Implementing CLAS: How states use assessments to stimulate engagement

As a planning and evaluation consultant for the Minnesota Department of Health’s Office of Minority and Multicultural Affairs, I worked for a year with the Minnesota Healthcare Disparities Task Force, from July 2004 to July 2005, to help the task force plan and implement a work plan for statewide implementation of the federal CLAS standards.  Co-sponsored by the Minnesota Department of Health and the Minnesota Department of Human Services, the statewide task force included over 30 healthcare organizations, including hospitals, integrated healthcare delivery systems, provider associations, and health plans.

As the task force’s planner, I developed and piloted new complex adaptive planning and evaluation (CAPE) methods to help the task force develop and implement a work plan to implement CLAS practices statewide, as part of a larger effort to reduce the state’s healthcare disparities.  In combination with traditional public health planning methods, I used complexity-based methods that were designed to support more rapid dissemination and diffusion of CLAS practices.

As the task force’s evaluator, I also conducted a qualitative case study that inventoried the task force member organizations’ CLAS practices.  I presented the study’s findings to the full task force in May 2005.  Based on an analysis of members’ practices, in particular the practices that distinguished the task force’s early adopters from other organizations, I developed a new complex adaptive model for implementing CLAS practices called socio-culturally and linguistically adaptive management (SLAM) that is designed to support more organic and adaptive organizational change implementing CLAS practices.

In contrast with comparable statewide task forces, the MN Healthcare Disparities Task Force was able to complete and begin implementation of its work plan in five months. The task force also took an unprecedented stand in a legislative budget battle to protect public health insurance benefits impacting the state’s racial/ethnic subpopulations, and initiated other system-level reforms as well.  This presentation will include new models (CAPE, SLAM), and many practical lessons learned from this unique natural experiment in CLAS adaptation and implementation.