1. Ensuring Language Access & Culturally Competent Services to Vulnerable Populations National Alliance to End Homelessness Conference 2011www.csh.org

2. Christine Haley christine.haley@csh.org 312.332.6690 x13 Corporation for Supportive Housing MA Department of Public Health Heartland Human Care Services

3. Today’s Presentation Systems Level Approach – Culturally & Linguistically Appropriate Services Standards Example: Heartland Human Care Services, HPRP Program, Chicago

4. CLAS Standards Developed by HHS Office of Minority Health Contribute to the elimination of racial and ethnic health disparities Make services more responsive to the individual needs of clients Inclusive of all cultures, but designed to address the needs of racial, ethnic, and linguistic minority population groups

5. Massachusetts Department of Public Health CLAS Initiative Led by the Office of Health Equity Administration’s priority to eliminate health disparities Integration of CLAS standards into DPH service delivery systems Included in direct service contracts www.mass.gov/dph/healthequity Georgia Simpson May – Director, Office of Health Equity

6. Making CLAS Happen

7. Heartland Human Care Services HPRP Program Three sites across City of Chicago Case Management: Outreach & Senior Case Managers Housing Location: Lead Housing Locators & Housing Locators Maura McCauley – Senior Director, Housing

8. CLAS Standards

9. Common Terms REL: Racially, Ethnically, and Linguistically (REL) diverse minority population LEP: Limited English Proficient Translation: written Interpreter/Interpretation: spoken

10. 14 Standards Standards 1-3: Culturally Competent Care Standards 4-7: Language Access Standards 8-14: Organizational Supports for Cultural Competence

11. Six Areas for Action

12. Build Community Partnerships Standards 12 & 14

13. Agencies maintain community partnerships (12) Participatory Collaborative Formal & informal partnerships Community involved in design & implementation of CLAS related activities

14. Agencies make public their progress (14) Public information on progress Successful innovations Public notice in the community about available information

15. How it works: Partnerships Partnership with Heartland Human Care Services and Voluntary Agencies (VolAgs) .25FTE coordinated relationships administratively; 1.0FTE Senior Case Manager HHCS processed application; Agencies provided culturally competent case management services

16. Reflect & Respect Diversity Standards 2 & 13

17. Agencies implement workforce diversity strategies (2) Staff and leadership representative of service area At all levels of the organization Strategies to Recruit; Retain; Promote staff and leadership.

18. Agencies have client conflict and grievance resolution processes (13) Process is: Culturally and linguistically sensitive Process can: Identify; Prevent; Resolve client cross-cultural conflicts or complaints.

19. How it works: Workforce Staff reflective of community being served Recruitment from Refugee Employment Program Bi-lingual/Bi-cultural – Spanish, Arabic

20. Foster Cultural Competence Standards 1 & 3

21. Agencies ensure that client’s receive from all staff members (1) Care that is: Effective Understandable Respectful Care that is compatible with: Cultural health beliefs; Cultural health practices; And in preferred language.

22. Agencies ensure that staff receive CLAS training (3) When? On-going training Who receives training? At all levels Across all disciplines What? Education & training Culturally & linguistically appropriate service delivery

23. How it works: Training Current immigrant and refugee population in Chicago Overview of immigration process Asking the right questions

24. Collect Diversity Data Standards 10, 11 & 14

25. Agencies ensure that client REL data is collected (10) REL – race, ethnicity, spoken and written language In health/client records Integrated into management information systems Periodically updated

26. Agencies maintain community profiles & needs assessment (11) Profile Demographic Cultural Epidemiological Needs Assessment Plan accurately Implement responsive services

27. How it works: Community Profiles Assigned to assess neighborhoods Identify community assets Include demographic profile – languages spoken, racial and ethnic populations Ensure staffing patterns reflect assessments

28. Benchmark: Plan and Evaluate Standards 8 & 9

29. Agencies have written plans on CLAS provision (8) Agency can Develop Implement Promote plan Plan includes: Goals Policies Operational plans Management accountability Oversight mechanisms

30. Agency should conduct CLAS related self-assessments (9) Initial On-going Integrate cultural & linguistic measures into: Internal audits Performance improvement programs Patient satisfaction assessments Outcomes-based evaluations

31. How it works: Assessment Completed CLAS Assessment Team responsible for identifying an areas of improvement

32. Ensure Language Access Standards 4,5,6 & 7

33. Organizations must offer and provide language assistance services (4) Provided by bi-lingual staff or Interpreter services At no cost to the patient/client At all points of contact In a timely manner During all hours of operation

34. Inform clients of their right to language assistance services (5) Clients informed both verbally and in writing Notice should be in client’s preferred language

35. Agencies assure the competence of language services (6) Quality of language services provided by interpreters or bi-lingual staff Family and friends should not be interpreters unless requested by client

36. Agencies provide language appropriate patient-related materials and post signage (7) Available to commonly encountered groups and/or groups in the service area Easily-understood patient-related materials Signage posted

37. How it works: Language Access Bi-lingual Staff: English, Spanish, Arabic Staff trained in face-to-face and telephonic interpreter services Service agreement set up with Heartland Alliance’s Cross Cultural Interpreter Services

38. Where to start… Assessment Recognize what you are doing well Prioritize needs Create line item in budget for CLAS related costs

39. Thank You Christine Haley, Associate Director, CSH IL Program christine.haley@csh.org 312.332.6690 x13