title: The Partnership Access Line: evaluating a child psychiatry consult program in Washington State.
abstract: OBJECTIVE
  To evaluate a telephone-based child mental health consult service for primary care providers (PCPs).
  
  
  METHODS
  Record review, provider surveys, and Medicaid database analysis.
  
  
  METHODS
  Washington State Partnership Access Line (PAL) program.
  
  
  METHODS
  A total of 2285 PAL consultations by 592 PCPs between April 1, 2008, and April 30, 2011.
  
  
  METHODS
  Primary care provider-initiated consultations with PAL service.
  
  
  METHODS
  The PAL call characteristics, PCP feedback surveys, and Medicaid claims between April 2007 and December 2009 for fee-for-service Medicaid children before and after a PAL call.
  
  
  RESULTS
  Sixty-nine percent of calls were about children with serious emotional disturbances, and 66% of calls were about children taking psychiatric medications. Primary care providers nearly always received new psychosocial treatment advice (87% of calls) and were more likely to receive advice to start rather than stop a medication (46% vs 24% of calls). Primary care provider feedback surveys reported uniformly positive satisfaction with the program. Among Medicaid children, there was significant increases in attention-deficit/hyperactivity disorder and antidepressant medication use after the PAL call but no significant change in reimbursements for mental health medications (P < .05). Children with a history of foster care experienced a 132% increase in outpatient mental health visits after the PAL call (P < .05).
  
  
  CONCLUSIONS
  Primary care providers used PAL for psychosocial and medication treatment assistance for particularly high-needs children and were satisfied with the service. Furthermore, PAL was associated with increased use of outpatient mental health care for some children.
authors.affiliation: Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, WA 98105, USA. robert.hilt@seattlechildrens.org
authors.forename: Robert J
authors.initials: RJ
authors.lastname: Hilt
authors.forename: Melissa A
authors.initials: MA
authors.lastname: Romaire
authors.forename: Michael G
authors.initials: MG
authors.lastname: McDonell
authors.forename: Jeanne M
authors.initials: JM
authors.lastname: Sears
authors.forename: Antoinette
authors.initials: A
authors.lastname: Krupski
authors.forename: Jeffery N
authors.initials: JN
authors.lastname: Thompson
authors.forename: Jim
authors.initials: J
authors.lastname: Myers
authors.forename: Eric W
authors.initials: EW
authors.lastname: Trupin
mesh_terms: D000293:Adolescent; D001291:Attitude of Health Personnel; D002491:Central Nervous System Agents / Q000191:economics / Q000627:therapeutic use; D002648:Child; D002665:Child Psychiatry; D002675:Child, Preschool; D004363:Drug Utilization / Q000191:economics / Q000706:statistics & numerical data; D005260:Female; D019538:Health Care Surveys; D006297:Health Services Accessibility; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D016014:Linear Models; D008297:Male; D008484:Medicaid / Q000706:statistics & numerical data; D001523:Mental Disorders / Q000175:diagnosis / Q000628:therapy; D008605:Mental Health Services / Q000191:economics / Q000458:organization & administration* / Q000706:statistics & numerical data; D015999:Multivariate Analysis; D011320:Primary Health Care / Q000191:economics / Q000458:organization & administration*; D015397:Program Evaluation; D019114:Remote Consultation / Q000191:economics / Q000379:methods / Q000706:statistics & numerical data; D013689:Telephone; D014481:United States; D014861:Washington
chemical_list: D002491:Central Nervous System Agents