1. 2005 Patient’s Rights Annual Training Conference Culturally and Linguistically Appropriate Services (CLAS) November 5, 2005 Rachel G. Guerrero, LCSW Chief, Office Multicultural Service Department of Mental Health

3. Objectives Review language Issues Review language Issues Describe CLAS Standards Describe CLAS Standards Questions and Answers Questions and Answers

4. Terms Interpretation (interpreting)- A conversion of a message (usually oral) from one language (source language) into oral form in another language (the target language). Person doing this is called interpreter (not a translator). (MH Training for Interpreters 2005) Translation- The conversion of a message from the source language into written form in the target language. Linguistic competence- Providing readily available, culturally appropriate oral and written language services to Limited English Proficiency (LEP) members through such means as bilingual/bicultural staff, trained medical interpreters, and qualified translators. (CMHS Planning CLAS)

5. Terms Continued Cultural and Linguistic Competence: “The ability of health care providers and health care organizations to understand and respond effectively to the cultural and linguistic needs brought by the patient to the health care encounter.” (DHHS 2000) Cultural Competence: A set of congruent behaviors, attitudes, and policies that come together in a system or agency or among professionals that enables effective interactions in a cross-cultural framework” (T.Cross et al 1989)

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

7. National Standards for Culturally and Linguistically Appropriate Services in Health Care (CLAS) National Standards for Culturally and Linguistically Appropriate Services in Health Care (CLAS) Issued by U.S. Department of HHS, Office of Minority Health, March 2001 Issued by U.S. Department of HHS, Office of Minority Health, March 2001 Proposed as a means to correct inequities in health services Proposed as a means to correct inequities in health services To make services more response to diverse clients and families To make services more response to diverse clients and families To contribute to the elimination of racial and ethnic health disparities To contribute to the elimination of racial and ethnic health disparities

8. CLAS 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 Competence (8-14) Organizational Supports for Cultural Competence (8-14) CLAS Standards Arranged into: Federal Mandates, Guidelines Recommendations CLAS Standards Arranged into: Federal Mandates, Guidelines Recommendations

9. What is CA Threshold Languages? DMH Threshold Languages by County- when 3,000 Medi-Cal beneficiaries or 5% of the Medi-Cal population in a county speak a language other than English. DMH Threshold Languages by County- when 3,000 Medi-Cal beneficiaries or 5% of the Medi-Cal population in a county speak a language other than English. 48 of CA. 58 counties have one of more threshold languages. (see chart) 48 of CA. 58 counties have one of more threshold languages. (see chart) County MH programs are still required to comply with Title VI of Civil Rights act for LEP speakers. County MH programs are still required to comply with Title VI of Civil Rights act for LEP speakers.

10. Resources/References National Standards for Culturally and Linguistically Appropriate Services in Health Care. U.S. Department of Health and Human Services, Office of Minority Health. March 2001. www.omhrc.gov.clas National Standards for Culturally and Linguistically Appropriate Services in Health Care. U.S. Department of Health and Human Services, Office of Minority Health. March 2001. www.omhrc.gov.claswww.omhrc.gov.clas Planning Culturally and Linguistically Appropriate Services: A Guide for Managed Care Plans. Download copy at Planning Culturally and Linguistically Appropriate Services: A Guide for Managed Care Plans. Download copy at http://www.cms.gov./healthplans/guality/project03.asphttp://www.cms.gov./healthplans/guality/project03.asp> http://www.cms.gov./healthplans/guality/project03.asp

11. References J Perkins, H Simon, F. Cheng, K Olson, Y. Vera. Ensuring Linguistic Access in Health Care Setting: Legal Rights and Responsibilities. National Health Law program. For Henry J Kaiser Family Foundation. January 1998. www.healthlaw.org J Perkins, H Simon, F. Cheng, K Olson, Y. Vera. Ensuring Linguistic Access in Health Care Setting: Legal Rights and Responsibilities. National Health Law program. For Henry J Kaiser Family Foundation. January 1998. www.healthlaw.orgwww.healthlaw.org HHS, Office of Civil Rights. Limited English Proficiency (LEP) Department of Justice. Final Guidance to Federal Financial Assistance Recipients Regarding Title VI Prohibition Against National Origin Discrimination Affecting Limited English Proficient Persons. Policy guidance document. www.hhs.gov/ocr/lep or HHS, Office of Civil Rights. Limited English Proficiency (LEP) Department of Justice. Final Guidance to Federal Financial Assistance Recipients Regarding Title VI Prohibition Against National Origin Discrimination Affecting Limited English Proficient Persons. Policy guidance document. www.hhs.gov/ocr/lep orwww.hhs.gov/ocr/lep http://www.usdoj.gov/crt/cor/lep/DOJLEPGuidApr122002.htm

12. “The significant problems we face cannot be solved at the same level of thinking we were at when we created them.” Albert Einstein