Washington State

House of Representatives

Office of Program Research

BILL

ANALYSIS

Early Learning & Human Services Committee

SSB 6452

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.

Brief Description: Expanding the activities of the children's mental health services consultation program.

Sponsors: Senate Committee on Ways & Means (originally sponsored by Senators Brown, Frockt, Carlyle, O'Ban, Walsh, Darneille, Miloscia, Kuderer and Saldaña).

Brief Summary of Substitute Bill

  • Establishes the Partnership Access Line (PAL) for Moms and Kids two-year pilot program.

  • Requires the Health Care Authority to enforce network adequacy and care coordination requirements for managed care organizations.

Hearing Date: 2/20/18

Staff: Dawn Eychaner (786-7135).

Background:

Medicaid Managed Care for Children.

The Health Care Authority (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.

When purchasing managed care for Medicaid participants, the HCA must ensure that managed care organizations (MCO) demonstrate the ability to supply a provider network sufficient to provide adequate access to all services covered under the contract. Legislation related to children's mental health enacted in 2017 further requires MCOs to:

Partnership Access Line.

The Partnership Access Line (PAL) is a telephone consultation service that is available at no charge to primary care providers who wish to consult with a pediatric psychiatrist. Through a contract with the HCA, Seattle Children's Hospital delivers the PAL program consultation services in affiliation with the University of Washington (UW). In 2017 the PAL provided approximately 1,500 telephone consultations, 54 percent of which were for Medicaid clients.

Summary of Bill:

To the extent that funds are specifically appropriated for this purpose, the HCA must collaborate with the UW Department of Psychiatry and Behavioral Sciences and Seattle Children's Hospital to implement a two-year PAL for Moms and Kids pilot program.

PAL for Moms and Kids must:

When conducting referrals, the PAL for Moms and Kids must collaborate with existing databases and resources to identify in-network mental health professionals.

The HCA must collaborate with the UW and Seattle Children's Hospital to report on data related to access and use of the PAL Moms and Kids resources, including:

Beginning December 30, 2018, the HCA must annually report to the Governor and the Legislature findings and recommendations for improving the PAL for Moms and Kids services and service delivery.

The HCA must enforce MCO contract requirements to ensure care coordination and network adequacy issues are addressed in order to remove barriers to access to mental health services that are identified in the HCA annual report.

Appropriation: None.

Fiscal Note: Requested on February 7, 2018.

Effective Date: The bill takes effect 90 days after adjournment of the session in which the bill is passed.