BILL ANALYSIS Ó
AB 496
Page 1
CONCURRENCE IN SENATE AMENDMENTS
AB 496 (Gordon)
As Amended June 25, 2014
Majority vote
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|ASSEMBLY: |54-20|(May 28, 2013) |SENATE: |25-10|(August 7, 2014) |
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|COMMITTEE VOTE: |11-1 |(August 20, 2014) |RECOMMENDATION: |concur |
|(B., P. & C.P.) | | | | |
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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
AB 496
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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.
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.
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4)CME and cultural competency. Existing law requires the Medical
Board of California (MBC) to adopt and administer 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: 0005161