U.S. DEPARTMENT OF HEALTH AND
HUMAN SERVICES
National Standards for Culturally and
Linguistically Appropriate Services in Health Care
 Overview
of OMH
 Rationale for Cultural Competence
 OMH’ s Center for Linguistic and Cultural
Competence in Health Care (CLCCHC)
 Describe the CLAS Standards
 Challenges
Office of Minority Health Mission
To improve the health of racial and ethnic
populations through the development of
health policies and programs that help to
eliminate health disparities and gaps.
OMH’s “7+4”
 (1)
Heart Disease & Stroke(2) Cancer; (3)
Substance Abuse; (4) Diabetes; (5) Homicide,
Suicide and Unintentional Injuries; (6) Infant
Mortality; (7) HIV/AIDS.
 Crosscutting
areas: (1) Access to health care;
(2) Improve Data Collection/Analysis; (3)
Health Professions Development; and (4)
Cultural Competence.
What Does Cultural
Competence Mean?
 Cultural
Competence is the:
– ability of health organizations and practitioners
to recognize the cultural beliefs, attitudes and
health practices of diverse populations, and
– to apply that knowledge in every intervention;
at the systems level or at the individual level.
Rationale for
Cultural Competence?
POR
QUE (Why)?
Legislative Framework for Cultural
Competence
 Disadvantaged
Minority Health Improvement
Act of 1990; and
 The Health Professions Education Partnership
Act of 1998.
Demographics
Language Diversity in U.S.
 Spanish
 French
 German
 Italian
 Chinese
 Tagalog
17.1 million
1.7 million
1.5 million
1.3 million
1.2 million
843,000
Source: U.S. Census 1990
Racial and Ethnic Distribution of Selected
Health Professions: Source: HRSA, U.S. Census 2000
89
82
90
80
White
Black
Hispanic
Asian/PI
AI
76
73
73
70
60
50
40
30
17
20
10
14
7
5 4
0.1
1 2 0.1
6
3
0.3
19
4 3
9
0.8
3
0
MDs
Dentists
PharmDs
LPN
RNs
6
0.4
Health Divide
 1985
Task Force Report on Black and
Minority Health revealed:
– Minorities continue to have poor health;
– Health disparities have worsened;
– Minorities chronically underserved by the
health care system.
 IOM
Report - March 2002.
The OMH Center for Linguistic and Cultural
Competence in Health Care
Mandated by Congress to develop projects to eliminate
language barriers for Limited English Proficient
(LEP) individuals to increase their access to health
care.
 Culturally and Linguistically Appropriate Services
(CLAS) Standards Project.
 Cultural Competency Curriculum Modules (CCCMs).
 Hispanic Cultural Competence for Medical Education
Curriculum.

Why CLAS Standards?
 Address
the patchwork of definitions,
guidelines, overlap, etc., on what constitutes
cultural competence service delivery.
 Provide a road-map for providing culturally
competent services.
 Serve as guiding principles for the delivery
of quality health care to diverse
populations.
CLAS As A Vehicle to Improve
Health
 Improve
 Reduce
access to services;
medical errors;
 Improve
effectiveness of preventive
services;
CLAS As A Vehicle to Improve
Health
 Improve
patient satisfaction;
 Improve
patient compliance; and
 Reduce
financial costs and risks.
CLAS Standards
 14
National Recommended Standards: inform,
guide, and facilitate implementation of CLAS.
 Three themes:
– Culturally Competent Care (1-3);
– Language Access Services(4-7); and
– Organizational Supports for Cultural
Competence (8-14).
Culturally Competent Care - 1
Patients and consumers
receive effective,
understandable, and
respectful health care.
Cultural Competent Care - 2
Recruitment, retention,
and promotion of
diverse staff and
leadership.
Cultural Competent Care - 3
All staff receive
ongoing education and
training.
Language Access - 4
Language assistance
services, including
bilingual staff and
interpreters must be
offered at no cost to
the patient.
Language Access - 5
Patients and
consumers must be
informed of their right
to language assistance
services.
Language Access - 6
Health organizations
must assure the
competence of
language assistance
provided by
interpreters/bilingual
staff.
Language Access - 7
Availability of easily
understood patient
materials and
applicable signage
posted.
Organizational Supports - 8
Written strategic plan
with clear goals,
policies, and
accountability
mechanisms.
Organizational Supports - 9
Conduct initial and
ongoing organizational
self-assessments, and
Integrate cultural and
linguistic competence
measures into overall
program activities.
Organizational Supports - 10
Patient data collection
to include: race,
ethnicity, and spoken
and written language.
Organizational Supports - 11
Maintain current
demographic, cultural, and
epidemiological
community profiles, and
Conduct needs assessment
on cultural and linguistic
characteristics of the
service area.
Organizational Supports - 12
Participatory, collaborative
partnerships to facilitate
community and patient/
consumer involvement.
Organizational Supports - 13
Ensure that conflict
and grievance
resolution processes
are culturally and
linguistically sensitive.
Organizational Supports - 14
Keep the public
informed about
progress and
successful innovations
in implementing the
CLAS standards.
Challenges
 Developing
the evidence.
 Marketing strategies.
 Collaborating with medical societies.
 Working at the State and Federal levels.
 Working with advocacy groups.
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U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES