BILL NUMBER: AB 1542 AMENDED
BILL TEXT
AMENDED IN SENATE AUGUST 3, 2010
AMENDED IN SENATE AUGUST 2, 2010
AMENDED IN SENATE JUNE 24, 2010
AMENDED IN SENATE APRIL 27, 2010
AMENDED IN SENATE JULY 1, 2009
AMENDED IN ASSEMBLY MAY 6, 2009
INTRODUCED BY Assembly Member Jones
MARCH 4, 2009
An act to add Chapter 3.34 (commencing with Section 1596.55) to
Division 2 of the Health and Safety Code, relating to medical homes
, and declaring the urgency thereof, to take effect immediately
.
LEGISLATIVE COUNSEL'S DIGEST
AB 1542, as amended, Jones. Medical homes.
Existing law provides for the licensure and regulation of clinics
and health facilities by the State Department of Public Health.
Existing law also provides for the registration, certification, and
licensure of various health care professionals and sets forth the
scope of practice for these professionals.
This bill would establish the Patient-Centered Medical Home Act of
2010 to encourage licensed health care providers and patients to
partner in a patient-centered medical home, as defined, that promotes
access to high-quality, comprehensive care, in accordance with
prescribed requirements.
This bill would declare that it is to take effect immediately as
an urgency statute.
Vote: majority 2/3 . Appropriation:
no. Fiscal committee: no. State-mandated local program: no.
THE PEOPLE OF THE STATE OF CALIFORNIA DO ENACT AS FOLLOWS:
SECTION 1. Chapter 3.34 (commencing with Section 1596.55) is added
to Division 2 of the Health and Safety Code, to read:
CHAPTER 3.34. PATIENT-CENTERED MEDICAL HOME ACT OF 2010
1596.55. (a) This chapter shall be known, and may be cited, as
the Patient-Centered Medical Home Act of 2010.
(b) It is the intent of the Legislature to encourage licensed
health care providers and patients to partner in a patient-centered
medical home that promotes access to high-quality, comprehensive care
and ultimately to ensure that all Californians have a medical home.
(c) It is the intent of the Legislature that a California practice
or other entity calling itself a medical home adhere to quality
standards that will do all of the following:
(1) Reduce disparities in health care access, delivery, and health
care outcomes.
(2) Improve quality of health care and lower health care costs,
thereby creating savings to allow more Californians to have health
care coverage and to provide for the sustainability of the health
care system.
(3) Integrate medical, mental health, and substance abuse care.
(4) Remove barriers to receiving appropriate health care.
(d) It is further the intent of the Legislature that payors
recognize the added value of a medical home by providing additional
payment for the increased services and overhead associated with this
practice model, including, but not limited to, all of the following:
(1) Coordination of care within the practice and between
consultants, ancillary providers, and community resources.
(2) Adoption and use of health information technology for quality
improvement.
(3) Increased patient access through advanced appointment systems,
electronic patient portals, secure electronic mail, remove access
monitoring systems, and telephone consultations.
(4) Risk adjustments based on the case mix, type and severity of
patient illness, and patient age for the patient population.
(5) Provision for monetary reimbursement for added services among
the various payment systems, including fee-for-service, value-added
global, shared savings, and capitated payments.
1596.56. (a) "Medical home," "patient-centered medical home,"
"advanced practice primary care," "health home," and "primary care
home" all mean a health care delivery model in which a patient
establishes an ongoing relationship with a physician or other
licensed health care provider acting within the scope of his or her
practice, working in a physician-directed practice team to provide
comprehensive, accessible, and continuous evidence-based primary and
preventative care, and to coordinate the patient's health care needs
across the health care system in order to improve quality and health
outcomes in a cost-effective manner.
(b) A health care delivery model described in this section shall
stress a team approach to providing comprehensive health care that
fosters a partnership among the patient, the licensed health care
provider acting within his or her scope of practice, other health
care professionals, and, if appropriate, the patient's family.
1596.57. Notwithstanding any other provision of law, a medical
home shall include all of the following characteristics:
(a) Individual patients have an ongoing relationship with a
physician or other licensed health care provider acting within his or
her scope of practice, who is trained to provide first contact and
continuous and comprehensive care, or if appropriate, provide
referrals to health care professionals that provide continuous and
comprehensive care.
(b) A team of individuals at the practice level collectively take
responsibility for the ongoing health care of patients. The team is
responsible for providing for all of a patient's health care needs or
taking responsibility for appropriately arranging health care by
other qualified health care professionals, including making
appropriate referrals.
(c) Care is coordinated and integrated across all elements of the
complex health care system and the patient's community. Care is
facilitated, if available, by registries, information technology,
health information exchanges, and other means to ensure that patients
receive the indicated care when and where they need and want the
care in a culturally and linguistically appropriate manner.
(d) All of the following quality and safety components:
(1) The medical home advocates for its patients to support the
attainment of optimal, patient-centered outcomes that are defined by
a care planning process driven by a compassionate, robust partnership
between providers, the patient, and the patient's family.
(2) Evidence-based medicine and clinical decision support tools
guide decisionmaking.
(3) Licensed health care providers in the medical practice who
accept accountability for continuous quality improvement through
voluntary engagement in performance measurement and improvement.
(4) Patients actively participate in decisionmaking and feedback
is sought to ensure that the patients' expectations are being met.
(5) Information technology is utilized appropriately to support
optimal patient care, performance measurement, patient education, and
enhanced communication.
(6) The medical home participates in a voluntary recognition
process conducted by an appropriate nongovernmental entity to
demonstrate that the practice has the capabilities to provide
patient-centered services consistent with the medical home model.
(7) Patients and families participate in quality improvement
activities at the practice level.
(e) Enhanced access to health care is available through systems
such as open scheduling, expanded hours, and new options for
communication between the patient, the patient's personal provider,
and practice staff.
1596.58. Nothing in this chapter shall be construed to do any of
the following:
(a) Permit a medical home to enter into a contractual relationship
that may result in the unlicensed practice of medicine.
(b) Change the scope of practice of physician and surgeons, nurse
practitioners, or other health care providers.
(c) Affect the ability of a nurse to operate under standard
procedures pursuant to Section 2725 of the Business and Professions
Code.
(d) Impede the ability of a practice or entity to call themselves
a medical home if specifically authorized by statute and the use of
the term medical home is for the purposes of complying with that
statute.
(e) Prevent or limit the ability of a practice or entity to
participate in activities, as authorized by Sections 2703, 3024, and
3502 of the federal Patient Protection and Affordable Care Act
(Public Law 111-148), as amended by the federal Health Care and
Education Reconciliation Act of 2010 (Public Law 111-152). Nothing in
this subdivision shall be construed to change the scope of practice
of physician and surgeons, nurse practitioners, or other health care
providers.
SEC. 2. This act is an urgency statute necessary
for the immediate preservation of the public peace, health, or safety
within the meaning of Article IV of the Constitution and shall go
into immediate effect. The facts constituting the necessity are:
In order to make the necessary statutory changes to avoid
participant confusion about medical homes as defined by this act, the
demonstration projects developed pursuant to Section 14180 of the
Welfare and Institutions Code, and participation in Section 2703, of
the federal Patient Protection and Affordable Care Act (Public Law
111-148), as amended by the federal Health Care and Education
Reconciliation Act of 2010 (Public Law 111-152), it is necessary that
this act take effect immediately.