Provides that the state board of medicine shall promulgate regulations requiring cultural competency courses in all colleges of medicine; requires all medical students and all physicians to complete cultural competency training.
BILL NUMBER: S123
TITLE OF BILL : An act to amend the education law, in relation to authorizing the state board for medicine and the commissioner of education to promulgate rules and regulations for physician training
PURPOSE OR GENERAL IDEA OF BILL : To authorize the state board for medicine together with the commissioner of education to promulgate regulations requiring cultural competency in physician training.
SUMMARY OF SPECIFIC PROVISIONS : Section 6523 of the education law, as amended by chapter 364 of the laws of 1991, states that the state board for medicine shall prescribe the following requirements for physician training, by regulation, in consultation with the commissioner: (a) The curriculum in each college of medicine in this state shall include one or more cultural competency courses which are designed to address the problem of race and gender-based disparities in medical treatment decisions and are developed in consultation with the Association of American Medical College or another nationally recognized organization which reviews medical school curricula.
JUSTIFICATION : The history of hospital care and access to health care has usually mirrored the educational, social and ethical issues confronting American society at any point in time in our history. Current advances in medical technology have increased the complexity of care, and research has shown measurable differences in access to medical procedures based on race and culture. Thus, African American patients are far less likely to undergo cardiac catherization, angioplasty and bypass graft surgery. They also undergo fewer invasive, diagnostic and therapeutic coronary procedures after myocardial infarction. Similar differences have been noted in decisions about discretionary surgery, surgical treatments for breast cancer, and prostate cancer treatment. Research also shows that African American patients with peripheral vascular disease are more likely to receive amputations than white patients, and patients suffering from sickle-cell disease, which disproportionately affects African Americans, have been misdiagnosed by health professionals as being drug addicts and denied treatment. Some of these differences can be attributed to differences in income, insurance coverage and resistance to treatment. However, even after discounting these variables, there are disparities that are clearly rooted in racial and cultural misperceptions and stereotypes. This legislation seeks to address these issues.
PRIOR LEGISLATIVE HISTORY : S.7711 of 2008 04/25/08 Referred to Higher Education
FISCAL IMPLICATIONS FOR STATE AND LOCAL GOVERNMENTS : None.
EFFECTIVE DATE : On the 90th day after it shall have become a law.
STATE OF NEW YORK ________________________________________________________________________ 123 2009-2010 Regular Sessions IN SENATE (PREFILED) January 7, 2009 ___________Introduced by Sen. SAMPSON -- read twice and ordered printed, and when printed to be committed to the Committee on Higher Education AN ACT to amend the education law, in relation to authorizing the state board for medicine and the commissioner of education to promulgate rules and regulations for physician training THE PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND ASSEM- BLY, DO ENACT AS FOLLOWS: Section 1. The legislature finds and declares that: a. The findings of a federally-funded study by Georgetown University, in conjunction with the Rand Corporation and the University of Pennsyl- vania, which were published in the New England Journal of Medicine, indicate that physicians are far less likely to refer blacks and women than white men with identical complaints of chest pain to heart special- ists for cardiac catheterization; and the authors of this study suggest that the difference in referral rates stems from racial and sexual bias- es; b. These findings are the latest in a growing body of medical litera- ture which documents race and gender-based disparities in the provision of health care, especially in the treatment of cardiovascular disease; however, according to the surgeon general of the United States, the Georgetown University study represents the best attempt to date to docu- ment the racial attitudes of physicians as a factor in the poorer health of African Americans; c. It is estimated that the minority population in the United States will have increased by 60% between 2005 and the year 2010; d. Cultural awareness and cultural competence are essential skills for providing quality health care to a diverse patient population; e. Only a small percentage of medical schools nationwide currently provide some formal training in cultural competence;EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets [ ] is old law to be omitted. LBD02053-01-9 S. 123 2
f. The Association of American Medical Colleges is working to help medical schools improve the teaching of cultural competency; and g. The public interest in providing quality health care to all segments of society dictates the need for a formal requirement that medical professionals be trained in the provision of culturally compe- tent health care as a condition of licensure to practice medicine in the state of New York. S 2. Section 6523 of the education law, as amended by chapter 364 of the laws of 1991, is amended to read as follows: S 6523. State board for medicine. 1. A state board for medicine shall be appointed by the board of regents on recommendation of the commis- sioner for the purpose of assisting the board of regents and the depart- ment on matters of professional licensing in accordance with section sixty-five hundred eight of this title. The board shall be composed of not less than twenty physicians licensed in this state for at least five years, two of whom shall be doctors of osteopathy. The board shall also consist of not less than two physician's assistants licensed to practice in this state. The participation of physician's assistant members shall be limited to matters relating to article one hundred thirty-one-B of this
[chapter]TITLE. An executive secretary to the board shall be appointed by the board of regents on recommendation of the commissioner and shall be either a physician licensed in this state or a non-physi- cian, deemed qualified by the commissioner and board of regents. 2. THE STATE BOARD FOR MEDICINE SHALL PRESCRIBE THE FOLLOWING REQUIRE- MENTS FOR PHYSICIAN TRAINING, BY REGULATION, IN CONSULTATION WITH THE COMMISSIONER: A. THE CURRICULUM IN EACH COLLEGE OF MEDICINE IN THIS STATE SHALL INCLUDE ONE OR MORE CULTURAL COMPETENCY COURSES WHICH ARE DESIGNED TO ADDRESS THE PROBLEM OF RACE AND GENDER-BASED DISPARITIES IN MEDICAL TREATMENT DECISIONS AND ARE DEVELOPED IN CONSULTATION WITH THE ASSOCI- ATION OF AMERICAN MEDICAL COLLEGES OR ANOTHER NATIONALLY RECOGNIZED ORGANIZATION WHICH REVIEWS MEDICAL SCHOOL CURRICULA. B. COMPLETION OF A CULTURAL COMPETENCY COURSE AS PROVIDED IN PARAGRAPH A OF THIS SUBDIVISION SHALL BE REQUIRED AS A CONDITION OF RECEIVING A DIPLOMA FROM A COLLEGE OF MEDICINE IN THIS STATE. C. A COLLEGE OF MEDICINE WHICH INCLUDES A CULTURAL COMPETENCY COURSE AS PROVIDED IN PARAGRAPH A OF THIS SUBDIVISION IN ITS CURRICULA SHALL OFFER FOR CONTINUING EDUCATION CREDIT, CULTURAL COMPETENCY TRAINING WHICH IS PROVIDED THROUGH ONE OR MORE COURSES, WORKSHOPS OR OTHER EDUCA- TIONAL PROGRAMS SPONSORED BY THE COLLEGE AND WHICH MEETS CRITERIA ESTAB- LISHED BY THE STATE BOARD FOR MEDICINE CONSISTENT WITH THOSE FOR COURSES DEVELOPED PURSUANT TO PARAGRAPH A OF THIS SUBDIVISION. D. A PERSON WHO RECEIVED A DIPLOMA FROM A COLLEGE OF MEDICINE IN THIS STATE PRIOR TO THE EFFECTIVE DATE OF REGULATIONS ADOPTED BY THE STATE BOARD FOR MEDICINE TO EFFECTUATE THE PURPOSES OF THIS SUBDIVISION SHALL BE REQUIRED, AS A CONDITION OF INITIAL LICENSURE BY THE STATE BOARD FOR MEDICINE TO DOCUMENT COMPLETION OF A MINIMUM OF SIXTEEN HOURS OF CULTURAL COMPETENCY TRAINING WHICH IS OFFERED PURSUANT TO PARAGRAPH C OF THIS SUBDIVISION TO THE SATISFACTION OF THE STATE BOARD FOR MEDICINE. E. A PHYSICIAN LICENSED TO PRACTICE MEDICINE IN THIS STATE SHALL BE REQUIRED, AS A CONDITION OF RELICENSURE, TO DOCUMENT COMPLETION OF A MINIMUM OF SIXTEEN HOURS OF CULTURAL COMPETENCY TRAINING WHICH IS OFFERED PURSUANT TO PARAGRAPH C OF THIS SUBDIVISION TO THE SATISFACTION OF THE STATE BOARD FOR MEDICINE NO LATER THAN THREE YEARS AFTER THE EFFECTIVE DATE OF THIS SUBDIVISION.S. 123 3
F. THE STATE BOARD FOR MEDICINE MAY WAIVE THE REQUIREMENTS OF PARA- GRAPH D OR E OF THIS SUBDIVISION IF AN APPLICANT FOR LICENSURE OR RELI- CENSURE, AS APPLICABLE, DEMONSTRATES TO THE SATISFACTION OF THE STATE BOARD FOR MEDICINE THAT THE APPLICANT HAS ATTAINED THE SUBSTANTIAL EQUIVALENT OF THIS REQUIREMENT THROUGH COMPLETION OF A SIMILAR COURSE IN HIS OR HER POST-SECONDARY EDUCATION WHICH MEETS CRITERIA ESTABLISHED BY REGULATION OF THE STATE BOARD FOR MEDICINE. S 3. This act shall take effect on the ninetieth day after it shall have become a law.