making the business case for culturally and linguistically appropriate ...

INTRODUCTIONHighlights:• Overview of U.S. demographic changes and implications for health careorganizations;• A brief description of how the government identified CLAS as a priority, andhow this was translated into a series of 14 standards for health careorganizations;• An explanation of the state of CLAS in health care; and• Information about the origin and goals of this business case study project.The U.S. Census has shown a consistent increase in immigrants and LEP populations in thepast 20 years, and experts forecast a dramatic increase in these populations over the next 20-40 years. Census experts estimate that by 2050 the proportion of "minorities" in the U.S. willapproach and perhaps exceed 50 percent. The rapid increase in population diversity bringswith it both opportunities and challenges for health care organizations. For example, thenumbers of racial and ethnic minorities, immigrants and LEP populations enrolled in U.S.health plans has increased. 4 The fact that health plans have increased enrollment among LEPpopulations brings with it a responsibility to meet the language and cultural needs of thesenew patients.Government Activity Supporting CLAS in Health CareThe Office of Minority Health (OMH), U.S. Department of Health and Human Services, wasmandated in 1994 by the United States Congress (P.L. 101-527) 5 to develop the capacity ofhealth care professionals to address cultural and linguistic barriers to health care delivery andincrease access to health care for people with limited or no English proficiency. In 1998, theU. S. Department of Health and Human Services reinforced its commitment to health care forall by establishing a Healthy People 2010 objective to eliminate health disparities amongracial and ethnic populations in America. 6Subsequently, OMH in 2000 published the National Standards for Culturally andLinguistically Appropriate Services (CLAS) in Health Care. The document included a set ofnational standards spelling out legal and regulatory requirements for the provision of healthservices to individuals with limited English proficiency. 1 The report outlined 14 voluntaryCLAS standards organized by three themes: culturally competent care (Standards 1-3);language access services (Standards 4-7) and organizational supports for cultural competence(Standards 8-14). See page 11 for a list of the CLAS standards. The standards wereestablished to systematically change and advance access and provision of health care servicesfor minority and non-English proficient populations. The goals of the CLAS standards are toimprove the health of all Americans by aiming to eliminate racial and ethnic healthdisparities, address the inequalities that currently persist in health care, and to make healthcare programming more adaptable to the needs of the individual patient.4 Planning Culturally and Linguistically Appropriate Services: A Guide for Managed Care Plans. Summary.February 2003. Agency for Healthcare Research and Quality, Rockville, MD.5 About the Center of Cultural and Linguistic Competence in Health Care;http://www.omhrc.gov/templates/browse.aspx?lvl=2&lvlID=166 Healthy People 2010; http://www.healthypeople.gov/9