Health Equity Continuing Education

Substitute Senate Bill 5229

The department has commenced rulemaking to implement Engrossed Substitute Senate Bill (ESSB) 5229 (Chapter 276, laws 2021). ESSB 5229 adds a new section to chapter 43.70 RCW to require the rule-making authority for each health profession licensed under Title 18 RCW and subject to continuing education (CE) requirements to adopt rules requiring a licensee to complete health equity CE training at least once every four years. ESSB 5229 also requires the department, in consultation with health care boards and commissions, to adopt model rules establishing the minimum standards for CE programs meeting the requirements of this section.

The department will work with many partners, communities, patients with lived experience, educators, advocates, professionals, experts, and other interested parties to consider how to best adopt model rules establishing minimum standards for health equity CE programs to meet the requirements of ESSB 5229. Establishing the minimum standards and content for CE programs in rule will allow for the monitoring and enforcement of conditions that protect patient safety. The department will also consider adopting health equity CE rules for professions under the Secretary's authority. These professions will have the option to conduct separate rulemaking to add any profession-specific requirements. Boards and commissions will conduct separate rulemaking to adopt requirements that allow licensees to complete health equity CE requirements specific to each license type.

What is health equity?

For the Washington State Department of Health, 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 whether they have a disability. Equity and equality are not the same. Equality gives everyone the same resources. 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. These have always existed. The COVID-19 pandemic has highlighted the different affects that people experience. This is because of discrimination and bias in the health care system. Access to health services and health care allows all families to enjoy productive and satisfying lives. Healthier Washingtonians lead to healthier, happier families, and communities.

What has been completed so far?

On September 23, 2021, a preproposal statement of inquiry, called a CR-101, was submitted (PDF) to announce the department's intention to begin gathering input to create model rules under chapter 246-12 WAC establishing minimum standards for health equity continuing education (CE) programs for health professions licensed under Title 18 RCW to implement Engrossed Second Substitute Bill (ESSB) 5229. On August 23, 2022, proposed rule making, called a CR-102, was submitted (PDF) to announce a public hearing and take public comments on the draft rules. At this time, the CR-103 was submitted and became effective December 24, 2022.

Community collaboration

The department gathered names of community leaders, educators, advocates, persons with lived experience, health equity experts, health care professionals, and others who are willing to participate in our process and advise us as we create these continuing education requirements. The department conducted a series of listening sessions and workshops to provide an open forum for all interested parties to provide input in the development of the health equity CE model rules. The department notified interested parties and partners of the dates of the workshops via the GovDelivery communications platform. You may sign up for GovDelivery updates at the bottom of the page.

Listening sessions

Listening sessions were scheduled through the month of February 2022. The Department of Health (DOH) reached out to individuals and communities who have experienced health inequities or racism in the health care system. Advocacy groups and health care professional associations were also invited. This  was an effort to learn how people are harmed due to inequities in the health care system. We want to acknowledge its role in the health system. We want to create positive change in the health care system. Information we gather from listening sessions will be used in future rule workshops. The department recognizes that sharing experiences about this subject may be difficult. We recognize and appreciate the emotional labor that may take place. We will make an intentional effort to create a safe space for participants and staff during this process. Sharing your experience was voluntary To listen to past listening sessions and rules workshops surrounding the model rules, see Listening Sessions and Rules Workshops.

Rules workshops

Rules workshops were scheduled in March, April, and May of 2022. Information was gathered from our listening sessions used during our workshops. Workshops were where individuals, communities, and health care workers worked together to create standards for health equity continuing education trainings. Rules were drafted and reviewed collaboratively during this process.

What is next? 

We're currently developing criteria for the Health Equity Continuing Education course. We will review and determine what free courses will meet this criteria. Once free trainings have been identified, they will be posted to this webpage.

Questions or comments

Please do not hesitate to contact us with any questions, concerns, or comments at