NATIONAL STANDARDS ON CULTURALLY AND LINGUISTICALLYAPPROPRIATE SERVICES (CLAS) 

Excerpted from the Office of Minority Health Website

The CLAS standards are proposed as one means to correct inequities that currently exist in the provision of health services and to make these services more responsive to the individual needs of all patients/consumers. The standards are intended to be inclusive of all cultures and not limited to any particular population group or sets of groups. However, they are especially designed to address the needs of racial, ethnic, and linguistic population groups that experience unequal access to health services. Ultimately, the aim of the standards is to contribute to the elimination of racial and ethnic health disparities and to improve the health of all Americans.  The CLAS standards serve several purposes. They provide a common understanding and consistent definitions of culturally and linguistically appropriate services in health care. They offer a practical framework for the implementation of services and organizational structures that can help health care organizations and providers be responsive to the cultural and linguistic issues presented by diverse populations.  

CULTURALLY COMPETENT CARE 

Standard 1 – Respectful Care Compatible with Cultural Health Beliefs Health care organizations should ensure that patients/consumers receive from all staff member's effective, understandable, and respectful care that is provided in a manner compatible with their cultural health beliefs and practices and preferred language.  

Standard 2 – Staff Recruitment
Health care organizations should implement strategies to recruit, retain, and promote at all levels of the organization a diverse staff and leadership that are representative of the demographic characteristics of the service area.  

Standard 3 – Ongoing Education and Training
Health care organizations should ensure that staff at all levels and across all disciplines receive ongoing education and training in culturally and linguistically appropriate service delivery.  

LANGUAGE ACCESS STANDARDS *

Standard 4 – Offer Language Services
Health care organizations must offer and provide language assistance services, including bilingual staff and interpreter services, at no cost to each patient/consumer with limited English proficiency at all points of contact, in a timely manner during all hours of operation.  *

Standard 5 – Inform of Right to Receive Language Assistance
Health care organizations must provide to patients/consumers in their preferred language both verbal offers and written notices informing them of their right to receive language assistance services.  *

Standard 6 – Assure Competence of Language Assistance Provided
Health care organizations must assure the competence of language assistance provided to limited English proficient patients/consumers by interpreters and bilingual staff. Family and friends should not be used to provide interpretation services (except on request by the patient/consumer).  *

Standard 7 -- Multi-Lingual Signage and Related Materials
Health care organizations must make available easily understood patient-related materials and post signage in the languages of the commonly encountered groups and/or groups represented in the service area.  

ORGANIZATIONAL SUPPORTS FOR CULTURAL COMPETENCE 

Standard 8 – Written Strategic Plan with Related Goals
Health care organizations should develop, implement, and promote a written strategic plan that outlines clear goals, policies, operational plans, and management accountability/oversight mechanisms to provide culturally and linguistically appropriate services.  

Standard 9 – Organizational Self-Assessment
Health care organizations should conduct initial and ongoing organizational self-assessments of CLAS-related activities and are encouraged to integrate cultural and linguistic competence-related measures into their internal audits, performance improvement programs, patient satisfaction assessments, and outcomes-based evaluations.  

Standard 10 – Information as Part of Medical Record
Health care organizations should ensure that data on the individual patient's/consumer's race, ethnicity, and spoken and written language are collected in health records, integrated into the organization's management information systems, and periodically updated.  

Standard 11 – Maintain Demographic Profile of Community
Health care organizations should maintain a current demographic, cultural, and epidemiological profile of the community as well as a needs assessment to accurately plan for and implement services that respond to the cultural and linguistic characteristics of the service area.  

Standard 12 – Develop Collaborative Community Partnerships
Health care organizations should develop participatory, collaborative partnerships with communities and utilize a variety of formal and informal mechanisms to facilitate community and patient/consumer involvement in designing and implementing CLAS-related activities.  

Standard 13 – Culturally Sensitive Conflict Resolution
Health care organizations should ensure that conflict and grievance resolution processes are culturally and linguistically sensitive and capable of identifying, preventing, and resolving cross-cultural conflicts or complaints by patients/consumers.  

Standard 14 – Publicize Successful Innovations in Implementing Standards
Health care organizations are encouraged to regularly make available to the public information about their progress and successful innovations in implementing the CLAS standards and to provide public notice in their communities about the availability of this information.  *Mandated for organizations receiving federal funds, including private physician practices receiving Medicaid or Medicare.