The Metropolitan King County Council Budget and Fiscal Management Committee on July 23 voted 7-0 to give a due-pass recommendation to proposed ordinance 2025-0165, a supplemental appropriation of $51,800,000 to the County Hospital Capital Fund to pay for a set of capital-maintenance projects at Harborview Medical Center over six years. Sam Porter, council central staff, told the committee "the executive's intent is that these projects would be funded by county hospital levy revenue."

Why it matters: The ordinance would allow immediate acquisition and early design work on a replacement location for Harborview's Pioneer Square Clinic and fund high-priority infrastructure repairs across the Harborview campus. Executive staff say the projects were prioritized through a multi-month risk analysis and coordination with Harborview facilities; the purchase-and-sale agreement for the Duncan Building contains a council-appropriation contingency and the agreement expires unless the appropriation is effective by Sept. 30.

The ordinance does not itself require county hospital levy dollars, but staff said the executive intends to use levy revenue. Table 1 in the staff report (packet page 24) lists the largest items in the package: $13,900,000 for an auxiliary loop replacement for CT scanners 3 and 4 in the West Hospital (anticipated complete in 2027); $21,900,000 covering the first six years of a 10-year program to replace campus HVAC controls; $825,000 to replace major isolation heating valves in the Ninth and Jefferson Building (anticipated this year); $313,000 to replace a major heating tube bundle in the Ninth and Jefferson Building; $7,500,000 to acquire and begin design for the Duncan Building to house the Pioneer Square Clinic; and $7,300,000 to replace elements of the steam system in the subbasement. The staff report also lists an initial estimate of $21,800,000 to cover additional renovation costs converting the Duncan Building for clinic use.

Tony Wright, director of Harborview Construction and Infrastructure, described the Duncan Building purchase as "a great opportunity" to secure a site close to the current clinic "without interruption of services." Wright said the existing clinic is county-owned and "is unreinforced masonry" and "is in pretty poor shape structurally," and recommended surplusing the old building and using proceeds for the hospital program. Wright said the appropriation would fund acquisition and design work and that the county would likely return later for renovation construction appropriations once design is complete.

On the HVAC controls project, Wright said the campus system is "well past end of life" and that the control backbone requires replacement rather than incremental fixes; he described the current control system as effectively obsolete and said replacing the backbone is the only practical path to modern monitoring and operations. On steam and resilient energy, Wright said the county is analyzing options and that future work could move toward locally generated or mid-temperature water systems as part of broader campus resiliency planning.

Staff also told the committee the purchase-and-sale agreement for the Duncan Building includes a council appropriation contingency; executive staff said all extensions on the PSA have been exhausted and the transaction must be completed by Sept. 30 to avoid expiration. If the county hospital levy is not issued in the years indicated or money is not designated for these projects, executive staff said they would work with Harborview on discontinuing, delaying or identifying alternate fund sources such as the general fund.

Council discussion covered sequencing, the risk-based prioritization process, zoning and permitting for the Duncan Building (staff reported the current zoning allows the proposed use and that a conditional use permit will be required), and a technical amendment correcting three references to the appropriation amount and updating the fund title to "County Hospital Capital Fund." Vice Chair Barone moved the ordinance and moved a technical Amendment 1; the committee adopted the amendment and then approved the ordinance as amended by roll call vote, 7 ayes, 0 noes. The roll call recorded votes by Council Member Balducci (Aye); Council Member Barone (Aye); Council Member Mosqueda (Aye); Council Member Perry (Aye); Council Member Quinn (Aye); Council Member Zahilay (Aye); and Chair Dombowski (Aye).

Discussion vs. action: Committee members and staff discussed project prioritization, the need for future appropriations for renovation work, sequencing to avoid interrupting hospital operations, and the contingency that the executive intends levy backing but the legislation does not legally require levy funding. The committee’s formal action was a due-pass recommendation to advance the ordinance to the full council on the consent agenda on an expedited basis.

What happens next: The ordinance (as amended) will be advanced to the full council consent agenda for final consideration and any additional appropriations for renovation work will be considered in subsequent budget or supplemental appropriation requests.