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Family initiated treatment (FIT)

As a provider, be aware that parents may consent to family initiated treatment (FIT) on behalf of youth who meet medical necessity. Consent from the youth is not required. The FIT process creates an additional access point but does not guarantee care on demand for youth admitted through FIT. You will have individual processes and requirements for evaluation and admission to services.

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Eligibility requirements

Youth ages 13-17 years old.

Provider requirements

In accordance with RCW 71.34.375, you must inform the parent or guardian of all available treatment options. As long as you have the capacity and skill, you must treat the youth, even if they refuse care. You can only admit a youth to treatment if it is medically necessary. (See RCW 71.34.600 for details.)

For more information, see the behavioral health treatment options for youth form.

Learn about FIT behavioral health treatment options.

FIT review notifications

Within 24 hours of all inpatient or outpatient admissions under FIT, you must notify HCA’s contractor and the FIT administration office via secure email at or via secure fax 206-859-6432.

For more information about the review process and what it should include, see the provider's guide to family initiated treatment (updated 3/27/2020).

Outpatient FIT

Medically necessary FIT outpatient services may be available.

For specific, step by step directions, see the provider's guide to family initiated treatment (updated 3/27/2020).

Inpatient and residential FIT

Medically necessary FIT may be available for inpatient or residential services.

Youth admitted to inpatient facilities under FIT must be released immediately upon the written request of the parent, or:

  • The youth's status changes to voluntary, or
  • A Designated Crisis Responder (DCR) initiates involuntary commitment proceedings.

For specific, step by step directions, see the provider's guide to family initiated treatment (updated 3/27/2020).

Mental health information disclosure

Washington state law about what information mental health professionals can share has changed. Mental health providers are now allowed to communicate some youth (age 13-17) treatment information to parents, if the provider believes that sharing this information would benefit the treatment process. This includes sharing information through Family Initiated Treatment (FIT). For more information about mental health disclosure see the mental health information disclosure guidance.

Frequently asked questions (FAQ)

In accordance with 71.34.650(6), there are no limits on intensive outpatient treatment services and use of partial hospitalizations. Intensive outpatient treatment services and partial hospitalizations are covered at the discretion of the behavioral health professionals.

In accordance with SHB 2883, the process for inpatient treatment applies and medical necessity is required.

Background and core values

FIT was developed, based in part on recommendations made by the Parent Initiated Treatment (PIT) Stakeholder Advisory Group that included youth, parents, clinicians, hospitals/emergency departments, and child systems advocates. PIT for acute inpatient evaluation and treatment is long standing and has evolved into FIT, which provides an avenue for outpatient evaluation and treatment as well as additional guidelines associated with the FIT legislation. The stakeholder group's findings and recommendations were delivered to the Children's Mental Health Work Group on December 1, 2018. In 2019, the Legislature enacted Engrossed Second Substitute House Bill 1874.

The Washington State prenatal through 25 behavioral health system is guided by three core values:

  • Family and youth driven
  • Culturally based services
  • Services that address diversity and health disparities

Youth who need services have the right to get those services in the least restrictive setting that best meet their need and keep them within their community whenever possible.

Page last updated: October 14, 2021