Panel Hears Bill to Shift PAL Administrator Costs Into Assessments, Saving State Funds

Committee staff and stakeholders described HB 22-54 on Jan. 30 as a technical, agency-request adjustment to the Partnership Access Line (PAL) funding model that would let the program include reasonable third-party administrator costs in the carrier assessment that funds telebehavioral health services.

Megan Morris, staff to the committee, explained that Seattle Children’s Hospital (in affiliation with the University of Washington) operates PAL programs—telephone-based psychiatry consultation and related services—under contract with the Health Care Authority (HCA). HCA currently covers the cost of a third-party administrator used to calculate and administer carrier assessments; HB 22-54 would permit those reasonable costs to be included in the proportional-share calculation rather than paid from the general fund. The current third-party administrator cost is cited as $282,000 per fiscal year.

Megan Morris provided a breakdown showing that under the proposal $33,000 would be paid with general fund state dollars, $33,000 with federal Medicaid, and $216,000 from the telebehavioral health access account—creating a four-year general fund state savings of $747,000, according to staff estimates.

Representatives from the health system and program operators urged support. Daniel Garcia of HCA said the bill is an agency-request, describing how HCA calculates the proportion of clients covered by Medicaid and collects proportional shares from carriers for non-Medicaid clients. Charlotte Shannon of UW Medicine described PAL’s 24/7 consult line and cited program reach from 2020–2024: more than 4,000 consultations and 1,600 unique providers across 38 of 39 counties. Bob Hill of Seattle Children’s, director of PAL programs, called the change a "smart technical fix," said administrative savings could allow reinvestment to restore staffing and service levels that had been reduced because of financial pressure, and urged the committee’s support.

The committee took no formal action during the hearing and requested a fiscal note. Witnesses emphasized that while the change is technical, details will matter for program capacity, oversight of assessments, and how any savings would be reinvested.