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.
Be it enacted by the Senate and House of Representa-
tives of the United States of America in Congress assembled, 
SECTION 1. SHORT TITLE. 
This Act may be cited as the ‘‘Good Medicine Cul-
tural 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, in-
come, age, and severity of conditions are com-
parable.
(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 like-
ly 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 di-
abetes is more than twice that for whites when dif-
ferences in age are taken into account.
(9) African Americans are 30 percent more 
likely to die of heart disease than whites when dif-
ferences 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-Amer-
ican infants as whites. 
(13) Studies show that even well-meaning phy-
sicians who are not overtly biased or prejudiced typi-
cally demonstrate unconscious negative racial atti-
tudes. 
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 com-
petence education for medical and health profes-
sionals.
(2) Mandating minimum professional training 
requirements for the delivery of high-quality knowl-
edge-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 deter-
mine the appropriateness of the guidelines and pro-
tocols for use among patients of color. 
(4) Engaging the leadership of such diverse or-
ganizations as the national consortium for African-
American children to help prioritize and provide cul-
tural competence training opportunities in such 
venues as school-based and school-linked health set-
tings, working with The Council for Exceptional 
Children to address issues relating to persons with 
special needs, and collaborating with geriatric ex-
perts 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, Divi-
sion 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 as-
sess improvements in health care outcomes for mi-
nority patients as a result of cultural competence 
education. 
(7) Broadening access to culturally competent 
health education by patients, providers, and organi-
zations. 
(8) Conducting a national policy forum to in-
form legislators at the Federal, State, and local lev-
els about cultural competence programs, research 
findings, and patient care outcomes. 
(9) Facilitating improvements in the effective-
ness of provider and patient interactions and com-
munications through cross-cultural education, health 
literacy training, and information. 
(10) Creating incentives for providers who have 
documented training and expertise in cultural com-
petence.
(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 com-
petence professional training, service delivery, and 
administrative requirements. 
(13) Establishing a national cultural com-
petence ‘‘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 Com-
mission shall be appointed for the life of the Com-
mission. 
(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 Commis-
sion 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 hear-
ings, sit and act at times and places, take testimony, and 
receive evidence as the Commission considers appropriate.
(b) POWERS OF MEMBERS AND AGENTS.—Any mem-
ber or agent of the Commission may, if authorized by the 
Commission, take any action that the Commission is au-
thorized 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 en-
able it to carry out this Act. Upon request of the Commis-
sion, 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 con-
ditions 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 Com-
mission 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 non-
reimbursable basis, the administrative support services
necessary for the Commission to carry out its responsibil-
ities under this Act. 
SEC. 7. REPORT. 
Not later than 4 years after the date of the enact-
ment of this Act, the Commission shall submit to the Con-
gress and the President a report containing a detailed 
statement of the findings and conclusions of the Commis-
sion, together with such recommendations as the Commis-
sion considers appropriate. 
SEC. 8. TERMINATION. 
The Commission shall terminate 180 days after sub-
mitting its final report pursuant to section 7.
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