Frequently Asked Questions

Definitions and Terminology

What is a tribal attestation?

An Indian health care provider applying for licensure and certification of a Behavioral Health Agency (BHA), Residential Treatment Facility (RTF), or Behavioral Health Hospital (also known as Private Psychiatric Hospital) may attest that their facility meets the applicable state minimum standards. The Department of Health (department) doesn't assert regulatory jurisdiction over a license issued through tribal attestation. Once the department accepts the tribal attestation, a facility license will be issued to the undersigned Indian health care provider. Tribal BHAs licensed through attestation will be included in the online BHA Directory (xlsx).

How is “Indian health care provider” defined?

“Indian health care provider" means a health care program operated by the Indian health service or by a tribe, tribal organization, or urban Indian organization as those terms are defined in the Indian health care improvement act (25 U.S.C. Sec. 1603).

What are the state minimum standards for BHAs, RTFs, and behavioral health hospitals?

State minimum standards for each facility type are as follows:

BHA Licensing and Certification Requirements - chapter 246-341 WAC
RTF - chapter 246-337 WAC
Behavioral Health Hospital (Private Psychiatric Hospitals) - chapter 246-322 WAC

Is an attestation equivalent to a regular BHA, RTF, or behavioral health hospital license?

Yes. Tribal attestations are equivalent to a standard facility license and recognized by third-party insurance and the courts.

Licensing Information and Fees

What is the process for obtaining a BHA, RTF, or Behavioral Health Hospital license from DOH through a tribal attestation?

Download and complete the Tribal Attestation BHA, RTF, and Behavioral Health Hospital Licensing Application (PDF).
Download and complete the Washington State Department of Health Tribal Attestation for BHA, RTF, and Behavioral Health Hospitals (PDF).
Mail completed materials (tribal BHA, RTF, and Behavioral Health Hospital license application packet and tribal attestation form) and administrative processing fee to:
Department of Health
P.O. Box 1099
Olympia, WA 98507-1099
When DOH receives your application materials, the Tribal Relations Director forwards the attestation to the Secretary of Health for review and signature. The Tribal Relations Director notifies the licensing team when the attestation is signed. That team then issues the license back to the tribal applicant.

What is the fee for licensure through attestation?

Fees apply to new, renewed, or amended attestations and licensing applications (WAC 246-341-0367).

Attestation agreement - $130

BHA License - $131

RTF License - $131

Behavioral Health Hospital License - $131

Amending services (changing location or services) - $131

Amending attestation (to add another facility type) - $130

Attestation Agreement Renewal - $130

License Renewal (for each facility type, as applicable) - $131

How can I check on the status of a tribal attestation?

You can check the status of an attestation on the DOH Facility Search webpage. This page will show if the attestation is “active,” “expired,” or “pending.”

To get specific details about where the attestation is within the approval process or information about an expired attestation, you can contact the Credentialing Unit at 360-236-4985 or via email.

How can we switch our regular BHA, RTF, or behavioral health hospital license to a tribal attestation?

A tribe that currently holds a regular BHA, RTF, or behavioral health hospital license, can switch it to a tribal attestation by submitting the application packet as described above under the process for obtaining a BHA, RTF, or Behavioral Health Hospital license under attestation.

On the Tribal Attestation License Application, check the box that says, “apply for a tribal attestation license and close current, non-attested license” and include the current BHA, RTF, or behavioral health hospital license number.

If you have questions, contact the Credentialing Unit at 360-236-4985 or via email.

Are the expiration dates for the attestation and facility license the same?

Yes. The expiration date for the attestation agreement and the facility license will always be synched. If a facility is added to an existing attestation agreement part way through a cycle, the license will be assigned the same expiration date as the original attestation, which may mean that the license will need to be renewed sooner than three years at the first renewal.

When can the facility expect to receive its license?

The DOH credentialing team mails the license within 30-45 days from when the application is received.

Opioid Treatment Program Licensing

When is opioid treatment program (OTP) certification required?

OTP certification is only required if you plan to provide methadone. Other medications for the treatment of opioid use disorder, such as buprenorphine, can be prescribed under a prescriber credential and do not require OTP certification.

Are there additional requirements for the opioid treatment program (OTP) certification?

Yes. There are other state and federal requirements that apply to all OTPs. Requirements include obtaining:

a drug other controlled substance registration (PDF) from the Pharmacy Quality Assurance Commission.
approval from the federal Drug Enforcement Administration (DEA).
- Questions about DEA requirements – seattle.diversion@dea.gov.
approval from the Substance Abuse and Mental Health Services Administration.
accreditation from a federally recognized accrediting organization. Note that “accreditation” is a federal requirement and different than “attestation.”

In addition, DOH is required by RCW 71.24.590(h) to provide public notice to all appropriate media outlets in the community in which the facility is proposed to be located that states the applicant is proposing a facility in that community. 

*Note: Tribally owned/operated OTPs must also complete a Community Relations Plan (CRP) (PDF), however, they are not required to submit the CRP to DOH with their attestation and license application.

Amending an Attestation

How can services be added, or updates made, to an existing tribal attestation?

Amending services: Submit an amended Tribal Attestation BHA, RTF, and Behavioral Health Hospital Licensing Application (PDF) and fee of $131.

Amending the attestation to add another facility type: Submit the Washington State Department of Health Tribal Attestation for BHA, RTF, and Behavioral Health Hospitals (PDF) and fee of $130.

Renewing an Attestation

How often does a tribal attestation need to be renewed and what is the fee?: Tribal attestations are renewed every three years. The fee will include $130 for the attestation agreement and $131 for each facility license.
How are tribal attestations renewed?: Submit a tribal attestation agreement, licensing application, and fee(s). Check the “renewal” box on the licensing application.

Inspections and Oversight

Does DOH conduct inspections of BHA facilities licensed through tribal attestation?: No. DOH does not conduct inspections or investigations of facilities licensed through tribal attestation.