BILL NUMBER: S319

SPONSOR: SALAZAR
 
TITLE OF BILL:

An act to amend the public health law, in relation to requiring anti-
bias training for every medical student, medical resident and physician
assistant student in the state

 
PURPOSE OR GENERAL IDEA OF BILL::

To improve health care outcomes and care through educating medical
students about implicit and explicit biases.

 
SUMMARY OF PROVISIONS::

Section 1 amends Article 2 of the public health law by adding a new
Title 3-A, Anti-Bias Training, which contains a new Section 245, titled:
Training in bias awareness and elimination procedures.

Section 245 Subdivision A establishes the mandate that all medical
students, medical residents, and physician assistant students in New
              

York State take part in orientation programs that have been approved by
the New York State Department of Health for awareness of and the elimi-
nation practices for both implicit and explicit biases.

Subdivision B states that the individual must provide documentation of
having completed the training.

Subdivision C states that the New York State Department of Health should
consult with the New York State Division of Human Rights and the New
York State Board of Medicine to develop guidelines for the training.

Subdivision D states that a year after the effective date of the law,
the New York State Department of Health must send a report to the Gover-
nor and the New York State Legislature on the progress of these train-
ings.

Section 2 establishes the effective date.

 
JUSTIFICATION::

In recent years, the health care community has shifted its focus to
further address health inequity and its impact on individuals from
traditionally marginalized communities, including but not limited to
people of color, women, and the LGBTQ+ Community. The COVID-19 Pandemic
further illustrated these inequities. A study conducted in all five
boroughs of New York City sought to gain understanding of the health
care experiences of Latinx immigrant women. Four themes were identified
in this study. They were related to structural inequities, discriminato-
ry experiences in health care settings, victimization in public insti-
tutions, and overcoming discrimination. 1 Research provides us with
further information that illustrates these inequities:

-According to the Brookings Institution, childbirth-related deaths
disproportionately affect Black women, regardless of their income or
education 2


- A study conducted by the Center for American Progress found that 15%
of LGBTQ+ respondents, and 28% of transgender respondents avoided seek-
ing medical care when sick or injured due to previous experiences of
discrimination in a healthcare setting. Additionally, 32% of transgender
participants indicated that the healthcare provider intentionally
misgendered them. 38% indicated that the doctor was physically rough or
abusive when treating them, 34% indicated that a doctor refused to
provide healthcare related to their transition, and 49% indicated that
the doctor was visibly uncomfortable while treating them. 3

Currently, not all medical students in the state of New York receive
implicit bias training, which could hamper the goal of health equity for
all. This bill mandates that all medical students in New York State must
take part in trainings regarding implicit and explicit bias, so that
they can be aware of and work towards reducing implicit and explicit
biases.It is critical to have well-trained and culturally competent
providers who are educated about implicit bias to ensure the best possi-
ble treatment of all individuals, and to ensure medical outcomes are not
skewed because of bias, whether implicit or explicit.

1 Damle, M., Wurtz, H., & Samari, G. (2022). Racism and health care:
Experiences of latinx immigrant women in NYC during COVID-19. SSM -
Qualitative Research in Health, 2, 100094.
https://doi.org/10.1016/j.ssmqr.2022.100094

2 Young, C. L. (2022, March 9). There are clear, race-based inequalities
in health insurance and Health Outcomes. Brookings.  Retrieved December
16, 2022, from https://www.brookings.edulblog/usc-brookings-schaeffer-
on- health-policy/
2020/02/19/there-are-clear-race-based-inequalities-in- health-insurance
-and-heafth-outcomes/

3 Mahowald, L., Gruberg, S., & Halpin, J. (2022, August 22). The state
of the LGBTQ community in 2020. Center for American Progress.  Retrieved
December 16, 2022, from
https://www.americanprogress.org/article/state-Igbtq-community-2020/

 
RACIAL JUSTICE IMPACT:

This bill would enhance racial justice as there are significant racial
disparities in health care, and these disparities result in more nega-
tive health outcomes for people of color as compared with white people.
This legislation will help to reduce these disparities and improve
health outcomes by educating health care providers on their biases and
how these might impact racial disparities that exist.

 
GENDER JUSTICE IMPACT:

This bill would enhance gender justice by improving bias awareness in
medical students, whether said implicit and explicit biases impact
women, people of color, the LGBTQ community, and/or other vulnerable
members of our communities.

 
PRIOR LEGISLATIVE HISTORY::

SENATE:

2019: S6889 (Salazar)- Referred to rules
2020: Referred to health

2021: S3077 (Salazar)- Referred to health. Passed Senate.

2022:  Referred to health

ASSEMBLY:

2019: A8741 (Reyes)- Referred to health

2020: Referred to health

2021-2022: A1404 (Reyes)- Referred to health

 
FISCAL IMPLICATIONS::

None.

 
EFFECTIVE DATE::

This act will take effect 180 days after enactment.