BILL ANALYSIS Ó
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THIRD READING
Bill No: AB 496
Author: Gordon (D), et al.
Amended: 6/25/14 in Senate
Vote: 21
SENATE BUSINESS, PROF. & ECON. DEV. COMM. : 8-2, 7/1/13
AYES: Lieu, Block, Corbett, Galgiani, Hernandez, Hill, Padilla,
Yee
NOES: Emmerson, Wyland
SENATE APPROPRIATIONS COMMITTEE : Senate Rule 28.8
ASSEMBLY FLOOR : 54-20, 5/28/13 - See last page for vote
SUBJECT : Medicine: continuing medical education: sexual
orientation, gender identity, and gender expression
SOURCE : Equality California
DIGEST : This bill amends the cultural competency continuing
medical education course requirement, pertaining to
understanding and applying cultural and ethnic data to the
process of clinical care, to also include information pertinent
to the appropriate treatment of, and provision of care to, the
lesbian, gay, bisexual, transgender, and intersex communities.
Senate Floor Amendments of 6/25/14 revise and recast, with a
similar intent, the provisions of this bill relating to cultural
competency.
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ANALYSIS : Existing law requires that all physician and
surgeons take continuing education courses in order to renew
their license. Licensees can choose from a variety of courses
within specific areas. All continuing medical education courses
are required to contain curriculum that includes cultural and
linguistic competency in the practice of medicine. The course
must address at least one or a combination of the following:
1.Applying linguistic skills to communicate effectively with the
target population.
2.Utilizing cultural information to establish therapeutic
relationships.
3.Eliciting and incorporating pertinent cultural data in
diagnosis and treatment.
4.Understanding and applying cultural and ethnic data to the
process of clinical care.
This bill amends the cultural competency continuing medical
education course requirement, pertaining to understanding and
applying cultural and ethnic data to the process of clinical
care, to also include information pertinent to the appropriate
treatment of, and provision of care to, the lesbian, gay,
bisexual, transgender, and intersex communities.
Background
Cultural competence . Cultural competence is defined as a set of
skills that allows providers to give culturally appropriate
high-quality care to individuals of cultures different from
their own and is an important aspect of care (Institute of
Medicine, 1999). In addition, cultural competence plays a
crucial role in understanding, diagnosing and delivering
appropriate care to patients. The ability of physicians and
other health care providers to effectively communicate with and
to create a welcoming and safe environment for their patients
has a demonstrable impact on patient health outcomes.
Comments
According to the author, "Cultural competency plays a crucial
role in understanding, diagnosing and delivering appropriate
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care to patients. The ability of physicians and other health
care providers to effectively communicate with, and to create a
welcoming and safe environment for their patients, has a
demonstrable impact not only on provider-patient relationships,
but also on patient health outcomes. ? The LGBT community is a
heterogeneous group, comprised of a multitude of different
identities. But what binds these groups is a shared history and
experience of discrimination and stigma. ? Discrimination and
longstanding attitudes are barriers to care. According to a
study, nearly one-fifth of physicians in California have
endorsed homophobic viewpoints as recently as the 1990s, with
approximately 18% reporting feeling uncomfortable treating gay
or lesbian patients. ?Because of the legacy of discrimination
and/or expectations of poor treatment, many LGBT patients have
reported a reluctance to reveal their sexual orientation or
gender identity to their providers, despite the importance of
such information for their health care. This reluctance or fear
to come out contributes to ongoing health disparities.
The author further states, "The Legislature has previously found
that culturally and linguistically competent care is essential
in providing the patients with the highest level of medical
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. Ensuring cultural competency for
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 mitigate disease transmission and progression,
reduce health care costs and increase overall mental and
physical well-being of all Californians. AB 496 will address
this issue by ensuring that when it comes to clinical care,
continuing medical education courses consider information
important to the appropriate treatment of, and provision of care
to, members of the lesbian, gay, bisexual, transgender, and
intersex communities."
FISCAL EFFECT : Appropriation: No Fiscal Com.: Yes
Local: No
SUPPORT : (Verified 6/26/14)
Equality California (source)
AIDS Legal Referral Panel
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Asian and Pacific Islander Wellness Center
California Pan-Ethnic Health Network
GLMA: Health Professionals Advancing LGBT Equality
Los Angeles Gay & Lesbian Center
Mental Health America of Northern California
National Center for Lesbian Rights
Our Family Coalition
Planned Parenthood Affiliates of California
Queer Humboldt
Rainbow Community Center of Contra Costa County
Transgender Law Center
ARGUMENTS IN SUPPORT : According to the bill's sponsor,
Equality California, "Lack of provider understanding is a major
barrier to adequate healthcare for LGBT people. ? LGBT patients
often experience inequities in treatment because their doctors
or dentists have not received training in cultural competency on
LGBT issues, and therefore do not understand the specific needs
of or the health disparities impacting the community. There is
no statutory requirement that doctors and dentists receive such
training, so most do not. ... AB 496 makes clear that LGBT
issues should be included in existing cultural competency
training for health care providers."
ASSEMBLY FLOOR : 54-20, 5/28/13
AYES: Alejo, Ammiano, Atkins, Bloom, Blumenfield, Bocanegra,
Bonilla, Bonta, Bradford, Brown, Buchanan, Ian Calderon,
Campos, Chau, Chesbro, Cooley, Daly, Dickinson, Eggman, Fong,
Fox, Frazier, Garcia, Gatto, Gomez, Gonzalez, Gordon, Gray,
Hall, Roger Hernández, Jones-Sawyer, Levine, Lowenthal,
Maienschein, Medina, Mitchell, Mullin, Muratsuchi, Nazarian,
Pan, Perea, V. Manuel Pérez, Quirk, Quirk-Silva, Rendon,
Salas, Skinner, Stone, Ting, Weber, Wieckowski, Williams,
Yamada, John A. Pérez
NOES: Allen, Bigelow, Conway, Dahle, Donnelly, Beth Gaines,
Gorell, Grove, Hagman, Harkey, Jones, Linder, Logue, Mansoor,
Melendez, Morrell, Olsen, Patterson, Wagner, Waldron
NO VOTE RECORDED: Achadjian, Chávez, Holden, Nestande, Wilk,
Vacancy
MW:e 6/26/14 Senate Floor Analyses
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SUPPORT/OPPOSITION: SEE ABOVE
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