A Looming Boondoggle at Harborview

When things go wrong in government, especially in public infrastructure projects, elected officials often try to save face with tight smiles and platitudes worthy of a halftime speech when a team is getting its butt kicked. So a King County Council meeting last month on a potential boondoggle brewing on a mega-construction project at Harborview Medical Center was refreshing.

The mess involves the second massive set of cost-overruns for a huge expansion at Harborview, thanks to the largess of King County taxpayers via a 2020 countywide vote on a $1.74B bond. By the county’s math, that project may now cost at least $2.2B, but they’re still in negotiations with their general contractor, so who knows? Deadlines were continuing to blow by. So things got spicy at the meeting, raising the question of what, if anything, would actually get built.

“How do we start this project if we know we don’t have the resources to build it?” asked Councilmember Rod Dembowski.

“The costs are just escalating beyond control,” said Councilmember Claudia Balducci. “It’s extraordinarily frustrating.”

Why you should care about this

Harborview, the premier safety net hospital in the region and the only level one trauma center in four states, has a special place in the civic heart of King County. But it’s aging, overcrowded and has ongoing financial problems. The bond was supposed to address all three (the hospital is owned by King County and run by UW Medicine). And big picture, the Harborview mess reaffirms growing skepticism about government’s ability to do big things.

The original plan pitched to voters deep into the pandemic was a new 10-story tower, a new behavioral health building, 150 respite beds in the adjacent Harborview Hall, a fixed-up Pioneer Square clinic and a host of upgrades. With King County Executive Dow Constantine as a lead cheerleader, voters showered it with a 76 percent yes margin in 2020.

And then things started going sideways. The construction delays and massive cost run-ups in the pandemic and beyond certainly didn’t help, but Constantine’s team apparently picked the wrong design-builder as well as the wrong owner’s rep. They were both replaced within the last year. It’s the second builder that is now locked in negotiations with the new division of King County government spun up specifically to do the project.

The financing was already in trouble by 2023, when new cost estimates showed the $1.74.B plan had ballooned to nearly $2.7B. Even in government work, missing the mark by $900M within three years is a whopper. That led to a work group skinnying the whole project down: 3 of those 10 new floors would be built but not finished, and the behavioral health facility and those Harborview Hall beds were scrapped. That got the estimate back down to the original bond amount, sort of. And deadlines were reset, aiming for a December 2028 move-in date. Not great, and definitely a candidate for the Observer’s unofficial Outrages in Public Projects (sounds like “ooops!”) scale, although not on the scale of Sound Transit’s screw-Ballard plan.

And then the deadlines started getting so thoroughly blown as to make them laughable. The first patient admitted won’t be until May 2032, more than 11 years after voters turned the spigot on. The project doesn’t yet have a master use permit from the city of Seattle.

So council members at last month’s come-to-Jesus meeting had reason to be incredulous. Councilmembers said they’ve not gotten regular updates, so there was some headscratching about one of the new budget bombs that had suddenly spiked – a $160M parking garage. But Councilmember Stephanie Fain said the need for more parking shouldn’t have been a surprise at all because it was flagged during that 2023 “rescoping” plan. She should know: she was chair of Harborview’s board at the time.

So what happens now? County Executive Girmay Zahilay’s team told the council he was committed to delivering the project.² He’s gotten credit for regularly meeting with Harborview about the project³, which says something about Constantine’s approach. But getting that done may mean cutting back the scope of what was sold to voters back in 2020 for a second time; or magicking some more money. That magic will likely involve a whole second pot of public money, a property tax for Harborview operations that is councilmatic (aka it didn’t get a public vote) thanks to 2024 legislation from Olympia, HB 2348. How much of those operations dollars get diverted to actually building the Harborview tower is tbd, and the council could hike up the tax, or bond against it. Either way, “Time is money, and we’re not moving fast,” said Balducci.

A version of this story first appeared on the Washington Observer website.
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