BILL ANALYSIS �
SB 747
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Date of Hearing: July 13, 2011
ASSEMBLY COMMITTEE ON APPROPRIATIONS
Felipe Fuentes, Chair
SB 747 (Kehoe) - As Amended: June 13, 2011
Policy Committee: Business and
Professions Vote: 6-2
Urgency: No State Mandated Local Program:
No Reimbursable: No
SUMMARY
This bill requires physicians and surgeons, physician
assistants, registered nurses, licensed vocational nurses, nurse
practitioners, psychologists, marriage and family therapists,
licensed clinical social workers, psychiatric technicians, and
certified nurse assistants (CNAs) to take at least one
continuing education (CE) course on the provision of adequate
care to lesbian, gay, bisexual, and transgender (LGBT)
individuals. This bill further requires that the CE course be
similar in content to a publication entitled, "Guidelines for
Care of Lesbian, Gay, Bisexual, and Transgender Individuals"
published by the Gay and Lesbian Medical Association.
FISCAL EFFECT
1)One-time costs of approximately $100,000 to the Department of
Public Health (DPH) to notify CNAs of the new requirements and
approve training programs.
2)Ongoing costs in the range of $120,000, combined, to the Board
of Registered Nursing and Board of Vocational Nursing and
Psychiatric Technicians within the Department of Consumer
Affairs (DCA) for additional staff to verify licensee
compliance with this measure.
3)Minor, absorbable costs to the Board of Behavioral Sciences,
Board of Psychology, and the Medical Board within the
Department of Consumer Affairs to communicate the new
requirements, modify license application and renewal forms,
and verify licensee compliance with this measure.
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COMMENTS
1)Rationale . Data indicate that lesbian, gay, bisexual and
transgender (LGBT) people face health disparities, and that
health care professionals have varying levels of comfort and
familiarity with LGBT-specific health and mental health
issues. The author contends that requiring health care
professionals to receive specific training on providing care
to LGBT patients is critical to ensuring that they are
delivering effective, appropriate care.
2)Background . Research suggests that LGBT individuals face
health disparities linked to stigma and discrimination. There
is recognition of the need for improved competency of care of
LGBT patients within the medical and psychological
communities. For example, a study by the American
Psychological Association found that there is a clear need for
further education to provide accurate information and to train
psychologists to be sensitive to bias based on sexual
orientation. The author also cites a similar statement made
by the American Medical Association.
3)Continuing Education (CE) . The specific content of CE courses
for health care professionals is generally not dictated by
statute or by the various boards that regulate health
professions. However, the Legislature has in some cases
mandated certain content be included, and has passed laws
encouraging boards to consider including certain content in CE
courses.
Professional boards within DCA differ with respect to their
approach to CE. Some boards, such as the Medical Board of
California, delegate responsibility for design of CE courses
to an outside entity and only verify that licensees have
completed an adequate number of units. Others, such as the
Board of Registered Nursing, take a more active role in
approving CE course curricula. Boards generally do not
require each licensee to submit proof of compliance with CE
requirements, but verify compliance by auditing a certain
number of licensees.
4)Related Legislation .
a) SB 380 (Wright) contains several provisions related to
educating physicians about the role of nutrition and
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lifestyle in preventing and treating chronic disease,
including authorization for the Medical Board to set
content standards for a continuing education activity
concerning prevention and treatment of chronic disease
through nutrition and lifestyle changes. A previous
version of SB 380 mandated physicians and surgeons to take
specific CE units related to the same topic. SB 380 is
pending in this committee.
b) SB 1729 (Migden), Chapter 550, Statutes of 2008 requires
that all registered nurses, certified nurse assistants,
licensed vocational nurses, and physicians working in
skilled nursing facilities or congregate living health
facilities participate in a training program, prescribed by
DPH, that focuses on preventing and eliminating
discrimination based on sexual orientation and gender
identity. CDPH has not yet promulgated regulations for CNA
training pursuant to SB 1729.
Analysis Prepared by : Lisa Murawski / APPR. / (916) 319-2081