Washington State

House of Representatives

Office of Program Research

BILL

ANALYSIS

Early Learning & Human Services Committee

HB 2451

This analysis was prepared by non-partisan legislative staff for the use of legislative members in their deliberations. This analysis is not a part of the legislation nor does it constitute a statement of legislative intent.

Background:

Partnership Access Line.

The Partnership Access Line (PAL) is a telephone consultation service based at Seattle Children's Hospital that is available at no charge to primary care providers who wish to consult with a pediatric psychiatrist. The Department of Social and Health Services implemented the PAL as a pilot program in 2008 in partnership with the Children's Mental Health Evidence-based Practice Institute (Institute) at the University of Washington (UW). Seattle Children's Hospital delivers the PAL program consultation services. In 2017 the PAL provided approximately 1,500 telephone consultations; 54 percent of which were for Medicaid clients.

The PAL Plus is a pilot program authorized in the operating budget for implementation by the Health Care Authority (HCA) in partnership with faculty from the UW. The PAL Plus pilot is an expansion of the PAL program and serves children and families with Medicaid coverage who have mild to moderate mental health concerns and are not already receiving services through a behavioral health organization. Primary care providers can refer their Medicaid enrolled patients for PAL Plus services which include mental health counseling to recipients either in person or over the phone. In addition, the PAL Plus trains behavioral health providers in the community to provide brief, in-person services. The HCA submitted a preliminary evaluation of the PAL Plus pilot to the Legislature in December 2017. A final evaluation report is due by December 31, 2018.

Health Care Authority.

The HCA administers Apple Health, the state-federal Medicaid program that provides health care for eligible low-income individuals. Apple Health for Kids is available at low or no cost for children whose families meet income eligibility criteria.

Evidence-Based Practice Institute.

The 2007 Legislature established the Institute at the University of Washington. The Institute collaborates with entities engaged in evaluating and promoting the use of evidence-based, research-based, promising or consensus-based practices in children's mental health treatment. The Institute is tasked with providing training and consultation to children's mental health providers and child-serving agencies.

Summary of Bill:

The HCA must collaborate with the Institute to operate the PAL as an ongoing program. The PAL is expanded to provide same-day phone consultation to obstetricians, pediatricians, primary care providers, mental health professionals, and other health care professionals for the assessment, diagnosis, and treatment of depression in pregnant women and new mothers. The stated purpose of the same-day phone consultations is to promote more accurate diagnoses and treatment.

The program must also facilitate referrals to children's mental health services and resources for parents and guardians. Referral activities must use existing databases and resources and must include:

assessing the level of needed services;
identifying, within seven days of a phone call from a parent or guardian, mental health professionals who are in-network with the child's health care coverage, accepting new patients, and taking appointments;
coordinating contact between the parent or guardian and the mental health professional; and
providing post-referral reviews to determine whether the child still has outstanding needs.