RCW 43.70.613
Health care professionals—Health equity continuing education.
(1) By January 1, 2024, the rule-making authority for each health profession licensed under Title 18 RCW subject to continuing education requirements must adopt rules requiring a licensee to complete health equity continuing education training at least once every four years.
(2) Health equity continuing education courses may be taken in addition to or, if a rule-making authority determines the course fulfills existing continuing education requirements, in place of other continuing education requirements imposed by the rule-making authority.
(3)(a) The secretary and the rule-making authorities must work collaboratively to provide information to licensees about available courses. The secretary and rule-making authorities shall consult with patients or communities with lived experiences of health inequities or racism in the health care system and relevant professional organizations when developing the information and must make this information available by July 1, 2023. The information should include a course option that is free of charge to licensees. It is not required that courses be included in the information in order to fulfill the health equity continuing education requirement.
(b) By January 1, 2023, the department, in consultation with the boards and commissions, shall adopt model rules establishing the minimum standards for continuing education programs meeting the requirements of this section. The department shall consult with patients or communities with lived experience of health inequities or racism in the health care system, relevant professional organizations, and the rule-making authorities in the development of these rules.
(c) The minimum standards must include instruction on skills to address the structural factors, such as bias, racism, and poverty, that manifest as health inequities. These skills include individual-level and system-level intervention, and self-reflection to assess how the licensee's social position can influence their relationship with patients and their communities. These skills enable a health care professional to care effectively for patients from diverse cultures, groups, and communities, varying in race, ethnicity, gender identity, sexuality, religion, age, ability, socioeconomic status, and other categories of identity. The courses must assess the licensee's ability to apply health equity concepts into practice. Course topics may include, but are not limited to:
(i) Strategies for recognizing patterns of health care disparities on an individual, institutional, and structural level and eliminating factors that influence them;
(ii) Intercultural communication skills training, including how to work effectively with an interpreter and how communication styles differ across cultures;
(iii) Implicit bias training to identify strategies to reduce bias during assessment and diagnosis;
(iv) Methods for addressing the emotional well-being of children and youth of diverse backgrounds;
(v) Ensuring equity and antiracism in care delivery pertaining to medical developments and emerging therapies;
(vi) Structural competency training addressing five core competencies:
(A) Recognizing the structures that shape clinical interactions;
(B) Developing an extraclinical language of structure;
(C) Rearticulating "cultural" formulations in structural terms;
(D) Observing and imagining structural interventions; and
(E) Developing structural humility; and
(vii) Cultural safety training.
(4) The rule-making authority may adopt rules to implement and administer this section, including rules to establish a process to determine if a continuing education course meets the health equity continuing education requirement established in this section.
(5) For purposes of this section the following definitions apply:
(a) "Rule-making authority" means the regulatory entities identified in RCW 18.130.040 and authorized to establish continuing education requirements for the health care professions governed by those regulatory entities.
(b) "Structural competency" means a shift in medical education away from pedagogic approaches to stigma and inequalities that emphasize cross-cultural understandings of individual patients, toward attention to forces that influence health outcomes at levels above individual interactions. Structural competency reviews existing structural approaches to stigma and health inequities developed outside of medicine and proposes changes to United States medical education that will infuse clinical training with a structural focus.
(c) "Cultural safety" means an examination by health care professionals of themselves and the potential impact of their own culture on clinical interactions and health care service delivery. This requires individual health care professionals and health care organizations to acknowledge and address their own biases, attitudes, assumptions, stereotypes, prejudices, structures, and characteristics that may affect the quality of care provided. In doing so, cultural safety encompasses a critical consciousness where health care professionals and health care organizations engage in ongoing self-reflection and self-awareness and hold themselves accountable for providing culturally safe care, as defined by the patient and their communities, and as measured through progress towards achieving health equity. Cultural safety requires health care professionals and their associated health care organizations to influence health care to reduce bias and achieve equity within the workforce and working environment.
[ 2021 c 276 § 2.]
NOTES:
Findings—2021 c 276: "The legislature finds that:
(1) Healthy Washingtonians contribute to the economic and social welfare of their families and communities, and access to health services and improved health outcomes allows all Washington families to enjoy productive and satisfying lives;
(2) The COVID-19 pandemic has further exposed that health outcomes are experienced differently by different people based on discrimination and bias by the health care system. Research shows that health care resources are distributed unevenly by intersectional categories including, but not limited to, race, gender, ability status, religion, sexual orientation, socioeconomic status, and geography; and
(3) These inequities have permeated health care delivery, deepening adverse outcomes for marginalized communities. This bill aims to equip health care workers with the skills to recognize and reduce these inequities in their daily work. In addition to their individual impact, health care workers need the skills to address systemic racism and bias." [ 2021 c 276 § 1.]
Structure Revised Code of Washington
Title 43 - State Government—Executive
Chapter 43.70 - Department of Health.
43.70.020 - Department created.
43.70.030 - Secretary of health.
43.70.040 - Secretary's powers—Rule-making authority—Report to the legislature.
43.70.041 - Five-year formal review process of existing rules.
43.70.045 - Warren Featherstone Reid Award for Excellence in Health Care.
43.70.047 - Warren Featherstone Reid Award for Excellence in Health Care.
43.70.050 - Collection, use, and accessibility of health-related data.
43.70.053 - Hospital consolidated annual income—Reporting.
43.70.054 - Health care data standards—Submittal of standards to legislature.
43.70.060 - Duties of department—Promotion of health care cost-effectiveness.
43.70.068 - Quality assurance—Interagency cooperation.
43.70.070 - Duties of department—Analysis of health services.
43.70.075 - Identity of whistleblower protected—Remedy for retaliatory action—Definitions—Rules.
43.70.080 - Transfer of powers and duties from the department of social and health services.
43.70.090 - Authority to administer oaths and issue subpoenas—Provisions governing subpoenas.
43.70.097 - Enforcement in accordance with RCW 43.05.100 and 43.05.110.
43.70.110 - License fees—Costs—Other charges—Waiver.
43.70.115 - Licenses—Denial, suspension, revocation, modification.
43.70.120 - Federal programs—Rules—Statutes to be construed to meet federal law.
43.70.125 - Health care facility certification—Unfunded federal mandates—Applicant fees.
43.70.130 - Powers and duties of secretary—General.
43.70.140 - Annual conference of health officers.
43.70.150 - Registration of vital statistics.
43.70.190 - Violations—Injunctions and legal proceedings authorized.
43.70.195 - Public water systems—Receivership actions brought by secretary—Plan for disposition.
43.70.210 - Right of person to rely on prayer to alleviate ailments not abridged.
43.70.220 - Transfer of powers and duties from the department of licensing.
43.70.230 - Office of health consumer assistance created—Duties.
43.70.240 - Written operating agreements.
43.70.250 - License fees for professions, occupations, and businesses.
43.70.270 - License moratorium for persons in the service—Rules.
43.70.290 - Funeral directors and embalmers subject to chapter 18.130 RCW.
43.70.310 - Cooperation with department of ecology.
43.70.323 - Hospital infection control grant account.
43.70.327 - Public health supplemental account—Annual statement.
43.70.334 - Temporary worker housing—Definition.
43.70.337 - Temporary worker housing building permit—Plans and specifications—Fees—Rules.
43.70.400 - Head injury prevention—Legislative finding.
43.70.410 - Head injury prevention—Program, generally.
43.70.420 - Head injury prevention—Information preparation.
43.70.435 - Diagnosed concussions of students—Report.
43.70.440 - Head injury prevention act—Short title—1990 c 270.
43.70.444 - Washington plan for suicide prevention—Steering committee—Report.
43.70.446 - Suicide-safer homes project—Suicide-safer homes project account.
43.70.470 - Retired health care provider liability malpractice insurance—Conditions.
43.70.480 - Emergency medical personnel—Futile treatment and natural death directives—Guidelines.
43.70.495 - Telemedicine training for health care professionals.
43.70.500 - Health care services practice indicators and risk management protocols.
43.70.510 - Health care services coordinated quality improvement program—Rules.
43.70.512 - Public health system—Foundational public health services—Intent.
43.70.515 - Foundational public health services—Funding.
43.70.525 - Immunization assessment and enhancement proposals by local jurisdictions.
43.70.526 - Childhood immunizations—Resources for expecting parents.
43.70.533 - Chronic conditions—Training and technical assistance for primary care providers.
43.70.540 - Data collection—Legislative finding and intent.
43.70.545 - Data collection and reporting rules.
43.70.550 - Public health services improvement plan—Contents.
43.70.555 - Assessment standards.
43.70.560 - Media violence—Reporting reduction efforts.
43.70.590 - American Indian health care delivery plan.
43.70.595 - Health equity zones.
43.70.600 - Survey regarding exposure to radio frequencies—Results.
43.70.605 - Personal wireless services—Random testing on power density analysis—Rules.
43.70.610 - Domestic violence education program—Established—Findings.
43.70.613 - Health care professionals—Health equity continuing education.
43.70.617 - Prenatal nutrition best practices—Educational resources for pregnant women.
43.70.619 - Pregnancy complications—Informational resources.
43.70.620 - List of contacts—Health care professions.
43.70.630 - Cost-reimbursement agreements.
43.70.640 - Workplace breastfeeding policies—Infant-friendly designation.
43.70.645 - Donor human milk—Milk bank safety standards.
43.70.650 - School sealant endorsement program—Rules—Fee—Report to the legislature.
43.70.660 - Product safety education.
43.70.665 - Early detection breast and cervical cancer screening program—Medical advisory committee.
43.70.670 - Human immunodeficiency virus insurance program.
43.70.675 - Public health advisory board.
43.70.680 - Volunteers for emergency or disaster assistance.
43.70.690 - State asthma plan.
43.70.705 - Fall prevention program.
43.70.715 - COVID-19 public health response account.
43.70.720 - Universal vaccine purchase account.
43.70.725 - Health extension program—Dissemination of evidence-based tools and resources—Rules.
43.70.738 - Down syndrome resources—Development.
43.70.740 - Adjudicative proceedings.
43.70.765 - Opioid drugs—Warning—Patient education materials.
43.70.770 - State opioid response plan.
43.70.780 - Fruit and vegetable incentives program.
43.70.790 - Health care facility inspection and investigation availability.
43.70.800 - Oversight, consolidation, and standardization—Review.
43.70.810 - Provision of medical information—Dissemination of requirements and authority.
43.70.815 - Environmental health disparities map.
43.70.820 - Environmental justice obligations of the department of health.
43.70.825 - School-based health center program office.
43.70.835 - Lead contamination in drinking water in school buildings—State-tribal compact schools.
43.70.840 - Lead contamination in drinking water in school buildings—Technical guidance.
43.70.850 - Suicide-safer homes task force.
43.70.901 - References to the director or department of licensing—1989 1st ex.s. c 9.
43.70.902 - References to the hospital commission—1989 1st ex.s. c 9.