Cultural Competence Guidelines in Managed Care Mental Health Services for Native American Populations

Guiding Principles

1. Principle of Sovereign Nation Status

Systems of health care for Native Americans who are members of sovereign nations must acknowledge the right of those sovereign nations to participate in the process of defining cultural competent managed care.

2. Principle of Cultural Competence

Cultural competence includes the attainment of knowledge, skills, and attitudes to enable administrators and practitioners within systems of care to provide effective care for diverse populations, i.e., to work within the person’s values and reality conditions. cultural competence acknowledges and incorporates variance in normative acceptable behaviors, beliefs, and values in:

3. Principle of Consumer-Driven System of Care

A consumer-driven system of care promotes consumer and family as the most important participants in the service-providing process. Whenever possible and appropriate, the services adapt self-help concepts from the minority culture, taking into account the significant role that mothers and fathers play in the life of the Native American consumer.

4. Principle of Community-Based System of Care

A community-based system of care includes a full continuum of care. The focus is on:

5. Principle of Managed Care

The costs of a managed care health care delivery system are best maintained through the delivery of effective, quality services, not by cutting or limited services. Effective systems provide individualized and tailor-made services. They emphasize outcome-driven systems and positive results. They acknowledge the importance of added-value inclusion of ethnic/cultural groups as treatment partners. The system includes an emphasis on managing care, not dollars. It recognizes that dollars will manage themselves if overall care is well managed. It recognizes Native American and other group-specific variables which have significant implications for individualized assessment and treatment.

6. Principle of Natural Support

Natural community support and culturally competent practices are viewed as an integral part of a system of care which contributes to desired outcomes in a managed care environment.

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