Phase II Final DOH Rules for Behavioral Health Agency Licensing and Certification

May 30, 2023

Hospital Action Required

To: Psychiatric Hospital and Inpatient Behavioral Health Executives and Administrators, Legal Counsel, Risk Management, and Government Affairs Staff
Staff Contact: Cara Helmer, RN, JD, Policy Director, Legal Affairs | (206) 577-1827
Subject: Phase II Final DOH Rules for Behavioral Health Agency Licensing and Certification



This bulletin informs hospitals that the new Department of Health (DOH) rules for Behavioral Health Agency licensing and certification requirements went into effect on May 1, 2023.


DOH has issued its second phase of regulations for the licensing and certification of all behavioral health services under Chapter 246-341 WAC. These regulations apply to facilities defined in law as “licensed or certified behavioral health agencies” (BHAs), which include psychiatric hospitals and acute care hospitals with inpatient units, as well as outpatient clinics that provide behavioral health services licensed and certified by DOH.

All hospital units, clinics, and settings that provide licensed and certified mental health and substance use (together “behavioral health”) services are BHAs. Hospital settings that accept Single Bed Certification under RCW 71.05.745 are not captured by these regulations.


  1. Review the information on DOH’s Phase 2 rulemaking webpage which includes a certification crosswalk, the new updated rules, a matrix and summary of the rule changes, frequently asked question, and revised BHA licensing and certification requirements. WSHA recommends BHAs review the new rules with legal counsel and clinical and administrative personnel, as appropriate.
  2. Review and update your policies and procedures:
    1. Update outdated WAC references. Many WAC sections have been renumbered and references to the WAC in any written documents will likely need to be updated.
    2. Check if the service requirements for your agency’s certification have changed and need updating.
    3. Note: DOH is preparing a policy and procedure review tool as well as an updated BHA licensing application. WSHA will share these documents when they are available.
  1. Familiarize yourself with the updated certifications and plan for license renewal: The Phase 2 rules creates broader categories of certifications, designed to integrate mental health and substance use disorder services and to combine individual services with common requirements. This is meant to provide agencies with greater flexibility to modify services and meet the needs of their communities.
    1. When it is time to renew your BHA license you will need to submit a renewal application aligned with the updated certification titles. To plan for recertification, familiarize yourself with the updated certifications that align with your agency’s current certification titles.
    2. The BHA Certification Crosswalk includes a list of where previous certifications are located in the revised rules along with associated changes to service standards.
  1. Prepare to participate in “Phase 3” of the rulemaking. The Phase 2 rules are the second of a multi-phase rulemaking project by DOH to update and modernize the licensing regime for behavioral health services in Washington. You can find WSHA’s bulletin on the Phase 1 rules here. DOH has not released the dates for when Phase 3 rulemaking will begin. WSHA will provide further details as they are available.

Chapter 246-341 WAC regulates the provision of all licensed behavioral health services. The chapter sets out the administrative requirements that facilities and providers must meet to provide behavioral health services, including those licensed under chapter 71.05 RCW (involuntary treatment of adults) and chapter 71.24 RCW (the Community Behavioral Health Services Act). These services were historically overseen by the Department of Social and Human Services (DSHS) but were transferred to DOH in 2018 as part of the state’s move toward integration.

In 2020, DOH initiated a multi-year, multi-phase rulemaking process to modernize the entire chapter, to reflect current practice, ease administrative burden, and help increase access to services by removing avoidable regulatory barriers.

  • Phase 1: Phase 1 took place in summer and fall 2020. The finalized Phase 1 rules became effective July 1, 2021, (compliance date January 1, 2022). Phase 1 concentrated on updating language, refining inconsistencies across services, and addressing other obvious areas of improvement. WSHA’s bulletin on the Phase 1 rules can be found here.
  • Phase 2: Phase 2 workshops took place starting summer 2021 through late fall 2021. The final Phase 2 rules went into effect on May 1, 2023. Phase 2 focused on updating behavioral health certifications to streamline the approach and create broader certification types.
  • Phase: Phase 3 will focus on aligning regulations across facility types. This rulemaking will be especially relevant for hospital BHAs, as dually regulated entities. The start date for this phase has not been set but is likely to be later in 2023.

WSHA and a member workgroup have been active participants in both the Phase 1 and Phase 2 rulemakings. WSHA worked closely with DOH leaders and other interested parties over the course of multiple months and many stakeholder meetings to revise and update the regulatory language. WSHA will continue to stay involved and advocate for hospital interests as Phase 3 progresses. Please reach out to Cara Helmer ( for more information about WSHA’s member workgroup.

WSHA’s 2023 New Law Implementation Guide
Please visit WSHA’s new law implementation guide online. The Government Affairs team is hard at work preparing resources and information on the high priority bills that passed in 2023 to help members implement the new laws, as well as links to resources such as this bulletin. In addition, you will find the Government Affairs team’s schedule for release of upcoming resources on other laws and additional resources for implementation.

246-341 WAC
DOH BHA Rulemaking Webpage
WSHA Bulletin on Phase 1 rules


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