Partnership Access Lines (PAL)

Background

In 2008, the Washington Partnership Access Line (PAL) service began through Seattle Children’s Hospital to provide elective consultations to community physicians treating children with complex mental health and behavioral symptoms. Limited access to specialized behavioral health services available to children and their families, along with the success of PAL, prompted the Washington legislature to look at ways to use the PAL model as a strategy to address other behavioral health needs and additional target populations.

This resulted in the creation of the two other programs that were made permanent as of July 1, 2021:

• Perinatal Psychiatry Consult Line for providers (PPCL), which helps providers diagnose and treat maternal behavioral health disorders
• Washington’s Mental Health Referral Service for Children and Teens (MHRS), which helps families seeking mental health services for their children

In 2019, the University of Washington launched a new service to support prescribing providers in Washington receive clinical advice regarding adult patients with mental health and/or substance use disorders. Under the direction of the Washington legislature, the Psychiatry Consultation Line (PCL) helps address the severe shortage of mental health professionals in the state by providing consultation to providers regarding assessment, diagnosis, and treatment planning.

Overview of PAL programs

There are four PAL program services.

Partnership Access Line (PAL)

Operated by Seattle Children’s Hospital for over 10 years, this line supports primary care providers with questions about children’s mental health care such as diagnostic clarification, medication adjustment, and treatment planning.

• View the Washington PAL webpage.

Mental Health Referral Service for Children and Teens

This program has been in operation since January 1, 2019 by Seattle Children’s Hospital. It connects patients and families with available evidence-based outpatient mental health services in their community.

• View the Mental Health Referral Service for Children and Teens webpage.

Perinatal Psychiatry Consultation Line for Providers (PPCL)

Previously known as PAL for Moms, the PPCL began operation at the University of Washington since 2016 with state funding since 2019. This service offers consultations for providers caring for pregnant or postpartum patients with behavioral health disorders. The line is staffed by perinatal psychiatry faculty.

• View the PPCL webpage.
• Email: ppcl@uw.edu

Psychiatry Consultation Line (PCL)

This program has been in operation since July 1, 2019 by the University of Washington. The PCL can help care providers in Washington who are seeking clinical advice regarding adult patients (18+) with mental health and/or substance use disorders. The program is fast and connects providers to faculty psychiatrists at UW Medicine.

• View the PCL webpage.
• Email: pclwa@uw.edu

PAL carrier assessment

In 2019, the Health Care Authority (HCA) convened the Children and Youth Behavioral Health Work Group. They recommended an alternative funding model for the four Washington PAL programs. The work group consisted of representatives from:

• The University of Washington
• Seattle Children's Hospital
• Managed care organizations (MCOs)
• Organizations connecting families to children's mental health services and providers
• Health insurance carriers
• The Office of the Insurance Commissioner (OIC).

In 2020, the legislature passed House Bill 2728 which directed HCA to collect a fee or assessment based on covered lives from Washington health insurers to keep PAL services operational. The assessment applies to both self-insured and fully insured health plans. This includes health carriers, self-funded multiple employer welfare arrangements, and employers or other entities that provide health care in Washington, including self-funding entities or employee welfare benefit plans.

Since 2021, HCA has contracted with KidsVax, LLC to act as the third-party administrator to calculate and administer the assessments. Assessments collected by KidsVax are deposited into a dedicated HCA account to support these important behavioral health PAL programs.

Expectations of health plans

Health plans (i.e., any entities with covered lives in Washington) are expected to submit quarterly covered lives reports to KidsVax within 45 days after the end of each quarter. KidsVax will then issue invoices to plans after receiving the covered lives report. Plans should remit their payments to WAPAL Fund as indicated in the invoice, rather than to HCA.

Plans should use the KidsVax website to submit their covered lives reports and to access current and historical documentation on the program.