Partnership Access Lines (PAL)

PAL stands for the Partnership Access Lines program, a shorthand term for four services that assist providers with managing their patients' psychiatric needs and help connect adults and children to care.

PAL program services

The four PAL program services are:

  • Partnership Access Line (PAL): Operated by Seattle Children’s Hospital for more than 10 years, this line supports primary care providers with questions about children’s mental health care such as diagnostic clarification, medication adjustment, or treatment planning.
  • Mental Health Referral Service for Children and Teens: A two-year pilot program that began January 1, 2019 and operated by Seattle Children’s Hospital, it connects patients and families with available evidence-based outpatient mental health services in their community.
  • Perinatal Psychiatry Consultation Line for Providers (PAL for Moms): A two-year pilot program that began January 1, 2019 and operated by the University of Washington (UW), this service supports providers caring for patients with behavioral health disorders who are pregnant, postpartum, or planning pregnancy.
  • Psychiatry Consultation Line (PCL): A new program in operation since July 1, 2019 and operated by UW, PCL provides 24/7 support to prescribing providers from primary care clinics, community hospitals, emergency departments, substance use treatment programs, evaluation and treatment programs, and municipal and county jails caring for adult patients with mental health and/or substance use disorders.

PAL carrier assessment

In 2020, the Legislature passed a bill that directed the Health Care Authority (HCA) to collect a fee, or assessment, based on covered lives from Washington health insurers in order to keep PAL services up and running. 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 this state, including self-funding entities or employee welfare benefit plans.

House Bill 2728 is the result of a partnership among the Legislature, providers, health plans, advocates, HCA, and the Children and Youth Behavioral Health Work Group (CYBHWG), among others.

HCA has chosen KidsVax, LLC as the apparent successful bidder to administer the assessment. KidsVax will act as the third-party administrator to calculate and administer the assessments, which will be deposited into a newly created account to support important behavioral health PAL programs.

What health plans can expect

KidsVax will begin reaching out to assessed entities later this summer with more information.

Plans will be expected to submit quarterly covered lives reports within 45 days after the end of each quarter, with the first quarter of measurement from July 1 to September 30, 2021. Invoices will then be issued upon filing the covered lives report.


HCA convened the Children and Youth Mental Health Work Group consisting of representatives from the UW, Seattle Children's Hospital, managed care organizations (MCOs), organizations connecting families to children's mental health services and providers, health insurance carriers, and the Office of the Insurance Commissioner (OIC). In 2019, the advisory group recommended an alternative funding model for the behavioral health consultation and referral services: PAL, Mental Health Referral Service for Children and Teens, PAL for Moms, and the PCL.