THE GENERAL ASSEMBLY OF PENNSYLVANIA

HOUSE BILL

INTRODUCED BY BOYLE, DeLUCA, BELFANTI, BRENNAN, BROWN, FREEMAN, KORTZ, MANN, McGEEHAN, MUNDY, MURPHY, M. O'BRIEN, M. SMITH, BRIGGS, BISHOP, JOSEPHS, FRANKEL, BRADFORD AND PASHINSKI, DECEMBER 9, 2009

AS REPORTED FROM COMMITTEE ON HEALTH AND HUMAN SERVICES, HOUSE OF REPRESENTATIVES, AS AMENDED, JUNE 30, 2010   

AN ACT

Creating the Pennsylvania Chronic Care Commission, providing for

responsibilities and duties of the commission and for duties

of the Department of Health.

The General Assembly of the Commonwealth of Pennsylvania

hereby enacts as follows:

Section 1.  Short title.

This act shall be known and may be cited as the Pennsylvania

Chronic Care Commission Act.

Section 2.  Definitions.

The following words and phrases when used in this act shall

have the meanings given to them in this section unless the

context clearly indicates otherwise:

"Chronic care model."  A model of care that includes the

following:

(1)  The provision of effective health management through

support and information that also promotes patient self-care

for patients with chronic conditions.

(2)  The use of evidence-based medicine to ensure

appropriate treatment decisions by health care providers.

(3)  The coordination of care and use of reasonably

accessible and updated patient information that encourages

follow-up care as a standard procedure.

(4)  The tracking of clinical information for individual

and general patient populations to guide treatment and

effectively anticipate community health care problems.

"Commission."  The Pennsylvania Chronic Care Commission.

"Department."  The Department of Health of the Commonwealth.

"Health care facility."  A health care facility as defined

under section 802.1 of the act of July 19, 1979 (P.L.130,

No.48), known as the Health Care Facilities Act, or an entity

licensed as a hospital under the act of June 13, 1967 (P.L.31,

No.21), known as the Public Welfare Code.

"Health care provider."  A health care provider licensed to

practice a component of the healing arts by a licensing board

within the Department of State who provides health care services

at a community-based health care clinic.

"Health payor."  An individual or entity paying for health

services for himself or itself or on behalf of another.

"Hospital."  An entity located in this Commonwealth that is

licensed as a hospital under the act of July 19, 1979 (P.L.130,

No.48), known as the Health Care Facilities Act.

"Insurer."  A company or health insurance entity licensed in

this Commonwealth to issue any health, sickness or accident

policy or subscriber contract or certificate or plan that

provides medical or health care coverage by a health care

facility or licensed health care provider that is offered or

governed under any of the following:

(1)  The act of May 17, 1921 (P.L.682, No.284), known as

The Insurance Company Law of 1921.

(2)  The act of December 29, 1972 (P.L.1701, No.364),

known as the Health Maintenance Organization Act.

(3)  The act of May 18, 1976 (P.L.123, No.54), known as

the Individual Accident and Sickness Insurance Minimum

Standards Act.

(4)  40 Pa.C.S. Ch. 61 (relating to hospital plan

corporations) or 63 (relating to professional health service

plan corporations).

"Regional community learning collaborative."  A collaboration

between health care facilities, health care providers,

hospitals, insurers, health payors and consumers to exchange

information about chronic care models and assist in efforts

toward adoption of a chronic care model.

Section 3.  Pennsylvania Chronic Care Commission.

There is established in the department the Pennsylvania

Chronic Care Commission whose purpose is to design and implement

the informational, technological and reimbursement

infrastructure needed to support widespread dissemination,

adaptation and implementation of the components for chronic care

in relevant health care facilities and among health care

providers throughout this Commonwealth.

Section 4.  Powers and duties.

The commission shall have the following powers and duties:

(1)  Determine how to align and integrate the components

for chronic care into the current health care system and into

currently existing chronic care models throughout this

Commonwealth. These components include, but are not limited

to, the following:

(i)  providing patients with chronic conditions

support and information to effectively manage their

health;

(ii)  providing information for health care providers

to make treatment decisions based on evidence-based

medicine;

(iii)  ensuring that health care providers have

access to current information about patients and that

follow-up care is provided as a standard procedure;

(iv)  collecting clinical information on individual

patients and groups of patients that leads to the

development of treatment guidelines;

(v)  engaging patients and health care providers in

chronic care improvement efforts; and

(vi)  forming partnerships with State and local

organizations to support and expand efforts to treat and

care for those with chronic diseases.

(2)  Participate in the establishment of regional

community learning collaboratives to educate health care

providers, health care teams and consumers on the components

for chronic care and evidence-based treatment of chronic

disease.

(3)  Identify, assess and disseminate information on

current efforts surrounding the implementation and

maintenance of chronic care models in each regional community

learning collaborative and across this Commonwealth.

(4)  Develop guidelines for the review of patient data by

the commission and regional community learning collaboratives

that maintain the confidentiality required by Federal and

State law.

(5)  Develop care protocols that assess the factors

influencing the implementation of the components for chronic

care.

(6)  Assess and potentially incorporate existing efforts

dealing with chronic care being performed by Commonwealth

agencies.

(7)  Develop and construct data measures that can be used

by the commission to measure provider performance.

(8)  Create evaluation processes and outcome measures to

monitor implementation of the components for chronic care in

different clinical settings.

Section 5.  Composition of commission.

(a)  Members.--The commission shall consist of the following

members:

(1)  Five members of the Governor's cabinet, or their

respective designees, who shall serve ex officio and one of

whom shall act as cochair, as selected by the Governor.

(2)  Individuals from each of the following categories

appointed by the Governor, one of whom shall act as cochair

as selected by the Governor:

(i)  a health insurer medical director;

(ii)  a health insurance actuary;

(iii)  a registered nurse, certified nurse

practitioner, clinical nurse specialist, physician

assistant or pharmacist that is currently practicing

within this Commonwealth;

(iv)  two primary care physicians who are members of

the Pennsylvania Medical Society;

(v)  a specialty care physician in active practice;

(vi)  an individual with a background in chronic care

from an academic medical center;

(vii)  a provider of home health care;

(viii)  a health services researcher with expertise

in chronic care;

(ix)  an individual with a background in information

technology and systems;

(x)  a representative from an organization that

represents individuals with chronic conditions;

(xi)  a consumer with a chronic condition or multiple

chronic conditions;

(xii)  a consumer with a chronic condition or

multiple chronic conditions who is at least 65 years of

age;

(xiii)  two individuals representing hospitals who

are members of the Hospital and Health System Association

of Pennsylvania; and

<--

(xiv)  a licensed dietitian-nutritionist; and

<--

(xiv) (xv)  any other individual who can assist the

<--

commission with the purposes under this act.

(b)  Term and compensation.--The members chosen under

subsection (a) shall each serve for a term of three years and

continue to serve until their successor is appointed. Members

shall serve without compensation except for payment of necessary

and actual expenses incurred in attending meetings and in

performing their duties and responsibilities as commission

members.

(c)  Staff.--The department shall provide staff and data

support to the commission.

Section 6.  Powers and duties of department.

The department shall have the following powers and duties:

(1)  Assist the commission with outreach efforts to

educate consumer groups and the health care provider

community in order to engage individuals to take necessary

steps to prevent chronic diseases and to better self-manage

their chronic conditions with the support of a health care

team.

(2)  Assist the commission in the development of a

Statewide chronic care information system, including rules

for secure information sharing, which permits the exchange of

information among the regional community learning

collaboratives and the department.

(3)  Establish registries that collect clinical data on

patients with chronic conditions and the methods for

disseminating this information for use by providers.

(4)  On or before December 31, 2010, and for each year

thereafter, provide a report to the General Assembly that

includes:

(i)  the number of individuals with chronic

conditions for the previous year in which information is

available;

(ii)  a list of each regional community learning

collaborative and the number of providers that

participate in each collaborative;

(iii)  support information for patients with chronic

conditions;

(iv)  information for providers on treatment options

based on best evidence that was reviewed by the

commission and the department in the past year; and

(v)  any other information the commission or the

department deems necessary to assist the public in

understanding how to reduce the number of chronic

conditions in this Commonwealth.

Section 7.  Effective date.

This act shall take effect immediately.