Presenters 2 Yvonne Fortier LPC, LISAC, Director of Clinical - PDF document

Presenters 2  Yvonne Fortier LPC, LISAC, Director of Clinical Services, Native American Connections  Teresa O. Peña, M.Ed., CHI, Cultural Sensitivity Understanding changes in Healthcare Administrator Mercy Maricopa Integrated Health through a Diversity lens: Care  Beatrice Salazar BSW, MA, Director of Children’s How the New and Revised CLAS standards respond to Health Services, Diversity and Learning Center of the changing demographics in our systems Excellence, Children’s Services/Administration, People of Color Network 15 th Annual Summer Institute 2014 State and Federal Legislation: Title VI of Why Cultural and Linguistic Competence? the Civil Rights Act of 1964 3 4 As implemented by Executive Order 13166,  To respond to current and projected demographic changes in organizations receiving federal funds must take the United States reasonable steps to provide meaningful access to their  To eliminate long-standing disparities in the health status of people of diverse racial, ethnic and cultural backgrounds programs for individuals with limited English  To improve the quality of services and health outcomes proficiency (Executive Order no. 13166, 2000).  To meet legislative, regulatory and accreditation mandates Furthermore, several states have recognized the  To gain a competitive edge in the market place importance of cultural and linguistic competency by  To decrease the likelihood of liability/malpractice claims legislating cultural and linguistic competency training in health care. The National Center for Cultural Competence 1

Federal Legislation: Affordable Care Act CLAS Awareness: 2000 ‐ 2012 of 2010 5 6 The Affordable Care Act of 2010 lays an important HHS Action Plan to Reduce Racial and Ethnic Health foundation for advancing health equity and improving Disparities – 2011  Goal II –Strengthen the Nation’s Health and Human the quality of services to diverse communities Services Infrastructure and Workforce (Andrulis, Siddiqui, Purtle, & Duchon, 2010;  Strategy II.A: Increase the ability of all health Youdelman, 2011). There are numerous provisions in professions and the healthcare system to identify the health care law related to cultural and linguistic and address racial and ethnic health disparities. competency, and the enhanced National CLAS  Action II.A.2: Collaborate with individuals and Standards serve as a resource, at all levels, in these health professional communities to make enhancements to the current National Standards areas. for Culturally and Linguistically Appropriate Services in Health Care (CLAS) National CLAS Standards Enhancement Initiative CLAS Awareness:2000 ‐ 2012State Level 2010 – 2012 Cultural Competency Legislation 7 8 Goals of the Initiative:  To examine the National CLAS Standards for their current relevance and applicability.  To have the enhanced National CLAS Standards serve as the cornerstone for culturally and linguistically appropriate services in the United States.  To launch new and innovative promotion and marketing initiatives, including via social media, for the National CLAS Standards.  To coordinate the Standards with the Affordable Care Act and other cultural and linguistic competency provisions (e.g. Joint Commission, National Committee for Quality Assurance). *Source: Think Cultural Health, 2011 Think Cultural Health 2

Comparison – 2000 and 2012 National CLAS Standards National CLAS Standards Enhancement Initiative: Timeline 9 10 2000 Standards 2012 Standards Research: 2010 Literature Review Public Comment Advisory Committee Goal: to decrease health care disparities and Goal: to advance health equity, improve quality make practices more culturally and linguistically and help eliminate health and health care appropriate disparities. Development: 2011 “Culture”: racial, ethnic and linguistic groups “Culture”: racial, ethnic and linguistic groups, as well as geographical, religious and spiritual, Analysis Consultations Drafting biological and sociological characteristics Audience: health care organizations Audience: health and health care organizations Launch: 2013 Implicit definition of health Explicit definition of health to include physical, Enhanced National CLAS Standards mental, social and spiritual well-being Recipients: patients and consumers Recipients: individuals and groups Expanded definition of “health”: Comparison-2000-2012 CLAS 11 12 Health is a state of physical, mental, social, and 2000 Themes 2012 Themes spiritual well ‐ being. Culturally Principal Standard Competent Care Governance, Standards targeted to a more inclusive audience: Leadership, and Language Workforce  Health and health care organizations ; beyond health Access Services care organizations Communication and Language Assistance  Individuals and groups ; beyond patients and Organizational consumers Supports Engagement, Continuous Improvement, and Accountability 3

All National CLAS Standards are of equal importance: 2012 CLAS Enhancements 13 14 Interrelationship of Aspects of Culture  The enhanced National CLAS Standards promote collective adoption of all Standards to most effectively Geography affect the health and well ‐ being of all Americans. Race & Religion or Ethnicity  Each of the 15 Standards is equally important to an Spirituality organization’s ability to advance health equity, improve quality, and help eliminate health care Biology Language disparities.  In the original National 2000 CLAS Standards, each Sociology ( Graves, 2001, rev. 2011) Standard was designated as a recommendation, More inclusive definition of “culture”; beyond racial mandate, or guideline. and ethnic minorities A broader definition of culture Cultural Competence Continuum 15 Culture refers to “the integrated pattern of thoughts, communications, actions, customs, beliefs, values, and Ignorance Sensitivity Competence institutions associated, wholly or partially, with racial, ethnic, or linguistic groups, as well as with religious, Awareness Understanding spiritual, biological, geographical, or sociological characteristics.” This definition is adapted from other widely accepted definitions of culture (e.g., Gilbert et al., 2007; HHS OMH, 2005) 16 4

Advancing Equity Definition of Linguistic Competence National Center for Cultural Competence 17 18 National Population Growth Projection By Ethnicity The capacity of an organization and its personnel to communicate effectively, and convey information in a manner that is easily understood by diverse audiences including persons of limited English proficiency, those who have low literacy skills or are not literate, Arizona Population Growth Projection By Ethnicity and individuals with disabilities. Source: Population Division U.S. Census Bureau Source: wpcarey asu, Office of University Economist, January 2013 Changing Face of the United States Introductory Statement of Intent 19 20  Changing demographic  Aging baby boomers  Growth of racial and ethnic minority groups to overtake The National CLAS Standards are intended to non-Hispanic White population within the next 45 years advance health equity, improve quality, and help  By 2015, non-Hispanic Whites will be primarily elderly population eliminate health care disparities by establishing a  By 2050, racial and ethnic minority group will account for blueprint for health and health care 90% of the total population growth organizations to: 5

Strategies for Achievement of the Principal Standard: Principal Standard 21 22 Provide effective, equitable, If each of Standards 2 through 15 is implemented understandable, and respectful quality and maintained, organizations will be better care and services that are responsive positioned to achieve the desired goal of “effective, equitable, understandable, and respectful quality to diverse cultural health beliefs and care and services that are responsive to diverse practices, preferred languages, health cultural health beliefs and practices, preferred languages, health literacy, and other communication literacy, and other communication needs.” needs. Theme 1: Governance, Leadership, and Workforce 23 24 Standard 2: Changing the name of Theme 1 from Culturally Advance and sustain Competent Care to Governance, Leadership, and Workforce provides greater clarity on the specific organizational governance and locus of action for each of these Standards and leadership that promotes CLAS emphasizes the importance of the implementation of CLAS as a systemic responsibility, requiring the and health equity through policy, investment, support, and training of all individuals practices, and allocated resources. within an organization. 6