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Care Coordination/Care Management in California

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The state of California has enacted a number of laws that allow for greater coordination of health care.  Specifically, California encourages demonstration projects that facilitate health information exchange to facilitate care coordination.1  Innovations in health care delivery have also been encouraged in California’s Medicaid and CHIP programs.  The law outlines several models that can be used to coordinate care within the programs, including the medical home model.2

Additionally, California law outlines several ways that patients can participate in managing their health care.  For example, hospitals are required to provide patients with written information regarding their rights with respect to the health care services provided by the hospital.3  Similarly, upon discharge, the hospital is required to provide the patient with discharge instructions, including medication information or transfer summaries if needed.4

 

Footnotes

  • 1. Health and Safety Code §130279
  • 2. Welfare and Institutions Code §14180; Welfare and Institutions Code §14182.2
  • 3. Health and Safety Code §1262.6
  • 4. Health and Safety Code §1262.5

 

Care Coordination/Care Management in California

Subtopic Statute/Regulation Description
Information sharing across providers (including communication with other providers, across state lines, patient transfer) Establishment of Demonstration Projects, Performance Data, and Reporting – Cal. Health & Safety Code §130279 “Demonstration projects; project participant applications; areas for projects; selection of projects; evaluation of issues; annual number of...
New coordinated systems of care (ACOs, Patient Centered Medical Homes/Health homes) (Cross reference with Quality Measurement) Health Care Waiver or Demonstration Project in California Medicaid – Cal. Welf & Inst. Code §14180 “Health care waiver or demonstration project; application; proposals; amendments”   The State Department of Health Services must...
Organized Health Care Delivery Models For Children Eligible For California Children Services (CCS) – Cal. Welf & Inst. Code §14182.2 “Organized health care delivery models for children eligible for California Children Services (CCS); establishment; report of expenditures;...
Patient authorization requirements (to provide health information to another individual) Patient Records: Confidentiality and Disclosure – Cal. Health & Safety Code § 11845.5. All substance abuse treatment records are confidential and privileged to the patient and may only be disclosed according to the statute, irrespective...
Treatment planning when using interdisciplinary team (including assessments, plan of care, discharge/transfer planning Patients Rights and the Duty of Hospitals to Provide Information Upon Admission of Patient – Cal. Health & Safety Code §1262.6 All hospitals are required to provide patients upon admission with written information regarding their rights to be informed of their health care,...
Discharge instructions/Required follow-up. Required Inpatient Patient Health Record Content – Cal. Code Regs. tit. 22 § 70749 Each inpatient patient record must contain the following: Name Address at time of admission Identification number (Social Security, Medi-...
Requirements for Discharge Planning Policy and Process – Cal. Health & Safety Code §1262.5 All hospitals are required to have a written discharge policy and process.  The law requires hospitals to make arrangements for post-hospital...
Click on the individual state law in the table above to see our summary of the individual law.


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