Crisis Relief Centers - Frequently Asked Questions

All facilities request a license to perform a certain service. These service types are considered a ‘Certification’ under the Behavioral Health Agency license. A CRC, is one such ‘certification’ that is part of a Behavioral Health Agency (BHA) license. The BHA license application, requesting certification as a CRC, may  be made in concert with other applications and more than one certification may be requested at the time of licensure.  

The Crisis Relief Center is a specific type of facility that must be built to specific standards (see WAC 246-341-0903 (5)-(8) ). Note: There is a requirement for a pre-submission conference with the department for projects with a construction value of $250,000 or more. 

Yes. So long as there are separate internal entrances, spaces and treatment areas such that no contact occurs between minor and adult 23-hour crisis relief center admissions.

Note: A CRC may serve adults only or minors only as well and it must be designated as ‘adult’, ‘minor’ or both on the BHA certification along with the number of recliners used for each and total.

Yes, and the differences can be significant. Rules related to the Adult CRC have been approved and went into effect in September of 2024. The WAC rules for the ‘Minor CRC’ are in process and are set to go into effect sometime in 2025. 

The CRC is a ’23-hour’ facility. Are there any exceptions to the ’23-hour’ rule?

In certain circumstances, there are exceptions. A person may stay up to a maximum of 36 hours when: 

• an admission is waiting on a designated crisis responder evaluation
• an admission is making an imminent transition to another setting as part of an established aftercare plan, including a minor who is:
  • allegedly abandoned according to RCW 13.34.030(1), and is receiving support from Department of Children, Youth, and Families (DCYF); 
  • transitioning to an alternative placement option; or
  • a dependent of the state who is transitioning to a DCYF placement.

The law was enacted in 2024: RCW 71.24.916: 23-hour crisis relief centers—Licensing and certification—Rules—Standards.

A CRC is an outpatient facility and only needs a BHA license with the proper certification.

Chapter 246-341 WAC

WAC 246-341-0903

More information and applications can be found: Behavioral Health Agencies (BHA) | Washington State Department of Health

Yes, but they must maintain separation. Multiple facilities can be under the same roof or on the same campus but they are licensed as separate facilities under the same Behavioral Health Agency (BHA).

No. The process for initiating involuntary treatment is specifically detailed here: 

• If the Designated Crisis Responder (DCR) has not been contacted and the Peace Officer is requesting the person in their custody be evaluated for treatment:
  • The person may be “dropped off” at the CRC.
  • A CRC may not refuse peace officer drop offs. RCW 10.31.110 states that when a police officer has reasonable cause to believe that the individual has a mental disorder or substance use disorder, the arresting officer is authorized and encouraged to take the individual to a 23-hour crisis relief center via an involuntary transport order (sometimes referred to as an IVT).
  • An individual delivered to a 23-hour crisis relief center by a peace officer may be held up to a period of twelve hours by the CRC.
  • The CRC is not, however, required to hold the individual for twelve hours. RCW 10.31.110(1)(b) does require the CRC to ensure the individual is examined by a mental health professional or SUDP within three hours of arrival. The examination will determine whether the individual will be admitted or released.
  • Upon evaluation the CRC could then admit the individual either voluntarily or they may contact the DCR for ITA evaluation. The CRC may also, however, choose to discharge the individual upon their request (assuming the individual does not meet criteria for admission or DCR evaluation pursuant to RCW 71.05.050(4)).
• If the DCR has been contacted, the person has not yet been evaluated and a peace officer is needing to deliver a person to a facility for the DCR evaluation:
  • The person may be delivered to the CRC by a peace officer and held until evaluation by the DCR within the given time restraints.
• If the Designate Crisis Responder (DCR) has been contacted, has evaluated the person, and is enacting the Involuntary Treatment Act (ITA)
  • The person is not to be delivered to a CRC. While a CRC cannot refuse Peace Office drop offs, they cannot accept a person that has been detained under an ITA order. RCW 71.05.153 states that after the DCR has determined the need for ITA the person is to delivered to an emergency department, evaluation and treatment facility, secure withdrawal management and stabilization facility if available with adequate space for the person, or approved substance use disorder treatment program if available with adequate space for the person, for not more than one hundred twenty hours as described in RCW 71.05.180.

Yes. If there is a reason to believe that a person meets criteria for involuntary treatment, a Designated Crisis Responder may be called to the CRC to evaluate whether the person meets criteria for involuntary treatment. If DRC decides that the person meets criteria, the person must be transferred to the appropriate facility. If the person is seen to not meet criteria, they must be discharged and/or offered a higher level of care as a voluntary admission.

No. A CRC may have a seclusion and restraint room but it is not a requirement. If a seclusion and restraint room is utilized, the CRC must follow the appropriate guidelines found in Chapter 246-337 WAC.

No. A CRC is considered a voluntary, non-secure facility. There may be delayed egress but the persons must be allowed to leave on their own accord.

Yes. 

RCW 71.05.020 (18) defines "Detention" or "detain" as the lawful confinement of a person.

If the staff of the CRC believe the person meets ITA criteria, then the CRC can detain the person for twelve hours from the notification to the DCR under RCW 71.05.050. 

RCW 71.05.050 (4) If a person is brought to or accepted at a 23-hour crisis relief center and thereafter refuses to stay voluntarily, and the professional staff of the 23-hour crisis relief center regard the person as presenting as a result of a behavioral health disorder an imminent likelihood of serious harm, or presenting as an imminent danger because of grave disability, they may detain the person for sufficient time to enable the designated crisis responder to complete an evaluation, and, if involuntary commitment criteria are met, authorize the person being further held in custody or transported to a hospital emergency department, evaluation and treatment center, secure withdrawal management and stabilization facility, or approved substance use disorder treatment program pursuant to the provisions of this chapter, but which time shall be no more than 12 hours from the time the professional staff notify the designated crisis responder of the need for evaluation.

No. Due to the requirement in RCW 71.24.916 that the CRC allows for a person to remain in the facility past the 24 hour mark requires the inpatient guidelines be used. The RCW does dictate that “Exceptions to the time limit made under this subsection shall not cause a 23-hour crisis relief center to be classified as a residential treatment facility under RCW 71.12.455” but that does not encompass building codes that require the facility to be seen as an “inpatient” facility. The Department will continue to view the facility under “outpatient” BHA rules and will not apply RTF standards except where specifically noted in rule.

If the DCR determines the individual meets criteria for emergency custody pursuant to RCW 71.05.153(1), the DCR may take the person, or cause by oral or written order, the person to be taken into emergency custody in an emergency department, evaluation and treatment facility, secure withdrawal management and stabilization facility or approved substance use disorder treatment program. The person remains at the CRC only until safe and proper transport to one of the above facilities may be arranged.

If, after the DCR evaluation, the DCR determines the individual does NOT meet criteria for ITA/emergency custody pursuant to RCW 71.05.153(1), the CRC must allow the individual to leave if they wish. If the individual decompensates further while at the CRC, the DCR may be called back for another evaluation.