BILL NUMBER: AB 2394 CHAPTERED 09/28/00 CHAPTER 802 FILED WITH SECRETARY OF STATE SEPTEMBER 28, 2000 APPROVED BY GOVERNOR SEPTEMBER 28, 2000 PASSED THE SENATE AUGUST 31, 2000 PASSED THE ASSEMBLY AUGUST 31, 2000 AMENDED IN SENATE AUGUST 30, 2000 AMENDED IN SENATE AUGUST 25, 2000 AMENDED IN SENATE AUGUST 14, 2000 AMENDED IN SENATE AUGUST 7, 2000 AMENDED IN SENATE JUNE 15, 2000 AMENDED IN ASSEMBLY MAY 2, 2000 AMENDED IN ASSEMBLY APRIL 11, 2000 INTRODUCED BY Assembly Member Firebaugh (Principal coauthor: Senator Ortiz) FEBRUARY 24, 2000 An act to add Sections 852 and 853 to the Business and Professions Code, relating to the healing arts. LEGISLATIVE COUNSEL'S DIGEST AB 2394, Firebaugh. Healing arts: cultural and linguistic competency. Existing law includes provisions generally applying to the licensure and certification of all healing arts practitioners. This bill would establish the Task Force on Culturally and Linguistically Competent Physicians and Dentists, chaired by the State Director of Health Services and the Director of Consumer Affairs, and would specify the task force's duties, including, among other things, developing recommendations for a continuing education program that includes language proficiency standards of a foreign language to meet linguistic competency, and identifying the key cultural elements necessary to meet cultural competency, and reporting to the Legislature and to licensing boards within 2 years of its establishment. This bill would establish a subcommittee of the task force and would require the subcommittee to submit a report to the task force by March 1, 2001, to be forwarded to the Legislature with any additional comments by April 1, 2001, on the feasibility of establishing a pilot program that would allow Mexican and Caribbean licensed physicians and dentists to practice in nonprofit community health centers in California's medically underserved communities. This bill would specify that the Medical Board of California and the Dental Board of California shall pay the state administrative costs associated with the task force and its subcommittee. THE PEOPLE OF THE STATE OF CALIFORNIA DO ENACT AS FOLLOWS: SECTION 1. The Legislature finds and declares all of the following: (a) Thirty-three and eight-tenths percent of Medi-Cal recipients in 1998 spoke a foreign language; Spanish was the number one foreign language spoken. (b) National medical journals and associations have acknowledged the importance of having medical providers be cultural and linguistically competent to serve culturally diverse patients. (c) The Journal of the American Medical Association, 1999, "Race, Gender, and Patient-Physician Relationship" Volume 282 #6, stated that "Without cultural competence, a physician may (1) unintentionally incorporate racial biases into his or her interpretations of patients' symptoms, predications of patients' behaviors, and medical decision making; (2) lack understanding of patients' ethnic and cultural disease models and attributions of symptoms; (3) be unaware of or have expectations of the visit that differ from patients' expectations." (d) In 1995, 1,641 underrepresented minorities applied to California medical schools and 231 were admitted; in 1998, this number declined to 1,223 applications and 184 admissions. (e) Only 0.8 percent of medical schools in the United States require a separate course on multicultural medicine; even fewer require any classes in cultural and linguistic competency. (f) The lack of cultural and linguistic competency among medical providers may be dangerous to the health of certain patients. SEC. 2. Section 852 is added to the Business and Professions Code, to read: 852. (a) The Task Force on Culturally and Linguistically Competent Physicians and Dentists is hereby created and shall consist of the following members: (1) The State Director of Health Services and the Director of Consumer Affairs, who shall serve as cochairs of the task force. (2) The Executive Director of the Medical Board of California. (3) The Executive Director of the Dental Board of California. (4) One member appointed by the Senate Committee on Rules. (5) One member appointed by the Speaker of the Assembly. (b) Additional task force members shall be appointed by the Director of Consumer Affairs, in consultation with the State Director of Health Services, as follows: (1) Representatives of organizations that advocate on behalf of California licensed physicians and dentists. (2) California licensed physicians and dentists that provide health services to members of language and ethnic minority groups. (3) Representatives of organizations that advocate on behalf of, or provide health services to, members of language and ethnic minority groups. (4) Representatives of entities that offer continuing education for physicians and dentists. (5) Representatives of California's medical and dental schools. (6) Individuals with experience in developing, implementing, monitoring, and evaluating cultural and linguistic programs. (c) The duties of the task force shall include the following: (1) Developing recommendations for a continuing education program that includes language proficiency standards of foreign language to be acquired to meet linguistic competency. (2) Identifying the key cultural elements necessary to meet cultural competency by physicians, dentists, and their offices. (3) Assessing the need for voluntary certification standards and examinations for cultural and linguistic competency. (d) The task force shall hold hearings and convene meetings to obtain input from persons belonging to language and ethnic minority groups to determine their needs and preferences for having culturally competent medical providers. These hearings and meetings shall be convened in communities that have large populations of language and ethnic minority groups. (e) The task force shall report its findings to the Legislature and appropriate licensing boards within two years after creation of the task force. (f) The Medical Board of California and the Dental Board of California shall pay the state administrative costs of implementing this section. (g) Nothing in this section shall be construed to require mandatory continuing education of physicians and dentists. SEC. 3. Section 853 is added to the Business and Professions Code, to read: 853. (a) A subcommittee of the task force established in Section 852 is hereby created to examine the feasibility of establishing a pilot program that would allow Mexican and Caribbean licensed physicians and dentists to practice in nonprofit community health centers in California's medically underserved areas. (b) The subcommittee shall consist of the following members: (1) The State Director of Health Services, who shall serve as the chair. (2) The Executive Director of the Medical Board of California. (3) The Executive Director of the Dental Board of California. (4) The Director of the Office of Statewide Health Planning and Development. (c) Additional subcommittee members shall be appointed by the State Director of Health Services, including the following: (1) Representatives of organizations that advocate on behalf of California licensed physicians and dentists. (2) A representative of a nonprofit clinic association that advocates on behalf of members of language and ethnic minority groups and provides health services to a patient population that meets the following characteristics: (A) Over 77 percent of patients are members of ethnic groups. (B) Over 92 percent of patients have incomes less than 200 percent of the poverty level. (C) Over 62 percent of patients do not speak English as their primary language. (d) The subcommittee shall report to the task force by March 1, 2001, and the task force shall forward the report, with any additional comments, to the Legislature by April 1, 2001. (e) The Medical Board of California and the Dental Board of California shall pay the state administrative costs of implementing this section.