Cultural Competence Standards in Managed Care Mental Health Services For Native American Populations | DECISION SUPPORT


The Health Plan should develop and maintain a database which can track utilization and outcomes for Native American consumers across all levels of care. It should also develop and manage databases of social and mental health indicators on the covered population of Native Americans and the Native American population at large. Findings from these data should be used to continually assess, improve, and inform strategic planning services to Native American consumers and families. For purposes of accountability, the Health Plan should report to the governing entity, in a regular and timely manner, performance and outcome data specific to Native American consumers and families.


Implementation Guidelines

1. Urban/Suburban and Rural/Reservation:

Aggregated data linkages with primary care plan, public health, substance abuse, developmental disability, education, courts, corrections, and juvenile justice should be established to cross-system utilization information on the mental health status.

2. Urban/Suburban and Rural/Reservation:

Data should be current, accurate, and include gender, ethnicity, socioeconomic status, linguistic proficiency, geographic area, and sexual orientation (at the consumer’s option).

3. Urban/Suburban and Rural/Reservation:

The Native American ethnicity category should be broad and inclusive, including a capacity to code all and multiple Native Americans and those of mixed race/ethnicity/Native American nation. The Native American category should be distinct and monitored separately even when consistent with U.S. Census Bureau practice.

4. Urban/Suburban and Rural/Reservation:

The Health Plan should track aggregated diagnostic and assessment information, service utilization trends, drop-outs, and utilization patterns across modalities, as well as behavioral and functional outcomes.

5. Urban/Suburban and Rural/Reservation:

Individual consumer data should be kept confidential with data sets coded in such a manner that client cannot be readily identified.


Recommended Performance Indicators

  1. Presence of a data system inclusive of the above mentioned elements.
  2. Use of a unified clinical record across all levels of care that legally allow for sharing of information to facilitate data collection and tracking.
  3. Regular reporting of performance and outcome indicators to the governing entity.


Recommended Outcomes

  1. Timely and accurate consumer data which provides for tracking across age, race, and ethnicity
    Benchmark: 90% satisfaction
  2. Timely transition of data to enhance continuity of care
    Benchmark: Real time authorizations for services
  3. More focused preventive and service planning for Native American consumers
    Benchmark: Increased specialized and preventive services to at-risk consumers