• Develop solutions and a dissemination strategy that distinguishes between the health technology needs of rural and urban communities in ways that make sense.
• Quickly advance research on the outcomes achieved from the effective and meaningful use of health technology among traditionally underserved populations.
• Design effective patient engagement campaigns that include patients as partners and active participants in their care in an environment where physicians respect and encourage the use of technology to achieve better outcomes.
• Develop technology solutions that are culturally competent, sensitive and universally designed for different ability and literacy levels.
• Engage patients and consumers in collaborative design, where they can participate in the design, development,  and testing process from the outset.

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There are three types of applications:

• one for individuals who are eligible for subsidies of their health insurance premiums (with incomes below 400 percent of the Federal Poverty Level)
• one for families who are eligible for subsidies, and
• one for individuals and/or families seeking health insurance coverage, but not eligible for subsidies.

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Link to Original Source

Link to Original Source

The enhanced standards are reorganized into a “principal standard”, and then three themes: Governance, Leadership, and Workforce; Communication and Language Assistance; and Engagement, Continuous Improvement, and Accountability:

1. Provide effective, equitable, understandable, and respectful quality care and services that are responsive to diverse cultural health beliefs and practices, preferred languages, health literacy, and other communication needs.

Governance, Leadership, and Workforce

2. Advance and sustain governance and leadership that promotes CLAS and health equity through policy, practices, and allocated resources.

3. Recruit, promote, and support a culturally and linguistically diverse governance, leadership, and workforce that are responsive to the population in the service area.

4. Educate and train governance, leadership, and workforce in culturally and linguistically appropriate policies and practices on an ongoing basis.

Communication and Language Assistance

5. Offer language assistance to individuals who have limited English proficiency 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.

Engagement, Continuous Improvement, and Accountability

9. Establish culturally and linguistically appropriate goals, policies, and management accountability, and infuse them throughout the organization’s planning and operations.

10. Conduct ongoing assessments of the organization’s CLAS-related activities and integrate CLAS-related measures into measurement and continuous quality improvement activities.

11. Collect and maintain accurate and reliable demographic data to monitor and evaluate the impact of CLAS on health equity and outcomes and to inform service delivery.

12. Conduct regular assessments of community health assets and needs and use the results to plan and implement services that respond to the cultural and linguistic diversity of the populations in the service area.

13. Partner with the community to design, implement, and evaluate policies, practices, and services to ensure cultural and linguistic appropriateness.

14. Create conflict and grievance resolution processes that are culturally and linguistically appropriate to identify, prevent, and resolve conflicts or complaints.

15. Communicate the organization’s progress in implementing and sustaining CLAS to all stakeholders, constituents, and the general public.

OMH has issued an extensive background document called the Blueprint for Advancing and Sustaining CLAS Policy and Practice to explain and provide more details on the enhanced standards.  Unfortunately,  the U.S. Department of Health and Human Services does not take any action to implement the enhanced CLAS standards by incorporating the standards into its own requirements for federally funded health care and services, grants, contracts, and other activities.

The enhanced CLAS standards broaden the OMH’s definition of culture as “the integrated pattern of thoughts, communications, actions, customs, beliefs, values, and institutions associated, wholly or partially, with racial, ethnic, or linguistic groups, as well as with religious, spiritual, biological, geographical, or sociological characteristics.”  This is a more inclusive definition that now incorporates DHHS’ activities to address  disparities in health and health care based on income, geography, disability, sexual orientation, gender identity, and other factors.

Similarly, the enhanced CLAS standards broaden the OMH’s definition of communication and language assistance to highlight the communication needs of Limited English Proficient individuals, persons with disabilities, and persons with lower health literacy.

The enhanced standards, blueprint, and other materials are available on the OMH’s Think Cultural Health website after a free registration process.  Note that the one sentence shorthand descriptions of the standards on the website and in the documents do not include the full detail of the wording of the actual standards.

1. Track and coordinate referrals
2. Provide access and timely communication
3. Identify and coordinate patient populations
4. Plan and manage care
5. Track and coordinate care
6. Measure and improve performance

The standards also are aligned with both Stage 1 and Stage 2 requirements for the meaningful use of electronic health records to be eligible for incentive payments from the Centers for Medicare & Medicaid Services.

NCQA has published a white paper describing the development of the Patient-Centered Specialty recognition program:

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Sixty-four specialty practices have committed to apply for Patient-Centered Specialty Practice recognition, with the goal of completing their applications and becoming recognized by the end of 2013.

The full standards and guidelines are available for free with registration on the NCQA website.

Link to Original Source

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• Practice leadership and practice culture are the most important – and subjective – factors for success
• Practices needed both practice facilitation and care management support.
• Practice facilitation was most effectively provided by an entity external to the practice with the relevant experience and skill set.
• Receptivity to care management/coordination supports by practices was mixed, and the belief that the practices would ultimately “take over” and provide care management activities proved unrealistic.
• Financial incentives were not the primary motivator or driver of change.
• HIT was too overwhelming for most practices to implement to its fullest capacity.
• Improving quality and reducing disparities in the practices will likely be more sustainable in medical home models.

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The report estimates that there are at least 267,000 lesbian, gay, bisexual, and transgender undocumented immigrants residing in the U.S., and an estimated 32,300 binational same-sex couples who are denied immigration status protections and benefits because of the misnamed Defense of Marriage Act (currently being challenged in the U.S. Supreme Court).

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The report includes the following useful infographic:

The bill has not yet been assigned a bill number.

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In the context of the implementation of the Patient Protection and Affordable Care Act, the foundation has decided to focus its grantmaking over the next five years on 1) getting Connecticut residents enrolled in and retaining affordable health care insurance,              2) navigating the health care system to get the health care they need, when they need it, and 3) getting health care that is affordable, comprehensive, and accountable for improving  health.

As of the end of 2011, the foundation had assets of nearly $103 million and made grants totaling $3 million that year.

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The foundation has produced the following infographic to illustrate its new strategic plan:

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