SB 5629 — Concerning hepatitis B and hepatitis C screening and health care services.

(4)(1) TheBy offeringJanuary of1, a2024, hepatitisthe Brule-making screeningauthority testfor andeach hepatitishealth Cprofession screeninglicensed test under thisTitle section18 RCW subject to continuing education requirements must beadopt culturallyrules andrequiring linguisticallya appropriate.licensee to complete health equity continuing education training at least once every four years.

(5)(2) ThisHealth sectionequity doescontinuing noteducation affectcourses themay scopebe oftaken practicein ofaddition any primary care provider or diminish any authority or legal or professional obligation of any primary care provider to offeror, aif hepatitis B screening test, hepatitis C screening test, or both, or a hepatitisrule-making Cauthority diagnosticdetermines test,the orcourse tofulfills provideexisting servicescontinuing oreducation carerequirements, forin theplace patient of aother hepatitiscontinuing Beducation screeningrequirements test,imposed hepatitisby Cthe screeningrule-making test,authority. or both, or a hepatitis C diagnostic test.

(6)(3)(a) AThe primarysecretary careand provider that fails to comply with the requirementsrule-making ofauthorities thismust sectionwork shallcollaboratively not be subject to anyprovide disciplinaryinformation actions related to theirlicensees licensureabout oravailable certification,courses. or to any civil or criminal liability, because of the primary care provider's failure to comply with the requirements of this section.

(7) The departmentsecretary mayand adoptrule-making rulesauthorities necessaryshall toconsult implementwith thispatients sectionor andcommunities anywith additionallived rulesexperiences involvingof thehealth offeringinequities ofor screeningracism testsin the health care system and treatmentrelevant requirementsprofessional fororganizations hepatitiswhen Bdeveloping andthe Cinformation and themust trainingmake forthis primaryinformation careavailable providers.by July 1, 2023.

(8)The Forinformation purposesshould ofinclude thisa section,course theoption followingthat definitionsis apply:free of charge to licensees.

(a)It "Follow-upis healthnot care"required includesthat providingcourses medicalbe managementincluded andin antiviralthe treatmentinformation forin chronicorder hepatitis B or hepatitis C according to fulfill the latesthealth nationalequity clinicalcontinuing practiceeducation guidelinesrequirement. p.

2(b) SBBy 5629January recommended1, by2023, the Americandepartment, associationin consultation with the boards and commissions, shall adopt model rules establishing the minimum standards for continuing education programs meeting the studyrequirements of liverthis diseases.section.

(b)The "Hepatitisdepartment Bshall screeningconsult test"with includespatients anyor laboratorycommunities testswith orlived testsexperience thatof detecthealth theinequities presenceor ofracism hepatitisin Bthe surfacehealth antigencare (HBsAg)system, andrelevant providesprofessional confirmationorganizations, ofand whether the patientrule-making hasauthorities ain chronicthe hepatitisdevelopment Bof infection.these rules.

(c) "HepatitisThe Cminimum diagnosticstandards test"must includesinclude anyinstruction laboratoryon testskills orto testsaddress that detect the presencestructural offactors, thesuch hepatitisas Cbias, virusracism, in the blood and providespoverty, confirmationthat ofmanifest whetheras thehealth patientinequities. has an active hepatitis C virus infection.

(d)These "Hepatitisskills Cinclude screeningindividual- test"level includesand anysystem-level laboratoryintervention, screening test or tests that detect the presence of hepatitis C virus antibodies in the blood and providesself-reflection confirmationto ofassess whetherp. the patient has ever been infected with the hepatitis C virus.

(e)4 "PrimaryESB care5629 providers"how includesthe generallicensee's practicesocial physicians,position familycan practitioners,influence internists,their pediatricians,relationship osteopathicwith physicians,patients naturopaths, physician assistants, and advancedtheir registeredcommunities. nurse practitioners licensed under this title.

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;

and (viii) Viral hepatitis screening and treatment, including courses related to recommendations from the federal centers for disease control and prevention and the United States preventive services task force.

(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 p.

5 ESB 5629 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.

36 SBESB 5629