[Congressional Bills 108th Congress]
[From the U.S. Government Publishing Office]
[H.R. 90 Introduced in House (IH)]






108th CONGRESS
  1st Session
                                 H. R. 90

            To establish the Cultural Competence Commission.


_______________________________________________________________________


                    IN THE HOUSE OF REPRESENTATIVES

                            January 7, 2003

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

_______________________________________________________________________

                                 A BILL


 
            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.
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