See other bills
under the
same topic
                                                      PRINTER'S NO. 2363



No. 1564 Session of 2008

           SEPTEMBER 16, 2008


                                     AN ACT

     1  Establishing the Keystone Care Program in the Department of
     2     Health to provide grants for health care services; and making
     3     an appropriation.

     4     The General Assembly of the Commonwealth of Pennsylvania
     5  hereby enacts as follows:
     6                             CHAPTER 1
     7                       PRELIMINARY PROVISIONS
     8  Section 101.  Short title.
     9     This act shall be known and may be cited as the Keystone Care
    10  Program Act.
    11  Section 102.  Definitions.
    12     The following words and phrases when used in this act shall
    13  have the meanings given to them in this section unless the
    14  context clearly indicates otherwise:
    15     "Community-based health care clinic."  A nonprofit health
    16  care center located in this Commonwealth that provides health
    17  care services to low-income and uninsured individuals, and meets
    18  either of the following criteria:

     1         (1)  serves a federally designated medically underserved
     2     area, a medically underserved population or a health
     3     professional shortage area; or
     4         (2)  serves a patient population with a majority of that
     5     population having an income less than 200% of the Federal
     6     poverty income guidelines, including:
     7             (i)  A federally qualified health center as defined
     8         in section 1905(l)(2)(B) of the Social Security Act (49
     9         Stat. 620, 42 U.S.C. § 1396d(l)(2)(B)) or a federally
    10         qualified health center look-alike.
    11             (ii)  A rural health clinic as defined in section
    12         1861(aa)(2) of the Social Security Act (49 Stat. 620, 42
    13         U.S.C. § 1395x(aa)(2)), certified by Medicare.
    14             (iii)  A hospital health clinic.
    15             (iv)  A free or partial-pay health clinic that
    16         provides services by volunteer and nonvolunteer health
    17         care providers.
    18             (v)  A nurse-managed health care clinic that is
    19         managed by advanced practice nurses and is associated
    20         with a department of nursing, a federally qualified
    21         health center or an independent nonprofit health or
    22         social services agency.
    23     "Health care resource network."  A sustainable, integrated
    24  network organized by a nonprofit entity to use community-based
    25  health care clinics and an organized physician volunteer
    26  component to provide access to a full continuum of health care
    27  services for participating patients residing in a local delivery
    28  area.
    29     "Local delivery area."  A city, county, multicounty or other
    30  regional area within this Commonwealth that institutes a health
    20080S1564B2363                  - 2 -     

     1  care resource network in accordance with this act.
     2     "Participating patient."  An individual who meets the
     3  criteria set forth in section 303.
     4     "Program."  The Keystone Care (KeyCare) Program established
     5  in section 301.
     6                             CHAPTER 3
     7                          KEYCARE PROGRAM
     8  Section 301.  Program.
     9     (a)  Establishment of KeyCare Program.--The Keystone Care
    10  (KeyCare) Program is hereby established within the Department of
    11  Health to administer and provide grants to an approved health
    12  care resource network.
    13     (b)  Purpose.--Health care resource networks across this
    14  Commonwealth shall be created to do all of the following:
    15         (1)  Encourage physicians, hospitals, dentists and other
    16     health care partners such as nurses, nurse practitioners,
    17     physician assistants, certified nurse midwives and dental
    18     hygienists to volunteer for participation in a health care
    19     resource network.
    20         (2)  Establish a referral system for participating
    21     patients with preference given to individuals referred from
    22     community-based health care clinics.
    23         (3)  Promote the support and involvement of interested
    24     persons, businesses and charitable organizations and
    25     foundations within local delivery areas for the formation and
    26     operation of networks.
    27  Section 302.  Health care resource network capacity and access.
    28     A health care resource network shall make available the
    29  following health care services for participating patients:
    30         (1)  Expanded health care capacity and access for
    20080S1564B2363                  - 3 -     

     1     participating patients.
     2         (2)  Participation of voluntary health care providers who
     3     donate their services and agree to see a set number of
     4     participating patients per year.
     5         (3)  Structured private physician specialty and primary
     6     care referral.
     7         (4)  Structured dentist referral that may include a
     8     network of dental services utilizing dental hygienist
     9     services under general dental supervision.
    10         (5)  Health care services which may vary by network.
    11         (6)  Preventative and chronic care and disease management
    12     that promotes wellness and patient responsibility and
    13     accountability through responsibility agreements by
    14     participating patients.
    15         (7)  Diagnostic and ancillary services.
    16         (8)  Centralized financial screening, enrollment and
    17     patient referrals.
    18  Section 303.  Participating patient requirements.
    19     A participating patient shall meet all of the following
    20  requirements:
    21         (1)  Be a Pennsylvania resident and reside in the local
    22     delivery area health care resource network for at least six
    23     months.
    24         (2)  Be at least 19 but less than 65 years of age.
    25         (3)  Have income that does not exceed 200% of Federal
    26     poverty income guidelines.
    27         (4)  Not receive or be eligible for Medicare or Medicaid.
    28         (5)  Not receive any other Federal or State medical
    29     benefits.
    30         (6)  Not be covered by any other private health
    20080S1564B2363                  - 4 -     

     1     insurance.
     2         (7)  Show an established health care need for primary or
     3     specialty medical care services.
     4  Section 304.  Administration.
     5     The Department of Health shall do all of the following:
     6         (1)  Administer the KeyCare Program.
     7         (2)  Within 90 days of the effective date of this
     8     section, develop and provide an application form consistent
     9     with this act. A grant under this section may be extended
    10     over two State fiscal years at the request of a health care
    11     resource network.
    12         (3)  Establish a process to allocate funding and issue
    13     grants based on any of the following:
    14             (i)  Initial creation of a health care resource
    15         network in a local delivery area.
    16             (ii)  Operation of a network in accordance with the
    17         requirements of this act.
    18             (iii)  Administration of a patient referral system
    19         that includes patient appointment reminder telephone
    20         calls.
    21             (iv)  Partnership between local government
    22         administration, private physicians, community-based
    23         health care clinics, medical societies, hospitals, area
    24         health education centers, pharmacists, social services
    25         and patients located in a local delivery area.
    26         (4)  Calculate and make grants to qualified health care
    27     resource networks from the funds deposited in the fund.
    28         (5)  Make the report required in section 305 available
    29     for public inspection and posted on the Department of
    30     Health's publicly accessible Internet website.
    20080S1564B2363                  - 5 -     

     1         (6)  Establish a Statewide association to assist local
     2     delivery areas in their efforts to create and sustain health
     3     care resource networks.
     4         (7)  Establish an online database of health care resource
     5     networks and local delivery areas.
     6  Section 305.  Report.
     7     The Department of Health shall provide an annual report no
     8  later than November 30 to the chairman and minority chairman of
     9  the Public Health and Welfare Committee of the Senate and the
    10  chairman and minority chairman of the Health and Human Services
    11  Committee of the House of Representatives. The report shall
    12  include:
    13         (1)  The total dollar amount for each grant awarded by
    14     name of grantee.
    15         (2)  The impact of the grant on improving the delivery
    16     and quality of health care in the local delivery area.
    17         (3)  The total amount of funds spent.
    18         (4)  Any recommendations for program improvements.
    19                             CHAPTER 21
    20                      MISCELLANEOUS PROVISIONS
    21  Section 2101.  Limitations on payments by Department of Health.
    22     Grants provided by the program shall not exceed the amount of
    23  funds available for the program and any payment shall not
    24  constitute an entitlement from the Commonwealth or a claim on
    25  any other funds of the Commonwealth.
    26  Section 2102.  Appropriation.
    27     The sum of $4,000,000 is hereby appropriated to the
    28  Department of Health to carry out the provisions of this act.
    29  Section 2103.  Effective date.
    30     This act shall take effect in 90 days.
    I12L35BIL/20080S1564B2363        - 6 -