AB 1208, as introduced, Pan. 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 2013 and would define a “medical home” and a “patient centered medical home” for purposes of the act to refer to a health care delivery model in which a patient establishes an ongoing relationship with a licensed health care provider, as specified. The bill would specify that it does not change the scope of practice of health care providers.
Vote: majority. Appropriation: no. Fiscal committee: no. State-mandated local program: no.
The people of the State of California do enact as follows:
Chapter 3.5 (commencing with Section 24300)
2is added to Division 20 of the Health and Safety Code, to read:
This chapter shall be known, and may be cited, as the
5Patient Centered Medical Home Act of 2013.
(a) “Medical home” and “patient centered medical
7home” mean a health care delivery model in which a patient
8establishes an ongoing relationship with a personal primary care
9physician or other licensed health care provider acting within the
10scope of his or her practice. The personal provider works in a
11physician-led practice team to provide comprehensive, accessible,
12and continuous evidence-based primary and preventative care, and
13to coordinate the patient’s health care needs across the health care
14system in order to improve quality and health outcomes in a
15cost-effective manner.
16(b) A health care delivery model described in this section shall
17stress a team approach to providing comprehensive health care
18that fosters a partnership among the
patient, the licensed health
19care provider acting within his or her scope of practice, other health
20care professionals, and, if appropriate, the patient’s family.
Unless otherwise provided by statute, a medical home
22shall include all of the following characteristics:
23(a) Individual patients shall have an ongoing relationship with
24a physician or other licensed health care provider acting within
25his or her scope of practice, who is trained to provide first contact
26and continuous and comprehensive care, or, if appropriate, provide
27referrals to health care professionals that provide continuous and
28comprehensive care.
29(b) A provider-led team of individuals at the practice level
30collectively that take responsibility for the ongoing health care of
31patients, including appropriately arranging health care by other
32qualified health care professionals and making appropriate
referrals.
33(c) Care shall be coordinated and integrated across all elements
34of the complex health care system, including mental health and
35substance use disorder care, and the patient’s community. Care
36shall be facilitated by health information technology, such as
37electronic medical records, electronic patient portals, health
38information exchanges, and other means to ensure that patients
39receive the indicated care when and where they need and want this
40care in a culturally and linguistically appropriate manner.
P3 1(d) All of the following quality and safety components are
2incorporated into the medical home:
3(1) Advocacy for patients to support the attainment of optimal,
4patient-centered outcomes that are defined by a care planning
5process driven by a compassionate, robust partnership between
6providers, the patient, and
the patient’s family.
7(2) Evidence-based medicine and clinical decision support tools
8guide decisionmaking.
9(3) The licensed health care providers in the practice accept
10accountability for continuous quality improvement through
11voluntary engagement in performance measurement and
12improvement.
13(4) Active patient participation in decisionmaking. Feedback is
14sought to ensure that the patients’ expectations are being met.
15(5) Information technology is utilized appropriately to support
16optimal patient care, performance measurement, patient education,
17and enhanced communication.
18(6) Patients and families participate in quality improvement
19activities at the practice level.
20(e) Enhanced patient access to health care that meets the
21requirements of a nationally recognized, independent, medical
22home accreditation agency.
Nothing in this chapter shall be construed to do any of
24the following:
25(a) Permit a medical home to engage in or otherwise aid and
26abet in the unlicensed practice of medicine, either directly or
27indirectly.
28(b) Change the scope of practice of physicians and surgeons,
29nurse practitioners, or other health care providers.
30(c) Affect the ability of a nurse to operate under standard
31procedures pursuant to Section 2725 of the Business and
32Professions Code.
33(d) Apply to activities of managed care plans, or their
34contracting providers, or county alternative models of care, or their
35
contracting providers, or local coverage expansion and enrollment
36demonstration projects, if those activities are part of demonstration
37projects developed pursuant to Section 14180 of the Welfare and
38Institutions Code.
39(e) Prevent or limit participation in activities authorized by
40Sections 2703, 3024, and 3502 of the federal Patient Protection
P4 1and Affordable Care Act (Public Law 111-148), as amended by
2the federal Health Care and Education Reconciliation Act of 2010
3(Public Law 111-152), if the participation is consistent with state
4law pertaining to scope of practice.
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