HOUSE BILL REPORT

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.

As Reported by House Committee On:

Early Learning & Human Services

Title: An act relating to expanding the activities of the children's mental health services consultation program.

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

Sponsors: Representatives Slatter, Senn, Kagi, Appleton, Tharinger and Doglio.

Brief History:

Committee Activity:

Early Learning & Human Services: 1/16/18, 1/17/18 [DPS].

Brief Summary of Substitute Bill

  • Expands the services provided by the Partnership Access Line (PAL).

  • Renames the PAL as the Partnership Access Line for Moms and Kids.

HOUSE COMMITTEE ON EARLY LEARNING & HUMAN SERVICES

Majority Report: The substitute bill be substituted therefor and the substitute bill do pass. Signed by 13 members: Representatives Kagi, Chair; Senn, Vice Chair; Dent, Ranking Minority Member; McCaslin, Assistant Ranking Minority Member; Eslick, Frame, Goodman, Griffey, Kilduff, Klippert, Lovick, Muri and Ortiz-Self.

Staff: Dawn Eychaner (786-7135).

Background:

Partnership Access Line.

The Partnership Access Line (PAL) is a telephone consultation service based at Seattle Children's Hospital and Regional Medical Center 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 with support from child psychiatrists with the UW Department of Psychiatry and Behavioral Sciences. 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 program 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 UW. The Institute collaborates with entities engaged in evaluating and promoting the use of evidence-based, research-based, and 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.

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Summary of Substitute Bill:

The program is named the PAL for Moms and Kids. The HCA must collaborate with the UW Department of Psychiatry and Behavioral Sciences and consult with Seattle Children's Hospital and Regional Medical Center to operate the PAL for Moms and Kids as an ongoing program. In addition to consultation for primary care providers for children with behavioral health disorders, the PAL for Moms and Kids provides 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 PAL for Moms and Kids 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:

Substitute Bill Compared to Original Bill:

The HCA must implement the program in collaboration with the UW Department of Psychiatry and Behavioral Sciences and in consultation with Seattle Children's Hospital and Regional Medical Center rather than with the Institute. The program is named the PAL for Moms and Kids.

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Appropriation: None.

Fiscal Note: Requested on January 18, 2018.

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

Staff Summary of Public Testimony:

(In support) Parents need help navigating the system to know where resources are. This bill provides parents with the connections to resources they need to strengthen families and communities. Close collaboration with the UW Department of Psychiatry and Behavioral Sciences will make this program successful and an amendment to house this with the Department of Psychiatry and Behavioral Sciences, rather than the Institute, is being requested. Several years ago when a group started coming together to talk about children's mental health, the strongest, most consistent message was that families face challenges when seeking treatment. People who are dealing with a crisis are in the most aggravating type of circumstance when they are trying to find help for their child. The PAL expansion will do that frustrating work for parents to help them find providers in their community who are taking their insurance and are available. Parents will continue to have difficulty finding providers unless they have help. Having someone follow up with the parent after a referral will be helpful, and the PAL will reach out to healthcare plans to let them know about network adequacy concerns if providers are not available. Some physical somatic complaints that are presented by patients in a pediatrician's office could be addressed by treating mental health needs. Early intervention is the intervention that is most effective.

(Opposed) None.

Persons Testifying: Representative Slatter, prime sponsor; Ian Goodhew, University of Washington School of Medicine; Laurie Lippold, Partners for Our Children; Robert Hilt, Seattle Children's Hospital; Julian Ayer, Washington Chapter of the American Academy of Pediatrics; and Seth Dawson, Washington State Psychiatric Association and Compass Health.

Persons Signed In To Testify But Not Testifying: None.