Journey to Cultural & Linguistic Competency: Pennsylvania System of Care CLC Pilot Program

Kelsey Leonard, JD, Cultural and Linguistic Competence Coordinator, PA System of Care Partnership

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• Pennsylvania

• Hiring CLC Coordinator

• PA StandardsSpecific CLC Standard

− Cultural competence is the integration and transformation of knowledge, behaviors, and attitudes from and about individuals or groups that enable policy makers, administrators, youth, families, service providers, and system partners to work effectively in cross-cultural situations. Cultural competence is a developmental process that evolves over an extended period of time.

National CLAS Informed

• De-Shelving CLC Plan

• Creation of statewide CLC Subcommittee

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• How did we start?

Our County is not Ethnically/Racially diverse, is there really anything for us to do to

enhance CLC?

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• CLC Iceberg

Culture Matters

When culture is ignored, families are at risk of not getting the support they need, or worse yet, receiving assistance that is more harmful than helpful.

Definition of Cultural Competence

• Individual Cultural Competence: The state of being capable of functioning effectively in the context of cultural differences.

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

• Culturally Competent Mental Health Care: Will rely on historical experiences of prejudice, discrimination, racism, and other culture-specific beliefs about health or illness, culturally unique symptoms and interventions with each cultural group to inform treatment.

Cross, Bazron, Dennis, & Isaacs, 1989; Pop-Davis, Coleman, Liu, & Toporek, 2003

• The capacity of an organization and its personnel to communicate effectively, and 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, and individuals with disabilities. (Goode & Jones, 2006).

• What is Linguistic Competence?

• 6 Counties

• Each phase of the project aims to: (1) heighten awareness, (2) influence attitudes toward practice and (3) motivate the development of knowledge and skills to incorporate cultural and linguistic competence into the county’s system of care. The pilot project phases include:

Conducting a CLC Assessment

Developing a CLC Plan

Implementing an Action Item from the County CLC Plan− Allocate Resources for Implementation Budget (up to $2500 Grants)

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• CLC Pilot Project

• The first phase of the pilot project addressed three aspects of the assessment process:

Preparing the CLC Assessment and CLC Advisory committee/team.

Assessing the Diversity of youth and families served and county demographics.

Identifying Gaps, Determining Priorities, and Briefing County Leadership Team.

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• Phase 1: CLC Assessment

• Planning for culturally and linguistically appropriate services begins with an awareness of the increasing diversity within a County.

Selecting the CLC advisory committee/team.

Educating the committee/staff about CLC.

Including the youth and family perspective. This will help ensure that the critical information needed is collected and that staff member/committee has the background to make appropriate decisions as the CLC plan is developed.

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• Phase 1: CLC Assessment

• The CLCPs developed by selected pilot counties contain examples of specific tasks and responsibilities within six critical CLC domains:

governance and organizational infrastructure

services and supports

planning and continuous quality improvement

collaboration

communication and

workforce development.

• The pursuit of cultural and linguistic competence is a developmental process.

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• Phase 2: CLC Plan

• Phase 3 of the project will support the implementation of one of the listed CLCP Action Items developed by each of the pilot counties.

• Generally, these action items may fall within three areas of concentration for improving CLC:

Providing Linguistic Services (oral and written).

Improving Cultural Competence.

Developing a Diverse Workforce.

• Identify the following parameters: (1) participant organizations; (2) Roles; (3) Action Steps; (4) Time Frame; (5) Person(s) responsible; and (6) benchmarks.

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• Implementation of CLCP Action Item

• Front desk Training with language adaptation

• CLC Training Videos

• CLC Mission Statements

• CLC Leadership Team Ethics Guidelines

• CLC Poverty Simulation

• CLC Demographic Profile Infographics

• CLC Building Audit

• Language Translation Software with Adaptive Dictionary

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• CLC Pilot Project Outcomes

Let’s Hear From Our Partners!

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York County

Colleen Igo

System & Community Initiatives Manager

Reasons for Participating in the Pilot

• Focused the efforts of our CLC Committee

• Provided opportunities to network with other SOCs

• Received funding support by the PA SOC

• Allowed SOC to address not only cultural but language issues

How Did We Do This?

Designed to help participants begin to understand what it might be like to live in a typical low-income family trying to survive from month to month.

Developed by Missouri Community Action Network

PARTICIPANTS• Simulation of 45 to 80 people (2 ½ to 3 hour

activity) assume roles of up to 26 different families facing poverty

Newly unemployedRecently deserted by the “breadwinner”HomelessGrandparents raising grandchildrenSingle Mom with 3 children

• Task of “families” is to provide the basic necessities and shelter during the course of four 15 minute “weeks”

• Conducted in large room with “families” seated in groups in the center

VOLUNTEERS• Around perimeter are tables representing

community resources & services for the “families”

Pawn broker

Utility Company

Child Care Center

Grocery

Social Services Caseworker

• Realistic portrayals contribute to the success of experience

• Add-On: Spanish Speaking Casemanager/Spanish Form

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• Objective to Sensitize Participants to the Realities Faced by Low-Income People

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• What Does It Look Like?

CLC Pilot Activities

• Developed Partnership with York College

• Recruited youth & families to participate as vendors

• Surveyed participants and asked for their feedback

• Reviewed post-assessments to measure attitudes, feelings, and beliefs

• Participants given opportunity to share their perspective in their specific role

Why Should Others Invest in CLC?

• Increases respect and mutual understanding

• Experiential learning was key to successful training

• Challenges: Training mass number of people who are already extremely busy

• Success: Participants from the previous training are stepping up to volunteer

Lessons Learned

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• Some of the principle obstacles encountered over the course of the program were:

Access to data varies across counties and different system partners

Some counties found it difficult to follow the fast-paced timeline, as well as scheduling events

Availability of templates for easy access and training pertaining to CLC

Limited Resources including staff and funding

Identifying greatest areas of need

Overcoming misperceptions of CLC

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• Obstacles Encountered

• York County

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Project Description

Piloted an

Audit and

Assessment of

a System

Partner

The SOC worked in collaboration with the JCC to

audit and assess the cultural and linguistic

competency of the internal and external

interactions with youth, family, staff and other

system partners.

• Some Pilot Project Successes

• Montgomery County

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Project Description

Development of

CLC Community

Stakeholder

Survey

Excellent tool to engage stakeholders, assess resources/ needs,

and share information

CLC Community

Forum

Great platform for communication, recruitment, and

development of recommendations

CLC training Continued education and awareness of CLC

• Some Pilot Project Successes

• Northumberland County

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• Some Pilot Project Successes

Project Description

Stakeholder

development

Educational system, family and youth

representation on the CLC subcommittee

Resource

Development

Grab and go resources for staff related to varying

cultures within the county

Training Basic Spanish training for front line staff

CLC Trainees = Future Volunteers for Implementation

CLC can be integrated and championed through existing projects!

Cultural Brokers are everywhere. We have tremendous local resources!

CLC needs to be an item on every agenda.

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Successes

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Description Recommendation

Individual values and

experiences of CLT members can

influence CLC progress/ planning

Enhance ground rules and accountability to them in

CLC planning/ discussion both in meetings and all

forms of communication

CLC is complicated and requires

time for discussion and

exploration

Reflect and review existing policies and group

culture as first step. Consider planning with

experienced facilitator to guide and focus CLC

planning/ discussion.

Create accomplishable goals

Structure a CLC plan with reasonable goals that can

be accomplished within the timeframe to build

momentum and awareness. Be action focused.

• Lessons Learned

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• Lessons Learned

Description Recommendation

It is important to allow

individuals a safe place to

explore their experiences

with varying cultures and

shape their views related to

culture.

Provide interactive training that allows for an

exchange of knowledge and a forum to

explore interpersonal issues related to CLC.

Focus on data

Develop and utilize common data elements

and sources to ensure that CLC efforts are

based on data that supports anecdotal

information provided from field work.

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• CLC is a Journey

• How can you do this in your System of Care?CLC Advisory Group

CLC Assessment

CLC Plans

Implement:− Develop Training Opportunities

− Review policies and procedures: Do you have a mission statement with CLC?

− Partner with local culture brokers (universities, community organizations, local vendors, faith-based centers, etc.)

− Value Quality Improvement and Evaluation: Don’t forget to assess/survey how your CLC program/event was perceived by participants.

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• Conclusions

Questions?

Thank You!!

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• Please contact Kelsey Leonard, CLC Coordinator for the Pennsylvania System of Care Partnership at leonardkt@upmc.eduwith any questions, comments and/or for additional resources.

• Thank You