Children's Long Term Inpatient
for Washington State (CLIP)
History of CLIP
1970s - The Beginning of CLIP
Prior to the development of the
CLIP Programs, Washington State children with severe psychiatric
disturbances were frequently placed in residential settings that were not
prepared to deal with their level of disturbance, or they were sent to
facilities out of state. In 1977, the Department of Social and Health
Services (DSHS) approached the private sector for assistance in developing a
program model to provide extended psychiatric residential care.
Supporting the model developed in the public/private partnership, in 1980
the Washington State legislature authorized funds to establish Residential
Treatment Beds for Psychiatrically Impaired Children and Youth (RTFs). These
state-funded beds were to be located at and administered by private,
non-profit agencies under contract to the Division of Mental Health
(DHHS/DMD). Rules and regulations for licensing standards were set forth in
Chapter 246-323 of the Washington Administrative Code and codified under
authority of Chapter 71.12 RCW, February 1980,
1980s - CLIP RTFs Open & New Law Enacted
In the early 1980s, four
Residential Treatment Facilities (RTFs) began serving psychiatrically
impaired children and youth. McGraw Center at Seattle Children's Home,
Seattle, opened in March 1981 as the first facility licensed under the new
regulations. Martin Center opened in February 1982 in Bellingham, operated
by Catholic Community Services Northwest. Tamarack Center opened in
September 1984 in Spokane County. Pearl Street Center opened in January 1985
in Tacoma, operated by the Tacoma Comprehensive Mental Center.
The RTFs were defined statewide resources. Any child in the state had equal
access to these services in the need was demonstrated. Locating the RTFs in
different regions of the state meant services could be provided as close to
home as possible.
Between 1981 and 1986 all children who were admitted to the RTFs met the
same admission criteria, whether they were voluntary applicants or committed
for involuntary mental health care. In January 1986, the new juvenile Mental
Health Services Act (RCW 71.34) came into effect. Under that law,
adolescents who were involuntarily committed on a 180-day Restrictive Order
for inpatient care were now automatically eligible for admission to the RTFs
and to Child Study and Treatment Center (CSTC), the state-operated
psychiatric hospital for children located in Tacoma.
The gave new over sight responsibilities to the CLIP Administration. The
CLIP Administration became a participant in the annual Medicaid Inspection
of Care audits conducted by the Mental Health Division.
1990s - CLIP consolidates, RSNs manage public mental health
While involuntary committed adolescents
were automatically eligible for admission to any of the five CLIP Programs,
there were two separate voluntary admissions procedures for CSTC and the
RTFs. To meet Medicaid requirements, the MHD directed the CLIP
Administration to assume all admissions decisions for the inpatient beds at
CSTC beginning in March 1991. This established a centralized access point to
extended inpatient care for all children.
In 1992, at the direction of the MHD, intersystem agreements were
established between the CLIP Administration, the five CLIP Programs and the
Regional Support Networks (RSNs). These agreements require identification of
a local intersystem collaborative team to access the strengths and needs of
an individual child and family, and plan individualized services and
supports to meet those needs. If admission to a CLIP program is felt to be
part of this overall plan of care, the local community makes application to
the CLIP Administration.
Since the mid-1900s, the CLIP
Administration's role and responsibilities have changed little. CLIP Program
services remain a statewide resource and any child in the state of
Washington has equal access to these services if the need is demonstrated.
The CLIP agreements with the Regional Support Networks (RSNs) are
modified in accord with current best practice standards, building upon gains
made since they were originally drafted.
In June of 2004 Martin Center, the Residential Treatment Facility operated
by Catholic Community Services Northwest closed. A portion of the publicly
funded bed capacity was redistributed to the three other Residential
Treatment Facilities. As a result there are currently 91 MHD-funded beds
available to serve children and adolescents with severe psychiatric
disturbance. Forty-four total beds are available in the three RTFs: McGraw
Center, Pearl Street Center and Tamarack Center. The remaining forty-seven
beds are available in three cottages at Child Study and Treatment Center.