Today the Office of Minority Health at the Department of Health and Human Services released the new National Standards for Culturally and Linguistically Appropriate Services (CLAS). The new CLAS Standards, which have been under development for several years, are a groundbreaking response to increasing awareness of the factors that frequently prevent diverse populations such as the LGBT community from getting the health care that they need.
The Office of Minority Health established the original CLAS Standards in 2001 as a framework for advancing health equity, improving care quality, and eliminating health care disparities. The new standards go beyond this original framework by creating a blueprint for health care providers to implement culturally and linguistically appropriate services in order to help all patients achieve better health and health care.
Cultural competency is a major concern for LGBT people in health care settings across the U.S. Earlier this year in Missouri, for example, Roger Gorley was arrested and forcibly removed from his husband’s bedside when the hospital refused to recognize them as a family. And in a 2010 incident that is unfortunately not unique for transgender people, Erin Vaught was ridiculed as “it” and refused treatment for a lung condition at a hospital in Indiana after hospital personnel learned she was a transgender woman.
Following the example of initiatives such as the LGBT-inclusive nondiscrimination requirements from The Joint Commission, the new CLAS standards fully incorporate the concerns of LGBT people into the framework of culturally and linguistically appropriate care.
The implementation blueprint for the standards emphasizes that discrimination based on factors such as sexual orientation, gender identity, and gender expression impedes the provision of quality care and services. It calls on facilities and providers to provide all individuals with assurances that disrespect or discrimination of any kind is not tolerated.
Further, to help avoid expensive and dangerous conflicts related to cultural misunderstandings between providers and their patients, the blueprint encourages facilities and health care providers to undertake regular trainings on the needs of patients from different cultural backgrounds, including LGBT people.
The blueprint also underscores that demographic data, including data on sexual orientation and gender identity, are vital to the effective practice of cultural competency. They note that though LGBT data collection is not yet as standardized as other demographic data collection, the Department of Health and Human Services is developing a national data progression plan on sexual orientation and gender identity data and that the CLAS Standards implementation blueprint will be updated to reflect advances in this process.
Finally, the standards will have important ramifications for LGBT inclusion in other national health initiatives, such as the provision of culturally competent services by navigators and health insurance marketplaces under the Affordable Care Act. And with the growing understanding that very few health care professionals receive adequate preparation for working with LGBT patients, it is likely that the new CLAS Standards will help remind medical and other health professions schools of their responsibility for ensuring that health care providers are equipped to offer the highest quality of care to all their patients, including LGBT people.
As Tawara Goode, the director of the National Center for Cultural Competence at Georgetown University, summarized at this morning’s event marking the release of the new CLAS Standards, “some people think cultural competency is a workshop, and that they already took it.” But as she reminded the audience, cultural competency isn’t that simple — it is an ongoing processes of changing the culture in our health care system at every level in order to understand and respect the complex backgrounds of all patients.