Among the many contributors to health inequities, the lack of culturally and linguistically appropriate services in health settings has been recognized as one of the more modifiable factors. Improving the availability of such services will not only improve the quality of care provided, but may reduce disparities experienced by racial and ethnic minorities and other underserved populations, who struggle because of language, literacy, or other cultural barriers (Saha, Beach, and Cooper, 2008). To provide meaningful and practical guidance on delivering culturally and linguistically appropriate services, the U.S. Department of Health and Human Services (HHS) Office of Minority Health (OMH) developed the National Standards for Culturally and Linguistically Appropriate Services in Health and Health Care (National CLAS Standards). The National CLAS Standards, which are targeted toward health and health care organizations (HCOs), were revised in 2013 to account for the increasing diversity of the U.S. population, the growth in cultural and linguistic competency fields, and the changing landscape with respect to new national policies and legislation, including the Affordable Care Act (ACA) (HHS OMH, 2013).

Successful implementation of the National CLAS Standards requires an organizational commitment. Undoubtedly, the National CLAS Standards have helped to increase awareness and activities related to the need for culturally and linguistically appropriate services. The organizations that are adopting and implementing the National CLAS Standards have taken concrete steps to address health inequities and meet the needs of the vulnerable populations they serve. However, what is less clear is the extent to which these organizations are evaluating the impact of their approach to improve inequities in care.

To help address these questions, OMH awarded a contract to RAND to develop a framework and toolkit to guide efforts in evaluating the implementation of the National CLAS Standards by HCOs. The resulting report, Development of a Long-Term Evaluation Framework for the National Standards for Culturally and Linguistically Appropriate Services (CLAS) in Health and Health Care, presents the details of the development of the framework (Davis et al., forthcoming), while this accompanying toolkit distills the elements of the framework and is intended to help guide the efforts of HCOs to evaluate the implementation of the National CLAS Standards across four settings: ambulatory care, behavioral health, hospitals, and public health.