BILL ANALYSIS                                                                                                                                                                                                    



                                                                       



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          |SENATE RULES COMMITTEE            |                  AB 1542|
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                                 THIRD READING


          Bill No:  AB 1542
          Author:   Jones (D), et al
          Amended:  8/27/10 in Senate
          Vote:     27 - Urgency

           
          WITHOUT REFERENCE TO FILE
           
          SENATE HEALTH COMMITTEE  :  6-2, 6/30/10
          AYES:  Alquist, Cedillo, Leno, Negrete McLeod, Pavley,  
            Romero
          NOES:  Strickland, Aanestad
          NO VOTE RECORDED:  Cox

           SENATE BUSINESS, PROF. & ECON. DEV. COMMITTEE  :  5-1, 8/9/10
          AYES:  Negrete McLeod, Corbett, Correa, Florez, Yee
          NOES:  Aanestad
          NO VOTE RECORDED:  Wyland, Calderon, Walters

           ASSEMBLY FLOOR  :  72-0, 5/14/09 - See last page for vote


           SUBJECT  :    Medical homes

          SOURCE  :     California Academy of Family Physicians


           DIGEST  :    This bill establishes 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.
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           ANALYSIS  :    

          Existing law:

          1. Establishes the Medical Practice Act to regulate and  
             govern the practice of physician and surgeons.  Provides  
             that any person who practices medicine must possess a  
             valid license issued by the Medical Board of California.

          2. Specifies that the Department of Public Health shall  
             license specified primary care clinics and other  
             specialty clinics.  Exempts from licensure any place or  
             establishment owned or leased and operated as a clinic  
             or office by one or more licensed health care providers  
             and used as an office for the practice of their  
             profession, within the scope of their license,  
             regardless of the name used publicly to identify the  
             place or establishment.

          3. Establishes the Medi-Cal program, administered by the  
             Department of Health Care Services (DHCS) and under  
             which qualified low-income persons receive health care  
             benefits, as specified.  

          4. Provides that DHCS shall submit an application to the  
             federal Centers for Medicare and Medicaid Services for a  
             waiver or a demonstration project to expand health care  
             coverage to low-income, uninsured residents, as  
             specified.  Specifies that the waiver or demonstration  
             project shall include proposals to restructure the  
             organization and delivery of services to Medi-Cal  
             enrollees, including proposals for the improved  
             coordination of care for children with significant  
             medical needs through the use of medical homes and  
             specialty centers, as specified.  

          This bill:

          1. Enacts the Patient-Centered Medical Home Act of 2010  
             which establishes standards for medical homes.

          2. States the following legislative intents:


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             A.    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 ensure that Californians have  
                a medical home.

             B.    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, 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.

             C.    Provides that the state will not provide  
                enhancement without legislative approval.

          3. Defines a medical home, patient-centered medical home  
             advanced practice primary care, health home and primary  
             care home as 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/her practice, working in a  
             physician-directed practice team to provide  
             comprehensive, accessible, and continuous evidence-based  
             primary and preventive 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.

          4. States that a health care delivery model described in  
             this measure shall stress a team approach to providing  
             comprehensive health care that fosters a partnership  

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             among the patient, the licensed health care provider  
             acting within his/her scope of practice, other health  
             care professionals, and if appropriate, the patient's  
             family.

          5. Requires a medical home to 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.


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                (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.

          6. Provides that this bill shall not 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.

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             C.    Affect the ability of a nurse to operate under  
                standard procedures, as specified.

             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 of  
                entity to participate in activities authorized by the  
                federal Patient Protection and Affordable Care Act,  
                as specified.  States that nothing in this  
                subdivision shall be construed to change the scope of  
                practice of physicians and surgeons, nurse  
                practitioners, or other health care providers.

           FISCAL EFFECT  :    Appropriation:  No   Fiscal Com.:  No    
          Local:  No

           SUPPORT  :   (Verified  8/30/10)

          California Academy of Family Physicians (source)
          American College of Physicians
          American Congress of Obstetricians and Gynecologists,  
          District IX
          American Nurses Association/California
          California Academy of Physician Assistants
          California Association of Physician Groups
          California Chiropractic Association
          California Medical Association
          California Psychiatric Association
          Latino Coalition for a Healthy California
          Osteopathic Physicians and Surgeons of California

           ARGUMENTS IN SUPPORT  :    According to the California  
          Academy of Family Physicians, the bill's sponsor, and other  
          supporters such as the Osteopathic Physicians and Surgeons  
          of California, the California Medical Association, and the  
          Latino Coalition for a Healthy California, the goal of a  
          medical home is to provide a patient with a broad spectrum  
          of coordinated care.  With the growing popularity of this  
          concept among consumers and providers, this bill will  
          ensure uniform standards of quality and access.

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           ASSEMBLY FLOOR  : 
          AYES:  Adams, Anderson, Arambula, Beall, Bill Berryhill,  
            Tom Berryhill, Blakeslee, Block, Blumenfield, Brownley,  
            Buchanan, Caballero, Charles Calderon, Carter, Chesbro,  
            Conway, Cook, Coto, Davis, De La Torre, De Leon, DeVore,  
            Duvall, Emmerson, Eng, Evans, Feuer, Fletcher, Fong,  
            Fuller, Furutani, Galgiani, Gilmore, Hagman, Harkey,  
            Hayashi, Hernandez, Hill, Huber, Huffman, Jeffries,  
            Jones, Knight, Krekorian, Lieu, Logue, Bonnie Lowenthal,  
            Ma, Mendoza, Miller, Monning, Nava, Nestande, Niello,  
            Nielsen, John A. Perez, V. Manuel Perez, Portantino,  
            Price, Ruskin, Salas, Silva, Skinner, Solorio, Audra  
            Strickland, Swanson, Torlakson, Torres, Torrico, Tran,  
            Villines, Yamada
          NO VOTE RECORDED:  Ammiano, Fuentes, Gaines, Garrick, Hall,  
            Saldana, Smyth, Bass


          CTW:mw  8/30/10   Senate Floor Analyses 

                         SUPPORT/OPPOSITION:  SEE ABOVE

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