PAL: Partnership Access Line

Holiday Hours:

Q: Is the PAL line open on holidays?
A: The PAL line will be closed for the following upcoming holidays:

Day After Independence Day (Monday, 7/5/10)
Labor Day (Monday, 9/6/2010)
Thanksgiving (Thursday, 11/25/10)
Day After Thanksgiving (Friday, 11/26/10)
Christmas Eve (Friday, 12/24/2010)
Christmas (Saturday, 12/25/2010)

Q: If I leave a message over a holiday, when will I receive a call back?
A: The PAL team will respond to messages left on the PAL line as soon as possible on the next business day. Feel free to let us know if you prefer a call back at a certain time or on a certain business day.

Q: What if my patient is in crisis on a day when the PAL line is closed? A: If your patient is in crisis, please access appropriate emergency services such as: calling 911, sending the patient to an emergency department, or a calling a local crisis line. PAL staff and psychiatrists will not be checking voicemail messages on days when the PAL line is closed.

Calling the Line:

Q: When can I call the PAL line?
A: You may call at any time. However, you will only get a live answer M-F, 9am-5pm. If you leave a message outside these hours, your call will be returned as soon as possible during business hours.

Q: What if I get the voicemail message during business hours?
A: Depending on the business of the PAL line for a given day, we may be attending to another call. However, we closely monitor voicemail messages left on the PAL line and we will return your call as soon as possible.

Q: Can I arrange for a specific call-back time from the PAL team?
A: Absolutely! You may leave us instructions in your voicemail about when and how best to reach you.

Q: Can my office staff or nurse call ahead and set a time for my PAL consultation?
A: Yes. Please have office or clinical staff call the same day that you would like to consult with PAL Psychiatrist. We will ask them for your contact information and for your patient’s demographic information in preparation for the consultation.

Q: What information will I need when I call?
A: You will be asked by the program assistant or social worker to provide us with the following:

Your name, title, practice
Your best business contact numbers
Your fax number
Patient demographics:
- Full name and spelling
- DOB
- Insurance coverage (including DSHS plans)
- Foster care situation (foster, not foster, formerly foster)
A brief description of why you are calling

Q: Will I have to give all of this information every time I call?
A: No. We will only ask for your clinic and contact information once (unless there have been updates). If you are calling about a patient you have called about previously, we will already have their information on file. We will verify with you that their insurance coverage has not changed. However, we do need the above patient information for each new patient about whom you call.

Q: My patient is over 21, but “young at heart”. May I call to consult about him/her?
A: Unfortunately, we cannot consult with you about your adult patients. However, we can direct you to an adult consult line, if needed.

Q: Do I have to talk to a PAL Psychiatrist when I call? What if I just want to discuss local resources?
A: If you feel it is unnecessary to talk with a PAL Psychiatrist, you may ask instead to be directly connected with a PAL Social Worker. Our social workers will work with you to best identify local resources to meet your patient’s needs, regardless of their insurance coverage. These resources may also include books, websites, support groups, etc. You will still need to provide us with the same information as if you were calling to consult with a PAL Psychiatrist (see above for details).

Q: Can families call the PAL line?
A: The PAL line is designed to be a consult service for Primary Care Providers only. Consulting with families directly is outside the scope of our service. Therefore, we will redirect families to have their PCPs call us if they would like to utilize our service.

Clinical:

Q: Are you HIPPA compliant? What happens to my patients’ information?
A: As we are a DSHS/State-funded program, we report directly to the state about our call volume. In addition, the state requires that we disclose information about DSHS clients whose providers have consulted with our PAL team. We do not disclose to the state identifying patient information about patients with private insurance. We may report to the state that, as a primary care provider, you have used the service.

Q: Can I call while a patient is in clinic with me?
A: You may consult with a PAL Psychiatrist while your patient is present, if you feel this is needed. However, we cannot always connect you immediately, and we do not require that your patient be present while you consult with us.

Q: Can I call about a patient whom I have not yet seen?
A: You may call about any psychiatric question about any child patient in Washington. If you feel that you would like to call prior to seeing a patient to prepare for the visit, you may do so. However, the more current clinical information you have available, the better.

Q: I have pertinent medical records that I want the PAL Psychiatrist to see. How can I send those to you?
A: You may send pertinent records to us, “Attn: PAL Program, fax: (206)987-2246”. It is helpful if you call to let us know to look for these records.

Q: My patient told me they are having suicidal thoughts/feelings. Is it appropriate to call PAL about this patient?
A: If your patient is in clinic during PAL business hours we can help. However, if they are in your clinic after PAL hours, and you do not feel they are safe enough to leave your clinic, please contact emergency services (e.g. 911, emergency room, crisis line).

Q: I’m a mental health specialist, not a primary care provider. Is this service available to me as well?
A: The PAL line is specifically designed to support primary care providers. We encourage mental health specialists with care questions to utilize their own supervision systems.

Medication Reviews:

Q: A hold has been placed on my DSHS patient’s medications. Can PAL help me with this?
A: DSHS has instituted specific regulations pertaining to DSHS-covered patients on ADHD medications and atypical antipsychotics. If a patient’s circumstances fall under certain criteria, a medication review may be required. There is specific information about these requirements in our care guide, Primary Care Principles for Child Mental Health. Although some of our PAL Psychiatrists are also contracted to complete these reviews on behalf of DSHS, this review process is independent of the PAL Program. You may call the PAL line with any psychiatric questions about your child patients. However, speaking with a PAL Psychiatrist will not exempt you from the DSHS review process. If you have questions regarding medication reviews, please contact Julia Pence at (206)987-2702.

Billing:

Q: I’m calling about a DSHS Fee-for-Service (coupon) client, and I heard that I can be reimbursed for my time. How does this work?
A: DSHS reimburses primary care providers for consulting with PAL about their patient once per patient, per day. Please reference the billing form on our website, or call the PAL line for more information.

Q: I’m calling about a DSHS Healthy Options client. Can I be reimbursed for my time spent calling?
A: Healthy Options plans are required to provide a primary care consult service such as PAL. If a plan has opted to support PCPs in using the PAL service, they may reimburse providers for consultation calls about patients covered by that specific plan. Please contact the Healthy Options plan directly or call the PAL line for information regarding this.

Appointments:

Q: I’m interested in having my patient seen for a consultation appointment. How does this process work?
A: The PAL program can offer a one-time in-person or telemedicine appointment with a PAL Psychiatrist. However, this is reserved for specific cases only. These cases may include: diagnostically complicated patients, patients with very little or delayed access to ongoing services, or patients for whom our advice would significantly benefit from an appointment. The PAL team recognizes that a child is often best served by initiating appropriate consistent care in their own community, and will seek to link families with those services. PAL Psychiatrists serve only in a consultation capacity, and will not take over care or prescribe medications.

Q: Where would my patient go for an appointment?
A: Depending on where a patient lives, their age and their individual disposition, we may recommend a variety of locations for their PAL appointment. In-person visits can happen in Seattle or Spokane, while telemedicine visits can take place in Seattle, Spokane, Olympia, Longview, or Richland. Our ultimate goal is to meet the family’s particular needs and preferences in scheduling PAL consultation appointments.

Q: I want to get my patient admitted to Seattle Children’s inpatient or outpatient units. Can the PAL line support me to do this?
A: The PAL team will provide you with all the information you need to make appropriate referrals. However, our assistance does not expedite or change the admit processes for the Seattle Children’s psychiatry department, despite our affiliation with the hospital. To access Seattle Children’s behavioral health outpatient intake line directly call 206-987-3560; for the psychiatric inpatient unit intake call 206-987-2195. Full referral instructions can be found at http://www.seattlechildrens.org/health_care_professionals/access

Follow-up:

Q: What documentation will I receive after consulting with someone on the PAL team?
A: A follow-up letter will be faxed within 1-2 days, summarizing the PAL Psychiatrist’s recommendations for your patient. On occasion this letter may arrive a few days later if the Psychiatrist needs more time to research and make their recommendations. If a social work referral is requested (for local resources) one of the PAL Social Workers will fax the referral within 1-2 weeks. If referral information is required sooner, please let us know so we can expedite this process for you. If a patient is seen in-person or via telemedicine for an appointment, you will receive a phone call or fax after the visit. A detailed dictation will be sent within the following weeks.