MDPH CLAS self-assessment for vendorsThe following questions are designed to help programs identify their own challenges and goals and develop a work plan with concrete tasks using basic elements of Culturally and Linguistically Appropriate Services (CLAS) standards for improvement. Below are the questions you will be asked to complete on the next page.
Vendor/Provider Organization and Contact Information (required) Organization Name Organization Address Name of DPH-funded program Contact Name Contact Title Contact Email Contact Phone Department of Public Health (DPH) Contact Information DPH Contract Manager Name
DPH Contract Manager email
DPH Source of Funding
Pappas Rehabilitation Hospital for Children Tewksbury Lemuel Shattuck Western
Which DPH bureau/office funds your program?
* must provide value
BCHAP - Bureau of Community Health & Prevention BHCSQ - Bureau of Health Care Safety and Quality BEH - Bureau of Environmental Health BFHN - Bureau of Family Health & Nutrition BHPL- Bureau of Health Professions Licensure BIDLS - Bureau of Infectious Disease & Laboratory Sciences BORIM - Board of Registry in Medicine BSAS - Bureau of Substance Addiction Services BPHH - Bureau of Public Health Hospitals OPH - Office of Population Health OLRH - Office of Local & Regional Health OPEM - Office of Preparedness and Emergency Management Office of Problem Gambling Office of Program Management Quality Improvement Office of Communication Not listed
Name of your Organization
* must provide value
Organization full Address (address, state, zip code)
* must provide value
Name of the program funded
* must provide value
DPH contact Email address
* must provide value
Culturally Competent Leadership and Workforce
1. Does your program recruit, retain, and promote staff that reflects the cultural / linguistic diversity of the community you serve? (Reference: CLAS Standard 3, Making CLAS Happen Manual, Chapter 5: Reflect and Respect Diversity) 2. Does your program have written policies and procedures that support recruitment, retention, and training and promotion practices of diverse workforce? (Reference to CLAS Standard 2, Making CLAS happen, Chapter5: Respect and Reflect Diversity ) 3. Do program staff members at all levels and disciplines receive training in culturally- and linguistically-appropriate service delivery? Check one. (Reference to CLAS Standard 4, Making CLAS happen, Chapter 1: Foster Cultural Competence
Language Access / Communication
4. Does your program provide timely professional interpreter services, at no cost, to all Limited English Proficiency (LEP) clients, including those clients who use American Sign Language (Reference CLAS Standard 5, Federal mandate, Making CLAS Happen: Chapter 6: Ensure Language Access ) 5. Do all LEP or Deaf / Hard of Hearing clients receive verbal and written notices about their right to language assistance services? (Reference: CLAS Standard 5, Federal mandate, Making CLAS Happen, Chapter 6: Ensure Language Access ) 6. Are Deaf / Hard of Hearing clients and clients with disabilities made aware of your program's Disability Access policy or notice? (Reference CLAS Standard 6, Federal mandate, Making CLAS happen , Chapter 6: Ensure Language Access ) 7. Does your program offer written materials in languages that target the diverse cultural / linguistic groups in your service area/population? (Reference CLAS Standard 8, Federal mandate, Making CLAS happen , Chapter 6: Ensure Language Access ) 8. Does your program clearly display images / post signage visibly that shows inclusivity for the diverse cultural / linguistic groups including LGBTQ and people with disabilities in your service area/population? (Reference: CLAS Standard 8, Federal mandate, Making CLAS happen, Chapter 6: Ensure Language Access )
Organizational Support and Accountability
9. Does your program have a plan to identify and address CLAS-related activities and integrate CLAS-related measures into your continuous quality improvement to meet the needs of the underserved populations?(Reference: CLAS Standard 9, Chapter 4: Benchmark Plan and Evaluate) 10. Does your program review your written CLAS work plan at least once a year to assess CLAS progress and needs?(Reference: CLAS Standard 10, Chapter 4: Benchmark Plan and Evaluate) 11. Does your program collect client's feedback (i.e. using satisfaction survey…) to inform culturally- and linguistically appropriate service (CLAS) delivery? (Reference: CLAS Standard 14, Chapter 5: Reflect and Respect Diversity) 12. Does your program use Race, Ethnicity, Language (REL) community/service area data to help design and deliver program services? (Reference: CLAS Standard 11, Chapter 3: Collect Diversity Data) 13. Does your program use Race, Ethnicity, Language (REL) client data to help design, deliver and evaluate program services? (Reference: CLAS Standard 11, Chapter 3: Collect Diversity Data) 14. Does your program partner with other agencies that target the diverse cultural / linguistic (ex. LEP, people with disability, LGBTQ, racial, ethnic, religious, social, economic, rural population, LEP, homeless, veteran, etc…) groups in your service area/population? (Reference: CLAS Standard 13, Chapter 2: Build Community Partnerships) 15. Are you familiar with and/or have you ever used the Making CLAS Happen manual? (An electronic version of the manual is posted on the DPH Office of Health Equity's website: https://www.mass.gov/lists/making-clas-happen-six-areas-for-action
Yes, fully reflects
Yes, partially reflects
No, does not currently reflect
Yes, fully aware
Yes,partially aware
No, does not currently
Yes, all staff
Yes, some staff, but not in a standardized / routine manner .
No, doesn't not currently
4. Does your program provide timely professional interpreter services, at no cost, to all Limited English Proficiency (LEP) clients, including those clients who use American Sign Language
(Reference CLAS Standard 5, Federal mandate, Making CLAS Happen: Chapter 6: Ensure Language Access )
* must provide value
Yes, always
Yes, sometimes
No, does not currently
Yes, both verbal and written notices
Yes, only written notices
No, does not currently
Yes, always
Yes, sometimes
No, does not currently
Yes, all cultural groups
Yes, some cultural groups
No, does not currently
8. Does your program clearly display images / post signage visibly that shows inclusivity for the diverse cultural / linguistic groups including LGBTQ and people with disabilities in your service area/population? Check one. (Reference: CLAS Standard 8, Federal mandate, Making CLAS happen, Chapter 6: Ensure Language Access )
* must provide value
Yes, all cultural groups
Yes, some cultural groups
No, does not currently
9. Does your program have a plan to identify and address CLAS-related activities and integrate CLAS-related measures into your continuous quality improvement to meet the needs of the underserved populations? Check one
(CLAS Standard 9, Chapter 4: Benchmark Plan and Evaluate)
* must provide value
Yes, fully developed and being implemented
Yes, currently in draft form or only partially implemented
No, does not currently
Yes, once a year
No, does not currently
11. Does your program collect client's feedbacks (i.e. using satisfaction survey…) to inform culturally- and linguistically appropriate service (CLAS) delivery? Check one.
(CLAS Standard 14, Chapter 5: Reflect and Respect Diversity)
* must provide value
Yes, always
Yes, sometimes
No, does not currently
13. Does your program use Race, Ethnicity, Language (REL) client data to help design, deliver and evaluate program services? Check one.
(CLAS Standard 11, Chapter 3: Collect Diversity Data)
* must provide value
Yes, always
Yes, sometimes
No, does not currently
Yes, always
Yes, sometimes
No, haven't used
The following items were identified as partial or not existing. Please choose an item(s) for improvement from each of the CLAS Areas of Action to develop a CLAS workplan with goals and activities that you would like to focus on this year by clicking the box on the right column
Please choose AT LEAST ONE in each Area of Action (Culturally Competent Leadership and Workforce, Language Access / Communication, Organizational Support and Accountability).
Your DPH contract manager will review, monitor and support your efforts. For additional technical assistance, please contact DPH CLAS coordinator at CLAS@mass.gov.
Areas of Action/Questions Answer Include in workplan? Culturally Competent Leadership and Workforce 1. Does your program recruit, retain, and promote staff that reflects the cultural / linguistic diversity of the community you serve? ______ 2. Does your program have written policies and procedures that support recruitment, retention, and training and promotion practices of diverse workforce? ______ 3. Do program staff members at all levels and disciplines receive training in culturally- and linguistically-appropriate service delivery? ______ 4. Does your program provide timely professional interpreter services, at no cost, to all Limited English Proficiency (LEP) clients, including those clients who use American Sign Language? ______ Language Access / Communication 5. Do all LEP or Deaf / Hard of Hearing clients receive verbal and written notices about their right to language assistance services? ______ 6. Are Deaf / Hard of Hearing clients and clients with disabilities made aware of your program's Disability Access policy or notice? ______ 7. Does your program offer written materials in languages that target the diverse cultural / linguistic groups in your service area/population? ______ 8. Does your program clearly display images / post signage visibly that shows inclusivity for the diverse cultural / linguistic groups including LGBTQ and people with disabilities in your service area/population? ______ Organizational Support and Accountability 9. Does your program have a plan to identify and address CLAS-related activities and integrate CLAS-related measures into your continuous quality improvement to meet the needs of the underserved populations? ______ 10. Does your program review your written CLAS work plan at least once a year to assess CLAS progress and needs? ______ 11. Does your program collect client's feedbacks (i.e. using satisfaction survey...) to inform culturally- and linguistically appropriate service (CLAS) delivery? ______ 12. Does your program use Race, Ethnicity, Language (REL) community/service area data to help design and deliver program services? 13. Does your program use Race, Ethnicity, Language (REL) client data to help design, deliver and evaluate program services? ______ 14. Does your program partner with other agencies that target the diverse cultural / linguistic (ex. LEP, people with disability, LGBTQ, racial, ethnic, religious, social, economic, rural population, LEP, homeless, veteran, etc...) groups in your service area/population?
Each workplan should include:
1. What is the specific problem as it relates to the CLAS area of Action you have chosen?the Making CLAS Happen: 6 Areas of Action for guidance and recommendations.
"Program provides timely professional interpreter services, at no cost, to all Limited English Proficiency (LEP) clients, including those clients who use American Sign Language." (Reference CLAS Standard 5, Federal mandate, Making CLAS Happen: Chapter 6: Ensure Language Access )
"Program clearly displays images / post signage visibly that shows inclusivity for the diverse cultural / linguistic groups including LGBTQ and people with disabilities in our service area/population." (Reference: CLAS Standard 8, Federal mandate, Making CLAS happen, Chapter 6: Ensure Language Access )
"Program has a plan to identify and address CLAS-related activities and integrate CLAS-related measures into our continuous quality improvement to meet the needs of the underserved populations." (Reference: CLAS Standard 9, Chapter 4: Benchmark Plan and Evaluate )
"Program collects client feedbacks (e.g. using satisfaction survey...) to inform culturally- and linguistically appropriate service (CLAS) delivery." (Reference: CLAS Standard 14, Chapter 5: Reflect and Respect Diversity)
"Program uses Race, Ethnicity, Language (REL) community/service area data to help design and deliver program services. " (Reference: CLAS Standard 11, Chapter 3: Collect Diversity Data)
"Program uses Race, Ethnicity, Language (REL) client data to help design, deliver and evaluate program services." (Reference: CLAS Standard 11, Chapter 3: Collect Diversity Data)
"Program partners with other agencies that target the diverse cultural / linguistic (ex. LEP, people with disability, LGBTQ, racial, ethnic, religious, social, economic, rural population, LEP, homeless, veteran, etc...) groups in our service area/population." (Reference: CLAS Standard 13, Chapter 2: Build Community Partnerships)
Are there any suggestions in how DPH can best support you and your program integrating CLAS into your program design and delivery?
