Domains/
Definitions |
Topic Area |
Measures/
Indicators |
Capacity/
Structure |
Process |
Outcome/
Impact |
Org.
View
point |
Vantage
Point |
Usage |
Literature
Citation |
VALUES AND
ATTITUDES |
Appreciate, respect
different cultures |
Checklist from
the NCCC on Values and Attitudes. Indicate A=
things I do frequently B= things I do occasionally
C= Things I do rarely or never.
- I recognize and accept that folk and
religious beliefs may influence a family's reaction
and approach to a child born with a disability
or later diagnosed with a disability or special
health care needs.
- I understand that traditional approaches
to disciplining children are influenced by culture.
- I understand that families from different
cultures will have different expectations of
their children for acquiring toileting, dressing,
feeding, and other self help skills.
|
|
|
|
X
|
|
|
Georgetown University
Child Development Center-National Center for Cultural
Competence (NCCC) Checklist on Values and
Attitudes. Tawara Goode. June 1989. Revised 1993,
1996, 1999 and 2000 |
|
|
- I accept and respect that customs and
beliefs about food, its value, preparation,
and use are different from culture to culture.
- Before visiting or providing services
in the home setting, I seek information on acceptable
behaviors, courtesies, customs and expectations
which are unique to families of specific cultures
and ethnic groups served by my program or agency.
- I seek information from family members
or other key community informants, which will
assist in service adaptation to respond to the
needs and preferences of culturally and ethnically
diverse children and families served by my program
or agency.
- I advocate for the review of my program's
or agency's mission statement, goals, policies,
and procedures to insure that they incorporate
principles and practices that promote cultural
diversity and cultural competence.
|
|
|
|
X
|
|
|
|
|
Values and Attitudes.
Appreciate, respect different cultures |
Checklist from
the NCCC on Values and Attitudes. Indicate A=
things I do frequently B= things I do occasionally
C= Things I do rarely or never.
- I avoid imposing values that may conflict
or be inconsistent with those of cultures or
ethnic groups other than my own.
- In group therapy or treatment situations,
I discourage children from using racial and
ethnic slurs by helping them understand that
certain words can hurt others.
- I screen books, movies, and other media
resources for negative cultural, ethnic, or
racial stereotypes before sharing them with
children and their parents served by my program
or agency.
- I intervene in an appropriate manner
when I observe other staff or parents within
my program or agency engaging in behaviors that
show cultural insensitivity or prejudice.
|
|
|
|
X
|
|
|
Georgetown University
Child Development Center-National Center for Cultural
Competence (NCCC) Checklist on Values and Attitudes.
Tawara Goode. June 1989. Revised 1993, 1996, 1999
and 2000 |
|
|
- I understand and accept that family
is defined differently by different cultures
(e.g. extended family members, fictive kin,
godparents).
- I recognize and accept that individuals
from culturally dive backgrounds may desire
varying degrees of acculturation into the dominant
culture.
- I accept and respect that male-female
roles in families may vary significantly among
different cultures (e.g. who makes major decisions
for the family, play and social interactions
expected of male and female children).
- I understand that age and life cycle
factors must be considered in interactions with
individuals and families (e.g. high value placed
on the decisions of elders or the role of the
eldest male in families).
- Even though my professional or moral
viewpoints may differ, I accept the family/parents
as the ultimate decision makers for services
and supports for their children.
|
|
|
|
X
|
|
|
|
|
|
- I recognize that the meaning or value
of medical treatment and health education may
vary greatly among cultures.
- I accept that religion and other beliefs
may influence how families respond to illnesses,
disease, and death.
|
|
|
|
|
|
|
|
|
Mission, vision
|
Mission/vision statements
commit to the delivery of culturally and linguistically
competent service. |
|
|
|
X
|
|
|
·
Maternal and Child Health Bureau (April 30, 2000).
Title V Block Grant Performance Measure. Health
Resources and Services Administration. ·
Getting Started... Planning, Implementing and Evaluating
Culturally Competent Service Delivery Systems for
Children with Special Health Needs and their Families,"
Georgetown University Child Development Center,
National Center for Cultural Competence and "
"Policy Brief 1: Rationale for Cultural
Competence in Health Care," Georgetown
University Child Development Center, National Center
for Cultural Competence |
|
Mission, vision
|
MCO
self-certification that its mission statement/strategic
vision support diversity and cultural competence
|
|
|
|
X
|
|
|
Abt Associates (January,
2000). Report on Recommendations for Measures of
Cultural Competence for the Quality Improvement
System for Managed Care. Report prepared for HCFA.
|
CULTURAL SENSITIVITY |
Non verbal communication
|
Translate and
make available signage and commonly used written
patient education and other materials for
members of the predominant language groups in
their service area |
X
|
|
|
|
|
|
Office of Minority Health (1999) Assuring Cultural
Competence in Health Care: Recommendations for National
Standards and an Outcomes-Focused Research Agenda,
Recommended Standards for Culturally and Linguistically
Appropriate Health Care Services.
The Bureau of Primary Health Care. (1999). Cultural
Competence: A Journey. Health Resources and
Services Administration, Bureau of Primary Health
Care. Health Resources
and Services Administration (2000). Cultural Competence
Works. Awards of Excellence. “Certificates of Recognition
Nominated Programs of Note” and “Certificate of
Recognition.” |
|
Non verbal communication
|
Number of pertinent
written and oral and symbolic consumer and family
materials (including consent forms, statement
of rights forms, posters, signs, and audio tape
recordings) provided to consumers from various
racial/ethnic groups and their families that are
interpreted from the appropriate cultural perspective,
as measured by consumer satisfaction surveys.
|
|
X
|
|
|
|
|
Center for Mental
Health Services (Nov, 1998)) Cultural Competence
in Managed Care. Overall System Standards and
Implementation Guidelines. Mental Health
Services for Four Underserved/ Underrepresented
Racial/Ethnic Groups Prepared for Substance Abuse
and Mental Health Services Administration. Purchase
Order No. 97MO4762401D |
|
Visual representation
|
Ensure that
posters, magazines, signs are in languages of
the community. |
X
|
|
|
|
|
|
The New York State Office of Mental Health. The
Research Foundation for Mental Hygiene. (September
1998) Cultural Competence Performance Measures for
Managed Behavioral Healthcare Programs. In
Collaboration with the Center for the Study of Issues
in Public Mental Health. Funded by the Substance
Abuse and Mental Health Services Administration,
Center for Mental Health Services.
The Bureau of Primary Health Care. (1999). Cultural
Competence: A Journey. Health Resources and
Services Administration, Bureau of Primary Health
Care. |
|
Culturally sensitive
encounters |
Conduct assessment
of patient/parent beliefs using the following
checklist:
-
Identification of beliefs that affect clinical
care
-
Suggest alternatives to harmful home remedies
-
Explain etiology and treatment rationale
for given biomedical condition
|
|
|
|
X
|
|
|
Progress Notes
(December 1999). A Model of Cultural Competency
in Health Care. A Newsletter of the Massachusetts
Chronic Disease Improvement Network. Vol.3, No.3
|
|
Culturally sensitive
clinical and non-clinical encounters |
Use the following
set of questions to assess folk illnesses and
remedies:
- Indicate awareness of the existence
of a folk illness that doctor may not know about
- Ask whether the patient has the illness
now
- Ask what treatment the patient is receiving
for the condit.
|
|
|
|
X
|
|
|
Progress Notes
(December 1999). A Model for Cultural Competency
in Health Care. A Newsletter of the Massachusetts
Chronic Disease Improvement Network. Vol.3, No.3
|
|
Culturally sensitive
clinical and non-clinical encounters |
Conduct health
beliefs inventory of patient to understand the
patient’s explanatory model for illness.
|
|
|
|
X
|
|
|
Progress Notes
(December 1999). Practicing Culturally Sensitive
Pediatrics. A Newsletter of the Massachusetts
Chronic Disease Improvement Network. Vol.3, No.3
|
COMMUNICATION |
Communication
styles |
Checklist from
the NCCC on Communication style. Indicate A= things
I do frequently B= things I do occasionally C=
Things I do rarely or never.
- For children who speak languages or
dialects other than English, I attempt to learn
and use key words in their language so that
I am better able to communicate with them during
assessment, treatment or other interventions.
- I attempt to determine any familial
colloquialisms used by children and families
that may impact on assessment, treatment or
other interventions.
- I use visual aids, gestures, and physical
prompts in my interactions with children who
have limited English proficiency.
- I use bilingual staff or trained volunteers
to serve as interpreters during assessment,
meetings, or other events for parents who would
require this level of assistance.
- When possible, I insure that all notices
and communiqués to parents are written in their
language of origin.
- I understand that it may be necessary
to use alternatives to written communications
for some families, as word of mouth may be a
preferred method of receiving information
|
|
|
|
X
|
|
|
Georgetown University
Child Development Center-National Center for Cultural
Competence (NCCC) Checklist on Communication
Styles. Tawara Goode. June 1989. Revised 1993,
1996, 1999 and 2000 |
COMMUNICATION |
Communication
styles |
Checklist from
the NCCC on Communication style. Indicate A= things
I do frequently B= things I do occasionally C=
Things I do rarely or never.
- When interacting with parents who have
limited English proficiency I always keep in
mind that:
- Limitations in English proficiency
is in no way a reflection of their level of
intellectual functioning.
- their limited ability to speak the
language of the dominant culture has no bearing
on their ability to communicate effectively
in their language of origin.
- they may or may not be literate in
their language of origin or English.
|
|
|
|
X
|
|
|
Georgetown University
Child Development Center-National Center for Cultural
Competence (NCCC) Checklist on Communication
Styles. Tawara Goode. June 1989. Revised 1993,
1996, 1999 and 2000 |
|
Interpreter |
Yearly updated
directory of trained interpreters available within
24 hours for routine situations and within one
hour or less for urgent situations. |
|
X
|
|
|
|
|
Center for Mental
Health Services (Nov, 1998)) Cultural Competence
in Managed Care. Overall System Standards and
Implementation Guidelines. Mental Health
Services for Four Underserved/Underrepresented
Racial/Ethnic Groups
Prepared for Substance Abuse and Mental
Health Services Administration. Purchase Order
No. 97MO4762401D |
|
Interpreter |
Percent decrease
in the use of interpreters as a result of increased
numbers of professional staff competent in the
communication styles of consumers from the ethnic/racial
groups. |
|
X
|
|
|
|
|
Center for Mental
Health Services (Nov, 1998)) Cultural Competence
in Managed Care. Overall System Standards and
Implementation Guidelines. Mental Health
Services for Four Underserved/ Underrepresented
Racial/Ethnic Groups
Prepared for Substance Abuse and Mental
Health Services Administration. Purchase Order
No. 97MO4762401D |
|
Interpreter |
Patient survey:
- How often is an interpreter present
during your office visits?(never, sometimes,
frequently, always, doctor speaks my language)
- If your primary language is other than
English, which of the following services does
your health plan offer in your primary language?
- Interpreter of bilingual staff in the
emergency room
- Interpreter or bilingual staff in the
laboratory
- Interpreter of bilingual staff in X-ray
- Interpreter or bilingual staff in EKG
- Interpreter for visits to authorized
non-Plan providers
- How satisfied are you with the language
interpreter you receive under your health plan?
- Have you ever had to wait more than
2 days to see a plan physician for attention
to a condition which you felt required immediate
attention due to the unavailability of a plan
provided interpreter?
- Who usually interprets during your
office visit?
|
|
X
|
|
|
|
|
Munoz, R.H.,
Sanchez, A.M. Developing Culturally Competent
Systems of Care for State Mental Health Services.
Center for Mental Health Services, Substance
Abuse and Mental Health Services Administration.
Prepared for the Substance Abuse and Mental Health
Services Administration under contract No. 94MF113927
|
|
Interpreter |
Percentage of
clients with limited English proficiency (LEP)
who have access to bilingual staff or interpretation
services. |
|
X
|
|
|
|
|
Office of Minority Health (1999) Assuring Cultural
Competence in Health Care: Recommendations for National
Standards and an Outcomes-Focused Research Agenda
Recommended Standards for Culturally and Linguistically
Appropriate Health Care Services.
The Bureau of Primary Health Care. (1999). Cultural
Competence: A Journey. Health Resources and
Services Administration, Bureau of Primary Health
Care. Health Resources
and Services Administration (2000). Cultural Competence
Works. Awards of Excellence. “Certificates of Recognition
Nominated Programs of Note” and “Certificate of
Recognition.” |
|
Interpreter |
- Percentage of bilingual staff and interpreters
certified or having formally demonstrated their
linguistic competence.
- Number of trainings provided to clinicians
in the use of interpreters for consumers from
the various racial/ethnic groups and their families.
- Percentage of translators working with
consumers from various racial/ethnic groups
and families who are trained in formal interpretation
techniques and supervised by culturally competent
specialist.
|
|
X
|
|
|
|
|
Center for Mental
Health Services (Nov, 1998)) Cultural Competence
in Managed Care. Overall System Standards and
Implementation Guidelines. Mental Health
Services for Four Underserved/Underrepresented
Racial/Ethnic Groups Prepared for Substance Abuse
and Mental Health Services Administration. Purchase
Order No. 97MO4762401D |
|
Translated materials
|
Activities and
material, including an updated listing of community
resources, are provided in the language(s) of
the population(s) being served. |
|
X
|
|
|
|
|
Center for Mental
Health Services (Nov, 1998)) Cultural Competence
in Managed Care. Overall System Standards and
Implementation Guidelines. Mental Health
Services for Four Underserved/Underrepresented
Racial/Ethnic Groups
Prepared for Substance Abuse and Mental
Health Services Administration. Purchase Order
No. 97MO4762401D |
|
Translated materials
|
Allocated resources
for interpretation and translation services for
medical encounters and health education / promotion
material |
X
|
|
|
|
|
|
Maternal and
Child Health Bureau. (April 30, 2000). Title V
Block Grant Measure. Health Resources and Services
Administration. |
|
Translated materials
|
Percent of clients
who receive oral and written notices, including
translated signage at key points of contact, in
their primary language informing them of their
right to receive no-cost interpreter services.
|
|
X
|
|
|
|
|
Office of Minority
Health (1999) Assuring Cultural Competence in
Health Care: Recommendations for National Standards
and an Outcomes-Focused Research Agenda Recommended
Standards for Culturally and Linguistically Appropriate
Health Care Services. |
|
Translated materials
|
Translate and
make available signage and commonly-used written
patient educational material and other materials
for members of the predominant language groups
in service areas. |
|
X
|
|
|
|
|
Office of Minority
Health (1999) Assuring Cultural Competence in
Health Care: Recommendations for National Standards
and an Outcomes-Focused Research Agenda Recommended
Standards for Culturally and Linguistically Appropriate
Health Care Services. |
|
Translated materials
|
- Policies and procedures regarding the
translation of patient consent forms, educational
materials, and other information in formats
that meet the literacy needs of patients.
- Policies and procedures to evaluate
the quality and appropriateness of interpretation
and translated services.
- Policies and procedures to periodically
evaluate consumer and personnel satisfaction
with interpretation and satisfaction services
that are provided.
|
|
X
|
|
|
|
|
National Center
for Cultural Competency (Winter, 2000) Policy
Brief 2: Linguistic Competence in Primary Health
Care Delivery Systems: Implications for Policy
Makers. |
|
Translated materials
|
Information on
rights is available in languages of community
|
|
X
|
|
|
|
|
The New York
State Office of Mental Health. The Research Foundation
for Mental Hygiene. (September 1998) Cultural
Competence Performance Measures for Managed Behavioral
Healthcare Programs. In Collaboration with
the Center for the Study of Issues in Public Mental
Health. Funded by the Substance Abuse and Mental
Health Services Administration, Center for Mental
Health Services. |
|
Linguistically
competent organization |
- Percent of racial/ethnic customers
receiving linguistically competent services
- Percentage of consumers from diverse
ethnic/racial groups served in their preferred
language
|
|
X
|
|
|
|
|
Center for Mental
Health Services (Nov, 1998)) Cultural Competence
in Managed Care. Overall System Standards and
Implementation Guidelines. Mental Health
Services for Four Underserved/ Underrepresented
Racial/Ethnic Groups Prepared for Substance Abuse
and Mental Health Services Administration. Purchase
Order No. 97MO4762401D |
|
Linguistically
competent organization |
- Language and dialects of community
available at the point of first contact
- # of trained translators and interpreters
available
- # staff proficient in languages of
the community
|
|
X
|
|
|
|
|
The New York
State Office of Mental Health. The Research Foundation
for Mental Hygiene. (September 1998) Cultural
Competence Performance Measures for Managed Behavioral
Healthcare Programs. In Collaboration with
the Center for the Study of Issues in Public Mental
Health. Funded by the Substance Abuse and Mental
Health Services Administration, Center for Mental
Health Services. |
|
Linguistically
competent organization |
Interpreters
and bilingual staff demonstrate bilingual proficiency
and receive training that includes the skills
and ethics of interpreting, and knowledge in both
languages of the terms and concepts relevant to
clinical or non-clinical encounters |
|
|
|
X
|
|
|
Office of Minority
Health (1999) Assuring Cultural Competence in
Health Care: Recommendations for National Standards
and an Outcomes-Focused Research Agenda Recommended
Standards for Culturally and Linguistically Appropriate
Health Care Services. |
|
Linguistically
competent organization |
Linguistically
and culturally factored consumer satisfaction
surveys are independently administered and include
health plan drop-out rates and short-term recipients.
|
|
|
X
|
|
|
|
Office of Minority
Health (1999) Assuring Cultural Competence in
Health Care: Recommendations for National Standards
and an Outcomes-Focused Research Agenda Recommended
Standards for Culturally and Linguistically Appropriate
Health Care Services. |
|
Linguistically
competent organization |
Patient Survey
- If your primary language is other than
English, which of the following services does
your health plan offer in your primary language?
- Health plan
forms and brochures describing benefits
- Answers by
phone or in person to questions about plan benefits
and procedures
- Telephone access
to doctors 24 hours a day in case of urgent need
- Making appointments
with your doctor
- Assistance
getting authorization to see a specialist
- Identification
of doctors who speak your language and/or understand
your culture
- Health education
and health prevention programs in your community
·
Handling complaints about your care or treatment
by the health plan
·
On-going updates on plan information |
|
X
|
|
|
|
|
Munoz, R.H.,
Sanchez, A.M. Developing Culturally Competent
Systems of Care for State Mental Health Services.
Center for Mental Health Services, Substance
Abuse and Mental Health Services Administration.
Prepared for the Substance Abuse and Mental Health
Services Administration under contract No. 94MF113927
|
|
Linguistically
competent organization |
Percentage of
consumers from diverse ethnic/racial groups served
in their preferred language. |
|
X
|
|
|
|
|
Center for Mental
Health Services (Nov, 1998)) Cultural Competence
in Managed Care. Overall System Standards and
Implementation Guidelines. Mental Health
Services for Four Underserved/ Underrepresented
Racial/Ethnic Groups Prepared for Substance Abuse
and Mental Health Services Administration. Purchase
Order No. 97MO4762401D |
|
Linguistically
competent organization |
Items from Patient
Satisfaction Survey Tool:
How well can you communicate with your doctor
in English? How
often is an interpreter present during your office
visits Who usually
interprets during your office visit?
If your primary language is other than English,
which of the following services does your health
plan offer in your primary language?
How satisfied are you with the language interpreting
you receive under your health plan?
How understandable are the written communications
you receive from your health plan?
Are the instructions for using the drug prescribed
for you which are on the labels of the pill bottles
written in your native language?
Does the pharmacist explain the instructions for
taking prescriptions to you in your native language?
|
|
|
X
|
|
|
|
Tirado, M. (January,
1996). Tools for Monitoring Cultural Competence
in Health Care. Latino Coalition for a Health
California. San Francisco, CA |
|
Linguistically
competent organization |
Policies and procedures are in place regarding the
translation of patient consent forms, educational
materials and other information in formats that
meet the literacy needs of the patient
Policies and procedures are in place to evaluation
the quality and appropriateness of interpretation
and translation services
Policies and resources are in place to support community
outreach initiatives to persons with limited English
proficiency. Policies
and procedures are in place to periodically review
the current and emergent demographic trends for
the geographic area served in order to determine
interpretation and translation services. |
|
X
|
|
|
|
|
Maternal and
Child Health Bureau (1990) State Children
with Special Health Care Needs Title V Directory
Workshop: Improving State Services for Culturally
Diverse Populations. |
|
Linguistically
competent organization |
Comprehensive
management strategy to address culturally and
linguistically appropriate services, including
strategic goals, plans, policies, procedures,
and designated staff responsible for implementation.
|
|
|
|
X
|
|
|
Office of Minority
Health (1999) Assuring Cultural Competence in
Health Care: Recommendations for National Standards
and an Outcomes-Focused Research Agenda Recommended
Standards for Culturally and Linguistically Appropriate
Health Care Services. |
|
Linguistically
competent organization |
Availability
of cultural competent policies in different languages.
|
|
X
|
|
|
|
|
The New York
State Office of Mental Health. The Research Foundation
for Mental Hygiene. (September 1998) Cultural
Competence Performance Measures for Managed Behavioral
Healthcare Programs. In Collaboration with
the Center for the Study of Issues in Public Mental
Health. Funded by the Substance Abuse and Mental
Health Services Administration, Center for Mental
Health Services. |
|
Linguistically
competent organization |
Policies and resources
to support ongoing pre-service, inservice
and professional development in the area of cultural
and linguistic competence |
|
X
|
|
|
|
|
Maternal and
Child Health Bureau (April 30, 2000). Title V
Block Grant Measure. Department of Health and
Human Services. |
|
Linguistically
competent organization |
MCO complies
with current law and regulation regarding interpreter
services as measured by whether MCO meets all
requirements or in a weighted average of compliance
ratings for individual items |
|
X
|
|
|
|
|
Abt Associates (January,
2000). Report on Recommendations for Measures of
Cultural Competence for the Quality Improvement
System for Managed Care. Report prepared for HCFA
|
|
Linguistically
competent organization |
Consumer education
information respects cultures, reflects literacy
levels and is in different formats |
|
|
|
X
|
|
|
The New York
State Office of Mental Health. The Research Foundation
for Mental Hygiene. (September 1998) Cultural
Competence Performance Measures for Managed Behavioral
Healthcare Programs. In Collaboration with
the Center for the Study of Issues in Public Mental
Health. Funded by the Substance Abuse and Mental
Health Services Administration, Center for Mental
Health Services. |
|
Linguistic capacity
of provider |
Conduct audit
of provider network which includes the following
components: Languages
and dialects of community available at points
of first contact
# trained translators and interpreters available
# clinicians and
staff proficient in languages of the community
|
X
|
|
|
|
|
|
The New York
State Office of Mental Health. The Research Foundation
for Mental Hygiene. (September 1998) Cultural
Competence Performance Measures for Managed Behavioral
Healthcare Programs. In Collaboration with
the Center for the Study of Issues in Public Mental
Health. Funded by the Substance Abuse and Mental
Health Services Administration, Center for Mental
Health Services. |
|
Linguistic capacity
of provider |
Policies to
support community outreach to persons with limited
English proficiency |
|
X
|
|
|
|
|
National Center
for Cultural Competency (Winter, 2000) Policy
Brief 2: Linguistic Competence in Primary Health
Care Delivery Systems: Implications for Policy
Makers. |
|
Linguistic capacity
of provider |
Use of language
fluency examinations to determine the level of
competence of clinicians and interpreters to provide
comprehensive clinical and preventive care |
|
X
|
|
|
|
|
Center for Mental
Health Services (Nov, 1998)) Cultural Competence
in Managed Care. Overall System Standards and
Implementation Guidelines. Mental Health
Services for Four Underserved/ Underrepresented
Racial/Ethnic Groups Prepared for Substance Abuse
and Mental Health Services Administration. Purchase
Order No. 97MO4762401D |
|
Linguistic capacity
of provider |
Procedures to
periodically review the current and emergent
demographic trends for the geographic area served
in order to determine interpretation and translation
service needs |
X
|
|
|
|
|
|
National Center
for Cultural Competency (Winter, 2000) Policy
Brief 2: Linguistic Competence in Primary Health
Care Delivery Systems: Implications for Policy
Makers. |
|
Language ability,
oral and written of consumer |
Consumer reading,
writing levels of primary language and dialects
recorded. |
|
X
|
|
|
|
|
The New York
State Office of Mental Health. The Research Foundation
for Mental Hygiene. (September 1998) Cultural
Competence Performance Measures for Managed Behavioral
Healthcare Programs. In Collaboration with
the Center for the Study of Issues in Public Mental
Health. Funded by the Substance Abuse and Mental
Health Services Administration, Center for Mental
Health Services. |
|
Provide information,
education |
Resource materials
are accessible to the diverse population served
|
X
|
|
|
|
|
|
Getting Started...
Planning, Implementing and Evaluating Culturally
Competent Service Delivery Systems for Children
with Special Health Needs and their Families,"
Georgetown University Child Development Center,
National Center for Cultural Competence and "
"Policy Brief 1: Rationale for Cultural
Competence in Health Care," Georgetown
University Child Development Center, National Center
for Cultural Competence |
|
Provide information,
education |
Information is available that:
- Respects
cultural values
- Is in
different formats
Information is available in the languages of the
community. Material
is reviewed by local key informants.
Information is disseminated to provider network.
|
X
|
|
|
|
|
|
The New York
State Office of Mental Health. The Research Foundation
for Mental Hygiene. (September 1998) Cultural
Competence Performance Measures for Managed Behavioral
Healthcare Programs. In Collaboration with
the Center for the Study of Issues in Public Mental
Health. Funded by the Substance Abuse and Mental
Health Services Administration, Center for Mental
Health Services. |
|
Provide information,
education |
Organization has the capacity to disseminate information
on health care plan benefits in languages of community.
Organization has
the capacity to disseminate information and explanation
of rights to enrollees. |
X
|
|
|
|
|
|
The New York
State Office of Mental Health. The Research Foundation
for Mental Hygiene. (September 1998) Cultural
Competence Performance Measures for Managed Behavioral
Healthcare Programs. In Collaboration with
the Center for the Study of Issues in Public Mental
Health. Funded by the Substance Abuse and Mental
Health Services Administration, Center for Mental
Health Services. |
|
Administration
and staff should be able to translate, cultural
brokering |
Promote and support
the attitudes, behaviors, knowledge, and skills
necessary for staff to work respectfully and effectively
with patients and each other in a culturally diverse
work environment. |
X
|
|
|
|
|
|
Office of Minority
Health (1999) Assuring Cultural Competence in
Health Care: Recommendations for National Standards
and an Outcomes-Focused Research Agenda Recommended
Standards for Culturally and Linguistically Appropriate
Health Care Services. |
POLICIES AND
PROCEDURES |
Choice of health
plan network |
Contract continuation
and renewal with health plan is contingent upon
successful achievement of performance targets
which demonstrate effective service, equitable
access and comparability of benefits for populations
of racial/ethnic groups |
|
X
|
|
|
|
|
Center for Mental
Health Services (Nov, 1998)) Cultural Competence
in Managed Care. Overall System Standards and
Implementation Guidelines. Mental Health
Services for Four Underserved/ Underrepresented
Racial/Ethnic Groups Prepared for Substance Abuse
and Mental Health Services Administration. Purchase
Order No. 97MO4762401D |
|
Choice of providers,
provider network |
Health plan contracts
with, and utilizes local racial/ethnic community-based
organizations and independent practitioners in
its network and includes them in the provider’s
network or panel. |
|
X
|
|
|
|
|
Center for Mental
Health Services (Nov, 1998)) Cultural Competence
in Managed Care. Overall System Standards and
Implementation Guidelines. Mental Health
Services for Four Underserved/ Underrepresented
Racial/Ethnic Groups Prepared for Substance Abuse
and Mental Health Services Administration. Purchase
Order No. 97MO4762401D |
|
Choice of providers,
provider network |
MCO self-certification
regarding specific requirements(e.g., designation
as an AA/EEO employer, job descriptions include
requirements for cultural competence, performance
evaluations measure and reward culturally competent
behaviors) |
|
X
|
|
|
|
|
Abt Associates (January,
2000). Report on Recommendations for Measures of
Cultural Competence for the Quality Improvement
System for Managed Care. Report prepared for HCFA.
|
|
Grievance and
conflict resolution |
Organization
has structures and procedures to address cross
cultural ethical and legal conflicts in health
care delivery and complaints or grievances by
patients and staff about unfair, culturally insensitive
or discriminatory treatment, or difficulty in
accessing services, or denial of services |
X
|
|
|
|
|
|
Office of Minority
Health (1999) Assuring Cultural Competence in
Health Care: Recommendations for National Standards
and an Outcomes-Focused Research Agenda Recommended
Standards for Culturally and Linguistically Appropriate
Health Care Services. |
|
Grievance and
conflict resolution |
There are feedback
mechanisms in place that track # grievances and
complaints and # incidents. |
X
|
|
|
|
|
|
The New York
State Office of Mental Health. The Research Foundation
for Mental Hygiene. (September 1998) Cultural
Competence Performance Measures for Managed Behavioral
Healthcare Programs. In Collaboration with
the Center for the Study of Issues in Public Mental
Health. Funded by the Substance Abuse and Mental
Health Services Administration, Center for Mental
Health Services. |
|
Grievance and
conflict resolution |
Patient complaints
and grievances (e.g., differences in the per capital
number of complaints or grievances filed by members
of each patient group) |
|
X
|
|
|
|
|
Abt Associates (January,
2000). Report on Recommendations for Measures of
Cultural Competence for the Quality Improvement
System for Managed Care. Report prepared for HCFA
|
|
Grievance and
conflict resolution |
Racial/ethnic
consumer awareness of and participation in Health
Plan benefits, appeals procedures, and ombudspersons,
as demonstrated by the comparability of the rate
of grievances and complaints. |
|
X
|
|
|
|
|
Center for Mental
Health Services (Nov, 1998)) Cultural Competence
in Managed Care. Overall System Standards and
Implementation Guidelines. Mental Health
Services for Four Underserved/ Underrepresented
Racial/Ethnic Groups Prepared for Substance Abuse
and Mental Health Services Administration. Purchase
Order No. 97MO4762401D |
|
Grievance and
conflict resolution |
The percentage
of complaints and grievances of individual practitioners
is tracked and factored into performance evaluations.
|
X
|
|
|
|
|
|
Center for Mental
Health Services (Nov, 1998)) Cultural Competence
in Managed Care. Overall System Standards and
Implementation Guidelines. Mental Health
Services for Four Underserved/ Underrepresented
Racial/Ethnic Groups Prepared for Substance Abuse
and Mental Health Services Administration. Purchase
Order No. 97MO4762401D |
|
Policy development
|
Incorporation
of cultural values and priorities in services
planning/implementation/evaluation activities.
|
|
X
|
|
|
|
|
Nelkin, V.S.
I (1994) To Improve access to Care and Quality
of Life for all Children with Special Healthcare
Needs and Their Families. |
|
Policy development
|
Provider Survey:
As a matter of
formal policy, does you agency: (no policy, considering
policy, currently writing formal policy, policy
in place)
- Use culture-specific
assessment instruments for diagnosis
- Use culture-specific
treatment approaches
- Envision community
empowerment as a treatment goal
- Review case
practices on a regular basis to determine relevancy
to client of color
- Provide or
facilitate transportation
- Allow access
after regular business hours
- Specifically
consider culture in services plans
- Take referrals
from non-traditional sources
- Translate agency
materials into languages that reflect the linguistic
diversity in your service area
- Solicit input
from groups of color with respect to physical
plant location and interior design |
|
X
|
|
|
|
|
Mason (1995)
Cultural Competence Self Assessment Questionnaire:
A Manual for Users. Multicultural Initiative Project,
Portland Sate University, Research and Training
Center on Family Support and Children’s Mental
Health |
|
Policy development
|
Does your organization have policies, training standards,
etc. That are used to promote culturally competent
system of care for ethnically diverse adults with
serious mental illness? Y____ N___.
What, if any, mechanism do you have for ensuring
that policies are carried out? |
X
|
X
|
|
|
|
|
Munoz, R.H.,
Sanchez, A.M. Developing Culturally Competent
Systems of Care for State Mental Health Services.
Center for Mental Health Services, Substance
Abuse and Mental Health Services Administration.
Prepared for the Substance Abuse and Mental Health
Services Administration under contract No. 94MF113927
|
|
Policy development
|
Program self-assessment
survey on policies and procedures:
In diagnosis and assessment, how is the client’s
culture taken into account?
- We have rarely
or never discusses this option, so far as I know
- We sometimes
discuss this option, and might change at some
point
- No special
instruments or guidelines are used, but workers
are instructed to take culture into account
- When needed,
workers or teams may use special instruments or
guidelines that address cultural concerns
- We have a series
of assessment questions addressing culture and
asked of all clients
In treating clients, how is culture taken into
account? (same response options as above) |
|
|
|
X
|
|
|
Weiss, C. I.,
& Minsky, S. (1994). Program self-assessment
survey for cultural competence: A manual. New
Jersey Division of Mental Health and Hospitals.
|
|
Policy Development
|
Program self-assessment
survey on policies and procedures:
How does the program decor reflect the cultural
heritage of clients and families using the facility
- Music in waiting
room, eating or drop-in areas, program activity
spaces, etc.
- Foods or beverages
served or sold
- Wall maps,
posters, photos or other art work of places or
people or objects familiar to clients (includes
individuals admired by the clients’ communities)
- Reading matter
in the waiting room or client reading area in
the first language of non-English speakers or
popular within clients’ communities
- Notices and
place signs in the first language of the non-English
speakers
- A bulletin
board with news items and other material of cultural
interest, e.g., local events or media broadcasts
|
|
|
|
X
|
|
|
Weiss, C. I.,
& Minsky, S. (1994). Program self-assessment
survey for cultural competence: A manual. New
Jersey Division of Mental Health and Hospitals.
|
|
Policy development
|
Program self-assessment
survey on policies and procedures:
How and when do program staff learn about: clients’
cultures and their service needs and barriers
to treatment; their beliefs, customs and norms,
as well as diversity within the groups; and their
helping resources
- During orientation
for new staff
- During in-service
training held on-site at least once a year
- Through a connection
with a nearby academic setting, informing the
program of learning opportunities and resources
- From a program
plan, report or other document
- By collecting
information about persons who use or need the
program
- Through a dialogue
with members of local communities
- From a library
of books and other resource
- From a bulleting
board announcing upcoming conferences; TV shows
- From guest
speakers
- Through collaboration
with outside researchers, clinicians, or others
|
|
|
|
X
|
|
|
Weiss, C. I.,
& Minsky, S. (1994). Program self-assessment
survey for cultural competence: A manual. New
Jersey Division of Mental Health and Hospitals.
|
|
Policy development
|
Program self-assessment
survey on policies and procedures:
How does the program help to pr
- These staff
receive career counseling, and leave from work
as needed, to aim for higher positions (e.g.,
skill building, test taking, pursuing postings)
- Promotional
opportunities are announced in general staff meetings
or on a circular bulleting board seen by all staff
- Orientation
include an affirmative action unit that tells
new staff where to get more information and how
to lodge a complaint
- Job requirements
do not bar paraprofessionals from positions where
they could perform well
- The program
has an affirmative action bulletin board, or section
of a bulletin board, that addresses discrimination
in hiring or promotions
- Complaints
about promotions are handled promptly, fairly
and without penalty to anyone complaining (even
if the appeal goes outside the program)
- Other |
|
|
|
X
|
|
|
Weiss, C. I.,
& Minsky, S. (1994). Program self-assessment
survey for cultural competence: A manual. New
Jersey Division of Mental Health and Hospitals.
|
|
Planning and governance
|
Demonstration
of a cultural competence system evaluation. |
X
|
|
|
|
|
|
Mason (1995)
Cultural Competence Self Assessment Questionnaire:
A Manual for Users. Multicultural Initiative Project,
Portland Sate University, Research and Training
Center on Family Support and Children’s Mental
Health. |
|
Planning and governance
|
Presence of a Cultural Competence Plan and defined
steps for its integration at every level of organizational
planning. Presence,
within the Cultural Competence Plan, of related
policy/procedure changes. |
|
X
|
|
|
|
|
Center for Mental
Health Services (Nov, 1998)) Cultural Competence
in Managed Care. Overall System Standards and
Implementation Guidelines. Mental Health
Services for Four Underserved/ Underrepresented
Racial/Ethnic Groups Prepared for Substance Abuse
and Mental Health Services Administration. Purchase
Order No. 97MO4762401D |
|
Planning and governance
|
Demonstration
of staff and consumer awareness and acceptance
of the Cultural Competence Plan. |
|
|
|
X
|
|
|
Center for Mental
Health Services (Nov, 1998)) Cultural Competence
in Managed Care. Overall System Standards and
Implementation Guidelines. Mental Health
Services for Four Underserved/ Underrepresented
Racial/Ethnic Groups Prepared for Substance Abuse
and Mental Health Services Administration. Purchase
Order No. 97MO4762401D |
|
Planning and governance
|
Presence of culturally-informed policies of practitioner
behavior and performance-based demonstrations of
implementation. |
|
X
|
|
|
|
|
Center for Mental
Health Services (Nov, 1998)) Cultural Competence
in Managed Care. Overall System Standards and
Implementation Guidelines. Mental Health
Services for Four Underserved/ Underrepresented
Racial/Ethnic Groups Prepared for Substance Abuse
and Mental Health Services Administration. Purchase
Order No. 97MO4762401D |
|
Planning and governance
|
Composition of
the governing board, advisory committee, other
policy-making and influencing groups, and consumers
served reflects service area demographics |
X
|
|
|
|
|
|
Center for Mental
Health Services (Nov, 1998)) Cultural Competence
in Managed Care. Overall System Standards and
Implementation Guidelines. Mental Health
Services for Four Underserved/ Underrepresented
Racial/Ethnic Groups Prepared for Substance Abuse
and Mental Health Services Administration. Purchase
Order No. 97MO4762401D |
|
Planning and governance
|
Health plan enrollee
cultures are represented on the governing board
(Data source: bios of board members |
X
|
|
|
|
|
|
The New York
State Office of Mental Health. The Research Foundation
for Mental Hygiene. (September 1998) Cultural
Competence Performance Measures for Managed Behavioral
Healthcare Programs. In Collaboration with
the Center for the Study of Issues in Public Mental
Health. Funded by the Substance Abuse and Mental
Health Services Administration, Center for Mental
Health Services. |
|
Adequate financing
|
Access to traditional
healers is covered by the health plan’s benefit
package. |
X
|
|
|
|
|
|
Center for Mental
Health Services (Nov, 1998)) Cultural Competence
in Managed Care. Overall System Standards and
Implementation Guidelines. Mental Health
Services for Four Underserved /Underrepresented
Racial/Ethnic Groups Prepared for Substance Abuse
and Mental Health Services Administration. Purchase
Order No. 97MO4762401D |
|
Staff hiring,
recruitment |
# of multilingual/multicultural staff
ratio by culture of staff to clients |
|
X
|
|
|
|
|
The Lewin Group
(1996) Draft Performance Indicator Worksheet.
Title IV. Prepared for HRSA. |
|
Staff hiring,
recruitment |
Provider survey:
Are there people
of color on the staff of your agency?
Are there people of color represented in: (none,
a few, some, many)
- Administrative
positions
- Direct service
positions
- Administrative
support positions
- Operational
support positions
- Board positions
- Agency consultants
- Case consultants
- Sub-contractors
Does your agency:
(none, a few, some, many)
- Hire natural
helpers or other non-credentialed people of color
as paraprofessionals
- Hire practicuum
students or interns of color
- Out-station
staff in communities of color
- Hire bilingual
staff Does your
agency emphasize active recruitment of people
of color? How well
has your agency been able to retain people of
color on staff? |
|
X
|
|
|
|
|
Mason (1995)
Cultural Competence Self Assessment Questionnaire:
A Manual for Users. Multicultural Initiative Project,
Portland Sate University, Research and Training
Center on Family Support and Children’s Mental
Health. |
|
Staff hiring,
recruitment |
Develop and implement
a strategy to recruit, retain and promote qualified,
diverse and culturally competent administrative,
clinical, and support staff that are trained and
qualified to address the needs of the racial and
ethnic communities being served. |
|
X
|
|
|
|
|
Office of Minority
Health (1999) Assuring Cultural Competence in
Health Care: Recommendations for National Standards
and an Outcomes-Focused Research Agenda Recommended
Standards for Culturally and Linguistically Appropriate
Health Care Services. |
|
Staff hiring,
recruitment |
Presence of a
plan for recruitment, retention and promotion
of staff of racial/ethnic backgrounds representative
of the target population served. |
|
X
|
|
|
|
|
Center for Mental
Health Services (Nov, 1998)) Cultural Competence
in Managed Care. Overall System Standards and
Implementation Guidelines. Mental Health
Services for Four Underserved/ Underrepresented
Racial/Ethnic Groups Prepared for Substance Abuse
and Mental Health Services Administration. Purchase
Order No. 97MO4762401D |
|
Staff hiring,
recruitment |
Recruitment,
retention, and career development plan for racial/ethnic
and other culturally competent mental health professionals.
|
|
X
|
|
|
|
|
Center for Mental
Health Services (Nov, 1998)) Cultural Competence
in Managed Care. Overall System Standards and
Implementation Guidelines. Mental Health
Services for Four Underserved/ Underrepresented
Racial/Ethnic Groups Prepared for Substance Abuse
and Mental Health Services Administration. Purchase
Order No. 97MO4762401D |
|
Staff hiring,
recruitment |
Proportionality
of racial/ethnic staffing to the needs of diverse
racial/ethnic populations. |
|
X |
|
|
|
|
Center or Mental
Health Services (Nov, 1998)) Cultural Competence
in Managed Care. Overall System Standards and
Implementation Guidelines. Mental Health
Services for Four Underserved/ Underrepresented
Racial/Ethnic Groups Prepared for Substance Abuse
and Mental Health Services Administration. Purchase
Order No. 97MO4762401D |
|
Staff hiring,
recruitment |
Human Resource
Development Plan is inclusive of recruitment,
retention and development of staff at all levels
to enhance and ensure quality culturally competent
services to consumers from the four groups and
their communities. |
|
X
|
|
|
|
|
Center for Mental
Health Services (Nov, 1998)) Cultural Competence
in Managed Care. Overall System Standards and
Implementation Guidelines. Mental Health
Services for Four Underserved/ Underrepresented
Racial/Ethnic Groups Prepared for Substance Abuse
and Mental Health Services Administration. Purchase
Order No. 97MO4762401D |
|
Incentive systems
|
Development of
rewards and incentives (e.g., salary, promotion,
bonuses) for cultural competence performance as
well as sanctions for cultural destructive practices.
|
|
X
|
|
|
|
|
Center for Mental
Health Services (Nov, 1998)) Cultural Competence
in Managed Care. Overall System Standards and
Implementation Guidelines. Mental Health
Services for Four Underserved/ Underrepresented
Racial/Ethnic Groups Prepared for Substance Abuse
and Mental Health Services Administration. Purchase
Order No. 97MO4762401D |
|
Incentive systems
|
Cultural competence
is an integral part of the employee-provider performance
evaluation system, and provider organization performance
system. |
|
X
|
|
|
|
|
Center for Mental
Health Services (Nov, 1998)) Cultural Competence
in Managed Care. Overall System Standards and
Implementation Guidelines. Mental Health
Services for Four Underserved/ Underrepresented
Racial/Ethnic Groups Prepared for Substance Abuse
and Mental Health Services Administration. Purchase
Order No. 97MO4762401D |
|
Incentive systems
|
Demonstration
of staff knowledge and skills regarding group
values, traditions, expression of illness, cultural
competence principles (e.g., credentialing and
performance based testing). |
|
|
|
X
|
|
|
Center for Mental
Health Services (Nov, 1998)) Cultural Competence
in Managed Care. Overall System Standards and
Implementation Guidelines. Mental Health
Services for Four Underserved/ Underrepresented
Racial/Ethnic Groups Prepared for Substance Abuse
and Mental Health Services Administration. Purchase
Order No. 97MO4762401D |
|
Incentive systems
|
Job responsibilities
and performance measures for staff and contracted
providers include criteria (knowledge, skills, etc.)
related to cultural and linguistic competence and
cross-cultural communication. |
|
X
|
|
|
|
|
Maternal and
Child Health Bureau (1990) State Children
with Special Health Care Needs Title V Directory
Workshop: Improving State Services for Culturally
Diverse Populations. |
TRAINING AND
STAFF DEVELOPMENT |
Training and professional
development |
Cultural competence
training is part of the credentialing process
for case managers. |
|
X
|
|
|
|
|
Center for Mental
Health Services (Nov, 1998)) Cultural Competence
in Managed Care. Overall System Standards and
Implementation Guidelines. Mental Health
Services for Four Underserved/ Underrepresented
Racial/Ethnic Groups Prepared for Substance Abuse
and Mental Health Services Administration. Purchase
Order No. 97MO4762401D |
|
Training and professional
development |
Budgetary expenditures
each year are allocated to professional development
related to cultural competence. |
X
|
|
|
|
|
|
Getting Started...
Planning, Implementing and Evaluating Culturally
Competent Service Delivery Systems for Children
with Special Health Needs and their Families,"
Georgetown University Child Development Center,
National Center for Cultural Competence and "
"Policy Brief 1: Rationale for Cultural
Competence in Health Care," Georgetown
University Child Development Center, National Center
for Cultural Competence |
|
Training and professional
development |
The
following four elements demonstrate cultural competent
training. Respondents were asked to check
the degree to which the elements have been incorporated
using a scale of 0 (not met) to 3 (completely
met): · A written
cultural competence plan for your training program
emphasizes your commitment to delivering a culturally
competent training experience to your staff; ·
Cultural and linguistic competency policies are
incorporated into the overall administration of
your program (recruitment plan and other policies
and procedures); ·
Cultural and linguistic competence knowledge and
skills building are included in the didactic
portion of your training experience; and
Cultural and linguistic competence knowledge and
skill building are included in the practicum/field/clinical
experience portion of your training experience
|
|
X
|
|
|
|
|
Maternal and Child
Health Bureau (2000) MCHB Performance Measures
Detail Sheet Number 21. Developed by The Lewin
Group. |
|
Training and professional
development |
Require and arrange
for ongoing education and training for administrative,
clinical, and support staff in culturally and
linguistically competent service delivery. |
|
X
|
|
|
|
|
Office of Minority
Health (1999) Assuring Cultural Competence in
Health Care: Recommendations for National Standards
and an Outcomes-Focused Research Agenda Recommended
Standards for Culturally and Linguistically Appropriate
Health Care Services. |
|
Training and professional
development |
% administrative staff with cultural competence
training % of administrative
staff attending ongoing cultural competence training
Ongoing cultural
competence training completed |
|
X
|
|
|
|
|
The New York
State Office of Mental Health. The Research Foundation
for Mental Hygiene. (September 1998) Cultural
Competence Performance Measures for Managed Behavioral
Healthcare Programs. In Collaboration with
the Center for the Study of Issues in Public Mental
Health. Funded by the Substance Abuse and Mental
Health Services Administration, Center for Mental
Health Services. |
|
Training and professional
development |
Development of specific job descriptions of staff
who work with patients of diverse cultural groups.
Percentage/number
of staff receiving initial and ongoing cultural
competence training. |
|
X
|
|
|
|
|
Maternal and
Child Health Bureau (1990) State Children
with Special Health Care Needs Title V Directory
Workshop: Improving State Services for Culturally
Diverse Populations. |
|
Training and
professional development |
The following
are indicators of culturally competent human resource
planning by a health plan:
Percentage of consumers from diverse ethnic/racial
groups served by, or under the supervision of,
culturally competent bilingual/bicultural Mental
Health Specialists.
Percentage of staff receiving at least five hours
of training annually in cultural competence awareness.
|
|
X
|
|
|
|
|
Center for Mental
Health Services (Nov, 1998)) Cultural Competence
in Managed Care. Overall System Standards and
Implementation Guidelines. Mental Health
Services for Four Underserved/ Underrepresented
Racial/Ethnic Groups Prepared for Substance Abuse
and Mental Health Services Administration. Purchase
Order No. 97MO4762401D |
|
Training and
professional development |
MCO self-certifies that it provides cultural competence
training for selected staff
MCO demonstrates effectiveness of cultural competence
training by measuring pre/post knowledge of participants
MCO demonstrates
effectiveness of cultural competence training by
measuring its impact on clinician/patient interactions
and satisfaction and/or clinical outcomes |
|
X
|
|
|
|
|
Abt Associates (January,
2000). Report on Recommendations for Measures of
Cultural Competence for the Quality Improvement
System for Managed Care. Report prepared for HCFA
|
|
Training and professional
development |
Provider Survey:
Does your agency
prepare new staff to work with people of color?
(not at all, barely, fairly well, very well)
Does your agency provide training that helps staff
work with people of color? (not at all, barely,
fairly well, very well) |
|
X
|
|
|
|
|
Mason (1995)
Cultural Competence Self Assessment Questionnaire:
A Manual for Users. Multicultural Initiative Project,
Portland Sate University, Research and Training
Center on Family Support and Children’s Mental
Health. |
|
New staff orientations
|
# of new employee
obtaining at least eight hours of cultural training
per year |
|
X
|
|
|
|
|
Texas Department
of Health. Journey Towards Cultural Competency:
Lessons Learned. National Maternal and Child
Health Resource Center on Cultural Competency.
Prepared for the Maternal and Child Health Bureau,
Health Resources and Services Administration,
U.S. Department of Health and Human Services.
|
|
Structured opportunities
for ongoing learning |
|
|
|
|
|
|
|
|
|
Bilingual trainin
|
Percent of interpreters
and bilingual staff that demonstrate bilingual
proficiency and receive training that includes
the skills and ethics of interpreting, and knowledge
in both languages of the terms and concepts relevant
to clinical or non-clinical encounters. |
|
X |
|
|
|
|
Office of Minority
Health (1999) Assuring Cultural Competence in
Health Care: Recommendations for National Standards
and an Outcomes-Focused Research Agenda Recommended
Standards for Culturally and Linguistically Appropriate
Health Care Services. |
|
Assessment of
the knowledge and skills/ attitudes of the provider.
|
Items from the
Provider Self-Assessment Survey
·
Some specific diseases are more common in 1 particular
ethnic or racial group compared to another. Assign
the following conditions to the groups in which
they are more common
·
Which of the following types of patients do you
find most challenging to care for? (english speaking
patients with symptomatic acute conditions, non-english
speaking patients with symptomatic acute conditions,
english speaking patients with symptomatic chronic
conditions)
·
How do you test the quality of the interpretation
when using an interpreter with a non-english speaking
patient?
·
On the average, how frequently do you meet with
people who interpret for you to discuss communications
with your patients?
·
Where available, family members, such as a patient’s
children, should be utilized to ensure more candid
responses to the provider’s questions? |
|
|
|
X
|
|
|
Tirado, M. (January,
1996). Tools for Monitoring Cultural Competence
in Health Care. Latino Coalition for a Health
California. San Francisco, CA |
|
Assessment of
the knowledge and skills/ attitudes of the provider.
|
Items from the
Provider Self-Assessment Survey
·
Where a provider’s knowledge of the patient’s
language is limited, he or she should avoid trying
to converse with the non-English speaking patient?
Y or N
·
How common is it for non-English speaking patients
ethnically diverse patients to mix traditional
treatments with the Western interventions physicians
have prescribed for them?
·
Do you feel that those of your patients who mix
traditional treatments with Western medications
should be free to continue to use traditional
remedies as long as those traditional remedies
are not harmful?
·
If your patient is found to be using such non-harmful
traditional treatments, how would you as the attending
physician react? |
|
|
|
X
|
|
|
Tirado, M. (January,
1996). Tools for Monitoring Cultural Competence
in Health Care. Latino Coalition for a Health
California. San Francisco, CA |
|
Assessment of
the knowledge and skills/ attitudes of the provider
|
Items from the
Provider-Self Assessment Tool:
A provider should anticipate similar medication
reactions when ordering prescriptions for one’s
non-English speaking ethnically diverse patients
as compared with one’s English speaking patients
assuming that all other things are equal? ( strongly
agree, agree, no opinion, disagree, strongly disagree)
When prescribing
medications for limited English speaking patients
from a culturally diverse ethnic/racial group,
it is oftern advantageous to prescribe smaller
quantities of the medication per prescription
in order to allow more frequent monitoring of
their compliance with the treatment? ( strongly
agree, agree, no opinion, disagree, strongly disagree)
|
|
|
|
X
|
|
|
Tirado, M. (January,
1996). Tools for Monitoring Cultural Competence
in Health Care. Latino Coalition for a Health
California. San Francisco, CA |
|
Assessment of
the knowledge and skills/ attitudes of the provider.
|
Periodic review
is conducted of the cultural competence of the
provider network |
|
X
|
|
|
|
|
The New York
State Office of Mental Health. The Research Foundation
for Mental Hygiene. (September 1998) Cultural
Competence Performance Measures for Managed Behavioral
Healthcare Programs. In Collaboration with
the Center for the Study of Issues in Public Mental
Health. Funded by the Substance Abuse and Mental
Health Services Administration, Center for Mental
Health Services. |
|
Assessment of
the knowledge and skills/ attitudes of the provider.
|
Existence of
provider network review procedures in the cultural
competent plan |
|
X
|
|
|
|
|
The New York
State Office of Mental Health. The Research Foundation
for Mental Hygiene. (September 1998) Cultural
Competence Performance Measures for Managed Behavioral
Healthcare Programs. In Collaboration with
the Center for the Study of Issues in Public Mental
Health. Funded by the Substance Abuse and Mental
Health Services Administration, Center for Mental
Health Services. |
|
Assessment of
the knowledge and skills/ attitudes of the provider.
|
Establishment
and evaluation of a credentialing process for
racial/ethnic Mental Health Specialists. |
X
|
|
|
|
|
|
Center for Mental
Health Services (Nov, 1998)) Cultural Competence
in Managed Care. Overall System Standards and
Implementation Guidelines. Mental Health
Services for Four Underserved/ Underrepresented
Racial/Ethnic Groups Prepared for Substance Abuse
and Mental Health Services Administration. Purchase
Order No. 97MO4762401D |
|
Assessment of
the knowledge and skills/ attitudes of the provider.
|
Checklist to
assess cultural competence of provider:
Demonstrate attitudes that indicate a respect
for the consumer's immigration, migration, colonization,
and acculturation experiences.
Demonstrate attitudes that indicate a respect
for the diverse heritages, cultures, and experiences
of consumers from the four groups.
Demonstrate attitudes that indicate a willingness
to work with culturally, ethnically, and racially
diverse populations. |
|
|
|
X |
|
|
Center for Mental
Health Services (Nov, 1998)) Cultural Competence
in Managed Care. Overall System Standards and
Implementation Guidelines. Mental Health
Services for Four Underserved/ Underrepresented
Racial/Ethnic Groups Prepared for Substance Abuse
and Mental Health Services Administration. Purchase
Order No. 97MO4762401D |
|
Assessment of
the knowledge and skills/ attitudes of the provider.
|
Employee evaluation examines completed cultural
competence training
Employee evaluation examines attended ongoing cultural
competence training
Employee evaluation examines violated cultural competence
principles |
|
X
|
|
|
|
|
The New York
State Office of Mental Health. The Research Foundation
for Mental Hygiene. (September 1998) Cultural
Competence Performance Measures for Managed Behavioral
Healthcare Programs. In Collaboration with
the Center for the Study of Issues in Public Mental
Health. Funded by the Substance Abuse and Mental
Health Services Administration, Center for Mental
Health Services. |
|
Cultural knowledge
|
Demonstration
of staff knowledge and skills regarding group
values, traditions, expression of illness, cultural
competence principles. |
|
|
|
X
|
|
|
Center for Mental
Health Services (Nov, 1998)) Cultural Competence
in Managed Care. Overall System Standards and
Implementation Guidelines. Mental Health
Services for Four Underserved/ Underrepresented
Racial/Ethnic Groups Prepared for Substance Abuse
and Mental Health Services Administration. Purchase
Order No. 97MO4762401D |
|
Knowledge of community
needs |
Provider shall
demonstrate ongoing assessment of health and behavioral
needs of racial/ethnic groups and their communities.
|
|
X
|
|
|
|
|
Center for Mental
Health Services (Nov, 1998)) Cultural Competence
in Managed Care. Overall System Standards and
Implementation Guidelines. Mental Health
Services for Four Underserved/ Underrepresented
Racial/Ethnic Groups Prepared for Substance Abuse
and Mental Health Services Administration. Purchase
Order No. 97MO4762401D |
|
Provider preparation
|
Percentage/number
of staff receiving initial and ongoing cultural
competence training. |
|
X
|
|
|
|
|
Center for Mental
Health Services (Nov, 1998)) Cultural Competence
in Managed Care. Overall System Standards and
Implementation Guidelines. Mental Health
Services for Four Underserved/ Underrepresented
Racial/Ethnic Groups Prepared for Substance Abuse
and Mental Health Services Administration. Purchase
Order No. 97MO4762401D |
FACILITY
CHARACTERISTICS, CAPACITY, AND INFRASTRUCTURE |
Available and
accessible services |
Transportation available from residential areas
to cultural competent provider
Flexibility to conduct home visits and community
outreach Culturally
competent services available evenings and weekends
|
X
|
|
|
|
|
|
The New York
State Office of Mental Health. The Research Foundation
for Mental Hygiene. (September 1998) Cultural
Competence Performance Measures for Managed Behavioral
Healthcare Programs. In Collaboration with
the Center for the Study of Issues in Public Mental
Health. Funded by the Substance Abuse and Mental
Health Services Administration, Center for Mental
Health Services. |
|
Available and
accessible services |
· Proportionality of access
to, and length of service of, the full range of
treatment services offered should be comparable
to overall service recipients for access to specific
levels and types of services.
· Percent of consumers
from ethnic/racial groups receiving blended, coordinated
or wrap-around services is comparable to overall
service population.
· Rate and timeliness of
response to telephone calls by consumers from
racial/ethnic groups. |
|
X
|
|
|
|
|
Office of Minority
Health (1999) Assuring Cultural Competence in
Health Care: Recommendations for National Standards
and an Outcomes-Focused Research Agenda Recommended
Standards for Culturally and Linguistically Appropriate
Health Care Services. |
|
Physical environment,
materials, and resources |
Checklist from
the NCCC on Physical Environment. Indicate A=
things I do frequently B= things I do occasionally
C= Things I do rarely or never.
· I display pictures, posters
and other materials which reflect the cultures
and ethnic backgrounds of children and families
served by my program or agency.
I insure that magazines, brochures, and other
printed materials in reception areas are of interest
to and reflect the different cultures of children
and families served by my program or agency.
When using videos, films or other media resources
for health education, treatment or other interventions,
I insure that they reflect the cultures of children
and families served by my program or agency.
When using food
during an assessment, I insure that meals provided
include foods that are unique to the cultural
and ethnic backgrounds of children and families
served by my program or agency.
I insure that toys and other play accessories
in reception areas and those which are used during
assessment are representative of the various cultural
and ethnic groups within the local community and
the society in general. |
X
|
|
|
|
|
|
Georgetown University
Child Development Center-National Center for Cultural
Competence (NCCC) Checklist on Physical Environment.
Tawara Goode. June 1989. Revised 1993, 1996, 1999
and 2000 |
|
Physical environment,
materials, and resources |
Develop institutional
structures and procedures to address cross-cultural
ethical and legal conflicts in health care delivery
and complaints or grievances by patients and staff
about unfair culturally insensitive or discriminatory
treatment, or difficulty in accessing or denial
of services |
X
|
|
|
|
|
|
Office of Minority
Health (1999) Assuring Cultural Competence in
Health Care: Recommendations for National Standards
and an Outcomes-Focused Research Agenda Recommended
Standards for Culturally and Linguistically Appropriate
Health Care Services. |
|
Information system
|
Maintenance
of timely and accurate consumer data which provides
for tracking across age and race ethnicity. |
X
|
|
|
|
|
|
Center for Mental
Health Services (Nov, 1998)) Cultural Competence
in Managed Care. Overall System Standards and
Implementation Guidelines. Mental Health
Services for Four Underserved/ Underrepresented
Racial/Ethnic Groups Prepared for Substance Abuse
and Mental Health Services Administration. Purchase
Order No. 97MO4762401D |
|
Information system
|
Tracking of
access and utilization rates for populations of
the different racial/ethnic groups in comparison
to the overall service population. |
X
|
|
|
|
|
|
Office of Minority
Health (1999) Assuring Cultural Competence in
Health Care:
Recommendations for National Standards and
an Outcomes-Focused Research Agenda Recommended
Standards for Culturally and Linguistically Appropriate
Health Care Services. |
|
Information system
|
Clients' primary spoken language and self-identified
race/ethnicity are included in the health care organization's
management information system as well as any patient
records used by provider staff.
Having a variety of methods to collect and utilize
accurate demographic, cultural, epidemiological
and clinical outcome data for racial and ethnic
groups in service area and become informed about
the ethnic/cultural needs, resources and assets
of the surrounding community
Timely and accurate consumer data which provides
for tracking across age and race/ethnicity. |
X
|
|
|
|
|
|
Office of Minority
Health (1999) Assuring Cultural Competence in
Health Care: Recommendations for National Standards
and an Outcomes-Focused Research Agenda Recommended
Standards for Culturally and Linguistically Appropriate
Health Care Services. |
|
Information system
|
Inclusion of
cultural competence elements in management information
systems. |
X
|
|
|
|
|
|
The New York
State Office of Mental Health. The Research Foundation
for Mental Hygiene. (September 1998) Cultural
Competence Performance Measures for Managed Behavioral
Healthcare Programs. In Collaboration with
the Center for the Study of Issues in Public Mental
Health. Funded by the Substance Abuse and Mental
Health Services Administration, Center for Mental
Health Services. |
INTERVENTIONS
AND TREATMENT MODEL FEATURES |
Diagnosis, care
planning, referral and treatment |
Psychosocial
evaluation conducted by qualified practitioners
trained in ethnic-specific biological, physiological,
cultural, socioeconomic and psychological variables
|
|
|
|
X
|
|
|
Center for Mental
Health Services (Nov, 1998)) Cultural Competence
in Managed Care. Overall System Standards and
Implementation Guidelines. Mental Health
Services for Four Underserved/ Underrepresented
Racial/Ethnic Groups Prepared for Substance Abuse
and Mental Health Services Administration. Purchase
Order No. 97MO4762401D |
|
Diagnosis care
planning, referral and treatment |
Provider Survey:
Do you use treatment
interventions that have been developed for populations
of color? (not at all, seldom, sometimes, often)
Do your treatment
plans contain a cultural perspective that acknowledges
different value systems of people of color? (not
at all, seldom, sometimes, often)
Do you use ethnographic interviewing as a technique
to gather more accurate information? (not at all,
seldom, sometimes, often)
Are you familiar with the limitations of mainstream
diagnostic tools as applied to people of color?
(not at all, seldom, sometimes, often) |
|
X
|
|
|
|
|
Mason (1995)
Cultural Competence Self Assessment Questionnaire:
A Manual for Users. Multicultural Initiative Project,
Portland Sate University, Research and Training
Center on Family Support and Children’s Mental
Health. |
|
Diagnosis, care
planning, referral and treatment |
Client assessment
are conducted in client’s primary language |
|
X
|
|
|
|
|
Cultural Competence
Works. January 10, 2000 Awards Ceremony. Description
of SouthCove Community Health Center |
|
Diagnosis, care
planning, referral and treatment |
The ratio of
the black infant mortality rate to the white infant
mortality rate |
|
|
X
|
|
|
|
Maternal and
Child Health Bureau (April 30, 2000). Title V
Outcome Measure |
|
Diagnosis, care
planning, referral and treatment |
Deaths of infants
and children aged 0 through 24 years enumerated
by age, subgroup, race and ethnicity. |
|
|
X
|
|
|
|
Maternal and
Child Health Bureau (April 30, 2000). Title V
Developmental Health Status Indicator |
|
Diagnosis, care
planning, referral and treatment |
Psychological
evaluation is provided that is based on the use
of culturally and linguistically competent literature
and other specialized approaches. |
|
|
|
X
|
|
|
Center for Mental
Health Services (Nov, 1998)) Cultural Competence
in Managed Care. Overall System Standards and
Implementation Guidelines. Mental Health
Services for Four Underserved/Underrepresented
Racial/Ethnic Groups Prepared for Substance
Abuse and Mental Health Services Administration.
Purchase Order No. 97MO4762401D |
|
Diagnosis, care
planning, referral and treatment |
Decrease in misdiagnosis
and inadequate treatment plans resulting from
failure to communicate effectively with consumers
from various racial and ethnic groups. |
|
|
X
|
|
|
|
Center for Mental
Health Services (Nov, 1998)) Cultural Competence
in Managed Care. Overall System Standards and
Implementation Guidelines. Mental Health
Services for Four Underserved/ Underrepresented
Racial/Ethnic Groups Prepared for Substance Abuse
and Mental Health Services Administration. Purchase
Order No. 97MO4762401D |
|
Diagnosis, care
planning, referral and treatment |
Percent of enrollees
who report they were unable to obtain referral
to a clinician of preferred background (either
from survey of enrollees or from administrative
records) overall or by demographic group. |
|
X
|
|
|
|
|
Abt Associates (January,
2000). Report on Recommendations for Measures of
Cultural Competence for the Quality Improvement
System for Managed Care. Report prepared for HCFA.
|
|
Diagnosis, care
planning, referral and treatment |
Compliance with regimens, follow-up visits (e.g.
differences in percentage of patients with apparent
con-compliance based on chart reviews or missed
out-patient appointments
Disease staging (i.e., statistically significant
and material differences among groups of enrollees
in state at first treatment/diagnosis)
Pharmaceutical records (e.g., the rates of reported
errors by providers in prescribing medication to
different patient groups) |
|
X |
|
|
|
|
Abt Associates (January,
2000). Report on Recommendations for Measures of
Cultural Competence for the Quality Improvement
System for Managed Care. Report prepared for HCFA
|
|
Culturally competent
services |
# of services
types adapted to different cultures |
|
X
|
|
|
|
|
The New York
State Office of Mental Health. The Research Foundation
for Mental Hygiene. (September 1998) Cultural
Competence Performance Measures for Managed Behavioral
Healthcare Programs. In Collaboration with
the Center for the Study of Issues in Public Mental
Health. Funded by the Substance Abuse and Mental
Health Services Administration, Center for Mental
Health Services. |
|
Culturally competent
service |
Indicators of
a culturally competent treatment service provided
to minority members in health plan:
Consumer and family satisfaction with treatment
services. Inclusion
of culturally specific activities and domains
of daily living (e.g., housing, access to primary
health care and maintenance, family role, behavioral/developmental,
vocational/ educational/employment, and community
tenure) in treatment services.
Benchmark: Comparable to overall population served
and significant improvement in at least one domain
of function for more than 75% of consumers.
Rates of symptom relapse and recidivism into restrictive
level of care or other restrictive placements.
Benchmark: Comparable to overall population served
and significant reductions over time.
Rates of medication side effects, adverse incidents,
and utilization of latest pharmacological interventions.
Benchmark: Comparable to overall population served
and reduction of medication side effects and adverse
incidents. Rates
of adverse occurrences during treatment (e.g.,
suicide, homicide, self-injury, accidents, physical
and sexual abuse) within comparable age groups.
|
|
|
X
|
|
|
|
Center for Mental
Health Services (Nov, 1998)) Cultural Competence
in Managed Care. Overall System Standards and
Implementation Guidelines. Mental Health
Services for Four Underserved/ Underrepresented
Racial/Ethnic Groups Prepared for Substance Abuse
and Mental Health Services Administration. Purchase
Order No. 97MO4762401D |
|
Culturally competent
service |
Demonstrated
incorporation of value of cultural identity, including
ethnicity (subgroup membership and mixed origin)
and other relevant factors in treatment services.
|
|
|
|
X
|
|
|
Center for Mental
Health Services (Nov, 1998)) Cultural Competence
in Managed Care. Overall System Standards and
Implementation Guidelines. Mental Health
Services for Four Underserved/ Underrepresented
Racial/Ethnic Groups Prepared for Substance Abuse
and Mental Health Services Administration. Purchase
Order No. 97MO4762401D |
|
Culturally competent
services |
Culturally competent
service provision by managed care organizations
whose "covered lives" include minorities:
Effectiveness of
an outreach program for Puerto Rican adolescents
with asthma in conjunction with population-based
measures of restricted activity caused by asthma;
Mammography rates
among minority women;
Member satisfaction with language and cultural
translation (or brokering) services |
|
|
X
|
|
|
|
Risa Lavizzo-Mourey,
MD, MBA
Elizabeth R. Mackenzie, PhD
(1996) Cultural Competence: Essential
Measurements of Quality for Managed Care Organizations.
Annals of Internal Medicine, 124:919-921. |
|
Culturally competence
and quality of care |
Indicators of
quality of care provided by health plan:
Proportional representation of consumers from
various racial/ethnic groups, providers, and community
members on the quality improvement team.
Occurrence of quality studies focusing on the
use of best practice in resolution of deficiencies
in the care of consumers from racial/ethnic groups.
Linguistically
and culturally factored consumer satisfaction
surveys which are independently administered and
include Health Plan drop-outs and short term recipients.
Regular reporting
of racial/ethnic specific quality assurance data
to the governing entity, including appeals and
grievances. Rates
of drop-out, grievances, restrictive care, unusual
occurrences, and adverse events for consumers
from racial/ethnic groups. |
|
X
|
|
|
|
|
Center for Mental
Health Services (Nov, 1998)) Cultural Competence
in Managed Care. Overall System Standards and
Implementation Guidelines. Mental Health
Services for Four Underserved/ Underrepresented
Racial/Ethnic Groups Prepared for Substance Abuse
and Mental Health Services Administration. Purchase
Order No. 97MO4762401D |
|
Culturally competent
health benefit design |
Indicators of
culturally competent benefit design by health
plan: Culturally
competent eligibility and level of care criteria
are formally established.
Eligibility determinations and service planning
are performed by, or under the supervision of
linguistically and culturally competent bilingual/bicultural
specialists. Consumers
from the various racial/ethnic groups receive
direct services provided by or from culturally
competent bilingual/bicultural personnel, or by
personnel supervised by culturally competent bilingual/bicultural
racial/ethnic mental health specialists.
Consumers receive consumer-friendly bilingual
materials on Health Plan benefits.
Percent of covered consumers who know benefits
and how to access them. |
|
X |
|
|
|
|
Center for Mental
Health Services (Nov, 1998)) Cultural Competence
in Managed Care. Overall System Standards and
Implementation Guidelines. Mental Health
Services for Four Underserved/ Underrepresented
Racial/Ethnic Groups Prepared for Substance Abuse
and Mental Health Services Administration. Purchase
Order No. 97MO4762401D |
|
Culturally competent
treatment plan |
The organization
has a written policy and a demonstrated practice
linking families to advocacy and education groups.
|
|
X |
|
|
|
|
Center for Mental
Health Services (Nov, 1998)) Cultural Competence
in Managed Care. Overall System Standards and
Implementation Guidelines. Mental Health
Services for Four Underserved/ Underrepresented
Racial/Ethnic Groups Prepared for Substance Abuse
and Mental Health Services Administration. Purchase
Order No. 97MO4762401D |
|
Culturally competent
treatment plan |
There is evidence
in the Treatment Plan that proposed psychotherapeutic
modalities address specific cultural issues and
are conducted with specific cultural values. |
|
|
|
X
|
|
|
Center for Mental
Health Services (Nov, 1998)) Cultural Competence
in Managed Care. Overall System Standards and
Implementation Guidelines. Mental Health
Services for Four Underserved/ Underrepresented
Racial/Ethnic Groups Prepared for Substance Abuse
and Mental Health Services Administration. Purchase
Order No. 97MO4762401D |
|
Culturally competent
care |
Culturally Competent
care: · Conducts home
visits for special outreach ·
Sponsors a community health fair
Works with local organizations and community leaders
|
|
X
|
|
|
|
|
Maternal and
Child Health Bureau (1990) State Children
with Special Health Care Needs Title V Directory
Workshop: Improving State Services for Culturally
Diverse Populations. |
|
Input into treatment
decision and service quality |
Use of culturally
appropriate community resources (e.g., family,
clans, etc) in the development of treatment plans.
|
|
X
|
|
|
|
|
Center for Mental
Health Services (Nov, 1998)) Cultural Competence
in Managed Care. Overall System Standards and
Implementation Guidelines. Mental Health
Services for Four Underserved/ Underrepresented
Racial/Ethnic Groups Prepared for Substance Abuse
and Mental Health Services Administration. Purchase
Order No. 97MO4762401D |
|
Input into treatment
decision and service quality |
Use of culturally
informed individuals, including family members
when appropriate, by clinicians serving consumers
from various racial/ethnic groups. |
|
X
|
|
|
|
|
Center for Mental
Health Services (Nov, 1998)) Cultural Competence
in Managed Care. Overall System Standards and
Implementation Guidelines. Mental Health
Services for Four Underserved/ Underrepresented
Racial/Ethnic Groups Prepared for Substance Abuse
and Mental Health Services Administration. Purchase
Order No. 97MO4762401D |
|
Input into treatment
decision and service quality |
The Treatment Plan reflects both consumer and family
involvement in its development and agreement. The
degree of family involvement depends on the wishes
of the consumer.
The Treatment Plan was developed with a culturally
competent clinician or consultation from such a
clinician Consumer
and family involvement and investment in the development
of, and agreement with, the Care Plan.
Culturally defined needs addressed in the care plans
of consumers from various racial/ethnic groups.
Leadership by racial/ethnic
Mental Health Specialists in the care planning process
for consumers from various racial/ethnic groups.
|
|
X
|
|
|
|
|
Center for Mental
Health Services (Nov, 1998)) Cultural Competence
in Managed Care. Overall System Standards and
Implementation Guidelines. Mental Health
Services for Four Underserved/ Underrepresented
Racial/Ethnic Groups Prepared for Substance Abuse
and Mental Health Services Administration. Purchase
Order No. 97MO4762401D |
|
Input into treatment
decision and service quality |
·
Involves culturally diverse groups in the planning
process Conducts
focus groups concerning the needs of cultural groups
|
|
X
|
|
|
|
|
Maternal and
Child Health Bureau (1990-1991). Improving State
Services for Culturally Diverse Populations: MCHB’s
Division of Services for Children with Special
Health Needs Activities |
|
Use of medicines
according to cultural belief and ethnopharmacology
|
|
|
|
|
|
|
|
|
|
Use of traditional
healers and healing methods |
Integration of “natural supports” (i.e., family
members, religious and spiritual resources, traditional
healers, churches, etc.) in the treatment care plan.
Inclusion of traditional
healers in the Care Plan for consumers or family
from the various racial/ethnic groups, except when
contraindicated. |
|
X
|
|
|
|
|
Center for Mental
Health Services (Nov, 1998)) Cultural Competence
in Managed Care. Overall System Standards and
Implementation Guidelines. Mental Health
Services for Four Underserved/ Underrepresented
Racial/Ethnic Groups Prepared for Substance Abuse
and Mental Health Services Administration. Purchase
Order No. 97MO4762401D |
|
Use of traditional
healers and healing methods |
Provider utilizes
indigenous healing practices and the role of belief
systems (religion and spirituality) in the treatment
of consumers from underserved/ underrepresented
groups. |
|
|
|
X
|
|
|
Center for Mental
Health Services (Nov, 1998)) Cultural Competence
in Managed Care. Overall System Standards and
Implementation Guidelines. Mental Health
Services for Four Underserved/ Underrepresented
Racial/Ethnic Groups Prepared for Substance Abuse
and Mental Health Services Administration. Purchase
Order No. 97MO4762401D |
|
Use of traditional
healers and healing methods |
# natural helpers, alternative community resources
included in health plan resource directory
# of referrals to culturally competent services
by health plan |
|
X
|
|
|
|
|
The New York
State Office of Mental Health. The Research Foundation
for Mental Hygiene. (September 1998) Cultural
Competence Performance Measures for Managed Behavioral
Healthcare Programs. In Collaboration with
the Center for the Study of Issues in Public Mental
Health. Funded by the Substance Abuse and Mental
Health Services Administration, Center for Mental
Health Services. |
|
Use of traditional
healers and healing methods |
Percent of consumers
receiving services by traditional healers. |
|
X
|
|
|
|
|
Office of Minority Health (1999) Assuring Cultural
Competence in Health Care: Recommendations for National
Standards and an Outcomes-Focused Research Agenda
Recommended Standards for Culturally and Linguistically
Appropriate Health Care Services.
The Bureau of Primary Health Care. (1999). Cultural
Competence: A Journey. Health Resources and
Services Administration, Bureau of Primary Health
Care. |
|
Use of traditional
healers and healing methods |
MCO provides
and documents awareness training in “non-traditional,
alternative, and complementary health practices
which providers may encounter in their clinical
practice, and to consider these in the context
of cultural beliefs and values. |
|
X
|
|
|
|
|
Abt Associates (January,
2000). Report on Recommendations for Measures of
Cultural Competence for the Quality Improvement
System for Managed Care. Report prepared for HCFA.
|
|
Use of interdisciplinary
teams |
Coordination
of services and case management a the community
level that is appropriate for diverse populations.
|
|
X
|
|
|
|
|
Maternal and
Child Health Bureau (1990) State Children
with Special Health Care Needs Title V Directory
Workshop: Improving State Services for Culturally
Diverse Populations. |
|
Use of inter-disciplinary
teams |
MCO self-certifies
that it has developed and implemented policies
and procedures to support cross-disciplinary practice
among “traditional” clinicians (e.g., doctors,
nurses, therapists, etc.) and with caregivers
from other backgrounds (e.g., acupuncturists,
chiropractors, traditional healers, etc.)
MCO provides and documents clinician training
on interdisciplinary collaboration, includes training
specific to caregivers commonly serving MCO enrollees.
|
|
X |
|
|
|
|
Abt Associates (January,
2000). Report on Recommendations for Measures of
Cultural Competence for the Quality Improvement
System for Managed Care. Report prepared for HCFA.
|
FAMILY AND COMMUNITY
PARTICIPATION |
Family centered
care |
Method to assure
representation of different perspectives in a
community-based strategic planning process such
as the inclusion of:
consumers and consumer groups
ethnic, racial, and/or cultural minority groups
pediatric / adolescent health care providers
non-profit agencies
insurance/business representatives
legislators
religious groups
school district officials |
X
|
|
|
|
|
|
Johns Hopkins University
(1995) Child Health Systems Primary Care Assessment:
Community Self-Assessment Guide. Child
Adolescent Policy Center at JHU. Prepared
for MCHB |
|
Family centered
care |
Community and family
members of diverse cultures are involved in all
partnerships and collaborations of the system. |
|
X |
|
|
|
|
Maternal and
Child Health Bureau (1990) State Children
with Special Health Care Needs Title V Directory
Workshop: Improving State Services for Culturally
Diverse Populations. |
|
Family centered
care |
Patient Survey:
Do members of your
family or friends play a role in your making health
decisions? Does
your doctor ask you about family members’ or friends’
roles in your health-related decisions and actions?
If you have told
you doctor that your family or friends play a
role in your health related decisions and actions,
how often does he or she make an effort to communicate
with that person or persons?
When you are discussing serious conditions or
therapies, how often does your doctor have other
adult family members in the room with you taking
part in your discussions? |
|
X
|
|
|
|
|
Munoz, R.H.,
Sanchez, A.M. Developing Culturally Competent
Systems of Care for State Mental Health Services.
Center for Mental Health Services, Substance
Abuse and Mental Health Services Administration.
Prepared for the Substance Abuse and Mental Health
Services Administration under contract No. 94MF113927
|
|
Community and
consumer participation |
Program self-assessment
survey on policies and procedures:
Which of the groups below, reflecting clients’
cultures, does the program contact from time to
time? (These contacts could serve some or all
of the following purposes: referral exchanges,
staff or board recruitment and training, public
information or education, client or community
advocacy, etc.
- Folk healers
or practitioners
- Clergy and
their congregations
- Media (radio,
TV, newspapers, magazines) and media staff or
personalities
- Civil/human
rights organizations, advocacy groups, tribal
or cultural organizations or other groups which
work for systems change
- Business leaders
- Service providers
- Special programs
for minority education or minority studies
- Other |
|
|
|
X
|
|
|
Weiss, C. I.,
& Minsky, S. (1994). Program self-assessment
survey for cultural competence: A manual. New
Jersey Division of Mental Health and Hospitals.
|
|
Community and
consumer participation |
Extent of family/consumer
representation on coordinating council for families,
professionals, educators |
X
|
|
|
|
|
|
Maternal and
Child Health Bureau (1995) Systems Indicator:
Development of Community Performance Measures.
A Preliminary Strategy for Assessing Community
Systems of Care for Women, Children and Adolescents.
|
|
Community and
consumer participation |
Extent of family
participation in community needs assessment, planning,
implementation and evaluation of a system of care
|
|
X
|
|
|
|
|
Maternal and
Child Health Bureau (1995) Systems Indicator:
Development of Community Performance Measures.
A Preliminary Strategy for Assessing Community
Systems of Care for Women, Children and Adolescents.
|
|
Community and
consumer participation |
Extent to which
systems utilize family members as providers of
care coordination and peer counseling. |
|
X
|
|
|
|
|
Maternal and
Child Health Bureau (1995) Systems Indicator:
Development of Community Performance Measures.
A Preliminary Strategy for Assessing Community
Systems of Care for Women, Children and Adolescents.
|
|
Community and
consumer participation |
Degree to which
families participate in key decision-making activities.
(Checklist) Family
participation on advisory committees or task forces;
Hiring of family
members to serve as consultants to providers/programs;
and Inclusion of
family members in planning, implementation and
evaluation of program activities. |
|
X
|
|
|
|
|
Maternal and
Child Health Bureau (2000) Draft performance measures.
Prepared by The Lewin Group. |
|
Community and
consumer participation |
Utilize family
members as speakers |
|
X
|
|
|
|
|
Johns Hopkins
University (1995) Child Health Systems Primary
Care Assessment: Community Self-Assessment Guide.
Child and Adolescent Policy Center at Johns Hopkins
University. Prepared for the Maternal and Child
Health Bureau. |
|
Community and
consumer participation |
# of meetings with family, AMI groups, advocate
participation (Data source: attendance records)
Family, advocate,
participants represent cultures of the community
(Data source: attendance records
Family satisfaction with meetings (Data source:
participant evaluation form) |
|
X
|
|
|
|
|
The New York
State Office of Mental Health. The Research Foundation
for Mental Hygiene. (September 1998) Cultural
Competence Performance Measures for Managed Behavioral
Healthcare Programs. In Collaboration with
the Center for the Study of Issues in Public Mental
Health. Funded by the Substance Abuse and Mental
Health Services Administration, Center for Mental
Health Services. |
|
Community and
consumer participation |
# of meeting with consumer participation (Data source:
attendance records)
Consumers participants represent cultures of the
community (Data source: attendance records)
Consumer satisfaction with meetings (Data source:
participant evaluation form) |
|
X
|
|
|
|
|
The New York
State Office of Mental Health. The Research Foundation
for Mental Hygiene. (September 1998) Cultural
Competence Performance Measures for Managed Behavioral
Healthcare Programs. In Collaboration with
the Center for the Study of Issues in Public Mental
Health. Funded by the Substance Abuse and Mental
Health Services Administration, Center for Mental
Health Services. |
|
Community and
consumer participation |
# of meetings
with community leaders, key informant (i.e., politicians,
law enforcement, business, clergy) participation
|
|
X
|
|
|
|
|
The New York
State Office of Mental Health. The Research Foundation
for Mental Hygiene. (September 1998) Cultural
Competence Performance Measures for Managed Behavioral
Healthcare Programs. In Collaboration with
the Center for the Study of Issues in Public Mental
Health. Funded by the Substance Abuse and Mental
Health Services Administration, Center for Mental
Health Services. |
|
Community and
consumer participation |
Utilize formal
mechanisms for community and consumer involvement
in the design and execution of service delivery,
including planning, policy making, operations,
evaluation, training and, as appropriate, treatment
planning. |
X
|
|
|
|
|
|
Office of Minority
Health (1999) Assuring Cultural Competence in
Health Care: Recommendations for National Standards
and an Outcomes-Focused Research Agenda Recommended
Standards for Culturally and Linguistically Appropriate
Health Care Services. |
|
Community and
consumer participation |
Including extended family members in family/provider
meetings and conferences
Participation by culturally diverse families in
local and State policy and planning groups, and
on project advisory boards. |
|
X
|
|
|
|
|
Maternal and
Child Health Bureau (1990) State Children
with Special Health Care Needs Title V Directory
Workshop: Improving State Services for Culturally
Diverse Populations. |
|
Family focus,
family-oriented, recognition of the uniqueness
of the role of the family |
Degree to which:
Include parents
on advisory group
Developed parent advisory committees
Hired parents as staff |
|
X
|
|
|
|
|
Nelkin, V.S.
(1994) Implementing the Surgeon General’s Action
Agenda. Survey of SPRANS Grantees. Prepared for
the Maternal and Child Health Bureau. |
|
Family focus,
family-oriented, recognition of the uniqueness
of the role of the family |
Degree to which:
Conducted focus
group with families
Include parents as partners in policymaking
Include parents as partners in planing and implementation
|
|
X
|
|
|
|
|
Nelkin, V.S.
(1994) Implementing the Surgeon General’s Action
Agenda. Survey of SPRANS Grantees. Prepared for
the Maternal and Child Health Bureau. |
|
Family focus,
family-oriented, recognition of the uniqueness
of the role of the family |
Family participation
in development of training curriculum
Provide input through family advisory group
Incorporate review by families of training materials
Parents consult
and assist in developing materials |
|
X
|
|
|
|
|
Nelkin, V.S.
(1994) Implementing the Surgeon General’s Action
Agenda. Survey of SPRANS Grantees. Prepared for
the Maternal and Child Health Bureau. |
|
Coalition-building
|
Developed a family
resource network |
X
|
|
|
|
|
|
Nelkin, V.S.
(1994) Implementing the Surgeon General’s Action
Agenda. Survey of SPRANS Grantees. Prepared for
the Maternal and Child Health Bureau. |
|
Coalition-building
|
Developed a parent-to-parent
network which includes the following elements:
Provide financial
support to families to facilitate parent-to-parent
program Disseminate
information through parent resource centers
Provide mentors for “new” parents entering the
system Developed
a parent support telephone network |
X
|
|
|
|
|
|
Nelkin, V.S.
(1994) Implementing the Surgeon General’s Action
Agenda. Survey of SPRANS Grantees. Prepared for
the Maternal and Child Health Bureau. |
|
Coalition-building
|
Education and training linkages are made with faith-based
organizations in the community.
The organization coordinates education and outreach
activities with community cultural organizations.
|
X
|
|
|
|
|
|
Center for Mental
Health Services (Nov, 1998)) Cultural Competence
in Managed Care. Overall System Standards and
Implementation Guidelines. Mental Health
Services for Four Underserved/ Underrepresented
Racial/Ethnic Groups Prepared for Substance Abuse
and Mental Health Services Administration. Purchase
Order No. 97MO4762401D |
|
Coalition-building
|
Developing interstate
coalitions to promote continuity in care, and
to deal with eligibility, identification and tracking
and case management issues. |
X
|
|
|
|
|
|
Maternal and
Child Health Bureau (1990) State Children
with Special Health Care Needs Title V Directory
Workshop: Improving State Services for Culturally
Diverse Populations. |
|
Community outreach
|
MCO publicly reports on community involvement (e.g.,
community benefits reporting model)
External reviewer evaluates level of community involvement
|
X
|
|
|
|
|
|
Abt Associates (January,
2000). Report on Recommendations for Measures of
Cultural Competence for the Quality Improvement
System for Managed Care. Report prepared for HCFA.
|
MONITORING,
EVALUTION AND RESEARCH |
Consumer/Member
satisfaction and feedback |
Satisfaction
rates due to communication styles and linguistically
competent services to racial/ethnic consumers.
|
|
|
X
|
|
|
|
Center for Mental
Health Services (Nov, 1998)) Cultural Competence
in Managed Care. Overall System Standards and
Implementation Guidelines. Mental Health
Services for Four Underserved/ Underrepresented
Racial/Ethnic Groups Prepared for Substance Abuse
and Mental Health Services Administration. Purchase
Order No. 97MO4762401D |
|
Consumer/Member
satisfaction and feedback |
MCO assesses patient satisfaction and clinician
satisfaction with access to alternative health practices
MCO assesses patient
and clinician satisfaction with access to team-based
care including participation of caregivers from
diverse communities. |
|
|
|
X
|
|
|
Abt Associates (January,
2000). Report on Recommendations for Measures of
Cultural Competence for the Quality Improvement
System for Managed Care. Report prepared for HCFA.
|
|
Consumer/Member
satisfaction and feedback |
% of consumers
satisfied cultural competence of MCO as measures
by: Did the MCO
allow you to communicate in your preferred language?
Was the MCO respectful
of your health beliefs and practices?
Do you have a preference regarding the demographic
characteristics of your clinician?
Were you able to choose a clinician that had these
charactert> |
|
|
X
|
|
|
|
Abt Associates (January,
2000). Report on Recommendations for Measures of
Cultural Competence for the Quality Improvement
System for Managed Care. Report prepared for HCFA.
|
|
Community needs
assessment |
Organization
has the capacity to conduct community profiles
containing information on the percentage of the
following that characterize target population:
% cultures
% age and % gender
% religions % refugees
and immigrants
% income distribution
% unemployed %
languages spoken and read
% non-English speaking
% 4th grade reading levels
types alternative/ complementary services |
X
|
|
|
|
|
|
The New York
State Office of Mental Health. The Research Foundation
for Mental Hygiene. (September 1998) Cultural
Competence Performance Measures for Managed Behavioral
Healthcare Programs. In Collaboration with
the Center for the Study of Issues in Public Mental
Health. Funded by the Substance Abuse and Mental
Health Services Administration, Center for Mental
Health Services. |
|
Community needs
assessment |
Organization
has the capacity to conduct enrollee profile contains
the following information:
% cultures % age
and % gender %
religions % refugees
and immigrants
% income distribution
% unemployed %
languages spoken and read
% non-English speaking
% 4th grade reading levels
types alternative/ complementary services
prior service use |
X
|
|
|
|
|
|
The New York
State Office of Mental Health. The Research Foundation
for Mental Hygiene. (September 1998) Cultural
Competence Performance Measures for Managed Behavioral
Healthcare Programs. In Collaboration with
the Center for the Study of Issues in Public Mental
Health. Funded by the Substance Abuse and Mental
Health Services Administration, Center for Mental
Health Services. |
|
Community needs
assessment |
The Managed Care Mental Health Plan assesses the
existence of racial/ethnic groups in the population
being served, assesses the needs and risk factors
associated with those populations, and takes these
factors into consideration in prevention, education,
and outreach activities.
The Managed Care Mental Health Plan maintains a
list of cultural community organizations and documents
the utilization of these organizations to assist
in education and outreach |
X
|
|
|
|
|
|
Center for Mental
Health Services (Nov, 1998)) Cultural Competence
in Managed Care. Overall System Standards and
Implementation Guidelines. Mental Health
Services for Four Underserved/ Underrepresented
Racial/Ethnic Groups Prepared for Substance Abuse
and Mental Health Services Administration. Purchase
Order No. 97MO4762401D |
|
Community needs
assessment |
MCO self-certifies that is obtains community input
regarding needs MCO
self-certifies that is obtains community input via
specific mechanisms (e.g., surveys, focus groups,
public meetings, advisory committees)
Self-certifies that specific information is provided
(e.g., demographics on race/ethnicity/gender/age/language/religion/sexual
orientation) Collects
information on patients’ racial and ethnic self-identification
and primary language.
Analyzes utilization of services and outcomes to
identify disparities among groups and uses this
information to improve performance. |
X
|
|
|
|
|
|
Abt Associates (January,
2000). Report on Recommendations for Measures of
Cultural Competence for the Quality Improvement
System for Managed Care. Report prepared for HCFA.
|
|
Community needs
assessment |
Provider Survey
on Knowledge of Communities:
How well are you able to describe the communities
of color in your service area? (not at all, barely,
fairly well, very well)
List the cultural groups of color who reside in
your service area and how much of the overall
population this represents.
How well are you able to describe within-group
differences? (not at all, barely, fairly well,
very well) How
well are you able to describe the strengths of
the groups of color in your service area? (not
at all, barely, fairly well, very well)
How well are you able to describe the social problems
of the groups of color in your service area? (not
at all, barely, fairly well, very well)
Do you know the prevailing beliefs, customs, norms
and values of the groups of color in your service
area? (not at all, barely, fairly well, very well)
Do you know the
greeting protocol within communities of color?
(not at all, barely, fairly well, very well) |
X
|
|
|
|
|
|
Mason (1995)
Cultural Competence Self Assessment Questionnaire:
A Manual for Users. Multicultural Initiative Project,
Portland Sate University, Research and Training
Center on Family Support and Children’s Mental
Health. |
|
Organizational
Assessment |
·
Percent of staff saying MCO is not competent to
care for some group.
·
Average percent of enrollees in groups for whom
staff members say MCO does not provide competent
care. |
|
X
|
|
|
|
|
Abt Associates (January,
2000). Report on Recommendations for Measures of
Cultural Competence for the Quality Improvement
System for Managed Care. Report prepared for HCFA.
|
|
Organizational
Assessment |
Conduct of ongoing organizational self-assessments
of cultural and linguistic competence, and integration
measures of access, satisfaction, quality, and outcomes
into other organizational internal audits and performance
improvement programs.
Prepare an annual progress report documenting the
organization’s progress with implementing CLAS standards,
including information on programs, staffing, and
resources. |
X
|
|
|
|
|
|
Office of Minority
Health (1999) Assuring Cultural Competence in
Health Care: Recommendations for National Standards
and an Outcomes-Focused Research Agenda Recommended
Standards for Culturally and Linguistically Appropriate
Health Care Services. |
|
Evaluation of
health plans |
Time from point
of first contact through service provision for
all levels of care are tracked by age, gender,
ethnicity (i.e., particular subgroup and mixed
origins), primary language, and level of functioning.
|
X
|
|
|
|
|
|
Center for Mental
Health Services (Nov, 1998)) Cultural Competence
in Managed Care. Overall System Standards and
Implementation Guidelines. Mental Health
Services for Four Underserved/ Underrepresented
Racial/Ethnic Groups Prepared for Substance Abuse
and Mental Health Services Administration. Purchase
Order No. 97MO4762401D |
|
Evaluation of
health plans |
Tracking of health
plans’ authorizations decisions including denials,
rationale, and disposition by ethnicity. |
X
|
|
|
|
|
|
Center for Mental
Health Services (Nov, 1998)) Cultural Competence
in Managed Care. Overall System Standards and
Implementation Guidelines. Mental Health
Services for Four Underserved/ Underrepresented
Racial/Ethnic Groups Prepared for Substance Abuse
and Mental Health Services Administration. Purchase
Order No. 97MO4762401D |
|
Evaluation of
services |
Measure of program
retention and drop out rates through: rates of
service use, reason-specific no-show rates, reason-specific
drop-out rates |
|
|
X
|
|
|
|
The New York
State Office of Mental Health. The Research Foundation
for Mental Hygiene. (September 1998) Cultural
Competence Performance Measures for Managed Behavioral
Healthcare Programs. In Collaboration with
the Center for the Study of Issues in Public Mental
Health. Funded by the Substance Abuse and Mental
Health Services Administration, Center for Mental
Health Services. |
|
Evaluation of
provider |
Percentage of
complaints and grievances of individual practitioners
is tracked and factored into performance evaluations.
|
|
X
|
|
|
|
|
Office of Minority
Health (1999) Assuring Cultural Competence in
Health Care: Recommendations for National Standards
and an Outcomes-Focused Research Agenda Recommended
Standards for Culturally and Linguistically Appropriate
Health Care Services. |