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:
Chapter 3.5 (commencing with Section 24300)
2is added to Division 20 of the Health and Safety Code, to read:
3
This chapter shall be known, and may be cited, as the
8Patient Centered Medical Home Act of 2013.
(a) “Medical home” and “patient centered medical
10home” mean a health care delivery model in which a patient
11establishes an ongoing relationship with a personal primary care
12physician or other licensed health care provider acting within the
13scope of his or her practice. The personal provider works in a
14physician-led practice team to provide comprehensive, accessible,
15and continuous evidence-based primary and preventative care, and
16to coordinate the patient’s health care needs across the health care
17system in order to improve quality and health outcomes in a
18cost-effective manner.
19(b) A
medical home shall stress a team approach to providing
20comprehensive health care that fosters a partnership among the
21patient, the licensed health care provider acting within his or her
22scope of practice, other health care professionals, and, if
23appropriate, the patient’s family or the patient’s representative,
24upon the consent of the patient.
Unless otherwise provided by statute, a medical home
26shall include all of the following characteristics:
27(a) Individual patients shall have an ongoing relationship with
28a physician and surgeon or other licensed health care provider
29acting within his or her scope of practice, who is trained to provide
30first contact and continuous and comprehensive care, or, if
31appropriate, provide referrals to health care professionals that
32provide continuous and comprehensive care.
33(b) Abegin delete provider-ledend deletebegin insert
provider, working in concert with a
34multidisciplinaryend insert team of individuals at the practicebegin delete levelend deletebegin insert level,end insert
35 shall takebegin delete collectiveend delete responsibility for the ongoing health care of
36patients, including appropriately arranging health care by other
37qualified health care professionals and making appropriate referrals.
P3 1(c) Care shall be coordinated and integrated across all elements
2of the complex health care system, including mental health and
3substance use disorder care, and the patient’s community. Care
4shall be facilitated by health information technology, such as
5electronic
medical records, electronic patient portals, health
6information exchanges, and other means to ensure that patients
7receive the indicated care when and where they need and want this
8care in a culturally and linguistically appropriate manner.
9(d) The medical home payment structure shall be designed to
10reward the provision of the right care in the right setting, and shall
11discourage the delivery of too much or too little care. The payment
12structure shall encourage appropriate management of complex
13medical cases, increased access to care, the measurement of patient
14outcomes, continuous improvement of care quality, and
15comprehensive integration and coordination across all stages and
16settings of a patient’s care.
17(e) All of the following quality and safety components shall be
18incorporated
into the medical home:
19(1) Advocacy for patients to support the attainment of optimal,
20patient-centered outcomes that are defined by a care planning
21process driven by a compassionate, robust partnership between
22providers, the patient, and the patient’s family or representative.
23(2) Evidence-based medicine and clinical decision support tools
24guide decisionmaking.
25(3) The licensed health care providers in the practice accept
26accountability for continuous quality improvement through
27voluntary engagement in performance measurement and
28improvement.
29(4) Active patient participation in decisionmaking. Feedback is
30sought to ensure that the patient’s expectations are
being met.
31(5) Information technology is utilized appropriately to support
32optimal patient care, performance measurement, patient education,
33and enhanced communication.
34(6) Patients and families or representatives participate in quality
35improvement activities at the practice level.
36(f) Patients shall be provided with enhanced access to health
37care that meets the requirements of a nationally recognized,
38independent medical home accreditation agency.
Nothing in this chapter shall be construed to do any of
40the following:
P4 1(a) Permit a medical home to engage in or otherwise aid and
2abet in the unlicensed practice of medicine, either directly or
3indirectly.
4(b) Change the scope of practice of physicians and surgeons,
5nurse practitioners, or other health care providers.
6(c) Affect the ability of a nurse to operate under standardized
7procedures pursuant to Section 2725 of the Business and
8Professions Code.
9(d) Require adherence to the Low Income Health Program
10
developed pursuant to Part 3.6 (commencing with Section 15909)
11of Division 9 of the Welfare and Institutions Code, including the
12program’s provider network and service delivery system, or to
13activities conducted as part of a demonstration project developed
14pursuant to Section 14180 of the Welfare and Institutions Code.
15(e) Prevent or limit participation in activities authorized by
16Sections 2703, 3024, and 3502 of the federal Patient Protection
17and Affordable Care Act (Public Law 111-148), as amended by
18the federal Health Care and Education Reconciliation Act of 2010
19(Public Law 111-152), if the participation is consistent with state
20law pertaining to scope of practice.
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