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The California Department of Public Health has issued an All Facilities Letter (AFL) notifying long-term care facilities (LTC) of the chaptering of SB 219, which prohibits LTC facility staff from discriminating against or denying care to seniors based on a person's actual or perceived sexual orientation, gender, gender identity, gender expression, or human immunodeficiency virus (HIV) status. The bill takes effect on January 1, 2018, and requires LTC facilities to employ procedures for record keeping that include the resident's gender identity, correct name, and pronoun as indicated by the resident. The bill also requires facilities to post a notice with its current nondiscriminatory policy and prohibits staff not directly involved in providing care to a resident from being present during physical examination or the provision of personal care if the resident is partially or fully unclothed without the express permission of that resident, or their legally authorized representative. Facilities must also take reasonable steps, such as installing curtains or effective visual barriers, to ensure privacy of residents whenever a resident is partially or fully unclothed. Until January 1, 2019, SB 219 requires LTC facilities to provide existing and newly hired employees access to the online learning tool, "Building Respect for LGBT Older Adults."

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