CLIP - Children's Long-term Inpatient Programs

The CLIP Programs serve children up to the age of 17 who have been diagnosed with a serious psychiatric illness. The children must be residents of the state of Washington.

There are two principal avenues for accessing CLIP resources:

Voluntary Application
and Certification

Involuntary Commitment (ITA)
180-day Restrictive Orders for
Inpatient Treatment

Voluntary Application and Certification
In accordance with the CLIP/RSN Agreements, the Regional Support Network (RSN) must review any voluntary CLIP application. Voluntary applicants or their guardian(s) must be residents of the state of Washington. In addition, voluntary applicants must have a severe psychiatric illness that warrants intensive services in an inpatient setting.

The RSN refers children to the CLIP Administration only after consideration and approval of the application at the local level. Application requirements are comprehensive and include records that document the child's inpatient and outpatient treatment, any out-of-home placements, school history and any other services the child may have received.

The CLIP Administration compiles a written summary that is submitted to the CLIP Certification Team for review. Based on the materials provided, the CLIP Certification Team determines whether an individual applicant meets Medicaid medical necessity criteria. If the CLIP Certification Team approves the application, the child's name is placed on the statewide waiting list until a bed becomes available at the most appropriate CLIP Program.

Involuntary Commitment (ITA) 180-day Restrictive Orders for Inpatient Treatment
Under Washington State's juvenile mental health services law (RCW 71.34), adolescents aged 13-17 may be committed for up to 180 days of involuntary inpatient psychiatric treatment. Under this 180-day restrictive court order, the adolescent becomes eligible for admission to a CLIP Program. The adolescent's name is placed on the statewide waiting list as of the date of the 180-day Restrictive ITA order.

The CLIP Administration's Placement Team is legally authorized to assign committed adolescents to one of the four CLIP Programs. The assignment is based on preferences expressed by family members, and by professionals directly involved in the adolescent's care. The location of the adolescent's supports and the availability of beds within the CLIP Programs also influence the assignment. Once admitted to a CLIP Program, the adolescent may agree at any time to remain as a voluntary patient.

Other Access
There are two other means of access to inpatient psychiatric care in a CLIP Program. These types of admissions are infrequent.

RCW 10.77 allows for children to be court-ordered, through the criminal justice system for psychiatric evaluation and/or to regain competency to stand trial. If an inpatient restoration to competency is needed, the child is admitted to Child Study & Treatment Center (CSTC). If the responsible RSN determines that the child should remain in treatment beyond the term of the 10.77 order (up to 90 days), a voluntary application must be submitted to the CLIP Administration according to voluntary application procedures.

RCW 71.34 also permits the transfer of an adjudicated youth from a Juvenile Rehabilitation Administration (JRA) facility to CSTC for up to 14 days of psychiatric evaluation and treatment. After the 14 days, the youth may only remain if placed on an involuntary order, or if approved for voluntary admission by the CLIP Administration.