§ 1399.870. — 1399.870. (Added by Stats. 2021, Ch. 143, Sec. 14.)

California § 1399.870.

• Jurisdiction: California
• Code HSC: Health and Safety Code - HSC
• Div. 2.: DIVISION 2. LICENSING PROVISIONS
• Ch. 2.2.: CHAPTER 2.2. Health Care Service Plans
• Art. 11.9.: ARTICLE 11.9. Health Equity and Quality

Text

(a)
(1)
On or before March 1, 2022, the department shall convene a Health Equity and Quality Committee to make recommendations to the department for standard health equity and quality measures, including annual benchmark standards for assessing equity and quality in health care delivery. The department may contract with consultants to assist the committee with the implementation and administration of its duties.
(2)
The committee shall provide initial recommendations, as well as recommendations on updating and revising standard health equity and quality measures and annual benchmark standards, consistent with this article. These
recommendations shall consider the interaction of multiple characteristics in determining where disparate outcomes exist, including, but not limited to, race, ethnicity, gender, sexual orientation, language, age, income, and disability.
(3)
Meetings of the committee shall be subject to the Bagley-Keene Open Meeting Act (Article 9 (commencing with Section 11120) of Chapter 1 of Part 1 of Division 3 of Title 2 of the Government Code).
(4)
The department may contract with consultants to assist the committee with the implementation and administration of its duties.
(b)
In appointing members to the committee, the director shall consider all of the following:
(1)
The expertise of each committee member so that the committee’s composition reflects a diversity of relevant expertise.
(2)
The racial, cultural, ethnic, sexual orientation, gender, economic, linguistic, age, disability, and geographical diversity of the state so that the committee’s composition reflects the communities of California.
(3)
The expertise of representatives from other state agencies that are engaged in the work of setting quality and equity goals or standards for health care entities.
(4)
The representation of consumer stakeholders that serve diverse populations.
(5)
Inclusion of experts, researchers, and community members who
are engaged in the development of alternative approaches to measuring health equity, consumer experience, and health outcomes.
(c)
On or before September 30, 2022, the committee shall provide the recommendations described in subdivision (a), which may consider and may include all of the following:
(1)
Quality measures, including, but not limited to, Healthcare Effectiveness Data and Information Set (HEDIS) measures and the federal Centers for Medicare and Medicaid Services Child and Adult Core Set measures.
(2)
Surveys or other measures to assess consumer experience and satisfaction, including alternative approaches that take into account cultural competence, health literacy, exposure to discrimination, and
social and cultural connectedness, such as connection to community, identity, traditions, and spirituality.
(3)
Other child and adult quality or outcome measures that the committee determines are appropriate, including establishing new measures for patient-reported outcomes.
(4)
Effective ways to measure health outcomes in the absence of quality measures, including both of the following:
(A)
Demographic data or other data related to race, ethnicity, or socioeconomic variables that are currently collected by health care service plans.
(B)
Other data sources, including the Health Care Payments Data Program established pursuant to Section 127671.1, the health evidence
initiative of Covered California for the individual and small group markets, and other statistically valid and reliable sources of data.
(5)
Approaches to stratifying reporting of results by factors, including, but not limited to, age, sex, geographic region, race, ethnicity, language, sexual orientation, gender identity, and income to the extent health plans or public programs have data on these factors and that the results are statistically valid and reliable.
(6)
Alternative methods to measure health outcomes that permit sufficient stratification to determine impacts on health equity and quality that are not subject to the methodological limitations of current measurement approaches.
(7)
Alternative methods to measure
physical and behavioral health outcomes, including, but not limited to, measures to assess social and cultural connectedness, such as connection to community, identity, traditions, and spirituality. The department shall consult with the Office of Health Equity in identifying these alternative methods.
(8)
Measures of social determinants of health, such as housing security, food insecurity, caregiving, and other nonmedical determinants of health.
(d)
The committee’s recommendations shall include setting annual health equity and quality benchmarks.
(e)
The department shall consider the committee’s recommendations in establishing the standard measures and annual benchmarks pursuant to Section 1399.871. The
department shall
enforce the established set of standard health equity and quality measures and applicable annual benchmarks consistent with Section 1399.872.
(f)
The department shall reconvene the committee following the establishment of the standard measures and annual benchmarks pursuant to Section 1399.871 for the purpose of reviewing or revisiting the standard measures and annual benchmarks after the department has received data from health care service plans pursuant to Section 1399.872.
(g)
Contracts entered into pursuant to this article are exempt from Part 2 (commencing with Section 10100) of Division 2 of the Public Contract Code, Section 19130 of the Government Code, and Chapter 6 (commencing with Section 14825) of Part 5.5 of Division 3 of Title 2 of the Government Code,
and are exempt from the review or approval of any division of the Department of General Services, until January 1, 2024.

Legislative History

Added by Stats. 2021, Ch. 143, Sec. 14. (AB 133) Effective July 27, 2021.