Working to transform the child welfare system.


HB 1874: Implementing policies related to expanding adolescent behavioral health care access as reviewed and recommended by the Children’s Mental Health Work Group

Updated on 4.12.19:

1st substitute:

  • Changed the intent section for the children’s mental health chapter;
  • Restored current law regarding the definition of “mental health professional;”
  • Modified the definition of “parent” for purposes of children’s mental health to include the following persons in order of priority:
    • A guardian or legal custodian;
    • A person authorized by the court to consent to medical care for a child in out-of-home placement;
    • A biological or adoptive parent who has legal custody of the child;
    • An individual whom the minor’s parent has given a signed authorization to make health care decisions for the minor patient; or
    • A competent adult representing himself or herself to be a relative responsible for the health care of such minor patient or a competent adult who has signed and dated a declaration under penalty of perjury stating that the adult person is a relative responsible for the health care of the minor patient;
  • Limits the notification of admission to inpatient treatment, discharge from inpatient treatment, and sharing of treatment information to mental health professionals providing solely mental health treatment information and not substance use disorder treatment to an adolescent;
  • Modifies parent-initiated outpatient treatment provisions to allow a parent to request and receive outpatient treatment for his or her adolescent without the consent of the minor if a determination is made by a provider that the adolescent is in need of such treatment for up to 12 outpatient sessions within a three-month period;
  • Allows a parent of an adolescent to request and receive treatment for his or her adolescent in a less restrictive setting, including partial hospitalization or intensive outpatient treatment without the consent of the adolescent;
  • Specified that entities providing solely mental health less restrictive treatment authorized by a parent of an adolescent must convene a treatment review at least every 30 days after the treatment begins and provide notification of the adolescent’s treatment to an independent reviewer at the HCA within 24 hours of the adolescent’s receipt of treatment to determine whether the treatment is medically necessary;
  • Entities providing less restrictive substance use disorder treatment must convene a treatment review and provide notification of the treatment to an independent reviewer at the HCA only if the adolescent provides consent or as permitted by federal law;
  • Prohibits mental health professionals from proactively providing treatment information with a parent unless the adolescent consents or in cases involving the imminent health and safety of the youth;
  • Eliminates psychoeducation about an adolescent’s substance use disorder from the treatment information that a mental health professional may share with a parent without an adolescent’s consent;
  • Requires that an adolescent receive an ample opportunity to express any concerns about disclosure of mental health treatment information without his or her consent well in advance of action to disclose that treatment information;
  • Allowed the disclosure of substance use disorder treatment or evaluation information to parents without consent of an adolescent if permitted by federal law;
  • Limited the liability of chemical dependency professionals providing inpatient or outpatient substance use disorder treatment information to a parent without an adolescent’s consent if permitted by federal law;
  • Limited the treatment information that the DCYF may share with care providers to mental health information; and
  • Made technical changes.
  • Amendment in Appropriations adding language related to the training for PIT and survey.

2nd substitute:

The Appropriations Committee recommended:

  • Including a requirement, subject to funds appropriated for this specific purpose, for the Health Care Authority (HCA) to provide online training for behavioral health providers regarding state law and best practices when providing services to children, youth, and families.
  • The training must be free for providers and must include information related to parent-initiated treatment, minor-initiated treatment, and other treatment services.
  • The HCA must also, subject to funds appropriated for this specific purpose, conduct an annual survey of parents, youth, and behavioral health providers to measure the impact of implementing policies included in the bill during the first three years of implementation.
  • The first survey must be complete by July 1, 2020, followed by subsequent surveys in 2021 and 2022.
  • The HCA must report annually on survey results to the Governor and the Legislature by November 1, beginning in 2020.
  • The final report is due November 1, 2022, and must include any recommendations for statutory changes identified as needed based on survey results.
  • Adding language providing that the bill is null and void if funding is not provided in the operating budget by June 30, 2019.

Senate (Updated on 4.12.19):

  • Required the check made to the Washington State Patrol missing persons database when an adolescent consents to inpatient mental health treatment without notice being provided to a parent, must be made once every eight hours for the first 72-hours and once every 24-hours thereafter.
  • Made technical amendments to clarify the definition of parent for the purposes of family-initiated treatment, and to clarify language related to the privacy of a minor’s mental health information
  • Changed the terms family-accessed treatment and adolescent-accessed treatment to family-initiated treatment and adolescent-initiated treatment.
  • Amended the definition of parent to eliminate a cross reference and include references to stepparents and kinship caregivers.
  • Allowed for notice to a parent of admission of an adolescent for adolescent-initiated mental health treatment to be withheld if it is determined that notice would be detrimental to the adolescent, but requires notice to be provided if the adolescent is listed in the Washington State Patrol missing persons database.

Provided that a mental health treatment provider is encouraged to share information about an adolescent’s mental health treatment with a parent when the treatment is begun through the family-initiated treatment process.