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:
- determining an individual’s mental wellness/illness, and
- incorporating those variables into assessment and treatment.
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:
- Whenever possible and appropriate, using the family or the individual’s recognized family as the base system of care;
- Including familiar and valued community resources from the minority culture;
- Investing in early intervention and preventative efforts; and,
- Treating the consumer in the least restrictive environment possible.
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.
- Traditional healing practices are used when relevant or possible.
- Family is defined by function rather than bloodlines. Native Americans, as well as other ethnic minorities, generally conceive of family much more broadly than mainstream individuals.