BILL ANALYSIS Ó
AB 496
Page 1
CONCURRENCE IN SENATE AMENDMENTS
AB 496 (Gordon)
As Amended June 25, 2014
Majority vote
-----------------------------------------------------------------
|ASSEMBLY: |54-20|(May 28, 2013) |SENATE: |25-10|(August 7, |
| | | | | |2014) |
-----------------------------------------------------------------
Original Committee Reference: B., P. & C.P.
SUMMARY : Includes information pertinent to the appropriate care
and treatment of lesbian, gay, bisexual, transgender (LGBT), and
intersex communities in recommended continuing medical education
(CME) requirements for cultural competency, and authorizes
associations that accredit CME courses to update continuing
education standards as needed.
The Senate amendments delete the Assembly version of this bill,
and instead:
1)Authorize associations that accredit continuing medical
education courses to update as needed the standards for
continuing medical education courses that contain curriculum
that includes cultural and linguistic competency in the
practice of medicine.
2)Expand the definition of cultural competency to include
understanding and applying information pertinent to the
appropriate treatment of, and provision of care to, the LGBT
and intersex communities to the process of clinical care, as
appropriate.
3)Make various technical or nonsubstantive changes.
COMMENTS :
1)Purpose of this bill. This bill is intended to promote better
education of physicians on issues affecting the delivery of
care to individuals in the LGBT and intersex communities by
including these issues under the definition of "cultural
competency" for purposes of CME requirements. This bill is
sponsored by Equality California.
AB 496
Page 2
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."
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
appropriate medical care, which 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)CME and cultural competency. Existing law requires the
Medical Board of California (MBC) to adopt and administer
AB 496
Page 3
standards for CME, and requires that all CME courses contain
curriculum that includes cultural and linguistic competency in
the practice of medicine. MBC recognizes certain associations
to accredit CME courses, and requires these associations to
develop standards to ensure that accredited CME courses comply
with MBC's standards.
Current law defines "cultural competency" as a set of
integrated attitudes, knowledge, and skills that enable a
health care professional or organization to care effectively
for patients from diverse cultures, groups, and communities.
This bill specifies that cultural competency is recommended to
include information pertinent to the appropriate treatment of,
and provision of care to, the LGBT and intersex communities.
This bill also authorizes the accrediting associations to
update their standards to accommodate this new directive.
5)Senate amendments. The previous version of this bill
attempted to achieve the same goal but by a different means.
The prior version heard in the Assembly reestablished and
expanded the Task Force on Culturally and Linguistically
Competent Physicians and Dentists to consider the needs of
LGBT groups and required the Cultural and Linguistic Physician
Competency Program to address LGBT groups of interest to local
medical societies. This bill now integrates the goal of
better understanding the healthcare needs of LGBT and intersex
communities into existing CME requirements. This bill no
longer includes dentists, however, and adds intersex
communities.
Analysis Prepared by : Sarah Huchel / B., P. & C.P. / (916)
319-3301
FN: 0004314