Amended in Assembly April 1, 2013

California Legislature—2013–14 Regular Session

Assembly Bill No. 1208

Introduced by Assembly Member Pan

February 22, 2013

An act to add Chapter 3.5 (commencing with Section 24300) to Division 20 of the Health and Safety Code, relating to medical homes.

LEGISLATIVE COUNSEL’S DIGEST

AB 1208, as amended, 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:

SECTION 1.  

Chapter 3.5 (commencing with Section 24300)
is added to Division 20 of the Health and Safety Code, to read:

 

Chapter  3.5. Patient Centered Medical Home Act of
2013

 

24300.  

This chapter shall be known, and may be cited, as the
Patient Centered Medical Home Act of 2013.

24301.  

(a) “Medical home” and “patient centered medical
home” mean a health care delivery model in which a patient
establishes an ongoing relationship with a personal primary care
physician or other licensed health care provider acting within the
scope of his or her practice. The personal provider works in a
physician-led 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.

24302.  

Unless otherwise provided by statute, a medical home
shall include all of the following characteristics:

(a) Individual patients shall 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 provider-led team of individuals at the practice level
begin delete collectively that take end delete begin insert shall take collective end insert responsibility for the
ongoing health care of patients, including appropriately arranging
health care by other qualified health care professionals and making
appropriate referrals.

(c) Care shall be coordinated and integrated across all elements
of the complex health care system, including mental health and
substance use disorder care, and the patient’s community. Care
shall be facilitated by health information technology, such as
electronic medical records, electronic patient portals, health
information exchanges, and other means to ensure that patients
receive the indicated care when and where they need and want this
care in a culturally and linguistically appropriate manner.

begin insert

(d) The medical home payment structure shall be designed to
reward the provision of the right care in the right setting, and shall
discourage the delivery of too much or too little care. The payment
structure shall encourage appropriate management of complex
medical cases, increased access to care, the measurement of patient
outcomes, continuous improvement of care quality, and
comprehensive integration and coordination across all stages and
settings of a patient’s care.

end insert begin delete

(d)

end delete

begin insert (e) end insert  All of the following quality and safety components begin delete are end delete begin insert shall
be end insert incorporated into the medical home:

(1) Advocacy for 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) The licensed health care providers in the practice accept
accountability for continuous quality improvement through
voluntary engagement in performance measurement and
improvement.

(4) Active patient participation in decisionmaking. Feedback is
sought to ensure that the begin delete patients’ end delete begin insert patient’s end insert expectations are being
met.

(5) Information technology is utilized appropriately to support
optimal patient care, performance measurement, patient education,
and enhanced communication.

(6) Patients and families participate in quality improvement
activities at the practice level.

begin delete

(e) Enhanced patient

end delete

begin insert (f) end insert begin insert   end insert begin insert Patients shall be provided with enhanced end insert access to health
care that meets the requirements of a nationally recognized,
independent begin delete , end delete medical home accreditation agency.

24303.  

Nothing in this chapter shall be construed to do any of
the following:

(a) Permit a medical home to engage in or otherwise aid and
abet in the unlicensed practice of medicine, either directly or
indirectly.

(b) Change the scope of practice of physicians and surgeons,
nurse practitioners, or other health care providers.

(c) Affect the ability of a nurse to operate under begin delete standard end delete
begin insert standardized end insert procedures pursuant to Section 2725 of the Business
and Professions Code.

begin delete

(d) Apply to activities of managed care plans, or their
contracting providers, or county alternative models of care, or their
contracting providers, or local coverage expansion and enrollment
demonstration projects, if those activities are part of demonstration
projects developed pursuant to Section 14180 of the Welfare and
Institutions Code.

end delete begin insert

(d) Apply to a Low Income Health Program developed pursuant
to Part 3.6 (commencing with Section 15909) of Division 9 of the
Welfare and Institutions Code, including the program’s provider
network and service delivery system, or to activities conducted as
part of a demonstration project developed pursuant to Section
14180 of the Welfare and Institutions Code.

end insert

(e) Prevent or limit participation in activities 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), if the participation is consistent with state
law pertaining to scope of practice.