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| PRIOR PRINTER'S NO. 2992 | PRINTER'S NO. 4064 |
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| THE GENERAL ASSEMBLY OF PENNSYLVANIA |
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| HOUSE BILL |
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| INTRODUCED BY BOYLE, DeLUCA, BELFANTI, BRENNAN, BROWN, FREEMAN, KORTZ, MANN, McGEEHAN, MUNDY, MURPHY, M. O'BRIEN, M. SMITH, BRIGGS, BISHOP, JOSEPHS, FRANKEL, BRADFORD AND PASHINSKI, DECEMBER 9, 2009 |
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| AS REPORTED FROM COMMITTEE ON HEALTH AND HUMAN SERVICES, HOUSE OF REPRESENTATIVES, AS AMENDED, JUNE 30, 2010 |
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| AN ACT |
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1 | Creating the Pennsylvania Chronic Care Commission, providing for |
2 | responsibilities and duties of the commission and for duties |
3 | of the Department of Health. |
4 | The General Assembly of the Commonwealth of Pennsylvania |
5 | hereby enacts as follows: |
6 | Section 1. Short title. |
7 | This act shall be known and may be cited as the Pennsylvania |
8 | Chronic Care Commission Act. |
9 | Section 2. Definitions. |
10 | The following words and phrases when used in this act shall |
11 | have the meanings given to them in this section unless the |
12 | context clearly indicates otherwise: |
13 | "Chronic care model." A model of care that includes the |
14 | following: |
15 | (1) The provision of effective health management through |
16 | support and information that also promotes patient self-care |
17 | for patients with chronic conditions. |
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1 | (2) The use of evidence-based medicine to ensure |
2 | appropriate treatment decisions by health care providers. |
3 | (3) The coordination of care and use of reasonably |
4 | accessible and updated patient information that encourages |
5 | follow-up care as a standard procedure. |
6 | (4) The tracking of clinical information for individual |
7 | and general patient populations to guide treatment and |
8 | effectively anticipate community health care problems. |
9 | "Commission." The Pennsylvania Chronic Care Commission. |
10 | "Department." The Department of Health of the Commonwealth. |
11 | "Health care facility." A health care facility as defined |
12 | under section 802.1 of the act of July 19, 1979 (P.L.130, |
13 | No.48), known as the Health Care Facilities Act, or an entity |
14 | licensed as a hospital under the act of June 13, 1967 (P.L.31, |
15 | No.21), known as the Public Welfare Code. |
16 | "Health care provider." A health care provider licensed to |
17 | practice a component of the healing arts by a licensing board |
18 | within the Department of State who provides health care services |
19 | at a community-based health care clinic. |
20 | "Health payor." An individual or entity paying for health |
21 | services for himself or itself or on behalf of another. |
22 | "Hospital." An entity located in this Commonwealth that is |
23 | licensed as a hospital under the act of July 19, 1979 (P.L.130, |
24 | No.48), known as the Health Care Facilities Act. |
25 | "Insurer." A company or health insurance entity licensed in |
26 | this Commonwealth to issue any health, sickness or accident |
27 | policy or subscriber contract or certificate or plan that |
28 | provides medical or health care coverage by a health care |
29 | facility or licensed health care provider that is offered or |
30 | governed under any of the following: |
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1 | (1) The act of May 17, 1921 (P.L.682, No.284), known as |
2 | The Insurance Company Law of 1921. |
3 | (2) The act of December 29, 1972 (P.L.1701, No.364), |
4 | known as the Health Maintenance Organization Act. |
5 | (3) The act of May 18, 1976 (P.L.123, No.54), known as |
6 | the Individual Accident and Sickness Insurance Minimum |
7 | Standards Act. |
8 | (4) 40 Pa.C.S. Ch. 61 (relating to hospital plan |
9 | corporations) or 63 (relating to professional health service |
10 | plan corporations). |
11 | "Regional community learning collaborative." A collaboration |
12 | between health care facilities, health care providers, |
13 | hospitals, insurers, health payors and consumers to exchange |
14 | information about chronic care models and assist in efforts |
15 | toward adoption of a chronic care model. |
16 | Section 3. Pennsylvania Chronic Care Commission. |
17 | There is established in the department the Pennsylvania |
18 | Chronic Care Commission whose purpose is to design and implement |
19 | the informational, technological and reimbursement |
20 | infrastructure needed to support widespread dissemination, |
21 | adaptation and implementation of the components for chronic care |
22 | in relevant health care facilities and among health care |
23 | providers throughout this Commonwealth. |
24 | Section 4. Powers and duties. |
25 | The commission shall have the following powers and duties: |
26 | (1) Determine how to align and integrate the components |
27 | for chronic care into the current health care system and into |
28 | currently existing chronic care models throughout this |
29 | Commonwealth. These components include, but are not limited |
30 | to, the following: |
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1 | (i) providing patients with chronic conditions |
2 | support and information to effectively manage their |
3 | health; |
4 | (ii) providing information for health care providers |
5 | to make treatment decisions based on evidence-based |
6 | medicine; |
7 | (iii) ensuring that health care providers have |
8 | access to current information about patients and that |
9 | follow-up care is provided as a standard procedure; |
10 | (iv) collecting clinical information on individual |
11 | patients and groups of patients that leads to the |
12 | development of treatment guidelines; |
13 | (v) engaging patients and health care providers in |
14 | chronic care improvement efforts; and |
15 | (vi) forming partnerships with State and local |
16 | organizations to support and expand efforts to treat and |
17 | care for those with chronic diseases. |
18 | (2) Participate in the establishment of regional |
19 | community learning collaboratives to educate health care |
20 | providers, health care teams and consumers on the components |
21 | for chronic care and evidence-based treatment of chronic |
22 | disease. |
23 | (3) Identify, assess and disseminate information on |
24 | current efforts surrounding the implementation and |
25 | maintenance of chronic care models in each regional community |
26 | learning collaborative and across this Commonwealth. |
27 | (4) Develop guidelines for the review of patient data by |
28 | the commission and regional community learning collaboratives |
29 | that maintain the confidentiality required by Federal and |
30 | State law. |
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1 | (5) Develop care protocols that assess the factors |
2 | influencing the implementation of the components for chronic |
3 | care. |
4 | (6) Assess and potentially incorporate existing efforts |
5 | dealing with chronic care being performed by Commonwealth |
6 | agencies. |
7 | (7) Develop and construct data measures that can be used |
8 | by the commission to measure provider performance. |
9 | (8) Create evaluation processes and outcome measures to |
10 | monitor implementation of the components for chronic care in |
11 | different clinical settings. |
12 | Section 5. Composition of commission. |
13 | (a) Members.--The commission shall consist of the following |
14 | members: |
15 | (1) Five members of the Governor's cabinet, or their |
16 | respective designees, who shall serve ex officio and one of |
17 | whom shall act as cochair, as selected by the Governor. |
18 | (2) Individuals from each of the following categories |
19 | appointed by the Governor, one of whom shall act as cochair |
20 | as selected by the Governor: |
21 | (i) a health insurer medical director; |
22 | (ii) a health insurance actuary; |
23 | (iii) a registered nurse, certified nurse |
24 | practitioner, clinical nurse specialist, physician |
25 | assistant or pharmacist that is currently practicing |
26 | within this Commonwealth; |
27 | (iv) two primary care physicians who are members of |
28 | the Pennsylvania Medical Society; |
29 | (v) a specialty care physician in active practice; |
30 | (vi) an individual with a background in chronic care |
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1 | from an academic medical center; |
2 | (vii) a provider of home health care; |
3 | (viii) a health services researcher with expertise |
4 | in chronic care; |
5 | (ix) an individual with a background in information |
6 | technology and systems; |
7 | (x) a representative from an organization that |
8 | represents individuals with chronic conditions; |
9 | (xi) a consumer with a chronic condition or multiple |
10 | chronic conditions; |
11 | (xii) a consumer with a chronic condition or |
12 | multiple chronic conditions who is at least 65 years of |
13 | age; |
14 | (xiii) two individuals representing hospitals who |
15 | are members of the Hospital and Health System Association |
16 | of Pennsylvania; and | <-- |
17 | (xiv) a licensed dietitian-nutritionist; and | <-- |
18 | (xiv) (xv) any other individual who can assist the | <-- |
19 | commission with the purposes under this act. |
20 | (b) Term and compensation.--The members chosen under |
21 | subsection (a) shall each serve for a term of three years and |
22 | continue to serve until their successor is appointed. Members |
23 | shall serve without compensation except for payment of necessary |
24 | and actual expenses incurred in attending meetings and in |
25 | performing their duties and responsibilities as commission |
26 | members. |
27 | (c) Staff.--The department shall provide staff and data |
28 | support to the commission. |
29 | Section 6. Powers and duties of department. |
30 | The department shall have the following powers and duties: |
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1 | (1) Assist the commission with outreach efforts to |
2 | educate consumer groups and the health care provider |
3 | community in order to engage individuals to take necessary |
4 | steps to prevent chronic diseases and to better self-manage |
5 | their chronic conditions with the support of a health care |
6 | team. |
7 | (2) Assist the commission in the development of a |
8 | Statewide chronic care information system, including rules |
9 | for secure information sharing, which permits the exchange of |
10 | information among the regional community learning |
11 | collaboratives and the department. |
12 | (3) Establish registries that collect clinical data on |
13 | patients with chronic conditions and the methods for |
14 | disseminating this information for use by providers. |
15 | (4) On or before December 31, 2010, and for each year |
16 | thereafter, provide a report to the General Assembly that |
17 | includes: |
18 | (i) the number of individuals with chronic |
19 | conditions for the previous year in which information is |
20 | available; |
21 | (ii) a list of each regional community learning |
22 | collaborative and the number of providers that |
23 | participate in each collaborative; |
24 | (iii) support information for patients with chronic |
25 | conditions; |
26 | (iv) information for providers on treatment options |
27 | based on best evidence that was reviewed by the |
28 | commission and the department in the past year; and |
29 | (v) any other information the commission or the |
30 | department deems necessary to assist the public in |
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1 | understanding how to reduce the number of chronic |
2 | conditions in this Commonwealth. |
3 | Section 7. Effective date. |
4 | This act shall take effect immediately. |
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