House of Representatives
Office of Program Research
Early Learning & Human Services Committee
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).
Hearing Date: 2/20/18
Staff: Dawn Eychaner (786-7135).
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:
follow up with individuals to ensure an appointment has been secured;
coordinate with primary care providers on individual treatment plans and medication management;
provide information to plan members and primary care providers the 24/7 behavioral health resource line; and
maintain an accurate list of providers contracted to provide mental health services to children and youth. The list must contain current information regarding providers' availability to provide services.
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:
support primary care providers in the assessment and provision of appropriate diagnosis and treatment of children with mental and behavioral health disorders;
provide same day phone consultation to obstetricians, pediatricians, primary care providers, mental health professionals, and other health care professionals in the assessment, diagnosis, and treatment of depression in pregnant women and new mothers; and
facilitate referrals to children's mental health services and resources for parents and guardians. Facilitation activities 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 postreferral reviews to determine whether the child still has outstanding needs.
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:
the number of, and demographic data for, individuals who accessed the resources;
the number of providers by type who accessed the resources;
a description of resources provided;
average time frames from receipt of call to referral for services or resources provided; and
barriers to services, as determined and defined by the HCA, the UW, and Seattle Children's Hospital.
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.
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.