Oregon Health Policy Board - Health Equity Committee Charter
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Health Equity Committee
Charter & Committee
Operations
2023
Oregon Health Policy Board - Health Equity Committee Charter
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Table of Contents
SECTION 1: Introduction
I. Authority and Committee Charge ................................................................................... 4
II. Problem Statement ........................................................................................................ 4
III. Committee Organizational Location and Relationship ..................................................... 5
IV. Health Equity Definition ................................................................................................. 6
V. Tribal Health Equity Statement....................................................................................... 6
SECTION 2: Mission, Vision, Values, & Scope of Work
VI. Mission and Vision ......................................................................................................... 7
VII. Values ............................................................................................................................ 7
VIII. Committee Scope & Deliverables .................................................................................... 8
IX. Health Equity Priority Populations .................................................................................. 9
X. Review, Reporting, & Evaluation .................................................................................. 10
SECTION 3: Committee Personnel
XI. Committee Membership .............................................................................................. 11
1. Composition ........................................................................................................................ 11
2. Recruitment ......................................................................................................................... 11
3. Appointment ....................................................................................................................... 12
4. Term lengths ........................................................................................................................ 12
5. Member transitions ............................................................................................................. 12
6. Replacement ....................................................................................................................... 12
7. Onboarding & Training ......................................................................................................... 12
8. Conflicts of interest .............................................................................................................. 12
9. Public officials ...................................................................................................................... 13
10. Compensation .................................................................................................................. 14
XII. Committee Duties and Roles ........................................................................................ 14
1. HEC Community Agreements ................................................................................................ 14
2. HEC Group Practices ............................................................................................................. 15
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3. Role of committee co-chairs ................................................................................................. 16
4. Ad Hoc workgroups .............................................................................................................. 17
5. Role of OHA Equity and Inclusion Division (E&I) .................................................................... 18
SECTION 4: Committee Operations
XIII. Committee Meetings and Decision-Making .................................................................. 19
1. Meeting frequency and format ............................................................................................. 19
2. Public status of committee meetings and records ................................................................. 20
3. Meeting documentation ...................................................................................................... 21
4. Decision-making .................................................................................................................. 21
XIV. Communications .......................................................................................................... 22
1. Committee communications ................................................................................................ 22
2. Media .................................................................................................................................. 22
3. Lobbyists ............................................................................................................................. 23
Appendix I: Definitions
XV. Key Definitions and Tools ............................................................................................. 24
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SECTION 1: Introduction
I. Authority and Committee Charge
Achieving health equity, including a healthcare workforce that reflects the demographics of the
communities it serves, is a priority for the Oregon Health Policy Board (OHPB), the Oregon Health
Authority (OHA), and the Governor. The purpose of the Health Equity Committee (HEC) is to
coordinate and develop health policy that proactively promotes and facilitates the elimination of
health inequities and the achievement of health equity for all people in Oregon and leading
efforts to develop best-practice policies which improve health equity. In 2017, the OHPB
established the HEC with the intention to simultaneously embed the principles of equity
throughout all policies while also using the Committee to provide enhanced attention to specific
needs and decisions. The OHPB is a nine-member citizen board which oversees the OHA,
develops and guides implementation of health care policy, and is committed to providing access
to quality, affordable health care for all Oregonians and improving population health. The OHPB
has significant influence in establishing regulatory guidance, payment policies and incentives,
performance measures and accountability, and other policies for Oregon’s health system through
its own actions and actions by its committees.
II. Problem Statement
Persistent and pervasive health inequities cause significant harm to many of those living in
Oregon, but especially to People of Color
1
, Oregon’s nine federally recognized tribes, immigrant
and refugee populations, people with disabilities, and members of the LGBTQIA2S+ community.
In recognition of these adverse health impacts, Oregon recently declared racism a public health
crisis
2
. To meet the Oregon Health Authority’s goal of eliminating health inequities by 2030,
policies and initiatives need to recognize, reconcile, and rectify past injustices while honoring the
resilience of communities that have been both harmed by and excluded from power structures.
Health inequities exist and persist on historical, structural, cultural, and interpersonal levels. HEC
acknowledges historic and contemporary racial injustice and colonialism, including the white
supremacist history of Oregon: in its explicitly exclusionary and violent constitution
3
; in the theft
of land from Indigenous communities; the use of stolen labor and the laws that have perpetuated
unjust outcomes among communities of color and tribal communities.
1
Racial and ethnic minority and minoritized groups inclusive of Asian Americans and Pacific Islanders, Black /
African Americans, Latinxs, and Native Americans
2
See House Resolution 6-2021
3
State of Oregon Diversity, Equity, and Inclusion Plan: A Roadmap to Racial Equity and Belonging, August 2021,
https://www.oregon.gov/das/Docs/DEI_Action_Plan_2021.pdf, p.6
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Historical and current institutional and individualized acts of racism and colonization have
created disadvantages for communities that are real, unjust and unacceptable. Until populations
and communities most harmed by long standing social injustice and inequities share decision-
making authority in our state, systems will favor the dominant culture, reinforcing institutional
bias and contributing to health inequities and unjust, unfair and avoidable inequities in health
outcomes. HEC commits to playing its role in eradicating racial injustice.
III. Committee Organizational Location and Relationship
At the beginning of 2023, there were eleven committees of the OHPB. The OHPB and its
committees are staffed and supported by a number of OHA Divisions, including the Health
Policy and Analytics Division, the Public Health Division, and the Division of Equity & Inclusion.
The HEC is specifically staffed and supported by OHA’s Equity and Inclusion Division. See the
figure below for a visual representation.
Figure 1: A visual representation of the Oregon Health Policy Board and its 11 committees. All
committees report to OHPB, and also engage with and support each other.
The HEC is charged, in collaboration with other OHPB committees, with reporting and making
recommendations regarding OHPB committee health equity policy development and goal
setting. OHPB will consult with the HEC on an ongoing basis and involve the committee in
regular discussion. The HEC is tasked with reporting to the board through quarterly activity
reports and at OHPB’s annual retreat. The HEC will convene yearly joint meetings with OHPB
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and its committees to review and develop health equity goals and make health equity
recommendations to OHPB.
IV. Health Equity Definition
In 2019, OHA adopted health equity as one of its core values and committed to its strategic goal
of eliminating health inequities by 2030.
V. Tribal Health Equity Statement
HEC recognizes that Oregon’s nine tribes are sovereign nations. In accordance with our
government-to-government relationship and the federal trust responsibility, HEC works to end
health inequities for Oregon’s tribes through supporting the five essential components of
health equity for American Indians and Alaska Natives as defined by the National Indian Health
Board
4
:
1. Resilience Through Culture
2. Tribal Sovereignty
3. Strong Tribal Institutions
4. Tribal Representation in State and Federal Governance
5. Federal Trust Responsibility
4
A Path to Health Equity, 2022 Inter-Tribal World Cafe, National Indian Health Board Tribal Health Equity Summit
Health Equity Definition:
Oregon will have established a health system that creates health equity when all people
can reach their full health potential and well-being and are not disadvantaged by their
race, ethnicity, language, disability, age, gender, gender identity, sexual orientation,
social class, intersections among these communities or identities, or other socially
determined circumstances.
Achieving health equity requires the ongoing collaboration of all regions and sectors of
the state, including tribal governments, to address:
• The equitable distribution or redistribution of resources and power; and
• Recognizing, reconciling and rectifying historical and contemporary injustices.
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SECTION 2: Mission, Vision, Values, Scope of Work
VI. Mission and Vision
o MISSION
HEC works to eliminate health inequities for all people in Oregon – especially those most
harmed by racism, colonization and all other forms of current and historical systemic
oppression, injustice, and discrimination. We achieve this through:
● Supporting health equity policy development informed by communities that have been
economically and socially marginalized
● Advocating for the adoption and implementation of best practices to advance health
equity
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in Oregon and monitoring its progress
● Collaborating with OHA and OHPB committees to support, guide, and lead their efforts to
advance health equity and social justice
o VISION
Health Equity
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is a fundamental right. All people in Oregon are safe, supported by community,
have the freedom of self-determination, and can reach their full health potential and well-
being.
VII. Values
Racial and Social Justice
● Recognizing, reconciling, and rectifying historical and contemporary injustices
● Honoring and elevating the voices and wisdom of communities, defined by identity
and/or location, and individuals with lived experiences
● Leading with race* and using an intersectional approach
● Naming, acknowledging, and redistributing privilege and power to a more
community-led approach
Partnership and Advocacy
● Valuing process and product and investing in relationships
● Working with local, regional, and statewide partners and communities
for meaningful systems change
5
See Health Equity definition
6
See Health Equity definition
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● Removing access barriers to institutions and organizations that promote
health
● Promoting best and emerging practices across health system partners
● Building sustainable and equitable coalitions/partnerships across
institutions, organizations, and communities
Diversity, Equity, and Inclusion (DEI)
● Creating a safe(r) environment for open and honest conversation
● Leveraging our group's diversity, wisdom, and expertise to make meaningful
changes
● Modeling health equity policy implementation for other agencies / partners
● Creating a culture of equity and inclusion where everyone can show up fully and feel like
they belong
Health Equity for All of Oregon
● Focusing on health for all people in Oregon
● Equitable distribution / redistribution of resources and power to promote health
● Promoting a whole-person, life-course and intersectional approach to public health
that proactively addresses disparities in health and well-being, as well as inequities in
social determinants of health
● Utilizing a population health approach in health policy development and
implementation
Tribal Sovereignty
● Honoring tribal sovereignty and government-to-government relationships with the
Nine Federally Recognized Tribes of Oregon
● Supporting the five essential components of health equity for American Indians and
Alaska Natives as defined by the National Indian Health Board: Resilience Through
Culture, Tribal Sovereignty, Strong Tribal Institutions, Tribal Representation in State and
Federal Governance, and Federal Trust Responsibility
VIII. Committee Scope & Deliverables
1. Policy Focus:
Using an equity-focused approach and framework, works with OHA, OHPB, Tribal Nations, and Community
Partners to steer Health Equity components of health care, health delivery, and legislative policy
development, review, adoption, and/or implementation.
Related activities include, but are not limited to:
● Provide input or guidance on agency and committee policies being considered by OHPB and OHA
● Assist the Equity and Inclusion Division with developing rules chapter to inform health equity-related
policy
● Advise on Coordinated Care Organization (CCO) health transformation efforts
● Provide input into OHA legislative concepts
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● Assist with agency and legislative policy development, gap identification, and impact evaluation
● Gather community input and build partnerships with community organizations
● Identify best practices to reduce/eliminate inequities in agency and committee work
● Serve as access and entry point for community-driven policies and practices to advance equity
2. Feedback focus:
Provide feedback on OHA’s progress towards eliminating health inequities by 2030, advancing health
equity and becoming a more culturally and linguistically responsive organization committed to anti-racism
and decolonization.
Related activities include, but are not limited to:
● Identify and advise on equity-related tools to support advancing equity for policy making
● Review appropriate organizational equity progress metrics and evaluation tools as presented by
relevant committees / workgroups and community
● Provide feedback on OHA / OHPB evaluation plan
● Receive and analyze regular reports from OHA divisions / OHPB committees
● Develop a regular recommendations report for OHPB
● Work with partner organizations to identify community defined priorities, metrics, and
recommendations
3. OHPB Committees focus:
Collaborates with OHA and other OHPB committees to support, guide, and lead their efforts to
advance health equity and social justice
Related activities include, but are not limited to:
● Ensure diverse, inclusive and equitable representation on committees
● Assist with utilizing Health Equity quality measures
● Assist Workforce committee to identify strategies that support health equity and integrated delivery
● Support the Public Health Division in integrating health equity into public health
● Work with Behavioral Health and Primary Care health transformation efforts
● Attend OHPB yearly retreat to support equity focus and framework
● Identify and promote equity-based committee practices (e.g. charter template)
● Collaborate with OHPB committees to set yearly equity strategies, goals, and targets
IX. Health Equity Priority Populations
In alignment with its mission to eliminate health inequities, HEC focuses on people in Oregon
most harmed by racism, colonization and all other forms of current and historical systemic
oppression, injustice, and discrimination. These “priority populations” are defined by Oregon
Revised Statutes and Oregon Administrative Rules
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as populations and communities including
but not limited to:
● Communities of color;
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ORS 413.042, OAR 943-021-0005
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● Tribal communities including the nine federally recognized tribes of Oregon and other
American Indians and Alaska Natives people;
● Immigrants;
● Refugees;
● Migrant and seasonal farmworkers;
● Low-income individuals and families;
● Persons with disabilities; and
● Individuals who identify as lesbian, gay, bisexual, transgender, or queer, or who question
their sexual or gender identity.
HEC strives to be inclusive and responsive to the health of all people in Oregon. Accordingly, in
addition to the health equity priority populations above, HEC will focus on any population that
experiences health systems access barriers and health inequities, inclusive but not limited to the
following:
● People without legal citizenship status
● People with limited English proficiency
● People experiencing houselessness and housing insecurity
● People who are currently or have been incarcerated
● Older adults, children, and pregnant people utilizing Medicaid and Medicare
The Health Equity Committee recognizes that this list is not exhaustive, and will revisit the
priority populations list in regular review of this charter.
X. Review, Reporting, & Evaluation
The Health Equity Committee will conduct an Annual Review of its work over the past calendar
year and submit an Annual Report to OHPB based on the review. The Annual Review will consist
of a summary of HEC’s strategic goals, objectives, actions, progress on these goals, and
potential updates or modifications to strategic goals. The Annual Report will share this
information in a concise and accessible format to the Oregon Health Policy Board and be made
available to the public.
HEC will also conduct, on a consistent and periodic basis, an Evaluation of the strategic goals,
objectives and implementation actions of the committee. The Periodic Evaluation will identify
HEC actions and their alignment with the HEC scope of work’s focus areas (Policy focus,
Feedback focus, OHPB committees focus), their implementation strategy and process (Process
Evaluation), and, in the long-term, their results (Impact Evaluation). Actions and goals will also
be linked to the priority populations, as defined above and by the current committee members,
describing how HEC’s work contributed to eliminating health inequities for priority populations.
The Periodic Evaluation will provide additional analysis of both successes and gaps in HEC’s
work for specific focus areas and priority populations, identifying opportunities for
improvement for HEC’s strategic goals, objectives, and actions.
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The Annual Review, Annual Report, and Periodic Evaluation will be conducted by a workgroup
of committee members, supported by OHA staff and contracted consultants, and reviewed by
the committee as a whole. The evaluation will be based on qualitative data collected from
interviews and group discussions with HEC members, and/or community partners and OHPB
committees, as relevant; a survey tool may also be used to collect quantitative outcome data.
The template for the Evaluation Report should include the following sections:
● Executive summary of evaluation and concise overview of the report
● Background information on the committee’s scope of work and priority populations
● Summary of evaluation findings, identifying successes and gaps
● Recommendations for improvement
SECTION 3: Committee Personnel
XI. Committee Membership
1. Composition
The HEC shall consist of 15 individuals with substantial health care or social service expertise
and/or health equity professionals, who have lived experience and/or cross-cultural experience
in health equity policy advocacy and policymaking processes. Additional efforts are made to
include individuals who are experienced and skilled in the review, analysis and development of
health equity policy, results-proven implementation, and social determinants of health.
There will be one dedicated seat for a Tribal representative that will be selected by Tribal
Health Directors. Tribal member participation on committees is managed by OHA’s Tribal
Affairs Office. OHA considers the Tribes as sovereign nations and accordingly, Oregon maintains
a government to-government relationship with the Tribal governments through the OHA Tribal
Consultation policy
8
.
2. Recruitment
Applications shall be solicited from a diverse group of candidates with lived experience and/or
cross-cultural experience. Selection shall be made to ensure the HEC is representative of
communities experiencing health disparities, including but not limited to, racially and ethnically
diverse populations, linguistically diverse populations, immigrant and refugee populations,
LGBTQIA2S+ populations, youth and aging populations, people with disabilities, rural
communities, and economically disadvantaged populations as well as individuals with
experience transforming health equity in operational settings as it relates to the key
populations listed above. These representational priorities will be updated regularly to reflect
the most current and culturally responsive language.
8
https://www.oregon.gov/oha/documents/Tribal_Consultation_and_UIHP_Confer_Policy.pdf
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The HEC shall prioritize lived experience and cross-cultural experience (see definitions section),
and other expertise in health equity generally, and racial equity specifically, as a requirement for
committee membership. Lived and cross-cultural experience can help the Board, Committee,
Workgroup, and OHA staff better understand and advance health equity.
3. Appointment
While recruitment and screening are conducted by E&I and the current HEC members, final
appointment to the HEC is the purview of the OHPB. One member seat will be reserved for a
Tribal representative as appointed by the Tribal Health Directors.
4. Term lengths
Terms will be 2 years, with staggered membership terms to ensure continuity. A member may
serve up to 2 consecutive terms.
5. Member transitions
If a member finds it necessary to resign from the committee, the member is encouraged to
remain until a replacement can be selected and to provide as much notice as possible. Members
are also encouraged to help the committee find a suitable replacement. Members who wish to
resign from HEC must submit a formal resignation letter to OHPB and E&I. HEC shall conduct “exit
interviews” with Committee members who term out or resign that includes questions about their
experience on the Committee as inclusive and equitable, and their recommendations for
increasing Committee diversity, including identifying potential diverse Committee members from
their own networks
6. Replacement
Replacement members will be appointed to the remainder of the resigning member’s term and
are eligible for reappointment at the discretion of OHPB and E&I.
OHPB may appoint a replacement for any member who misses more than two consecutive
unexcused absences or a total of 20% of the meetings per year. OHPB and E&I will also consider
extenuating circumstances on a case-by-case basis.
7. Onboarding & Training
Members will receive required trainings and materials regarding public official status, conflicts
of interest, non-discrimination, and any other training mandated by OAR, ORS, and OHPB. HEC
members will also be given a review of the institutional and organizational structure of OHPB,
OHA, and E&I. New members will have both small group and one-on-one onboarding sessions
with E&I staff to facilitate smooth transition onto the committee, to the extent possible given
member and staff availability.
8. Conflicts of interest
To maintain objectively, transparency, and integrity of HEC, members must comply with this
policy. Members are required to:
● Sign conflict of interest disclosure form at the time of their appointment regarding any
relevant financial relationships or commercial interests which would pose an actual or
potential conflict of interest before participating in any committee activities
● Update disclosures annually or whenever there are any relevant changes (such as a new
financial relationship).
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● Verbally disclose any actual conflicts of interest before voting on any motion. o If a
member has a potential conflict related to a motion, the member should state the
conflict. E&I staff and HEC will then determine whether the member shall participate in
the vote or be recused.
Key Conflict of Interest Definitions:
Relevant financial relationships are financial relationships, in any amount, during the past twelve
months with any organization or individual that is currently, or potentially, an applicant for OHA
approval of CE opportunities, programs, or activities. Financial relationships are those
relationships in which the individual, or an immediate family member, benefits by receiving a
salary, consulting fee, honoraria, royalty, intellectual property rights, ownership interest (e.g.,
stocks, stock options or other ownership interest, excluding diversified mutual funds), or other
financial benefits
Commercial interests exist when an individual, or immediate family member, has any ownership
interest in any organization producing, offering, selling, marketing, reselling, or distributing
services or products that are used in continuing education for health professionals. Immediate
family members are defined as spouses, domestic partners, children, siblings, and parents,
including family members related by marriage, adoption, etc.
9. Public officials
In 1974, voters approved a statewide ballot measure to create the Oregon Government Ethics
Commission (Commission). The measure established laws that are contained in Chapter 244 of
the Oregon Revised Statutes (ORS). When the Commission was established, it was given
jurisdiction to implement and enforce the provisions in ORS Chapter 244 related to the conduct
of public officials. In addition, the Commission has jurisdiction for ORS 171.725 to 171.785 and
171.992, related to lobbying regulations, and ORS 192.660 and 192.685, the executive session
provisions of Oregon Public Meetings law.
The provisions in Oregon Government Ethics law restrict some choices, decisions or actions of a
public official. The restrictions placed on public officials are different than those placed on private
citizens because service in a public office is a public trust and the provisions in ORS Chapter 244
were enacted to provide one safeguard for that trust. Public officials must know that they are
held personally responsible for complying with the provisions in Oregon Government Ethics law.
This means that each public official must make a personal judgment in deciding such matters as
the use of official position for financial gain, what gifts are appropriate to accept, when to disclose
the nature of conflicts of interest, and the employment of relatives or household members
One provision, which is the cornerstone of Oregon Government Ethics law, prohibits public
officials from using or attempting to use their official positions or offices to obtain a financial
benefit for themselves, relatives or businesses with which they are associated if that financial
benefit or opportunity for financial gain would not otherwise be available but for the position or
office held.
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Oregon Government Ethics law limits and restricts public officials and their relatives as to gifts
they may solicit or accept. Under specific circumstances, public officials may accept certain gifts.
Another provision that frequently applies to public officials when engaged in official actions is
the requirement to disclose the nature of conflicts of interest.
Health Equity Committee members are considered “public officials” as they have applied and
were selected to a position for which you have volunteered to serve the State of Oregon.
For further information, consult Oregon Government Ethics Law - A Guide for Public Officials.
10. Compensation
House Bill 2992
9
states that any member of a state board or commission, other than a member
who is employed in full-time public service, who is authorized by law to receive compensation
for time spent in performance of official duties, shall receive a payment for each day or portion
thereof during which the member is actually engaged in the performance of official duties. Except
as otherwise provided by law, all members of state boards and commissions, including those
employed in full-time public service, may receive actual and necessary travel or other expenses
actually incurred in the performance of their official duties within the limits provided by law or
by the Oregon Department of Administrative Services under ORS 292.210 to 292.250.
The compensation to be provided is equal to the per diem paid to members of the Legislative
Assembly under ORS 171.072.
HB 2992 Defines “qualified member” as a member who is not in full-time public service and who
had an adjusted gross income in the previous tax year:
● Of less than $50,000, as reported on an income tax return other than a joint income
tax return; or
● Of less than $100,000, as reported on a joint income tax return.
All members of state boards and commissions, including those employed in full-time public
service, may receive actual and necessary travel or other expenses actually incurred in the
performance of their official duties within the limits provided by law or by the Oregon
Department of Administrative Services under ORS 292.210 to 292.250.
A member of a state board or commission may decline to accept compensation or
reimbursement of expenses related to the member’s service on the state board or commission.
XII. Committee Duties and Roles
1. HEC Community Agreements
HEC meeting community agreements reflect our values and direct our behaviors and actions
during all HEC meetings while we work together to achieve health equity for our communities
and state. These agreements help us create more inclusive meeting space. By participating in
HEC meetings, all agree to demonstrate the following during each meeting:
9
https://olis.oregonlegislature.gov/liz/2021R1/Downloads/MeasureDocument/HB2992
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● Be present. Be on time and participate as much as possible.
● Move up, move back. Be mindful of taking too much or too little space.
● Create a space for multiple truths. Speak your truth and seek understanding of truths
that differ from yours. Celebrate and embrace different perspectives. Be open to non-
dominant ways of working together.
● Call each other in as we call each other out. When challenging someone’s ideas or
behavior, give feedback respectfully. When your own ideas or behavior are challenged,
receive feedback respectfully.
● Notice power dynamics. Power shows up in many ways—be aware of how you might be
unconsciously using your privilege and power. For example, we commit to identifying and
naming white supremacy in group dynamics and to co-creating anti-racist group
processes.
● Assume best intentions. Everyone comes in with a different set of experiences and
knowledge. Seek first to understand and assume best intentions in all interactions.
● Recognize that intent is different from impact. The things we say or do may have a
negative impact on others, despite our intent. Be accountable for the impact of your
actions and words.
● Share gratitude for feedback. It is a gift when someone takes time and risk to give
feedback. Thank them for the learning opportunity and recognize you may have work to
do.
● Center learning and growth. This work is sometimes uncomfortable and uncertain. We
may not always know the answers nor arrive at neat, tidy resolutions. We will make
mistakes along the way. Remember we are all here to learn and grow, both individually
and collectively. We won’t “fix” it all in one meeting, but we will get closer if we are willing
to be uncomfortable.
2. HEC Group Practices
How members participate in meetings and shared spaces is critical in achieving our shared goal
of equity. This section outlines the practices expected of each member in our efforts to create
equity and act as good stewards of resources in and outside of meetings. Members’ words and
actions can create both a safe space that fosters comfort, compassion and inclusivity, as well as
a brave space to cultivate productive dialogues so that all are encouraged to speak honestly
and critically from their own experience towards the end of mutual learning and liberation.
● Prepare for and set aside time for HEC meetings and the whole process.
● Participate fully, honestly, and fairly, commenting constructively and specifically.
● Speak respectfully, briefly, and non-repetitively, not speaking again on a subject until all
other members desiring to speak have had the opportunity to talk.
● Allow people to state their ideas or opinions without fear of reprisal from HEC
members.
● Avoid side conversations during meetings and be fully present.
● Provide information in advance of the meeting in which such information is to be used
and share all relevant information to the maximum extent possible.
● Generate and explore all options on their merits, keeping an open mind and listening to
different points of view to understand the underlying interests of other HEC members.
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● Work toward fair, practical, and durable recommendations that reflect the diverse
interests of the entire HEC and the public.
● When communicating with others, accurately summarize the HEC process, discussion,
and meetings, presenting a full, fair, and balanced view of the issues and arguments,
both out of respect for the process and other members.
● Once the HEC has reached a decision, do not attempt to affect a different outcome
outside of the HEC process
● Strive vigorously for consensus and closure on issues. This means HEC members will
work together to identify underlying values, interests, and concerns to develop widely
accepted solutions.
● Self-regulate and help other members abide by these commitments.
● Do not disparage, undermine, or affirmatively work against the goals and mission of the
HEC.
● Adhere to ground rules established for the HEC and all its committees and workgroups.
● When members are not acting in their official HEC capacity, they shall consider the
impact on the HEC, the HEC members, or OHA when using social media. HEC members
may express themselves as individuals about matters of public concern but must not
imply that their personal opinions reflect the views of the HEC, the HEC members, or
OHA. This shall apply regardless of whether members use personal equipment or the
State’s information technology assets.
● When providing personal opinions on matters involving the agency, give a disclaimer
similar to the following: “This is my personal opinion, and I am not representing the
official position of the HEC.”
3. Role of committee co-chairs
HEC co-chairs are selected by the committee and serve a 2-year term. Co-chairs commit to the
following roles:
Work with OHBP and E&I staff to steer HEC’s ongoing work, including developing agendas
and materials for HEC meetings
Review draft meeting minutes before meeting at which they will be approved
Facilitate HEC meetings and guide HEC in achieving deliverables
Serve as HEC spokespersons at OHPB/OHA meetings
Sign HEC-approved documents for OHPB/OHA, letters of support, and other
correspondence on behalf of HEC, as its formal leadership authority
Designate, in the absence of Co-Chairs, or when appropriate to conduct HEC business,
other HEC members to perform duties including, but not limited to, attending OHPB, OHA,
or other public meetings and approving/reviewing documents which require Co-Chair
action
Foster collaboration and authentic exchange among the group.
○ Share a meeting agenda before each meeting.
○ Communicate goals and expectations for participants at the onset of meetings.
○ Ensure all participants’ opinions are received and/or followed through.
○ Provide time for reflections and debriefs.
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HEC Co-Chairs have the critical role of facilitating HEC meetings. Facilitator is defined as a person
who plans, guides and manages a group event to meet its goals. As facilitators, Co-Chairs hold
power and responsibility in moving a group process along with effectiveness and efficiency and
managing differences and conflicts with fairness and equity. Because of this power dynamic, Co-
Chairs as facilitators shall build awareness of how they show up in meeting spaces, including their
own prejudices and biases in order to exercise their power consciously and effectively.
Here are some principles to guide co–chairs in anti-racist and inclusive facilitation:
● Acknowledge that structural inequity and racism is ever-present in our institutions and
systems, which affect all of us and may show up in meetings and shared spaces. Make
these principles known at the onset of each HEC meeting.
● Invite group participants to self-identity themselves and how they want to be addressed.
● Use clear and intentional language when addressing racial identities and inequities to
avoid further marginalizing or erasing a particular community.
● Actively create space and hold space for Tribal communities and communities of color in
meetings
● Honor and uplift the lived experience, stories and expertise of those directed impacted in
strategic and policy discussions
● Welcome differences and discomfort and not be deterred by mistakes
● Commit to continuous learning and unlearning around how to become antiracist.
Continue to identify and dismantle group practices that stem from white supremacy,
racial capitalism, and colonialism.
● Offer emotional regulation tools for the group. Recognize that because of systemic
inequities, systems change, and equity work bring up discomfort, pain, and emotional
dysregulation that will affect how the participants show up and how we achieve our
shared goals.
4. Ad Hoc workgroups
An "ad hoc" (Latin meaning "for this”) group exists to accomplish a specific, time-limited
objective. They can also be called “work groups.” Typically, but not exclusively, Ad Hoc work
groups are formed to perform one of two functions. One is to investigate, and the other is to
carry out an action that has been adopted. Work groups do not make decisions, but rather
prepare recommendations that go back to the full HEC for final approval.
Organizing an “ad hoc” work group will require the committee to allocate time, expertise, and
resources to the effort. Ad Hoc Work Groups are established by the HEC co-chairs to work on a
specific project. To ensure these group are successful, when creating an ad hoc work group, the
committee shall:
● define the scope or task,
● specify membership,
● provide guidance on process and product, and
● define expectations for cadence of HEC updates on the project status.
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Defining the mission or task involves conceptualizing the problem or issue and strategizing how
to best address it. The HEC under the guidance of HEC Co-Chairs will devote ample time to this
part of planning including the number of participants, the length of time the work group will
function, the deliverables and the communication channels between the work group and the full
committee. Once the task is adequately defined, HEC Co-Chairs will solicit the participation of
HEC members and/or other internal OHA and external parents if applicable. Ad Hoc work group
members can be nominated and enlisted.
Information about the Work Group (purpose, task, participants, deliverables and timeline) should
be clearly outlined in the Health Equity Committee’s minutes.
5. Role of OHA Equity and Inclusion Division (E&I)
The role of the division is two-fold: to provide a) staff support to the committee and b) technical
assistance and consultation on health equity, health inequities, health policy goals, development,
and equity and inclusion.
E&I Staff Basic Functions
● Serve as informed resource persons to the co-chairs and committee members.
● Assist Co-chairs in facilitating committee discussion and activities that address the
committee's charge as delineated in the committee's charter, by-laws, and strategic plan.
● Work with the Co-Chairs to ensure that all committee work is consistent with the
committee's goals and objectives.
Committee Staff Responsibilities
● Provide a thorough orientation for each new committee co-chair.
● Support the development of committee work plans with timelines that will keep the
committee focused and accomplish its priorities.
● Work with the HEC Co-chairs and E&I leadership in developing agendas and conducting
effective meetings.
● Provision of administrative and on-site support for planning, execution, and follow-up of
all committee meetings.
● Provide orientation for new and continuing committee members each year.
● Work with the co-chairs, other committee members, and E&I leadership to ensure that
the committee's work is carried forth between meetings.
● Facilitate communication of committee activities, including requests for action and/or
proposed policies, to OHPB and OHA leadership, when applicable.
● Prepare agendas and distribute them before meetings.
● Keep the committee webpage up to date, including updating meeting schedules and
resources.
● Foster a culture of openness, transparency, and respect for all committee members as
equal discussion partners.
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● Draft committee reports, letters, and memos of committees for review and approval.
SECTION 4: Committee Operations
XIII. Committee Meetings and Decision-Making
1. Meeting frequency and format
● The HEC shall meet once a month and all regular HEC meetings shall be open to the public.
● The HEC shall ensure that meeting venues are accessible and can support optimal video
conference participation
● Committee meetings that are virtual/videoconference meetings shall include the use of
chat functions, breakout groups, polling, language interpretation, closed captioning, and
other technologies for maximizing participation from both Committee members and the
public.
● The HEC shall ensure public access to Committee meetings for individuals with languages
other than English and for individuals with disabilities.
● Committee staff shall send written notice of the place, date, time, telephone/video
conferencing access information, agenda of each meeting, past meeting notes and any
other meeting resources to each member.
● The agenda for each committee meeting will be drafted by the Co-Chairs with input from
the HEC, E&I Director, E&I Equity and Policy Manager and committee staff.
● The agenda may be developed through any means of communication chosen by the Co-
Chairs, including electronic mail
● Communications about agenda items (other than discussions that take place in open
meeting), shall be limited to an exchange of views on whether to include the item, and
clarification of a proposed item. Development of the agenda through such
communications may not involve substantive discussion of the merits of proposed agenda
items.
● The agenda shall be published on the HEC website, with all the information necessary for
the public to access the meeting such as location, telephone, videoconferencing no less
than five (5) calendar days prior to the meeting. The agenda shall provide a brief
description of the items of business to be transacted or discussed and the name of the
presenters.
● No item shall be added to the agenda after the agenda is posted. However, HEC may take
action on items of business not appearing on the posted agenda under any of the
conditions stated below:
o Upon a determination by two-thirds of all voting members that an emergent need
exists.
o Upon a determination by a two-thirds vote of voting members or, if less than two
thirds of voting members are present, by a unanimous vote of voting members
Oregon Health Policy Board - Health Equity Committee Charter
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present, that there exists a need to take immediate action and that the need for
action came to the attention of the HEC subsequent to the agenda being posted.
● Notice of the additional item to be considered shall be provided to each member of the
HEC as soon as is practicable after a determination of the need to consider the item is
made. An update to the agenda shall also be made available on HEC’s website as soon as
is practicable after the decision to consider additional items at a meeting has been made.
At the end of every meeting HEC Co-Chairs will review and confirm with the group all
decisions made including timelines, parties responsible and any next steps.
2. Public status of committee meetings and records
Public Comments
The Oregon Health Policy Board (OHPB) and its committees, including the Health Equity
Committee, are public bodies that accept public comments related to discussion topics.
Written Comment Before Meeting
Written public comment may be submitted by email to HEC Committee staff 48 hours before the
monthly HEC public meeting. Written comments submitted at least 48 hours before public
meetings will be included in the meeting materials packet reviewed by members.
Written comments should be limited to 1,000 words (pdf/word formats). Materials provided to
Committee members become public documents. Written public comments not related to any
topic on the meeting agenda will be emailed to members but may not be discussed at the HEC
meeting.
Verbal Public Comments during meetings
Members of the public are provided with several ways to provide verbal comments at each
Health Equity Committee meeting. HEC has allocated time under each agenda item for the public
to participate. The public may comment on the subject/topic on that section of the agenda, or
any other matter related to OHPB/HEC/OHA priorities. Members of the public can request the
opportunity to provide verbal public testimony in two ways:
● In advance: Verbal public comments requested at least 24 hours before the HEC meeting
may be noted on the agenda and distributed to members.
● During the meeting: Members of the public will be invited to provide public comment
after each agenda item. The public can request time in advance or come forward when
HEC Co-Chairs open it to public comment. HEC asks that the persons identify themselves
to ensure their name and organization are reflected in the HEC meeting notes.
Verbal public comments are limited to two minutes per individual share, to ensure adequate
access for all those wishing to give verbal comments.
Accessibility
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Everyone has a right to know about and use Oregon Health Authority (OHA) programs and
services. OHA provides free help. Some examples of the free help OHA can provide are:
● Sign language and spoken language interpreters
● Written materials in other languages
● Braille
● Large print
● Audio and other formats
HEC shall ensure that committee documents are developed with a font type and size that are
universally accessible – at least 14 point font.
3. Meeting documentation
A record shall be made by the HEC staff or designee of the attendance of HEC members and
actions taken by the HEC during each meeting. The draft meeting notes are considered as
meeting notes only and are not official minutes unless later approved by the HEC at an open
meeting. Once approved by HEC the minutes shall be posted on the web within 30 days following
adoption and shall be a public record.
Language and Documentation Equity considerations
Equity is a guiding model for language and action in all of HEC’s materials. These materials include
public communications, presentations, meeting notes, website text, membership applications,
and any other materials generated by HEC operations. HEC commits to ensuring that committee
information is written such that is:
● In plain language. Oregon law requires all state agencies to prepare public
communications in language that is as clear and simple as possible (ORS 183.750). HB
2702 specifies an additional standard for written documents.
● Culturally responsive
● Accessible
● Readily available in languages that represent communities in all of Oregon.
● Using gender-inclusive language
● Aware of ableism and how it enters the language we use when referring to people with
and without disabilities.
4. Decision-making
All voting actions of the HEC shall be expressed in the form of a motion and/or resolution. When
a motion has been made, the HEC shall strive to reach consensus (i.e., unanimity). However, if
the Co-Chairs determine that a consensus cannot be reached, a vote will be called, and decisions
will be made by 51% of the quorum. Before making a decision, HEC Co-Chairs will make sure
everyone has had an opportunity to speak or pass.
Voting when there is a Recusal or Abstention
a. “Recuse” shall be defined as the act of not voting to avoid a conflict of interest.
Oregon Health Policy Board - Health Equity Committee Charter
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b. “Abstain” shall be defined as the act of not voting when present and entitled to vote for
any reason not indicated in subsection (a), including, but not limited to, not voting for
personal reasons.
c. Abstentions and recusals by HEC members shall have the following effects on HEC
proceedings:
a. HEC members who recuse themselves may not be counted toward a quorum, and
their recusal may not be interpreted as support for, acquiescence in, or opposition
to, any actions taken by the HEC.
b. HEC members who are present, but abstain, are counted toward a quorum.
c. HEC members who abstain are deemed to agree in the resolution reached by HEC
provided that the HEC may not act without support from at least a simple majority
of HEC’s quorum.
All motions and resolutions shall be recorded in the minutes.
Quorum
Committee actions and decisions must be made by a quorum of members. A quorum is defined
as a simple majority of HEC members. In the absence of a quorum, no official business may be
conducted by the HEC, and the Co-Chairs reserve the right to cancel the meeting. The HEC may
hear presentations, discuss issues and deal with administrative matters in the absence of a
quorum, but it may not adopt any recommendation during a meeting unless a quorum has been
established first.
Manner of Voting
1. The voting on elections shall be by nomination and vote by silent ballot. A simple majority
carries the vote, and the vote will be documented in meeting notes by percentage, without
names.
2. The voting on motions and resolutions shall be by voice vote; if necessary, the Co-Chairs or
committee member may request a roll call or show of hands and the Co-Chair will honor any such
request.
XIV. Communications
1. Committee communications
The OHA E&I Director will be considered the primary point of contact for all communications. All
comments and/or questions from HEC members will be directed to the committee staff and
committee staff will inform the E&I Director and HEC Co-Chairs. The OHPB committee staff will
support the E&I Director, Co-Chairs and committee staff in this function.
All comments and/or questions from the public will be directed to the E&I Director. OHA
External Relations staff and OHPB committee staff will support the E&I Director, Co-Chairs and
committee staff in this function.
2. Media
All media requests should be funneled to HEC co-chairs or Equity and Inclusion Division staff.
Individual HEC members do not represent the views of HEC, Oregon Health Policy Board, Equity
and Inclusion Division, or Oregon Health Authority, but can speak to their own individual,
Oregon Health Policy Board - Health Equity Committee Charter
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personal, and professional perspective, including that of the organizations they are affiliated
with.
3. Lobbyists
While it is expected that HEC members will advocate for their policy positions both inside and
outside of HEC spaces, HEC members are considered public officials. As such, they must comply
with all public official rules and statues, including those pertaining to state government ethics,
conflicts of interest, and gifts
10
.
10
See Oregon Revised Statutes (ORS) Chapter 244, Government Ethics.
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APPENDIX I: Definitions
XV. Key Definitions and Tools
1. Ableism
Ableism is discrimination in favor of nondisabled people. Ableism is the discrimination of and
social prejudice against people with disabilities based on the belief that typical abilities are
superior.
2. Colonialism
Colonialism: Some form of invasion, dispossession and conquering of a people. To colonize is to
take over or impose one’s values, attitudes and beliefs on another. The invasion does not need
to be military. It can begin — or continue — as a geographical invasion in the form of agricultural,
urban or industrial trespassing. The result of physical colonizing is original inhabitants’ loss of vast
amounts of land. It is often legalized after the fact. The long-term result of colonialism is the
institutionalized creation of privilege for certain groups, which then creates inequities. The
colonizer and colonized relationship is by nature inequitable and benefits the colonizer at the
expense of the colonized
3. Conflict of Interest
Oregon Revised Statutes (ORS) 244.020 defines both an active conflict of interest and a
potential conflict of interest.
● Actual conflict of interest occurs when you participate in an action that would affect the
financial interest of yourself, your relatives, or a business with which you or your
relative is associated.
● Potential conflict of interest occurs when you participate in an action that could affect
the financial interest of yourself, your relatives, or a business with which you or your
relative is associated.
4. Community engagement
Creating community partnerships through relationship and trust building facilitates the
communication needed to understand how to meaningfully improve systems. Community
engagement “often involves partnerships and coalitions that help mobilize resources and
influence systems, change relationships among partners, and serve as catalysts for changing
policies, programs, and practices” (CDC, 1997, p. 9).
11
5. Cross-Cultural Experience
Cross-cultural experience refers to your personal, volunteer, or professional experience with
populations and communities. This experience must include an equity-centered, anti-racist,
anti-oppressive, and culturally appropriate approach. Cross-cultural experience is different
than your self-reported identity (see the definition for lived experience). Cross cultural
11
Community Engagement Strategies Checklist: Oregon Health Authority (OHA)
https://www.ohsu.edu/sites/default/files/2020-
12/Community%20Engagement%20Strategies%20Checklist%20Oregon%20Health%20Authority.pdf
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experience can include:
● experiences with family members or friends,
● working toward health equity with racially and ethnically diverse populations and
communities,
● learning another language, or
● living in a country other than the U.S.
6. Diversity
Diversity is “honoring and including people of different backgrounds, identities and experiences
collectively and as individuals. It emphasizes the need for representation of communities that
are systemically underrepresented and under-resourced. These differences are strengths that
maximize the state’s competitive advantage through innovation, effectiveness, and adaptability
(Oregon Governor’s definition)
7. Equity
Equity is the effort to provide different levels of support based on an individual’s or group’s needs
in order to achieve fairness in outcomes. Equity acknowledges that not all people, or all
communities, are starting from the same place due to historic and current systems of oppression.
Equity empowers communities most affected by systemic oppression and requires the
redistribution of resources, power and opportunity to those communities. (Oregon Governor’s
definition)
8. Health Disparities
Health disparities: Differences between the health of one population and another in measures
of who gets disease, who has disease, who dies from disease and other adverse health conditions
among specific population groups. If a health outcome is seen to a greater or lesser extent
between populations, there is disparity.
9. Health Equity
Health equity: Oregon will have established a health system that creates health equity when all
people can reach their full health potential and well-being and are not disadvantaged by their
race, ethnicity, language, age, disability, gender, gender identity, sexual orientation, social class
or the intersections among these communities or identities or other socially determined
circumstances.
Achieving health equity requires the ongoing collaboration of all regions and sectors of the
state, including tribal governments to address:
• The equitable distribution or redistribution of resources and power, and
• Recognizing, reconciling and rectifying historical and contemporary injustices.
10. Health Equity Impact Assessment (HEIA)
HEIA is a decision support tool which walks users through the steps of identifying how a program,
policy or similar initiative will impact population groups in different ways. HEIA surfaces
unintended potential impacts. The end goal is to maximize positive impacts and reduce negative
impacts that could potentially widen health disparities between population groups—in short,
more equitable delivery of the program, service, policy, etc. (MOHLTC 2019)
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11. Health Inequities
Health inequities: Systematic, avoidable, unjust and unfair differences in health status and
mortality rates across population groups. These differences are rooted in social and economic
injustice attributed to the social, economic and environmental conditions in which people live,
work and play.
12. Implicit Bias
Implicit bias: Associations that people unknowingly hold, also known as unconscious or hidden
bias. They are expressed automatically, without awareness. These learned stereotypes and
prejudices operate automatically and unconsciously when interacting with others.
13. Inclusion
Inclusion is a state of belonging when persons of different backgrounds, experiences
and identities are valued, integrated and welcomed equitably as decision makers, collaborators
and colleagues. Ultimately, inclusion is the environment that organizations create to allow these
differences to thrive. (Oregon Governor’s definition)
14. Institutional Racism
Institutional Racism: As the name suggests, this form of racism occurs within institutions and
reinforces systems of power. It is often more difficult to name or witness because it is more
deeply embedded in practices and policies, often presenting as a norm. Institutional racism refers
to the discriminatory policies and practices of particular institutions (government, schools,
workplaces, etc.) that routinely cause racially inequitable outcomes for people of color and
advantages for white people. Individuals within institutions take on the power of the institution
when they reinforce racial inequities. Further, institutional racism causes severe racial trauma
with mental and emotional impacts that often escape those who are not experiencing this
trauma.
15. Intersectionality
Intersectionality: Methodology of studying and examining how various socially and culturally
constructed categories (sex, gender, race, class, disability, etc.) interact on multiple and often
simultaneous levels and contribute to systematic inequities. Intersectionality examines and
attempts to clarify ways in which a person can simultaneously experience privilege and
oppression. It is a way to see the interactive efforts of various forms of discrimination and
disempowerment. Intersectionality looks at the way racism interacts with patriarchy,
heterosexism, classism, xenophobia and ableism. It views the overlapping vulnerabilities created
by these systems to create specific challenges. It means significant numbers of people in our
communities aren’t being served by social justice efforts because they do not address particular
ways they are experiencing discrimination.
16. Lived Experience
Lived experience refers to one’s life experience based on self-reported identity, meaning
someone who has personal knowledge about the world gained through direct, first-hand
involvement in everyday events such as racism, houselessness, behavioral health, etc. that
might help the Committee and OHA staff better understand and advance health equity.
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17. Priority populations
Populations and communities who have been most harmed by historic and contemporary
injustices and health inequities include but are not limited to: communities of color, Tribal
communities including the nine federally recognized tribes of Oregon and other American Indians
and Alaska Natives people, immigrants, refugees, migrant and seasonal farmworkers, individuals
and families with low income, people with disabilities, and LGBTQIA2S+ communities.
12
18. Racial Equity
Racial Equity means closing the gaps so that race can no longer predict any person’s success,
which simultaneously improves outcomes for all. To achieve racial equity, we must transform our
institutions and structures to create systems that provide the infrastructure for communities to
thrive equally. This commitment requires a paradigm shift on our path to recovery through the
intentional integration of racial equity in every decision.
13
19. Racism
Racism: Distinct from racial prejudice, hatred or discrimination, racism involves one group having
the power to carry out systematic discrimination through the institutional policies and practices
of the society and by shaping the cultural beliefs and values that support those racist policies and
practices.
20. Self-Reported Identity
Self-reported identity, such as race, ethnicity, language, disability, age, gender, gender identity,
identity, sexual orientation, social class, and intersections among these identities, or other
socially determined circumstances that may impact health equity and an individual’s ability to
reach their full health potential and well-being.
21. Structural Racism
Structural racism: A system in which public policies, institutional practices, cultural
representations and other norms work in various, often reinforcing ways to perpetuate racial
group inequities. It is a feature of the society in which we all exist.
22. Systemic ableism
Systemic ableism: A system of institutions, policies and societal values that disadvantage people
based on social values of intelligence, physical abilities and mental abilities. Systemic ableism
relates to barriers such as attitude, communication, physical space, policy, programs, criminal
justice, social and environmental issues, and transportation. Advocates define systemic ableism
as a system that places value on people’s bodies and minds based on socially constructed ideas
of normalcy, intelligence, excellence and productivity.
23. Targeted Universalism
Scholars and practitioners have been employing the phrase, “targeted universalism,” to
successfully break through the binary of universal responses versus targeted solutions in these
attempts to remedy the effects of inequity. Universal responses and statements are a way
12
Regional Health Equity Coalition Statute:
ttps://sharedsystems.dhsoha.state.or.us/DHSForms/Served/he3786e_2.pdf
13
https://www.oregon.gov/das/Docs/DEI_Action_Plan_2021.pdf
Oregon Health Policy Board - Health Equity Committee Charter
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of signaling the desire for a diverse and equitable society, but can strike people, especially people
who have been oppressed for generations, as being too grand and ambitious without any direct
way of helping those who are still being harmed. Targeted policies are more direct and localized,
but they often seek to meet the needs of a particular group, so can be viewed from a zero-sum
perspective, causing hostility and resentment. This plan, however, recommends applying the
concept of “targeted universalism,” by “setting universal goals pursued by targeted processes to
achieve those goals.” Specific solutions of all scales are built into a goal-oriented framework to
equitably benefit all groups concerned.
14
14
https://belonging.berkeley.edu/targeteduniversalism
