Massachusetts Health Disparities Council

1. Massachusetts Health Disparities Council Recommendations of the Health Disparities Commission Russell D. Aims Chief of Staff Massachusetts Board of Registration in Medicine July 27, 2009

2. BOARD MISSION STATEMENT To ensure that only qualified physicians are licensed to practice in the Commonwealth, and to support an environment that maximizes the high quality of health care in Massachusetts.

3. SPECIFIC COMMISSION RECOMMENDATIONS

4. Recommendations • Require health care professionals licensing boards to develop regulations for ensuring that licensed health care professionals receive training and education in these basic knowledge and skills. Successful qualification, credentialing and licensure of health professionals should be linked to the demonstration of specific cultural competencies and understanding of health disparities. • Certify, with evidence-based criteria, health profession training programs that qualify health professionals to meet the standards for basic cultural competence and health disparities skills.

5. RESPONSE • Health disparities/cultural competence education is a core competency of the Accreditation Council for Graduate Medical Education (ACGME) for all U.S. residency programs • U.S. residencies are also required for all International Medical Graduates • The Joint Commission and the FSMB also require the same of training programs

6. RESPONSE • The Board will explore requiring physician training programs to certify their adherence to the ACGME core competencies. • Add language to Board regulations supporting elimination of health disparities and promoting cultural competence of physicians.

7. Recommendations • Convene the Deans of the health professions schools and other experts to discuss and establish core standards for a curriculum, including the skills and knowledge needed to address health disparities and achieve cultural competency. • Require health disparities education which is related to the nature and causes of health disparities to be incorporated early on into the core curricula of medical, dental, nursing and allied health professions and public health schools. • Expand health education programs in schools to include health literacy skills that will result in expanded access to culturally appropriate health education

8. Recommendations • Health professional schools and associations for health professionals should adopt, review and promote policies, procedures and incentives to encourage community-engaged scholarship and research (also known as community-based participatory research). • Require academic institutions to incorporate service internships in areas with documented health disparities as a condition of graduation.

9. BORIM RESOURCES TO SUPPORT HEALTH DISPARITIY RESEARCH • Data Repository • Data Analysis • Partnership with DPH, Hospitals, MMS, Others

10. HOSPITAL REPORTING DATA BY RACE/ETHNICITY • DPH AND BORIM-PCA SHARE THE SAME DATA ELEMENTS • INTER-AGENCY CHECKS AND BALANCES ON DATA RECEIVED • REPORT JOINTLY TO THE HEALTH CARE QUALITY AND COST COUNCIL • JOINT COMMISSION ACCEPTS BORIM REPORTING PROCESS

11. BORIM Patient Care Assessment Division Project

12. Race/Ethnicity Data Gathered from PCA Incident Reports

13. Preliminary Data on Race and Ethnicity from BORIM:

14. Known Cases from 2005 Hospital Discharges

15. OTHER BORIM PLANS • New Effort to Collect Race/Ethnicity Data on Physicians • Expanded Collection of Data on Practice Setting and Patient Care Hours • Data Analysis of Race/Ethnicity by Geographic Area/Specialty/Practice Setting • Data Partnership with DPH Health Boards

16. QUESTIONS?