BILL ANALYSIS Ó
AB 496
Page 1
ASSEMBLY THIRD READING
AB 496 (Gordon)
As Amended April 10, 2013
Majority vote
BUSINESS & PROFESSIONS 10-1 APPROPRIATIONS 12-5
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|Ayes:|Gordon, Bocanegra, |Ayes:|Gatto, Bocanegra, |
| |Campos, Dickinson, | |Bradford, |
| |Eggman, Holden, | |Ian Calderon, Campos, |
| |Maienschein, Mullin, | |Eggman, Gomez, Hall, |
| |Skinner, Ting | |Ammiano, Pan, Quirk, |
| | | |Weber |
| | | | |
|-----+--------------------------+-----+--------------------------|
|Nays:|Jones |Nays:|Harkey, Bigelow, |
| | | |Donnelly, Linder, Wagner |
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SUMMARY : Reestablishes and expands the Task Force on Culturally
and Linguistically Competent Physicians and Dentists (Task
Force) to consider the needs of lesbian, gay, bisexual and
transgender (LGBT) groups and report findings to the Legislature
and appropriate licensing boards by January 1, 2016, and further
requires the Cultural and Linguistic Physician Competency
Program (Program) to address the lesbian, gay, bisexual, and
transgender groups of interest to local medical societies.
Specifically, this bill :
1)Reestablishes the Task Force with the following changes to
membership:
a) Replaces the State Director of Health Services with the
Deputy Director of the Office of Health Equity (OHE);
b) Authorizes the Deputy Director of OHE, Director of
Consumer Affairs, Executive Director of the Medical Board
of California, and the Executive Director of the Dental
Board to designate a representative to the Task Force;
c) Requires the participation of California-licensed
physicians and dentists who provide health services to LGBT
groups; and,
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d) Requires the participation of representatives of
organizations that advocate on behalf of, or provide health
services to, LGBT groups.
2)Requires the Task Force to hold hearings and convene meetings
to obtain input from persons belonging to LGBT groups in
communities that have large populations of LGBT groups.
3)Requires the Task Force to report its findings to the
Legislature and appropriate licensing boards by January 1,
2016.
4)Requires the Program to address the LGBT groups of interest to
local medical societies.
5)Requires the Program to include educational classes about LGBT
groups.
6)Requires Program trainings to be formulated in collaboration
with LGBT medical societies, among others.
7)Amends the definition of "cultural and linguistic competency"
to include:
a) Understanding and applying the roles that race, sexual
orientation, gender identity, and gender expression play in
diagnosis, treatment, and clinical care; and,
b) Awareness of how attitudes, values, and beliefs of
society influence and impact professional and patient
relations.
8)Makes other technical changes to conform to current law.
FISCAL EFFECT : According to the Assembly Appropriations
Committee, $110,000 annually for two years. Approximately half
of the costs would come from the Medical Board and half from the
Dental Board.
COMMENTS :
1)Purpose of this bill . This bill is intended to better educate
physicians and dentists on issues in the LGBT community that
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may impact healthcare and healthcare delivery. This bill
builds upon a previous task force that met between 2001 and
2003 and published a report with several comprehensive
suggestions for increasing the cultural and linguistic
competency of physicians and dentists. This bill is sponsored
by Equality California.
2)Author's statement . According to the author's office, "The
Legislature has found culturally and linguistically competent
care to be essential in providing patients with the highest
level of care. Medical groups, community organizations and
even the federal government are reaching a consensus that more
time and resources need to be dedicated to ensure that all
Americans have access to quality health care. Extending
cultural competency provisions to members of the LGBT
community is not only a medical necessity, but makes common
sense. By addressing the needs of the LGBT community, we can
reduce disease transmission and progression, reduce health
care costs and increase overall mental and physical well-being
for all Californians.
"AB 496 will address the issue of LGBT cultural competency by
reauthorizing the Task Force on Culturally and Linguistically
Competent Physicians and Dentists to include input from
relevant lesbian, gay, bisexual and transgender interest
groups and medical societies. The Task Force will be comprised
of health professionals, advocates, and providers and
consumers of care."
3)Unique Health Challenges for the LGBT Community . Multiple
medical and dental studies have noted unique social and health
challenges of the LGBT community, and that additional training
for healthcare providers can enhance the quality of care
delivered to this population.
According to a 2011 article published in the Journal of the
American Medical Association, "[LGBT] individuals have
specific health and health care needs relating to chronic
disease risk, adult and adolescent mental health, unhealthy
relationships (e.g. intimate partner violence), gender
identity, sexually transmitted infections, and [HIV]
infection, among others. Compared with heterosexual and
nontransgender socioeconomically matched peers, LGBT
individuals are more likely to face barriers accessing
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appropriate medical care, with may create or increase existing
disparities. A 2011 Institute of Medicine report on the
health of LGBT individuals noted that 'although LGBT
individuals share with the rest of society the full range of
health risks, they also face a profound and poorly understood
set of additional health risks due largely to social stigma."
A 2009 article in the Journal of Dental Education noted the
need to make progress within the professional dental
population to understand the particular needs of LGBT patients
and create a more welcoming environment for both LGBT patients
and practitioners.
4)Office of Health Equity . OHE was established in 2012 by AB
1467 (Budget Committee), Chapter 23, Statutes of 2012, to
provide leadership in reducing physical and mental health
disparities in vulnerable communities. OHE is tasked with
many ambitious goals, including:
a) Achieving the highest level of health and mental health
for all people, with special attention focused on those who
have experienced socioeconomic disadvantage and historical
injustice, including, but not limited to, vulnerable
communities and culturally, linguistically, and
geographically isolated communities; and,
b) Improving the health status of all populations and
places, with a priority on eliminating health and mental
health disparities and inequities.
To do this, OHE is statutorily required to establish an
advisory committee by October 1, 2013, and conduct periodic
demographic analyses on health and mental health disparities
and inequities (updated periodically, but not less than every
two years). OHE explicitly recognizes the health disparities
that afflict LGBT populations in California.
5)2001 Task Force on Culturally and Linguistically Competent
Physicians and Dentists . The original Task Force, created in
2001, published 22 recommendations in its 2003 report to the
Legislature. It is unclear to what extent, if any, those
recommendations were acted upon.
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Analysis Prepared by : Sarah Huchel / B.,P. & C.P. / (916)
319-3301
FN: 0000813