ALMA Services Guide
El Futuro’s Advancing Latinx Mental Health Access (ALMA) Program Guide. Compiled and Coauthored by: Rachel Anna Galanter, MPH and Leah Piehl, MPH
CLAS Standards
CLAS (Culturally and Linguistically Appropriate Services) standards were developed by the US Department of Health and Human Services’ Office of Minority Health in 2013 to provide a framework on assessing cultural responsiveness and linguistic accessibility. The standards grow out of an understanding that when the provision of services is respectful and responsive to the beliefs, practices, and needs of clients that we not only provide a high quality of care, we also address the inequity in health outcomes that currently exists. El Futuro envisions the CLAS standards as one potential measure of an agency’s ability to provide culturally responsive care. These standards are broken up into four different subcategories.
Principle Standard
- 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.
Governance, Leadership, and Workforce
- Advance and sustain organizational governance and leadership that promotes CLAS and health equity through policy, practices, and allocated resources.
- Recruit, promote, and support a culturally and linguistically diverse governance, leadership, and workforce that are responsive to the population in the service area.
- Educate and train governance, leadership, and workforce in culturally and linguistically appropriate policies and practices on an ongoing basis.
Communication and Language Assistance
- 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.
- Inform all individuals of the availability of language assistance services clearly and in their preferred language, verbally and in writing.
- Ensure the competence of individuals providing language assistance, recognizing that the use of untrained individuals and/or minors as interpreters should be avoided.
- Provide easy-to-understand print and multimedia materials and signage in the languages commonly used by the populations in the service area.
Engagement, Continuous Improvement, and Accountability
- Establish culturally and linguistically appropriate goals, policies, and management accountability, and infuse them throughout the organization’s planning and operations.
- Conduct ongoing assessments of the organization’s CLAS-related activities and integrate CLAS-related measures into measurement and continuous quality improvement activities.
- 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.
- Conduct regular assessments of community health assets and needs and use the results to plan and implement services that respond to the cultural and linguistic diversity of populations in the service area.
- Partner with the community to design, implement, and evaluate policies, practices, and services to ensure cultural and linguistic appropriateness.
- Create conflict and grievance resolution processes that are culturally and linguistically appropriate to identify, prevent, and resolve conflicts or complaints.
- Communicate the organization’s progress in implementing and sustaining CLAS to all stakeholders, constituents, and the general public.
CLAS Standards Assessment Questions
Potential Resources/Services Offered
Because there are some common barriers to treatment, we have identified some common strategies to support institutions in developing their capacity to provide more culturally responsive and linguistically accessible mental health services to Latinx clients. However, this list is intended to be a starting point to develop a plan that fits an institution’s needs.
- Lack of Spanish-speaking service providers
- Limited English proficiency
- Lack of insurance/financial constraints
- Lack of culturally responsive services
- Fears about immigration status and losing custody of children while in treatment
- Negative attitudes toward providers
- Discrimination
Essential tasks include activities related to: leadership, planning, evaluation/monitoring, workforce/staff development, and operations.
Leadership Tasks
- Commit to cultural competence and the resources needed to promote it
- Develop culturally competent governing and advisory boards
- Create a cultural competence committee
- Assign a senior manager to oversee the organizational development of culturally responsive practices and services
Planning Tasks
- Review and update vision, mission, and value statements
- Address cultural competence in strategic planning processes
- Engage clients, staff, and community in the planning, development, and implementation of culturally responsive services
- Develop a cultural competence plan
- Review and develop policies and procedures to ensure culturally responsive organizational practices
Evaluation and Monitoring Tasks
- Create demographic profiles of the community, clientele, staff, and board
- Conduct an organizational self-assessment of cultural competence
Workforce and Staff Development Tasks
- Develop staff recruitment, retention, and promotion strategies that reflect the population(s) served
- Create training plans and curricula that address cultural competence
- Give culturally congruent clinical supervision
- Evaluate staff performance on culturally congruent and complementary attitudes, knowledge, and skills
Operations Tasks
- Create an environment that reflects the populations served
- Develop outreach strategies to improve access to care
- Plan for language services proactively
- Establish practice and training guidelines for the provision of language services
Alvely Alcántara, LCSW
Rossy C. Garcia, MEd 
Katy Sims, MD 
Everardo Aviles, LCSW, LCAS (Eve)
As a medical anthropologist and social work researcher, Dr. Gulbas’ research embodies interdisciplinarity through the integration of applied theories of health and human development with qualitative and ethnographic methodologies. Her work seeks to understand how people—children, families, and providers—navigate complex sociocultural landscapes in the pursuit of mental health. Most of her work, to date, focuses attention on developing more robust interpretations of suicide risk. With funding from the National Institutes of Mental Health, this body of research has contributed to advancements in theoretical and empirical knowledge of the broader contexts within which youth suicide risk is situated. 
R. Gabriela Barajas-Gonzalez is a developmental psychologist and an assistant professor of Population Health at NYU Grossman School of Medicine. Dr. Barajas-Gonzalez is the principal investigator of a study that examines the impact of immigration-related threat and stress on school communities. She earned a PhD in developmental psychology from Columbia University and hold a BA in human biology from Stanford University. Dr. Barajas-Gonzalez is the daughter of Mexican immigrants and a first gen college student.
Dr. Parra-Cardona is an Associate Professor in the Steve Hicks School of Social Work (SHSSW) at the University of Texas at Austin. At the SHSSW, he serves as Coordinator for Mexico and Latin American initiatives. He also serves as Area Director for Research at the UT Austin Latino Research Institute. Dr. Parra-Cardona’s program of research is focused on the cultural adaptation of evidence-based parenting interventions for low-income Latinx populations in the US and Latin America.
Bianka Reese, PhD, MSPH is a research scientist and program evaluator specializing in adolescent and young adult sexual and reproductive health. Her previous research in the experiences of Latinx LGBTQ+ youth stems from her work as the Research and Evaluation Manager at SHIFT NC (Sexual Initiatives For Teens), where she led largescale evaluations of multilevel, community-based sexual health promotion initiatives and research projects aimed at elevating the voices of diverse youth in North Carolina. Dr. Reese is currently the Senior Research Strategist at Creative Research Solutions, LLC, an award-winning national evaluation, research, and assessment firm.
Tania Connaughton-Espino, MPH is an independent researcher focused on adolescent and young adult sexual and reproductive health. Her interest in the experiences of Latinx LGBTQ+ youth stems from her previous work with SHIFT NC (Sexual Initiatives For Teens), where she led the training and evaluation department, conducted capacity-building workshops for youth serving professionals including on the topic of how to be more affirming of LGBTQ youth, and from her extensive experience working with the Latinx population in NC.
Maru Gonzalez, EdD is an Assistant Professor and Youth Development Specialist in the Department of Agricultural and Human Sciences at North Carolina State University. Her areas of inquiry include youth development with a focus on activism, social justice, and the experiences of LGBTQ+ young people across familial, school, and community contexts. 
Nayeli Y. Chavez-Dueñas, PhD
Hector Y. Adames, PsyD