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Molina Healthcare covers lower intensity outpatient mental health (MH) services for mild-to-moderate mental health conditions including psychotherapy, psychological testing and medication management for AH members. If a Molina AH member needs higher intensity mental health services including inpatient mental health services, partial hospital programs and/or intensive outpatient programs, or substance use disorder (SUD) services, Molina will coordinate services with the local Behavioral Health Organization (BHO). Members can receive services through Molina while awaiting assessments and services through the BHO to ensure access to care.

There is no “wrong door” for members to access MH services and they can self-refer at any time. However, Molina recommends members be connected to a primary care provider (PCP) who can assess members for mental health or substance use concerns and refer as needed. PCPs should support and encourage members toward recovery and educate them on the benefits of treating these conditions as well as the risks of not treating them.

Click here for more information on Molina’s AH covered behavioral health (BH) services. Click here to see what BH services require a prior authorization.

Also see member-facing information on mental health services.

Evaluation of Fully Integrated Managed Care in Southwest WA
Preliminary First-Year Findings

Bree Collaborative - Behavioral Health Integration Report and Recommendations
This Report and Recommendations is focused on integrating behavioral health care services into primary care for those with behavioral health concerns and diagnoses for whom accessing services through primary care would be appropriate. This workgroup focused on using available evidence and existing models to develop eight common elements that outline a minimum standard of integrated care.

DSHS Department of Behavioral Health and Recovery

HCA BH Integration Video

Learn more about:

• Neurological Affects of Drug Addiction
• Understanding Mental Illnesses

• SAMHSA Working Definition of Recovery
• Recovery and Recovery Support
• Peer Support

Medication Review Program for Second Opinion Network (SON)

Seattle Children's Hospital provides pediatric mental health second-opinion medication reviews. Second-opinion reviews are required when a psychiatric medication is prescribed outside of guidelines set by the Pediatric Mental Health Workgroup. Seattle Children’s schedules second-opinion reviews between their psychiatrists and the pediatric prescribers within Molina’s network after the SON receives the necessary information about the child and the requested medication dosage. In addition, they are responsible for sending the written second opinion review back to HCA.

As part of the authorization process, prescribers are required to engage in a phone consultation from the SON. If a SON review is required, the SON team will call the prescriber to schedule an appointment. To receive payment for the phone consultation, use procedure code 99441 on the claim. If you are a prescriber and have any questions, please contact Molina at (800) 869-7165.

Partnership Access Line (PAL)

The Partnership Access Line is a consultation program provided through Seattle Children’s Hospital for primary care physicians (PCPs). The consultation is free, funded by the Washington State Legislature and the Washington Health Care Authority. Any primary care doctor, nurse practitioner, or physician assistant throughout Washington state can call this line for assistance with any type of child mental health advice for any child the practitioner sees.

Call (866) 599-7257 Monday – Friday, 8:00 a.m. to 5:00 p.m. PST for assistance, or visit www.seattlechildrens.org/PAL.

PAL for Moms

PAL for Moms is a free state-funded program providing perinatal mental health consultation, recommendations and referrals for providers caring for pregnant or postpartum patients. Providers can consult on any behavioral health-related questions for patients who are pregnant, in the first year postpartum, or who have pregnancy-related complications.

Learn more at the UW Psychiatry & Behavioral Sciences Maternal-Child Mental Heal Program website.

PAL Training Calendar
PAL Outreach Flyer
PAL 2019-2020 Program Highlights

• NREPP Resources

• Collaborative Care Implementation Guide
• Collaborative Care originated in a research culture and has now been tested in more than 80 randomized controlled trials in the US and abroad. Several recent meta-analyses make it clear that Collaborative Care consistently improves on care as usual. It leads to better patient outcomes, better patient and provider satisfaction, improved functioning, and reductions in health care costs, achieving the Triple Aim of health care reform. Collaborative Care necessitates a practice change on multiple levels and is nothing short of a new way to practice medicine, but it works. The bottom line is that patients get better.

UW AIMS Center - Patient Tracking Spreadsheet
WA State AIMS Caseload Tracker
UW AIMS Center- Resource Library

UW Medicine Pain Consult
1-844-520-PAIN (7246). Clinical advice for health care providers caring for patients with complex pain medication regimens, particularly high dose opioids. By UW Medicine pain management pharmacists and physicians. Monday through Friday 8:30 AM – 4:30 PM, excluding holidays. Provide resources for local pain clinics for patient referrals.

UW Tele-Pain Services
An audio and videoconference-based knowledge network of interprofessional specialists with expertise in the management of challenging chronic pain problems. The goal is to increase the knowledge and skills of community practice providers who treat patients with chronic pain. Available Wednesdays from 12:00-1:30 pm

UW Psychiatry Consultation Line

Supports prescribing health care providers in WA State (PC clinics, community hospitals, ED’s, evaluation and treatment centers, and county and municipal correctional facilities). 

Pain Clinic Closures

Healthier Washington Health Systems Transformation and Innovation Shared Calendar

National Alliance on Mental Illness (NAMI)