Skip to main content
facebookAbout | Contact
Search Options

Cultural Competence and Limited English Proficiency

On this page
  FAQs
Tools
Funding
Documents
Organizations
Terms & Acronyms
Contacts
Bibliographies
  

Culturally and linguistically competent health and human services are essential for America’s diverse populations. Cultural competence describes the ability of service delivery systems to provide quality assistance to clients with diverse values, beliefs, or traditions, including tailoring delivery to meet their social, cultural, and linguistic needs. It is a set of behaviors, attitudes, and policies that come together in an agency or among professionals enabling them to work effectively in cross–cultural situations.

Limited English proficiency (LEP) refers to the restricted ability to read, speak, write, or understand English by individuals who do not speak English as their primary language. These individuals may be entitled language assistance with respect to a particular type or service, benefit, or encounter. Collectively, cultural competence and LEP address the necessity to understand and respond effectively to the cultural and linguistic needs among people of different nationalities, ethnicities, and cultures.

Related Guides

Frequently Asked Questions

Tools

Ask Me 3
Web site
Provides information about health literacy for health care providers, patients, employers, and the media. Includes brochures in English and Spanish, lists questions to ask a doctor, nurse, or pharmacist, and offers tips to help better understand personal health.
Sponsoring organization: Pfizer

CDC Health Literacy: Accurate, Accessible and Actionable Health Information for All
Web site
Provides information and tools to improve health literacy and public health.
Sponsoring organization: Centers for Disease Control and Prevention

Civil Rights Division - Federal Coordination and Review Section
Web site
Government-wide program of technical and legal assistance, training, interagency coordination, and regulatory, policy, and program review, to assure that federal agencies enforce various landmark civil rights statutes and related Executive Orders that prohibit discrimination in federally assisted programs and in the federal government's own programs and activities.
Sponsoring organization: U.S. Department of Justice

Community Health Workers Toolkit
Web site
Contains eight modules about community health worker programs, how the programs work and how to use community health workers in the local community.
Sponsoring organization: Rural Assistance Center

Consumer Health Brochures in Multiple Languages
Web site
Electronic access to over 200 health education brochures in 24 different languages.
Sponsoring organization: Utah Department of Health

Cross Cultural Health Care Program
Web site
Serves as a bridge between communities and health care institutions to ensure full access to quality health care that is culturally and linguistically appropriate. Provides a combination of cultural competency trainings, interpreter trainings, research projects, and community coalition building.
Sponsoring organization: Cross Cultural Health Care Program

CuidadoDeSalud.gov (Healthcare.gov)
Web site
Website in Spanish to help consumers take control of their health care by connecting them to new information and resources that will help them access quality, affordable health care coverage.
Sponsoring organization: U.S. Department of Health and Human Services

Cultural and Linguistic Competence Policy Assessment (CLCPA)
Web site
A self-assessment instrument designed to examine cultural and linguistic competence in four dimensions: values, policy, structure, and practice.
Sponsoring organization: National Center for Cultural Competence

Cultural Brokering Web Portal
Web site
Encourages the use of cultural brokering in health and mental health care by providing information and resources.
Sponsoring organization: National Center for Cultural Competence

Cultural Competency and Health Literacy Resources for Health Care Providers
Web site
Highlights projects on cross-cultural health care. Helps health care providers enhance their clinical and organizational skills in cultural competence
Sponsoring organization: Health Resources and Services Administration

Cultural Competency Curriculum for Disaster Preparedness and Crisis Response
Web site
A free online educational program designed for first responders of disaster preparedness and crisis response including emergency medical technicians, psychologists, psychiatrists and social workers.
Sponsoring organization: HHS Office of Minority Health

Cultural Competency Toolkit: Ten Grant Sites Share Lessons Learned
Web site
Provides an overview of 10 model cultural competency programs. Includes their project goals, implementation plans, and program materials. This information will assist other consumer supporter organizations to launch similar cultural competency outreach programs.
Sponsoring organization: Mental Health America

Culturally Competent Nursing Care: A Cornerstone of Caring
Web site
Free, online educational program accredited for nurses and social workers to help meet the cultural and linguistic needs of an increasingly diverse patient population.
Sponsoring organization: HHS Office of Minority Health

Culturally Specific Patient Health Information for non-English speakers
Web site
Librarian recommended reference sites for culturally specific patient health information.

Dictionary of Health Related Terms, 3rd Edition (English - Spanish)
Print publication
An instrument for health care personnel and other professionals working with the Latino population in the United States. Purpose is to strengthen communication between Spanish-speaking populations and the health workers serving them, and facilitate dialogue by reducing cultural and linguistic barriers.
Sponsoring organization: California Office of Binational Border Health

English Language Learner Resources
Web site
A variety of Limited-English Proficient (LEP) resources that include assessment tools, documents, brochures, case decisions, and FAQs.
Sponsoring organization: U.S. Department of Education

EthnoMed
Web site
Contains medical and cultural information about immigrant and refugee groups.
Sponsoring organization: University of Washington

Evaluation Tools for Racial Equity
Web site
Provides tools, resources and success stories to help evaluate racial equity within a group, a community, or an organization.
Sponsoring organization: Charles Stewart Mott Foundation

Got Funding?
Web site
Provides customized funding searches focused on minority health and related issues (1.800.444.6472). Includes information to support grant writing activities and lists links to government and private funding sources.
Sponsoring organization: HHS Office of Minority Health

Guide to Choosing and Adapting Culturally and Linguistically Competent Health Promotion Materials
Web site
Provides guidance on how to assure that health promotion materials reflect the principles and practices of cultural and linguistic competence.
Sponsoring organization: National Center for Cultural Competence

Harborview Project: Accessing Online Information for Immigrant and Refugee Health
Web site
Helps users find Internet-based health information for specific immigrant populations to better understand their health and diagnosed disorders.
Sponsoring organization: National Library of Medicine

Health Information in Multiple Languages
Web site
Provides access to consumer health information in languages other than English.
Sponsoring organization: National Library of Medicine

Health Information Translations
Web site
Provides culturally appropriate materials to promote health education and wellness among Limited English Proficiency (LEP) populations.
Sponsoring organization: Ohio State University

Health Literacy and Cultural Competency: Research Findings
Web site
Lists links to research activities of the Agency for Healthcare Research and Quality (AHRQ) that are related to health literacy and cultural competency.
Sponsoring organization: Agency for Healthcare Research and Quality

Health Literacy Measurement Tools
Web site
Two tools in English and Spanish to measure an aspect of health literacy: an individuals' reading comprehension in a medical context. These tools can be used for research, clinical, or program planning purposes.
Sponsoring organization: Agency for Healthcare Research and Quality

Health Literacy Special Collection: Tools and Resources for Health Literacy Initiatives
Web site
Contains health curricula for literacy classes, resources that provide basic health information in simple terms, resources in languages other than English, information about the link between literacy & health status, and links to organizations dedicated to health and literacy education.
Sponsoring organization: Literacy Information and Communication System

Health Literacy Universal Precautions Toolkit
Web site
Offers primary care practices a way to assess their services for health literacy considerations, raise awareness of the entire staff, and work on specific areas.
Sponsoring organization: Agency for Healthcare Research and Quality

Health Literacy: Get Training
Web site
Web-based training to educate public health professionals on the importance of health literacy and their role in providing health information and services and promoting public health literacy.
Sponsoring organization: Centers for Disease Control and Prevention

Healthy Roads Media
Web site
Source of health information on several topics in many languages and multiple formats.
Sponsoring organization: National Library of Medicine

HRET Disparities Toolkit
Web site
Provides hospitals, health systems, clinics, and health plans information and resources for systematically collecting race, ethnicity, and primary language data from patients.
Sponsoring organization: American Hospital Association

HRSA Health Literacy
Web site
Overviews health literacy issues and provides access to additional health literacy resources. Includes access to "Unified Health Communication" course, which can be taken for credit (CEU/CE, CHES, CME, CNE) or not for credit and addresses health literacy, cultural competency and patient communication skills.
Sponsoring organization: Health Resources and Services Administration

HUD Limited English Proficiency (LEP)
Web site
Provides documents from the U.S. Department of Housing and Urban Development (HUD) that are translated into various languages including, but not limited to: Arabic, Cambodian, Chinese, Creole, Hmong, Korean, Russian, Spanish, and Vietnamese.
Sponsoring organization: U.S. Department of Housing and Urban Development

Interpreter Associations
Web site
A list of local and regional interpreting associations with a special focus on healthcare interpreting.
Sponsoring organization: National Council on Interpreting in Health Care

Knowledge Path: Spanish-Language Health Resources
Web site
A guide of high-quality Spanish-language health resources for health professionals and consumers. The collection covers a wide range of health topics, each with a section that focuses on topics of interest to families and professionals in the maternal and child health (MCH) community.
Sponsoring organization: National Center for Education in Maternal and Child Health

Language Access Resource Guide
Web site
Contains materials related to interpreter training and resources, such as publications, organizations, listservs, and agencies.
Sponsoring organization: Cross Cultural Health Care Program

Language and Cultural Access Program
Web site
Established by Asian Health Services to help reduce language and cultural barriers that immigrants face in accessing health care.

Language Assistance Self-Assessment and Planning Tool for Recipients of Federal Financial Assistance
Web site
Assists organizations that receive Federal financial assistance in their efforts to ensure that program goals and objectives address meaningful access for all of the people they serve, including those who are limited-English proficient.
Sponsoring organization: U.S. Department of Justice

Language Services Action Kit: Interpreter Services in Health Care Settings for People with Limited English Proficiency
Print publication
Toolkit for advocates and others working to ensure that people with limited English proficiency in their state get appropriate language assistance services in medical settings. Available for $25 in English or Spanish.
Sponsoring organization: Access Project

Learning Services
Web site
A list of documents and reports on language services in health care settings and people with limited English proficiency.
Sponsoring organization: Access Project

Limited English Proficiency (LEP) and Hispanic Worker Initiative
Web site
Provides a variety of resources regarding multilingual and multicultural strategies for serving job seekers and workers with limited English proficiency.
Sponsoring organization: Employment and Training Administration

Limited English Proficiency: A Federal Interagency Website
Web site
Website of the Federal Interagency Working Group that promotes a positive and cooperative understanding of the importance of language access to federally conducted and federally assisted program. Also acts as a clearinghouse, providing and linking to information, tools, and technical assistance regarding limited English proficiency and language services for federal agencies, recipients of federal funds, users of federal programs and federally assisted programs, and other stakeholders.
Sponsoring organization: U.S. Department of Justice

Maternal and Child Health Library: Non-English Materials and Resources
Web site
An online catalog of maternal and child health materials and resources for consumers and professionals in numerous languages other than English.
Sponsoring organization: National Center for Education in Maternal and Child Health

National AHEC Organization - AHEC Directory
Web site
Lists contact information for regional AHECs by state. AHEC's (Area Health Education Centers) work to recruit, train and retain health professionals committed to underserved populations.
Sponsoring organization: National Area Health Education Center Organization

National Association of State Offices of Minority Health Directors
Web site
Lists contact information for directors of state offices of minority health.

National Prevention Information Network - Cultural Competence
Web site
Provides information and resources about cultural competence and how it applies to HIV/AIDS, STD, and TB prevention.
Sponsoring organization: Centers for Medicare and Medicaid Services

National Resource Center on Advancing Emergency Preparedness for Culturally Diverse Communities
Web site
An information exchange portal designed to facilitate communication, networking and collaboration to improve preparedness and eliminate disparities for racially and ethnically diverse communities in public health emergencies.
Sponsoring organization: HHS Office of Minority Health

New Americans Health Information Portal (NAHIP)
Web site
Serves as an Internet portal to identified quality multi-lingual health education documents and as a receptacle for health documents created by Heartland's Refugee Health Programs.
Sponsoring organization: Heartland Alliance for Human Needs & Human Rights

Office for Civil Rights, Headquarters and Regional Addresses
Web site
Lists the contact information for the main Office of Civil Rights and the regional Offices of Civil Rights. Accepts complaints regarding Federal civil rights laws that protect the rights of all persons in the United States to receive health and human services without discrimination based on race, color, national origin, disability, age, and in some cases, sex and religion. This includes LEP persons who are not provided language access in an appropriate manner.
Sponsoring organization: U.S. Department of Health and Human Services

Office for Civil Rights: Limited English Proficiency (LEP) - Resources
Web site
Includes documents pertaining to persons with Limited English Proficiency (LEP).
Sponsoring organization: U.S. Department of Health and Human Services

Office of Minority Health Cultural Competency Section
Web site
Provides information, training and other resources on cultural competency.
Sponsoring organization: HHS Office of Minority Health

Office of Minority Health Regional Minority Health Consultants (RMHCs)
Web site
A locator map of the Office of Minority Health Regional Minority Health Consultants (RMHCs) who work to build partnerships with consumers and professionals working on minority health issues at the regional, state and community level.
Sponsoring organization: HHS Office of Minority Health

Office of Minority Health Resource Center Information and Referral Services
Web site
A resource center that provides publications, articles, statistics, data, funding sources as well as database searches on minority health topics. Can be contacted by phone at 1.800.444.6472, or by e-mail at info@omhrc.gov.
Sponsoring organization: U.S. Department of Health and Human Services

Oral, Linguistic, and Culturally Competent Services: Guides for Managed Care Plans
Web site
Guides offering approaches to defining cultural needs in managed care and developing appropriate services for them.
Sponsoring organization: Agency for Healthcare Research and Quality

Other Language Resources
Web site
Provides links to multilingual materials on health related topics.
Sponsoring organization: National Library of Medicine

Patient Education Resources All Languages
Web site
List of links to patient education materials and brochures available in a variety of different languages.
Sponsoring organization: University of Washington

Physician Toolkit and Curriculum: Resources to Implement Cross-Cultural Clinical Practice Guidelines for Medicaid Practitioners
Print publication
This toolkit aids healthcare providers in the practical application of the Cross-Cultural Clinical Practice Guidelines. It introduces the basic fundamentals of cross-cultural practice and offers steps and processes essential to delivering quality care to culturally diverse populations.
Sponsoring organization: HHS Office of Minority Health

Physician's Practical Guide to Culturally Competent Care
Web site
A website that offers CME, CNE, and CEU credit and equips health care professionals with awareness, knowledge, and skills to treat the increasingly diverse U.S. population they serve. Includes a self-directed training course for family physicians and other health care professionals with an interest in cultural competency.
Sponsoring organization: U.S. Department of Health and Human Services

Rural Health Research: Cultural competency
Web site
Provides summaries of current and completed rural health research projects and related publications addressing the topic of cultural competency, produced by the Office of Rural Health Policy's funded rural health research centers.
Sponsoring organization: Rural Health Research Gateway

Rural Minority and Multicultural Health Information Warehouse
Web site
Central source for finding information about rural minority and multicultural health. Lists research studies, reports, journal articles, and rural minority population data. Prepared by the South Carolina Rural Health Research Center with funding from the Office of Rural Health Policy.
Sponsoring organization: National Rural Health Association

SNAP Informational Materials in Other Languages
Web site
Offers links to materials in languages other than English. Materials are designed for partners, advocates, and the public to distribute to consumers who may be eligible to participate in the Supplemental Nutrition Assistance Program (SNAP), formerly the Food Stamp Program.
Sponsoring organization: U.S. Department of Agriculture

Speaking Together Toolkit
Web site
Provides advice to hospitals on improving quality and accessibility of language services.
Sponsoring organization: Robert Wood Johnson Foundation

Think Cultural Health
Web site
Provides culturally competency programs with continuing education credits and other resources for physicians, pharmacists, and nurses to better meet the cultural and linguistic needs of an increasingly diverse patient population. Offers a free online accredited educational program for a variety of health care providers: physicians, PAs, nurses, and emergency & disaster preparedness workers.
Sponsoring organization: HHS Office of Minority Health

Tool for Assessing Cultural Competence Training (TACCT)
Web site
An instrument for measuring cultural competence in the undergraduate medical school curriculum. Website provides guidelines and a resource guide to assist with TACCT implementation.
Sponsoring organization: Association of American Medical Colleges

TrainingFinder Real-time Affiliate Integrated Network (TRAIN)
Database
Information on learning opportunities, particularly online learning, for health care professionals who work for the public's health. Searchable by subject, keyword, target audience, core competencies, etc.
Sponsoring organization: Public Health Foundation

Why The Difference Initiative
Web site
Designed to increase provider awareness about disparities in health care. The website also provides a Speaker's Kit to help physicians talk to patients about cardiovascular care.
Sponsoring organization: Kaiser Family Foundation

Funding

California Endowment Grant Programs
Grants to expand access to affordable, quality health care for the underserved and to improve the health status of all Californians.

Commonwealth Fund Health Grants
Supports independent research on health and social issues and makes grants to improve health care practice and policy.

Dollar General Adult Literacy Grants
Awards funding to non-profit organizations that provide direct service to adults in need of literacy assistance.

Dollar General Family Literacy Grants
Grants to direct family literacy service providers.

Humana Foundation Community Grants
The Humana Foundation supports charitable activities that promote healthy lives and communities.

Regional Community Health Grants Program
This program provides funding focused on reducing disparities in health care among racial and ethnic populations in eligible geographic areas.

Inactive Funding

Inactive Funding Opportunities - Lists additional funding programs for this topic that are not currently accepting applications. Programs that are inactive may be offered again in the future.

Regulations, Forms & Other Useful Documents

Addressing Racial Disparities in Health Care: A Targeted Action Plan for Academic Medical Centers
Sponsoring organization: Association of American Medical Colleges
Report focuses on how academic health centers in the United States should commit to the goal of eliminating racial disparities in health care as part of their mission to preparing future generations of physicians to provide the highest quality care for the U.S. population including rural.
Date: 2009

Advancing Effective Communication, Cultural Competence, and Patient- and Family-Centered Care: A Roadmap for Hospitals
Sponsoring organization: Joint Commission
Provides methods for hospitals to begin or improve upon their efforts to integrate concepts that will ensure that all patients receive the same high quality care.
Date: 2010

And the Journey Continues: Achieving Cultural and Linguistic Competence in Systems Serving Children and Youth with Special Health Care Needs and their Families
Author(s): Tawara D. Goode, Wendy Jones, Suzanne Bronheim, Clare Dunne
Sponsoring organization: National Center for Cultural Competence
Offers insights and lessons learned by the National Center for Cultural Competence and provides success stories from State Title V Children with Special Health Care Needs programs.
Date: 2007

Building Our Understanding: Culture Insights Communicating with Hispanic/Latinos
Sponsoring organization: Centers for Disease Control and Prevention
Addresses effective strategies of health communication with Latino/Hispanic audiences.
Date: 2011

Certification of Health Care Interpreters: A Primer, a Status Report and Considerations for National Certification
Author(s): Cynthia Roat
Sponsoring organization: California Endowment
Provides an overview of certification issues for health care interpreters in the United States.
Date: 09 / 2006

Cultural Competence Training Survey - Results 2008
Author(s): Anne Turner
Sponsoring organization: Cross Cultural Health Care Program
Results from a cultural competence training survey developed to learn more about the needs of the professionals who purchase or deliver cultural competence training within hospitals, health care organizations, and other institutions.
Date: 2008

Culturally and Linguistically Appropriate Services (CLAS) Toolkit
Sponsoring organization: New Mexico Department of Health Division of Policy and Performance
Provides implementation strategies and resources both statewide and regionally to address the four mandated Language Access Services Standards.
Date: 2009

Executive Order 13166: Improving Access to Services for Persons with Limited English Proficiency
Sponsoring organization: U.S. Department of Justice
The Executive Order that requires Federal agencies to examine the services they provide, identify any need for services to those with limited English proficiency (LEP), and develop and implement a system to provide those services so LEP persons can have meaningful access to them.
Date: 08 / 2000

Guide for Advancing Family-Centered and Culturally and Linguistically Competent Care
Sponsoring organization: National Center for Cultural Competence
Discusses ways in which family-centered care and cultural and linguistic competence can be integrated to support and sustain a community-based system of services that provide high quality of care to families who have children and youth with special health care needs.

Guidelines for Providing Health Care Services through an Interpreter
Sponsoring organization: Cross Cultural Health Care Program
Basic information to help health care professionals work with an interpreter when providing health care.

Health Care Language Services Implementation Guide
Sponsoring organization: U.S. Department of Health and Human Services
Guide to help healthcare organizations implement effective language access services (LAS) to meet the needs of their patients with limited English proficiency (LEP), thereby increasing their access to health care. Requires registration.
Date: 2007

Health Literacy Practices in Primary Care Settings: Examples from the Field
Author(s): Sharon E. Barrett, Jennifer Sheen Puryear, Kathie Westpheling
Sponsoring organization: Commonwealth Fund
Reports on the findings from a 2005 study in which the Association of Clinicians for the Underserved administered an online survey of health care facilities across the country, then followed up with visits to five selected sites, including rural, for staff and patient interviews.
Date: 01 / 2008

Hospitals, Language, and Culture: A Snapshot of the Nation
Author(s): Amy Wilson-Stronks, Erica Galvez
Sponsoring organization: Joint Commission
A qualitative cross-sectional study designed to provide a snapshot of how 60 hospitals across the country are providing health care to culturally and linguistically diverse patient populations.
Date: 2007

Improving Access to Care Among Medicare Beneficiaries With Limited English Proficiency: Can Medicare Do More?
Sponsoring organization: AARP Public Policy Institute
Examines problems associated with language barriers in health care setting, describes federal efforts to address the barriers, and makes policy recommendations.
Date: 2008

Improving Access to Language Services in Health Care: A Look at National and State Efforts
Author(s): Melanie Au, Erin Fries Taylor, Marsha Gold
Sponsoring organization: Mathematica Policy Research, Inc.
Assesses emerging national efforts to address language barriers and profiles work in three states—California, Minnesota, and New York—to highlight challenges, successes, and implications for future policy and activities related to providing language services.
Date: 04 / 2009

Improving Quality of Health Care Relies on Effective Language Services
Sponsoring organization: Robert Wood Johnson Foundation
Highlights how data are helping hospitals improve the way they provide language services to America's increasingly diverse patient populations.
Date: 09 / 2007

Interpreter Services for Patients in Medical and Dental Settings
Sponsoring organization: Interpreter Services Work Group
Outcome of a study involving a work group in Minnesota, who examined ensuring access to interpreter services; complying with requirements of federal law and guidance; developing a quality assurance program to ensure the quality of health care interpreting services; and identifying broad-based funding mechanisms for interpreter services.
Date: 02 / 2008

Language Access Services in Critical Access Hospitals for Patients with Limited English Proficiency in Rural Minnesota
Sponsoring organization: Minnesota Department of Health
Examines how well Critical Assess Hospitals (CAHs) were meeting the needs of patients with limited English proficiency in rural Minnesota.
Date: 03 / 2008

Language Access Solutions for OBGYN Medical Practices
Provides policy and practice recommendations to promote the use of language access practices that ensure interpretation, confidentiality, adherence to medical ethics standards, while discouraging the use of inappropriate methods.
Date: 2007

Language Proficiency and Adverse Events in U.S. Hospitals: A Pilot Study (Summary)
Author(s): Chandrika Divi, Richard G. Koss, Stephen P. Schmaltz, Jerod M. Loeb
Sponsoring organization: Commonwealth Fund
Reports on the type and frequency of adverse events experienced by LEP (limited English proficiency) and English-speaking patients in six U.S. hospitals.
Date: 04 / 2007

Language Services for Patients with Limited English Proficiency: Results of a National Survey of Internal Medicine Physicians
Sponsoring organization: American College of Physicians
Presents the findings of a national survey of American College of Physicians members to determine whether internal medicine practices provide language services for LEP patients.
Date: 2007

MedlinePlus and the Challenge of Low Health Literacy: Findings From the Colonias Project
Author(s): Cynthia A. Olney, Debra G. Warner, Greysi Reyna, Fred B. Wood, Elliot R. Siegel
Sponsoring organization: Medical Library Association
Discusses the Colonias Project, an 18-month outreach project with the goal of increasing the usage of MedlinePlus and MedlinePlus en español and overcoming associated problems with health literacy in low-income, medically underserved Hispanic communities (colonias) along the Texas-Mexico border, where residents primarily speak Spanish.
Journal citation: Journal of the Medical Library Association Volume 95 Issue 1 Pages: 31-39
Date: 01 / 2007

Modest and Uneven: Physician Efforts to Reduce Racial and Ethnic Disparities
Author(s): James D. Reschovsky, Ellyn R. Boukus
Sponsoring organization: Center for Studying Health System Change
Reports on a 2008 HSC Health Tracking Physician Survey the steps they and their practices have taken to reduce language and cultural barriers and generate information at the practice level to improve care for minority patients.
Date: 02 / 2010

Multicultural Health Care: A Quality Improvement Guide
Sponsoring organization: National Committee for Quality Assurance
Provides a quality improvement framework for health care organizations seeking to promote culturally appropriate care, provide equitable access for individuals with limited English proficiency and reduce health care disparities.
Date: 2008

National Standards for Culturally and Linguistically Appropriate Services in Health Care: Executive Summary
Sponsoring organization: Health Resources and Services Administration
A summary with list of the National Standards for Culturally and Linguistically Appropriate Services in Health Care as issued by the U.S. Department of Health and Human Services' Office of Minority Health (OMH) to ensure that all people entering the health care system receive equitable and effective treatment in a culturally and linguistically appropriate manner. These standards are proposed as a means to correct inequities that currently exist in the provision of health services and to make these services more responsive to the individual needs of all patients/consumers.
Date: 03 / 2001

National Standards for Culturally and Linguistically Appropriate Services in Health Care: Final Report
Sponsoring organization: Health Resources and Services Administration
Provides a list and discussion of the National Standards for Culturally and Linguistically Appropriate Services in Health Care as issued by the U.S. Department of Health and Human Services' Office of Minority Health (OMH) to ensure that all people entering the health care system receive equitable and effective treatment in a culturally and linguistically appropriate manner. These standards are proposed as a means to correct inequities that currently exist in the provision of health services and to make these services more responsive to the individual needs of all patients/consumers.
Date: 03 / 2001

National Standards on Culturally and Linguistically Appropriate Services (CLAS)
Sponsoring organization: HHS Office of Minority Health
A list of the Culturally and Linguistically Appropriate Services (CLAS) standards as developed by the National Project Advisory Committee, in conjunction with the U.S. Department of Health and Human Services, and the Office of Minority Health. These standards are directed at health care organizations; however, individual providers are also encouraged to use the standards to make their practices more culturally and linguistically accessible.
Date: 2000

Outcomes of Community Health Worker Interventions
Sponsoring organization: Agency for Healthcare Research and Quality
Results of a systematic review on the characteristics of community health workers (CHWs) and CHW interventions, outcomes of such interventions, costs and cost-effectiveness of CHW interventions, and characteristics of CHW training. Includes references to rural.
Date: 06 / 2009

Patient Centeredness, Cultural Competence and Healthcare Quality
Author(s): Somnath Saha, Mary Catherine Beach, Lisa A. Cooper
Sponsoring organization: Commonwealth Fund
Explores and compares the historical evolution of both cultural competence and patient centeredness - interpersonal and healthcare systems levels.
Journal citation: Journal of the National Medical Association
Date: 11 / 2008

Patient-Centered Guide to Implementing Language Access Services (LAS) in Healthcare Organizations (Executive Summary)
A summary of full document of same title intended to help healthcare organizations implement effective language access services to meet the needs of their limited English proficient patients (LEP), and increase their access to health care.
Date: 09 / 2005

Priority Populations Initiative: Breaking New Ground and Building Capacity in Cultural Tailoring
Author(s): Helen Lettlow, Guillermo Brito,
Sponsoring organization: Legacy
Highlights the importance of cultural tailoring to the successful servicing of traditionally underserved populations.
Date: 03 / 2007

Providing Language Services in State and Local Health-Related Benefits Offices: Examples from the Field
Author(s): Mara Youdelman, Jane Perkins, Jamie D. Brooks, Deborah Reid
Sponsoring organization: Commonwealth Fund
The National Health Law Program visited and conducted telephone interviews and surveys with Medicaid and other public programs offices to assess effective models of providing language services to people who are LEP.
Date: 01 / 2007

Public Health Preparedness and Response for At-Risk Populations: Harnessing the Power of Health Information and Communication Technologies
Author(s): Anne Rader, Margo Edmunds, Joan Bishop
Sponsoring organization: Booz Allen Hamilton Inc.
Outlines the preparedness challenges for people with disabilities and other at-risk groups, describes the information and communications technologies being used by healthcare providers and consumers, and gives examples of ways state governments and local communities are using technology to reach those who are most at risk.
Date: 2010

Reducing Racial and Ethnic Health Disparities: Key Health Equity Provisions
Sponsoring organization: Families USA
Identifies how health reform presents an opportunity to address fundamental inequities in the health care system and among communities by helping to reduce racial and ethnic disparities.
Date: 03 / 2010

Resident Physicians' Preparedness to Provide Cross-Cultural Care: Implications for Clinical Care and Medical Education Policy
Author(s): Joseph R. Betancourt, Joel S. Weissman, Minah K. Kim, Elyse R. Park, Angela W. Maina
Sponsoring organization: Commonwealth Fund
Reports on a national study of resident physicians in their final year of training regarding the preparedness to care for patients from racial and ethnic minorities and from diverse cultures.
Date: 05 / 2007

Serving Patients with Limited English Proficiency: Results of a Community Health Center Survey
Sponsoring organization: National Association of Community Health Centers
Discusses the challenges of serving people with limited English proficiency (LEP) at health care safety net organizations.
Date: 06 / 2008

Sound of Success: Efficient And Effective Language Services Becoming A Reality In Some Hospitals
Sponsoring organization: Robert Wood Johnson Foundation
Reports on a national initiative aimed at identifying, testing and assessing strategies for hospitals to provide effective language services to LEP patients.
Date: 09 / 2008

Talking With Patients: How Hospitals Use Bilingual Clinicians and Staff to Care for Patients with Language Needs
Author(s): Jennifer Huang, Christal Ramos, Karen Jones, Marsha Regenstein
Sponsoring organization: George Washington University Department of Health Policy
Presents findings from a survey conducted by researchers at George Washington University and supported by funding from the California Endowment to learn more about the individuals in a hospital setting who interact with patients who speak a language other than English.
Date: 08 / 2009

Toolkit for Serving Diverse Communities
Sponsoring organization: Administration on Aging
Highlights a method for providing respectful, inclusive and sensitive services for any diverse community. Consists of a four-step process and a questionnaire that assists professionals, volunteers and grassroots advocates with every stage of program planning, implementation and service delivery for older adult communities, their families and caregivers, including rural populations.
Date: 06 / 2011

Using Professionally Trained Interpreters to Increase Patient/Provider Satisfaction: Does It Work?
Author(s): Ann D. Bagchi, Stacy Dale, Natalya Verbitsky-Savitz, Sky Andrecheck
Sponsoring organization: Mathematica Policy Research, Inc.
A study addressing the research suggesting a link between the use of a professional interpreter during ED visits and higher levels of patient and provider satisfaction.
Date: 02 / 2010

What Did the Doctor Say?: Improving Health Literacy to Protect Patient Safety
Sponsoring organization: Joint Commission
Discusses how cultural, language, and communication barriers can lead to misunderstandings between patients and their health care providers and can place patients at a greater risk of preventable adverse events.
Date: 2007

Organizations

Access Project
Nonprofit/Foundation
Part of the Center for Community Health Research and Action. Works to strengthen community action, promote social change, and improve health, especially for those who are most vulnerable.

Association of Clinicians for the Underserved (ACU)
National organization
A nonprofit, transdisciplinary organization of clinicians, advocates, and health care organizations working to improve the health of America's underserved populations and to enhance the development and support of the medical and dental clinicians serving these populations.

CDC's Office of Minority Health & Health Disparities (OMHH)
Federal government
Aims to accelerate CDC’s health impact in the U.S population and to eliminate health disparities for vulnerable populations as defined by race/ethnicity, socio-economic status, geography, gender, age, disability status, risk status related to sex and gender, and among other populations identified to be at-risk for health disparities.

Commonwealth Fund
Nonprofit/Foundation
Supports independent research on health and social issues and makes grants to improve health care practice and policy. Dedicated to helping people become more informed about their health care and improving care for vulnerable populations such as children, elderly people, low-income families, minority Americans, and the uninsured.

Cross Cultural Health Care Program (CCHCP)
National organization
Serves as a bridge between communities and health care institutions to ensure full access to quality health care that is culturally and linguistically appropriate.

DiversityRx
National organization
Promotes language and cultural competence to improve the quality of health care for minority, immigrant, and ethnically diverse communities.

HHS Office of Minority Health (OMH)
Federal government
Serves to improve and protect the health of racial and ethnic minority populations through the development of health policies and programs that will eliminate health disparities. Part of the U.S. Department of Health & Human Services.

Institute for Diversity in Health Management
National organization
Committed to expanding health care leadership opportunities for ethnically, culturally, and racially diverse individuals, and increasing the number of these individuals entering and advancing in the field.

National Center for Cultural Competence (NCCC)
National organization
Mission is to increase the capacity of health and mental health programs to design, implement, and evaluate culturally and linguistically competent service delivery systems. Provides a variety of tools, publications and other resources online. Information available in Spanish.

National Center on Minority Health and Health Disparities (NCMHD)
Federal government
The mission is to promote minority health and to lead, coordinate, support, and assess the NIH effort to reduce and eliminate health disparities. NCMHD will conduct and support basic, clinical, social, and behavioral research, promote research infrastructure and training, foster emerging programs, disseminate information, and reach out to minority and other health disparity communities.

National Council on Interpreting in Health Care (NCIHC)
National organization
A multidisciplinary organization based in the United States whose mission is to promote culturally competent professional health care interpreting as a means to support equal access to health care for individuals with limited English proficiency.

National Health Service Corps (NHSC)
Federal government
Works to improve the health of the underserved by recruiting and retaining the health professionals to deliver health care in underserved communities. Provides technical assistance to federally designated Health Professional Shortage Areas (HPSAs) on projects that enhance the NHSC's site development mission. Part of the Bureau of Health Professionals, Health Resources and Services Administration.

National Medical Association (NMA)
National organization
Represents African American physicians and health professionals in the United States. Promotes the collective interests of physicians and patients of African descent.

National MultiCultural Institute (NMCI)
National organization
Works with individuals, organizations, and communities to facilitate change in order to build an inclusive society that is strengthened and empowered by its diversity. Provides seminars and online training regarding effective teamwork, developing a diverse workforce, conflict resolution, cultural competence and leadership skills.

ProLiteracy
Nonprofit/Foundation
ProLiteracy champions the power of literacy to improve the lives of adults and their families, communities, and societies.

Refugee Health Information Network (RHIN)
National organization
A national collaborative partnership, managed by refugee health professionals, whose objective is to provide quality multilingual, health information resources for those providing care to resettled refugees and asylees.

Robert Wood Johnson Foundation
Nonprofit/Foundation
The largest philanthropy devoted exclusively to health and health care in the United States.

U. S. Department of Justice Civil Rights Division
Federal government
Works to uphold the civil and constitutional rights of all Americans, particularly some of the most vulnerable members of our society. Division enforces federal statutes prohibiting discrimination on the basis of race, color, sex, disability, religion, familial status and national origin.

W.K. Kellogg Foundation
Nonprofit/Foundation
Works to help people help themselves through the practical application of knowledge and resources to improve their quality of life and that of future generations.

WellShare International
International organization
WellShare International, formerly Minnesota International Health Volunteers works to improve the health of women, children and their communities around the world.

Terms & Acronyms

Acculturation Cultural modification of an individual or a group by adapting to, or borrowing traits from another culture often a result of long term contact.

Capacity building Efforts to develop human skills or society infrastructures with a community or organization.

Community Interpreter Service Pool A pool of trained and qualified interpreters providing interpreter services in several languages, including American Sign Language (ASL) to a number of hospitals, private practices, and other local health and social services agencies.

Cultural Attunement A process that involves constant communication, sensitivity to the dynamics of relationships within a culture, and respect for the values and beliefs of a culture. Involves active “tuning in” on an ongoing basis.

Cultural Brokering The act of bridging, linking or mediating between groups or persons of different cultural backgrounds to effect change.

Cultural Competency A competency based on the premise of respect for individuals and cultural differences, and an implementation of a trust-promoting method of inquiry.

Culturally and Linguistically Appropriate Services (CLAS) Services that reflect a set of behaviors, attitudes, and policies that enable effective work in cross-cultural situations.

Culture A specific set of social, educational, religious and professional behaviors, practices and values that individuals learn and adhere to while participating in or out of groups they usually interact with.

Encounter A communication event in which the services of an interpreter are required.

Ethnic Of or relating to large groups of people classed according to a common racial, national, tribal, linguistic, or cultural origin or background.

Interpretation The act of receiving a message in one language and sending exactly the same message in another language through a verbal exchange. Interpretation also includes body language messages.

Language Access Services (LAS) Services designed to ensure effective communication between limited English proficient individuals and English speakers. May include oral interpretation and written translation services and other provisions that enhance communication such as signage and symbols.

Linguistic Competence The ability of an organization and its personnel to effectively communicate and convey information in a manner that is understood by a diverse audience.

Office for Civil Rights (OCR) Agency of the Department of Health and Human Services charged with enforcing HIPAA civil penalties and handling complaints. The agency to contact regarding discrimination complaints associated with federal health care and social service programs, and LEP services.

Promotoras A person who, with or without compensation, provides a bilingual liaison between health care providers and patients through activities that include assisting in case conferences, providing patient education, making referrals to health and social services, conducting needs assessments, distributing surveys to identify barriers to health care delivery, making home visits, and providing language services.

Referral List Includes specific services and providers (in-house or outside) who may be selected to provide care or other services, e.g. pastoral care, patient representation, interpretation, social services, nutrition, shelter, etc.

Transcription Accurate written rendition of oral or recorded information such as medication dosages, diet, wound care, etc.

Translation The rendering, in writing, of a written text from one language to another.

Contacts

For information on cultural competency programs and training
National Center for Cultural Competency (NCCC)
Telephone: 1.800.788.2066/202.687.5384
E-mail: cultural@georgetown.edu

For publications, articles, and database searches on minority health topics; for a list of cultural competence trainers
DHHS Office of Minority Health Resource Center (OMHRC)
Telephone: 800.444.6472
E-mail: info@omhrc.gov
Information services available in both English and Spanish

For cultural competence and medical interpreter training and referral
Cross Cultural Health Care Program (CCHCP)
270 So. Hanford St., Suite 208 Seattle, WA 98134
Telephone: 1.206.860.0329
E-mail: training@xculture.org (Training); resource@xculture.org (Resource Center)

For information on or to file a complaint regarding discrimination on the basis of race, color, national origin, or sex in programs or activities of federally-assisted entities
U.S. Department of Justice
Civil Rights Division
Coordination and Review Section - NYA
950 Pennsylvania Avenue, N.W
Washington, DC 20530
Title VI Hotline: 1-888-TITLE-06 (1.888.848.5306) (Voice/TDD)
What's New
What's new RSS
About RSS Feeds

Page last updated 11/1/2011
Topic last reviewed 5/25/2011

About this Page
Credits
Lizette M. Rivera, DHHS Office of Minority Health, Rockville, MD

Developed by:
Kathy Spencer
kathy@raconline.org



Suggest a resource for this page.

Phone: 1-800-270-1898
Email: info@raconline.org

Copyright@ 2002–2012 Rural Assistance Center. All rights reserved.
Accessibility | Disclaimer | Privacy Policy | Sitemap

Funding for this project was supported by Grant Number U56RH05539 from the Office of Rural Health Policy, Health Resources and Services Administration, U.S. Department of Health and Human Services. The contents of this website are solely the responsibility of the authors and do not necessarily represent the official views of the funder.