CULTURAL & LINGUISTIC

COMPETENCETITLE VI

Carlos F. Martinez, MHA, M.Ed.

What is Cultural Competence?

What is Linguistic Competence?

What is Title VI?

Overview

Cultural Competence is a set of congruent behaviors, attitudes, and policies that come together in a system, agency, or among professionals that enable them to work effectively in cross-cultural situations.

CULTURAL COMPETENCE IS AN ONGOING PROCESS

Cultural Competence

Cultural competence begins with an honest desire not to allow biases to keep us from treating individuals with respect.

It requires an honest assessment of our positive and negative assumptions about others.

It requires us to avoid negative stereotypes and prejudices.

Cultural Competence

Cultural Competence = Quality of Care Cultural Competence = Disparity Reduction Cultural Competence = Risk Management Cultural Competence = Parity (within MH

system) Cultural Competence = Linguistic

Competence Cultural Competence = A Social

Responsibility

Rationale for Cultural Competence

6

Points to Consider

ETIC Approach

EMIC Approach

AsiansLatinos/Hispanics

BlacksWhites etc.

Mexican

African A.

Haitian

Anglo

individual

individual

individual

individual

Vietnam individual

The Continuum of Working Across Cultures

Cultural EfficiencyCultural CompetenceCultural Pre-CompetenceCultural BlindnessCultural IncapacityCultural Destructiveness

By Georgetown University’s Child Development Center(Cross, Bazaron, Dennis & Isaacs, 1989)

The capacity of an organization and its personnel to communicate effectively and to convey information in a manner that is easily understood by diverse audiences; including persons of limited English proficiency, those who have low literacy skills or are not literate, individuals with disabilities, and those who are deaf or hard of hearing.

Linguistic Competence

Linguistic competence requires

organizational and provider capacity to

respond effectively to the health and mental

health literacy needs of populations served.

Organizations must have policies, structures,

practices, procedures and dedicated

resources to support the capacity.

Linguistic Competence

Linguistically competent agencies have: Bilingual/bicultural or

multilingual/multicultural staff Cultural brokers Foreign language interpretation services

including distance technologies Sign language interpretation services TTY and other assistive technology devices Print materials in easy to read, low literacy,

picture and symbol formats

Linguistic Competence

Materials in alternative formats (e.g., audiotape, Braille, enlarged print)

Legally binding documents (e.g., consent forms, confidentiality and consumer rights statements, release of information, applications)

Health education materials Public awareness materials and campaigns Information in the media in languages other

than English (e.g., television, radio, Internet, newspapers, periodicals)

Signage

Linguistic Competence

Title VI is part of the Civil Rights Act of 1964, and its implementing regulations mandate that no person shall be subject to discrimination on the basis of race, color, or national origin under any program or activity that receives federal financial assistance.

What is Title VI?

Title VI applies to any organization or individual that receives federal financial assistance, either directly or indirectly, through a grant, contract or subcontract.

Includes DHHS, all county social services, health departments, area mental health agencies, and other local agencies that receive federal money.

Examples: hospitals, nursing homes, home health agencies, HMOs, health service providers and human services agencies.

To whom does Title VI apply?

When interpretation is needed and is reasonable, it should be provided in a timely manner.

To be meaningfully effective, language assistance should be timely.

Language assistance should be provided at a time and place that avoids the effective denial of the service.

Title VI

Explain to the LEP individual (through your interpreter) that they have a right to a “free of charge” interpreter.

Explain the complications of interpreting and if they refuse, they have a right to use their own.

Be sure to document this action for liability and compliance purposes.

Never allow a child to interpret.

LEPs Using Their Own Interpreter

Loss of federal fundsLoss of future federal and state fundingSubject to legal actions from the

NCDHHS, legal services organizations, and private individuals

Possible “Informed Consent” issues which could lead to medical malpractice charges

Source: http://www.ncdhhs.gov/ocs/title6.htm

Penalty for non-compliance with Title VI

:

Best Practices for LEP Consumers

Best Practices…•Bilingual/Bicultural Professionals •Frontline bilingual support staff•Double-sided bilingual forms (Releases, consumer’s rights, confidentiality, consent for services)•Bilingual materials in lobby •Building signage•Special aid to illiterate clients•Negotiate alternative cultural treatments

NOT Recommended Practices•Use of interpreters•Use of family members /children to interpret•Only English language forms prepared for consumer’s signature•Voice mail with only English options•Unresolved prejudices•Inaccurate diagnoses and treatment due to lack of cultural knowledge

THANK YOU

GRACIAS