2559. Hospital Holds

Original Date: September 1995

Revised Date: October 31, 2019

Sunset Review Date: October 31, 2023

Approved by: Jody Becker, Deputy Secretary of Children and Families

Policy Update Memo Effective July 1, 2023


Hospital administrators or physicians have legal authority to delay discharge of a child through a hospital hold for up to 72 hours, without DCYF taking placement and care authority (PCA). The hospital administrator or physician must believe a child is in imminent danger if released to their parents or guardians. This policy provides direction on how to respond to a hospital hold.


This policy applies to DCYF child welfare employees.


RCW 26.44.056   Protective detention or custody of abused child - Reasonable cause - Notice - Time limits - Monitoring plan - Liability.


  1. When a hospital administrator or physician detains a child on a hospital hold, DCYF must determine if the child is at risk of imminent danger if discharged to the parents or guardians.
  2. If it is determined that the child is unsafe, DCYF must take PCA of the child through one of the following:
    1. Protective custody (PC) by law enforcement (LE) or hospital administrator or physician with a signed Child Custody Transfer DCYF 10-157 form.
    2. Court order.


  1. When a child is placed on a hospital hold, caseworkers must:
    1. Contact the hospital to identify and determine the child’s:
      1. Release date.
      2. Medical issues if the child is not ready for discharge.
      3. Medical and behavioral needs once released.
    2. Document the information received from the hospital in a FamLink case note.
    3. Follow Indian Child Welfare (ICW) Initial Intake policy and procedures when there is reason to know a child is or may be a member, or is the biological child of a member, and eligible for membership in a federally recognized tribe.
    4. If the child is at imminent risk and placement is being considered then follow the Placement Out-of-Home and Conditions for Return Home.
      1. If it is determined at the FTDM that the child cannot be safely discharged to their parents or guardians obtain PCA through one of the following:
        1. Child Custody Transfer DCYF 10-157 form.
        2. Court order
      2. If the child can be safely discharged home, return the child to the parents or guardians and monitor the child’s safety for at least six months if the child was placed on a hospital hold and on PC by LE.
  2. If DCYF takes PCA, the caseworker must:
    1. Verify that a Child Custody Transfer DCYF 10-157 form has been signed by law enforcement, a hospital administrator, or a physician. 
    2. Upload the completed and signed form into FamLink. 
    3. Review the discharge summary to identify the child’s medical and behavioral needs.
    4. Verify the child receives necessary follow-up health care as specified by the medical provider in the Health Care Services for Children Placed in Out-of-Home Care policy.
    5. Follow the:
      1. Placement Out-of-Home and Conditions for Return Home policy.
      2. Dependency Petition Process policy.
      3. Medically Fragile Children policy.


Child Custody Transfer DCYF 10-157 (located on the DCYF CA Intranet)