Substitute Senate Bill 5229
The Department of Health (DOH) has implemented Engrossed Substitute Senate Bill (ESSB) 5229 (chapter 276, laws 2021). ESSB 5229 requires that health care professionals credentialed under Title 18 RCW, and subject to continuing education requirements, complete health equity continuing education training. This training must be taken at least once every four years. The department, in consultation with health profession boards and commissions, was required to adopt model rules. These model rules, found in WACs 246-12-800 through 830, establish the minimum standards for health equity continuing education training courses. Health care profession boards and commissions may adopt rules that exceed the minimum standards.
Model Rules
WAC 246-12-820 requires that health care professionals must complete a minimum of two hours in health equity continuing education training at least once every four years, unless the relevant rule making authority (board or commission) specifies a higher number of hours in rule. If you are credentialed in one of these professions that require continuing education, you must meet these requirements. Specific requirements for your profession can be found through your profession’s continuing education rules.
What is Health Equity?
For the DOH, health equity exists when all people can attain their full health potential. That means people aren't disadvantaged from achieving this potential because of the color of their skin, ancestry, level of education, gender identity, sexual orientation, age, religion, socioeconomic status, the job they have, the neighborhood they live in, or their disability status.
Equity and equality are not the same; equality gives everyone the same resources while equity gives people the resources they need. With equity, everyone has the same opportunities as others. Research shows that inequities are part of the health care system and have always existed.
The COVID-19 pandemic has highlighted the various impacts of health inequity that communities experienced due to structural discrimination and bias in the health care system. Access to health services and health care allows all people to enjoy productive and satisfying lives, and healthier Washingtonians lead to healthier, happier communities.
Community Collaboration
During the development of the model rules, the DOH reached out to community leaders, educators, advocates, persons with lived experience, health equity experts, health care professionals, and others. We engaged those who were willing to participate and advise us as we created continuing education minimum requirements. We held a series of listening sessions and workshops to provide an open forum for all interested parties. The community provided input in the development of health equity continuing education training model rules.
In addition to this outreach, we notified the community through the GovDelivery communications platform and held numerous rules workshops. If you would like to be involved in future projects, you may sign up for GovDelivery updates at the bottom of the page.
Course Requirements
The minimum standards for health equity continuing education training are in WAC 246-12-830 as well as RCW 43.70.613. Trainers for these courses have demonstrated knowledge and experience related to health equity, and research referenced in the training is based on current empirical research and known best practices. These trainings must include:
- Implicit bias training to identify strategies to reduce bias during assessment and diagnosis, and may include, but is not limited to at least one of the topics included in RCW 43.70.613 such as training in bias, racism, and poverty, that manifest as health inequities.
- Development of individual and system level interventions and self-reflection to assess how the licensee’s social position can influence their relationship with patients and their communities.
- Skills to enable a health care professional to care effectively for patients from diverse cultures, groups, and communities.
- Assessing the health care professional’s ability to apply health equity concepts into practice.
To learn more about the statutory requirements as well as the model rules, we encourage you to read RCW 43.70.613 and WAC 246-12 (specifically, Part 15 which is dedicated to continuing education health equity).
Please note: Certain health care professions may require more frequent training, more hours of training, or training with additional content. If you are credentialed in one or more of these professions, you will be required to meet those requirements, which can be found through that profession’s continuing education rules.
Free Trainings
These training courses are provided for free by the listed provider and meet the model rules’ minimum health equity continuing education training requirements. These courses may be designed for a specific profession or focus on a specific community. Your profession may require additional training related to health equity continuing education. Please refer to your specific profession’s rules for more information on requirements.
Training name | Provider | Length | Modality
(Listed trainings are in alphabetical order)
- Improving Cultural Competency for Behavioral Health Professionals | US Dept. of Health and Human Service | Four Sessions for 4 – 5.5 hours | Online
- Racism, Bias, and Other Determinants of Health: Issues and Actions |Region IV Public Health Training Center | Two Modules for 90mins (will need to take an additional course to meet hour requirements) | Online
- Washington Implicit Bias in Healthcare | Online Self Study | Two hours of CE | Develop skill to address the structural factors, such as bias, racism, and poverty, that manifest as health inequities, including individual-level and system-level intervention, and self-reflection. Identify the phenomenon of implicit bias and its impact on health equity. Recognize the historical and contemporary exclusion of minority communities in health care. Analyze ways in which to improve communication across different cultural, racial, gender and religious identities, among others. Recall individual and system level interventions and self-reflection to assess how the licensee’s social position can influence their relationship with patients and their communities.
Documentation of Trainings
It is the professional’s responsibility to maintain their certificates demonstrating completion of trainings that adhere to WAC 246-12-830. Upon renewal of your license, you may be asked to provide verification of your health equity training. At that time, you would provide your certificate of completion. Please do not mail certificates of completion to the Department of Health as we do not have a method of saving training certificates until your renewal date.
Other Educational Opportunities (May require clarification from your profession's board, commission, or committee).
These require watching a video. Individuals that watch these videos will not receive a certificate, assessment, or document at the end. Please refer to your specific profession’s continuing education rules for more information on requirements and if these will count for fulfilling the health equity continuing education training requirement. Attending or writing a paper about the content may be sufficient in and of itself, but please verify this with your profession's rules prior to assuming this to be the case.
Training name | Provider | Length | Modality
(Listed trainings are in alphabetical order)
- Tribal Sovereignty and the Indian Health Care System | American Indian/Alaska Native Providers | 5 Modules for 5 hours | Webinar Videos
- Who We Are: A Chronicle of Racism in American | Documentary by Jeffrey Robinson | 2 hours | Video
Contact Us
Contact us with any questions, concerns, or comments regarding the identification of health equity training programs that meet the model rules’ minimum health equity continuing education requirements. If you have any questions regarding these requirements for a specific health care profession, please reach out to that profession. If you do not know who to contact, we can help direct you to the correct program.
The Department of Health will review training offerings annually and potentially update our list with new additions at that time. If you’re interested in submitting a training that fulfills the requirements as established in WAC 246-12-830, please email our team.