Cultural Competency Resources

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Glossary of Terms

Additional Terms Related to Cultural Competence
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  • Cultural appropriateness, awareness, congruence, diversity, humility, knowledge, pluralism, proficiency, responsiveness, security, safety, and sensitivity
  • Intercultural effectiveness, interactivity, readiness, sensitivity, adjustment
  • Multiculturalism
  • Transculturalism
  • Cross-cultural competencies
  • Equity intervention

Cultural Competence Plan Requirements (CCPR)
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The CCPR provide a framework for the planning, implementation, and evaluation of services with the goal of eliminating cultural, linguistic, racial, and ethnic mental health and substance use disorder disparities. The CCPR are organized under the following eight separate criteria:

  • Criterion (CR) 1: Commitment to Cultural Competence
    • Promotes commitment to planning, service delivery and evaluation to be based on cultural and linguistic competence
  • CR 2: Updated Assessment of Service Needs
    • Requires the collection, analysis and reporting of demographic, consumer utilization, and mental health disparities data. Specifications include: general County population by ethnicity, age, and gender; Medi-Cal population service needs by ethnicity, language, age, and gender; 200% Below Federal Level of Poverty Population Service Needs; and Analysis of disparities by ethnicity, age, gender, and threshold language
  • CR 3: Strategies and Efforts for Reducing Racial, Ethnic, Cultural and Linguistic Mental Health Disparities
    • Identifies strategies in place to address the needs of unserved/ underserved target populations with disparities for Medi-Cal and MHSA funded populations
  • CR 4: Client/Family Member/Community Committee
    • Supports the rationale for the departmental Cultural Competency Committee as a State requirement
  • CR 5: Culturally Competent Training Activities
    • Specifies that 100% of the workforce from Directly Operated, Legal Entities/Contracted Providers, and Administrative programs must receive annual cultural competence training
  • CR 6: County’s Commitment to Growing a Multicultural Workforce Highlights recruitment, hiring and retention strategies conducive to strengthening the system of care with culturally and linguistically diverse workforce capable of meeting the needs of constituents
  • CR 7: Language Capacity
    • Emphasizes mandates related to the provision of mental health services to persons who have Limited English Proficiency (LEP)
  • CR 8: Adaptation of Services
    • Promotes the implementation and utilization of consumer-driven/operated recovery and wellbeing programs, consumer outcome measures, and grievance and complaint process
    • Source: DHCS, Info Notice 10-02

Cultural Humility
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A lifelong process of self-awareness, self-reflection and self-critique with the goal of identifying preconceptions, addressing power imbalances, striving to respect any differences while providing health care services, and developing partnerships with communities.

Source: Alsharif, N. Z. PharmD, PhD. (2012). American Journal of Pharmaceutical Education. Cultural Humility and Interprofessional Education and Practice: A Winning Combination. (Adapted)

Culture
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The integrated pattern of thoughts, communication, actions, customs, beliefs, values, and institutions associated, wholly or partially, with racial, ethnic, or linguistic groups, as well as religious, spiritual, biological, geographical, or sociological characteristics.

Source: National Standards for Culturally and Linguistically Appropriate Services (CLAS) in Health and Health Care: A Blueprint for Advancing and Sustaining CLAS Policy and Practice, April 2013

Disparities
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A type of health difference/outcome that is closely linked with social, economic, and/or environmental disadvantage which result in worse health or greater health risks than more advantaged social groups. Source: Center for Medicare Advocacy

Ethnic Services Manager (ESM)
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The designated County person responsible to: align Department’s response to the local, State and Federal cultural competence requirements; development and implementation of policies and procedures pertinent to cultural competence, tracking of service utilization outcomes; and promoting inclusion of cultural and linguistic competence in departmental practices, policies with the goal of increasing health equity and decreasing mental health disparities.

Health Inequities
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Differences in health status that occur among population groups defined by specific characteristics. They mostly result from inequalities in the distribution of the underlying determinants of health across populations. Source: Reducing Health Disparities – Roles of the Health Sector: Recommended Policy Directions and Activities (Adapted).

Implicit Bias
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Unconscious and unintentional biases are likely formed by associations in the brain that link two ideas together (i.e. a group of people with a trait), through early experiences, affective experiences, and learned cultural perspectives. Implicit biases allow individuals to easily understand and interact with their world, especially in uncertain situations.Source: Royer, C., Hido, D., & Slotnick, M. (2010). Defining Implicit Bias. Cornell University Law School Social Science and Law.

Individual and Organizational Cultural Competence
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    • Individual cultural competence refers to a set of attitudes, knowledge, and skills that enable the person or individual to interact effectively in cross-cultural situations.
    • Organizational cultural competence refers to the existence of policies, procedures, practices, and organizational infrastructure to support the delivery of culturally and linguistically sensitive and appropriate health care services where culture is broadly defined.

Source: Cross, T.L., Bazron, B.J., Dennis, K.W., and Issacs, M.R.(1989). Towards a culturally competent system of care. Washington, DC: Georgetown University Child Development Center, CASSP Technical Assistance Center.

National Standards for Culturally and Linguistically Appropriate Services (CLAS) for Healthcare Organizations
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The 15 National CLAS Standards intend to advance health equity, improve quality, and help eliminate health care disparities by providing a blueprint for individuals and health and health care organizations to implement culturally and linguistically appropriate services. Overall, the CLAS Standards specify that health care organizations are federally required to provide effective, equitable, understandable, and respectful quality care and services that are responsive to diverse cultural health beliefs and practices, preferred languages, health literacy, and other communication needs. Source: National Standards for Culturally and Linguistically Appropriate Services (CLAS) in Health and Health Care: A Blueprint for Advancing and Sustaining CLAS Policy and Practice, April 2013

Social Determinants of Health
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Refers to the collective impact on health derived from each person’s biology and genetics; health practices; access to, utilization and quality of health services; social factors; geography and neighborhood; exposure to stress; and the environment Source: Office of Disease Prevention and Health Promotion. Healthy People 2020.
LACDMH Strategies to reduce mental health disparities and increase health equity
      • Outreach & Engagement
      • Community education to increase mental health awareness and decrease stigma
      • Multi-lingual/multicultural materials
      • Collaboration with faith-based and other trusted community entities/groups
      • School-based services
      • Field-based services
      • Programs and projects that target specific ethnic and language groups
      • Designating and tracking ethnic targets for Full Service Partnerships (FSP)
      • Flexibility in FSP enrollment such as allowing “those living with family” to qualify as “at-risk of homeless”
      • Countywide FSP Networks to increase linguistic and cultural access
      • Integrated Supportive Services
      • Co-location with other county departments (DCFS, DPSS, DHS)
      • Interagency Collaboration
      • Consultation to gatekeepers
      • Trainings/case consultation
      • Provider communication and support
      • Multi-lingual/multi-cultural staff development and support
      • Evidence-based Practices/Community-defined Evidence for ethnic populations
      • Investments in learning
      • Increase mental health service accessibility to underserved populations
      • Physical health, mental health and substance abuse service integration
      • Utilizing community’s knowledge and capacity to identify and prescribe ways of promoting health and well-being from within
      • Implementation of new departmental policies and procedures that improve the quality and timeliness of mental health services
      • Implementation of new technologies to enhance the Department’s service delivery
      • Creation of new committees, subcommittees and taskforces that address cultural and linguistic competent service delivery.
      • Health Agency level collaborations to enhance the cultural and linguistic competence within and across Departments of Health Services, Mental Health, and Public Health
LACDMH Cultural Competency Policies and Procedures
      • Policy 200.02 – Interpreter Services for the Deaf and Hard of Hearing Community
      • Policy 200.03 – Language Translation and Interpretater Services
      • Policy 200.09 – Culturally and Linguistically Inclusive Services (currently being developed)
      • Policy 602.01 – Bilingual Bonus
      • Parameters for Clinical Care:
        • Delivery of Culturally Competent Clinical Services
        • Peer Advocates
        • Spiritual Support
        • Family Inclusion
        • Assessment and Treatment of Individuals with Co-Occurring Intellectual Disabilities
        • Treatment of Co-Occurring Substance Use Disorders