What is Cultural Competence? What is Linguistic Competence? What is Title VI?
CulturalCompetence is a set of congruent behaviors, attitudes, and policies that come together in a system, agency, or among professionals that enable them to work effectively in cross-cultural situations. CULTURAL COMPETENCE IS AN ONGOING PROCESS
Cultural competence begins with an honest desire not to allow biases to keep us from treating individuals with respect. It requires an honest assessment of our positive and negative assumptions about others. It requires us to avoid negative stereotypes and prejudices.
Cultural Competence = Quality of Care Cultural Competence = Disparity Reduction Cultural Competence = Risk Management Cultural Competence = Parity (within MH system) Cultural Competence = Linguistic Competence Cultural Competence = A Social Responsibility
Asians Latinos/HispanicsETIC Approach Blacks Whites etc. Vietnam individual Mexican individual African A. individualEMIC Approach Haitian individual Anglo individual 6
Cultural Efficiency Cultural Competence Cultural Pre-Competence Cultural Blindness Cultural Incapacity Cultural DestructivenessBy Georgetown University’s Child Development Center(Cross, Bazaron, Dennis & Isaacs, 1989)
The capacity of an organization and its personnel to communicate effectively and to convey information in a manner that is easily understood by diverse audiences; including persons of limited English proficiency, those who have low literacy skills or are not literate, individuals with disabilities, and those who are deaf or hard of hearing.
Linguistic competence requires organizational and provider capacity to respond effectively to the health and mental health literacy needs of populations served. Organizations must have policies, structures, practices, procedures and dedicated resources to support the capacity.
Linguistically competent agencies have: Bilingual/bicultural or multilingual/multicultural staff Cultural brokers Foreign language interpretation services including distance technologies Sign language interpretation services TTY and other assistive technology devices Print materials in easy to read, low literacy, picture and symbol formats
Materials in alternative formats (e.g., audiotape, Braille, enlarged print) Legally binding documents (e.g., consent forms, confidentiality and consumer rights statements, release of information, applications) Health education materials Public awareness materials and campaigns Information in the media in languages other than English (e.g., television, radio, Internet, newspapers, periodicals) Signage
TitleVI is part of the Civil Rights Act of 1964, and its implementing regulations mandate that no person shall be subject to discrimination on the basis of race, color, or national origin under any program or activity that receives federal financial assistance.
Title VI applies to any organization or individual that receives federal financial assistance, either directly or indirectly, through a grant, contract or subcontract. Includes DHHS, all county social services, health departments, area mental health agencies, and other local agencies that receive federal money. Examples: hospitals, nursing homes, home health agencies, HMOs, health service providers and human services agencies.
When interpretation is needed and is reasonable, it should be provided in a timely manner. To be meaningfully effective, language assistance should be timely. Language assistance should be provided at a time and place that avoids the effective denial of the service.
Explain to the LEP individual (through your interpreter) that they have a right to a “free of charge” interpreter. Explain the complications of interpreting and if they refuse, they have a right to use their own. Be sure to document this action for liability and compliance purposes. Never allow a child to interpret.
Loss of federal funds Loss of future federal and state funding Subject to legal actions from the NCDHHS, legal services organizations, and private individuals Possible “Informed Consent” issues which could lead to medical malpractice chargesSource: http://www.ncdhhs.gov/ocs/title6.htm
Best Practices… : NOT Recommended•Bilingual/Bicultural PracticesProfessionals •Use of interpreters•Frontline bilingual support •Use of family membersstaff /children to interpret•Double-sided bilingual •Only English languageforms (Releases, consumer’s forms prepared forrights, confidentiality, consumer’s signatureconsent for services) •Voice mail with only English•Bilingual materials in lobby options•Building signage •Unresolved prejudices•Special aid to illiterate •Inaccurate diagnoses andclients treatment due to lack of•Negotiate alternative cultural knowledgecultural treatments