When someone begins working for the state of Washington, a school district, or participating employer group, they fill out their Public Employee Benefits Board (PEBB) or School Employee Benefits Board (SEBB) forms to enroll in health care coverage. Currently, the SEBB and PEBB enrollment forms ask only two, optional demographic-related questions: sex assigned at birth and gender identity. This doesn’t fully capture a person’s identity.

There are several teams at the Health Care Authority (HCA) working to expand the demographic data we collect. Collectively, these teams want to more fully encompass all aspects of a person’s demographic information, such as race, ethnicity, and language (REL) data. One team, the Employees and Retirees Benefits (ERB) REL Data Workgroup (REL Workgroup), is designing enrollment questions for PEBB and SEBB members. We’re calling it the REL project.

REL project questions include information about one’s preferred language, gender identity, and much more. These new REL questions are voluntary and will help HCA find and address gaps in services and care delivery within the PEBB and SEBB programs.

Why this work is important

We want to promote health equity by developing a better understanding of the communities we serve in the SEBB and PEBB programs. Another goal is to measure our progress in advancing equity for the communities within our programs. By not expanding our data, we have no way of knowing whether our PEBB/SEBB programs are equitable and supporting all members.

Collecting more demographic data will help us:

  • Measure SEBB and PEBB program outcomes by demographic category (i.e., language, gender identity, etc.), which will:
    • Ensure marginalized members are not left behind.
    • Help us focus on quality initiatives in the PEBB/SEBB programs, such as expanding language services, enhancing maternal health care for women of color, and establishing family counseling and support services for LGBTQ+ individuals and their families.
  • Identify gaps where health care benefits are not utilized. Use focused community engagement to learn, directly from those being impacted, what we can do to minimize or eliminate those gaps.
  • Identify and train our staff in the skills needed for better community engagement, accountability, data collection to improve program roles/activities that increase equity for underserved populations.

Q&A with Missy

To learn more about the REL project, we spoke with Missy Yates, stakeholder engagement coordinator for HCA’s ERB Division.

How does HCA protect the REL data we collect?

A new law—Senate Bill (SB) 5421, passed in 2023—protects all data that HCA collects as part of the benefits enrollment process. This means benefit enrollment information—including REL data—collected and maintained by HCA is exempt from the Public Records Act.

In addition, providing demographic information will be optional and won’t be connected to anyone in an identifiable manner. The REL Workgroup is working closely with HCA’s IT and Data Governance teams to develop and follow guidelines and governance on how to protect this data. (E.g., how store data and what happens if there’s a change due to leadership or legislation requests.) The REL Workgroup is also working with the PEAR Data Strategy and Reporting workstream group to ensure the REL project maintains its health equity focus.

What’s the status of the REL project right now?

We are currently in the community engagement stage, seeking feedback on the questions we’d like to ask on our PEBB/SEBB forms—including format and terminology—and discussing ways we can build trust and confidence when requesting this type of information from members.

We are collecting comments, concerns, and questions to address in our communications about the REL questions. If you’d like to share feedback or learn more, please email me (Missy Yates). Feedback will help HCA determine how we allocate resources and design benefits packages to meet our PEBB/SEBB members’ needs.

What do you enjoy most about this work?

I’ve really enjoyed sharing the new REL questions with members of the community and hearing their feedback. I like building relationships with folks as I learn more about them and they share their experiences. It’s great being able to see it from multiple perspectives.

What is something you’d like people reading this to know about your work?

I’m no expert. This whole process is continuously evolving, and it’s a life-long learning experience. I learn something new every time I speak with someone about this work. People change and grow, and we must change and grow with them. That is why I think it is so important to do this and to continue doing this work.

Health equity work at HCA

We’re making intentional efforts to address health equity and diversity, equity, inclusion, and belonging (DEIB) in all our practices. For example, we’re applying a health equity lens to HCA’s books of business.

This includes (but is not limited to):

  • Health insurance programs: Apple Health (Medicaid) and School & Public Employees Benefits Boards (SEBB & PEBB)
  • Prevention, treatment, and recovery behavioral health programs
  • Medicaid Transformation Project (MTP) waiver renewal
  • Efforts to lower health care costs for consumers and increase transparency
  • Eliminating Hepatitis C
  • HCA policies, such as Plain Talk
  • And more

Our vision is that HCA employees embody a culture in which we openly recognize health inequities and are empowered to work together, and with the people we serve, to reduce inequities through fair and equitable distribution of programmatic, financial, and informational resources.

Learn more about HCA’s health equity work.

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