Overview
California legislators enacted Assembly Bill (AB) 2319 last fall in a landmark attempt to reduce racial and ethnic disparities in maternal and infant healthcare by addressing implicit bias in pregnancy, childbirth, and postnatal care to create a more equitable healthcare system. The bill expands and strengthens implicit bias training for healthcare providers and explicitly recognizes birthing people to include nonbinary persons and persons of transgender experience. AB 2319 builds upon the California Dignity in Pregnancy and Childbirth Act (Senate Bill (SB) 464), which aimed to reduce maternal mortality rate among persons of color.
Together, AB 2319 and SB 464 represent steps by California legislators toward achieving health equity at a time when healthcare providers that receive federal funds must ensure their actions comply with US President Donald Trump’s executive orders on diversity, equity, and inclusion (DEI) and gender ideology. Providers subject to the executive orders will need to review their implicit bias training to ensure it satisfies the requirements of AB 2319 in a facially race-neutral manner.
In Depth
AB 2319 mandates that all healthcare providers involved in perinatal care, as well as those regularly interacting with perinatal patients, complete the revised implicit bias training by June 1, 2025, for current providers and within six months for new hires. This training must now cover the recognition of intersecting identities and the multiple layers of potential biases that could harm patients and their infants.
The bill explicitly requires all physician assistants, medical assistants, licensed vocational nurses, and doctors and individuals licensed under Division 2 of the California Business and Professions Code who provide perinatal care to complete the implicit bias training.
Additionally, starting February 1, 2026 (and each year thereafter), all hospitals, alternative birth centers, and primary care clinics providing perinatal care must provide proof of compliance with the implicit bias training requirements to the state attorney general, including the names of the providers and the date they completed the training. The bill authorizes the attorney general to pursue civil penalties of $5,000 for the first violation and $15,000 for each subsequent violation, plus attorneys’ fees and costs. The attorney general may also post on its website the names of the facilities that failed to submit proof of compliance.
Hospitals, alternative birth centers, and primary care clinics receiving federal funding must also ensure that the implicit bias training complies with the executive orders. On March 14, 2025, the US Court of Appeals for the Fourth Circuit halted the previously issued preliminary injunction against the executive orders, allowing the government to resume targeting DEI programs pending appeal. As a result, providers subject to the executive orders will need to review their implicit bias training programs to ensure they satisfy the requirements of AB 2319 in a facially race-neutral manner, such as by utilizing statistics across all racial demographics in training sessions.
TAKEAWAYS
Facilities subject to AB 2319 should review and update their implicit bias training programs to reflect the changes implemented by the bill. They should also establish systems to track the completion of the training programs in preparation of the yearly reporting requirements imposed by AB 2319. Further, facilities must carefully navigate the complex intersection between complying with federal and state laws.
Please contact one of the authors of this article or your regular McDermott lawyer(s) to discuss the potential legal implications of AB 2319 and President Trump’s executive orders on your business.
