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Using REALD and SOGI to identify and address health inequities

Honoring the diversity of people living in Oregon

To advance health equity, the Oregon Health Authority (OHA) established a strategic goal to eliminate health inequities by 2030. A critical component to meeting this goal is ensuring meaningful access to services for everyone in Oregon, regardless of:

  • Their race, ethnicity, language or disability (REALD); or
  • Their sexual orientation or gender identity (SOGI).

REALD and SOGI both help to reveal the diversity of the people living in Oregon. This helps us:

  • Identify and address health disparities, and
  • Support data justice in communities most affected by health disparities.

What is data justice?

Data justice supports communities using data to elevate their voice and reveal the systemic inequities they experience. 

  • As noted in the following overview developed in partnership with the Coalition of Communities of Color, communities perform data justice, not governments. 
  • However, governments can support data justice by making changes that recognize and value community-led approaches to data. 

Learn more in the data justice overview (March 2022)

For OHA, REALD and SOGI are two changes that support data justice, with a focus on data equity. This requires the understanding that data are not neutral or objective; instead, they are the products of unequal social relations. This context is essential for conducting accurate, ethical analysis (D'ignazio and Klein, 2020). 

What is REALD?

REALD is an effort to increase and standardize race, ethnicity, language, and disability data collection across the Oregon Department of Human Services (ODHS) and OHA.

Learn more about REALD

What is SOGI?

SOGI is an effort to increase and standardize sexual orientation and gender identity data collection across ODHS and OHA. OHA has drafted recommendations with proposed questions to use when collecting SOGI data. 

Review OHA's draft SOGI data recommendations

House Bill 3159 implementation

In 2021, the Oregon Legislature passed House Bill 3159. This law requires OHA to:

  • Add SOGI questions to the current data collection standards in OHA Oregon Administrative Rules,
  • Build a data collection system for both REALD and SOGI, 
  • Develop and implement reporting requirements (including rulemaking) for provider and health plan reporting, and
  • Create a grant program to help community partners and community-based organizations serving underrepresented populations report this data.

In early 2023, OHA will form a Rules Advisory Committee to advise on the rule changes to incorporate SOGI data collection standards. Please visit the OEI Rulemaking page to keep informed when RACs are scheduled.

HB 3159 directs OHA to create a robust, secure, and efficient system of data collection, storage and reporting for REALD and SOGI data to support OHA’s vision of eliminating health inequities by 2030. 

OHA plans to have this new system active no sooner than late 2024. 

Once this system is active:

  • Providers and insurers will need to submit REALD and SOGI data at least annually regardless of type of encounter.
  • Providers and health plans will be able to query the registry for information on their patients.
  • Patients will also be able to add and update information in the registry directly.
  1. Staffing ​REALD and SOGI Team (Nov. 2021 – Sep. 2022)
  2. SOGI Learning Collaborative (Sep.-Dec. 2022)
  3. Updating REALD Oregon Administrative Rules to include SOGI (Aug. – Oct. 2022)
  4. Planning for REALD and SOGI data collection system, including design of the eventual HB 3159 data registry (front end) and repository (back end) (2022-2023). 
  5. Future Rules Advisory Committees for HB 3159 specific to the registry and how providers need to submit the data (TBD, likely late 2023/early 2024).
  6. Building and pilot of ​the HB 3159 registry (front end) and repository (back end) (2026).

​OHA must establish a data system (Registry) for collecting REALD and SOGI data. The registry must allow:

  • All users to submit data at least annually (every 365 days) for any type of encounter (not limited to COVID-19 encounters).
  • Patients/members/clients to directly submit data.
  • ​Providers, insurers and CCOs to electronically submit data , query the registry to determine if data is current, and report to OHA that a patient/client/member refused to answer the REALD+SOGI questions.

​Under HB 3159 OHA is required to establish rules for:

  • Collecting, transmitting and reporting the data.
  • The timelines for collection and submission of data.
  • The criteria for extensions of timelines and a process for reviewing requests for extensions.
  • The criteria for exempting certain health care providers or classes of health care providers from REALD+SOGI collection and reporting requirements and a process for reviewing requests for exemptions.
  • Allowing data to be submitted in paper or electronic form.
  • Requiring CCOs, providers and insurers to inform patients/client/members how the data will be used and how it cannot be used; and that they are not required to answer.
  • Provider incentives to help defer implementation costs.   

HB 3159 also directs that:

  • REALD+SOGI data be considered confidential and only released publicly in the aggregate.
  • OHA monitor compliance. 
    • OHA can but is not required to impose civil penalties.
    • OHA can't impose any penalties or enforce the provisions of HB 3159 until the Registry and a process for submitting the data are established.






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December 2021