2005 Patient’s Rights Annual 2005 Patient’s Rights Annual Training ConferenceTraining Conference

Culturally and Linguistically Culturally and Linguistically Appropriate Services Appropriate Services

(CLAS)(CLAS)November 5, 2005 November 5, 2005

Rachel G. Guerrero, LCSWRachel G. Guerrero, LCSW

Chief, Office Multicultural ServiceChief, Office Multicultural Service

Department of Mental Health Department of Mental Health

ObjectivesObjectives

Review language IssuesReview language Issues

Describe CLAS StandardsDescribe CLAS Standards

Questions and Answers Questions and Answers

TermsTerms

Interpretation (interpreting)-Interpretation (interpreting)- A conversion of a message A conversion of a message (usually oral) from one language (source language) into oral (usually oral) from one language (source language) into oral form in another language (the target language). Person doing form in another language (the target language). Person doing this is called interpreter (not a translator). (MH Training for this is called interpreter (not a translator). (MH Training for Interpreters 2005)Interpreters 2005)

Translation-Translation- The conversion of a message from the source The conversion of a message from the source language into written form in the target language. language into written form in the target language.

Linguistic competence-Linguistic competence- Providing readily available, culturally Providing readily available, culturally appropriate oral and written language services to Limited appropriate oral and written language services to Limited English Proficiency (LEP) members through such means as English Proficiency (LEP) members through such means as bilingual/bicultural staff, trained medical interpreters, and bilingual/bicultural staff, trained medical interpreters, and qualifiedqualified translators. (CMHS Planning CLAS) translators. (CMHS Planning CLAS)

Terms ContinuedTerms Continued

Cultural and Linguistic Competence:Cultural and Linguistic Competence: “The ability of “The ability of health care providers and health care organizations to health care providers and health care organizations to understand and respond effectively to the cultural and understand and respond effectively to the cultural and linguistic needs brought by the patient to the health linguistic needs brought by the patient to the health care encounter.” (DHHS 2000) care encounter.” (DHHS 2000)

Cultural Competence:Cultural Competence: A set of congruent behaviors, A set of congruent behaviors, attitudes, and policies that come together in a system attitudes, and policies that come together in a system or agency or among professionals that enables or agency or among professionals that enables effective interactions in a cross-cultural framework” effective interactions in a cross-cultural framework”

(T.Cross et al 1989) (T.Cross et al 1989)

Statue and RegulationStatue and Regulation

Section 601 of Title VI of the Civil Rights Act of Section 601 of Title VI of the Civil Rights Act of 1964, 42 U.S.C. Section 2000d 1964, 42 U.S.C. Section 2000d et.et. Seq.Seq. states: states:“No person in the United States shall on the “No person in the United States shall on the ground of race, color, or national origin, be ground of race, color, or national origin, be excluded from participation in, be denied the excluded from participation in, be denied the benefits of, or be subjected to discrimination benefits of, or be subjected to discrimination under any program or activity receiving under any program or activity receiving Federal financial assistance.” Federal financial assistance.”

National Standards for Culturally and National Standards for Culturally and Linguistically Appropriate Services in Health Linguistically Appropriate Services in Health

Care (CLAS) Care (CLAS)

Issued by U.S. Department of HHS, Office of Issued by U.S. Department of HHS, Office of Minority Health, March 2001 Minority Health, March 2001

Proposed as a means to correct inequities in Proposed as a means to correct inequities in health serviceshealth services

To make services more response to diverse To make services more response to diverse clients and familiesclients and families

To contribute to the elimination of racial and To contribute to the elimination of racial and ethnic health disparitiesethnic health disparities

CLAS StandardsCLAS Standards

There are 14 CLAS Standards:There are 14 CLAS Standards: Culturally Competent care (1-5)Culturally Competent care (1-5) Language Access Services (4-7)Language Access Services (4-7) Organizational Supports for Cultural Organizational Supports for Cultural

Competence (8-14) Competence (8-14) CLAS Standards Arranged into: CLAS Standards Arranged into:

Federal Mandates, Federal Mandates, Guidelines Guidelines RecommendationsRecommendations

What is CA Threshold Languages? What is CA Threshold Languages?

DMH Threshold Languages by County- when DMH Threshold Languages by County- when 3,000 Medi-Cal beneficiaries or 5% of the 3,000 Medi-Cal beneficiaries or 5% of the Medi-Cal population in a county speak a Medi-Cal population in a county speak a language other than English. language other than English.

48 of CA. 58 counties have one of more 48 of CA. 58 counties have one of more threshold languages. (see chart) threshold languages. (see chart)

County MH programs are still required to County MH programs are still required to comply with Title VI of Civil Rights act for comply with Title VI of Civil Rights act for LEP speakers.LEP speakers.

Resources/ReferencesResources/References

National Standards for Culturally and Linguistically National Standards for Culturally and Linguistically Appropriate Services in Health Care. U.S. Appropriate Services in Health Care. U.S. Department of Health and Human Services, Office of Department of Health and Human Services, Office of

Minority Health. March 2001. Minority Health. March 2001. www.omhrc.gov.claswww.omhrc.gov.clas Planning Culturally and Linguistically Planning Culturally and Linguistically

Appropriate Services: A Guide for Managed Appropriate Services: A Guide for Managed Care Plans. Download copy atCare Plans. Download copy at

http://www.cms.gov./healthplans/guality/project03.asphttp://www.cms.gov./healthplans/guality/project03.asp>>

References References J Perkins, H Simon, F. Cheng, K Olson, Y. Vera. Ensuring J Perkins, H Simon, F. Cheng, K Olson, Y. Vera. Ensuring

Linguistic Access in Health Care Setting: Legal Rights and Linguistic Access in Health Care Setting: Legal Rights and Responsibilities. National Health Law program. For Henry J Responsibilities. National Health Law program. For Henry J Kaiser Family Foundation.Kaiser Family Foundation.January 1998. January 1998. www.healthlaw.orgwww.healthlaw.org

HHS, Office of Civil Rights. Limited English Proficiency HHS, Office of Civil Rights. Limited English Proficiency (LEP) Department of Justice. Final Guidance to Federal (LEP) Department of Justice. Final Guidance to Federal Financial Assistance Recipients Regarding Title VI Financial Assistance Recipients Regarding Title VI Prohibition Against National Origin Discrimination Affecting Prohibition Against National Origin Discrimination Affecting Limited English Proficient Persons. Policy guidance Limited English Proficient Persons. Policy guidance document. document. www.hhs.gov/ocr/lepwww.hhs.gov/ocr/lep or or

http://www.usdoj.gov/crt/cor/lep/DOJLEPGuidApr122002.htmhttp://www.usdoj.gov/crt/cor/lep/DOJLEPGuidApr122002.htm

““The significant problems we The significant problems we face cannot be solved at the face cannot be solved at the

same level of thinking we were same level of thinking we were at when we created them.”at when we created them.”

Albert EinsteinAlbert Einstein