The New and Enhanced Culturally and Linguistically Appropriate Services (CLAS) Standards Will Help Eliminate Disparities in Health and Health Care

This April, the Office of Minority Health at the Department of Health and Human Services released the enhanced National Standards for Culturally and Linguistically Appropriate Services (CLAS) in Health and Health Care. With implementation of the Affordable Care Act in full swing and growing interest in improving the delivery of care and addressing health care costs, these standards will serve as a critical guide to developing policies and strategies that improve the quality of health care services and meet the needs of an increasingly diverse population.

Racial and ethnic minorities bear a disproportionate burden of chronic illnesses, are more likely to be uninsured, face unequal access to quality health care services, and suffer worse health care outcomes than the general population. First introduced in 2000, the CLAS standards are a set of guidelines for improving cultural and linguistic competency in the health care system with the goal of reducing racial and ethnic health care disparities.

The enhanced standards expand the scope of the goals laid out in the standards released in 2000. They broaden the concepts of “culture” and “health” and encourage health care organizations to consider not just race and ethnic background, but also beliefs, values, institutions, language, and geographical and sociological characteristics. The new standards also advocate for a broader view of health that encompasses physical, mental, social, and spiritual well-being. In this way, the enhanced CLAS standards aim to improve overall quality of care, eliminate health care disparities, and achieve health equity.

Beyond a conceptual framework, the enhanced CLAS standards provide specific recommendations for addressing inequities at every point of patient contact with the health care system. The end goal of the enhanced CLAS standards are to ensure “effective, equitable, understandable, and respectful quality care and services that are responsive to diverse needs.” The standards are organized into three themes:

• Theme 1: Governance, Leadership, and Workforce

Provides guidance on developing leadership capacity in health care organizations for promoting and sustaining CLAS

• Theme 2: Communication and Language Assistance

Provides recommendations to health care organizations for addressing language and other communication barriers to adequately meet the needs of people with limited English proficiency

• Theme 3: Engagement, Continuous Improvement, and Accountability

Provides a blueprint for establishing community engagement and includes recommendations on conducting community assessments

There are many opportunities to use CLAS standards to effectively enroll populations in health coverage through the new state marketplaces that open on October 1. For example, health care organizations that carry out enrollment assistance activities should put the CLAS guidelines into practice. Beyond the Affordable Care Act, the CLAS standards are an important guide for improving quality in the delivery of care. A hospital that is working to enhance patient engagement should look to CLAS standards on data collection and community partnerships.

The Office of Minority Health has launched a new resource center, ThinkCulturalHealth, in order to support health care organizations and stakeholders interested in embarking on CLAS policy and practice. The site includes cultural competence training curriculum for providers, a clearinghouse of research papers on health disparities, as well as updates for upcoming CLAS webinars and events hosted by the Office of Minority Health. As our country looks for ways to promote better health and health care, the enhanced CLAS standards provide a useful roadmap for achieving this goal.