Revisiting the National CLAS Standards
“CLAS” stands for Culturally and Linguistically Appropriate Services. The National CLAS Standards were first developed by the Office of Minority Health of the U.S. Department of Health and Human Services (HHS) in 2000. Ten years later, the standards were updated to account for a significant growth in the field of cultural competency as well as an increasingly diverse patient population.
Health Equity for All Patients
HHS defines health equity as “the attainment of the highest level of healthcare for all people.” Patients who do not speak English or with limited English proficiency (LEP), for example, face language barriers that hinder their access to care. Research demonstrates these patients tend to delay seeking care longer than English speaking counterparts. When they do seek care, they experience poorer patient outcome in comparison to English speaking patients. To eliminate these disparities in care, any barriers hindering the level of care provided must be removed. In the case of LEP, Deaf and Hard of Hearing (HoH) patients, the barrier is a difference in preferred language. Providers can eliminate this barrier by providing patients with a qualified medical interpreter.
Communication and Language Assistance Standards (CLAS) 5-8
CLAS standards 5 through 8 specifically address communication and language assistance in healthcare for LEP patients:
5. Offer language assistance to individuals who have LEP and/or other communication needs, at no cost to them, to facilitate timely access to all health care and services.
6. Inform all individuals of the availability of language assistance services clearly and in their preferred language, verbally and in writing.
7. Ensure the competence of individuals providing language assistance, recognizing that the use of untrained individuals and/or minors as interpreters should be avoided.
8. Provide easy-to-understand print and multimedia materials and signage in the languages commonly used by the populations in the service area.
HHS developed the Blueprint to serve as an implementation guide for hospitals to ensure programs are culturally competent and accessible to all patients. Hospitals can access the Blueprint here.
The communication and language assistance CLAS standards are further emphasized in Section 1557 of the Affordable Care Act of 2016. In addition to requiring the provision of a language interpreter and visible notification to LEP patients of the availability of such services, the act expressly prohibits the use of an untrained or ad hoc interpreter barring extreme circumstance. This is in response to mounting evidence demonstrating the detrimental effect the use of an untrained interpreter, often a family or bilingual staff member, has on patient outcome.
To both comply with federal regulations and improve LEP patient care, the key word is qualified. Studies show a higher number of errors occur resulting in adverse effect when an untrained interpreter is used versus a qualified medical interpreter to facilitate communication with LEP patients. Patient satisfaction has also been shown to rise significantly when a qualified interpreter is used versus a family member or untrained bilingual staff member. Learn more about that here.
The Keyword is Qualified
At AMN Healthcare Language Services, our interpreters are highly qualified and required to pass stringent quality assessment processes and extensive medical training before going live on our platform. By having interpreters available in person, over video and phone in a wide variety of languages, hospitals can significantly increase interpreter availability and patient access to language services. Learn more about our interpreters here.
Our Video Remote Interpreting solution is accessible from many telehealth programs. With this interoperability, hospitals can provide on-demand access to medically qualified interpreters from within telehealth solutions to better support virtual patient/provider encounters. By including non-English speaking patients in all healthcare programs, e.g., telehealth programs, hospitals are taking actionable steps to further improve health equity for LEP patients.