II. Cultural Competence Planning

Cultural Competence Planning

Standard

An APIA Cultural Competence Plan for both public and private sectors shall be developed and integrated within the overall organization and/or provider network plan, using an incremental strategic approach for its achievement, to assure attainment of cultural competence within manageable but concrete timelines Development and integration of the Cultural Competency Plan shall be achieved with the participation and representation of top and middle management administrators, front-line staff, consumers and/or their families, and community stakeholders. An individual at the executive level shall have authority to monitor implementation of the Cultural Competence Plan. Additionally, each individual shall be accountable for the success of the Cultural Competence Plan based on his/her level within the organization.

Implementation Guidelines

The APIA Cultural Competence Plan shall include:

A process for integrating the APIA Cultural Competence Plan into the overall state and/or department plan, and for including the principles of cultural competency in all aspects of organizational strategic planning and in any future planning process;
A process for determining unique APIA regionally-based needs and ecological variables within the communities/populations served using existing agency databases, surveys, community forums, and key informants;
Identification of service modalities and models which are appropriate and acceptable to the APIA communities served (i.e., urban, frontier and rural), population densities and targeted population subgroups, (e.g., children, adolescents, adults, elders, sexual minorities, and individuals with co-occurring conditions).
Identification and involvement of community resources, (e.g., family members, clans, spiritual leaders, churches, civic clubs, and community organizations) and cross-system alliances (e.g., corrections, juvenile justice, education, social services, substance abuse, developmental disability, primary care plans, public health and tribal health agencies) for purposes of integrated consumer support and service delivery;
Identification of APIA natural supports (e.g., family members, religious leaders and spiritual leaders, clan leaders, traditional healers, churches, civic clubs, community organizations) for purposes of reintegrating the individual within his/her natural environment.
Working to assure culturally competent care to APIA consumers at each level of care within the system (e.g., crisis, inpatient, outpatient, residential, home-based, health maintenance, community health liaison services.)
Stipulation of adequate and culturally diverse staffing representative of the APIA population served, and minimal skill levels (including gender, ethnicity, and language as well as licensing, certification, credentialing, and privileging) for all staff, clerical through executive management.
The use of culturally competent indicators, which are adapted for APIA cultural values and beliefs, in developing, implementing, and monitoring the Cultural Competence Plan.
Development of rewards and incentives (e.g., salary, promotion, bonuses) for cultural competence performance, as well as sanctions for culturally destructive practices (e.g., discrimination). Cultural competence performance shall be an integral part of the employee-provider performance evaluation system, and provider organization performance evaluation system.
Development of a plan to integrate on-going training and development related to APIA mental health care into the overall Cultural Competence Plan.
Development and ongoing plan monitoring of indicators to assure equal access, comparability of benefits, and outcomes across each level of the system of care and for all services provided to APIA consumers through the Health Plan.

Recommended Performance Indicators

Presence of a Cultural Competence Plan for APIA consumers, and defined steps for its integration at every level of organizational planning.
Established linkages to Federal, state, private, public, HMOs for including principles of cultural competency in all aspects of organizational strategic planning and in any future planning process.
Presence, within the Cultural Competence Plan, of related policy/procedure changes.
Percentage/number of staff receiving initial and ongoing cultural competence training related to APIA mental health care.
Established linkages with APIA community resources and natural supports, and cross-systems alliances.
Demonstration of staff knowledge and skills regarding APIA group group values, traditions, expression of illness, cultural competence principles (e.g., credentialing and performance based testing).
Demonstration of a cultural competence system evaluation that includes an evaluation of APIA mental health care concerns (e.g., Mason, 1995, Cultural competence self assessment questionnaire: A Manual for users).
Demonstration of staff and consumer awareness of the APIA Cultural Competence Plan.
Presence of a plan for recruitment, retention, and promotion of APIA staff representative of target population served.

Recommended Outcomes

Percent of APIA consumers compared to overall representation in the community.

Benchmark: Comparable to overall general population

Percent of APIA consumers served by, or under direct supervision of, APIA culturally competent Mental Health Specialist.

Benchmark: 100% served

APIA Consumer satisfaction with services.

Benchmark: 90% satisfaction

Proportionality of access to, and length of service of, the full range of treatment services offered

Benchmark: Comparable to overall service recipients for access to specific levels and types of services

Restrictiveness of placement (including incarceration/detention) for APIA consumers versus the overall community

Benchmark: Comparable restrictiveness and overall reduced restrictiveness.

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