BILL ANALYSIS �
ACR 152
Page 1
ASSEMBLY THIRD READING
ACR 152 (Pan)
As Introduced May 22, 2014
Majority vote
HEALTH 15-2
--------------------------------
|Ayes:|Pan, Maienschein, |
| |Ammiano, Bonilla, Bonta, |
| |Chesbro, Gomez, Gonzalez, |
| |Roger Hern�ndez, |
| |Lowenthal, Nazarian, |
| |Nestande, Ridley-Thomas, |
| |Rodriguez, Wieckowski |
| | |
|-----+--------------------------|
|Nays:|Mansoor, Wagner |
| | |
--------------------------------
SUMMARY : States that the Legislature supports and encourages
the development and expansion of a California health care
delivery system that identifies patient centered medical homes
(PCMH) and is based upon certain principles of coordination of
patient care. Specifically, this resolution makes the following
legislative findings, among others:
1)Patients frequently confront health care providers working in
independent silos that impede care coordination and cause
patients with multiple health issues to fall through the
cracks.
2)Patients are forced to navigate an exceedingly complex system
with little or no guidance, seeing multiple physicians and
other health providers in various settings.
3)The absence of accountability, quality improvement
programming, and clinical information systems leads to poorer
quality of patient care.
4)"Patient centered medical home" is a health care delivery
system model in which health care providers work in
partnership with one another, their patients, and their
patients' families to coordinate care and ensure that patients
ACR 152
Page 2
receive the right care at the right time.
EXISTING LAW defines PCMH under the federal Patient Protection
and Affordable Care Act and authorizes tests of innovative
Medicaid (Medi-Cal in California) and Medicare service delivery
models in federal fiscal years 2010 to 2019, to reduce program
expenditures while preserving or enhancing patient quality of
care. Provides that innovative models include PCMHs for
high-need patients.
FISCAL EFFECT : None
COMMENTS : According to the author, having a definition for
"patient centered medical home" in California would send an
important signal to health care providers and patients that our
state supports care that is patient centered, cost efficient,
continuous, focused on prevention, and based on sound,
evidence-based medicine rather than episodic, illness oriented
care. According to the American Academy of Family Physicians
(AAFP), the PCMH model is an approach to providing comprehensive
primary care for children, adolescents, and adults. The PCMH is
a health care setting that facilitates partnerships between
patients and their personal physicians, and when appropriate,
the patient's family.
This definition was laid out by the AAFP, the American College
of Physicians, the American Academy of Pediatrics, and the
American Osteopathic Association in the 2007 Joint Principles
for the Patient Centered Medical Home, which defines critical
principles within the PCMH model as:
1)Access to a personal physician who leads the care team within
a medical practice;
2)A whole-person orientation to providing patient care;
3)Integrated and coordinated care;
4)Focus on quality and safety; and,
5)Through the medical home model, practices seek to improve the
quality, effectiveness, and efficiency of the care they
deliver, and to ensure that the activities within the practice
are focused on meeting patient needs first. The PCMH model
ACR 152
Page 3
seeks to foster a relationship of trust between the care team
and the patient, and to actively engage patients as partners
in their health care.
The California Academy of Family Physicians is the sponsor of
this resolution and writes that more than 40 states have adopted
medical home legislation including North Carolina, which
developed an innovative Medicaid management program: Community
Care of North Carolina. AAFP explains that providers there
offer continuous, healing relationships with whole-person
orientation and have resources to assist with at-risk patients
to better manage their care and prevent high cost interventions
and that the program was so successful that it saved the state
between $230 million and $260 million in 2004. AAFP further
notes that despite other states' successes, California has been
slow to act and that out of control health care costs and
diminishing state revenue, coupled with the high cost and low
quality of compartmentalized patient care, must be addressed if
the expanded health care coverage mandated in federal reform is
to be successful.
There is no opposition to this resolution.
Analysis Prepared by : Lara Flynn / HEALTH / (916) 319-2097
FN: 0003941