The Oregon State Legislature passed House Bill 4212 (2020 Special Session) sections 40-43, which requires licensees of the Oregon Medial Board to collect race, ethnicity, language, and disability (REALD) data from patients during a COVID-19 encounter.
Communities of color and disabled communities are disproportionally impacted by COVID-19. Without the collection and reporting of REALD data for COVID-19 encounters, these inequities cannot be adequately tracked and measured, and the state's response to mitigating the spread and health impacts of COVID-19 for the purpose of service provision will continue to be impaired. REALD data is a critical building block to eliminate health inequities in order to achieve full health equity and rectify the root causes related to racism, discrimination, and oppression.
REALD data collected during a COVID-19 encounter must be reported to the Oregon Health Authority (OHA) in accordance with the state's disease reporting rules. A COVID-19 encounter is an interaction between a patient, or the patient's legal representative, and a health care provider, whether that interaction is in person or through telemedicine, for the purpose of providing health care services related to COVID-19, including but not limited to ordering or performing a COVID-19 test. More information and specific requirements for disease reporting and appropriate timelines can be found in OAR 333-018-0011 and 333-018-0016, or the state's Disease Reporting website.
This standardized data collection methodology will improve the ability of the OHA, Oregon Department of Human Services, providers, and decision makers to recognize, address, target, and eliminate inequities experienced by distinct racial, cultural, and linguistic communities, and by people with disabilities. The standards for collecting REALD information can be found at OAR 943, Division 70.
Providers are not required to collect and report this data if:
- They previously collected and reported the data within the last year;
- Know that another health care provider has collected and reported the data within the last year; or
- The patient or the patient's caregiver is unable to provide answers to the questions because of incapacity.
As required in OAR 333-018-0016, health care providers must report the following to the OHA within 24 hours (including weekends and holidays):
- COVID-19 cases
- COVID-19 hospitalizations
- COVID-19 deaths
- MIS-C (multisystem inflammatory syndrome in children)
Health care providers must report all negative COVID-19 test results within one working day.
OHA will report non-compliant licensees to the Board. The Board will work to bring health care providers into compliance, but the collection and reporting of REALD information is a priority for the state and will be taken seriously.
Providers must report REALD data to OHA at the time a COVID-19 test is ordered or when reporting COVID-19 information as required in OAR 333-018-0016:
- By electronically sending CSV files in accordance with standards established by the Oregon Health Authority;
- Through online reporting at www.healthoregon.org/howtoreport; or
- By facsimile (only if online reporting is not operable);
More information and specific requirements for disease reporting and appropriate timelines can be found in OAR 333-018-0011 and 333-018-0016, or the state's Disease Reporting website.
REALD data collection phased implementation timeline:
- As of October 1, 2020
- Hospitals (excluding psychiatric hospitals)
- Health care providers within a health system
- This includes any organization that delivers health care through at least one hospital in Oregon and through other facilities, clinics, medical groups, and other entities, all under common control or ownership.
- Health care providers working in a federally qualified health center
- Beginning March 1, 2021
- Health care facilities
- Health care providers working in or with individuals in a congregate setting
- Beginning January 1, 2022
- All health care providers
REALD data plays an important role in addressing health disparities in Oregon by:
- Helping to ensure access and equity in services, processes, and outcomes;
- Providing consistency in data collection;
- Identifying inequities and determining which groups are most impacted;
- Improving client/patient/member services;
- Addressing inequities through policy and legislative efforts;
- Reallocating resources and funds needed to effectively address inequities; and
- Designing culturally appropriate and accessible interventions.
Question regarding REALD data and reporting may be directed to the OHA's Office of Equity and Inclusion, firstname.lastname@example.org.