Building Linguistic Capacity: A Health Department's Response to Key Recommendations from a Countywide Baseline Assessment of Linguistic Access

Background: Organizations have long conducted assessments of their level of cultural and linguistic competence to inform planning efforts. However, few counties have conducted countywide assessments. In August 2006, the San Mateo County Health Department (SMCHD) conducted a countywide assessment which served to both identify high priority areas and strategies for improving linguistic access and provide a baseline against which to measure future improvement efforts. Since the release of the study results the SMCHD has taken several steps to internally address the study's key findings and recommendations for the organization.

Objective: To implement key recommendations for improving access to Health Department services for limited English proficient (LEP) populations.

Methods: A multi-disciplinary Health Disparities Initiatives Oversight (HDIO) group was formed and includes leadership representation from each SMCHD Division. HDIO has provided guidance in implementation of the study results and evaluation strategies including development of an 18-month Action Plan intended to address key findings of the baseline assessment and monitor progress.

Results: A set of Health Department-tailored standards, policies and protocols related to culturally and linguistically appropriate services were developed. The policies are both comprehensive and practical and accomplished through the collaboration and input from managers and front line staff and an assessment of availability and quality of existing language resources including the linguistic diversity of staff. In addition, SMCHD has implemented capacity building strategies in areas and populations identified by the study as our greatest linguistic access gaps and established a local “clearinghouse” of training opportunities, self-assessment tools, and other resources.