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H. B. No. 198 As IntroducedAs Introduced
128th General Assembly | Regular Session | 2009-2010 |
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Representatives Lehner, Ujvagi
Cosponsors:
Representatives Grossman, Harris, Jones, Weddington, Foley, Domenick, Hackett, Burke, Bacon, Blair, Ruhl, Martin, Yuko, Derickson, Newcomb, Harwood, Letson, Moran, Winburn
A BILL
To enact sections 3333.611 and 3901.90 of the Revised
Code to establish the Medical Home Model
Demonstration Project; to provide for Choose Ohio
First Scholarships to be awarded to medical
students who agree to practice primary care; to
repeal section 3901.90 of the Revised Code,
effective March 1, 2012; and to make an
appropriation.
BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF OHIO:
Section 1. That sections 3333.611 and 3901.90 of the Revised
Code be enacted to read as follows:
Sec. 3333.611. (A) All of the following shall jointly
develop a proposal for the creation of a primary care component of
the choose Ohio first scholarship program operated under section
3333.61 of the Revised Code under which scholarships are annually
made available and awarded to medical students who meet the
requirements specified in division (C) of this section:
(1) The dean of the Ohio state university school of medicine;
(2) The dean of Case western reserve university school of
medicine;
(3) The dean of the university of Toledo college of medicine;
(4) The president and dean of northeastern Ohio universities
colleges of medicine and pharmacy;
(5) The dean of the university of Cincinnati college of
medicine;
(6) The dean of the Boonshoft school of medicine at Wright
state university;
(7) The dean of the Ohio university college of osteopathic
medicine.
(B) The proposal for the component shall be submitted to the
chancellor of the Ohio board of regents not later than October 30,
2009. The chancellor shall review the proposal and determine
whether to implement the component as part of the program.
(C) To be eligible for a scholarship made available under the
component, a medical student shall meet all of the
following
requirements:
(1) Commit to a post-residency primary care practice in this
state for not less than three years;
(2) Accept a proportion of medicaid recipients, as specified
in the scholarship, as patients, without
restriction;
(3) Identify specific medical home training opportunities
that the medical student will access during the student's medical
training.
Sec. 3901.90. (A) There is hereby established the medical
home model demonstration project. The demonstration
project shall
be operated to evaluate the medical home model of
care, as that
model of care is defined by the American academy of
family
physicians.
(B)(1) The demonstration project shall be implemented and
administered by the medical home council, which
shall be composed
of the following members:
(a) Three individuals appointed by the health care coverage
and quality council created under section 3923.90 of the Revised
Code, each of whom
shall serve at the pleasure of the council;
(b) Three individuals appointed by the governing board of the
greater Dayton primary care collaborative, each of whom shall
serve at the
pleasure of the governing board;
(c) Subject to division (A)(2) of this section, three
individuals from the governing board of an entity similar to the
greater Dayton primary care collaborative, but which is located in
Lucas county, each of whom shall serve at the pleasure of the
governing board.
(2) The three individuals described in division (B)(1)(c) of
this section shall not serve on the council until the health care
coverage and quality council selects an entity in Lucas county
that is similar to the greater Dayton primary care collaborative.
(3) The department of insurance shall provide
administrative
support to the council.
(C) The demonstration project shall be implemented not later
than October 1, 2009. The medical home council
shall do all of
the following:
(1) Develop a set of expected outcomes for the demonstration
project;
(2) Accept applications from primary care physician practices
located in the greater Dayton metropolitan area that are seeking
to participate in the demonstration project and:
(i) Not later than October 1, 2009, select no more than ten
physician practices for inclusion in the project;
(ii) Not earlier than October 1, 2010, select no more than
ten additional physician practices for inclusion in the project.
(3) Accept applications from primary care physician practices
located in Lucas county that are seeking to participate in the
demonstration project and, not earlier than January 1, 2010,
select no more than ten physician practices for inclusion in the
project.
(D) To be eligible for inclusion in the demonstration
project, a physician practice shall meet all of the following
requirements:
(1) Consist of physicians who are board-certified in family
medicine, general pediatrics, or internal medicine, as those
designations are issued by a medical specialty board of the
American medical association or American osteopathic association;
(2)(a) If located in the greater Dayton metropolitan area,
not later than October 1, 2009, offer primary care services in the
geographic area of the city of Dayton, which may include any of
the surrounding areas of Dayton and the counties contiguous to
Montgomery county.
(b) If located in Lucas county, not earlier than January 1,
2010, offer primary care services in the geographic area of Lucas
county, which may include areas in the counties contiguous to
Lucas county.
(3) Be capable of adapting the practice during the
demonstration project in such a manner that it is fully compliant
with the minimum standards for a patient-centered medical home, as
those standards are determined by the national committee for
quality assurance;
(4) If located in Lucas county, the physician practice shall
be approved by the health care coverage and quality council;
(5) Meet any other criteria established by the medical home
council as
part of the selection process.
(E) The demonstration project shall include the following
services and supports for each physician practice included in the
project:
(1) Each practice shall receive reimbursement for not greater
than seventy-five per cent of the cost to purchase any health
information technology required to convert to the medical home
model of care, including appropriate training and technical
support.
(2) The physicians and staff of the practice shall receive
comprehensive training on the operation of a medical home,
including assistance with leadership training, scheduling changes,
staff support, and chronic care management.
(F) The medical home council shall enter into a contract with
each physician practice selected for inclusion in the
demonstration project. The contract shall include the terms and
conditions for participation in the project, including a
requirement that the physician practice provide primary care
services to patients and serve as the patient's medical home.
(G) As part of the demonstration project, the medical home
council shall
establish a medical education component to support
the training of
new primary care physicians in the medical home
model of care,
including both medical students and participants
in primary care
residencies. The council shall develop a
curricula designed to
thoroughly prepare primary care physicians
to practice within the
medical home model of care. In developing
the curricula, the
council shall consult with and obtain
assistance from the Wright
state university Boonshoft school of
medicine, the Ohio
university college of osteopathic medicine,
and the university of Toledo college of medicine.
(H)(1) The medical home council shall prepare reports of its
findings and
recommendations from the demonstration project. Each
report shall
include an evaluation of the medical outcomes and
costs of the
demonstration project. The reports shall be
completed in
accordance with the following schedule:
(a) An interim report not later than March 1, 2010;
(b) An update of the interim report not later than March 1,
2011;
(c) A final report not later than March 1, 2012.
(2) The council shall submit each of the reports to the
governor, president of the senate, and speaker of the house of
representatives.
Section 2. Section 3901.90 of the Revised Code is hereby
repealed, effective March 1, 2012.
Section 3. In fiscal year 2010 and fiscal year 2011, the
Chancellor of the Board of Regents shall award no less than fifty
Choose Ohio First Scholarships, as prescribed in sections 3333.60
to 3333.70 of the Revised Code, to state-assisted institutions of
higher education with proposals for training medical students in
the Medical Home Care Model. All Ohio state-assisted institutions
of higher education with a school or college of medicine are
eligible to submit a proposal for scholarships under this section.
The proposals need not comply with the out-of-state recruitment
requirements of division (B) of section 3333.66 of the Revised
Code. Proposals shall include a mechanism to ensure that each
student accepting a Choose Ohio First Scholarship will complete
residency training in a family medicine, general internal
medicine, or
general pediatrics
specialty in Ohio and will
practice family or
primary care
medicine in Ohio for a minimum
of three years after
the student's
completion of residency
training and meet the
established criteria for the inclusion of
Medicaid recipients.
Section 4. All items in this section are hereby appropriated
as designated out of any moneys in the state treasury to the
credit of the General Revenue Fund. For all appropriations made in
this act, those in the first column are for fiscal year 2010 and
those in the second column are for fiscal year 2011. The
appropriations made in this act are in addition to any other
appropriations made for the FY 2010-FY 2011 biennium.
BOR BOARD OF REGENTS
GRF |
235519 |
|
Family Practice |
|
$ |
800,000 |
|
$ |
600,000 |
TOTAL GRF General Revenue Fund |
|
$ |
800,000 |
|
$ |
600,000 |
TOTAL ALL BUDGET FUND GROUPS |
|
$ |
800,000 |
|
$ |
600,000 |
The foregoing appropriation item 235519, Family Practice,
shall be used to support the development of medical school
curricula at the Wright State University School of
Medicine, the
Ohio University College of Osteopathic Medicine, and the
University of Toledo College of Medicine
to prepare primary care
physicians to practice within the Medical
Home Model of care.
A portion of the foregoing appropriation item 235519, Family
Practice, shall be used to enhance residency design and curricula
development in the Medical Home Model of care for family practice
residencies within the geographic areas served by the Medical Home
Model Demonstration Project under section 3901.90 of the Revised
Code.
INS DEPARTMENT OF INSURANCE
GRF |
820501 |
|
Medical Home Model |
|
$ |
1,406,000 |
|
$ |
2,465,000 |
TOTAL GRF General Revenue Fund |
|
$ |
1,406,000 |
|
$ |
2,465,000 |
TOTAL ALL BUDGET FUND GROUPS |
|
$ |
1,406,000 |
|
$ |
2,465,000 |
Of the foregoing appropriation item 820501, Medical Home
Model, the Medical Home Council, as described in section 3901.90
of the Revised Code, shall receive up to $640,000 in fiscal year
2010 and $1,635,000 in fiscal year 2011. These funds shall be used
to provide not more than 75% of the cost to convert 20 physician
practices to the medical home model of care and shall include
administrative costs of not more than $150,000 in fiscal year 2010
and not more than $150,000 in fiscal year 2011.
Within the limits set forth in this act, the Director of
Budget and Management shall establish accounts indicating the
source and amount of funds for each appropriation made in this
act, and shall determine the form and manner in which
appropriation accounts shall be maintained. Expenditures from
appropriations contained in this act shall be accounted for as
though made in the main operating appropriations act of the 128th
General Assembly.
The appropriations made in this act are subject to all
provisions of the main operating appropriations act of the 128th
General Assembly for the FY 2010-FY 2011 biennium that are
generally applicable to General Revenue Fund appropriations.
Section 5. Sections 3, 4, and 5 of this act are not subject
to the referendum. Therefore, under Ohio Constitution, Article II,
Section 1d and section 1.471 of the Revised Code, Sections 3, 4,
and 5 go into immediate effect when this act becomes law.
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