cultural and linguistic competence policy in action vcu msw lecture feb 2014
DESCRIPTION
An introduction to key concepts in cultural and linguistic competence and laws and policies that are connected with these concepts.TRANSCRIPT
DBHDSVirginia Department of
Behavioral Health andDevelopmental Services
“Policy in Action” Planning for Culturally and Linguistically Appropriate
Services in Human Services
Cecily RodriguezOffice of Cultural & Linguistic Competence
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DBDHSVirginia Department of Behavioral Health and
Developmental Services Topics
• Common understanding of the terms
• Why is CLC in health & human services important?
• CLC Planning and Policy Development
Page 3
DBDHSVirginia Department of Behavioral Health and
Developmental Services
What is culture?
Office of Cultural and Linguistic Competency - DBHDS
A COMMON FRAMEWORK
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DBDHSVirginia Department of Behavioral Health and
Developmental Services
CULTURE IS FLUID
and IT CAN BE….
Thick
Thin
Compartmentalized
Dr. Viviann Jackson, NCCC
Office of Cultural and Linguistic Competency - DBHDS
Rethinking Culture
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DBDHSVirginia Department of Behavioral Health and
Developmental Services Dimensions of Culture
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DBDHSVirginia Department of Behavioral Health and
Developmental ServicesIs Culture an Iceberg?
Culture is Not an Iceberg – Milton J. Bennett PhD. 2013
RACE
CULTURAL ARTIFACTS
(CLOTHING, HAIRSTYLE, ETC)
LANGUAGE
AGE
ATTITUDE TOWARDS ANIMALS
DEFINITION OF SIN
GOVERNING CHILD-RAISING
CONCEPTS OF HUMOR
VISIBLE
HIDDEN
Don’t forget to adjust for acculturation, generational differences and other variables
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DBDHSVirginia Department of Behavioral Health and
Developmental Services
Office of Cultural and Linguistic Competency - DBHDS
ROCCO RODRIGUEZ
and the Iceberg Effect
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DBDHSVirginia Department of Behavioral Health and
Developmental Services
What is Cultural CompetenceNational Center for Cultural Competence
Value
Diversity
Conduct Self
Assessment
Manage the
Dynamics of
difference
Acquire and institutionaliz
e cultural knowledge
Adapt to the cultural contexts of
your community
And incorporate the above in all aspects of policy making, administration, practice, service delivery and involve systematically
consumers, key stakeholders and communities.
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DBDHSVirginia Department of Behavioral Health and
Developmental Services Levels of Cultural Competency
Individual Level
Right skills, knowledge, and attitude to work for
a diverse population Organizational SystemsPolicies and procedures in place and an infrastructure
that supports diverse communities
System’s LevelsLaws and regulations in place and an infrastructure that supports diverse
communities
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DBDHSVirginia Department of Behavioral Health and
Developmental ServicesWhat is Linguistic Competence?
National Center for Cultural Competence
The capacity of an organization and its personnel to communicate effectively, and convey information
in a manner that is easily understood by diverse audiences
including persons of limited English proficiency, those who
have low literacy skills or are not literate, and individuals with
disabilities.
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DBDHSVirginia Department of Behavioral Health and
Developmental Services The Case for CLC
Disparities in Access and OutcomesMental Health: Culture, Race, Ethnicity Supplement to Mental Health: Report
of the Surgeon General
Minority populations have a disproportionate burden of death and disability. Research has proven that communities of color don’t access services in proportion to the white community and their outcomes are less successful than that of the white community.
• Documented disparities for people of color include: – Less availability and access to services– Lower likelihood of receiving services– Greater likelihood of receiving poorer quality of care and disproportionate
treatment outcomes– Over represented in hospitalizations (more restrictive settings)– Under represented in research 2001
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DBDHSVirginia Department of Behavioral Health and
Developmental Services The Case for CLC• Over 350 languages are spoken in the
U.S.
• More women in the workplace than ever
• There are more than 47 million people in the nation who speak a language other than English, and over 30 million who were born outside the United States
• During the past decade, the number of Spanish and Asian-language speakers grew by 50%
• Over 17% of the nation’s population speak a language other than English at home.
• Range of ages in the workplace
• New workforce tends to be more culturally diverse
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DBDHSVirginia Department of Behavioral Health and
Developmental Services The Case for CLCFEDERAL LAW
Civil Rights Act of 1964The Civil Rights Act of 1964 says that no person
shall be excluded from participation in, be denied the benefits of, or be subjected to discrimination based on race, gender, ethnicity or national origin under any program or activity receiving Federal financial assistance."
Four factor analysis video clip - Presidential Executive Order 13166http://www.lep.gov/13166/eo13166.html
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DBDHSVirginia Department of Behavioral Health and
Developmental Services
Title VI - “Meaningful Access”Organizations are required to take reasonable steps to
ensure meaningful access to their programs and activities by LEP persons. The Guidance explains that the obligation to provide meaningful access is fact-dependent and starts with an individualized assessment that balances four factors:
1. Number or Proportion of LEP Individuals
2. Frequency of Contact With the Program
3. Nature and Importance of the Program
4. Resources Available
The Case for CLC
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DBDHSVirginia Department of Behavioral Health and
Developmental Services The Case for CLCInova Health System Fairfax – $145,000
settlement for failure to provide sign-language interpreting for parents of a newborn with medical complications.
Maryland Department of Health and Mental Hygiene DOJ required periodic language needs assessments to ensure all populations were considered in services.
DBHDS investigation into allegations of discrimination based on national origin. As a result, language policy and procedures were developed.
US Dept. of Justice
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DBDHSVirginia Department of Behavioral Health and
Developmental Services Challenges To Cultural Competence
Individual challenges• Lack of self awareness of bias and value systems• Unclear connection b/w bias and decision making• Individual “isms”• Cultural blindness• Ethnocentrism
Organizational challenges• Lack of valid performance measures• Operationalization of CLC• Competing priorities• Systemic “isms” • Budget constraints• Regulatory ambiguousness• Staff turnover
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DBDHSVirginia Department of Behavioral Health and
Developmental Services
Models for Culturally and Linguistically Appropriate Services
Patient centeredness, cultural competence and healthcare quality – Saha, Beach, & Cooper, 2010.
Age
ncy
for
Hea
lthca
re R
esea
rch
and
Qua
lity
(AH
RQ
)
Com
mis
sion
on
Acc
redi
tatio
n of
R
ehab
ilita
tion
Fac
ilitie
sStandards for Culturally & Linguistically Appropriate Services 2013
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DBDHSVirginia Department of Behavioral Health and
Developmental Services Organizational Planning
Technical Assistance Partnership www.tapartnership.org/docs/clcPlanTemplateFinal.doc
1. Governance and organizational infrastructure
2. Services and Supports3. Planning and continuous quality improvement4. Collaboration5. Communication6. Workforce Development
Any plan should address the six critical domains
related to cultural and
linguistic competence.
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DBDHSVirginia Department of Behavioral Health and
Developmental ServicesCLC in Practice
Utilize outreach
strategies and engage cultural
brokers?
Do we explore new methods
for recruitment and retention of culturally
competent staff
Diversity Councils
Safevenues for people
to discuss their communication
differences?
Provide training on addressing bias, discrimination, and racism in systems. Standardize ways to assess a candidate’s cross cultural skills
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DBDHSVirginia Department of Behavioral Health and
Developmental ServicesCLC in Practice
LinguisticCompetence
Hire bilingual/bicultural staff
Use varied approaches
to communicate With individuals who experience
cognitive disabilities
Require the use of qualified interpreters Pre-test the reader-
friendliness of enrollment
and education materials
with focus groups
Offer multilingual Tele-communication
systems
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DBDHSVirginia Department of Behavioral Health and
Developmental Services Critical Components of a CLC Plan
You don’t know where to go if you don’t know where you are.
Organizational Cultural Competence
Engagement
Assessment
PlanImplement
Evaluate/ Document
Achievement