Washington State: Cultural Competency Training

In an effort to reduce racial and ethnic disparities in health care, Washington State has joined New Jersey in requiring cultural competency training for certain health care professionals. The legislation, sponsored by Senate leader Rosa Franklin (D) and others and signed into law in 2006, calls for the establishment of an ongoing multicultural health awareness and education program "…to raise awareness and educate health care professionals regarding the knowledge, attitudes, and practice skills necessary to care for diverse populations to achieve a greater understanding of the relationship between culture and health." All professions regulated by the Washington State Department of Health (DOH) must integrate multicultural education into their basic curriculum by July 1, 2008.

To assist with this requirement, the DOH anticipates having a training tool available through its Web site for all health professionals by the July deadline. Use of this tool will be voluntary; training programs can develop their own educational approaches. In addition, the terms of the legislation can be met through a continuing multicultural education component for professions that already require continuing education.

According to Vickie Ybarra, chair of the Governor's Interagency Council on Health Disparities, "this legislation will importantly increase the availability of cultural competence training for health care professionals currently completing their education as well as those already in practice. Our state will learn much from this process that we are confident will help address health disparities in our increasingly diverse state."

Other states have passed legislation involving cultural competency training, including California, which requires cultural competency curricula in continuing medical education courses, and Maryland, which encourages education about health disparities and is piloting cultural competency training for certain health care providers. Bills addressing this issue have been proposed in Arizona, New York, Illinois, and Ohio.

In addition to cultural competency training, states are attempting to reduce health disparities through their Medicaid programs. Strategies include: standardizing and collecting race and ethnicity information on enrollees; incorporating financial incentives and disparities reduction goals into health plan contracts; and requiring access to translators and culturally appropriate care. These approaches are summarized in a recent Center for Health Care Strategies, Inc., issue brief, From Policy to Action: Addressing Racial and Ethnic Disparities at the Ground Level.