To establish the Cultural Competence Commission.

January 7, 2003

Ms. JACKSON-LEE of Texas introduced the following bill; which was referred to the Committee on Energy and Commerce

To establish the Cultural Competence Commission.

Be it enacted by the Senate and House of Representatives of the United States of America in Congress assembled,

SECTION 1. SHORT TITLE.

This Act may be cited as the `Good Medicine Cultural Competence Act of 2003'.

SEC. 2. FINDINGS.

The Congress finds as follows:

(1) Racial and ethnic minorities receive lower-quality health care, even when insurance status, income, age, and severity of conditions are comparable.

(2) In overall health, at each stage of life until age 44, African Americans, Latinos, and Native Americans have, on average, higher mortality rates than whites.

(3) The Department of Health and Human Services found at least 6 areas in which racial and ethnic minorities experience serious disparities in health access outcomes: infant mortality, cancer screening and management, cardiovascular disease, diabetes, HIV/AIDS infection, and immunizations.

(4) African-American children are twice as likely to have asthma and 6 times as likely to die from asthma as white children.

(5) Asthma hospitalization rates are higher in urban, low-income, and minority communities.

(6) African Americans are 30 percent more likely to die of cancer than whites when differences in age are taken into account.

(7) African-American women are at greater risk for being diagnosed with more advanced forms of breast cancer.

(8) The African-American death rate due to diabetes is more than twice that for whites when differences in age are taken into account.

(9) African Americans are 30 percent more likely to die of heart disease than whites when differences in age are taken into account.

(10) Of the AIDS cases reported in 2000, 47 percent involved African Americans.

(11) The annual AIDS case rate is 4 times higher for Latinos than for whites.

(12) Infant mortality rates, one of the most sensitive indicators of the health and well-being of a population, are twice as high among African-American infants as whites.

(13) Studies show that even well-meaning physicians who are not overtly biased or prejudiced typically demonstrate unconscious negative racial attitudes.

SEC. 3. ESTABLISHMENT.

There is established a commission to be known as the Cultural Competence Commission (in this Act referred to as the `Commission').

SEC. 4. DUTIES.

The Commission shall conduct a study and, under section 7, submit a report on the following:

(1) Establishing standards in cultural competence education for medical and health professionals.

(2) Mandating minimum professional training requirements for the delivery of high-quality knowledge-based patient care, and mandating annual hearings on the status of patient care for minority and low-income patients.

(3) Collaborating with the Agency for Healthcare Research and Quality and the American Hospital Association to ensure that the review and assessment process for updating clinical guidelines and protocols incorporates a mechanism to determine the appropriateness of the guidelines and protocols for use among patients of color.

(4) Engaging the leadership of such diverse organizations as the national consortium for African-American children to help prioritize and provide cultural competence training opportunities in such venues as school-based and school-linked health settings, working with The Council for Exceptional Children to address issues relating to persons with special needs, and collaborating with geriatric experts to improve access to culturally competent care for seniors in long-term care facilities.

(5) Working with diverse organizations such as the Asian and Pacific Islander American Health Forum, the National Alliance for Hispanic Health, the Johns Hopkins University Institute of Urban Health, and the Utah Department of Health, Division of Health Systems Improvement Primary Care Rural and Ethnic Health, to address the needs of vulnerable populations served by community and tribal health centers.

(6) Increasing outcomes-based research to assess improvements in health care outcomes for minority patients as a result of cultural competence education.

(7) Broadening access to culturally competent health education by patients, providers, and organizations.

(8) Conducting a national policy forum to inform legislators at the Federal, State, and local levels about cultural competence programs, research findings, and patient care outcomes.

(9) Facilitating improvements in the effectiveness of provider and patient interactions and communications through cross-cultural education, health literacy training, and information.

(10) Creating incentives for providers who have documented training and expertise in cultural competence.

(11) Collaborating with the National Board of Medical Examiners, the Joint Commission on the Accreditation of Health Care Organizations, and other professional licensing boards and accrediting bodies to devise and monitor a method for assessing provider attitudes, knowledge, and skills in culturally competent health care.

(12) Developing and enforcing mechanisms to ensure organizational compliance with cultural competence professional training, service delivery, and administrative requirements.

(13) Establishing a national cultural competence `think tank' comprised of expert advisers known in the areas of research, advocacy, education, public health policy, and human services.

SEC. 5. MEMBERSHIP.

(a) NUMBER AND APPOINTMENT- The Commission shall be composed of 17 members appointed as follows:

(1) 4 members appointed by the Speaker of the House of Representatives.

(2) 4 members appointed by the minority leader of the House of Representatives.

(3) 4 members appointed by the majority leader of the Senate.

(4) 4 members appointed by the minority leader of the Senate.

(5) 1 member appointed by the President.

(b) TERMS-

(1) IN GENERAL- Each member of the Commission shall be appointed for the life of the Commission.

(2) VACANCIES- A vacancy in the Commission shall be filled in the manner in which the original appointment was made.

(c) BASIC PAY- Members of the Commission shall serve without pay.

(d) TRAVEL EXPENSES- Each member shall receive travel expenses, including per diem in lieu of subsistence, in accordance with applicable provisions under subchapter I of chapter 57 of title 5, United States Code.

(e) CHAIRPERSON- The Chairperson of the Commission shall be elected by the Commission from among its members.

SEC. 6. POWERS OF COMMISSION.

(a) HEARINGS AND SESSIONS- The Commission may, for the purpose of carrying out this Act, hold hearings, sit and act at times and places, take testimony, and receive evidence as the Commission considers appropriate.

(b) POWERS OF MEMBERS AND AGENTS- Any member or agent of the Commission may, if authorized by the Commission, take any action that the Commission is authorized to take by this section.

(c) OBTAINING OFFICIAL DATA- Notwithstanding sections 552 and 552a of title 5, United States Code, the Commission may secure directly from any department or agency of the United States information necessary to enable it to carry out this Act. Upon request of the Commission, the head of that department or agency shall furnish that information to the Commission.

(d) MAILS- The Commission may use the United States mails in the same manner and under the same conditions as other departments and agencies of the United States.

(e) STAFF OF FEDERAL AGENCIES- Upon request of the Commission, the head of any Federal department or agency may detail, on a nonreimbursable basis, any of the personnel of that department or agency to the Commission to assist it in carrying out its duties under this Act.

(f) ADMINISTRATIVE SUPPORT SERVICES- Upon the request of the Commission, the Administrator of General Services may provide to the Commission, on a nonreimbursable basis, the administrative support services necessary for the Commission to carry out its responsibilities under this Act.

SEC. 7. REPORT.

Not later than 4 years after the date of the enactment of this Act, the Commission shall submit to the Congress and the President a report containing a detailed statement of the findings and conclusions of the Commission, together with such recommendations as the Commission considers appropriate.

SEC. 8. TERMINATION.

The Commission shall terminate 180 days after submitting its final report pursuant to section 7.

END