Improving culturally and linguistically appropriate services (CLAS) through organizational assessment: Lessons from six years in community health centers

Health and human service organization in communities throughout the US are challenged to plan, implement and monitor progress with federal and state legislation for culturally and linguistically appropriate services (CLAS). Since 2001, the National Standards for CLAS have guided organizations in understanding and improving their capacity to serve diverse population. In 2002, a collaboration between an organization of community health centers and a research team used the National Standards to develop and implement an organizational assessment to examine CLAS in order to strategically plan programs and policies. The assessment process was designed to be incorporated into the organization for improvements in human resources, training, health promotion, and quality assurance. The process uses findings and lessons from a brief staff survey, key informant interviews, and direct observations to outline explicit strengths, areas for improvement, and recommendations linked to mandates and guidelines of the CLAS Standards. Over the past six years, the assessment has been implemented three times with results and lessons applied to ongoing improvement of language access and culturally responsive patient care. This presentation illustrates this process through the multi-year quantitative and qualitative findings and their application in programs and policies. Challenges and strategies for engaging administrative and clinical leadership in CLAS are discussed with an emphasis on how to integrate CLAS assessment to improve staff hiring and training, health promotion, and quality assurance. Budgetary and staffing issues to sustain CLAS assessment and action are discussed with attention to how organizations can plan and implement methods to eliminate health disparities.