WASHINGTON -- The Obama administration on Wednesday released updated cultural policies and principles to help providers better relate to minorities, address their care needs, and ultimately reduce health disparities.
The updated National Standards for Culturally and Linguistically Appropriate Services in Health and Health Care – or CLAS Standards for short – are a set of guidelines to help practices relate culturally and provide linguistically appropriate health services.
The Department of Health and Human Service's (HHS) Office of Minority Health released the standards in 2000. The newly revised guidelines are broader -- going beyond their original focus on race, ethnicity, and language -- and now encompass socioeconomic status, spirituality, disability, sexual orientation, gender identity, and geography.
HHS updated the standards due to the changing demographics of the country and the growth of linguistic competency, and to ensure the relevance and applicability of the standards.
"The enhanced standards are also grounded in a broad definition of culture," Nadine Gracia, MD, director of the HHS Office of Minority Health, said at a release event Wednesday. "The enhanced standards are also directed toward a broader audience to more fully address the importance of more culturally and linguistically appropriate services at every point of contact along the health and human services continuum."
The 15 standards go beyond providing for an interpreter and aim to get providers to think about a patient's culture when going about their care.
For example, they call for practices to recruit and promote a work force that is representative of patients. Furthermore, providers should educate and train leadership and work force in culturally and linguistically appropriate policies and practices.
A panel of stakeholders and advocates offered their input for the updated standards, which include:
- Offering language assistance to individuals who have limited English proficiency and/or other communication skills at no cost
- Informing patients of the availability of language assistance and ensuring the competence of individuals providing language assistance
- Providing easy-to-understand print and multimedia materials and signage in commonly used languages
- Creating conflict and grievance resolution processes that are culturally and linguistically appropriate
- Conducting regular assessments of community health assets and needs and use results to plan services
- Collecting and maintaining accurate demographic data to monitor and evaluate the CLAS standards
The standards and adoption is purely voluntary. But to help providers implement the standards, HHS also developed and released Wednesday a blueprint to help incorporate the standards into practices and policies.
"The blueprint is a resource to organizations and individuals on how to implement and sustain culturally and linguistically appropriate services, practices, and policies by providing implementation strategies, resources, and promising models," Gracia said.
Richard Umbdenstock, president of the American Hospital Association, called the updated standards an "important and most concise road map" for providing culturally sensitive care. He added that healthcare providers have not only a moral responsibility to implement the standards, but also a business responsibility.
"Organizations and professionals will not be able to break through to the next level of quality if they don't know in very specific detail the populations they serve, the unique challenges of those populations, and then tailor the strategies of care to meet those needs," Umbdenstock said. "These organizations and professionals will not succeed in that environment without that additional dimension."
Howard Koh, MD, MPH, HHS Assistant Secretary for Health, said his hope is that a body of evidence grows that shows using these standards will prove to small providers a return on investment as use grows.
"We hope over time that this will be practice and also good business as well," Koh said.
In responding to questions about the burden on time and resources this could have on smaller organizations, Gracia said the goals of the CLAS Standards are to better health outcomes and reduce disparities. "As providers, as organizations, that should be within our charge, that we want to provide high quality care."