Report 2022-102 Recommendation 10 Responses

Report 2022-102: California Department of Public Health: It Has Missed Opportunities to Collect and Report Sexual Orientation and Gender Identity Data (Release Date: April 2023)

Recommendation #10 To: Public Health, Department of

To consistently collect accurate SOGI data, Public Health should periodically identify all of its forms and review whether the forms are required to collect SOGI data or whether a statutory exemption applies.

Annual Follow-Up Agency Response From October 2024

- Public Health piloted an internal review process of forms identified during the CSA 2022-102 audit to ensure they are compliant with the audit recommendations. Based off the results of this pilot test CDPH plans to move forward with initiating this internal review of forms across all relevant CDPH CDOs

- Public Health completed a second round of review of forms identified during the CSA 2022-102 audit to assess potential form updates to include the latest SOGI data collection recommendations put forth by the SOGI workgroup, including whether a statutory or other exemption A summary of these findings are attached (see Attachment 4 - CHSI Response Support - Program Findings Summary.pptx and Attachment 5 - CHSI Response Support - SOGI Internal Audit Report Leg Hearing March 14 Response RN.docx).

California State Auditor's Assessment of Annual Follow-Up Status: Pending

We look forward to reviewing Public Health's progress toward implementing our recommendation.

1-Year Agency Response

- Center for Health Statistics and Informatics (CHSI): CHSI is currently conducting an internal review of forms identified during the CSA 2022-102 audit. Results of this internal review will be shared with the CA Health and Human Services Committee.

- Center for Infectious Disease (CID): Forms have not been identified as noncompliant. While CID forms were not found to be noncompliant, Public Health is proceeding with updating all infectious disease reporting forms to include SOGI data. In addition, Public Health is considering a disease reporting data collection/forms workgroup to review all data collection forms utilized and streamline demographic data collection practices.

California State Auditor's Assessment of 1-Year Status: Pending

We look forward to reviewing the Public Health's progress toward implementing our recommendation.

6-Month Agency Response

- Center for Family Health (CFH). Effective July 1, 2023, the Adolescent Family Life Program (AFLP) has updated the data collection form "Comprehensive Baseline Assessment" (CBA) to be in SOGI compliance. See "CBA July 2023_Required Only.pdf & CBA July 2023_Required Only (sp).pdf"

- Center for Healthy Communities (CHC). Two forms (Common Initial Visit Clinical Care Information and Screening and Risk Reduction Counseling Form) are SOGI compliant as of July 1, 2023. The updated Screening and Risk Reduction Counseling Form was distributed on September 30, 2023. See "Form_CADC Common Initial Visit Clinical Care Information.pdf"

- Center for Health Statistics and Informatics (CHSI). Per Health and Safety Code (HSC) 102425, gender is not included in statute with a Live Birth Certificate, which the "Delayed Registration of Birth Form" closely follows. If a person requests to amend their sex to reflect their gender identity, they may do so without a court order per HSC 103426(a). The Sex (Field 2) portion of the form allows the applicant to choose between (1) Male, (2) Female, and (3) Non-Binary to be within statute and SOGI compliance.

- Center for Infectious Disease (CID). No forms identified as being non-compliant.

Public Health is considering a data collection/forms workgroup to review all data collection forms utilized and streamline data collection practices, including a periodic review whether forms are required to collect SOGI data, assessment of SOGI data collection processes, and review of program reasons for not collecting SOGI data in accordance with the departmental standards, once those standards are distributed.

California State Auditor's Assessment of 6-Month Status: Pending

60-Day Agency Response

- Public Health is continuing to support the 2022 SOGI Workgroup on the data collection recommendations, which provide updated guidance on SOGI question wording and response options. These recommendations are with the Director's Office for review and approval.

- Planning is underway on reconvening the SOGI Workgroup to address SOGI data display standards. Issuance of data display standard recommendations will complete the goals of this workgroup.

- Of the seven forms identified as non-compliant in the audit report, further investigation has revealed that three of these forms were one-time use only and no longer relevant to the report. Two forms will be compliant by July 1, 2023 and the other form will be compliant by September 30, 2023. Public Health is in conversation with the program responsible for the one remaining form to develop a workplan to make the form compliant.

- Public Health will direct all centers to form data collection/forms workgroups to review all data collection forms utilized within the centers and streamline data collection practices, including a periodic review whether forms are required to collect SOGI data, assessment of SOGI data collection processes, and review of branches' reasons for not collecting SOGI data, in accordance with Departmental standards.

California State Auditor's Assessment of 60-Day Status: Pending

We look forward to reviewing Public Health's progress towards implementing this recommendation.

All Recommendations in 2022-102

Agency responses received are posted verbatim.