BILL ANALYSIS �
SB 393
Page 1
SENATE THIRD READING
SB 393 (Ed Hernandez)
As Amended June 15, 2012
Majority vote
SENATE VOTE :30-7
HEALTH 13-3
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|Ayes:|Monning, Atkins, Bonilla, |
| |Eng, Gordon, Hayashi, |
| |Roger Hern�ndez, Bonnie |
| |Lowenthal, Mitchell, |
| |Nestande, Pan, Silva, |
| |Williams |
| | |
|-----+--------------------------|
|Nays:|Logue, Garrick, Mansoor |
| | |
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SUMMARY : Establishes the Patient-Centered Medical Home (PCMH)
Act of 2011 to define a PCMH as a health care delivery model
that conforms to the definition contained in the federal Patient
Protection and Affordable Care Act (ACA) and meets other
specified criteria consistent with providing patient-centered,
coordinated care. Specifically, this bill :
1)Defines PCMH, "medical home," "advanced practice primary
care," "health home," "person-centered health care home," and
"primary care home," all to mean a health care delivery model
as defined in the ACA, and any subsequent federal rules or
regulations, and that meets the following criteria:
a) Facilitates a relationship between a patient and his or
her personal physician or other licensed primary care
provider in a physician-directed practice team to provide
comprehensive and culturally competent primary and
preventive care; and,
b) Meets the criteria of, and participates in, a voluntary
recognition process conducted by a nongovernmental entity
to demonstrate that the practice has the capabilities to
provide patient-centered services consistent with the
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medical home model.
2)Prohibits this bill from being construed to alter the scope of
practice of any health care provider, or to authorize the
delivery of health care services in a setting or manner
otherwise authorized by law.
FISCAL EFFECT : None
COMMENTS : According to the author, this bill establishes a
definition for the set of best health care practices known as
PCMH to ensure uniform standards of quality and access. The
author argues that out-of-control health care costs, diminishing
state revenue, a growing shortage of primary care professionals,
inadequate distribution of health care providers, and a sharp
increase in the demand for services for those with chronic
disease and mental health disorders drive the need for the PCMH
model of health care delivery. The author maintains that
establishing a definition for this model in state law makes it
more likely that California will receive crucial federal health
care dollars.
The ACA includes provisions requiring the federal Secretary of
Health and Human Services to establish a program to provide
grants to, or enter into contracts with, eligible entities to
establish community health teams to support the PCMH model. The
ACA defines a PCMH as a mode of care that includes personal
physicians; whole person orientation; coordinated and integrated
care; safe and high-quality care through evidence-informed
medicine, appropriate use of health information technology, and
continuous quality improvements; expanded access to care; and,
payment that recognizes added value from additional components
of patient-centered care.
This bill requires a primary care practice to meet the criteria
of, and participate in, a voluntary recognition process
conducted by a nongovernmental entity to demonstrate that it
provides patient-centered services consistent with a PCMH.
Standards developed by the National Committee for Quality
Assurance (NCQA) are most often used to identify which primary
care practices have achieved designation as a medical home. The
California Academy of Family Physicians, a cosponsor of this
bill, notes that there are other organizations that also have
PCMH recognition programs, including the Joint Commission, the
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Accreditation Association for Ambulatory Health Care, and the
Utilization Review Accreditation Commission. This bill requires
a practice to obtain PCMH recognition using any of these
multiple program options.
Supporters, representing various provider and consumer advocacy
groups, agree that a medical home serves as a centralized hub to
provide patients and their families with coordinated services,
such as preventive and wellness care, referrals for specialty
care, and help in coordinating care across specialties. They
state that the PCMH model is particularly effective for children
as it encourages a "whole child" approach that increases the
ability to avoid or successfully manage chronic childhood
conditions and, in doing so, it could produce potentially
significant cost savings over a lifetime. Supporters write
that, as the PCMH model continues to evolve and grow in
popularity, this bill will ensure uniform application of the use
of the PCMH in California and provide clarity on the appropriate
standards of care for this model in the state. They add that
this bill ensures that all licensed providers are included as
partners in the medical home model and sends an important signal
that California supports health care that is comprehensive,
accessible, cost-effective, and evidence-based.
Analysis Prepared by : Cassie Royce / HEALTH / (916) 319-2097
FN: 0004417