Through a Cooperative Agreement with the Substance Abuse and Mental Health Services Administration s (SAMHSA), Center for Substance Abuse Treatment, (CSAT) and Center for Mental Health Services, (CMHS) Morehouse School of Medicine established the Historically Black Colleges and Universities Center for Excellence in Behavioral Health (HBCU-CFE), funded as Grant No. TI025590.
Promote student behavioral health to positively impact student retention Expand campus service capacity, including the provision of culturally appropriate behavioral health resources Facilitate best practices dissemination and behavioral health workforce development
Promoting Behavioral Health Equity: Applying the National Standards for Culturally and Linguistically Appropriate Services (CLAS) in Health and Health Care Roslyn Holliday Moore, Public Health Analyst Krystle Canare, SAMHSA Intern SAMHSA, Office of Behavioral Health Equity January 13, 2014
Promoting Behavioral Health Equity: Applying the National Standards for Culturally and Linguistically Appropriate Services (CLAS) in Health and Health Care Roslyn Holliday Moore, Public Health Analyst Krystle Canare, SAMHSA Intern SAMHSA, Office of Behavioral Health Equity January 13, 2014
Overview Historical Context Purpose Policy/Legislative Drivers Populations Growth/Demographic Trends Need for Cultural and Linguistic Competency
Timeline of CLAS-Related Events 1940s Hill-Burton Act (Hospital Survey and Construction Act) 1946 1960s Civil Rights Act of 1964 1980s Report of the HHS Secretary s Task Force on Black and Minority Health 1985 HHS Office of Minority Health Founded 1986 1990s Healthy People 2000-1990 HHS OMH Center for Linguistic and Cultural Competency in Health Care Founded National Center for Cultural Competence at Georgetown Founded 1995 2000s Executive Order 13166 - Improving Access to Services for Persons with Limited English Proficiency National CLAS Standards Released 2000 Healthy People 2010 2000 Institute of Medicine s Report: Unequal Treatment 2003 2010s Patient Protection and Affordable Care Act Healthy People 2020 2010 HHS Strategy to Reduce Health Disparities 2011 Enhanced National CLAS Standards 2013
Enhanced National CLAS Standards: Purpose Established to: - advance health equity, - improve quality, and - help eliminate health care disparities.
National CLAS Standards: The Blueprint
Behavioral Health and CLAS Not for Public Distribution
CLAS Standards in Action: Training IOM Unequal Treatment (Smedley, Stith, Nelson, 2003) cultural competency critical for addressing health care disparities Curricula development and accreditation Examples include: National Medical Association American Association of Colleges of Nursing Association of Schools of Public Health State Cultural Competency Legislation All states have legislation regarding language access services (OMH, 2001)
National CLAS Standards in States denotes legislation requiring (WA, CA, CT, NJ, NM) or strongly recommending (MD) cultural competence training that was signed into law. denotes legislation that has been referred to committee and is currently under consideration. denotes legislation that died in committee or was vetoed. https://www.thinkculturalhealth.hhs.gov/content/legislatingclas.asp
CLAS Standards in States The National Association of State Offices of Minority Health provides information regarding guiding principles, core competencies, and contact information for the various state-level OMHs across the country. The National Health Law Program (NHeLP) tracks laws and legislation as they pertain to issues of language access.
CLAS Standards in Action: Policy Legislation and Language Access Services Certification Title VI of Civil Rights Act of 1964 (Executive Order 13166) no individual can be discriminated against on the basis of proficiency in English. any organization receiving any funding from the federal government must provide services to limited English proficient individuals in accordance with Title VI (US, DOJ, 2002)
CLAS in Action: Federal Guidelines Department of Justice Guidance to Federal Financial Assistance Recipients Regarding Title VI, Prohibition Against National Origin Discrimination Affecting Limited English Proficient Persons HHS Office of Civil Rights Office of Civil Rights Guidance on National Origin Discrimination Enforcement of Title VI of the Civil Rights Act of 1964 - National Origin Discrimination Against Persons With Limited English Proficiency" (2002 LEP Guidance)
National Data Sizeable demographic shifts Trend towards less than 50% of the total US population will be White by 2050 (Roberts, 2009) Presently, several states have a larger populations of racial/ethnic minority individuals than White individuals (Yen, 2010) Increase in the number of individuals proficient in multiple languages over 23 million Americans are limited English proficient (Au, Taylor and Gold, 2009)
CLAS Standards in Action: Moving Forward Patient Protection and Affordable Care Act of 2010 Data collection and reporting by race and ethnicity Workforce diversity, including cultural competency education and organizational support Health insurance exchanges required to be culturally and linguistically appropriate Insurers are required to provide information that is culturally and linguistically competent, including claims process and summary of benefits HHS Health Disparities Action Plan (HHS, 2011) National Stakeholder Strategy for Achieving Health Equity (National Partnership for Action, 2011a)
Behavioral Health and Social Services 360 (BHSS360) Web-based tool to assess an organization s readiness to address the needs of diverse populations. Aligned with the National CLAS Standards. www.clearview360.org
Use as part of a Continuous Quality Improvement Effort Assess Re-assess BHSS360 Identify Strengths/ Improvement Opportunities Tailored Interventions/ Solutions
Neighborhood and Built Environment Economic Stability Social Determinants of Health Health and Health Care Education Social and Community Context 21
Most Commonly Spoken Languages Other than English or Spanish (2014)
Quality Improvement Business Processes Management Partnerships Resources Data Infrastructure Budget Capacity Workforce Technology Reporting Program Data
Using Data 2012 National Healthcare Disparities Report http://www.ahrq.gov/research/findi ngs/nhqrdr/nhdr12/highlights.html
Culture and Language
Thank you for your attention! Website: http://samhsa.gov/behavioral-healthequity
1-866-988-HBCU (4228) www.hbcucfe.net Email: hbuc_cfe@msm.edu www.hbcucfe.net