Professional Documents
Culture Documents
Prepared by:
PAPA 5316 Fall 2014
Virginia Tech Center for Public Administration and Policy (CPAP)
City of Alexandria
Department of Community and Human Services
Alexandria, Virginia
Acknowledgement:
The CPAP team would be negligent without expressing our deepest gratitude to all groups and
individuals who supported our effort. We are deeply grateful for and recognize the hard work that
the Alexandria Children, Youth and Families Collaborative Commission put forth, with many
other stakeholders, in creating the Alexandria Children and Youth Master Plan.
Special thanks are due to Kate Garvey, Director, Department of Community and Human Services
City of Alexandria, and Jaci Coachman, Youth Services Program Specialist City of Alexandria
Department of Community & Human Services, who have provided us this professional
development opportunity and have been invaluable in our effort in completing this report.
Finally, we would like to sincerely thank our professor, Dr. Thomas A. Hickok, for his
conscientious guidance, leadership and support throughout the project.
EXECUTIVE SUMMARY
Cultural competence refers to peoples awareness of their own cultural view and their ability to
understand, communicate with and effectively interact with people across cultures. (Martin pp.
31-36). The Alexandria Department of Community and Health Services (DCHS) are dedicated to
fostering parity regarding service delivery around cultural competency. With only half of
Alexandria youth reporting knowledge of and comfort with people of different cultural, racial and
ethnic backgrounds, an innovative focus on Cultural and Linguistic Competency (CLC) is greatly
needed.
It is important to expand the discussion of culture beyond color by integrating race, ethnicity, and
cultural characteristics on a holistic basis. The image of an iceberg has been used to explain the
many layers of culture. Similar to an iceberg, individuals have physical characteristics that are
above surface such as color, gender, age, and hair color that are visible, however, there is so
much more below the surface that is essential to the process of fully developing an appreciation
and understanding of others.
The characteristics that are hidden from view are qualities such as sexual orientation, language and
communication styles, religion, and disabilities to name just a few. Diversity embodies the
recognition of all the differences that make up an individual, not only those that can be visually
observed, to embrace and a make positive use for the community.
The Virginia Tech Center for Public Administration and Policy (CPAP) team explored best
practices of CLC standards and accordingly developed the following three performance outcomes
for the Alexandria DCHS:
1. Enhanced institutional cultural and linguistic competence to improve service delivery
2. Enhanced cultural competence of staff to improve service delivery
3. A respectful, safe, and positive school and community environment
In order to realize the vision of the CYMP and these three performance outcomes, the study team
recommends the establishment of a Project Management Unit (PMU) that will be responsible for
coordination of the implementation process.
This CPAP report and presentation stand as an acknowledgement and recognition of the City of
Alexandrias effort to develop a meaningful implementation plan for its Children and Youth
Master Plan. In preparing this report, the CPAP team chose to focus its efforts on one goal
subsection that could serve as a useful model in approaching the action planning of other CYMP
goals. Considering both the number of recommendations set forth in this implementation plan and
the many responsibilities of DHCS staff members, the team recognizes that not all of these
recommended actions may be feasible in the short term.
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Table of Contents
EXECUTIVE SUMMARY .......................................................................................................... 3
LIST OF ACRONYMS ................................................................................................................ 5
1
INTRODUCTION................................................................................................................. 6
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LIST OF ACRONYMS
ACPS
ATC
CBOs
CLC
CPAP
CSSG
CYFCC
CYMP
DCHS
ITP
Invitation to Participate
PMU
PPP
Public-Private-Partnership
RASCI
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1 INTRODUCTION
OVERVIEW
The Children, Youth & Families Collaborative Commission (CYFCC) of the City of Alexandria
in partnership with relevant groups in the city developed the Children and Youth Master Plan
(CYMP) to help coordinate and align effective delivery of services to children and youth in the
city. The ACPS School Board approved the plan on May 17, 2014. In the same way, the
Alexandria City Council adopted the plan on June 24, 2014. CYMP sets long-term, communitywide priorities, strategies, and action steps in order to realize the five goals of the plan that envision
all children and youth are healthy and safe, academically and vocationally prepared, and socially
and civically connected.
The Virginia Tech Center for Public Administration and Policy (CPAP) PAPA 5316 Fall 2014
team1 reviewed the CYMP and its five goals. The team was tasked with the assignment to develop
an initial implementation plan. In order to do this, the team identified Goal 3 of the plan as a focus,
which envisions EVERY CHILD WILL BE SOCIALLY CONNECTED, EMOTIONALLY SECURE &
CULTURALLY COMPETENT. This goal has four strategies of which the team worked on the fourth
strategy. Strategy four aspires to contribute to the achievement of this goal by way of Cultivating
cultural competence and connections among children and youth and those who serve them.
Building on the Effective and Efficient Services for Everyone report provided by students of
CPAP in Summer-2014, this team researched best practices from other cities and local
governments to design an implementation plan. The team explored best practices on Culture and
Linguistic Competency (CLC) and other relevant standards covering three levels of program
implementation:
Institutional Policy level (Alexandria City Council, Children and Youth Family
Commission, Alexandria City Public Schools, DCHS, etc.)
Human Resource level (staff with the city, schools, and partnering community based
organizations)
Community level (Youth/students, parents and Faith groups, businesses, and nonprofits)
the community at large.
Accordingly, the team developed the following three performance outcomes for the Alexandria
DCHS:
Enhanced institutional cultural and linguistic competence to improve service delivery
Enhanced cultural competence of staff to improve service delivery
A respectful, safe, and positive school and community environment
This implementation plan covers the various performance recommended action steps, strategic
actions and performance measures to ensure the successful implementation of the plan to
GOVERNMENTAL ADMINISTRATION II: Systems Skills for Managers (each student in the Fall 2014 semester
was assigned a role as a team member in researching project requirements).
Cultivating Cultural Competence and Connections
34
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ultimately align them with the city wide vision of healthy children and youth in the city as
indicated in the citywide Alex stat measurement plans.
This class project and presentation stands as an acknowledgement and recognition of the City of
Alexandrias effort to develop a meaningful implementation plan for its Children and Youth
Master Plan. This document presents findings by the CPAP team on the definitions of cultural
and linguistic competency, best practices by a comprehensive assessment of other state and local
public service delivery agencies, recommendations for implementing the three suggested action
steps, and performance measures to track outcomes of the CLC program.
2 MANAGEMENT OVERVIEW
The City Manager and the Superintendent of Alexandria Schools have issued a directive
empowering the City School Staff Group (CSSG) to develop the initial implementation plan for
the CYMP on June 30, 2014. The CSSG is expected to continue to have a lead role not only in
developing the implementation plan but also in overseeing at least part of whole implementation
process. As the implementation kicks off, the need for man-hours and knowledge based
engagement is expected to increase. Hence it is important that the coordination role of
implementing the CYMP be housed and staffed in a project management unit structure.
Therefore the CSSG should consider the following recommended actions regarding the overall
management of the implementation of CYMP:1.
Develop Project Management Unit (PMU) that will be entrusted with the following:
o
The community indicators project is a good way to engage citizens in a community. It is also an important project for city
planning because if the city knows how the people feel, they can make better decisions. See more information at
http://blogs.lt.vt.edu/sameea13/2012/12/12/city-of-alexandria-quality-of-life-indicator-system/
Cultivating Cultural Competence and Connections
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34
environment).
Coordinate with the City of Alexandrias Community Indicators Task Force3
to develop performance indicators for program monitoring and evaluation (i.e.,
data collection and research in selecting certain indicators).
2.
3.
Identify and supply the necessary financial and logistic resources needed for a smooth
functioning of the PMU
o Leverage resources available through Public-Private-Partnership (PPP).
o Inquire about fundraising opportunities and resource availability from private
entities to supplement general funds as well as state and federal grants for these
types of activities. In particular identify recommended action steps and possible
federal grants that can be accessed for them.
4.
Launch CYMP awareness and community mobilization campaign to pave the way for
its successful implementation
o Developing flyers and using the existing printed and electronic materials of the
master plan for use
o Hold Open House to showcase what has been done and what the community
plans on doing in the future.
5.
Ibid. The Community Indicators Task Force, which includes a committee of city residents involved in the project and
Alexandria city staff, developed a process by which the people of Alexandria could select the indicators that were of most
importance to them and the community.
Cultivating Cultural Competence and Connections
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34
3 PERFORMANCE MONITORING
The CYMP is a comprehensive plan involving all of the Citys Stakeholders goals, a plan designed
to takes all of its priority areas into consideration. The Plan is aligned with the Citys Strategic
Plan, the Alexandrias City Public Schools Strategic Plan and the Partnership for a Healthier
Alexandria Strategic Plan. The CYMP allows the ability to access and implement indicators in all
of the Community Priority Areas for the City of Alexandrias neighborhood. Establishing uniform
indicators in place is important to measure progress for the diverse plans and their respective
Community Priority Areas which include Developing Resilience, Empowering & Equipping
Families, Creating Caring Network & Systems, Promoting Equity & Nurturing Cultural
Connections and Improving Economic Conditions. This is important and necessary for the overall
mission and success of the CYMP.
Presently the following Strategic Plans indicate Community Priority Areas for PROMOTING
EQUITY & NURTURING CULTURAL CONNECTIONS. They are the following:
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Activities
Outputs
Intermediate
Outcomes
Enhanced institutional
cultural & linguistic
competence to improve
service delivery
Volunteers to join
subcommittee, current
members of the CYFCC,
meeting space
Create a subcommittee of
the CYFCC to focus on
cultural competence.
Subcommittee members
are encouraged &
empowered to move
forward on addressing
CLC issues for CYFCC
Recommendations from
subcommittee are
incorporated into
CYFCC materials
Awareness of others in
Alexandria government
who are also involved in
implementation of CLC
policy & training
Formation of a network
within City offices &
departments dedicated
to aligning department
CLC policies to central
CLC policy
Enhanced institutional
cultural & linguistic
competence to improve
service delivery
Committee members
recognize that they
represent the diverse
elements in the
Alexandria community
Committee members
provide information to
the agencies they work
with on CLC issues,
ideas, suggestions, &
recommendations
Enhanced cultural
competence of staff to
improve service
delivery
Training recommendations
from Virginia Tech, trainers
in DCHS, time allocated for
training, requirements that
employees must take & pass
CLC training
Establish a Training
Framework for CLC at
DCHS
Recognition by DCHS
and City staff of the
importance of CLC in
their jobs and interaction
with members of the
public
Enhanced cultural
competence of staff to
improve service
delivery
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Indicators
1.
2.
3.
4.
5.
6.
7.
1.
2.
3.
4.
1.
2.
3.
4.
Performance Target
Data Source
1.
2.
3.
4.
Milestone Y/N
Milestone Y/N
Milestone Y/N
75% by year end (2015)
M&E Report
Alexandrias current Community
Indicators
ACTION Alexandria
5.
Milestone Y/N
6.
Milestone Y/N
7.
Milestone Y/N
1.
3.
80% by 2016
1.
2.
Milestone Y/N
3.
4.
Milestone Y/N
2.
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DCHS Report
5.
6.
7.
8.
5.
Milestone Y/N
6.
Milestone Y/N
7.
8.
Milestone Y/N
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1.2
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7 IMPLEMENTATION SCHEDULE
Recommended
Activities
Set up a PMU
0-3 Months
4-6 Months
7-9 Months
10-12 Months
1 Year+
Leverage existing
resources
Promote On-Going
Awareness Campaign
Develop flyers
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APPENDIX A: REFERENCES
Alexandria City Council. (2010). Alexandria City Council Strategic Plan 2004-2015 (Adopted
September 2004, Revised January 2006, Revised January 2010). Retrieved from:
http://alexandriava.gov/uploadedFiles/council/info/ApprovedStrategicPlan.pdf.
Alexandria Department of Community & Human Services. (2013). Alexandria Children &
Youth Well-Being Profile 2013.
Alexandria Department of Community & Human Services. (2013). Strategic Plan: Fiscal Year
2013 through Fiscal Year 2015. Retrieved
from:
https://www.alexandriava.gov/uploadedFiles/dchs/WebBoxes/2012_DCHS_Strateg
icPlan.pdf.
Alexandria Department of Community & Human Services. (2014). Alexandria Children &
Youth Master Plan 2014.
Alignment Nashville 2010 Annual Report. Alignment Nashville. 2010.
Betancourt J.R., Green A.R., Carrillo J.E., & Ananeh-Firempong, O. (2003). Defining cultural
competence: A practical framework for addressing racial/ethnic disparities in health and health
care. Public Health Rep 2003; 118:293-302.
Betancourt, Joseph R., et al. "Defining cultural competence: a practical framework for
addressing racial/ethnic disparities in health and health care. "Public health reports 118.4 (2003):
293.
Buss, N., Ciampaglio, J., Dorsey, S., Hoit, J., Rodriguez, C., Silva, G., & Wepplo, T. (2014).
Effective and Efficient Services for Everyone: Advancing Culturally and Linguistically
Appropriate Services in the City of Alexandria Department of Human and Community Services.
Virginia Tech Center for Public Administration and Policy, 1-41.
Chicago Department of Family & Support Services. Children Services Division. Retrieved from:
http://www.childrenserviceschicago.com/.
Conceptual Frameworks / Models, Guiding Values and Principles. (n.d.). Retrieved December
12, 2014, from http://nccc.georgetown.edu/foundations/frameworks.html#ccdefinition.
Cross, T., Bazron, B., Dennis, K., & Isaacs, M., (1989). Towards A Culturally Competent System
of Care, Volume I. Washington, DC: Georgetown University Child Development Center, CASSP
Technical Assistance Center. Retrieved
from:
http://files.eric.ed.gov/fulltext/ED330171.pdf.
Fostering Cultural Diversity.(2011 May 3). Middle Earth: Partnering with Youth for Responsible
Adulthood.Retrievedfrom http://middleearthnj.wordpress.com/2011/05/03/fostering-culturaldiversity/
Goode, Tamara D., & Jones, Wendy. (2000, August 1). Linguistic Competence. Retrieved
December 12, 2014, fromhttp://nccc.georgetown.edu/documents/Definition of Linguistic
Competence.pdf
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Hanley, Jerome. (1999). Beyond the tip of the iceberg: Five stages toward cultural competence.
Reaching todays youth. Vol. 3 No.2.
Integrating "Youth Guided" and "Cultural and Linguistic Competence" Values Into Systems of
Care. (2011, July 1). Retrieved December 12, 2014, from
http://www.tapartnership.org/docs/0782_Integrating_v4b.pdf.
Lee, Katherine. Teaching Kids About Race and Cultural Diversity: How to help your gradeschooler learn to appreciate differences in people. Retrieved from
http://childparenting.about.com/od/socialdevelopment/a/teachdiversity.htm
Lynch, Eleanor W., and Marci J. Hanson. Developing cross-cultural competence: A guide for
working with young children and their families. Paul H. Brookes Publishing, 1992.
Lynch, Eleanor W., and Marci J. Hanson. Developing cross-cultural competence: A guide for
working with young children and their families. Paul H. Brookes Publishing, 1992.
Martin, M. & Vaughn, B. (2007). Strategic diversity and inclusion management magazine, pp.
31-36. DTUI Publications Division: San Francisco, CA.
Metropolitan Nashville Public Schools. MNPS Way Ahead of the Curve for Graduation Rates.
October 2011. Children and Youth Master Plan. Mayors Child and Youth Master Plan
Taskforce. July 2010.
National Center for Cultural Competence. (2002). A Guide to: Planning and Implementing
Cultural Competence, Organizational Self Assessment. Retrieved
from: http://nccc.georgetown.edu/documents/ncccorgselfassess.pdf
National Center for Cultural Competence. The Compelling Need for Cultural Competence.
1997. Retrieved from: http://nccc.georgetown.edu/foundations/need.html.
Technical Assistance Partnership for Child and Family Mental Health. (2010). A System of Care
Team Guide to Implementing Cultural and Linguistic Competence. Cultural
Competence Action Team. Retried from:
http://www.tapartnership.org/docs/clcCommitteeDescription_200705.pdf.
The City of Alexandria Children and Youth Master Plan. (2013, October 30). Retrieved
December 12, 2014, from
http://www.alexandriava.gov/uploadedFiles/dchs/info/YMPFinal2.pdf.
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bullying. The campaign, led by trained high school students and supported by a team of
adults, provides curriculum and activities that schools can use during the school year and
an online community where students can go for support, share their struggles and
successes, and connect with their peers.
The Anti-Defamation League (ADL) provides materials, programs and services to build bridges
of communication, understanding and respect among diverse groups. Using A Classroom of
Difference, ADL focuses on creating an environment of respect, inclusiveness and civility. A
Classroom of Difference maintains and trains through a variety of programs designed to target preK through 12th grade school communities - educators, administrators, youth and families.
Parents Expectations Support Achievement (PESA) is a program designed in Los Angeles, CA,
based on the idea that parents expectations are a significant indicator for their childs academic
achievement. The program is linked to a teacher program that focuses on the expectations for
youth as perceived by the teacher. In connection with the teacher program (TESA), the program
targets parents, guardians and caregivers. The targets are taught techniques to, help raise a childs
academic performance, improve communication with the family and enhance self-confidence.
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CLC Committee is to ensure that the agency adopts a systemic, systematic and strategic approach
to increasing the cultural and linguistic competence of services and supports delivered to the
individuals they serve, eliminate or reduce cultural, racial, ethnic or geographic disparities, and
encourage sensitivity and appreciation for diversity and cultural issues throughout the agency.
Recommended Composition of the Committee:
The executive team should identify, recruit and select members for the committee with input from
cultural leaders and representatives of the individuals they serve. The individuals selected for this
committee should be key decision-makers, subject matter experts or those with influence within
the agency. The committee should include, but not be limited to representatives from the following
stakeholder groups:
Family members
Individuals served
Representatives from partnering agencies
Community members that represent the populations of focus including cultural and faith-based
leaders
Staff representatives (administration and management, practitioners and support staff)
Member of executive team
Member of agency board
Recruitment of Members:
To the extent possible, the committee should reflect the populations of focus, the public and
community-based service organizations participating in the system of care and decision makers
from the agency. Recruitment should include invitations to informal community leaders, cultural
leaders, representatives of the faith community and the leaders of emerging population groups
within the community. Members should be appointed by the Executive Director.
Retention of Members:
An orientation and induction process should be instituted to assist every member to fully
participate in the committees deliberation and activities. A strength-based assessment of the assets
of members (skills, knowledge and attributes) should be conducted to ensure that each member is
positioned to make a valuable contribution to the work. It is also recommended that mentors and/or
buddies be assigned to those who have limited experience serving on community-wide
committees. Similarly, an orientation and buddy system may be needed for agency representatives
who may not be familiar with committees with significant family/youth/consumer participation.
Role of the Committee Chairperson(s):
The leadership of the committee should be structured both to maximize action by the agency as
well as the trust of the cultural communities. This will ensure that the recommendations made by
the committee are used to inform decision-making at all levels, and reflect the needs and interests
of the communities of focus. The chair is responsible for establishing the committees agenda,
scheduling and facilitating meetings, and working in concert with staff and other members to
assign tasks and monitor the progress of task completion as indicated within the Cultural and
Linguistic Competence (CLC) Plan.
Recommended Goals and Responsibilities:
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Also can focus on the specific population groups and/or health issues that are relevant to the
community your facility serves.
It also should address the linguistic access needs of patients with limited English proficiency, as
outlined in the National Standards on Culturally and Linguistically Appropriate Services (CLAS).
Conducting an organizational cultural assessment is a critical first step. Some organizations dont
know what they dont know. Doing an assessment helps determine the strengths and weaknesses of staff
in regard to cultural competency, and this information can be used to help design an effective training
program.
Other experts recommend conducting an assessment both before and after implementing the formal
training, to determine how much staff have learned. It can also serve as a benchmark down the line.
If the organization primarily serves a specific population, such as Latinos, it should target that group
or subgroups to discuss more specific care.
An effective training program should address the three themes of the CLAS standards: organizational,
clinical and linguistic competence.
A well-rounded program also should help providers with assessment issues, such as identifying issues
specific to certain ethnic patient populations but also address organizational issues that look at how
gatekeepers impact access and outcomes to care.
Many good presenters begin their presentations with a frank discussion about organizational racism.
But, trainers and training directors should be careful to understand the overall orientation of the audience
before delving into topics that the audience may not be ready for. Most experts agree that we have to
look at ourselves because we have individual and organizational biases. Many times we arent even
aware of them, but they impact the way we provide care.
This was highlighted in the 2003 report Unequal Treatment: Confronting Racial and Ethnic
Disparities in Health Care, which found that bias, prejudice and stereotyping on the part of health care
providers may contribute to minority patients receiving lower quality care than Caucasians. A good
training program needs to have such knowledge passed on in a way that speaks the individual orientation
of the participant and the overall orientation of the organization.
Tips for integrating cultural and linguistic competence into your training program from the National
Center for Cultural Competence.
Create a structure. Convene a work group with the sole purpose of determining how core
concepts relating to cultural and linguistic competency can be integrated into all aspects of the
ORGANIZATIONS training program. This group will serve as the primary body for
conceptualizing, planning, and framing the way in which this integration takes place. The work
group membership should be diverse and should include such key stakeholders as faculty, staff,
students, and community partners.
Clarify values and philosophy. Each ORGANIZATIONS training program will need to establish
its own philosophy and values of cultural and linguistic competence. This approach is essential
for creating a shared vision among faculty and staff to guide all efforts in this area.
Develop a logic model for cultural and linguistic competence. There are numerous concepts and
definitions for cultural and linguistic competence. (See Conceptual Frameworks/Models,
Guiding Values and Principles developed by the NCCC at
http://gucchd.georgetown.edu/nccc/.html). Reach consensus on a definition or framework for
cultural competence and linguistic competence within the context of the ORGANIZATIONS
training program and/or department. The term logic model refers to a visual schematic that
summarizes the relationship between the resources, activities, and outcomes of a culturally and
linguistically competent system of care (Santiago, 2003). For more information, see the Kellogg
Foundation Logic Model Development Guide, available directly from
http://www.wkkf.org/Pubs/Tools/Evaluation/Pub3669.pdf. See also a PowerPoint presentation
providing an introduction to the use of logic models (Dr. Rachele Espiritus Developing a Logic
Model).
Adapt or create curricula. The logic model and framework should be used to guide the adaptation
or creation of curricula that infuse content on principles, values, and practices of cultural and
linguistic competence that have been determined by the work group.
Determine faculty and staff development needs and interests. Conduct an initial assessment of
faculty and staff to determine what they perceive as their training or professional development
needs and interests related to cultural and linguistic competence. The assessment should query
faculty and staff on the preferred methods, approaches, and formats for increasing awareness and
acquiring new skills and areas of knowledge. Such an assessment should be repeated periodically
as the group acquires knowledge and skills. Ensure that resources are budgeted to support this
effort.
Conduct faculty and staff development assessment. Knowledge of cultural and linguistic
competence will vary among faculty and staff. Assessment results should be used to inform
strategies for faculty and staff development. Plan and conduct ongoing faculty and staff
development activities based on individual needs and preferences. Careful consideration should
be given to the fact that faculty and staff will have different levels of comfort with this content
area. Appropriate supports should be provided and may include:
1. provide opportunities for faculty and staff to meet informally to share opinions and
engage in discussions;
2. create a book club that is dedicated to exploring themes and issues of culture, race, and
ethnicity that are often difficult or controversial to discuss solely on an interpersonal
level;
3. convene facilitated sessions to address major issues or concerns;
4. offer mediation and conflict resolution as warranted by specific circumstances.
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Create a refuge for sharing and learning. It is critical to provide a safe, non-judgmental forum to
explore honestly cultural considerationstheir own and those of the constituency groups they
serve. Creating such a structure provides a much-needed venue to support faculty, staff, and
students in their journey toward cultural and linguistic competence. Utilize social media,
intranet, and online learning communities. Make it interactive, real time, and motivating. Move
as far away from the traditional classroom based, obligatory, boring training as you can.
Conduct an evaluation. Develop an evaluation strategy that measures at a minimum:
(1) the extent to which faculty and staff have increased the incorporation of cultural and
linguistic competence into all aspects of the ORGANIZATIONS training program;
(2) the extent to which students have increased awareness, knowledge, and skills in cultural and
linguistic competence;
(3) student perspectives on the effectiveness of the faculty and training program in incorporating
principles and practices of cultural and linguistic competence; and
(4) the extent to which key consumers benefit from the culturally and linguistically competent
approaches employed by the ORGANIZATIONS training program.
There are several options for providing cultural competence training. These include using existing
training programs that can be adapted for your organization; hiring a consultant to develop a program
specifically for your organization; creating your own in-house training program; or a combination of all
three.
Packaged or established training programs
There are lots of effective any effective cultural competency training programs that have already been
developed by experts? One of the best for mental health is CBMCS Multicultural Training Program.
http://www.sagepub.com/cbmcs/index.htm. It is specifically designed and tested for mental health
providers and agencies.
Some of the more widely used programs include those offered by the Cross Cultural Health Care
Program, Management Sciences for Health, and the Center for Cross-Cultural Health, to name just a few
(see Resources sidebar).
Respected cultural competency models that can be found in literature include those developed by
Issaacs and Bazron, Andrews and Boyle, Campinha-Bacote, Giger and Davidhizar, Leininger, Purnell and
Spector.
Train-the-trainer programs, such as the Cultural Competence Leadership Fellowship sponsored by the
Health Research & Educational Trust and others, are considered one of the most effective formats for
providing cultural competence education. The main reason is that this type of program enables an
organization to reach many individuals.
The primary benefit of using an established program is that it has been proven effective. Additionally,
many of these programs provide a consultant as part of the package to explain the program and how to
implement it.
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It is also important to spend the necessary time needed to research the various programs to determine
which one best fits your organizations needs. For instance, some programs may emphasize cross-cultural
communication skills while others may center on building community partnerships or addressing clinical
issues.
The main disadvantage of using an existing program is that it will have to be modified to fit your
organization. But many of these programs were designed to be adapted. Plus, the consultant can work
with you to help make the necessary adjustments.
Hiring a Consultant
A cultural competence consultant/trainer offers an objective perspective, something that is difficult to
obtain from within your organization. An outside consultant can direct your organization in assessing its
needs, design a program that incorporates those needs and help guide its implementation.
While a national consultant can be very knowledgeable, a local consultant knows the community and
the populations your facility serves.
In either case, the trainer should have expertise in both clinical and organizational issues, with
credentials from a reputable national or international credentialing body. A history of research and/or
publications in the area of cultural competency is important. The individual should demonstrate a history
of continuing growth in this field, because it continues to evolve. Outstanding interpersonal skills, a
genuine passion for the subject and an ethics/values and personality fit with your institution round out the
qualifications.
The trainer does not necessarily have to be a racial or ethnic minority but should have extensive
experience working with minority populations. You may want to ask the consultant for client references
that you can contact.
Doing It Yourself
The benefit of developing your own cultural competency training program from scratch is that your
training department knows your organizations culture best and therefore has a good grasp of what
approaches will be most effective. The disadvantage is that the individual responsible for this task may
lack experience and/or expertise in cross-cultural health issues.
It will be especially important to use the findings from your organizational assessment to develop
your in house training program.
A do it yourself approach allows you to have a multi-prong approach to training as well. Classroom
training doesnt have to be the only way that people are exposed to intercultural learning. There are other
ways that employees can develop these skills. Mitchell Hammer, creator of the Intercultural
Development Inventory Assessment tool suggests there are 12 key learning opportunities for intercultural
learning. Using these anchors, training programs could be developed that are highly interactive and
experiential. This approach also allows for shorter interventions that may be more practical for
employees whose work is scheduled by appointment with clients.
Making It Work
No matter which training option an organization chooses, experts agree that buy-in from administration is
essential for the program to be effective. The top players need to be committed to the concept of cultural
competency, because it is their attitude that will filter down to the staff.
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Leadership should be visible and send the message to middle management that they must be on board
with the training initiative as well.
On-going training and creating of new learning opportunities is an important step in the program. A core
set of training modules can be developed for incoming staff, but there must be new and ongoing
opportunities for staff that have been around a while. It means that time and money must be invested into
the developing training programs. It is an investment that will pay off in enhanced services and
outcomes.
Adapted from material developed by the Virginia Department of Behavioral Health and
Developmental Services Office of Cultural and Linguistic Competence. Additional
information found at https://www.dbhds.virginia.gov/OHRDM-CLC.htm
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