Cultural Competency in Healthcare Heads to Governor
May 22, 2013 — Sen. Jackie Winters said 40 or 50 years ago, when some black Americans had diabetes, they had a colloquial term for it — “the sugars” — which their doctors may not understand.
Winters, a black Republican senator from Salem, told The Lund Report that ethnic and racial minorities often face increased health disparities, often for purely cultural reasons, since physicians and nurse practitioners are more likely to come from an ethnic group different than their own.
That’s what’s led her to find a legislative route that would compel health professionals to become educated in cultural competency. On Tuesday, she saw the fruition of a multi-year effort with the Senate’s passage of House Bill 2611 — which allows the state health professional boards to require cultural competency training as a right of licensure.
The boards license everyone from doctors and nurses to chiropractors, massage therapists and direct-entry midwives. The bill also affects home care workers, who assist elderly Oregonians.
HB 2611 allows the state universities and community colleges to require that anyone providing healthcare to students be trained in cultural competency.
“We can’t deliver patient-delivered care if it does not respond to the individual culture of the patient,” Winters told her Senate colleagues, who approved HB 2611 on a 26-2 vote.
Winters has been invited to discuss cultural competency and her legislative victory with a presentation next month in San Francisco at the National Black Caucus of State Legislature’s Promoting Healthy Lifestyles Symposium.
Ron Williams, the executive director of Oregon Action, praised Winters: “She really stepped up, and we’re really pleased with the strong vote she got in the Senate.”
Oregon Action has been one of several community groups spearheading the effort to push Oregon’s health community to become more culturally competent.
Originally, the bill would have required that all health professionals in Oregon inform their licensing boards by 2017 that they had received cultural competency training. The revised bill leaves the requirements to the discretion of the individual boards.
Sen. Elizabeth Steiner Hayward, a Portland Democrat and physician at Oregon Health & Science University, said she would have opposed the bill if it had forced all health professionals to take cultural competency courses, but she was pleased with the amended bill, which allows the state health professional licensing boards to include it in licensees’ continuing education.
Steiner Hayward added she had been involved with cultural competency courses at the state medical school and understands their importance.
But Sen. Chip Shields, D-Portland, told The Lund Report that the Legislature may need to do more if it finds that licensing boards are ignoring the desire to integrate cultural competency training into their continuing education curriculum.
“I think it will stay on people’s radar,” he said. “If we find the boards are not adopting cultural competency, we’ll come back and make it mandatory.”
Williams said a critical aspect of the legislation is that it will allow state agencies to track how many professionals are actually taking cultural competency courses.
Two years ago, the mandated requirement passed the Senate only to die on the House floor in a chamber with an even party split. The new approach found broad bipartisan support this session and passed the House on a 46-12 vote in early April.
The state has a ways to go to meet HB 2611’s objective. Sen. Laurie Monnes Anderson, D-Gresham, said that a culturally competent healthcare workforce does not yet exist in Oregon.
“Many Oregonians face a lot of barriers to good healthcare,” she said.
Tricia Tillman, the director of the Oregon Health Authority Office of Equity & Inclusion, said her office would engage the health community to help lay out just what kinds of courses need to be offered.
Tillman said there is a wide range of interest in cultural competency across 21 different boards, but that the Oregon Medical Association and Oregon Nursing Association had shown a lot of enthusiasm in offering programs to their members.
The Senate also passed House Bill 2134 on a unanimous vote, which would require the Oregon Health Authority and the Department of Human Services to engage community groups to gather demographic data that is more precise.
Monnes Anderson carried this bill on the Senate floor Tuesday, telling her colleagues that collecting more specific data about ethnic groups in Oregon would give the state agencies better tools to improve health outcomes and public health. The information acquired is voluntarily reported from the public.
Currently, such public health surveys may not break racial groups down beyond white, black, Asian, Hispanic, American Indian and other large racial constructs. Within each of these racial groups are a wide range of ethnicities who may have very different health experiences and needs.
HB 2134 was amended slightly from the House version to encompass all public health surveys, not just those administered through the Oregon Health Plan.