About CLAS > The Case for CLAS

There are hurdles to effectively tackling cultural competence, language access and disparities reduction. In addition to financial and other business challenges, there may be several organization-specific barriers, not the least of which is a scarcity of leadership and organizational support that may stem from a lack of understanding of the issues and opposition to change.

The support of senior leadership for CLAS and disparities initiatives is essential to their success. For organizations without such backing, making the case for implementing QI initiatives to improve care for diverse populations will be crucial in accomplishing meaningful change. The argument for this work can be based on legal regulatory compliance14-1714. Executive Order No. 13166 Fed. Reg. 65 No. 159 (August 11, 2000)

15. CA Dept. Managed Health Care Code Title 28, § 1300.67.04

16. Van Kempen, A. Health Law: Legal Risks of Ineffective Communication. American Medical Association Journal of Ethics. Virtual Mentor. August 27, Vol 9, No 8, 555-558

17. Rosenbaum, S., Burke, T., Nath, S.W., Santos, J., and Thomas, D. The Legality of Collecting and Disclosing Patient Race and Ethnicity Data. Policy Brief, Legal Barriers to Health Information Law, Robert Wood Johnson Foundation. June 2006. Available at: http://healthinfolaw.org/uploads/racial_and_ethnic_data.pdf. Accessed October 4, 2007.
, good business practices and on moral grounds.

The leadership and staff of many health care organizations recognize the inherent value of meeting the cultural and linguistic needs of their diverse patient populations. According to a 2007 Alliance of Community Health Plans (ACHP) report, Making the Business Case for Culturally and Linguistically Appropriate Services in Care: Case Studies from the Field,1818. The Alliance of Community Health Plans Foundation’s 2007 publication, Making the Business Case for Culturally and Linguistically Appropriate Services in Care: Case Studies from the Field. (www.achp.org/library/download.asp?id=7035)  “Many organizations that have engaged in or implemented CLAS standards…are doing so because they believe it is the right thing to do, and not because they are required to do so by law or regulation. Organizations with a history of meeting the needs of diverse patient populations view their role in addressing the needs of all patients they serve as an important part of their organizational culture.”

QI teams and other individuals committed to improving care for diverse populations will undoubtedly appreciate the importance of an organization that supports their efforts—not only through support of specific projects or initiatives, but also by creating an organizational culture that stresses equitable care and cultural and linguistic competence as goals for staff and leadership alike. Differences in health care quality and outcomes have been shown to result from differences in the culture of health care organizations. Differences in culture may also be responsible for different degrees of improvement in the provision of culturally competent and equitable care.77. Masi, Blackman, Peek, Interventions to Enhance Breast Cancer Screening, Diagnosis, and Treatment among Racial and Ethnic Minority Women. Medical Care Research and Review, Vol 64; 195 Suppl, 2007.

There is also evidence that pursuing cultural competence can bring a noticeable return on an organization’s investment. The ACHP report states that health plans providing CLAS have increased enrollment and market share among the insured. According to the report, “cultural competency attracts business,” and leads to reduced cost of interpretation services and length of hospital stay and increased patient and provider satisfaction.