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| To enact sections 3333.611 and 3901.90 of the Revised | 1 |
| Code to establish the Medical Home Model | 2 |
| Demonstration Project; to provide for Choose Ohio | 3 |
| First Scholarships to be awarded to medical | 4 |
| students who agree to practice primary care; to | 5 |
| repeal section 3901.90 of the Revised Code, | 6 |
| effective March 1, 2012; and to make an | 7 |
| appropriation. | 8 |
| Section 1. That sections 3333.611 and 3901.90 of the Revised | 9 |
| Code be enacted to read as follows: | 10 |
| Sec. 3333.611. (A) All of the following shall jointly | 11 |
| develop a proposal for the creation of a primary care component of | 12 |
| the choose Ohio first scholarship program operated under section | 13 |
| 3333.61 of the Revised Code under which scholarships are annually | 14 |
| made available and awarded to medical students who meet the | 15 |
| requirements specified in division (C) of this section: | 16 |
| (1) The dean of the Ohio state university school of medicine; | 17 |
| (2) The dean of Case western reserve university school of | 18 |
| medicine; | 19 |
| (3) The dean of the university of Toledo college of medicine; | 20 |
| (4) The president and dean of northeastern Ohio universities | 21 |
| colleges of medicine and pharmacy; | 22 |
| (5) The dean of the university of Cincinnati college of | 23 |
| medicine; | 24 |
| (6) The dean of the Boonshoft school of medicine at Wright | 25 |
| state university; | 26 |
| (7) The dean of the Ohio university college of osteopathic | 27 |
| medicine. | 28 |
| (B) The proposal for the component shall be submitted to the | 29 |
| chancellor of the Ohio board of regents not later than October 30, | 30 |
| 2009. The chancellor shall review the proposal and determine | 31 |
| whether to implement the component as part of the program. | 32 |
| (C) To be eligible for a scholarship made available under the | 33 |
| component, a medical student shall meet all of the following | 34 |
| requirements: | 35 |
| (1) Commit to a post-residency primary care practice in this | 36 |
| state for not less than three years; | 37 |
| (2) Accept a proportion of medicaid recipients, as specified | 38 |
| in the scholarship, as patients, without restriction; | 39 |
| (3) Identify specific medical home training opportunities | 40 |
| that the medical student will access during the student's medical | 41 |
| training. | 42 |
| Sec. 3901.90. (A) There is hereby established the medical | 43 |
| home model demonstration project. The demonstration project shall | 44 |
| be operated to evaluate the medical home model of care, as that | 45 |
| model of care is defined by the American academy of family | 46 |
| physicians. | 47 |
| (B)(1) The demonstration project shall be implemented and | 48 |
| administered by the medical home council, which shall be composed | 49 |
| of the following members: | 50 |
| (a) Three individuals appointed by the health care coverage | 51 |
| and quality council created under section 3923.90 of the Revised | 52 |
| Code, each of whom shall serve at the pleasure of the council; | 53 |
| (b) Three individuals appointed by the governing board of the | 54 |
| greater Dayton primary care collaborative, each of whom shall | 55 |
| serve at the pleasure of the governing board; | 56 |
| (c) Subject to division (A)(2) of this section, three | 57 |
| individuals from the governing board of an entity similar to the | 58 |
| greater Dayton primary care collaborative, but which is located in | 59 |
| Lucas county, each of whom shall serve at the pleasure of the | 60 |
| governing board. | 61 |
| (2) The three individuals described in division (B)(1)(c) of | 62 |
| this section shall not serve on the council until the health care | 63 |
| coverage and quality council selects an entity in Lucas county | 64 |
| that is similar to the greater Dayton primary care collaborative. | 65 |
| (3) The department of insurance shall provide administrative | 66 |
| support to the council. | 67 |
| (C) The demonstration project shall be implemented not later | 68 |
| than October 1, 2009. The medical home council shall do all of | 69 |
| the following: | 70 |
| (1) Develop a set of expected outcomes for the demonstration | 71 |
| project; | 72 |
| (2) Accept applications from primary care physician practices | 73 |
| located in the greater Dayton metropolitan area that are seeking | 74 |
| to participate in the demonstration project and: | 75 |
| (i) Not later than October 1, 2009, select no more than ten | 76 |
| physician practices for inclusion in the project; | 77 |
| (ii) Not earlier than October 1, 2010, select no more than | 78 |
| ten additional physician practices for inclusion in the project. | 79 |
| (3) Accept applications from primary care physician practices | 80 |
| located in Lucas county that are seeking to participate in the | 81 |
| demonstration project and, not earlier than January 1, 2010, | 82 |
| select no more than ten physician practices for inclusion in the | 83 |
| project. | 84 |
| (D) To be eligible for inclusion in the demonstration | 85 |
| project, a physician practice shall meet all of the following | 86 |
| requirements: | 87 |
| (1) Consist of physicians who are board-certified in family | 88 |
| medicine, general pediatrics, or internal medicine, as those | 89 |
| designations are issued by a medical specialty board of the | 90 |
| American medical association or American osteopathic association; | 91 |
| (2)(a) If located in the greater Dayton metropolitan area, | 92 |
| not later than October 1, 2009, offer primary care services in the | 93 |
| geographic area of the city of Dayton, which may include any of | 94 |
| the surrounding areas of Dayton and the counties contiguous to | 95 |
| Montgomery county. | 96 |
| (b) If located in Lucas county, not earlier than January 1, | 97 |
| 2010, offer primary care services in the geographic area of Lucas | 98 |
| county, which may include areas in the counties contiguous to | 99 |
| Lucas county. | 100 |
| (3) Be capable of adapting the practice during the | 101 |
| demonstration project in such a manner that it is fully compliant | 102 |
| with the minimum standards for a patient-centered medical home, as | 103 |
| those standards are determined by the national committee for | 104 |
| quality assurance; | 105 |
| (4) If located in Lucas county, the physician practice shall | 106 |
| be approved by the health care coverage and quality council; | 107 |
| (5) Meet any other criteria established by the medical home | 108 |
| council as part of the selection process. | 109 |
| (E) The demonstration project shall include the following | 110 |
| services and supports for each physician practice included in the | 111 |
| project: | 112 |
| (1) Each practice shall receive reimbursement for not greater | 113 |
| than seventy-five per cent of the cost to purchase any health | 114 |
| information technology required to convert to the medical home | 115 |
| model of care, including appropriate training and technical | 116 |
| support. | 117 |
| (2) The physicians and staff of the practice shall receive | 118 |
| comprehensive training on the operation of a medical home, | 119 |
| including assistance with leadership training, scheduling changes, | 120 |
| staff support, and chronic care management. | 121 |
| (F) The medical home council shall enter into a contract with | 122 |
| each physician practice selected for inclusion in the | 123 |
| demonstration project. The contract shall include the terms and | 124 |
| conditions for participation in the project, including a | 125 |
| requirement that the physician practice provide primary care | 126 |
| services to patients and serve as the patient's medical home. | 127 |
| (G) As part of the demonstration project, the medical home | 128 |
| council shall establish a medical education component to support | 129 |
| the training of new primary care physicians in the medical home | 130 |
| model of care, including both medical students and participants | 131 |
| in primary care residencies. The council shall develop a | 132 |
| curricula designed to thoroughly prepare primary care physicians | 133 |
| to practice within the medical home model of care. In developing | 134 |
| the curricula, the council shall consult with and obtain | 135 |
| assistance from the Wright state university Boonshoft school of | 136 |
| medicine, the Ohio university college of osteopathic medicine, | 137 |
| and the university of Toledo college of medicine. | 138 |
| (H)(1) The medical home council shall prepare reports of its | 139 |
| findings and recommendations from the demonstration project. Each | 140 |
| report shall include an evaluation of the medical outcomes and | 141 |
| costs of the demonstration project. The reports shall be | 142 |
| completed in accordance with the following schedule: | 143 |
| (a) An interim report not later than March 1, 2010; | 144 |
| (b) An update of the interim report not later than March 1, | 145 |
| 2011; | 146 |
| (c) A final report not later than March 1, 2012. | 147 |
| (2) The council shall submit each of the reports to the | 148 |
| governor, president of the senate, and speaker of the house of | 149 |
| representatives. | 150 |
| Section 2. Section 3901.90 of the Revised Code is hereby | 151 |
| repealed, effective March 1, 2012. | 152 |
| Section 3. In fiscal year 2010 and fiscal year 2011, the | 153 |
| Chancellor of the Board of Regents shall award no less than fifty | 154 |
| Choose Ohio First Scholarships, as prescribed in sections 3333.60 | 155 |
| to 3333.70 of the Revised Code, to state-assisted institutions of | 156 |
| higher education with proposals for training medical students in | 157 |
| the Medical Home Care Model. All Ohio state-assisted institutions | 158 |
| of higher education with a school or college of medicine are | 159 |
| eligible to submit a proposal for scholarships under this section. | 160 |
| The proposals need not comply with the out-of-state recruitment | 161 |
| requirements of division (B) of section 3333.66 of the Revised | 162 |
| Code. Proposals shall include a mechanism to ensure that each | 163 |
| student accepting a Choose Ohio First Scholarship will complete | 164 |
| residency training in a family medicine, general internal | 165 |
| medicine, or general pediatrics specialty in Ohio and will | 166 |
| practice family or primary care medicine in Ohio for a minimum | 167 |
| of three years after the student's completion of residency | 168 |
| training and meet the established criteria for the inclusion of | 169 |
| Medicaid recipients. | 170 |
| Section 4. All items in this section are hereby appropriated | 171 |
| as designated out of any moneys in the state treasury to the | 172 |
| credit of the General Revenue Fund. For all appropriations made in | 173 |
| this act, those in the first column are for fiscal year 2010 and | 174 |
| those in the second column are for fiscal year 2011. The | 175 |
| appropriations made in this act are in addition to any other | 176 |
| appropriations made for the FY 2010-FY 2011 biennium. | 177 |
| 178 | |
| General Revenue Fund | 179 |
| GRF | 235519 | Family Practice | $ | 800,000 | $ | 600,000 | 180 | ||||
| TOTAL GRF General Revenue Fund | $ | 800,000 | $ | 600,000 | 181 | ||||||
| TOTAL ALL BUDGET FUND GROUPS | $ | 800,000 | $ | 600,000 | 182 | ||||||
| FAMILY PRACTICE | 183 |
| The foregoing appropriation item 235519, Family Practice, | 184 |
| shall be used to support the development of medical school | 185 |
| curricula at the Wright State University School of Medicine, the | 186 |
| Ohio University College of Osteopathic Medicine, and the | 187 |
| University of Toledo College of Medicine to prepare primary care | 188 |
| physicians to practice within the Medical Home Model of care. | 189 |
| A portion of the foregoing appropriation item 235519, Family | 190 |
| Practice, shall be used to enhance residency design and curricula | 191 |
| development in the Medical Home Model of care for family practice | 192 |
| residencies within the geographic areas served by the Medical Home | 193 |
| Model Demonstration Project under section 3901.90 of the Revised | 194 |
| Code. | 195 |
| 196 | |
| General Revenue Fund | 197 |
| GRF | 820501 | Medical Home Model | $ | 1,406,000 | $ | 2,465,000 | 198 | ||||
| TOTAL GRF General Revenue Fund | $ | 1,406,000 | $ | 2,465,000 | 199 | ||||||
| TOTAL ALL BUDGET FUND GROUPS | $ | 1,406,000 | $ | 2,465,000 | 200 | ||||||
| MEDICAL HOME MODEL | 201 |
| Of the foregoing appropriation item 820501, Medical Home | 202 |
| Model, the Medical Home Council, as described in section 3901.90 | 203 |
| of the Revised Code, shall receive up to $640,000 in fiscal year | 204 |
| 2010 and $1,635,000 in fiscal year 2011. These funds shall be used | 205 |
| to provide not more than 75% of the cost to convert 20 physician | 206 |
| practices to the medical home model of care and shall include | 207 |
| administrative costs of not more than $150,000 in fiscal year 2010 | 208 |
| and not more than $150,000 in fiscal year 2011. | 209 |
| Within the limits set forth in this act, the Director of | 210 |
| Budget and Management shall establish accounts indicating the | 211 |
| source and amount of funds for each appropriation made in this | 212 |
| act, and shall determine the form and manner in which | 213 |
| appropriation accounts shall be maintained. Expenditures from | 214 |
| appropriations contained in this act shall be accounted for as | 215 |
| though made in the main operating appropriations act of the 128th | 216 |
| General Assembly. | 217 |
| The appropriations made in this act are subject to all | 218 |
| provisions of the main operating appropriations act of the 128th | 219 |
| General Assembly for the FY 2010-FY 2011 biennium that are | 220 |
| generally applicable to General Revenue Fund appropriations. | 221 |
| Section 5. Sections 3, 4, and 5 of this act are not subject | 222 |
| to the referendum. Therefore, under Ohio Constitution, Article II, | 223 |
| Section 1d and section 1.471 of the Revised Code, Sections 3, 4, | 224 |
| and 5 go into immediate effect when this act becomes law. | 225 |