Call for Comments on the Existing National Standards for the Culturally and Linguistically Appropriate Services in Health Care, 57957-57958 [2010-23760]
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Federal Register / Vol. 75, No. 184 / Thursday, September 23, 2010 / Notices
DEPARTMENT OF HEALTH AND
HUMAN SERVICES
Call for Comments on the Existing
National Standards for the Culturally
and Linguistically Appropriate
Services in Health Care
Department of Health and
Human Services, Office of the Secretary,
Office of the Assistant Secretary for
Health, Office of Minority Health.
ACTION: Notice.
AGENCY:
The HHS Office of Minority
Health (OMH) announces the launch of
an enhancement initiative of the
existing National Standards for
Culturally and Linguistically
Appropriate Services in Health Care
(CLAS Standards). The public comment
period will begin September 20, 2010
and conclude December 31, 2010.
During this time three regional meetings
on the standards will be held
throughout the country. Individuals and
organizations are encouraged to submit
their comments on the 14 standards and
their current application and use. The
enhanced national standards, as revised
in accordance with public comment and
subject matter expertise, will be
published for review in spring of 2011
with the final versions being published
in fall of 2011.
DATES: The initial comment and
submission period is September 20
through December 31, 2010.
ADDRESSES: (1) Electronically through
the public comment site https://
clasenhancements.thinkculturalhealth.
org.
(2) By mail, comments postmarked no
later than December 31, 2010, can be
submitted to: CLAS Standards c/o HHS
Office of Minority Health, 1101 Wootton
Parkway, Suite 600, Rockville,
Maryland 20852. Comments sent by
courier will be accepted until 5 p.m.
EST on December 31.
(3) Individuals may register for one of
the regional meetings by using the
online registration form at https://
clasenhancements.thinkculturalhealth.
org. To request a registration form by
mail, write to CLAS Standards
Enhancement Initiative meeting, c/o
SRA International, Inc., 6003 Executive
Blvd, Suite 400, Rockville, MD 20852.
FOR FURTHER INFORMATION CONTACT:
Guadalupe Pacheco, Office of Minority
Health, 1101 Wootton Parkway, Suite
600, Rockville, MD 20852, Attn: CLAS,
Telephone: (240) 453–6174; Fax: (240)
453–2883; E-mail:
Guadalupe.Pacheco@hhs.gov.
Background: To help achieve its
mission of ‘‘improving the health of
racial and ethnic minority populations
srobinson on DSKHWCL6B1PROD with NOTICES
SUMMARY:
VerDate Mar<15>2010
16:52 Sep 22, 2010
Jkt 220001
through the development of effective
health policies and programs that help
to eliminate disparities in health,’’ the
OMH published the National Standards
for Culturally and Linguistically
Appropriate Services in Health Care
(CLAS Standards) in 2001. The CLAS
Standards were developed on the basis
of an analytical review of key laws,
regulations, contracts, and standards
used by Federal and State agencies and
other national organizations, with input
from a national advisory committee of
policymakers, health care providers,
and researchers. Open public hearings
were held to obtain input from
communities throughout the nation. The
CLAS Standards represent the first
national standards for cultural
competence in health care and offer
comprehensive guidance on what
constitutes culturally competent service
delivery. They consist of 14 guidelines,
recommendations, and mandates that
serve to inform, guide, and facilitate
implementation of culturally and
linguistically appropriate services in
health care. The CLAS Standards are
organized by three themes: Culturally
Competent Care, Language Access
Services, and Organizational Supports.
They recognize that culture and
language are central to the delivery of
health services.
Disparities in health care have been
documented in a number of
groundbreaking reports: Findings of the
Supplement to Mental Health: A Report
of the Surgeon General (CMHS, 2001a)
reveal that ‘‘racial and ethnic minorities
bear a greater burden from unmet
mental health needs and thus suffer a
greater loss to their overall health and
productivity.’’ Findings from the 2000
Surgeon General’s Report Oral Health in
America: A Report of the Surgeon
General indicated significant disparities
‘‘between racial and socioeconomic
groups in regards to oral health and
ensuing overall health issues’’ (DHHS,
2000). The 2003 report from the
Institute of Medicine, Unequal
Treatment: Confronting Racial and
Ethnic Disparities in Healthcare
(Smedley, Stith & Nelson, 2003), and its
supplementary paper contributions such
as Racial and Ethnic Disparities in
Diagnosis and Treatment: A Review of
the Evidence and a Consideration of
Causes (Geiger, 2003) and The Civil
Rights Dimension of Racial and Ethnic
Disparities in Health Status (Perez,
2003), brought to the forefront that
minorities receive lower quality health
care even when socioeconomic and
access-related factors are controlled.
The report also showed that bias,
stereotyping, prejudice, and clinical
PO 00000
Frm 00071
Fmt 4703
Sfmt 4703
57957
uncertainty may contribute to racial and
ethnic disparities in health care
(Smedley et al., 2003).
A significant body of research
released since the 2003 IOM report
corroborates these findings. The
National Healthcare Disparities Report
prepared by the Agency for Healthcare
Research and Quality states that
‘‘although varying in magnitude by
condition and population, disparities
are observed in almost all aspects of
health care’’ (The Agency for Healthcare
Research and Quality, 2006). Inspired
by the CLAS Standards, national
organizations including the American
Medical Association (AMA), American
Association of Medical Colleges
(AAMC), the Joint Commission, the
National Committee for Quality
Assurance (NCQA), the National Quality
Forum (NQF) and others have released
standards to help support the provision
of culturally and linguistically
appropriate care. Many of these
standards promote the education and
training of health care providers in
culturally appropriate care.
Increasingly, national experts are
looking to cultural competency training
as a means to reduce disparities in
health care. Evidence suggests that the
most effective cultural competence
training helps providers develop new
knowledge, skills, and attitudes in order
to effectively treat minority and
immigrant populations (Smedley et al.,
2003). The concepts of cultural and
linguistic competency as well as health
disparities are featured prominently in
the health care reform legislation
enacted and signed by President Barack
Obama in March 2010. References to the
concepts of cultural and linguistic
competency illustrate how pervasive
and important the constructs have
become.
Public comment period: It has been
nearly ten years since the release of the
landmark report regarding the CLAS
Standards. In the report, the HHS, OMH
provided the framework for all health
care organizations to establish services
and policies to best serve our
increasingly diverse communities. In
the decade following the release of the
CLAS Standards, the field of cultural
and linguistic competency has seen
tremendous growth. It has evolved from
a fledgling concept to a recognized
intervention in the quest for health
equity. The field of cultural and
linguistic competency is dynamic and
as such requires routine enhancement
and nurturing. With this in mind, HHS,
OMH has begun to revisit the National
CLAS Standards.
The OMH has determined that the
appropriate next step is for the CLAS
E:\FR\FM\23SEN1.SGM
23SEN1
srobinson on DSKHWCL6B1PROD with NOTICES
57958
Federal Register / Vol. 75, No. 184 / Thursday, September 23, 2010 / Notices
Standards to undergo a national process
of public comment that will result in a
broader awareness of HHS interest in
CLAS, significant input from
stakeholder groups on the existing
CLAS Standards, as well as a final
revision of the CLAS Standards and
accompanying commentary supported
by the expertise of a National Project
Advisory Committee. The final revisions
will be published in the Federal
Register as recommended national
standards for adoption or adaptation by
stakeholder organizations and agencies.
The publication of the CLAS
Standards in the Federal Register, and
publicizing the availability of the
complete report with commentary on
the Internet and through local, regional,
and national organizations will facilitate
reaching as wide an audience of
stakeholders as possible. This period of
dissemination and awareness-raising
will include three regional meetings to
gather and solicit detailed input from
interested individuals and organizations
that will complement and enhance the
public comments received by OMH
through electronic and written means.
Individuals and organizations
desiring to provide input on the
standards are encouraged to send
comments during the public comment
period which is from September 20
through December 31, 2010. Individuals
mailing comments are requested to
include the following information:
Name, position, organization, mail, and
e-mail addresses and to identify
specifically those portions of their
comments that pertain to: The wording
or the content of individual standards,
the purpose of the standards and/or the
intended audience for the national
standards.
Dates and locations of the meetings
are as follows:
Baltimore, Maryland, Friday, October
22, 2010, The Hyatt Regency, 300 Light
Street, Baltimore, MD 21202.
San Francisco, California, Thursday,
November 4, 2010, The Stanford Court,
A Renaissance Hotel, 905 California
Street, San Francisco, CA 94108.
Chicago, Illinois, Monday, November
15, 2010, The James Hotel, 55 East
Ontario Street, Chicago, IL 60611–2727.
All meetings will convene at 9 a.m.
and conclude at 3 p.m. On-site
registration will be available starting at
7:30 a.m.
Information about the CLAS
Standards Enhancement Initiative is
available electronically at https://
clasenhancements.thinkculturalhealth.
org.
VerDate Mar<15>2010
16:52 Sep 22, 2010
Jkt 220001
Dated: September 2, 2010.
Garth N. Graham,
Deputy Assistant Secretary for Minority
Health.
[FR Doc. 2010–23760 Filed 9–22–10; 8:45 am]
BILLING CODE 4150–29–P
DEPARTMENT OF HEALTH AND
HUMAN SERVICES
Solicitation of Written Comments on
Draft Tier 2 Strategies/Modules for
Inclusion in the ‘‘HHS Action Plan to
Prevent Healthcare-Associated
Infections’’
Department of Health and
Human Services, Office of the Assistant
Secretary for Health, Office of
Healthcare Quality.
ACTION: Notice.
AGENCY:
The Office of Healthcare
Quality is soliciting public comment on
three new strategies or modules of the
‘‘HHS Action Plan to Prevent
Healthcare-Associated Infections.’’ To
further the HHS mission to protect the
health and well-being of the nation, the
HHS Steering Committee for the
Prevention of Healthcare-Associated
Infections has developed draft
comprehensive strategies for preventing
and reducing healthcare-associated
infections in ambulatory surgical
centers and end-stage renal disease
facilities, as well as a strategy to
increase influenza vaccination coverage
among healthcare personnel. These Tier
2 modules build upon and are to be
included in the existing ‘‘HHS Action
Plan to Prevent Healthcare-Associated
Infections’’ that focuses on reducing
hospital-acquired infections (Tier 1).
DATES: Comments on the draft Tier 2
modules should be received no later
than 5 p.m. on October 11, 2010.
ADDRESSES: The draft Tier 2 modules
can be found at https://www.hhs.gov/
ophs/initiatives/hai/actionplan/
index.html#tier2. Comments are
preferred electronically and may be
addressed to OHQ@hhs.gov. Written
responses should be addressed to the
Department of Health and Human
Services, 200 Independence Ave, SW.,
Room 719B, Washington, DC 20201,
Attention: Draft Tier 2 Modules.
FOR FURTHER INFORMATION CONTACT:
Danielle Doughman, (202) 690–6476 or
OHQ@hhs.gov.
SUMMARY:
SUPPLEMENTARY INFORMATION
I. Background
Healthcare-associated infections are
among the leading causes of morbidity
and mortality in the United States and
the most common type of adverse event
PO 00000
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Fmt 4703
Sfmt 4703
in the field of healthcare today. They are
defined as localized or systemic adverse
events, resulting from the presence of an
infectious agent or toxin, occurring to a
patient in a healthcare setting. An
epidemiologic study by the Centers for
Disease Control and Prevention (CDC)
revealed that the subset of HAIs with
hospital-onset accounted for 1.7 million
infections annually and were associated
with 99,000 deaths in 2002. The fiscal
cost is steep as well. Healthcareassociated infections contribute to an
additional $28 to $33 billion dollars in
healthcare expenditures annually.
For these reasons, the prevention and
reduction of healthcare-associated
infections is a top priority for the U.S.
Department of Health and Human
Services (HHS). Multiple agencies
within HHS have been working to
reduce the incidence and prevalence of
healthcare-associated infections for
decades. To further efforts, the HHS
Steering Committee for the Prevention
of Healthcare-Associated Infections was
established in July 2008 and charged
with developing a comprehensive
strategy to progress toward the
elimination of healthcare-associated
infections.
In 2009, the Steering Committee
issued the initial version of the ‘‘HHS
Action Plan to Prevent HealthcareAssociated Infections.’’ The initial
strategy (Tier 1) focused on the
prevention of infections in the acute
care hospital setting and includes a
prioritized research agenda; an
integrated information systems strategy;
policy options for linking payment
incentives or disincentives to quality of
care and enhancing regulatory oversight
of hospitals; and a national messaging
plan to raise awareness of HAIs among
the general public, providers, and other
stakeholder groups. The Action Plan
also delineates specific measures and
five-year goals to focus efforts and track
national progress in reducing the most
prevalent infections. In addition, the
plan intended to enhance collaboration
with non-government stakeholders and
partners at the national, regional, state,
and local levels to strengthen
coordination and impact of efforts.
Recognizing the need to coordinate
prevention efforts across healthcare
facilities, HHS began to transition into
the second phase (Tier 2) of the Action
Plan in late 2009. Tier 2 expands efforts
outside of the acute care setting into
outpatient facilities (e.g., ambulatory
surgical centers, end-stage renal disease
facilities). The healthcare and public
health communities are increasingly
challenged to identify, respond to, and
prevent healthcare-associated infections
across the continuum of settings where
E:\FR\FM\23SEN1.SGM
23SEN1
]]>Agencies
[Federal Register Volume 75, Number 184 (Thursday, September 23, 2010)]
[Notices]
[Pages 57957-57958]
From the Federal Register Online via the Government Printing Office [www.gpo.gov]
[FR Doc No: 2010-23760]
[[Page 57957]]
-----------------------------------------------------------------------
DEPARTMENT OF HEALTH AND HUMAN SERVICES
Call for Comments on the Existing National Standards for the
Culturally and Linguistically Appropriate Services in Health Care
AGENCY: Department of Health and Human Services, Office of the
Secretary, Office of the Assistant Secretary for Health, Office of
Minority Health.
ACTION: Notice.
-----------------------------------------------------------------------
SUMMARY: The HHS Office of Minority Health (OMH) announces the launch
of an enhancement initiative of the existing National Standards for
Culturally and Linguistically Appropriate Services in Health Care (CLAS
Standards). The public comment period will begin September 20, 2010 and
conclude December 31, 2010. During this time three regional meetings on
the standards will be held throughout the country. Individuals and
organizations are encouraged to submit their comments on the 14
standards and their current application and use. The enhanced national
standards, as revised in accordance with public comment and subject
matter expertise, will be published for review in spring of 2011 with
the final versions being published in fall of 2011.
DATES: The initial comment and submission period is September 20
through December 31, 2010.
ADDRESSES: (1) Electronically through the public comment site https://clasenhancements.thinkculturalhealth.org.
(2) By mail, comments postmarked no later than December 31, 2010,
can be submitted to: CLAS Standards c/o HHS Office of Minority Health,
1101 Wootton Parkway, Suite 600, Rockville, Maryland 20852. Comments
sent by courier will be accepted until 5 p.m. EST on December 31.
(3) Individuals may register for one of the regional meetings by
using the online registration form at https://clasenhancements.thinkculturalhealth.org. To request a registration
form by mail, write to CLAS Standards Enhancement Initiative meeting,
c/o SRA International, Inc., 6003 Executive Blvd, Suite 400, Rockville,
MD 20852.
FOR FURTHER INFORMATION CONTACT: Guadalupe Pacheco, Office of Minority
Health, 1101 Wootton Parkway, Suite 600, Rockville, MD 20852, Attn:
CLAS, Telephone: (240) 453-6174; Fax: (240) 453-2883; E-mail:
Guadalupe.Pacheco@hhs.gov.
Background: To help achieve its mission of ``improving the health
of racial and ethnic minority populations through the development of
effective health policies and programs that help to eliminate
disparities in health,'' the OMH published the National Standards for
Culturally and Linguistically Appropriate Services in Health Care (CLAS
Standards) in 2001. The CLAS Standards were developed on the basis of
an analytical review of key laws, regulations, contracts, and standards
used by Federal and State agencies and other national organizations,
with input from a national advisory committee of policymakers, health
care providers, and researchers. Open public hearings were held to
obtain input from communities throughout the nation. The CLAS Standards
represent the first national standards for cultural competence in
health care and offer comprehensive guidance on what constitutes
culturally competent service delivery. They consist of 14 guidelines,
recommendations, and mandates that serve to inform, guide, and
facilitate implementation of culturally and linguistically appropriate
services in health care. The CLAS Standards are organized by three
themes: Culturally Competent Care, Language Access Services, and
Organizational Supports. They recognize that culture and language are
central to the delivery of health services.
Disparities in health care have been documented in a number of
groundbreaking reports: Findings of the Supplement to Mental Health: A
Report of the Surgeon General (CMHS, 2001a) reveal that ``racial and
ethnic minorities bear a greater burden from unmet mental health needs
and thus suffer a greater loss to their overall health and
productivity.'' Findings from the 2000 Surgeon General's Report Oral
Health in America: A Report of the Surgeon General indicated
significant disparities ``between racial and socioeconomic groups in
regards to oral health and ensuing overall health issues'' (DHHS,
2000). The 2003 report from the Institute of Medicine, Unequal
Treatment: Confronting Racial and Ethnic Disparities in Healthcare
(Smedley, Stith & Nelson, 2003), and its supplementary paper
contributions such as Racial and Ethnic Disparities in Diagnosis and
Treatment: A Review of the Evidence and a Consideration of Causes
(Geiger, 2003) and The Civil Rights Dimension of Racial and Ethnic
Disparities in Health Status (Perez, 2003), brought to the forefront
that minorities receive lower quality health care even when
socioeconomic and access-related factors are controlled. The report
also showed that bias, stereotyping, prejudice, and clinical
uncertainty may contribute to racial and ethnic disparities in health
care (Smedley et al., 2003).
A significant body of research released since the 2003 IOM report
corroborates these findings. The National Healthcare Disparities Report
prepared by the Agency for Healthcare Research and Quality states that
``although varying in magnitude by condition and population,
disparities are observed in almost all aspects of health care'' (The
Agency for Healthcare Research and Quality, 2006). Inspired by the CLAS
Standards, national organizations including the American Medical
Association (AMA), American Association of Medical Colleges (AAMC), the
Joint Commission, the National Committee for Quality Assurance (NCQA),
the National Quality Forum (NQF) and others have released standards to
help support the provision of culturally and linguistically appropriate
care. Many of these standards promote the education and training of
health care providers in culturally appropriate care.
Increasingly, national experts are looking to cultural competency
training as a means to reduce disparities in health care. Evidence
suggests that the most effective cultural competence training helps
providers develop new knowledge, skills, and attitudes in order to
effectively treat minority and immigrant populations (Smedley et al.,
2003). The concepts of cultural and linguistic competency as well as
health disparities are featured prominently in the health care reform
legislation enacted and signed by President Barack Obama in March 2010.
References to the concepts of cultural and linguistic competency
illustrate how pervasive and important the constructs have become.
Public comment period: It has been nearly ten years since the
release of the landmark report regarding the CLAS Standards. In the
report, the HHS, OMH provided the framework for all health care
organizations to establish services and policies to best serve our
increasingly diverse communities. In the decade following the release
of the CLAS Standards, the field of cultural and linguistic competency
has seen tremendous growth. It has evolved from a fledgling concept to
a recognized intervention in the quest for health equity. The field of
cultural and linguistic competency is dynamic and as such requires
routine enhancement and nurturing. With this in mind, HHS, OMH has
begun to revisit the National CLAS Standards.
The OMH has determined that the appropriate next step is for the
CLAS
[[Page 57958]]
Standards to undergo a national process of public comment that will
result in a broader awareness of HHS interest in CLAS, significant
input from stakeholder groups on the existing CLAS Standards, as well
as a final revision of the CLAS Standards and accompanying commentary
supported by the expertise of a National Project Advisory Committee.
The final revisions will be published in the Federal Register as
recommended national standards for adoption or adaptation by
stakeholder organizations and agencies.
The publication of the CLAS Standards in the Federal Register, and
publicizing the availability of the complete report with commentary on
the Internet and through local, regional, and national organizations
will facilitate reaching as wide an audience of stakeholders as
possible. This period of dissemination and awareness-raising will
include three regional meetings to gather and solicit detailed input
from interested individuals and organizations that will complement and
enhance the public comments received by OMH through electronic and
written means.
Individuals and organizations desiring to provide input on the
standards are encouraged to send comments during the public comment
period which is from September 20 through December 31, 2010.
Individuals mailing comments are requested to include the following
information: Name, position, organization, mail, and e-mail addresses
and to identify specifically those portions of their comments that
pertain to: The wording or the content of individual standards, the
purpose of the standards and/or the intended audience for the national
standards.
Dates and locations of the meetings are as follows:
Baltimore, Maryland, Friday, October 22, 2010, The Hyatt Regency,
300 Light Street, Baltimore, MD 21202.
San Francisco, California, Thursday, November 4, 2010, The Stanford
Court, A Renaissance Hotel, 905 California Street, San Francisco, CA
94108.
Chicago, Illinois, Monday, November 15, 2010, The James Hotel, 55
East Ontario Street, Chicago, IL 60611-2727.
All meetings will convene at 9 a.m. and conclude at 3 p.m. On-site
registration will be available starting at 7:30 a.m.
Information about the CLAS Standards Enhancement Initiative is
available electronically at https://clasenhancements.thinkculturalhealth.org.
Dated: September 2, 2010.
Garth N. Graham,
Deputy Assistant Secretary for Minority Health.
[FR Doc. 2010-23760 Filed 9-22-10; 8:45 am]
BILLING CODE 4150-29-P
