BUILDING BRIDGES

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BUILDING BRIDGES

• PRACTICAL METHODS FOR IMPROVING
• CULTURAL COMPETENCE FOR COMMUNITY-BASED
  ORGANIZATIONS
• Karen R. Chatfield, M.A.

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LA FRONTERA CENTER, INC.

• Community-based nonprofit behavioral health
  center established in 1968
• Full range of behavioral health recovery services
  at 20 locations
• Employ approximately 500 people with annual
  budget over 53 million
• Serve approximately 17,000 children, youth, and
  adults annually
• History of commitment to cultural competence

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DIVERSITY OF CLIENTS STAFF, FY 20062007
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LFCs CULTURAL COMPETENCE INITIATIVE

• 75,000 grant from U.S. Office of Minority Health
• Five-part program
• 1. Spanish classes
• 2. Bilingual stipends
• 3. Cultural competence training
• 4. Assessment tool
• 5. Regional conference
• 3-year strategic plan
• Cultural Competence Committee
• Knowledge dissemination

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ONGOING ACTIVITIES

• Choose accessible locations for facilities
• Evaluate mission statement, organizational
  values, and policies for cultural competence
• Recruit diverse staff at all levels within the
  organization
• Pay differential for bilingual staff
• Career development and tuition assistance
  leadership training opportunities

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ONGOING ACTIVITIES (CONTD)

• Cultural competence training for all staff
• Written materials available in English and
  Spanish
• Sponsor and/or participate in community events
  celebrating local cultural groups
• Include questions related to culture on Client
  Satisfaction Survey
• Publish articles related to culture in agency
  newsletter
• Include cultural considerations in client
  assessment instrument

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ROLE OF AGENCY BOARD

• Self-monitor to ensure that board composition
  reflects community diversity.
• Evaluate the agencys success in serving the
  community, as defined in mission statement.
• Support agency initiatives to increase cultural
  competence.
• Request and review annual staff report on
  cultural competence activities (may be part of
  strategic plan).
• Serve as community role model.

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ROLE OF AGENCY STAFF

• Assemble Cultural Competence Committee.
• Administer cultural competence assessment to
  employees.
• Conduct focus groups to identify specific areas
  in need of improvement and possible actions to be
  taken.
• Develop and implement annual work plan assign
  tasks and target completion dates.
• Monitor progress and report to Quality
  Improvement Committee and Board of Directors.

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ESTABLISHING COMMON GROUND

• Prior to administering the assessment, establish
  a frame of reference to ensure that all
  participants understand the concept of cultural
  competence and what the organization is trying to
  achieve.
• Definitions
• Purpose
• Desired outcome

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ELEMENTS OF CULTURE

• Shared values, traditions, norms, customs, arts,
  history, and institutions of a group of people.
  (OSAP Communication Series, 1993)
• Integrated patterns of human behavior that
  include the language, thoughts, communications,
  actions, customs, beliefs, values, and
  institutions of racial, ethnic, religious or
  social groups. (U.S. Office of Minority Health,
  2000)

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ELEMENTS OF CULTURE (CONTD)

• Geographic location
• Age
• Ethnicity
• Socioeconomic status
• Physical abilities
• Family status
• Employment status

• Race
• Sexual orientation
• Gender identity
• Religion
• Education
• Marital status
• Housing

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WHAT IS CULTURAL COMPETENCE ?

• Knowledge, attitudes, and policies within an
  agency that allow individuals to work effectively
  in cross-cultural situations. This requires the
  willingness and ability to utilize
  community-based values, traditions, and practices
  in developing and evaluating interventions,
  communications, and other activities. (Arizona
  Department of Health Services, Center for
  Minority Health, 1994)

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WHAT IS CULTURAL COMPETENCE? (CONTD)

• The ability to demonstrate skills and knowledge
  which enable a person to work effectively across
  cultures . . . the ability to provide effective
  services to people of a specific cultural
  background, including one different from the
  provider. (National Latino Behavioral Health
  Group, 1996)

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WHY IS CULTURAL COMPETENCE IMPORTANT?

• Enables one to understand perspective of person
  from different background
• Increases solution pool
• Increases staff knowledge and skill level
• Improves client treatment outcomes
• Decreases stereotyping
• Decreases unintentional offending
• Decreases intergroup conflict

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ADMINISTERING THE ASSESSMENT

• Introduce the instrument and explain purpose.
• Ask participants to complete each of the four
  sections
• 1. Organizational Environment
• 2. Public Relations/Working with the
  Community
• 3. Human Resources
• 4. Service Delivery
• Score the instrument.

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SIX STAGES OF CULTURAL COMPETENCE

• Stage 1 Cultural oppression Discriminates
  against other cultures and groups, sees other
  cultures as inferior
• Stage 2 Cultural incapacity Adopts
  paternalistic posture toward so-called inferior
  people
• Stage 3 Cultural indifference Seeks to
  assimilate differences, ignore strengths
• Stage 4 Cultural precompetence Realizes
  weaknesses and makes effort to improve

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SIX STAGES OF CULTURAL COMPETENCE (CONTD)

• Stage 5 Cultural competence Interacts
  effectively with members of diverse cultures and
  groups, recognizes need for continuing education
• Stage 6 Cultural advocacy Actively promotes
  cultural competence throughout the community

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COMPLETING THE ASSESSMENT

• For each item in the left column of Section 1,
  read the six descriptions in the row to the right
  and circle the description that best describes
  the agency being assessed .
• Repeat the above process for Sections 2 through
  4.

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SCORING THE ASSESSMENT

• For each stage in Section 1, count the number of
  circles in the column and multiply that number by
  the number of the stage (e.g., 2 circles in stage
  3 6 points).
• Add the total number of points for the section
  and insert in the score sheet on page 15, where
  indicated. Using the key at the bottom of the
  page, determine the developmental stage.
• Repeat the above process for Sections 2 through
  4.
• Add the scores from the four sections to
  determine the overall score and developmental
  stage.

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CONDUCTING THE FOCUS GROUP

• Discuss responses in each of the four sections.
• Use a flip chart to record all comments.
• Dont judge the validity of the comments.
• Ask staff to identify areas in each section that
  need improvement.
• Encourage staff to propose strategies for
  overcoming identified weaknesses.

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CONDUCTING THE FOCUS GROUP (CONTD)

• Invite interested staff to join the Cultural
  Competence Committee.
• Collect score sheets.
• Tally scores and compile comments.

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DEVELOPING THE WORK PLAN

• Using input from focus groups, identify
  objectives and deliverables for each of the four
  sections.
• Submit draft plan to Cultural Competence
  Committee for review revise as needed.
• Determine appropriate individual(s) to achieve
  tasks, possibly including persons not on the
  committee.

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DEVELOPING THE WORK PLAN (CONTD)

• Set target dates for completion of tasks.
• Monitor status of work plan objectives at monthly
  committee meetings.
• Submit quarterly status reports to Quality
  Management Committee or other oversight body.
• Submit yearend report to Board of Directors.

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CONTACT INFORMATION

• Karen Chatfield
• Director of Public Relations, Customer Service
  Cultural Initiatives
• La Frontera Center, Inc.
• 504 W. 29th St.
• Tucson, AZ 85713
• [phone]
• kchatfield_at_lafrontera.org