY BEHAVIORAL HEALTH RESPONSES FOR CLIENTS WHO HAVE BEEN DISCHARGED FROM COMMUNITY HOSPITALS AND EVALUATION AND TREATMENT (E&amp;T) FACILITIES ON A LESS RESTRICTIVE ORDER (LRO), LESS RESTRICTIVE ALTERNATIVE (LRA), OR CONDITIONAL RELEASE (CR). THE GOAL OF AOSP IS TO SUCCESSFULLY TRANSITION CLIENTS FROM A HIGHER LEVEL OF CARE TO OUTPATIENT BEHAVIORAL HEALTH SERVICES AS WELL AS ENSURE THAT CLIENTS MAINTAIN A HIGH LEVEL OF ENGAGEMENT IN OUTPATIENT SERVICES FOR THE DURATION OF THEIR LRO, LRA OR CR. KING COUNTY PROVIDES AN INCENTIVE PAYMENT WHEN VALLEY CITIES ENGAGES AN AOSP ENROLLED CLIENT IN AT LEAST 12 CONTACTS PER MONTH. CLIENTS ARE ENROLLED IN AOSP FOR THE DURATION OF THEIR LRO, LRA OR CR WHICH IS TYPICALLY 3 MONTHS BUT CAN BE 6 MONTH</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PAGE 2, PART III, LINE 4D</FormAndLineReferenceDesc>
        <ExplanationTxt>CLINICAL SUPPORT SERVICES CLINICAL SUPPORT SERVICES INCLUDES INFORMATION SYSTEMS, ACCESS SERVICES INCLUDING ALL TELEPHONE SCREENING AND INITIAL INTAKE SERVICES, AFTER-HOURS CRISES TEAM, FRONT DESK SUPPORT, MEDICAL RECORDS, CALL CENTER AND QUALITY MANAGEMENT SERVICES. THESE PROGRAMS DIRECTLY SUPPORT ALL CLINICAL PROGRAMS BY PROVIDING EITHER CLIENT ASSISTANCE AND/OR DATA COLLECTION AND REPORTING IN ORDER TO MANAGE CLIENT CARE. THE DEVELOPMENT DEPARTMENT CARRIES OUT FUNDRAISING, MARKETING, PUBLIC RELATIONS, GRANT WRITING, AND PUBLIC POLICY ADVOCACY. THE HUMAN RESOURCES DEPARTMENT OVERSEES PERSONNEL, STAFF TRAINING, STUDENT INTERN, AND VOLUNTEER FUNCTIONS, AND THE ADMINISTRATION AND FINANCE DEPARTMENTS OVERSEE THE REVENUE CYCLE TEAM, SUPPORT STAFF, ACCOUNTING AND PAYROLL OPERATIONS.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PAGE 6, PART VI, LINE 11B</FormAndLineReferenceDesc>
        <ExplanationTxt>THE FINANCE COMMITTEE REVIEWS A DRAFT COPY OF THE FORM 990 FOR ACCURACY AND PRESENTS TO THE FULL BOARD OF DIRECTORS FOR APPROVAL BEFORE FILING.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PAGE 6, PART VI, LINE 12C</FormAndLineReferenceDesc>
        <ExplanationTxt>WRITTEN CONFLICT OF INTEREST POLICY IN PLACE THAT EACH BOARD MEMBER AND OFFICER IS REQUIRED TO SIGN AND DISCLOSE THEIR INTERESTS ANNUALLY.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PAGE 6, PART VI, LINE 15A</FormAndLineReferenceDesc>
        <ExplanationTxt>HUMAN RESOURCES PERFORMS A SALARY COMPARISON WITH LIKE AGENCIES FOR THE POSITION. THE CEO HAS AN "AT WILL" CONTRACT REVIEWED AND APPROVED BY THE BOARD ANNUALLY, AND CAN BE TERMINATED AT ANYTIME.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PAGE 6, PART VI, LINE 15B</FormAndLineReferenceDesc>
        <ExplanationTxt>HUMAN RESOURCES PERFORMS A SALARY COMPARISON WITH LIKE AGENCIES FOR THE POSITION. SALARY IS REVIEWED AND APPROVED BY THE CEO, CFO, CMO, COO, AND THE EXECUTIVE COMMITTEE OF THE BOARD OF DIRECTORS.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PAGE 6, PART VI, LINE 19</FormAndLineReferenceDesc>
        <ExplanationTxt>THE GOVERNING DOCUMENTS ARE PROVIDED TO FUNDERS, AUDITORS, AND THE STATE OF WASHINGTON. ALL DOCUMENTS ARE MADE AVAILABLE UPON REQUEST.</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleO>
  </ReturnData>
</Return>
