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Do You Have CLAS?

Date: 03/15/16

The push for practitioners and health-care organizations to provide culturally and linguistically appropriate services to a diverse group of patients has been steadily on the rise since the inception of the Office of Minority Health’s (OMH) National Standards for Culturally and Linguistically Appropriate Services (CLAS) in Health and Healthcare in 2000. The National CLAS Standards are a comprehensive series of guidelines that inform, guide and facilitate practices, related to culturally and linguistically appropriate health services for physicians to administer to a diverse patient base. In 2013, the OMH enhanced these standards to ensure that demographic and cultural trends were reflective of the increasing diversity of the nation, and in alignment with legislation and policies, including the Affordable Care Act.

At Superior, it is important that providers deliver services that are culturally and linguistically competent.  Developing cultural competence is a dynamic and evolutionary process that takes time and typically progresses along a continuum.  The National Center for Cultural Competence at Georgetown University’s Center for Child and Human Development describes the six stages of this continuum:

  1. Cultural Destructiveness – is characterized by organizational attitudes, policies, structures and practices that are destructive to a cultural group.
  2. Culture Incapacity – is the lack of capacity to respond effectively to the needs, interests and preferences of culturally and linguistically diverse groups.
  3. Cultural Blindness – is the predominant philosophy that views and treats all people as the same.
  4. Cultural Pre-Competence –is a level of awareness of strengths and areas for growth to respond effectively to culturally and linguistically diverse populations.
  5. Cultural Competence – is characterized by an acceptance and respect for culture that is consistently demonstrated in policies, structures, practices and attitudes.
  6. Cultural Proficiency – is defined by an organization that holds culture in high esteem and uses this as a foundation to guide all endeavors.

If providers would like to find out where they, or their organization, fall within the continuum, they can conduct a cultural competence assessment.  These are not designed to censure, but rather increase sensitivity and awareness to practitioners and health-care organizations on the importance of cultural and linguistic competence in health and health care. Care should be individualized. Equality does not equate to equity. A few examples of assessment questions are listed below.

Practitioners

  • Do I have pre-conceived ideologies about people of a certain race, gender or sexual orientation?
  • Do I understand the principles and practices of linguistic competency and apply them within my program/organization or advocate for them within my program or organization?
  • Do I avoid imposing values that may conflict or be inconsistent with those of cultures or ethnic groups other than my own?

Health-Care Organizations

  • Does my organization recognize that the meaning or value of medical treatment and health education may vary greatly among cultures?
  • Does my organization screen books, movies and other media resources for negative cultural, ethnic or racial stereotypes before sharing them with individuals and families served by my program or organization?
  • Does my organization make sure that staff are representative of the population my organization serves? And, does my organization use bilingual/bicultural or multilingual/multicultural staff, and/or personnel and volunteers who are skilled or certified in the provision of medical interpretation services during treatment, interventions, meetings or other events for individuals and families who need, or prefer, this level of assistance?

A willingness to conduct honest assessments is just the beginning on the cultural competence journey, but signifies a good start. Provision of culturally and linguistically competent services to Superior members has been known to improve patient satisfaction, Consumer Assessment of Healthcare Providers & Services (CAHPS) outcomes and health disparities.

Management Sciences for Health has developed the Provider’s Guide to Quality & Cultural Quiz, an online assessment tool for providers.

There are numerous opportunities for providers to not only meet, but exceed, CLAS Standards. For more information on culturally and linguistically competent services please visit the Office of Minority Health website at http://minorityhealth.hhs.gov/, or the National Center for Cultural Competence website at http://nccc.georgetown.edu/.