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Medical Home Bill Passes Senate

In the last hours of a late-night vote, the Legislature passed a bill that establishes the Patient-Centered Medical Home Act of 2010. Passage of AB 1542  by Dave Jones (D-Sacramento) did not come easily. It failed a vote the day before, and only got the votes it needed at the end of the final day of the session.

(Update: New developments are covered in the Sept. 7 Capitol Desk.)

A relieved Dave Jones practically bounced out of Senate chambers when several Senate members changed their votes and the bill passed.

“It’s what we’ve been working on for hours, to get those last votes,” Jones said. “It was the effort of the primary care physicians who have been making calls, and they convinced a few people, explained just what the medical home is.”

That was one of the hurdles for the bill — getting people to understand the purpose and language of it. It’s one of the new buzz phrases in health policy, the medical home, but legislators were not so familiar with it.

In fact, when Sen. Elaine Alquist (D-Santa Clara) introduced AB 1542 for a vote, she felt the need to explain just what that phrase means.

“Currently in California, there is no definition of a medical home,” Alquist said. “Some might think it’s a house with blue shutters and a red roof. But really it’s a model for the delivery of health care in California.”

The idea of the patient-centered medical home is to have patients involved in their care, to have a primary care provider coordinate the patient’s treatment with other providers and to use medical best practices to make treating chronic diseases (such as diabetes) a more seamless and effective process.

“We’re really happy to establish a standard for medical homes,” Jones said. “In particular, the coordinated care aspect of the medical home.”

On Monday, the bill failed, despite getting a 26-0 vote in favor of it. For technical reasons, the bill had an urgency status, which meant it needed a two-thirds vote — that is, 27 yes votes.

The bill received permission for reconsideration, and on another vote yesterday, the bill couldn’t muster close to the 26 votes. But on one of the last re-votes of the evening, it passed 28-9. So what did all of those previous votes matter, Jones asked, smiling.

“Today we got 28,” he said.

In other action Tuesday:

• A bill that would set up an umbilical cord blood collection program, AB 52 by Anthony Portantino (D-La Canada), passed 33-1. If the governor signs it, it would administer the collection of units of umbilical cord blood for public use, for transplantation and some research.

• The effort to establish the regulation of health insurance companies’ rate hikes, AB 2578 by Dave Jones (D-Sacramento), failed for a second straight day.

“We heard this bill yesterday,” Senate member Alan Lowenthal (D-Long Beach) said when re-introducing the bill. “It would require approval from the Department of Insurance or the Department of Managed Health Care for health insurance rate increases,” he said. “And any rate hikes that are excessive would be rejected, while any rate hikes that are reasonable would be accepted.”

Lowenthal said rate hikes recently proposed by Blue Cross at an average of 20% and by Blue Shield at an average of 29% might not be rejected — but they would be reviewed, he said.

“It’s the same as the regulation of rates that we do for car insurance and other kinds of insurance,” Lowenthal said. “It would protect California consumers from excessive rates.”


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