Common use of Cultural Considerations Clause in Contracts

Cultural Considerations. The Contractor shall participate in and cooperate with HCA efforts to promote the National Standards for Culturally and Linguistically Appropriate Services (CLAS) in Health and Health Care. The Contractor will 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. At a minimum, the Contractor shall: Educate and train governance, leadership, and workforce in culturally and linguistically appropriate policies and practices on an ongoing bases. (CLAS Standard 4); 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. (CLAS Standard 5); Inform all Individuals of the availability of language assistance services clearly and in their preferred language, verbally, and in writing. (CLAS Standard 6); Ensure the competence of Individuals providing language assistance, recognizing that the use of untrained individuals and/or minors as interpreters should be avoided. (CLAS Standard 7); Provide easy-to-understand print and multimedia materials and signage in the languages commonly used by the populations in the service area. (CLAS Standard 8); Establish culturally and linguistically appropriate goals, policies, and management accountability, and infuse them throughout the organization’s planning and operations. (CLAS Standard 9); 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. (CLAS Standard 11); and Create conflict and Grievance resolution processes that are culturally and linguistically appropriate to identify, prevent, and resolve conflict or complaints. (CLAS Standard 14). Mental Health Advance Directive (MHAD)

Cultural Considerations. The Contractor shall participate in and cooperate with HCA efforts to promote the National Standards for Culturally and Linguistically Appropriate Services (CLAS) in Health and Health Care. The Contractor will 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. At a minimum, the Contractor shall: Educate and train governance, leadership, and workforce in culturally and linguistically appropriate policies and practices on an ongoing bases. (CLAS Standard 4); 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. (CLAS Standard 5); Inform all Individuals of the availability of language assistance services clearly and in their preferred language, verbally, and in writing. (CLAS Standard 6); Ensure the competence of Individuals providing language assistance, recognizing that the use of untrained individuals and/or minors as interpreters should be avoided. (CLAS Standard 7); Provide easy-to-understand print and multimedia materials and signage in the languages commonly used by the populations in the service area. (CLAS Standard 8); Establish culturally and linguistically appropriate goals, policies, and management accountability, and infuse them throughout the organization’s planning and operations. (CLAS Standard 9); 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. (CLAS Standard 11); and Create conflict and Grievance resolution processes that are culturally and linguistically appropriate to identify, prevent, and resolve conflict or complaints. (CLAS Standard 14). Mental Health Advance Directive (MHAD).

Cultural Considerations. The Contractor shall participate in and cooperate with HCA efforts to promote the National Standards for Culturally and Linguistically Appropriate Services (CLAS) in Health and Health Care. The Contractor will 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. The Contractor shall participate in and cooperate with HCA efforts to promote the National Standards for Culturally and Linguistically Appropriate Services (CLAS) in Health and Health Care. At a minimum, the Contractor shall: Educate and train governance, leadership, and workforce in culturally and linguistically appropriate policies and practices on an ongoing bases. basis (CLAS Standard 4); Offer language assistance to Individuals individuals who have limited English proficiency and/or or other communication needs, at no cost to them, to facilitate timely access to all health care and services. services (CLAS Standard 5); Inform all Individuals individuals of the availability of language assistance services clearly and in their preferred language, verbally, verbally and in writing. writing (CLAS Standard 6); Ensure the competence of Individuals individuals providing language assistance, recognizing that the use of untrained individuals and/or or minors as interpreters should be avoided. avoided (CLAS Standard 7); Provide easy-–to-understand print and multimedia materials and signage in the languages commonly used by the populations in the service area. area (CLAS Standard 8); Establish culturally and linguistically appropriate goals, policies, and management accountability, and infuse them throughout the organization’s planning and operations. goals (CLAS Standard 9); Conduct ongoing assessments of the organization’s CLAS– related activities and integrate CLAS-related measures into measurement and continuous quality improvement activities (CLAS Standard 10); 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. delivery (CLAS Standard 11); and Create conflict and Grievance resolution processes that are culturally and linguistically appropriate to identify, prevent, and resolve conflict or complaints. complaints (CLAS Standard 14). Mental Health Advance Directives and Physician Orders for Life Sustaining Treatment (POLST) The Contractor shall meet the requirements of WAC 182-501-0125, 42 C.F.R. § 438.6, 438.10, 422.128, 489.100 and 489 Subpart I as described in this section. The Contractor’s Advance Directive policies and procedures shall be disseminated to all affected providers, Enrollees, HCA, and, upon request, Potential Enrollees. The Contractor shall develop policies and procedures to address Physician Orders for Life Sustaining Treatment (MHAD)POLST) and ensure that they are distributed in the same manner as those governing Advance Directives. The Contractor’s policies and procedures respecting the implementation of advance directives and POLST rights shall be included in the Enrollee handbook at a location designated in its template by HCA, and shall be featured on the Contractor’s website in the member/enrollee section. The Contractor’s written policies respecting the implementation of Advance Directive POLST rights shall include a clear and precise statement of limitation if the Contractor cannot implement an Advance Directive as a matter of conscience. At a minimum, this statement must do the following: Clarify any differences between Contractor conscientious objections and those that may be raised by individual physicians. Identify the state legal authority permitting such objection. Describe the range of medical conditions or procedures affected by the conscience objection. If an Enrollee is incapacitated at the time of initial enrollment and is unable to receive information (due to the incapacitating condition or a mental disorder) or articulate whether or not he or she has executed an Advance Directive or received a POLST, the Contractor may give a Directive information to the Enrollee's family or surrogate in the same manner that it issues other materials about policies and procedures to the family of the incapacitated Enrollee or to a surrogate or other concerned persons in accordance with state law. The Contractor is not relieved of its obligation to provide this information to the Enrollee once he or she is no longer incapacitated or unable to receive such information. Follow-up procedures must be in place to ensure that the information is given to the individual directly at the appropriate time. The Contractor must require and ensure that the Enrollee’s medical record documents, in a prominent part, whether or not the individual has executed an Advance Directive or received a POLST. The Contractor shall not condition the provision of care or otherwise discriminate against an Enrollee based on whether or not the Enrollee has executed an Advance Directive or received a POLST. The Contractor shall ensure compliance with requirements of state and federal law (whether statutory or recognized by the courts of the State) regarding Advance Directives or POLSTs. The Contractor shall provide education to staff concerning its policies and procedures on Advance Directives or POLSTs. The Contractor shall provide community education regarding Advance Directives that may include material required herein, either directly or in concert with other providers or entities. Separate community education materials may be developed and used, at the discretion of the Contractor. The same written materials are not required for all settings, but the material should define what constitutes an Advance Directive, emphasizing that an Advance Directive is designed to enhance an incapacitated individual's control over medical treatment, and describe applicable state and federal law concerning Advance Directives. The Contractor shall document its community education efforts. The Contractor is not required to provide care that conflicts with an Advance Directive; and is not required to implement an Advance Directive if, as a matter of conscience, the Contractor cannot implement an Advance Directive and state law allows the Contractor or any Subcontractor providing services under this Contract to conscientiously object. The Contractor shall inform Enrollees that they may file a Grievance with the Contractor if the Enrollee is dissatisfied with the Contractor’s Advance Directive policy and procedure or the Contractor’s administration of those policies and procedures. The Contractor shall also inform Enrollees that they may file a Grievance with the Washington State Department of Health (DOH) if they believe the Contractor is non-compliant with Advance Directive and POLST requirements.