1. + AB 496 LGBT Cultural Competency for Health Care Providers Kirstee Novak GNRS 504 Bioethics April 8 th, 2015

2. + Cultural & Linguistic Competency Education that equips providers to: Provide culturally suitable health care to individuals whose cultures are different from their own Diagnose and treat patients--crucial to health care The Cultural and Linguistic Competency of Physicians Act of 2003 Patient’s ethnicity Language Customs Race Religion Social Status Personal identification National Institute of Health; Gordon 2014

3. + LGBT & Intersex in Health Care No education of LGBT & intersex patients or health disparities of LGBT communities LGBT people often experience unequal treatment from their HCPs due to lack of education on LGBT issues In 2013, 726,000 people identified as a partner in a same- sex household Important in providing equally superior health care to all minority groups & creating safe environments for all patients U.S. Census Bureau, 2013; Gordon, 2014

4. + California Assembly Bill 496 Enhances cultural competency of HCPs Provide safe & accessible health care Revises definition of CLC to “understanding that race, sexual orientation, gender identity and expression all play a role in diagnosis, treatment, and clinical care” Supporters of AB 496 Equality CA Medical Board of CA The AIDS Legal Referral Panel Opposition of AB 496 The California Right to Life Committee

5. + AB 496 & Nurses Currently in Nursing, CEUs -National LGBT Health Education Center to enhance knowledge of nurses Health Education About LGBT Elders (HEALE) clinics & nursing homes to more than 500 HCPs Change in Curriculum at Johns Hopkins University Nursing NSNA 66% of vote Educate nursing students in BSN and MSN to ensure adequate knowledge Nurses are trained to be conscious of culture, race, ethnicity, and creed, but are not versed in LGBT issues

6. + Utilitarianism Based on the well-being, pleasure, happiness, and satisfaction for the greater good Lack of LGBT education by HCPs hindering overall health of society Increasing HCP competency Create safe environments for LGBT individuals & groups Obtain treatment & prevention education Increase in healthier individuals Less disease transmission Creation of a healthier community Ex: transmittable diseases Hepatitis B, Hepatitis C, HIV & HPV were highest (61%) among gay & bisexual men in 2009 Beauchamp & Childress, 2009

7. + Justice Involves the fair & equal treatment of individuals in ALL communities and population groups The fair opportunity rule and unfair discrimination Demands equality for all individuals in order to overcome any unfortunate health circumstances Provider attitudes toward LGBT patients indicate a sexual stigma such as homophobia or transphobia Beauchamp & Childress, 2009

8. + ANA Nursing Code of Ethics Provision 1: “The nurse is responsible for practicing compassion and respect for the dignity of each individual without regards to personal characteristics” Nursing care is to be “respectful and unrestricted” by sexual orientation Provision 3 : “Nurses contribute to creating environments that foster quality health care through individual and collective action” Welcoming for all individuals and groups International Council of Nurses, 2013; ANA, 2010

9. + Spiritual Implications LGBT people are deprived of spiritual wellness and respect AB 496 aims to discontinue discrimination of LGBT individuals and communities.

10. + Conclusion  Education on LGBT & intersex minority groups will:  Create a health system where HCPs & nurses are more educated in order to provide equality care  Create safe environments and improve overall health of society

11. + References American Community Survey 1 Year Data (2013). In U.S. Census Bureau. Retrieved March 19, 2015, from www.census.gov/acswww.census.gov/acs Beauchamp, T. L., & Childress, J. F. (2009). Principles of Biomedical Ethics (6th ed., pp. 240-350 & 333-340). New York, NY: Oxford University Press. Continuing Education (2015). In National LGBT Health Education Center. Retrieved March 19, 2015, from http://www.lgbthealtheducation.org/training/online- courses/continuing-education/ http://www.lgbthealtheducation.org/training/online- courses/continuing-education/ Fowler, M. D. (2010). Guide to the Code of Ethics for Nurses (pp. 1-8 & 71-85). Silver Spring, MD: American Nurses Association. Gordon, R. (2013, July 19). AB 496. In Leginfo. Retrieved March 19, 2015. Gordon, R. (2014, August 19). AB 496- LGBT Cultural Competency for Health Care Providers. In Equality California. Retrieved March 19, 2015. Hopkins Nursing Curriculum to Address LGBT Cultural Competency (2010, December 9). In Johns Hopkins University School of Nursing. Retrieved March 20, 2015.