2559. Hospital Holds

Original Date:  September 1995

Revised Date:  July 1, 2024

Policy Sunset Review:  July 31, 2028

Approved by:  Natalie Green, Assistant Secretary of Child Welfare Division

Purpose

Hospital administrators or physicians have legal authority to delay discharge of a child or youth through a hospital hold for up to 72 hours, without DCYF taking placement and care authority (PCA). The hospital administrator or physician must believe a child or youth is in imminent physical harm if released to their parents or guardians. This policy provides direction on how to respond to a hospital hold.

Scope

This policy applies to child welfare employees.

Laws

RCW 26.44.056  Protective detention or custody of abused child-Reasonable cause-Notice- Time limits-Monitoring plan-Liability

Policy

Caseworkers must:

1. Assess if the child or youth is in imminent physical harm due to child abuse or neglect if discharged to the parents or guardians, when hospital administrators or physicians puts a child or youth on a hospital hold. 
2. Obtain the PCA of the child or youth if it is determined that they are in imminent physical harm and a safety plan cannot be developed to control or manage the identified threat.

Procedures

Caseworkers must complete the following when children or youth are placed on hospital holds:

1. Contact the hospital to identify and determine the child’s or youth’s: 
   1. Release date. 
   2. Medical issues if they are not ready for discharge.
   3. Medical and behavioral needs once released.
2. Document the information received from the hospital in a FamLink case note. 
3. Follow the Indian Child Welfare (ICW) Intake policy when there is reason to know children are or may be Indian children. 
4. If the child or youth is at risk of imminent physical harm and placement is being considered, follow the Safety Assessment and Family Team Decision Making (FTDM) policies and when it is determined the child or youth: 
   1. May be safely discharged home, return them to the parents or guardians.
   2. Cannot be safely discharged to their parents or guardians:
      1. Obtain PCA through one of the following:
         1. Child Custody Transfer DCYF 10-157 form, when DCYF takes PCA of a child or youth from a hospital hold and:
            1. Verify the Child Custody Transfer DCYF 10-157 form has been signed by one of the following:
               1. Hospital administrator
               2. Physician
            2. Upload the completed and signed form into FamLink.
            3. Review the discharge summary to identify the child’s or youth’s medical and behavioral needs. 
            4. Verify the child or youth receives necessary follow-up health care as specified by the medical provider in the Health Care Services for Children Placed in Out-of-Home Care policy. 
         2. Court order
         3. VPA 
      2. Follow these policies:
         1. Out-of-Home Placements
         2. Dependency Petition Process 
         3. Medically Fragile Children

Forms

Child Custody Transfer DCYF 10-157 (located in the Forms repository on the DCYF intranet)

Resources

Dependency Petition Process policy

Family Team Decision Making (FTDM) policy

Health Care Services for Children Placed in Out-of-Home Care policy

ICW Intake policy

Medically Fragile Children policy

Out-of-Home Placements policy

Safety Assessment policy

Safety Plan policy

Voluntary Placement Agreement (VPA) policy