Cultural and Linguistic Competence Initiatives at Virginia Dept. of Behavioral Health & Developmental Services 2012

  • 60 views
Uploaded on

 

  • Full Name Full Name Comment goes here.
    Are you sure you want to
    Your message goes here
    Be the first to comment
    Be the first to like this
No Downloads

Views

Total Views
60
On Slideshare
0
From Embeds
0
Number of Embeds
0

Actions

Shares
Downloads
2
Comments
0
Likes
0

Embeds 0

No embeds

Report content

Flagged as inappropriate Flag as inappropriate
Flag as inappropriate

Select your reason for flagging this presentation as inappropriate.

Cancel
    No notes for slide
  • Standard one asks you to understand that there are levels of cultural competence and each level has specific responsibilities and goals that are aligned with the others but may require different approachesIndividual level….this level really deals with an employees individual desire to work effectively with consumers from across all cultures and perspectives. Learning about different cultures and cross cultural communication strategies are an exampleOrganizational level- deals with evaluating and modifying policies and procedures to ensure equal access to and effective treatment of illness, disabilities and disorders. Making sure that language services are in place to provide access to LEP consumers is an example.Systems level…..deals with how to develop infrastructure that addresses equity in healthcare. Laws prohibiting discrimination based on race and ethnicity is an example.
  • Data on who and how services are delivered are critical for this goal. Analyzing disparities in service access and outcomes is a cornerstone of evaluating whether a program is effective and efficient within all populations. And if you aren’t looking at all populations, then you have some populations who are the beneficiaries of effective and efficient services and other populations who are not.It is well known that
  • http://en.wikipedia.org/wiki/Lau_v._NicholsLau v Nichols found people who had limited English proficiency were entitled to language services under Title VI of the Civil Rights Act of 1964 because of national origin.Because any program or activity receiving Federal financial assistance includes organizations that receive medicaid reimbursements and federal grant dollars, almost every organizations in the DBHDS system is required to provide language services for its LEP populations.
  • (1) the number or proportion of LEP persons eligible to be served or likely to be encountered by the program or grantee; (2) the frequency with which LEP individuals come into contact with the program; (3) the nature and importance of the program, activity or service provided by the recipient to its beneficiaries; and (4) the resources available to the grantee/recipient and the costs of interpretation/translation services. There is no "one size fits all" solution for Title VI compliance with respect to LEP persons, and what constitutes "reasonable steps" for large providers may not be reasonable where small providers are concerned.
  • Marketing- newsletter (highlighting good practices, passionate people, stories from the field- annual plan, annual report, website, Google group, list serves, Facebook postings, Linked-in postingsLanguage services focus- The carrot that gets people interested in hearing what we have to say. From there, we introduce the other critical elements that make language services work.
  • Challenges for the futureKeeping up momentum- for us, it has been easy to have success b/c there was so much to do but now that we need to be looking at the more complex things…how do we get buy in and funding to do that.Keeping the steering committee as active as they have been in the past- in the past, we had lots of tasks for them to participate on, now that many of those foundational things have been done, they have more of a consultative role and less of an active role.Evaluation of the effectiveness of our work- measuring progress and trying to focus on those activities that move us forward.Continuing to engage providers as services by private providers expand outside of public agencies- around 1000 private providers of services who are not regulated under contracts with DBHDS.Keeping CLC as a priority- there is a degree of pushback as CLC as a buzzword that is getting overused.Perceived “competition” with other departmental priorities
  • Readiness assessment is two fold- sends message from leadership that clc will be a focus and also build awareness to what clc really isClc plan can be simple to startSMART plan!Identify benchmarksUse it!Revisit it!Clc training for advisory committees, soc staff, conferences, etc.

Transcript

  • 1. DBHDS Virginia Department of Behavioral Health and Developmental Services Staff Member Name Title Equity and Language Access Initiatives in Virginia Behavioral Health & Developmental Services
  • 2. Page 2 DBDHS Virginia Department of Behavioral Health and Developmental Services Overview • Getting on the same page- common understanding of terms • Why should we plan for cultural & linguistic competence?. • What does it look like? • Lessons learned • Possible strategies for other agencies
  • 3. Page 3 DBDHS Virginia Department of Behavioral Health and Developmental Services WHAT IS CULTURAL COMPETENCE? Adapt to the cultural Contexts of your community Acquire and institutionalize cultural knowledge Manage the Dynamics of difference Conduct Self Assessment Value Diversity Cultural Competence And incorporate the above in all aspects of policy making, administration, practice, service delivery and involve systematically consumers, key stakeholders and communities. National Center for Cultural Competence
  • 4. Page 4 DBDHS Virginia Department of Behavioral Health and Developmental Services Levels of Cultural Competency System’s Levels Laws and regulations in place and an infrastructure that supports diverse communities
  • 5. Page 5 DBDHS Virginia Department of Behavioral Health and Developmental Services What is Linguistic Competence The capacity of an organization and its personnel to communicate effectively, and convey information in a manner that is easily understood by diverse audiences including persons of limited English proficiency, those who have low literacy skills or are not literate, and individuals with disabilities. National Center for Cultural Competence
  • 6. Page 6 DBDHS Virginia Department of Behavioral Health and Developmental Services Why Plan for CLC? * Alignment with Secretary Initiatives * Legal requirements related to language access * Growing Population diversity * Limited staff with CLC expertise * Lack of organizational and systemic focus on CLC Efforts
  • 7. Page 7 DBDHS Virginia Department of Behavioral Health and Developmental Services Secretariat Initiatives • Virginia Health Reform Initiative • Systems Transformation • Organizational and Program Effectiveness
  • 8. Page 8 DBDHS Virginia Department of Behavioral Health and Developmental Services Systems Transformation “In 2006, Virginia embarked on a bold mission: to bring about a true systems transformation that will afford individuals across all ages and disability populations personal choice and easier access to needed long-term supports that are integrated, individualized and simple to use. This is occurring by improving services access, enhancing person- centered practices and self direction, and transforming information technology to support systems change.” http://www.hhr.virginia.gov/Initiatives/SystemsTransformation/
  • 9. Page 9 DBDHS Virginia Department of Behavioral Health and Developmental Services Healthcare Reform Virginia Health Reform Initiative “Ensure that meaningful reform is achieved throughout the Commonwealth. There is a desire to see that the health care delivery system as a whole is positively impacted as a result of the work accomplished through the initiative.” Health and Well-Being Improve the health and well-being of the population. HHR Human Resources: Spotlight on Collaborative HR Strategies, Sept. 27, 2011.
  • 10. Page 10 DBDHS Virginia Department of Behavioral Health and Developmental Services Organizational and Program Effectiveness Organizational Effectiveness Provide services in the most effective and efficient possible manner Program Effectiveness Programmatically deliver services which will strengthen the family, take care of children, aid the impaired, aged, and disabled. HHR Human Resources: Spotlight on Collaborative HR Strategies, Sept. 27, 2011.
  • 11. Page 11 DBDHS Virginia Department of Behavioral Health and Developmental Services Why Plan for CLC? FEDERAL LAW Civil Rights Act of 1964 The Civil Rights Act of 1964 says that no person shall be excluded from participation in, be denied the benefits of, or be subjected to discrimination based on race, gender, ethnicity or national origin under any program or activity receiving Federal financial assistance."
  • 12. Page 12 DBDHS Virginia Department of Behavioral Health and Developmental Services Why Plan for CLC Presidential Executive Order 13166 Sec. 3 – Federally Assisted Programs “Each agency providing federal financial assistance shall draft title VI guidance specifically tailored to its recipients that is consistent with the LEP Guidance issued by the Dept. of Justice” Executive Order on Limited English Proficiency, August 11, 2000
  • 13. Page 13 DBDHS Virginia Department of Behavioral Health and Developmental Services Title VI - “Meaningful Access” Organizations are required to take reasonable steps to ensure meaningful access to their programs and activities by LEP persons. The Guidance explains that the obligation to provide meaningful access is fact-dependent and starts with an individualized assessment that balances four factors: 1. Number or Proportion of LEP Individuals 2. Frequency of Contact With the Program 3. Nature and Importance of the Program 4. Resources Available
  • 14. Page 14 DBDHS Virginia Department of Behavioral Health and Developmental Services Americans with Disabilities Act The ADA prohibits discrimination on the basis of disability in employment, State and local government, public accommodations, commercial facilities, transportation, and telecommunications. It also applies to the United States Congress.
  • 15. Page 15 DBDHS Virginia Department of Behavioral Health and Developmental Services Other Federal Laws Prohibiting Discrimination in Human Services The Social Security Act prohibits discrimination in the Maternal and Child Health Services Block Grant. The Public Health Service Act prohibits discrimination in the Community Mental Health Services Block Grant and Substance Abuse Prevention and Treatment Block Grants. The Public Health Service Act prohibits discrimination in the Preventative Health and Health Services Block Grants
  • 16. Page 16 DBDHS Virginia Department of Behavioral Health and Developmental Services Consequences • Inova Health System has agreed to a $145,000 settlement after the U.S. Department of Justice filed a complaint on behalf of a hearing-impaired couple who claimed they were not properly provided with a sign-language interpreter after their newborn son developed medical complications while in Inova Fairfax Hospital. • Maryland Department of Health and Mental Hygiene DOJ review required county health departments have agreed to conduct periodic language needs assessments of their service areas and to incorporate a variety of data sources in the process. • DBHDS investigation into allegations of discrimination based on national origin. As a result, language policy and procedures were developed.
  • 17. Page 17 DBDHS Virginia Department of Behavioral Health and Developmental Services Why Plan for CLC? Over 350 languages are spoken in the U.S. There are more than 47 million people in the nation who speak a language other than English, and over 30 million who were born outside the United States During the past decade, the number of Spanish and Asian-language speakers grew by 50% Over 17% of the nation’s population speak a language other than English at home. Virginia is one of the top 15 states for refugee resettlement
  • 18. Page 18 DBDHS Virginia Department of Behavioral Health and Developmental Services
  • 19. Page 19 DBDHS Virginia Department of Behavioral Health and Developmental Services CLC in Practice Cultural Competence Do our practices Inhibit or prohibit engagement? Do we seek meaningful inclusion of cultural considerations throughout the planning process? Do we get regular feedback from employees? Do we have ONGOING training that develops a workforce able to work cross culturally?
  • 20. Page 20 DBDHS Virginia Department of Behavioral Health and Developmental Services CLC in Practice Cultural Competence Do we utilize outreach strategies and engage cultural brokers? Do we explore new methods for recruitment and retention of culturally competent staff Do we provide safe venues for people to discuss their communication differences? Do we maintain demographic, cultural, and epidemiological profiles? Provide training on addressing bias, discrimination, and racism in health, mental health, and social service systems. Standardize ways to assess a candidate’s ability to deliver culturally competent services
  • 21. Page 21 DBDHS Virginia Department of Behavioral Health and Developmental Services CLC in Practice Linguistic Competence Hire bilingual/ bicultural staff Use varied approaches to communicate With individuals who experience cognitive disabilities Require the use of qualified interpreters Pre-test the reader- friendliness of enrollment and education materials with focus groups Offer multilingual Tele-communication systems
  • 22. Page 22 DBDHS Virginia Department of Behavioral Health and Developmental Services CLC in Practice Linguistic Competence Offer TTY and other assistive technology devices Offer materials in Alternative formats (e.g., audiotape, Braille, enlarged print ) Use qualified translation Services especially for legally binding documents Print materials in Easy to read, low literacy, picture and symbol formats Utilize ethnic media in languages for outreach to diverse communities
  • 23. Page 23 DBDHS Virginia Department of Behavioral Health and Developmental Services OCLC- Critical Foundations • Conferences that built awareness and enthusiasm prior to developing specific initiatives. • Formal Statewide Committee • Visible Leadership • Documents that provided a foundation to our work – charter, position statement • Having roots in community work and community partners
  • 24. Page 24 DBDHS Virginia Department of Behavioral Health and Developmental Services OCLC- Focus Areas OCLC Language Services Planning at Secretariat, Agency, and Local level Workforce Diversity, and Inclusion (Recruitment, Retention, and Succession) Organizational CLC Training and Consultation CLC Resource Development
  • 25. Page 25 DBDHS Virginia Department of Behavioral Health and Developmental Services OCLC- Keys for Success • Broad support from leadership • Active and passionate statewide advisory committee • Emphasis on outreach, building partnerships, and networking • Commitment to supporting existing work and initiatives • Focus on language services • LOTS of free training! • Utilization of interns • GRIT!!
  • 26. Page 26 DBDHS Virginia Department of Behavioral Health and Developmental Services OCLC Challenges for the future • Lifting the discussion to the macro level • Keeping up momentum- Engaging all services in our purview and integrating CLC principles in existing and new initiatives • Finding support and funding for more complex issues • Developing indicators for progress • Expanding the number of engaged providers • Keeping CLC as a priority
  • 27. Page 27 DBDHS Virginia Department of Behavioral Health and Developmental Services Possible Agency Approaches Agencies with an existing CLC/disparity effort (POC) • Include CLC staff in planning, consultation, staff orientation, policy work, and training efforts • Leverage CLC office staff for readiness and assessment activities, training, community engagement efforts, social marketing and program strategies • Include CLC plans and goals as agency plans and goals and vice versa to avoid duplication of efforts
  • 28. Page 28 DBDHS Virginia Department of Behavioral Health and Developmental Services Possible Agency Approaches Agencies without an existing CLC/disparity efforts (POC) • Have leadership articulate a message of the importance of CLC/disparity efforts • Designate someone to coordinate efforts • Convene a CLC/Multicultural/Disparity Advisory Council • Commit to a diversity of all advisory groups • Carry out a readiness assessment • Develop a CLC plan • Incorporate CLC training at all levels of the work • Don’t isolate CLC/disparity efforts