I 

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.

1 Be it enacted by the Senate and House of Representa2 tives of the United States of America in Congress assembled,

3 SECTION 1. SHORT TITLE. 

4 This Act may be cited as the ‘‘Good Medicine Cul5 tural Competence Act of 2003’’. 

6 SEC. 2. FINDINGS. 

7 The Congress finds as follows: 

8 (1) Racial and ethnic minorities receive lower9 quality health care, even when insurance status, in10 come, age, and severity of conditions are com11 parable. 
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1 (2) In overall health, at each stage of life until 

2 age 44, African Americans, Latinos, and Native 

3 Americans have, on average, higher mortality rates 

4 than whites. 

5 (3) The Department of Health and Human 

6 Services found at least 6 areas in which racial and 

7 ethnic minorities experience serious disparities in 

8 health access outcomes: infant mortality, cancer 

9 screening and management, cardiovascular disease, 

10 diabetes, HIV/AIDS infection, and immunizations. 

11 (4) African-American children are twice as like12 ly to have asthma and 6 times as likely to die from 

13 asthma as white children. 

14 (5) Asthma hospitalization rates are higher in 

15 urban, low-income, and minority communities. 

16 (6) African Americans are 30 percent more 

17 likely to die of cancer than whites when differences 

18 in age are taken into account. 

19 (7) African-American women are at greater risk 

20 for being diagnosed with more advanced forms of 

21 breast cancer. 

22 (8) The African-American death rate due to di23 abetes is more than twice that for whites when dif24 ferences in age are taken into account. 
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1 (9) African Americans are 30 percent more 

2 likely to die of heart disease than whites when dif3 ferences in age are taken into account. 

4 (10) Of the AIDS cases reported in 2000, 47 

5 percent involved African Americans. 

6 (11) The annual AIDS case rate is 4 times 

7 higher for Latinos than for whites. 

8 (12) Infant mortality rates, one of the most 

9 sensitive indicators of the health and well-being of a 

10 population, are twice as high among African-Amer11 ican infants as whites. 

12 (13) Studies show that even well-meaning phy13 sicians who are not overtly biased or prejudiced typi14 cally demonstrate unconscious negative racial atti15 tudes. 

16 SEC. 3. ESTABLISHMENT. 

17 There is established a commission to be known as the 

18 Cultural Competence Commission (in this Act referred to 

19 as the ‘‘Commission’’). 

20 SEC. 4. DUTIES. 

21 The Commission shall conduct a study and, under 

22 section 7, submit a report on the following: 

23 (1) Establishing standards in cultural com24 petence education for medical and health profes25 sionals. 
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1 (2) Mandating minimum professional training 

2 requirements for the delivery of high-quality knowl3 edge-based patient care, and mandating annual 

4 hearings on the status of patient care for minority 

5 and low-income patients. 

6 (3) Collaborating with the Agency for 

7 Healthcare Research and Quality and the American 

8 Hospital Association to ensure that the review and 

9 assessment process for updating clinical guidelines 

10 and protocols incorporates a mechanism to deter11 mine the appropriateness of the guidelines and pro12 tocols for use among patients of color. 

13 (4) Engaging the leadership of such diverse or14 ganizations as the national consortium for African15 American children to help prioritize and provide cul16 tural competence training opportunities in such 

17 venues as school-based and school-linked health set18 tings, working with The Council for Exceptional 

19 Children to address issues relating to persons with 

20 special needs, and collaborating with geriatric ex21 perts to improve access to culturally competent care 

22 for seniors in long-term care facilities. 

23 (5) Working with diverse organizations such as 

24 the Asian and Pacific Islander American Health 

25 Forum, the National Alliance for Hispanic Health, 
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1 the Johns Hopkins University Institute of Urban 

2 Health, and the Utah Department of Health, Divi3 sion of Health Systems Improvement Primary Care 

4 Rural and Ethnic Health, to address the needs of 

5 vulnerable populations served by community and 

6 tribal health centers. 

7 (6) Increasing outcomes-based research to as8 sess improvements in health care outcomes for mi9 nority patients as a result of cultural competence 

10 education. 

11 (7) Broadening access to culturally competent 

12 health education by patients, providers, and organi13 zations. 

14 (8) Conducting a national policy forum to in15 form legislators at the Federal, State, and local lev16 els about cultural competence programs, research 

17 findings, and patient care outcomes. 

18 (9) Facilitating improvements in the effective19 ness of provider and patient interactions and com20 munications through cross-cultural education, health 

21 literacy training, and information. 

22 (10) Creating incentives for providers who have 

23 documented training and expertise in cultural com24 petence. 
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1 (11) Collaborating with the National Board of 

2 Medical Examiners, the Joint Commission on the 

3 Accreditation of Health Care Organizations, and 

4 other professional licensing boards and accrediting 

5 bodies to devise and monitor a method for assessing 

6 provider attitudes, knowledge, and skills in culturally 

7 competent health care. 

8 (12) Developing and enforcing mechanisms to 

9 ensure organizational compliance with cultural com10 petence professional training, service delivery, and 

11 administrative requirements. 

12 (13) Establishing a national cultural com13 petence ‘‘think tank’’ comprised of expert advisers 

14 known in the areas of research, advocacy, education, 

15 public health policy, and human services. 

16 SEC. 5. MEMBERSHIP. 

17 (a) NUMBER AND APPOINTMENT.—The Commission 

18 shall be composed of 17 members appointed as follows: 

19 (1) 4 members appointed by the Speaker of the 

20 House of Representatives. 

21 (2) 4 members appointed by the minority leader 

22 of the House of Representatives. 

23 (3) 4 members appointed by the majority leader 

24 of the Senate. 
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1 (4) 4 members appointed by the minority leader 

2 of the Senate. 

3 (5) 1 member appointed by the President. 

4 (b) TERMS.—

5 (1) IN GENERAL.—Each member of the Com6 mission shall be appointed for the life of the Com7 mission. 

8 (2) VACANCIES.—A vacancy in the Commission 

9 shall be filled in the manner in which the original 

10 appointment was made. 

11 (c) BASIC PAY.—Members of the Commission shall 

12 serve without pay. 

13 (d) TRAVEL EXPENSES.—Each member shall receive 

14 travel expenses, including per diem in lieu of subsistence, 

15 in accordance with applicable provisions under subchapter 

16 I of chapter 57 of title 5, United States Code. 

17 (e) CHAIRPERSON.—The Chairperson of the Commis18 sion shall be elected by the Commission from among its 

19 members. 

20 SEC. 6. POWERS OF COMMISSION. 

21 (a) HEARINGS AND SESSIONS.—The Commission 

22 may, for the purpose of carrying out this Act, hold hear23 ings, sit and act at times and places, take testimony, and 

24 receive evidence as the Commission considers appropriate. 
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1 (b) POWERS OF MEMBERS AND AGENTS.—Any mem2 ber or agent of the Commission may, if authorized by the 

3 Commission, take any action that the Commission is au4 thorized to take by this section. 

5 (c) OBTAINING OFFICIAL DATA.—Notwithstanding 

6 sections 552 and 552a of title 5, United States Code, the 

7 Commission may secure directly from any department or 

8 agency of the United States information necessary to en9 able it to carry out this Act. Upon request of the Commis10 sion, the head of that department or agency shall furnish 

11 that information to the Commission. 

12 (d) MAILS.—The Commission may use the United 

13 States mails in the same manner and under the same con14 ditions as other departments and agencies of the United 

15 States. 

16 (e) STAFF OF FEDERAL AGENCIES.—Upon request 

17 of the Commission, the head of any Federal department 

18 or agency may detail, on a nonreimbursable basis, any of 

19 the personnel of that department or agency to the Com20 mission to assist it in carrying out its duties under this 

21 Act. 

22 (f) ADMINISTRATIVE SUPPORT SERVICES.—Upon the 

23 request of the Commission, the Administrator of General 

24 Services may provide to the Commission, on a non25 reimbursable basis, the administrative support services 
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1 necessary for the Commission to carry out its responsibil2 ities under this Act. 

3 SEC. 7. REPORT. 

4 Not later than 4 years after the date of the enact5 ment of this Act, the Commission shall submit to the Con6 gress and the President a report containing a detailed 

7 statement of the findings and conclusions of the Commis8 sion, together with such recommendations as the Commis9 sion considers appropriate. 

10 SEC. 8. TERMINATION. 

11 The Commission shall terminate 180 days after sub12 mitting its final report pursuant to section 7.

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