Section 3999.301 - Scope of Patient Care Services(a) The Primary Care Team (PCT) shall be responsible for coordinating care for patients within the assigned panel, including other health care staff, as necessary, to meet the needs of the patient. (1) The Department shall ensure patients are provided timely access to laboratory services that are medically necessary to assist the PCT in establishing diagnoses and making recommendations for additional diagnostic work-up.(2) The Department shall ensure patients are provided timely access to safe and cost-effective medical imaging services that are medically necessary in order to establish diagnoses, make recommendations for additional diagnostic work-up, and establish treatment plans.(b) The PCT shall provide the full scope of primary care services to patients within an assigned patient panel including, but not limited to: (2) Initial and ongoing health risk assessment.(3) Preventive services, such as health screenings, health promotion, and health maintenance services.(4) Diagnosis and treatment of acute and chronic illness.(5) Allied health services required for diagnosis and treatment of acute and chronic illness such as diagnostic testing, medication administration, nutritional services, and health care equipment and supplies.(7) Planning for end-of-life care such as advance directives, physicians' orders for life-sustaining treatment, and palliative care.(8) Referrals to higher levels of care and follow-up.(9) Facilitating handoffs between providers in health care settings or between care teams to ensure care for the patient and continuity of planned care, pending appointments or services, medications, medical equipment and supplies, and all other necessary treatment.(c) Outpatient specialty services. (1) The Department shall ensure access to safe and cost-effective specialty services that are medically necessary in order to establish diagnoses, make recommendations for diagnostic work-up, provide therapy, and establish treatment plans that include frequency of follow-up appointments with the specialist or the Primary Care Provider (PCP).(2) Specialty services shall be ordered by PCPs who practice within the California Department of Corrections and Rehabilitation and shall indicate the timeframe in which the service is necessary:(A) Emergent: immediately referred for emergency care.(B) High priority: provided within 14 calendar days of the PCP order.(C) Medium priority: provided between 15-45 calendar days of the PCP order.(D) Routine: provided within 46-90 calendar days of the PCP order.(3) If a patient is approved for a medium priority or routine specialty service and is transferred to another institution before the service occurs, the receiving institution shall not cancel or void the specialty service unless the PCP at the receiving institution examines the patient and determines that it is no longer medically necessary or can be rescheduled to a later date.(4) The patient shall be seen by the PCP within five calendar days after a high priority specialty services appointment.(5) Following a medium priority or routine specialty services appointment, the PCT shall review the clinical documentation and schedule the patient for a follow-up appointment with the PCP or Registered Nurse, as clinically indicated. Specialty providers may not directly order follow-up consultations, diagnostic studies, or treatments.(6) If a specialty service request is denied, the PCP shall provide the patient with alternate treatment strategies during the next patient encounter which shall be within 30 calendar days of the denial of the specialty service.Cal. Code Regs. Tit. 15, § 3999.301
1. New section filed 7-1-2019 as an emergency; operative 7-1-2019 (Register 2019, No. 27). Pursuant to Penal Code section 5058.3, a Certificate of Compliance must be transmitted to OAL by 12-9-2019 or emergency language will be repealed by operation of law on the following day.
2. New section refiled 12-5-2019 as an emergency; operative 12-10-2019 (Register 2019, No. 49). Pursuant to Penal Code section 5058.3, a Certificate of Compliance must be transmitted to OAL by 3-9-2020 or emergency language will be repealed by operation of law on the following day.
3. New section refiled 3-9-2020 as an emergency; operative 3-10-2020 (Register 2020, No. 11). A Certificate of Compliance must be transmitted to OAL by 6-8-2020 or emergency language will be repealed by operation of law on the following day.
4. Certificate of Compliance as to 3-9-2020 order transmitted to OAL 6-8-2020 and filed 7-20-2020 (Register 2020, No. 30). Note: Authority cited: Section 5058, Penal Code. Reference: Section 5054, Penal Code; and Plata v. Newsom (No. C01-1351 JST), U.S. District Court, Northern District of California.
1. New section filed 7-1-2019 as an emergency; operative 7/1/2019 (Register 2019, No. 27). Pursuant to Penal Code section 5058.3, a Certificate of Compliance must be transmitted to OAL by 12-9-2019 or emergency language will be repealed by operation of law on the following day.
2. New section refiled 12-5-2019 as an emergency; operative 12/10/2019 (Register 2019, No. 49). Pursuant to Penal Code section 5058.3, a Certificate of Compliance must be transmitted to OAL by 3-9-2020 or emergency language will be repealed by operation of law on the following day.
3. New section refiled 3-9-2020 as an emergency; operative 3/10/2020 (Register 2020, No. 11). A Certificate of Compliance must be transmitted to OAL by 6-8-2020 or emergency language will be repealed by operation of law on the following day.
4. Certificate of Compliance as to 3-9-2020 order transmitted to OAL 6-8-2020 and filed 7/20/2020 (Register 2020, No. 30).