The Vermont Statutes Online

Title 18: Health

Chapter 006: Health Equity

• §§ 251-255. Recodified. 1999, No. 62, § 123e

• § 251. Definitions

  As used in this chapter:

  (1) “Cultural competency” means a set of integrated attitudes, knowledge, and skills that enables a health care professional to care effectively for patients from cultures, groups, and communities other than that of the health care professional. At a minimum, cultural competency should include the following:

  (A) awareness and acknowledgement of the health care professional’s own culture;

  (B) utilization of cultural information to establish therapeutic relationships;

  (C) eliciting and incorporating pertinent cultural data in diagnosis and treatment;

  (D) understanding and applying cultural and ethnic data to the process of clinical care; and

  (E) the ability to recognize the importance of communication, language fluency, and interpretation in the provision of health care services and assist with access to interpretation and appropriate communication services.

  (2) “Cultural humility” means the ability to maintain an interpersonal stance that is other-oriented, or open to the other, in relation to aspects of cultural identity that are most important to the client or patient.

  (3) “Health disparity” means differences that exist among specific population groups in the United States in attaining individuals’ full health potential that can be measured by differences in incidence, prevalence, mortality, burden of disease, and other adverse health conditions.

  (4) “Health equity” means all people have a fair and just opportunity to be healthy, especially those who have experienced socioeconomic disadvantage, historical injustice, and other avoidable systemic inequalities that are often associated with the social categories of race, gender, ethnicity, social position, sexual orientation, and disability.

  (5) “Health equity data” means demographic data, including race, ethnicity, primary language, age, gender, socioeconomic position, sexual orientation, disability, homelessness, or geographic data that can be used to track health equity.

  (6) “LGBTQ” means Vermonters who identify as lesbian, gay, bisexual, transgender, queer, or questioning.

  (7) “Non-White” means Black, Indigenous, and Persons of Color. It is not intended to reflect self-identity, but rather how people are categorized in the racial system on which discrimination has been historically based in the United States and how Vermont typically disaggregates data solely by White and non-White.

  (8) “Race and ethnicity” mean the categories for classifying individuals that have been created by prevailing social perceptions, historical policies, and practices. Race and ethnicity include how individuals perceive themselves and how individuals are perceived by others.

  (9) “Social determinants of health” are the conditions in the environments where people are born, live, learn, work, play, worship, and age, such as poverty, income and wealth inequality, racism, and sex discrimination, that affect a wide range of health, functioning, and quality-of-life outcomes and risks. They can be grouped into five domains: economic stability, education access and quality, health care access and quality, neighborhood and built environment, and social and community context. Social determinants of health are systematic, interconnected, cumulative, and intergenerational conditions that are associated with lower capacity to fully participate in society. (Added 2021, No. 33, § 3; amended 2021, No. 105 (Adj. Sess.), § 346, eff. July 1, 2022.)

• § 252. Health Equity Advisory Commission

  (a) Creation. There is created the Health Equity Advisory Commission to promote health equity and eradicate health disparities among Vermonters, including particularly those who are Black, Indigenous, and Persons of Color; individuals who are LGBTQ; and individuals with disabilities. The Advisory Commission shall amplify the voices of impacted communities regarding decisions made by the State that impact health equity, whether in the provision of health care services or as the result of social determinants of health. The Advisory Commission shall also provide strategic guidance on the development of the Office of Health Equity, including recommendations on the structure, responsibilities, and jurisdiction of such an office.

  (b) Membership.

  (1) The Advisory Commission shall be composed of the following members:

  (A) the Executive Director of Racial Equity established pursuant to 3 V.S.A. § 5001 or designee;

  (B) the Commissioner of Health or designee;

  (C) the Commissioner of Mental Health or designee;

  (D) the Commissioner of Disabilities, Aging, and Independent Living or designee;

  (E) the Commissioner of Vermont Health Access or designee;

  (F) the Commissioner for Children and Families or designee;

  (G) the Commissioner of Housing and Community Development or designee;

  (H) the Commissioner of Economic Development or designee;

  (I) the Chief Performance Officer or designee;

  (J) the Chief Prevention Officer or designee;

  (K) a member, appointed by the Racial Justice Alliance;

  (L) a member, appointed by the Rutland Area NAACP;

  (M) a member, appointed by the Association of Africans Living in Vermont;

  (N) a member, appointed by the Windham County Vermont NAACP;

  (O) a member, appointed by the Pride Center of Vermont;

  (P) a member, appointed by Outright Vermont;

  (Q) a member, appointed by Migrant Justice;

  (R) a member, appointed by Out in the Open;

  (S) a member, appointed by Another Way Community Center;

  (T) a member, appointed by Vermont Psychiatric Survivors;

  (U) a member, appointed by the Vermont Center for Independent Living;

  (V) a member, appointed by the Elnu Abenaki Tribe;

  (W) a member, appointed by the Nulhegan Abenaki Tribe;

  (X) a member, appointed by the Koasek Traditional Nation of Missiquoi;

  (Y) a member, appointed by the Abenaki Nation of Missiquoi;

  (Z) a member, appointed by the Vermont Commission on Native American Affairs;

  (AA) a member, appointed by Green Mountain Self-Advocates;

  (BB) a member, appointed by the Vermont Developmental Disabilities Council;

  (CC) a member, appointed by Vermont Federation of Families for Children’s Mental Health; and

  (DD) any other members at large that the Advisory Commission deems necessary to appoint to carry out the functions of this section, including ensuring equitable representation and a balance between impacted communities, and that health care provider perspectives are represented, based on a majority vote of the members.

  (2) The term of office of each appointed member shall be three years, with the exception that members at large shall each have a term of one year. Of the members first appointed, who are not designated as at-large members, 10 shall be appointed for a term of one year, 10 shall be appointed for a term of two years, and nine shall be appointed for a term of three years. Members shall hold office for the term of their appointments and until their successors have been appointed. All vacancies shall be filled for the balance of the unexpired term in the same manner as the original appointment. Members are eligible for reappointment.

  (c) Powers and duties. The Advisory Commission shall:

  (1) provide guidance on the development of the Office of Health Equity, which shall be established based on the Advisory Commission’s recommendations not later than January 1, 2023, including on:

  (A) the structure, responsibilities, and jurisdiction of the Office;

  (B) whether the Office shall be independent and, if not, in which State agency or department it shall be situated;

  (C) how the Office shall be staffed;

  (D) the populations served and specific issues addressed by the Office;

  (E) the duties of the Office, including how grant funds shall be managed and distributed; and

  (F) the time frame and necessary steps to establish the Office;

  (2) provide advice and make recommendations to the Office of Health Equity once established, including input on:

  (A) any rules or policies proposed by the Office;

  (B) the awarding of grants and the development of programs and services;

  (C) the needs, priorities, programs, and policies relating to the health of individuals who are Black, Indigenous, and Persons of Color; individuals who are LGBTQ; and individuals with disabilities; and

  (D) any other issue on which the Office of Health Equity requests assistance from the Advisory Commission;

  (3) review, monitor, and advise all State agencies regarding the impact of current and emerging State policies, procedures, practices, laws, and rules on the health of individuals who are Black, Indigenous, and Persons of Color; individuals who are LGBTQ; and individuals with disabilities;

  (4) identify and examine the limitations and problems associated with existing laws, rules, programs, and services related to the health status of individuals who are Black, Indigenous, and Persons of Color; individuals who are LGBTQ; and individuals with disabilities;

  (5) advise the Department of Health and General Assembly on any funding decisions relating to eliminating health disparities and promoting health equity, including the distribution of federal monies related to COVID-19;

  (6) to the extent funds are available for the purpose, distribute grants that stimulate the development of community-based and neighborhood-based projects that will improve the health outcomes of individuals who are Black, Indigenous, and Persons of Color; individuals who are LGBTQ; and individuals with disabilities; and

  (7) advise the General Assembly on efforts to improve cultural competency, cultural humility, and antiracism in the health care system through training and continuing education requirements for health care providers and other clinical professionals.

  (d) Assistance. The Advisory Commission shall have the administrative, legal, and technical assistance of the Agency of Administration at the request of the Executive Director of Racial Equity.

  (e) Report. Annually, on or before January 15, the Advisory Commission shall submit a written report to the Senate Committee on Health and Welfare and to the House Committees on Health Care and on Human Services with its findings and any recommendations for legislative action. The Advisory Commission is encouraged to base recommendations on the data collected and analysis completed pursuant to section 253 of this title.

  (f) Meetings.

  (1) The Executive Director of Racial Equity or designee shall call the first meeting of the Advisory Commission to occur on or before September 1, 2021.

  (2) The Advisory Commission shall select a chair and vice chair at its first meeting and annually thereafter.

  (3) The Advisory Commission shall adopt procedures to govern its proceedings, including voting procedures and how the staggered terms shall be apportioned among members.

  (4) All meetings of the Advisory Commission and any subcommittees of the Advisory Commission shall be open to the public with opportunities for public comment provided on a regular basis.

  (g) Acceptance of grants and other contributions. The Advisory Commission may accept from any governmental department or agency, public or private body, or any other source grants or contributions to be used in carrying out its responsibilities under this chapter.

  (h) Compensation and reimbursement. Appointed members of the Advisory Commission shall be entitled to per diem compensation and reimbursement of expenses as permitted under 32 V.S.A. § 1010 for meetings as deemed appropriate by the Advisory Commission within the appropriation provided. These payments shall be made from monies appropriated to the Agency of Administration. (Added 2021, No. 33, § 3.)

• § 253. Data responsive to health equity inquiries

  (a) Each State agency, department, board, or commission that collects health-related, individual data shall include in its data collection health equity data disaggregated by race, ethnicity, gender identity, age, primary language, socioeconomic status, disability, and sexual orientation. Data related to race and ethnicity shall use separate collection categories and tabulations, disaggregated beyond non-White and White, in accordance with the recommendation made by the Executive Director of Racial Equity, in consultation with the Advisory Commission.

  (b)(1) The Department of Health shall systematically analyze such health equity data using the smallest appropriate units of analysis feasible to detect racial and ethnic disparities, as well as disparities along the lines of primary language, sex, disability status, sexual orientation, gender identity, and socioeconomic status, and report the results of such analysis on the Department’s website periodically, but not less than biannually. The Department’s analysis shall be used to measure over time the impact of actions taken to reduce health disparities in Vermont. The data informing the Department’s analysis shall be made available to the public in accordance with State and federal law.

  (2) Annually, on or before January 15, the Department shall submit a report containing the results of the analysis conducted pursuant to subdivision (1) of this subsection to the Senate Committee on Health and Welfare and to the House Committees on Health Care and on Human Services. (Added 2021, No. 33, § 3.)