2024 -- S 2716

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LC004572

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     STATE OF RHODE ISLAND

IN GENERAL ASSEMBLY

JANUARY SESSION, A.D. 2024

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A N   A C T

RELATING TO HEALTH AND SAFETY -- PRIMARY CARE TRAINING SITES PROGRAM

     

     Introduced By: Senators Lauria, Ruggerio, Pearson, DiMario, Miller, and Lawson

     Date Introduced: March 05, 2024

     Referred To: Senate Finance

     It is enacted by the General Assembly as follows:

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     SECTION 1. The general assembly hereby makes the following findings of fact:

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     (1) Primary care healthcare in the State of Rhode Island is in crisis.

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     (2) There currently exists a national and regional shortage of primary care healthcare

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providers.

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     (3) Many primary care healthcare providers are retiring early and many more are

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approaching retirement age.

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     (4) Primary care healthcare is provided by physicians, nurse practitioners and physician

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assistants and the overall numbers of medical professionals entering the field of primary care

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healthcare is declining.

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     (5) It is increasingly difficult for primary care practices to hire nurses, medical assistants,

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behavioral health clinicians and other key staff, which is leading to even higher burnout among

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primary care providers.

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     (6) Fewer students are going into primary care as a profession due to lower salaries, high

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student loans and increasing administrative burden leading to provider burnout.

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     (7) Our aging Rhode Island population requires more medical care.

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     (8) As a state, we must recruit, train, retain and sustain the number of primary care

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providers sufficient to meet the population health needs of all Rhode Islanders.

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     (9) Investments in primary care are essential for access to health services, improving the

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health of the population and reducing overall healthcare costs.

 

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     SECTION 2. Title 23 of the General Laws entitled "HEALTH AND SAFETY" is hereby

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amended by adding thereto the following chapter:

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CHAPTER 17.29

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PRIMARY CARE TRAINING SITES PROGRAM

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     23-17.29-1. Short title.

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     This chapter shall be known and may be cited as the "Primary Care Training Sites

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Program".

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     23-17.29-2. Definitions.

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     As used in this chapter, the following words and phrases are construed as follows:

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     (1) "Director" means the director of the department of health;

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     (2) "Grant" means a sum awarded pursuant to a contract executed pursuant to § 23-17.29-

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7(b);

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     (3) "National Committee for Quality Assurance" or "NCQA" means the nonprofit

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organization headquartered in the District of Columbia working to improve healthcare quality

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through the administration of evidence-based standards, measures, programs and accreditation;

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     (4) "Office" means the office of primary care training established pursuant to the provisions

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of § 23-17.29-3;

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     (5) "Patient-centered medical home" or "PCMH" means a model of healthcare that puts

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patients at the forefront of care by providing team-based healthcare delivery led by a healthcare

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provider to render comprehensive and continuous medical care to patients with a goal to obtain

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maximal health outcomes;

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     (6) "Primary care" means day-to-day healthcare provided by a healthcare professional.

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Typically, the healthcare professional acts as the first contact and principal point of continuing care

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for patients within a healthcare system, and coordinates other specialist care that the patient may

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require; and

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     (7) "Primary care site" means a site, location or medical practice that serves as the patient's

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entry point into the healthcare system and acts as the continuing focal point for all required

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healthcare services.

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     23-17.29-3. Creation of office of primary care training.

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     There is hereby authorized, created and established an office of primary care training

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within the department of health.

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     23-17.29-4. Purpose.

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     The purpose of the office of primary care training shall be to:

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     (1) Assist the director in developing an application and selection process for the awarding

 

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of grants pursuant to the provisions of this chapter;

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     (2) Provide oversight of grant recipients;

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     (3) Coordinate meetings and related logistics to implement the provisions of this chapter;

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     (4) Assist applicants for grants to comply with the process to include providing information

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and assistance in processing of grant awards;

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     (5) Recommend acceptance or rejection of proposed contracts and grants to be approved

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by the director in accordance with the provisions of § 42-11-11;

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     (6) Coordinate with the approval of the director, and with the director of administration,

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the approval of all contracts negotiated pursuant to the provisions of this chapter and the provisions

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of § 42-11-11;

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     (7) Establish evidence-based standards to measure the success and performance of all

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recipients of grants provided pursuant to the provisions of this chapter; and

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     (8) Perform all other duties as assigned by the director.

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     23-17.29-5. Staff.

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     The office of primary care training shall be staffed by the person or persons assigned by

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the director.

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     23-17.29-6. Contracts.

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     In compliance with the provisions of § 42-11-11, the director shall have the authority to

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enter into contracts for medical education to be conducted at primary care practice sites pursuant

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to the provisions of § 23-17.29-7.

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     23-17.29-7. Contract terms.

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     (a) Any contract entered into pursuant to the authority granted in § 23-17.29-6 shall

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contain, at a minimum, the following terms, conditions and provisions:

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     (1) The primary care site shall serve as an enhanced interdisciplinary clinical training site;

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     (2) The primary care site shall have achieved and shall maintain NCQA PCMH distinction;

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     (3) The primary care site shall provide integrated behavioral health services;

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     (4) The primary care site shall provide an agreed curriculum of training for physicians,

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nurse practitioners and physician assistants; and

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     (5) Training shall include a minimum of five (5) hours didactic training and shall introduce

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the trainees to the concept of PCMH and how the principles of the model have been operationalized

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in the primary care delivery setting.

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     (b) The contract may include a grant award not to exceed ninety thousand dollars ($90,000)

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per primary care site contract recipient, per calendar year.

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     23-17.29-8. Appropriations.

 

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     (a) For the fiscal year beginning July 1, 2024, there is hereby appropriated out of any money

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in the treasury not otherwise appropriated, the sum of two million, seven hundred thousand dollars

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($2,700,000) deposited into a restricted account to implement the primary care training sites

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program established pursuant to the provisions of this chapter, and the state controller is hereby

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authorized and directed to draw to the controller's orders upon the general treasurer for payment of

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said sum, or so much thereof as may be from time to time required, upon receipt by the general

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treasurer of properly authenticated vouchers submitted by the director.

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     (b) For fiscal year 2025-2026, and each fiscal year thereafter, the general assembly shall

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annually appropriate a sum as it may deem necessary to carry out the purposes of this chapter, and

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the state controller is hereby authorized and directed to draw the controller's orders upon the general

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treasurer for the payment of the sum or sums or so much thereof as may be required from time to

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time to be deposited in a restricted receipt account upon receipt by the general treasurer of properly

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authenticated vouchers submitted by the director.

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     23-17.29-9. Rules and regulations.

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      The director shall promulgate rules and regulations to implement the provisions of this

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chapter.

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     23-17.29-10. Audits.

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     (a) The director shall submit annually all financial records and receipts of disbursements

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to the auditor general and the director of administration.

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     (b) The auditor general and the director of administration are authorized to review and audit

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all records, receipts, disbursements and transactions concerning the primary care training sites

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program and the funds associated with the primary care training sites.

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     23-17.29-11. Reports.

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     The director shall report annually to the general assembly and the governor no later than

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December 31 of each year on the status and progress of the primary care training sites program

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established and administered pursuant to the provisions of this chapter.

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     23-17.29-12. Severability.

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     If any provision of this chapter or any rule or regulation promulgated pursuant to the

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provisions of this chapter, or its application to any person or circumstance, is held invalid by a court

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of competent jurisdiction, the reminder of the chapter, rule or regulation and the application of the

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provision to other persons or circumstances shall not be affected by its invalidity. The invalidity of

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any section or sections or portion of any section or sections of this chapter shall not affect the

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validity of the remainder of this chapter.

 

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     SECTION 3. This act shall take effect on July 1, 2024.

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EXPLANATION

BY THE LEGISLATIVE COUNCIL

OF

A N   A C T

RELATING TO HEALTH AND SAFETY -- PRIMARY CARE TRAINING SITES PROGRAM

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     This act would establish the primary care training sites program to provide training for

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physicians, nurse practitioners and physician assistants within the department of health (DOH).

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This act would appropriate two million seven hundred thousand dollars ($2,700,000) to implement

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the program.

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     This act would take effect on July 1, 2024.

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LC004572

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