The purpose of this bulletin is to remind hospitals of their obligation to provide parents/guardians seeking mental health or substance use disorder (SUD) treatment or evaluation for a minor child notice of all legally available treatment options, per RCW 71.34.375. This notice requirement arises when a parent/guardian brings a child aged 13 to 18 years old to a facility without the child’s consent—a treatment option for adolescents under RCW 71.34 known as Parent-Initiated Treatment (PIT).
This bulletin also provides updated resources to help fulfill the notice requirement, including:
- Written notice prepared by the Health Care Authority (HCA) that includes both mental health and SUD treatment options;
- A list of facilities that provide adolescent SUD and co-occurring disorders (COD) residential care services;
- A list of facilities that provide adolescent acute inpatient services for mental health disorders; and
- Contact information for the HCA’s PIT notice and review administrator.
The notice requirement for PIT under RCW 71.34.375 applies to hospitals licensed under RCW 70.41, psychiatric hospitals licensed under RCW 71.12, as well as state psychiatric hospitals licensed under RCW 72.23.
In order to comply with the notice requirement, hospitals must:
- Discuss with parents/guardians all the available treatment options available under RCW 71.34;
- Provide parents/guardians written notice regarding all the available treatment obtains; and
- Obtain a signed acknowledgement by a parent/guardian that he or she received both the verbal and written notice.
To ensure compliance, WSHA recommends that facilities be sure to obtain a signature from a parent/guardian evidencing his or her receipt of the notice, or indicate the reason(s) why a signature could not be obtained. A copy of the signed notice should be included in the minor patient’s chart.
Under PIT, RCW 71.34.600-670, parents/guardians may bring a minor child 13 to 18 years old to a hospital for the purposes of evaluation and treatment without the child’s consent. PIT is one of the available treatment options for these patients within this age group who may need mental health and SUD evaluation or treatment. Other treatment options include minor-initiated treatment, RCW 71.34.500-530, and involuntary treatment, RCW 71.34.700-795.
No provider is obligated to provide treatment to a minor under PIT. However, the minor’s refusal to consent to treatment cannot be the sole basis for a decision to decline services. In any event, notice must be provided.
The PIT notice requirement. RCW 71.34.375 requires that hospitals promptly provide verbal and written notification of all statutorily available treatment options when a parent/guardian brings in his or her minor child for mental health or SUD evaluation or treatment. The notice must contain the following:
- All current statutorily available treatment options including minor-initiated treatment, PIT, and involuntary treatment; and
- The processes involved in utilizing each of the treatment options.
A parent/guardian must sign an acknowledgement that he or she received the written notice.
Updated written notice. As part of its obligation to provide facilities a written notice that satisfies the above requirements, the HCA has updated its written notice to reflect the inclusion of both mental health and SUD treatment options.
The updated written notification and acknowledgement form will soon be available online under the HCA’s Children, Youth and Family webpage. WSHA will advise members when that resource becomes available.
Failure to provide verbal and written notice. Failure to provide verbal and written notice could lead to a civil penalty of $1,000 for each failure to provide adequate notice. For facilities licensed under RCW 70.41 or RCW 71.12, failure to provide verbal and written notice is subject to the enforcement authority of the Department of Health.
1. Mental health and SUD facilities lists. To assist members in fielding questions about SUD facilities, WSHA has obtained a list of facilities that offer SUD (and co-occurring) residential treatment. We are also including a list of facilities that offer adolescent acute inpatient mental health treatment. These lists include bed capacity and contact information.
Please note: The HCA is presently working on making these lists available online with regular updates. Bed capacity changes frequently. WSHA will advise hospitals when this process becomes available online. In any event, we recommend that you contact each facility to confirm capacity.
2. HCA Contact Information for PIT admissions. The provider in charge of making admission decisions is required to inform the HCA that a minor needs to be held under PIT within 24 hours of completing an evaluation, per RCW 71.34.600. Further notice to the HCA is required if the provider in charge believes the minor must be held for more than 7 days, per RCW 71.34.610. These notices should be sent to the Children’s Long-Term Inpatient Program (CLIP), which is responsible for PIT notices and reviews.
Notification for all PIT admissions and need for PIT reviews:
CLIP Administration Office Phone number: (206) 588-2985
Children’s Long-Term Inpatient Program (CLIP) Administration Office:
Background and References