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The Importance of Culturally and
Linguistically Appropriate Services
and How to Achieve Them
C. Godfrey Jacobs
Program Man...
What are we talking about today?

Culturally & Linguistically
Appropriate Services

Why?

How?
What are culturally and linguistically
appropriate services (CLAS)?
Services that are respectful of and responsive
to indi...
What are culturally and linguistically
appropriate services (CLAS)?
Services that are respectful of and responsive
to indi...
Culture
World Population, 2012
World Population, 2050 Estimate
Majority Religion by Country

Pew Research Center,
2012
Population Density, 2010
English Speakers
Demographics in the U.S.
Reporting a
disability:
12.1%

Limited English
Proficient:
22%

Over the age of 65: 13%
Under the...
LGBT
There are
approximately
9 million
LGBT Americans,
a figure roughly
equivalent to the
population of New
Jersey.
Health Literacy
Patient Safety
Events

Greater Risk for
Medical Errors

Poorer Health
Outcomes

Higher Rate of
Readmissions
Communication
A two-way process in which messages are
negotiated until the information is correctly
understood by both par...
Communication
• When providers understand and integrate the
information gleaned from patients.
• When patients comprehend ...
Why Are These Issues Important?
Quality

Litigation

Patient Need

Legislation
Informed
Consent
Changing
Demographics

Dis...
The Case for Culturally and
Linguistically Appropriate Services
Business

OMH, 2013

Social
Litigation
Misinterpretation of one word:
Intoxicado
$71million dollar
settlement
19
Disparities

Eliminating health disparities
for minorities would have
reduced direct medical care
expenditures by
$229.4 b...
Patient Need-Satisfaction

When a non-English speaking
patient comes to the hospital
everything is strange…
The only famil...
Quality

Rita Quintero
Medical Error

9 out of 10
Social Justice & Other Implications

"Please don't cry, Mama;
they tell me I have
cancer".
Legislation
Regulation
Accreditation
Every Point of Contact
Initial point of
contact &
appointment
scheduling

Preparation for
the visit

Entering &
navigating...
How can we address
these issues?
The National Standards for Culturally and
Linguistically Appropriate Services
in Health and Health Care

• Published by th...
The National CLAS Standards

Physical

Mental

Social

Spiritual

Health
The National CLAS Standards

Advance
health
equity

Help
eliminate
disparities

Improve
quality of
services

32
What are the
National CLAS Standards?
Principal Standard

1. Provide effective, equitable, understandable,
and respectful quality care and services that
are res...
Theme 1: Governance, Leadership
and Workforce

governance

leadership

workforce
Standards on Governance,
Leadership, and Workforce
2. Advance and sustain organizational governance
and leadership that pr...
Theme 2: Communication and
Language Assistance
Standards on Communication
and Language Assistance
5. Offer language assistance to individuals who have limited
English pr...
Theme 3: Engagement, Continuous
Improvement and Accountability
Standards on Engagement, Continuous
Improvement, and Accountability
9. Establish culturally and linguistically appropriate...
Standards on Engagement, Continuous
Improvement, and Accountability
12. Conduct regular assessments of community health
as...
Where can you find more information
about the National CLAS Standards?

National CLAS
Standards:
A Blueprint for
Advancing...
Where do we go from here?
Think Cultural Health
Godfrey_Jacobs@sra.com
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C. Godfrey Jacobs Legislative Updates ILSC 2013

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C. Godfrey Jacobs, Program Manager Health Determinants & Disparities Practice SRA International, discusses Legislative Updates - CLAS Standards & What They Mean for Hospitals and Interpreters

Published in: Health & Medicine, Business
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C. Godfrey Jacobs Legislative Updates ILSC 2013

  1. 1. The Importance of Culturally and Linguistically Appropriate Services and How to Achieve Them C. Godfrey Jacobs Program Manager, Health Determinants & Disparities Practice at SRA International, Inc. October 11, 2013 International Language Services Conference Advancing Health Equity at Every Point of Contact
  2. 2. What are we talking about today? Culturally & Linguistically Appropriate Services Why? How?
  3. 3. What are culturally and linguistically appropriate services (CLAS)? Services that are respectful of and responsive to individual cultural health beliefs and practices, preferred languages, health literacy levels, and communication needs and employed by all members of an organization (regardless of size) at every point of contact. OMH, 2013
  4. 4. What are culturally and linguistically appropriate services (CLAS)? Services that are respectful of and responsive to individual cultural health beliefs and practices, preferred languages, health literacy levels, and communication needs and employed by all members of an organization (regardless of size) at every point of contact. OMH, 2013
  5. 5. Culture
  6. 6. World Population, 2012
  7. 7. World Population, 2050 Estimate
  8. 8. Majority Religion by Country Pew Research Center, 2012
  9. 9. Population Density, 2010
  10. 10. English Speakers
  11. 11. Demographics in the U.S. Reporting a disability: 12.1% Limited English Proficient: 22% Over the age of 65: 13% Under the age of 18: 25%
  12. 12. LGBT There are approximately 9 million LGBT Americans, a figure roughly equivalent to the population of New Jersey.
  13. 13. Health Literacy
  14. 14. Patient Safety Events Greater Risk for Medical Errors Poorer Health Outcomes Higher Rate of Readmissions
  15. 15. Communication A two-way process in which messages are negotiated until the information is correctly understood by both parties. The Joint Commission, 2010
  16. 16. Communication • When providers understand and integrate the information gleaned from patients. • When patients comprehend accurate, timely, complete, and unambiguous messages The Joint Commission, 2010
  17. 17. Why Are These Issues Important? Quality Litigation Patient Need Legislation Informed Consent Changing Demographics Disparities Social Justice Medical Error Regulation Accreditation
  18. 18. The Case for Culturally and Linguistically Appropriate Services Business OMH, 2013 Social
  19. 19. Litigation Misinterpretation of one word: Intoxicado $71million dollar settlement 19
  20. 20. Disparities Eliminating health disparities for minorities would have reduced direct medical care expenditures by $229.4 billion in 2003-2006.
  21. 21. Patient Need-Satisfaction When a non-English speaking patient comes to the hospital everything is strange… The only familiar thing in this alien environment is the voice of the interpreter.
  22. 22. Quality Rita Quintero
  23. 23. Medical Error 9 out of 10
  24. 24. Social Justice & Other Implications "Please don't cry, Mama; they tell me I have cancer".
  25. 25. Legislation
  26. 26. Regulation
  27. 27. Accreditation
  28. 28. Every Point of Contact Initial point of contact & appointment scheduling Preparation for the visit Entering & navigating the health organization Registration Waiting in the lobby Procedures, radiology & lab work Assessment & clinical encounter including physical exam Diagnosis and explanation of treatment & discharge plans Discussion & referrals Billing Pharmacy Reminders & follow-up communication Patient Feedback
  29. 29. How can we address these issues?
  30. 30. The National Standards for Culturally and Linguistically Appropriate Services in Health and Health Care • Published by the HHS Office of Minority Health in 2000 • Re-published in 2013
  31. 31. The National CLAS Standards Physical Mental Social Spiritual Health
  32. 32. The National CLAS Standards Advance health equity Help eliminate disparities Improve quality of services 32
  33. 33. What are the National CLAS Standards?
  34. 34. Principal Standard 1. Provide effective, equitable, understandable, and respectful quality care and services that are responsive to diverse cultural health beliefs and practices, preferred languages, health literacy, and other communication needs. 34
  35. 35. Theme 1: Governance, Leadership and Workforce governance leadership workforce
  36. 36. Standards on Governance, Leadership, and Workforce 2. Advance and sustain organizational governance and leadership that promotes CLAS and health equity through policy, practices, and allocated resources. 3. Recruit, promote, and support a culturally and linguistically diverse governance, leadership, and workforce that are responsive to the population in the service area. 4. Educate and train governance, leadership, and workforce in culturally and linguistically appropriate policies and practices on an ongoing basis. 36
  37. 37. Theme 2: Communication and Language Assistance
  38. 38. Standards on Communication and Language Assistance 5. Offer language assistance to individuals who have limited English proficiency and/or other communication needs, at no cost to them, to facilitate timely access to all health care and services. 6. Inform all individuals of the availability of language assistance services clearly and in their preferred language, verbally and in writing. 7. Ensure the competence of individuals providing language assistance, recognizing that the use of untrained individuals and/or minors as interpreters should be avoided. 8. Provide easy-to-understand print and multimedia materials and signage in the languages commonly used by the populations in the service area. 38
  39. 39. Theme 3: Engagement, Continuous Improvement and Accountability
  40. 40. Standards on Engagement, Continuous Improvement, and Accountability 9. Establish culturally and linguistically appropriate goals, policies, and management accountability, and infuse them throughout the organization’s planning and operations. 10. Conduct ongoing assessments of the organization’s CLAS-related activities and integrate CLAS-related measures into measurement and continuous quality improvement activities. 11. Collect and maintain accurate and reliable demographic data to monitor and evaluate the impact of CLAS on health equity and outcomes and to inform service delivery. 40
  41. 41. Standards on Engagement, Continuous Improvement, and Accountability 12. Conduct regular assessments of community health assets and needs and use the results to plan and implement services that respond to the cultural and linguistic diversity of populations in the service area. 13. Partner with the community to design, implement, and evaluate policies, practices, and services to ensure cultural and linguistic appropriateness. 14. Create conflict and grievance resolution processes that are culturally and linguistically appropriate to identify, prevent, and resolve conflicts or complaints. 15. Communicate the organization’s progress in implementing and sustaining CLAS to all stakeholders, constituents, and the general public. 41
  42. 42. Where can you find more information about the National CLAS Standards? National CLAS Standards: A Blueprint for Advancing and Sustaining CLAS Policy and Practice
  43. 43. Where do we go from here?
  44. 44. Think Cultural Health
  45. 45. Godfrey_Jacobs@sra.com

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