Background: Massachusetts has a growing immigrant population, yet gaps exist in the provision of equitable health and social services to immigrant families. The Culturally and Linguistically Appropriate Services (CLAS) Standards were established to ensure that organizations are inclusive and responsive to the needs of diverse populations. The extent to which service organizations in Massachusetts adhere to these standards is poorly understood.

Objective: To assess how health and social service organizations in three MA communities meet the National Standards for CLAS.

Methods: Organizations from each of the following sectors: Housing, Education, Health, Environment, Religious, Cultural and Food Security, were selected to be evaluated using a modified version of the CLAS checklist (governance, leadership, communication, and accountability practices). Then, a modified photovoice methodology was used to visually document and analyze organizational practices.

Results: Organizations in the housing and health sectors were found to have stronger governance and workforce diversity efforts and to be more compliant with CLAS standards in these areas. However, communication and language support were found to be underdeveloped in most sectors, with limited formal language support or translation services available. Many organizations promoted diversity, equity and inclusion, but lacked clearly structured systems for continuous improvement and accountability.

Conclusion: While there are efforts to address governance and diversity, improvements in communication and language support are critical to ensuring equitable access to services for immigrants in MA. Further development of structured mechanisms for continuous improvement and accountability, and reduction of language barriers will be necessary to improve the quality of services.