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Fundamentals of the National Standards for Culturally and Linguistically Appropriate Services in Health and Health Care

This live webinar, held on March 17, 2016, explored culturally and linguistically appropriate services (CLAS), why they matter, and how the National CLAS Standards can help organizations provide culturally responsive and respectful services. Following the slide presentation, the Deputy Assistant Secretary for Minority Health, Dr. J. Nadine Gracia, MD, MSCE, answered questions posed by webinar participants.

Today, our presenter is Dr. Nadine Gracia, the Deputy Assistant Secretary for Minority Health and the Director of the Office of Minority Health at the U.S. Department of Health and Human Services.

Under Dr. Gracia's leadership,the Office of Minority Health oversees the implementation of the HHS Action Plan to Reduce Racial and Ethnic Health Disparities and the National Partnership for Action to End Health Disparities.

A pediatrician with epidemiology training, Dr. Gracia has held positions in federal government and academia, including Chief Medical Officer for the HHS Office of the Assistant Secretary for Health and Clinical Instructor at the Children's Hospital of Philadelphia and the Children's Hospital of Pittsburgh.

Without further ado, I will pass the presentation on to Dr. Gracia.

Thank you, Teddy, and hello, everyone. I'm glad to be with you today to talk about the National Standards for Culturally and Linguistically Appropriate Services in Health and Health Care, more simply known as the National CLAS Standards.

And it's wonderful to see the great interest in today's webinar.This webinar is the first in a series of webinars about the National CLAS Standards that will be hosted by the HHS Office of Minority Health.

This first webinar is meant to serve as an introduction to the National CLAS Standards, and I will be discussing the fundamentals of the standards.

For those of you who may already be familiar with the National CLAS Standards, we encourage you to also tune in to our subsequent webinars.

The second webinar will present the case for the National CLAS Standards, and the third webinar will discuss implementation strategies. So stay tuned for more information and invitations for the remaining webinars in this series.

For this presentation, I will provide a brief background on the Office of Minority Health at HHS, as well as provide an overview of culturally and linguistically appropriate services.

I'll then discuss the case for CLAS and then delve into the National CLAS Standards, and, lastly, talk about an online resource known as Think Cultural Health.

The National CLAS Standards were developed by the Office of Minority Health at the U.S. Department of Health and Human Services. The Office of Minority Health works to improve the health of racial and ethnic minority populations through the development of health policies and programs that will help eliminate health disparities, and, as many of you know, there is a significant body of research that documents the persistent and widespread disparities experienced by many communities in our nation.

So before we begin, we'd like to start with a polling question. The first thing, how familiar are you with culturally and linguistically appropriate services, also known as CLAS?

So the results are in. Dr. Gracia, the audience can see that 35 percent are very familiar, 34 percent are somewhat familiar, 11 percent vaguely, and 19 percent don't know what the standards are at all.

Great. Thank you, Teddy. So we have a wide array of familiarity with the CLAS standards, and that's the purpose of today's webinar, to provide you with the fundamentals of the National CLAS Standards.

Our next polling question: How familiar are you specifically with the National CLAS Standards?

Okay. And so we have 10 percent who are very familiar, 40 percent somewhat familiar, and 20 percent not familiar and 20 percent vaguely familiar, and we have 10 percent of the audience who has never heard of the National CLAS Standards.

Thank you, Teddy. So we'll start, then, with an overview of culturally and linguistically appropriate services, or, what is CLAS?

It's an acronym that stands for culturally and linguistically appropriate services. CLAS is defined as services that are respectful of and responsive to individual cultural health beliefs, and practices, preferred languages, health literacy levels and communication needs.

CLAS should be employed by all members of an organization, regardless of size, at every point of contact. We know that a ne-size-fits-all approach is not the best approach to health care and public health, and implementing CLAS helps health and human services professionals treat individuals with respect and be mindful of their culture and language.

Culturally and linguistically appropriate services are increasingly recognized as effective in improving the quality of care and services. CLAS helps health and human service professionals build rapport and a trusting relationship with individuals and groups so that they can better understand and address their needs.

There are many reasons to promote culturally and linguistically appropriate services at your organization. CLAS supports an organization's efforts to achieve its mission

Every organization strives to provide high-quality services to all individuals to offer an open and welcoming environment. Providing services that are culturally and linguistically appropriate are a key strategy for doing so.

Providing CLAS also helps improve quality of care and services by helping an organization meet the needs of the populations they serve. As examples, research has shown that minorities and vulnerable populations are more likely to be readmitted within 30 days of discharge for chronic conditions.

Studies have also shown that limited-English-proficient individuals may be at greater risk for medical errors, longer length of hospital stay and avoidable readmissions when trained interpreters are not used. This impacts the quality and cost of care and services. So from individual and family engagement to improving communication and individual satisfaction with services to increasing utilization of preventive services, follow-up care and adherence to treatment, delivering culturally competent and linguistically appropriate services is a key strategy to improving the quality of care and services.

There is also a significant demographic shift that is underway in the United States as the U.S. is becoming increasingly diverse, with the majority of the population projected to be racial and ethnic minorities by 2042.

However, the health workforce is not diversifying as quickly, which can contribute to a widening cultural and linguistic difference between health professionals and the individuals they serve, and, as an organization that provides CLAS, it's better able to help respond to the changing demographics in its service area, not only racial and ethnic differences, but also linguistic, diversity, an aging population, and a vastly culturally diverse population.

Additionally,national health care policies and legislation, such as the Affordable Care Act, have helped to redefine and underscore the importance of culturally and linguistically approach services as vital to providing quality health care and services.

The Affordable Care Act has initiated a significant transformation in health care and delivery system reform to achieve the goals of better care, smarter spending and healthier people. Furthermore, accrediting bodies such as the Joint Commission and the National Committee for Quality Assurance have established accreditation standards that focus on improving communication, cultural competency, patient-centered care and the provision of language assistant services.

Implementing CLAS can help to make sure you're meeting these accreditation requirements. CLAS also plays an important role in reducing risk of litigation. Research shows that effective communication helps avoid cases of malpractice due to diagnostic and treatment errors, which can cost millions of dollars in liability or malpractice claims.

Culturally and linguistically appropriate services can help to reduce the possibility of such errors. So as you can see, CLAS makes sense, no matter what way you look at it. It makes good business sense because you can boost an organization's bottom line and competitiveness in the marketplace while reducing costly medical errors and malpractice.

From a social justice perspective, it's also the right thing to do. CLAS is an important way to help reduce health and health care disparities, because CLAS helps overcome cultural and linguistic barriers which can lead to poor quality of care and services. Now that you have an understanding of what culturally and linguistically appropriate services are and why they matter, you can ask the question, how do you actually provide CLAS?

To operationalize the concept of CLAS, the Office of Minority Health developed the National CLAS Standards,which provide a set of concrete action steps that guide professionals and organizations in providing CLAS. The National CLAS Standards originated in the 1990s.

While culturally and linguistically appropriate services were recognized as a strategy to help eliminate health inequities, the lack of a unified implementation approach left organizations and providers without clear guidance on how to provide CLAS in health and health care settings. The Office of Minority Health recognized the need for a recommended set of comprehensive national standards for CLAS in order to support a more consistent and comprehensive approach to cultural and linguistic competence.

In response, in 1997, the Office of Minority Health undertook the development of national standards to provide this much-needed framework. The National CLAS Standards were developed in collaboration with advisors representing an array of health-related fields, and public comment was also collected nationwide. And these standards were first published in 2000.

Following their original release, the fields of cultural and linguistic competency, as well as related policies and legislation, evolved significantly. In response to these developments, the National CLAS Standards were enhanced from 2010 to 2013, and in making these enhancements, the Office of Minority Health consulted with subject matter experts and solicited public comments that were used to create the initial CLAS standards.

And as a result, in 2013, the Office of Minority Health released the Enhanced National Standards for Culturally and Linguistically Appropriate Services in Health and Health Care to provide guidance and strategies for individuals and health organizations to implement CLAS.

The National CLAS Standards are intended to advance health equity, improve quality, and help eliminate health disparities. The standards establish a blueprint for health and health care organizations to implement and provide culturally and linguistically appropriate services.

So let's walk through some of the foundational concepts of the National CLAS Standards. These are concepts that we honed in on as we were developing the standards themselves, so they serve as the underpinning for the entire set of standards.

First, we broadened the definition of culture to help underscore the fact that every encounter is a cross-cultural encounter. We defined culture as the integrated pattern of thoughts, communications, actions, customs, beliefs, values and institutions associated wholly or partially with racial, ethnic and linguistic groups, as well as with religious, spiritual, biological, geographical or sociological characteristics. Culture is dynamic in nature, and individuals may identify with multiple cultures over the course of their lifetime.

This definition goes beyond racial, ethnic and linguistic groups, the language from the 2000 standards, to also encompass other characteristics that help to shape an individual, including age, socioeconomic status, country of origin, disability status, geography, meaning whether one comes, for example, from an urban community or lives in a rural area, sexual orientation and gender identity.

We conceptualize health as encompassing many aspects, including physical, mental, social and spiritual well-being. This definition is derived from the World Health Organization's definition of health, and it reflects the fact that many aspects of health influence one's well-being. Since we think of health broadly, the audience for the National CLAS Standards is health and health care organizations, meaning any public or private institutions addressing individual or community health and well-being.

We purposely designed the standards for a wide array of fields, including health care, public health, areas such as social work and community health and emergency health and more. And with the inclusion of mental well-being in the explicit definition of health, we expanded the reach of the standards to behavioral health.

And since, as I mentioned, our conceptualization of culture is very broad, the National CLAS Standards are relevant to any organization, no matter what the demographics of its service area. The National CLAS Standards are structured to include a principal standard, which is Standard 1, that serves as the foundation for all of the other standards.

The rest of the standards are divided into three themes. The Governance, Leadership and Workforce theme emphasizes that implementing CLAS is the responsibility of the entire system, requiring the investment, support and training of all individuals within an organization.

The Communication and Language Assistance covers all communication needs and services, including sign language, Braille, oral interpretation and written translation. The Engagement, Continuous Improvement and Accountability theme focuses on the supports necessary for adoption, implementation and maintenance of CLAS.

In your role, you likely have certain responsibilities that encompass one or more of these themes, and you have the opportunity to help your organization adopt and implement the standards as a way to provide culturally and linguistically appropriate services. As I tell you about the standards, I invite you to think about what role you could play in adopting and advocating for the National CLAS Standards.

The Principal Standards, shown here, frames the essential goal of all of the National CLAS Standards. Conceptually, if the other 14 standards are adopted, implemented and maintained, then the Principal Standard will be achieved. So, providing effective, equitable, understandable and respectful quality care and services helps to create a safe and welcoming environment at every point of contact that both fosters appreciation of the diversity of individuals and provides patient and family-centered care.

It ensures that all individuals receiving health care and services experience culturally and linguistically appropriate encounters.It meets the communication needs so that individuals understand the care and services that they are receiving, can participate effectively in their own care and can make informed decisions, and it also helps in eliminating discrimination and disparities. So looking at the first theme, Governance, Leadership and Workforce. This thematic area provides greater clarity on the specific locus of action for these standards. This theme emphasizes that implementing CLAS is the responsibility of the entire system.

Implementing CLAS really requires the investment, support and training of all individuals within an organization. The impetus for CLAS can often come from the bottom up. However, it is important that an organization's leadership that shapes the culture of the organization through its priorities, expectations and behavior that it models that the leadership play a key role in implementing and advancing the CLAS standards.

Therefore, the impetus for implementing CLAS should also come from the top down. Standard 2 addresses governance and leadership. It will help organizations ensure the provision of appropriate resources necessary to support and sustain CLAS initiatives. It also models an appreciation and respect for diversity, inclusiveness and all beliefs and practices.

Standard 3 addresses recruiting, promoting and supporting a diverse governance, leadership and workforce. It helps organizations to create an environment in which culturally diverse individuals feel welcomed and valued. It helps to infuse multicultural perspectives into planning, design and implementation of CLAS. Standard 4 addresses educating and training governance,< leadership and workforce.

It will help organizations prepare and support a workforce that works well with diverse populations. It will help organizations assess the progress of staff in developing cultural, linguistic and health literacy competency.In the second theme of Communication and Language Assistance, it broadens the understanding and application of appropriate services to include all communication needs and services, including sign language, Braille, oral interpretation and written translation.

The standards in this theme will help organizations comply with requirements such as Title VI of the Civil Rights act of 1964, The Americans with Disabilities Act and other relevant federal, state and local requirements to which they may need to adhere. Standard 5 addresses offering language assistance. It will help organizations ensure that individuals with limited English proficiency and/or other communications needs have equitable access to health services.

It will help organizations improve patient safety and reduce medical errors related to miscommunication. Standard 6 addresses informing individuals of the availability of language assistance services. It will help organizations inform individuals with limited English proficiency in their preferred language that language services are readily available at no cost to them.

It will also help to facilitate access to language services. Standard 7 addresses ensuring the competence of individuals providing language assistance. It will help organizations provide accurate and effective communication between individuals and providers. It will also help to empower individuals to negotiate and advocate on their own behalf for important services via effective and accurate communication with health and human services staff.

Standard 8 addresses providing easy-to-understand materials and signage. It will help organizations ensure that readers of other languages and individuals with various health literacy levels are able to access care and services. It will also help to enable all individuals to make informed decisions regarding their health and their care and service options. In the third thematic area of Engagement, Continuous Improvement and Accountability, it underscores the importance of establishing both individual and organizational responsibility for implementing CLAS.

Effective delivery of CLAS demands action across an organization. This theme focuses on the supports necessary for adoption, implementation and maintenance of culturally and linguistically appropriate policies and services regardless of one's role within an organization or practice, that all individuals are accountable for upholding the values and the intent of the National CLAS Standards.

Standard 9 addresses infusing CLAS throughout the organization's planning and operations. It will help organizations make CLAS central to the organization's service, administrative and supportive functions. It will link CLAS to other organizational activities, including policy, procedures and decision-making related to outcomes accountability.

Standard 10 addresses conducting organizational assessments. It will help organizations assess performance and monitor progress in implementing the National CLAS Standards. It will also help in obtaining information about the organization and the people it serves, which can be used to tailor and improve services.

Standard 11 addresses collecting and maintaining demographic data. It will help organizations to accurately identify population groups within a service area. It helps to monitor individual needs, access, utilization, quality of care and outcome patterns.

Still in the theme of Engagement, Continuous Improvement and Accountability, Standard 12 addresses conducting assessments of community health assets and needs. It will help organizations determine the service assets and needs of the populations in the service areas essence, a needs assessment.

It also helps organizations identify all of the services available and not available to the populations in the service areas, therefore doing a resource inventory and gap analysis. It helps organizations determine what services to provide and how to implement them based on the results of the community assessment.

Standard 13 addresses the important factor of partnering with the community. It will help organizations provide responsive and appropriate service delivery to a community. It will help organizations to empower members of the community in becoming active participants in the health and health care process.

Standard 14 addresses creating conflict and grievance resolution processes that are culturally and linguistically appropriate. It will help organizations facilitate open and transparent two-way communications and feedback mechanisms between individuals and organizations. It will help organizations anticipate, identify and respond to cross-cultural needs.

The last standard, Standard 15, addresses communicating the organization's progress. It will help organizations convey information to intended audiences about efforts and accomplishments in meeting the National CLAS Standards, as well as build and sustain communication on CLAS priorities and foster the trust between the community and the service setting.

So with that background on the National CLAS Standards, there are resources that exist to help with not only the adoption, but the implementation of the standards. A Blueprint for Advancing and Sustaining CLAS Policy and Practice, simply referred to as the Blueprint, is a guidance document for the National CLAS Standards that is available to you at no cost.

The Blueprint explains the case for CLAS, the enhancements and the concepts that are found throughout the National CLAS Standards. In addition, it lists many resources found online for additional information and guidance. The Blueprint provides the additional guidance and information that was also requested during the public comment period in the development of the National CLAS Standards. There is one chapter for each of the 15 standards that describes the standard, its purpose and some strategies and resources for implementing the standard.

And this Blueprint is available on the Think Cultural Health website free of charge. Think Cultural Health is a website with CLAS-related resources that we at the Office of Minority Health run. You can find it at ThinkCulturalHealth.HHS.gov. The goal of Think Cultural Health is to advance health equity at every point of contact through the development and promotion of culturally and linguistically appropriate services.

Think Cultural Health serves as a national online clearinghouse of information and resources on cultural and linguistic competency. In addition to the National CLAS Standards and the Blueprint, Think Cultural Health also offers free e-learning programs and other resources that are based on the standards. As continuing education resources, Think Cultural Health features e-learning programs that are free and available to anyone.

As you can see listed on this slide, Think Cultural Health houses accredited e-learning programs that are specifically designed for various providers. The physicians' program is accredited for physicians, physician assistants and nurse practitioners. The nurses' program is accredited for nurses and social workers. The disaster program is accredited for first responders, psychologists and psychiatrists, social workers and dentists.

The oral health program is accredited for dentists, dental hygienists and dental assistants. In addition, we offer an e-learning program for promotores de salud and community health workers known as the Promoting Healthy Choices and Community Changes e-learning program. At Think Cultural Health, you can also access additional resources.You can access a comprehensive guide to providing effective communication and language assistance services with tracks that are tailored specifically for administrators and direct service providers.

The CLAS Clearinghouse, a compilation of hundreds of online resources related to health equity and CLAS, is also available at Think Cultural Health. There's also a map of the United States displaying proposed and/or passed state legislation related to cultural and linguistic competency. I encourage you to also sign up to receive our quarterly e-newsletter to stay abreast of the latest developments and resources in the field.

So that concludes our overview of the National CLAS Standards, and so now we'd like to ask another polling question before we move into questions, which is, what do you see as the challenges to implementing the National CLAS Standards at your organization?

Okay, so about 53 percent cite lack of funding or financial resources. About 50 percent, competing priorities. Thirty percent, lack of leadership support. Twenty-two percent, lack of technical assistance. And 5 percent, other.

Thank you, Teddy, for reading those poll results. And as you'll see, in particular with the resource of the Blueprint that's available at the Think Cultural Health website, some of these questions, such as lack of leadership support or technical assistance where you can identify actual promising strategies each of the standards, as I mentioned, has a section within the Blueprint that describes the standard in more detail.

It also offers strategy and implementation strategies of organizations or other entities that are implementing that specific standard and models of practice that you can use so that, one, especially for those with competing priorities that you don't have to reinvent the wheel to be able to see some of the tool kits and other resources that may be available. So we certainly encourage you to utilize the Blueprint, as well as contacting us, and we'll provide our Think Cultural Health how to submit questions into our Think Cultural Health website so that, if you have additional questions, you're able to do so. And I think now we're going to move into some questions.

We're just pulling up questions now,so just give us a moment, and we will start to answer some of those questions. So we will have Jennifer reading the questions for Dr. Gracia. Whenever you're ready, Jennifer, you can begin.

Good afternoon. So a good question that came in is, "Are the National CLAS Standards mandated nationally for all health care entities, or are they merely guidelines?" Thank you for that question. The National CLAS Standards are not mandated. However, implementing the standards will help an organization to meet legislative and regulatory requirements, including, for example, accreditation requirements through the Joint Commission or the National Committee for Quality Assurance.

There is also guidance specific, for example, to language access for individuals who are limited-English-proficient that, for organizations who are recipients of federal funds, federal financial assistance that there are specific requirements with regards to the provision of language access and services, and so actually implementing the National CLAS Standards can help to meet those requirements.

And remember what the aim of the National CLAS Standards are, which is to help improve the quality of services and care,as well as help to reduce health disparities and advance health equity. And when we think about the cost of disparities, both economic cost as well as the human cost of health disparities,the National CLAS Standards really are a strategic tool that can be used by organizations to help meet those goals.

Thank you. Another question we're getting is,"Are there training modules for agencies specifically interested in implementing CLAS relative to Hispanic patients or clients?"

The training modules that I mentioned, the e-learning programs, for example, e-learning programs for physicians or for nurses or other personnel, are not specific to a specific racial or ethnic minority population, but they are broadly applicable. And one of the things that we encourage as you are, as an organization, working to adopt and implement the National CLAS Standards is really to tailor the standards to the population that you are serving. And so, again, as I mentioned, in the Blueprint, you'll see different ways in which organizations have actually worked to implement the National CLAS Standards, each of the different standards.

And so that's an important aspect of understanding that there's not a one-size-fits-all approach; that it's important to understand and tailor the services that you provide to the community so that it meets their needs.

Getting some questions about interpretation and what kind of legal and what are best practices with interpretation? So we have the question, "Some [inaudible] patients refuse to use our video remote interpreter systems prefer to have access to a face-to-face interpreter. Are we required to provide a face-to-face interpreter?"

Another question having to do with that is, "When using a fully bilingual nurse or doctor as an ad hoc interpreter, is it required to assess their language proficiency in advance?"

Another question, "Is it legal or illegal to ask a minor to interpret for a parent or family member?" So a lot of questions having to do with what's actually legally regulated versus what's a best practice having to do with providing language assistance.

Thank you for those questions and series of questions. So it's important to note that, when you're utilizing untrained interpreters and, in some cases, using interpreters who are minors, it can lead to miscommunication, and so that's where you see in the Communication and Language Assistance theme of the National CLAS Standards with the standards that specifically look at offering language assistance, informing individuals of the availability of language assistance services, that we really want to ensure that those who are providing those interpreter services are trained to do so, and I think some of the strategies that we mention and recommend within the Blueprint are, for example, assessing an individual's language ability so that you can determine the need for language assistance, and there are organizations, certainly, that have issued standards of practice, such as the National Council on Interpreting in Health Care, that can be resource to an organization with regards to the provision of services.

There are cases and as I mentioned with regards to if you are, for example, a recipient of federal financial assistance, when you look at Title VI of the Civil Rights Act in providing meaningful access to services, it's ensuring that individuals who are limited-English-proficient do have access to language assistance services.

And so there are resources, for example, at a website called LEP.gov, which has various resources that are available, and it can also walk through, what are some of the specific requirements with regards to the provision of language assistance services. But I always want to bring it back to the overarching goals of the standards with regards to improving quality of care and services that, if untrained interpreters are utilized, it can increase the risk of miscommunication, may lead to longer hospital stays, hospital readmissions and so there certainly is a compelling need to have high-quality services where an individual and a patient really is empowered in understanding the care and services that they're receiving.

Okay. And a final question, "Is it the organization's own responsibility to implement and take care of all the requirements of implementation of each of the National CLAS Standards?"

Thanks for that question. So the National CLAS Standards, as I mentioned,the Principal Standard of providing effective, equitable, understandable and respectful quality care and services, that's the overarching goal that, if you are to implement the other 14 standards, you will achieve that Principal Standard. But we know that organizations have differing resources and capacities, and so an important thing is to not feel overwhelmed that you have to try to take on all of the standards all at once and be able to determine, what are some of the most pressing needs? So again, the importance of really understanding the community that is being served and identifying where some of the most pressing needs may be and using starting points of certain standards to be able to start to implement culturally and linguistically appropriate services, but we encourage, certainly, for an organization in adopting the National CLAS Standards that they see the standards really as a collective, because in order to really meet the needs of diverse communities that are being served, it's this collective set of standards that will help to achieve those goals.

But if there are those kind of resource constraints, being able to identify the most pressing needs for the community, as a starter, is certainly a good place to start.

Okay. And I know I said last question, but a couple of good ones came in right at the end here. "As a nonprofit organization looking into promoting CLAS, may we use Think Cultural Health as a tool for our training?"

Absolutely. The National CLAS Standards were certainly designed to be applicable across many fields, and not only in health and health care, but certainly in other sectors as well, where we understand, as the populations that we are serving are increasingly diverse, as we see a greater cultural diversity of the population, these standards really are applicable to meeting those needs, so we encourage you to certainly utilize the resources that are available on Think Cultural Health.Absolutely. The National CLAS Standards were certainly designed to be applicable across many fields, and not only in health and health care, but certainly in other sectors as well, where we understand, as the populations that we are serving are increasingly diverse, as we see a greater cultural diversity of the population, these standards really are applicable to meeting those needs, so we encourage you to certainly utilize the resources that are available on Think Cultural Health.

As I mentioned, there is a communication and language assistance guide. There are the e-learning programs, if applicable to your organization. There also is a wealth of literature that's available through Think Cultural Health, and you can sign up for the quarterly e-newsletter, which will also give you up-to-date information on latest advances and studies and available tool kits and materials related to cultural and linguistic competency. So we certainly encourage you to utilize Think Cultural Health.

"If our organization is in an implementation phase,is there anyone we could contact when we have specific questions or we need a particular consultation or direction?"

Yes.We encourage you to send your questions or share your ideas and stories of implementation to AdvancingCLAS@ThinkCulturalHealth.HHS.gov. We'll enter that into the chat room. And I'll say that one more time. You can send an email to AdvancingCLAS@ThinkCulturalHealth.HHS.gov. And you can certainly send in your questions, your ideas, your stories and strategies for implementation. And that was a perfect question to set up this next slide that you're seeing right now, which is, to join us for the upcoming webinars, our second webinar will be on The Case for the National CLAS Standards, so for those of you, for example, that identified competing priorities or lack of leadership support, this will be areas that will be helpful to you, and that webinar will be on June 30th at 3:00 p.m. Eastern.

The third webinar is Implementing the National CLAS Standards, where we'll talk in more depth about implementation strategies, and that webinar will be on July 28th, also at 3:00 p.m. To find out how to sign up for those webinars, we have a couple of resources available to you. You may have gotten the invitation for today's webinar directly, but it also may have been forwarded to you, so if you didn't get this directly, we certainly encourage you to sign up for our listservs. The HHS Office of Minority Health sends out email updates and newsletters, and you can sign up through our listserv at MinorityHealth.HHS.gov.

You can also, as I mentioned earlier, sign up for the Think Cultural Health e-newsletter that's available at ThinkCulturalHealth.HHS.gov, and there's a tab called "Join the CLCCHC" on the right side, and that stands for Center for Linguistic and Cultural Competency in Health Care, so I encourage you to sign up for those so that you get the invitations for the following webinars.

And lastly, just some additional resources to leave you with. Again, for the Blueprint and additional resources, please visit the Think Cultural Health website, which you see on your screen there, as well as, if you have questions about the National CLAS Standards or would like to share your ideas and stories of implementation, AdvancingCLAS@ThinkCulturalHealth.HHS.gov.

Think Cultural Health is really a trusted site to turn to for information related to CLAS and health equity, and so I encourage you to visit the website frequently. Successful implementation of the National CLAS Standards depends on all of us and depends on all of us working together, so we look forward to collaborating with you to promote, implement and assess the National CLAS Standards.

Thank you.Thank you very much, Dr. Gracia. Thank you, Jennifer, for reading out the questions. And thank you all for all of your great questions. If you have more questions,please contact Info@MinorityHealth.HHS.gov.

There are handouts available of today's presentation. It includes the slides, as well as some information on the CLAS standards. Again, thank you all for joining us, and a copy of today's presentation will be available to all registrants. You will receive an email with the link to today's recording within 48 hours. Again, thank you all for joining us, and have a good evening.

  • Presented 03/16/2016
  • Presenter Dr. J Nadine Gracia, MD, MSCE ? Deputy Assistant Secretary for Minority Health