Developing a Self-Assessment Toolfor Culturally - Office of Minority ...

Public Health Practice Program Office 1991). This population faces significant barriers toaccessing quality health care, because studies have shown racial and ethnic minorities andpeople who are LEP are more likely to lack health insurance than English speakers (TheHenry J. Kaiser Family Foundation 2003; Smedley et al. 2002). Consequently, studieshave documented how the uninsured have greater difficulty accessing health care thanthose who have insurance (Felt-Lisk et al. 2001).2.1.2 Provision of CLAS in LPHAsTitle VI of the Civil Rights Act of 1964 prohibited discrimination based on race,color, and national origin in programs that receive federal funding, and Executive Order13166 of 2000 went further, to require that federally funded programs be made accessibleto those who are not proficient in English. This order includes LPHAs which receivefunding from the federal government. Based on these requirements and other research,OMH issued a set of recommended national CLAS standards developed under anotherproject (Federal Register 2000), which may guide LPHAs in developing their ownstandards.LPHAs are aware of the increasing need for CLAS provision and strive to ensure thattheir clients’ needs are met. Some LPHAs have formed committees to investigate theircommunities’ needs (Interpreter Standards Advisory Committee 1998). For instance, theWashington State Department of Health has produced a report describing a formalizedtraining process for cultural awareness, changes in federal and state systems, and currentefforts to promote CLAS (Washington State Department of Health 1995). The ArizonaDepartment of Health Services has developed a needs assessment tool to ascertain theknowledge and attitudes of health management and staff regarding different cultures(Arizona Center for Minority Health Service 1996). Such assessments will help identifyhow CLAS (and overall quality of care) can be improved.While there is increasing literature that discusses health disparities of the underservedand the need for greater CLAS provision in health care settings, little was found whichdiscussed CLAS in LPHAs. This suggests that this topic should be further researched,especially in terms of quality and effectiveness of services.2.1.3 The Importance of Culture and Language in Health CareThe term culture refers to “the thoughts, communications, actions, customs, beliefs,values, and institutions of racial, ethnic, religious, or social groups” (OMH 2001). Allindividuals have a culture, and some individuals are associated with multiple culturalgroups simultaneously. Cultural categories and groups often are thought of in terms ofrace, ethnicity, and/or country of national origin. Similarly, an individual’s “culturalidentity” often is associated with groups of individuals along racial and ethnic lines.COSMOS Corporation, December 2003 2-2