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Cultural Competency Plan
Draft
CULTURAL COMPETENCY PLAN
HEALTH ACCESS COLLABORATIVE
The range of activities conducted by health and social service organizations with the intention of improving cultural competency is so broad that it is often hard to get a precise picture of what a particular organization means by cultural competency. Local needs are unique in many ways, so it's entirely appropriate that definitions of cultural competency and efforts to achieve it will vary greatly. However, developing a consensus on local needs and methods is essential to conducting objective evaluation to determine our level of success in achieving cultural competency as an ongoing process.
The member organizations of Health Access Collaborative have had active cultural competency programs in their respective institutions for years. We are in the process of adopting a cultural competency plan that incorporates our collective experience in order to give a clearer picture of what we will accomplish individually and collectively. Following is a topical outline that is being used to develop consensus on major components of cultural competency that we will focus on together to increase the pace of institutional change and improvements in services.
Our present planning effort is necessarily incomplete and includes only goals that are realistic and achievable in the short term because cultural competency represents a moving target and our resources are currently saddled with overwhelming burdens. No doubt local need and our understanding of cultural competency will grow as we pool our resources and implement changes that will benefit all participating organizations and residents of the region.
Definition:
For the purpose of immediate joint efforts by members of Health Access Collaborative, cultural competency represents the mutual understanding that health and social service providers seek to achieve with ethnic communities as a whole and with individual patients/clients in Southeast Massachusetts. Achieving such understanding requires a network of day-to-day working relationships among organizations that is supported by organizational policy and based on planning and monitoring of measurable indicators by senior management.
Components
of leadership and change:
This initial plan of Health Access Collaborative to improve cultural competency
is based on fostering effective coordination and mutual benefit among the
following four components of leadership and change.
A. Ethnic
communities
1. Leadership
Senior management of major community-based organizations (CBOs) and other
individuals with track records as advocates for ethnic communities will continue
to take an active role in directing the efforts of Health Access Collaborative.
These leaders served as incorporators of the collaborative and presently serve
on its board of directors. They will also serve on task forces assigned to
implement specific projects when funding is obtained.
2. Direct
benefits to individuals
Patients, clients, and their family members will receive direct benefits by
improving culturally appropriate services that will be monitored and reported to
our board of directors and funding sources. For example, training and
utilization of medical and administrative interpreters will be conducted in such
a way as to improve providers' understanding of consumers and consumers'
understanding of health issues that affect them personally.
High priority will be given to creating employment opportunities as interpreters and other career positions for bilingual persons. For example, select CBO staff will receive formal training, which will make their bilingual and cultural knowledge more valuable to CBOs, to themselves, to the collaborative network, and to their communities. The purpose of a related program that we plan to initiate will be to coordinate training in office skills with training of interpreters, which will create opportunities for individuals and give employers more flexibility in meeting administrative and interpreter needs.
3.
Benefits to CBOs
In addition to directly benefiting constituents of community-based
organizations, the CBOs themselves will benefit from their staff receiving
interpreter training and related employment training as these organization
endeavor to fulfill their missions. It isn't feasible for them to offer such
staff training without collaboration with other employers.
B.
Providers of health and social services
1. Senior management
Health Access Collaborative is an effective mechanism to bring about
institutional changes because senior management of major health and social
service providers had an active role in creating the collaborative, including
serving as incorporators. They continue to take leadership roles in day-to-day
implementation of tasks and in serving on our Board of Directors. We can be
assured of getting full cooperation from technical staff during implementation
of specific tasks because their senior managers will be overseeing
implementation.
2. Member
organizations
Hiring and retention policies of member organizations are intended to assure
that staff composition will be representative of communities being served. To
the extent feasible, participating organizations will fill a representative
number of positions with bilingual staff, including positions with
decision-making responsibility. Where persons with appropriate training aren't
readily available from under represented ethnic backgrounds, employers will work
with the collaborative to pool their efforts in trying to attract qualified
persons to the area.
The purpose of our various education programs will be to achieve mutual understanding among staff and patients/clients regarding cultural and health issues, which will foster quality care and cost efficiency.
3.
Physicians
Obviously, patient-physician communications represent the most critical
interface for interpreter services in hospitals, community health centers, and
physician offices. They also represent the most challenging efforts because of
the sheer volume, around-the-clock occurrence, busy schedules of physicians, and
physician reluctance to pay for interpreter services in their offices. Health
Access Collaborative decided to focus our initial efforts on hospitals, health
centers and CBOs, then bring physician leaders into the collaborative and
conduct constructive, mutually beneficial discussions when we receive funding to
improve clinical interpreter services.
C. Mutually beneficial collaboration among CBOs and service providers
1. Role
of CBOs in health care
Every day people with limited English seek help from community-based
organizations in Fall River and New Bedford where staff is on hand to meet their
particular linguistic and cultural needs. CBOs help constituents by providing a
wide range of health-information services, such as understanding and following
instructions on prescriptions, physician instructions, continuing with
medication, follow-up visits to physicians, preventive care, and interpreting
when patients see their physicians. But CBOs don't have sufficient funds to
employee staff with sufficient training in health care and medical interpreting.
CBOs provide health information because their constituents seek information from
sources they trust and where they feel most comfortable.
Health Access Collaborative will create a network of routine working relations among CBOs and service providers that will be directly beneficial to all participants: patients/clients, CBOs, and providers.
2. Flow
of people and ideas
An important aspect of our network of working relations will be that employees
will work in the various settings represented by members of the collaborative.
We will devise appropriate strategies so staff get first-hand knowledge of
problems in the communities. For example, full-time staff will be encouraged to
rotate in different settings, and some staff will fill part-time positions in
different organizations. The result will be a flow of people and ideas, as well
as increased employment opportunities for bilingual staff.
There will be an explicit policy to avoid the situation where better funded organizations may inadvertently hire the best staff away from CBOs. The rotation strategy will be one method of enhancing employee skills without depriving CBOs of outstanding employees.
3. Collective ability to implement new programs among CBOs and providers of health and social services will enhance our ability to attract funding and implement programs that otherwise may not come to the region because organizations acting alone lack sufficient resources to present winning proposals. Funding sources often recognize the synergy and efficiency that are feasible through collaboration, and they are more likely to fund projects that are supported by top decision makers in the region.
Organizations that participate in collaborative projects will enhance their image among their respective constituencies because of offering a wider range and higher quality of services than would be feasible acting alone.
D. Other
local leadership
1. Political leaders
Local legislators had a unique, critical role in creating Health Access
Collaborative because of their long history of involvement with immigrant
communities and their overarching goal of supporting efforts that help build
better communities. They continue to take an active role in the collaborative.
Two prominent legislators serve on our board of directors, and their broad
perspectives in the region and state will directly benefit our programs.
The direct involvement of elected officials will help keep them informed about needs of their constituents, CBOs, and service providers, which will aid in fulfilling their legislative duties and contribute to their roles of making government sensitive to local needs.
2. Individual consumers and community leaders who are prominent consumer and community leaders, but not employed by members of our collaborative, will be asked to participate in developing policy and overseeing implementation of specific projects.
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