45172. End-of-Life Care

Applies To:  This policy applies to child welfare employees.

Policy Number & Title:  45172. End-of-Life Care

Effective Date:  July 1, 2024


Purpose

The purpose of this policy is to provide guidance when a child’s or youth’s medical provider makes a recommendation to begin making end-of-life decisions for a dependent child or youth in out-of-home care. This policy does not apply to a child in tribal custody or youth in Extended Foster Care.

Authority

RCW 74.13.031   Duties of the department, child welfare services and children’s services advisory committee

Policy

  1. When a child’s or youth’s medical provider makes a recommendation to begin making end-of-life decisions for hospice or the issuance of a Do-Not-Resuscitate (DNR) order caseworkers must:
    1. Immediately notify their supervisor and the regional medical consultant (RMC). The supervisor may notify the area administrator, as applicable. Notify the following individuals of the medical provider’s recommendations:
      1. Child’s or youth’s parents and parent’s attorney, if the child or youth is not legally-free
      2. Assistant attorney general (AAG)
      3. Child’s or youth’s out-of-home caregiver
      4. Guardian Ad Litem (GAL)
      5. Child’s or youth’s attorney, if assigned
    2. Document efforts made to locate the parent in FamLink if the parent of the child or youth cannot be located.
    3. Contact the child’s or youth’s tribe if there is reason to know a child is or may be an Indian child to determine their role in making end-of-life decisions.
    4. Conduct a shared planning meeting if any party to the case disagrees with the medical provider’s recommendations
    5. Assist the child’s or youth’s family and caregivers to identify community-based services and supports that address grief and loss.
  2. AAG consultation is required if organ donation is proposed. 

Resources

End-of-Life Care procedures (Located in the DCYF Policies & Rules SharePoint) 

Indian Child Welfare Reason to Know policy

Shared Planning Meetings policy


Original Date:  October 31, 2016

Revised Date:   July 1, 2024

Review Date:   July 31, 2028

Approved by:  Natalie Green, Assistant Secretary of Child Welfare Division