CSPS ADDRESSES CULTURAL AND LINGUISTIC COMPETENCY ISSUES-2017
DEFINING CULTURAL & LINGUISTIC COMPETENCY
What is Cultural Competency?
Cultural Competency refers toa set of integrated attitudes, knowledge, and skills that enables a health care professional or organization to care effectively for patients from diverse cultures, groups and communities.
What is Linguistic Competency?
Linguistic competency refers tothe ability of a physician and surgeon to provide patients who do not speak English or who have limited ability to speak English direct communication in the patient’s primary language.
Brief Review of Federal and State Law Regarding
Linguistic Access and Services for Limited English Proficient Persons
This brief review is intended to assist the CSPS in satisfying the requirements set forth in B&P code 2190.1. California law requiring physicians to obtain training in cultural and linguistic competency as part of their continuing medical education and professional development programs. This document and the accompanying information are intended to provide physicians with an overview of federal and state laws regarding linguistic access and services for limited English proficient (“LEP”) persons. This document is not intended to be comprehensive.There may be additional federal and state laws governing the manner physicians and healthcare providers render services for disabled, hearing impaired, or other protected categories. We recommend physicians review the CMA California Physician’s Legal Handbook for a comprehensive review of laws affecting a physician’s medical practice in California.
Federal Law – Federal Civil Rights Act of 1964, Executive Order 13166, August 11, 2000,
and Department of Health and Human Services (“HHS”) Regulations and LEP Guidance
The Federal Civil Rights Act of 1964, as amended, and HHS regulations require Recipients of federal financial assistance to take reasonable steps to ensure that LEP persons have meaningful access to federally funded programs and services. HHS recently issued revised guidance documents for Recipients to ensure they understand their obligations to provide language assistance services to LEP persons. A copy of HHS’s summary document titled “Guidance for Federal Financial Assistance Recipients Regarding Title VI and the Prohibition Against National Origin Discrimination Affecting Limited English Proficient Persons—Summary” is attached for your review. Additional in-depth guidance is available at HHS’s website at
As noted above, Recipients generally must provide meaningful access to their programs and services for LEP persons. The rule, however, is a flexible one and HHS recognizes that “reasonable steps” may differ depending on the Recipient’s size and scope of services. HHS advised that Recipients, in designing an LEP program, should conduct an individualized assessment balancing four factors, including: (i) the number or proportion of LEP persons eligible to be served by the Recipient; (ii) the frequency with which LEP individuals come into contact with the Recipient’s program; (iii) the nature and importance of the program, activity or service provided by the Recipient; and (iv) the resources available to the Recipient and the costs of interpreting and translation services.
Based on the Recipient’s analysis, the Recipient should then design an LEP plan based on five recommended steps, including: (i) identifying LEP individuals who may need assistance; (ii) identifying language assistance measures; (iii) training staff; (iv) providing notice to LEP persons; and (v) monitoring and updating the LEP plan. A Recipient’s LEP plan likely will include translating vital documents and providing either on-site interpreters or telephone interpreter services, or using shared interpreting services with other Recipients. Recipients may take other reasonable steps, such as hiring bilingual staff who are competent in the skills required for medical translation, hiring staff interpreters, or contracting with outside public or private agencies that provide interpreter services.
California Law – Dymally-Alatorre Bilingual Services Act
The California legislature enacted the California’s Dymally-Alatorre Bilingual Services Act (Govt. Code 7290 et seq.) in order to ensure that California residents would appropriately receive services from public agencies regardless of the person’s English language skills.The Act generally requires state and local public agencies to provide interpreter and written document translation services in a manner that will ensure that LEP individuals have access to important government services. Agencies may employ bilingual staff, and translate documents into additional languages representing the clientele served by the agency. Public agencies also must conduct a needs assessment survey every two years documenting the items listed in Government Code section 7299.4, and develop an implementation plan every year that documents compliance with the Act. A copy of this law may be found at the following
Medical Literature Related to Ethnicity & Plastic Surgery(Note: This list is not intended to be all-inclusive, but serve as a reference tool for your use. A new updated list will be available on the CSPS website in June 2016!)Any links to external Web sites and/or cultural and linguistic competency information provided in CSPS’ handout are provided as a courtesy. They should not be construed as an endorsement by CSPS of the content or views of the linked materials. Please respect all copyrights.
boxEffect of federal and state policy changes on racial/ethnic variation in immediate postmastectomy breast reconstruction.
Mahmoudi E, Giladi AM, Wu L, Chung KC.
Plast Reconstr Surg. 2015 May;135(5):1285-94. doi: 10.1097/PRS.0000000000001149.
Going into surgery: Risk factors for hypertrophic scarring.
Butzelaar L, Soykan EA, Galindo Garre F, Beelen RH, Ulrich MM, Niessen FB, Mink van der Molen A.
Wound Repair Regen. 2015 Apr 8. doi: 10.1111/wrr.12302. [Epub ahead of print]
Factors influencing incidence and type of postmastectomy breast reconstruction in an urban multidisciplinary cancer center.
Iskandar ME, Dayan E, Lucido D, Samson W, Sultan M, Dayan JH, Boolbol SK, Smith ML.
Plast Reconstr Surg. 2015 Feb;135(2):270e-6e. doi: 10.1097/PRS.0000000000000888.
Buttock Reshaping With Intramuscular Gluteal Augmentation in an Asian Ethnic Group: A 6-Year Experience With 130 Patients.
Park TH, Whang KW.
Ann Plast Surg. 2014 Dec 19. [Epub ahead of print]
A Pilot Assessment of Ethnic Differences in Cosmetic Outcomes following Breast Conservation Therapy.
Hirsch EM, Chukwu CS, Butt Z, Khan SA, Galiano RD.
Plast Reconstr Surg Glob Open. 2014 Feb 7;2(1):e94. doi: 10.1097/GOX.0000000000000013. eCollection 2014 Jan.
Revision rhinoplasty in ethnic patients: pollybeak deformity and persistent bulbous tip.
Slupchynskyj O, Rahimi M.
Facial Plast Surg. 2014 Aug;30(4):477-84. doi: 10.1055/s-0034-1367715. Epub 2014 Jul 30.
Multicultural issues in facial plastic surgery.
Thomas JR.
Facial Plast Surg Clin North Am. 2014 Aug;22(3):ix. doi: 10.1016/j.fsc.2014.06.001. No abstract available.
Considerations in non-Caucasian facial rejuvenation.
Sykes JM, Nolen D.
Facial Plast Surg Clin North Am. 2014 Aug;22(3):463-70. doi: 10.1016/j.fsc.2014.04.008.
Laser skin treatment in non-Caucasian patients.
Richter AL, Barrera J, Markus RF, Brissett A.
Facial Plast Surg Clin North Am. 2014 Aug;22(3):439-46. doi: 10.1016/j.fsc.2014.04.006. Epub 2014 Jun 10. Review.
Asian blepharoplasty.
Lam SM.
Facial Plast Surg Clin North Am. 2014 Aug;22(3):417-25. doi: 10.1016/j.fsc.2014.04.002. Epub 2014 Jun 10. Review.
Rhinoplasty in the Mestizo nose.
Cobo R.
Facial Plast Surg Clin North Am. 2014 Aug;22(3):395-415. doi: 10.1016/j.fsc.2014.04.011.
Rhinoplasty in the Mestizo nose.
Cobo R.
Facial Plast Surg Clin North Am. 2014 Aug;22(3):395-415. doi: 10.1016/j.fsc.2014.04.011.
Individualized Asian rhinoplasty: a systematic approach to facial balance.
Li Z, Unger JG, Roostaeian J, Constantine F, Rohrich RJ.
Plast Reconstr Surg. 2014 Jul;134(1):24e-32e. doi: 10.1097/PRS.0000000000000294.
Update on Asian eyelid anatomy and clinical relevance.
Saonanon P.
Curr Opin Ophthalmol. 2014 Sep;25(5):436-42. doi: 10.1097/ICU.0000000000000075. Review.
What is the best strategy for Asians with involutional entropion?
Asamura S, Kakizaki H, Shindou E, Itani Y, Isogai N.
J Craniofac Surg. 2014 May;25(3):972-5. doi: 10.1097/SCS.0000000000000475.
Incidence of oral clefts among different ethnicities in the state of California.
Saad AN, Parina RP, Tokin C, Chang DC, Gosman A.
Ann Plast Surg. 2014 May;72 Suppl 1:S81-3. doi: 10.1097/SAP.0000000000000164.
The impact of geographic, ethnic, and demographic dynamics on the perception of beauty.
Broer PN, Juran S, Liu YJ, Weichman K, Tanna N, Walker ME, Ng R, Persing JA.
J Craniofac Surg. 2014;25(2):e157-61. doi: 10.1097/SCS.0000000000000406.
ONLINE RESOURCES:The CSPS is dedicated to providing you with the necessary data assessment tools as well asthe development and availability of resources you may use to address these issues in your practice.
The CSPS will be updating information for you to use in your practice on the member side of its website at Included in this information will be a California Endowment commissioned report “Addressing Language Access Issues In Your Practice – A Toolkit for Physicians and Their Staff Members”.
As we are continually assessing the needs of our meeting’s participants, please indicate on your evaluation form in the box provided how the CSPS may better assist you, through its educational programs, in addressing cultural and linguistic competency issues in your practice.
QUESTIONS: If you have any questions, please contact the CSPS Executive Office at (510) 243-1662.