Cultural Competency Continuing Education Requirements for Healthcare Professionals

To advance health equity and ensure the delivery of culturally respectful and linguistically responsive health services, many states have mandated cultural competency continuing education for healthcare professionals. This article provides a comprehensive overview of cultural competency continuing education requirements, focusing on the Oregon model as an example.

The Mandate for Cultural Competency Education

Several states, including Oregon, have recognized cultural and linguistic competency as an important strategy for improving the quality of care provided to clients. The Oregon Legislature mandated cultural competency continuing education for healthcare professionals starting July 1, 2021, through House Bill No. In other states, such as Connecticut, Public Act 13-76 took effect on October 1, 2013, requiring licensed mental health providers to complete continuing education coursework in cultural competency.

Who is Required to Complete Cultural Competency Education?

In Oregon, healthcare professionals whose license is at a practicing status must meet this requirement. The only exceptions are providers in residency training and volunteer camps. This mandate extends to all initial applications, every renewal, and reactivation applications.

Defining Cultural Competence

Cultural competence encompasses a range of elements, including:

Possession of knowledge
Positive attitudes
Understanding
Self-awareness
Practice skills

These elements enable a professional person to serve clients from diverse socioethnic backgrounds effectively.

The NASW Code of Ethics emphasizes that social workers should:

Understand culture and its functions, recognizing the strengths within all cultures.
Have knowledge about their clients’ cultures and differences among cultural groups.
Seek education and understanding about the nature of social diversity and oppression for all cultural groups.

Meeting the Requirements in Oregon

Hour Requirements and Audit Periods

Providers in Oregon must complete an average of at least one hour of cultural competency education per year during an audit period. An audit period spans two renewal cycles, typically every four years for most providers. The required hours are based on the number of years licensed during the audit period; any portion of a year licensed necessitates one hour of cultural competency education. For instance, a provider licensed for 3.5 years during the audit period must obtain four hours of cultural competency education. Hours can be accumulated at any point during the audit period.

Tracking and Attestation

Providers may track their educational hours using an OMB record-keeping form. During license renewal (annually or biennially, depending on the license), providers attest to completing the required hours by checking a box and reporting the number of hours obtained.

Audits and Documentation

The OMB will conduct audits for compliance every other renewal cycle, with the first audit occurring during the Fall 2023 renewal cycle. The cultural competency audit will be included within the existing audit for CME compliance. Audited providers will be required to produce documentation of their cultural competency educational experiences.

Approved Courses and Providers

The Oregon Health Authority (OHA) maintains a list of approved cultural competency continuing education courses. Licensees are encouraged to obtain Cultural Competency CE from this approved list.

Acceptable Training Topics

The topics that qualify under the Cultural Competency requirement include, but are not limited to:

Training related to race
Ethnicity
Language diversity
Immigrant or refugee status
Religion
Sexual orientation
Disability

As stated in the NASW Standards for Cultural Competence in Social Work, "The word ‘culture’ is used because it implies the integrated pattern of human behavior that includes thoughts, communications, actions, customs, beliefs, values, and institutions of a racial, ethnic, religious, or social group. Culture often is referred to as the totality of ways being passed on from generation to generation."

Examples of Training Programs and Resources

Several organizations offer training programs and resources to help healthcare professionals meet cultural competency requirements:

Oregon Health Authority (OHA)-Approved Courses: Quality Interactions offers OHA-approved courses.
OSU College of Pharmacy: Offers a Cultural Competence and Preventing Health Disparities course.
Think Cultural Health: The US Department of Health & Human Services provides free CME credits through e-learning programs.
Centers for Disease Control and Prevention (CDC): Offers online courses in health literacy, plain language, and culture and communication.
Quality Interactions®: Provides case-based instruction on cross-cultural health care.
Critical Measures: Offers CME courses.
Substance Abuse and Mental Health Services Administration (SAMHSA): Provides publications to assist practitioners and clinicians in providing sensitive and effective mental health services to people of diverse cultural backgrounds.

Meeting Requirements in Other States

Connecticut

Under Public Act 13-76, licensed mental health providers, including LMSWs and LCSWs, who have a continuing education requirement must attain at least one hour per license year of training or education on the topic of cultural competency.

General Guidelines

Continuing education providers may state that the program meets the requirement in the program publicity. NASW/CT continuing education programs include language stating that the program meets the requirement for cultural competence along with the number of continuing education credits offered. If the provider does not include such a statement, the attendee should use the above definition as guidance.

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The requirement is at least one hour of training on cultural competency per license year. In-person, webinar, online, and home study all qualify.

Additional Resources and Tools

I Speak Card: Enables individuals with limited English proficiency (LEP) to correctly identify the language for which they need interpretation services.
EmblemHealth presentations: Provides resources for health care providers to better understand the common issues that arise while working with people of diverse populations.
Askme3®: A health literacy education program designed to improve communication between patients and health care providers, encourage patients to become more active members of their health care team, and promote improved health outcomes.

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