The California Senate Health Committee recently passed a bill through Committee to improve access to gender affirming care. Under the legislation, staff and contracted providers of a Medi-Cal managed care plan or a health care service plan would be required to complete evidence-based cultural competency training, incorporated into continuing medical education (CME). The goal would be to ultimately provide trans-inclusive health care for patient who identify as transgender, gender nonconforming, and intersex (TGI).
The bill would require the California Department of Managed Health Care (DMHC) to impose sanctions to ensure compliance and would also require health plans to publicly report certain information related to compliance, monitoring, and any related complaints or grievances, on an annual basis.
The bill would also require the California Health and Human Services Agency (CalHHS) to convene a working group including TGI people to develop a quality standard for TGI patient experience to ensure that providers are providing appropriate care to TGI people, and also to create appropriate training standards for providers.
Senator Scott Weiner, one of the sponsors of the legislation, emphasized that the bill is not focused on criminalizing providers, but instead focused on ensuring that providers have all the resources and training they need to treat all patients effectively and with compassion.
Erin Pollard, a clinician who specializes in gender affirming mental health care for LGBTQ+ patients, believes that cultural competency training is critical for clinicians. “These trainings are often very difficult to find which results in only a small amount of properly trained clinicians. This leaves our TGI patients guessing as to where they can find competent care appropriate to their needs,” she said. “In order for care to be affirming and inclusive, the clinician needs to not only understand medical transition options, but also the complex social and emotional impact of being trans, nonbinary, or intersex in our society. Without this training, clinicians often provide misguided treatment that is in fact harmful to our TGI patients.”
Senator Melissa Melendez raised concerns about an unclear accreditation process in the bill for the organizations and individuals who will be conducting the cultural competency training for providers. Senator Richard Pan clarified that because the training would be included in CME, there would be an accreditation process involved.
Senator Monique Limon believes that this bill would help improve the health care system as a whole due to its incorporation into CME. “I believe that more training is the right direction to go to be inclusive of the [large amounts of] information that need to be understood to be a better provider,” she said. “We have to get training continuously, and the reason we do this is because there is always more we can learn. And if we only do it on a one time basis and not do it ongoing, we limit how helpful we can be.”
The bill was passed through the Committee and has been re-referred to the Senate Committee on Appropriations, for a hearing on May 16th.