BILL ANALYSIS
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|SENATE RULES COMMITTEE | SB 1729|
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UNFINISHED BUSINESS
Bill No: SB 1729
Author: Migden (D)
Amended: 8/13/08
Vote: 21
SENATE HEALTH COMMITTEE : 7-3, 4/16/08
AYES: Kuehl, Alquist, Cedillo, Negrete McLeod,
Ridley-Thomas, Steinberg, Yee
NOES: Aanestad, Cox, Wyland
NO VOTE RECORDED: Maldonado
SENATE APPROPRIATIONS COMMITTEE : 8-4, 5/22/08
AYES: Torlakson, Cedillo, Corbett, Florez, Kuehl, Oropeza,
Simitian, Yee
NOES: Cox, Aanestad, Ashburn, Dutton
NO VOTE RECORDED: Ridley-Thomas, Runner, Wyland
SENATE FLOOR : 24-15, 5/27/08
AYES: Alquist, Calderon, Cedillo, Corbett, Correa,
Ducheny, Florez, Kehoe, Kuehl, Lowenthal, Migden, Negrete
McLeod, Oropeza, Padilla, Perata, Ridley-Thomas, Romero,
Scott, Simitian, Steinberg, Torlakson, Vincent, Wiggins,
Yee
NOES: Aanestad, Ackerman, Ashburn, Battin, Cogdill, Cox,
Denham, Dutton, Harman, Hollingsworth, Maldonado,
Margett, McClintock, Runner, Wyland
NO VOTE RECORDED: Machado
ASSEMBLY FLOOR : 43-28, 8/15/08 - See last page for vote
SUBJECT : Health care facilities: training
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SOURCE : Equality California
DIGEST : This bill requires all registered nurses,
certified nurse assistants, licensed vocational nurses, and
physicians working in skilled nursing facilities or
congregate living health facilities to participate in a
training program focused on preventing and eliminating
discrimination based on sexual orientation and gender
identity.
Assembly Amendments were clarifying.
ANALYSIS :
Existing law:
1. Requires the Department of Public Health (DPH) to
license and regulate skilled nursing facilities (SNFs)
and congregate living health facilities, as defined.
2. Requires each of the Area Agencies on Aging to include
the needs of lesbian, gay, bisexual, and transgender
(LGBT) seniors in their needs assessment and area plans.
3. Requires the Department of Aging to provide technical
assistance to the Area Agencies on Aging regarding the
unique needs of LGBT seniors.
4. Places a number of training and continuing education
requirements on nurses and physicians related to
cultural competence, but none are specifically related
to LGBT issues.
This bill:
1. Makes several declarations and findings regarding the
marginalization of LGBT seniors and the opportunity
California has to continue to serve as a model for other
states in the protections it affords to LGBT persons.
2. Requires all registered nurses, certified nurse
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assistants, licensed vocational nurses, and physicians
working in SNF or congregate living health facilities to
participate in a training program, prescribed by the
DPH, that focuses on preventing and eliminating
discrimination based on sexual orientation and gender
identity.
3. Permits DPH to incorporate the training prescribed in #2
above, into any existing training program that is
designed to prevent or eliminate discrimination in
senior care facilities.
4. Permits DPH to charge each licensed SNF and congregate
living health facility a fee associated with determining
compliance and requires the fee to not exceed DPH's
costs for the enforcement of the provisions of this
bill.
5. Clarifies existing law which defines sexual orientation
and gender identity as follows:
A. "Sexual orientation" means heterosexuality,
homosexuality, or bisexuality.
B. "Gender identity" means sex, including a person's
gender-related appearance and behavior whether or not
stereotypically associated with the person's assigned
sex at birth.
Background
According to a 2000 Policy Institute of the National Gay
and Lesbian Task Force Foundation report of public policy
issues affecting LGBT seniors, three to eight percent of
Americans over the age of 65 are LGBT. According to the
report, some of the reasons why LGBT seniors may be at
higher risk for institutionalization are:
1. Social Security pays survivor benefits to widows and
widowers but not to the surviving same-sex life partner
of someone who dies.
2. Married spouses are eligible for Social Security spousal
benefits, which can allow them to earn half their
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spouse's Social Security benefit if it is larger than
their own Social Security benefit. Unmarried partners
in lifelong relationships are not eligible for spousal
benefits.
3. Medicaid regulations protect the assets and homes of
married spouses when the other spouse enters a nursing
home or long-term care facility, but no such protections
are offered to same-sex partners.
4. Tax laws and other regulations of 401(k)s and pensions
discriminate against same-sex partners.
5. Rights, such as hospital visitation or the right to die
in the same nursing home, are regularly denied same-sex
partners.
FISCAL EFFECT : Appropriation: No Fiscal Com.: Yes
Local: Yes
According to the Senate Appropriations Committee:
Fiscal Impact (in thousands)
Major Provisions 2008-09 2009-10
2010-11 Fund
Administration $18 $60 $60
General
SUPPORT : (Verified 5/23/08) (Unable to reverify)
Equality California (source)
California Alliance for Retired Americans
Lambda Letters Project
Stonewall Democratic Club of Greater Sacramento
OPPOSITION : (Verified 5/23/08) (Unable to reverify)
California Association of Health Facilities
Capitol Resource Family Impact
ARGUMENTS IN SUPPORT : According to Equality California
(EQCA), social marginalization of LGBT seniors is often
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exacerbated once these individuals enter institutionalized
care. EQCA states that lack of recognition of LGBT
seniors' partners or family structures may deprive
individuals of needed support and lead to increased
isolation, and LGBT seniors may face outright homophobia
and transphobia while institutionalized, limiting their
access to essential services, programs and activities.
EQCA writes that this bill would ensure that licensed
health professionals who have constant interaction with
seniors in institutional settings will better understand
how to foster an environment that is free from
discrimination based on sexual orientation and gender
identity. EQCA contends that such trainings will educate
providers about nondiscrimination laws and policies, how to
avoid assumptions based on heterosexual experience, and how
to create a culture of respect for gender and sexual
orientation diversity. These trainings have already proven
effective in transforming institutions to be more inclusive
of, and welcoming to, LGBT seniors.
ARGUMENTS IN OPPOSITION : The California Association of
Health Facilities states: "This bill will have a large
cost to both SNF employers and to the state Medi-Cal
system, and is unnecessary. Why is it unnecessary? The
California Fair Employment and Housing Act (FEHA) was
amended in 1984 to prohibit harassment in the workplace
(See Government Code 12940). The anti-harassment
provisions of FEHA make an employer liable for harassment
in the workplace and requires the employer to 'take all
reasonable steps to prevent harassment from occurring.' In
2004, the Legislature passed AB 1825 [Chapter 933], which
requires employers with 50 or more employees to provide two
hours of training and education regarding sexual harassment
to all supervisory employees, once every two years.
Because discrimination based on sexual orientation and
gender identity is included under the protections of FEHA,
supervisors are trained in this area."
ASSEMBLY FLOOR :
AYES: Arambula, Beall, Berg, Brownley, Caballero, Carter,
Coto, Davis, De La Torre, De Leon, DeSaulnier, Eng,
Evans, Feuer, Fuentes, Furutani, Galgiani, Hancock,
Hayashi, Hernandez, Huffman, Jones, Karnette, Krekorian,
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Laird, Leno, Levine, Lieber, Lieu, Ma, Mendoza, Mullin,
Nava, Nunez, Parra, Portantino, Ruskin, Salas, Saldana,
Solorio, Swanson, Wolk, Bass
NOES: Adams, Aghazarian, Anderson, Benoit, Blakeslee,
Cook, DeVore, Duvall, Emmerson, Fuller, Gaines, Garrick,
Horton, Houston, Huff, Jeffries, Keene, La Malfa, Maze,
Nakanishi, Niello, Silva, Smyth, Spitzer, Strickland,
Tran, Villines, Walters
NO VOTE RECORDED: Berryhill, Charles Calderon, Dymally,
Garcia, Plescia, Price, Sharon Runner, Soto, Torrico
CTW:mw 8/19/08 Senate Floor Analyses
SUPPORT/OPPOSITION: SEE ABOVE
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