Washington's DOH licenses behavioral health agencies for one calendar year from issuance and certifies each service on the license. A new agency pays $2,250 to apply, then annual outpatient fees of $1,650 to $5,800 by service hours. Accredited agencies with deemed status pay $830 to $2,900 and half the per-bed fee.
Washington licenses the agency and certifies the services. The Department of Health (DOH) issues a behavioral health agency license, and the license must "specify the types of services provided by the behavioral health agency that meet the standards adopted" under chapter 71.24 RCW (RCW 71.24.037(4)). Washington also does something most states do not: it publishes a fee schedule that rewards accreditation, which makes the decision to accredit partly a budgeting question.
Is a Washington license annual?
"Licensure or certification as a behavioral health agency is effective for one calendar year from the date of issuance" (RCW 71.24.037(4)). Renewal follows the same standards as initial approval. The department licenses any agency that pays the fee and submits a complete application showing it can comply with the statute and rules (71.24.037(1)), and publishes a current list of licensed agencies (71.24.037(8)).
Two practical rules come with the license. An agency may not advertise or represent itself as licensed or certified if approval has not been granted or has been denied, suspended, revoked or canceled (71.24.037(3)). And it "may not provide types of services for which the licensed or certified behavioral health agency has not been certified," although it may provide a service whose approval has been sought and is pending, as long as approval for that service was never previously revoked or denied (71.24.037(7)).
What does deemed status do?
RCW 71.24.037(2) directs the department to provide "for deeming of licensed or certified behavioral health agencies as meeting state minimum standards as a result of accreditation by a recognized behavioral health accrediting body recognized and having a current agreement with the department." In the fee rule, deemed agencies pay lower annual outpatient fees and lower per-bed fees. Accreditation does not replace the license; the agency still applies to DOH and still holds a DOH license. What deeming changes is how the agency shows it meets the minimum standards, and what it pays.
Which fees does DOH charge?
WAC 246-341-0365(5) sets the schedule. Application fees:
- new agency: $2,250
- branch agency: $1,150
- adding one or more certifications: $450
- change of ownership: $1,150
Annual outpatient fees depend on the agency's annual service hours and on deemed status:
| Annual service hours | With deemed status | Without deemed status |
|---|---|---|
| Up to 3,999 | $830 | $1,650 |
| 4,000 to 14,999 | $1,200 | $2,400 |
| 15,000 to 29,999 | $1,600 | $3,200 |
| 30,000 to 49,999 | $2,380 | $4,750 |
| 50,000 or more | $2,900 | $5,800 |
Residential and inpatient services cost $125 per licensed bed with deemed status and $250 without. A substantiated complaint investigation, or a substantiated critical incident investigation that leads to required corrective action, costs $2,250.
How are service hours counted?
Every year the agency completes a DOH form reporting its national accreditation status, licensed beds and annual outpatient service hours (WAC 246-341-0365(4)). Existing agencies compute hours from the most recent state fiscal year; agencies seeking initial licensure project their hours for the first 12 months of operation. A new agency's projection therefore sets its first-year fee, so it is worth building the projection from the staffing plan rather than guessing.
Refunds are limited. DOH may refund half of the application fee if an application is withdrawn before certification or denial, and does not refund fees when licensure or certification is denied, revoked or suspended (WAC 246-341-0365(2)-(3)).
What rules apply to residential and withdrawal management services?
Agencies providing voluntary inpatient or residential substance use disorder treatment or withdrawal management must meet the policy submission and mandatory reporting requirements in RCW 71.24.847, and may not refuse services or admission based solely on a person having previously left a facility before a clinical determination that treatment was complete (RCW 71.24.037(9)).
Separately, any agency treating opioid use disorder or alcohol use disorder must give each patient seeking that treatment an unbiased explanation of all clinically appropriate FDA-approved medication options, and support the patient's choice by providing the medication or by a warm handoff referral. An agency that does not meet that requirement may not advertise that it treats those disorders, or treat them at all (71.24.037(10)). That belongs in the policy manual from day one.
How does Washington decide opioid treatment program applications?
For an opioid treatment program, RCW 71.24.590 requires DOH to consult county and city legislative authorities, license only programs sited in line with local land use ordinances, consider the size of the population in need, nearby certified programs and transportation access, consider the applicant's capability to meet the legislature's treatment goals, and give public notice in the community. No city or county may impose a maximum capacity on an opioid treatment program. That is a need-style review layered on the federal approvals; see certificate of need and need review for new OTPs. Washington State DOH is also on SAMHSA's list of OTP accrediting bodies.
Can we prepare a Washington agency application?
We prepare the agency application and each service certification, write policies to chapter 246-341 WAC, build the service-hours projection from your staffing plan, and get you ready for DOH review. If you plan to pursue deemed status, our Accreditation Readiness service ($2,995 for the first program) prepares you for the accreditor's survey; the organization applies and is surveyed. The State License package is $1,995 for an outpatient agency site or $2,995 for residential, and adding a certification is $595 from us plus the state's $450. Social workers and counselors joining you from out of state have their own steps; see White Glove Social Work's Washington LICSW guide. Sources are on the Washington page.
Common questions
- What is deemed status in Washington?
- An agency accredited by a recognized behavioral health accreditor that has a current agreement with DOH can be deemed to meet state minimum standards (RCW 71.24.037(2)). Deemed agencies still hold a DOH license but pay lower outpatient and per-bed fees.
- How much does a Washington behavioral health agency license cost?
- The new agency application is $2,250. Annual outpatient fees range from $1,650 to $5,800 by service hours, or $830 to $2,900 with deemed status; residential beds cost $250 each, or $125 with deemed status (WAC 246-341-0365).
- Can a Washington agency start a new service while approval is pending?
- Yes, if approval has been sought and is pending and that service was never previously revoked or denied (RCW 71.24.037(7)).
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