Bill Text: CA ACR152 | 2013-2014 | Regular Session | Chaptered
Bill Title: Patient centered medical homes.
Spectrum: Strong Partisan Bill (Democrat 55-5)
Status: (Passed) 2014-09-02 - Chaptered by Secretary of State - Res. Chapter 143, Statutes of 2014. [ACR152 Detail]
Download: California-2013-ACR152-Chaptered.html
BILL NUMBER: ACR 152 CHAPTERED
BILL TEXT
RESOLUTION CHAPTER 143
FILED WITH SECRETARY OF STATE SEPTEMBER 2, 2014
ADOPTED IN SENATE AUGUST 14, 2014
ADOPTED IN ASSEMBLY JULY 3, 2014
AMENDED IN ASSEMBLY JULY 3, 2014
INTRODUCED BY Assembly Member Pan
(Coauthors: Assembly Members Achadjian, Alejo, Ammiano, Atkins,
Bloom, Bocanegra, Bonilla, Bonta, Bradford, Brown, Buchanan, Ian
Calderon, Campos, Chau, Chávez, Chesbro, Cooley, Dababneh, Daly,
Dickinson, Eggman, Fong, Frazier, Garcia, Gatto, Gomez, Gonzalez,
Gordon, Gray, Hall, Roger Hernández, Holden, Jones-Sawyer, Levine,
Logue, Lowenthal, Maienschein, Medina, Melendez, Mullin, Muratsuchi,
Nazarian, Perea, John A. Pérez, V. Manuel Pérez, Quirk, Quirk-Silva,
Rendon, Ridley-Thomas, Rodriguez, Salas, Skinner, Stone, Ting,
Waldron, Weber, Wieckowski, Williams, and Yamada)
MAY 22, 2014
Relative to patient centered medical homes.
LEGISLATIVE COUNSEL'S DIGEST
ACR 152, Pan. Patient centered medical homes.
This measure would state that the Legislature supports and
encourages the development and expansion of a California health care
delivery system that identifies patient centered medical homes and is
based upon certain principles of coordination of patient care.
WHEREAS, 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; and
WHEREAS, Numerous studies identify fragmented care at the
national, state, and community levels as one of the main causes of
the poor performance of health care systems in the United States; and
WHEREAS, Patients are forced to navigate an exceedingly complex
system with little or no guidance, seeing multiple physicians and
other health care providers in various settings; and
WHEREAS, The lack of coordination of patient care, and the lack of
communication between patients and health care providers regarding
the coordination of patient care, increases inefficiency and the
chance of medical errors, waste, and the duplication of costly
services; and
WHEREAS, An absence of accountability, quality improvement
programming, and clinical information systems leads to poorer quality
of patient care; and
WHEREAS, The "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, navigate the complex and often confusing
health care system, and ensure that patients receive the right care
at the right time; and
WHEREAS, Medical homes address the ominous trends in health care,
including increasing costs, a shortage of primary care professionals,
and the sharp increase in the demand for services for those with
chronic diseases and mental health disorders; and
WHEREAS, Several other states have leapt ahead in their commitment
to the patient centered medical home model and are reaping the
rewards, including, but not limited to, quality improvement and costs
reduction; and
WHEREAS, Several other states have obtained substantial federal
funding for implementation of medical home demonstration projects;
and
WHEREAS, Fee-for-service model rewards volume for services
provided, and can unnecessarily drive up the costs and capitation,
which can result in the underprovision of services; and
WHEREAS, Inclusion of a blended payment model to support patient
centered medical homes tempers the negative incentives of capitation
and fee-for-service models and allows for flexibility in how to
organize and provide medical home services; and
WHEREAS, Thirty-nine states have created a definition for "medical
home," "patient centered medical home," or another synonymous term;
and
WHEREAS, 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
siloed care; now, therefore, be it
Resolved by the Assembly of the State of California, the Senate
thereof concurring, That the Legislature supports and encourages the
further development and expansion of a California health care
delivery system that identifies a patient centered medical home model
and is based on the following principles of coordination of patient
care, including, but not limited to:
(a) A collaborative team approach to providing comprehensive
health care that fosters a partnership among the patient, the
physician-led practice team, and other health care professionals,
and, if appropriate, the patient's family or the patient's
representative, upon the consent of the patient.
(b) The ability to provide access to continuous and comprehensive
care, or, if appropriate, referrals to health care professionals that
provide continuous and comprehensive care.
(c) A provider, working in concert with a multidisciplinary team
of individuals, who takes responsibility for the ongoing health care
of patients, including appropriately arranging health care by other
qualified health care professionals and making appropriate referrals.
(d) Care that is coordinated and integrated between all elements
of the complex health care system, including, mental health and
substance use disorder care, and the patient's community.
(e) Care that is 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.
(f) A payment structure designed to reward the provision of the
right care in the right setting that discourages the delivery of too
much or too little care and that encourages the appropriate
management of complex medical cases, increased access to care, the
measurement of patient outcomes, continuous improvement of care
quality, and the comprehensive integration and coordination across
all stages and settings of a patient's care.
(g) Compensation that recognizes the increased services and
overhead associated with the medical home practice model and the
potential savings from better management of chronic diseases and
conditions, recognizing the value of non-face-to-face communication
by telephone and email, the coordination of care with other providers
and community agencies, and the use of health information technology
to support medical home functions; and be it further
Resolved, That "patient centered medical home" and "medical home"
means a health care delivery model in which a patient establishes an
ongoing relationship with a personal primary care physician or other
personal licensed health care provider working 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; and
be it further
Resolved, That all of the following quality and safety components
are incorporated into the patient centered medical home model:
(a) 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.
(b) Evidence-based medicine and clinical decision support tools
that guide decisionmaking.
(c) The licensed health care providers in the practice accept
accountability for continuous quality improvement through voluntary
engagement in performance measurement and improvement.
(d) Active patient participation in decisionmaking and feedback is
sought to ensure that the patient's expectations are being met.
(e) Information technology is utilized appropriately to support
optimal patient care, performance measurement, patient education, and
enhanced communication.
(f) Patients and families, or representatives, participate in
quality improvement activities.
(g) Patients are provided with enhanced access to health care; and
be it further
Resolved, That the Chief Clerk of the Assembly transmit copies of
this resolution to the author for appropriate distribution.
