BILL ANALYSIS                                                                                                                                                                                                    �



                                                                  SB 393
                                                                  Page  1

          SENATE THIRD READING
          SB 393 (Ed Hernandez)
          As Amended August 24, 2012
          Majority vote

           SENATE VOTE  :30-7  
           
           HEALTH              13-3                                        
           
           -------------------------------- 
          |Ayes:|Monning, Atkins, Bonilla, |
          |     |Eng, Gordon, Hayashi,     |
          |     |Roger Hern�ndez, Bonnie   |
          |     |Lowenthal, Mitchell,      |
          |     |Nestande, Pan, Silva,     |
          |     |Williams                  |
          |     |                          |
          |-----+--------------------------|
          |Nays:|Logue, Garrick, Mansoor   |
          |     |                          |
           -------------------------------- 
           SUMMARY  :  Establishes the Patient-Centered Medical Home (PCMH) 
          Act of 2012 to define a PCMH as a health care delivery model 
          that meets specified criteria consistent with providing 
          patient-centered, coordinated care.  Specifically,  this bill  :

          1)Defines a PCMH as a health care delivery model that meets the 
            following criteria:

             a)   Facilitates a relationship between a patient and his or 
               her personal physician and surgeon or other licensed 
               primary care provider in a physician-directed practice team 
               to provide comprehensive and culturally competent primary 
               and preventive care;

             b)   Utilizes a team approach to care;

             c)   Delivers high-quality, comprehensive and coordinated 
               care including whole person orientation, as specified;

             d)   Uses evidence-based medicine, patient input and clinical 
               decision support tools, as specified;

             e)   Enhances patient access to, and communication with, his 
               or her medical home team; and,








                                                                  SB 393
                                                                  Page  2


             f)   Engages in continuous quality improvement, as specified.

          1)Prohibits this bill from being construed to do any of the 
            following:

             a)   Alter the scope of practice of any licensed or certified 
               health care provider; 

             b)   Apply to a Low Income Health Plan, as specified; 

             c)   Apply to public health care programs, as specified; and,

             d)   Prevent or limit participation in activities authorized 
               by a federal health program or grant, as specified.

           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.  
           
          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 








                                                                  SB 393
                                                                  Page  3

          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: 0005526