BILL NUMBER: AB 1208 AMENDED
BILL TEXT
AMENDED IN ASSEMBLY MAY 9, 2013
AMENDED IN ASSEMBLY APRIL 23, 2013
AMENDED IN ASSEMBLY APRIL 1, 2013
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 medical home 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 or the patient's representative,
upon the consent of the patient.
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 and surgeon 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 provider, working in
concert with a multidisciplinary team of individuals at the
practice level level, shall take
collective 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.
(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.
(e) All of the following quality and safety components shall be
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 or representative.
(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 patient's 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 or representatives participate in
quality improvement activities at the practice level.
(f) Patients shall be provided with enhanced access to health care
that meets the requirements of a nationally recognized, independent
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 standardized
procedures pursuant to Section 2725 of the Business and Professions
Code.
(d) Require adherence to the 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.
(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.