130th Ohio General Assembly
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H. B. No. 198  As Introduced
As Introduced

128th General Assembly
Regular Session
2009-2010
H. B. No. 198


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
General Revenue Fund
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

FAMILY PRACTICE
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
General Revenue Fund
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

MEDICAL HOME MODEL
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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