NCCC Topical Conference Call # 2:
Cultural Competence Organizational Self-Assessment:
Implications for State MCH/CSHCN Programs
This call was conducted on January 31, 2002, from 3:00 – 4:30 p.m. EST
The featured speakers included:
§ James Mason, Ph.D., Faculty, Portland State University, NCCC Senior Consultant and author of the Cultural Competence Self-Assessment Questionnaire,
§ Trish Thomas, Outreach Project Director, Family Voices, and
§ Richard Aronson, MD, Chief Medical Officer, Maternal and Child Health, Wisconsin Division of Public Health
Moderator: I’m here with the National Center for Cultural Competence, my name is Tawara Goode, and we welcome you to the second in a series of topical conference calls that we’re conducting in the area of cultural and linguistic competence.
For those of you who may not have had an opportunity to join us before, I’ll share with you very quickly our mission statement and a little bit as to why we are using this approach to technical assistance.
The mission of the National Center for Cultural Competence is to increase the capacity of health care and mental health programs to design, implement, and evaluate culturally and linguistically competent service delivery systems. One of our major objectives is to provide concentrated technical assistance related to cultural competence in policies, procedures, and practices. And in particular, assisting with the Maternal and Child Health Bureau’s, strategic plan. It is intended to support, through the incorporation of cultural and linguistic competence, into all aspects of Title V Children with Special Health Care Needs program, and with that said, I’d like to indicate who else is here from the National Center, and very quickly they can introduce themselves.
Clare Dunne: Hi, I’m Clare Dunne, I’m a research associate here at the NCCC.
Rosalind German: Rosalind German, a family supports coordinator.
Marisa Brown: Marisa Brown, director of the Bureau of Primary Health Care Project of the NCCC.
Suzanne Bronheim: Suzanne Bronheim, project director of the SIDS and Other Infant Death Component.
Moderator: Wendy Jones, director of the MCH project for the NCCC.
Kimberly Gordon: And Kimberly Gordon, project assistant for MCH and SIDS.
Moderator: On your agenda, it includes a welcome and purpose, and it does not include Diana Denboba, who is indeed our federal project officer, and will share perspective now.
Diana: Thank you, Tawara, I’d also like to welcome everyone, we have a wide range of people on the call, from our state Title V and MCH programs, to HRSA funded grantees in genetics, integrated services, newborn screenings, LEND programs, DMS, it’s just a wonderful diversity. We would also like to welcome our federal partners in the field offices of the Bureau of Primary Health Care Programs.
Just a little introduction to why cultural competence is important to children with special health care needs programs, above and beyond that it’s something that should be done. As Tawara had mentioned, we do have in our current MCHB strategic plan, a goal related to 100 percent of our state programs showing that they have cultural competence integrated into policies, procedures, and practices.
In addition to that, our program, along with over 170 partners, has our 2010 Express, it’s a ten-year action plan to achieve community based service systems for children and youth with special health care needs. And throughout that plan, we’ve tried to integrate cultural competence, but in particular, with goal one that relates to family serving as partners in their care and being satisfied with the services they receive.
So our programs are all trying to integrate cultural competence for a variety of reasons, and with that I’ll turn it over to our facilitator.
Moderator: This is Wendy Jones. At this time we would like to introduce our first speaker, James Mason. He is senior consultant for the NCCC and the author of Cultural Competence Self-Assessment Questionnaire that we’ve used in many of our demonstration site activities over the past five years of our work. Dr. Mason is on faculty at Portland State University, and James, would you give us a little bit of your background as it relates to cultural competence organizational self-assessments?
Dr. James Mason: Good morning Wendy, thank you. About maybe ten, fifteen years ago, I was doing research in the area of mental health, and particularly looking at services to diverse populations, and started working with Terry Cross and some other folks on developing a model called cultural competence, building on the work of people like James Lee out of the University of Washington and others. Shortly after that, I got involved in developing tools and process instruments that helped agencies take a look at themselves with respect to serving diverse populations. And I’ve been doing it ever since, and watching others develop in a similar way.
Moderator: Thanks, James. Our next speaker will then be Trish Thomas, who is Outreach Project Director for Family Voices. Trish?
Trish Thomas: Yes, I’m Trish Thomas, and I work with Family Voices, which is a national organization that speaks on behalf of children with special health care needs, and I’m also the parent of two children with special health care needs, and because I also live on the Pueblo Indian Reservation, I have been involved, for some time, in looking at services and information that meet the needs of minority populations.
Moderator: Thank you, Trish. Our last but not least speaker is Dr. Richard Aronson, who is the Chief Medical Officer at Maternal and Child Health, Wisconsin Division of Public Health.
Dr. Richard Aronson: Thanks, Wendy. First of all I want to thank both the National Center for Cultural Competence and the MCH bureau for their tremendous support of Wisconsin over the years with respect to cultural and linguistic competence. And I’m here today representing our Title V maternal and child health, children with special health care needs program. I have with me Lorraine Wiszinsky, who is our parent consultant for children with special health care needs, [inaudible] with me as well, and managers who have done a great job over the past decade on working on this issue. We also have the director of our office of Affirmative Action in civil rights compliance for our Department of Health and Family Services sitting in. So it’s really good to be here, this is a journey, and we’re in the midst of that journey and so we look forward to sharing that with you today.
Moderator: The NCCC has prepared a series a questions to facilitate our discussion with questions, and the first set of questions will go to James Mason. So Dr. Mason, can you please explain what your philosophy is regarding cultural competence organizational self-assessments?
Dr. James Mason: Sure. Essentially I start from the bias/ belief that most people want to, that most organizations want to provide quality care, comprehensive services to all the people within their area, or their service area. What I also know is that most of us, as professionals, were not trained to deal with the diversity that America is now experiencing, and so many of us are often caught behind the eighth-ball, so to speak.
As we struggle to get better, one of the things that’s interesting is we’re not always sure if we’re moving in the proper direction and where we still need to grow. So essentially, I believe in taking a fairly safe, non-threatening approach to helping agencies take a look at themselves with respect to underserving diverse populations in their areas.
The goal of the assessment, in most instances, is to identify ways in which agencies can grow. A secondary goal, and we’ve learned this by experience, is that by doing assessments, we often uncover hidden resources and talents within a community that we weren’t aware of.
Another bias/belief that I think that I bring with me, is that there are multiple stakeholders who need to be involved in this process, including organizational administrators and managers, but also line staff, parents, family members, consumers, community and culturally based advocates, and all these need to be involved in a process that is fairly well managed but keeps its eye on the prize, and the prize is enhanced service delivery to diverse populations. If we do it correctly, it becomes a win-win situation, because we improve services to diverse populations and we as professionals feel better about the work we do. And, of course family members, consumers, and advocates will begin to understand and appreciate the work we do better. So I guess my philosophy is one that starts from a fairly benign perspective and tries to build upon that.
Moderator: Thank you, James. James, with the MCH programs, and with a lot of other federally funded programs, you’re hearing a lot about accountability and performance. What are the benefits of self-assessment versus monitoring that has kind of a ring of, you know, someone will have to see you if you’re not performing?
Dr. James Mason: Well, that’s an excellent question. As I mentioned, our approach has been that it’s not punitive or judgmental, and often when we talk about monitoring or hear about monitoring, there’s this ring of sanction if we don’t measure up. That hasn’t been our goal.
One of the things we’ve recognized is that various programs start at different places, and the goal is how to get people, how to get organizations moving more progressively on this cultural competence continuum. Monitoring almost suggests if we don’t measure up, we’re punished. Assessment, on the other hand, in our experience, is conducted to design an intervention that promotes growth in the agency and in the staff, and hopefully also in consumers and family members as well.
Moderator: Thanks, James. In your experience, what have been some of the results of cultural competence organizational self-assessment, you actually named a couple, but if you don’t mind just reiterating?
Dr. James Mason: Well, we’ve done it well and I think we’ve done it well in a lot of instances. One of the certain benefits is greater involvement on behalf of families, communities, and consumers. And as a result, with their participation, there seems to be a greater satisfaction with services, or a greater awareness that services may change to become more satisfactory, that’s one benefit.
Another benefit has been that it’s been empowering for workers who come to the table wanting to serve diverse populations, either because of their own experiences, their own backgrounds, their own knowledge, so they’ve been validated.
It’s also been reassuring for workers who wanted to be comprehensive in their service delivery approaches but didn’t know where to begin. So ultimately what I would suggest is that when we’ve done self-assessment, we’ve brought various members of the community together to focus on improving services to children and families, not only from diverse backgrounds but all children and families, it’s been empowering for workers who have come to this work wanting to be all they can be, and it’s validating for families who, all of a sudden, have a stronger role and voice in how services are provided.
In other instances it’s resulted in more diversification in the work forces. And we’re fortunate that we have Dr. Aronson on the phone today, because I think Milwaukee is kind of a classic example of what can be done, and they take a real panoramic view of changes, while at the same time, recognizing within their organization a great deal of strength, talent, and resources exist that heretofore hadn’t been tapped.
The other benefit is that when we see this permeate an organization so that it doesn’t just apply to workers of color or workers who speak diverse languages, but it actually bubbles up to the top and affects administration, while also trickling down to people who are in line staff positions. The benefits can be multiple, and I think our approach to cultural self-assessment isn’t to impose upon an organization, but to work collaboratively with that organization, so that we both, as a national center grow, but also help that organization grow in ways that are meaningful to that organization, and not so much, or necessarily meaningful to us as a national center.
Moderator: Thank you James, and for those of you who are interested in looking at the actual tools, please get in touch with NCCC, but we thought the discussion today would encompass prospects and outcomes.
Moderator: James, do you have any recommendations for agencies or organizations that might be thinking about doing a cultural competence organizational self-assessment? What do they have to consider in terms of preparing for it, mobilizing resources, finances, and other variables?
Dr. James Mason: Well, one of the things that’s important for an organization to consider is are they going to comprise a task group, or do they have a task group in place that’s empowered to do this work. And that task group should not only be comprised of, let’s say line staff, but should also have some management personnel, administrative personnel, who bring with them some clout, some influence, and some resources, and can go back to management and explain to them what’s happening and why.
Throughout the whole process, however, everyone within this task group needs to be explaining to the rest of the personnel within the organization why this is being done, how it’s going to be done, how it’s not going to be threatening, how it’s going to be beneficial, and that’s an ongoing task. It’s also an opportunity to reach out to consumer organizations, family member organizations, community-based organizations, who also have on their agendas to improve services to populations they care about as well.