Cultural Competency Action Group Meeting 2 Discussion Board
Meeting 2 Notes
Welcome to Meeting 2 of the Cultural Competency Action Group!

[NOTE: Comments listed here are based on notes taken during the meeting and may not accurately capture or summarize comments made by participants. Corrections and clarifications are welcomed and should be emailed to Connie Satzler, csatzler@kansas.net.]


Members present: Gaby Flores, Representative Delia Garcia, Barbara Gibson, Oliver Green, Susan Kang, Kim Kimminau, Paula Marmet, Karry Moore, Ghazala Perveen, Elaine Schwartz, Brandon Skidmore

Paula gave overview of process to date. Steering Committee prioritized action steps that could best move forward 10 Leading Health Indicators. Steering Committee members voted on those action steps most interested in working on. Action groups formed around top 3 (cultural competency, disparities data, comprehensive tobacco use prevention and control)

Refer to Meeting 1 Summary

Review recommendations. Add more specificity.

Consider:
1. Program changes: Do these require legislative change?
2. Policy changes: Can these be implemented directly by Steering Committee?

How broad?

State agencies? Community groups?

Might be useful to start with state agencies.

Promote self assessment by all types of organizations.

What are we targeting with cultural competency assessment?

There are some national cultural and linguistic standards that could be endorsed that could have cultural competence assessment.

What are we trying to accomplish?

Barb: Surveyed Local Health Departments on primary languages spoken in communities. Not only because we needed to know but also so we can see if they knew.

Assessment need, language access assurance plan...

To whom does this apply?

Not dealing with general population, dealing with service providers. We want to know the diverse make up, but are our service providers competent to serve population in the area.

How would this happen?

Have taken on offering cultural competence training. There are resources for groups that are interested. These can be large contributions. Big focus in cultural competence is national...biggest newly emergent problem in language.

Paula: Requirement that interpreters available?

Barb: No, by going through assessment can determine what you are required to do for persons with limited English proficiency (LEP).

There are thresholds.

Barb: Many parts of state have telephone available. Around the state, LHD, others, need assistance in...

Face-to-face language cards.

Some baseline information that we could use...

Barb: How many service providers have done assessments...we don't know who is doing what.

Barb: See inventory and clearinghouse as office of minority health role.

Barb: Part of strategy is to try to recruit members of underrepresented groups into health professions.

Elaine: So...really no good baseline data.

No, not at this time.

Now, new immigrant populations in Kansas.

Barb: Enforcement issue related to cultural competency.

Who enforces? Office of Civil Rights.

Oliver: Doing some training now. Language is a big problem. At some point, this group might want to look at Garden City. All signs in elementary school in English, Spanish, Laotian, and Vietnamese.

Paula: So conducting baseline assessment in the state a priority? If so, how broad? Include social services?

Representative Garcia: Doing a community assessment now in my neighborhood. There is a health component, social services, political. Door-to-door survey.

Do a cultural competency piece - with

Kim: Might be doing the obvious. Do we feel like this is the convincing piece of data that we need? Would resources best be spent elsewhere?

It's beyond linguistics. It's not just black and white. We know there's a need there. Given that, what tools and resources are needed at the community level to move forward?

All of those things exist; we don't have to ask them. By letting them know that we have a clearinghouse of various cultural competency assessment and planning resources. Need to be able to assure to federal partners and to us, language access to persons with limited English proficiency (LEP). How do they assure to us?

Think there's an enormous amount of data we currently sit on that demonstrates quickly the need. To some, you're telling them what they already know. To others, you're giving them new information to act on.

Garden City has embraced the diversity and it has permeated their systems. All recognized that it's a good thing. Good example of how you do it right. Leader in multicultural issues.

Can go from extreme in issues - Garden City to others.

Whether you see the wave coming at you or not, there's a need.

Promote how important it is to do assessment. Most people want to learn, they are very hungry for this.

Where is the clearinghouse?

Office of Minority Health

Broader than Office of Minority Health.

See Office of Minority Health working across agencies. Not a health problem. Broader than that.

Would like to see at a cabinet level. It's only going to move disparities if embraced and owned by every agency.

Need resource hubbing. Supporting agencies like public health association, etc. Responsibility shouldn't be on office of one or two.

Should be in Office of Minority Health, but office should be broader.

Is this happening in other states? Yes - Minnesota, Alaska, Hawaii.

Region VII Office of Minority Health has been very helpful. Office for Civil Rights (OCR) has been very hands-off. Only if formal grievances in multiples will they do an investigation.

Agreement that some kind of state assessment of needs and resources, but focus on clearinghouse, providing tools to organizations.

Jump right into tools.

Recommend that Office of Minority Health becomes a cultural competency clearinghouse.

Prepare and distribution from resources we already have needs.

To find out where resources are - long-term effort. Where are training resources? Where are community experiences? Where are benchmarking leader organizations?

There is no place we can point someone to.

Recommend Office of Minority Health becomes the clearinghouse, the go-to place.

Oliver: Have created diversity network. (He works in Human Resources) Looking at Human Resources issue. How do we share resources? Training videos, whatever, to better address these issues. Scheduled 4 summits to look at recruitment, retention, etc. Having Diversity Summits, coordinated by Diversity Network. Getting some interesting data about what we need to do in HR to open our doors and get more diverse in. Governor has been supportive. Think climate is ripe for this type of activity. Summits sponsored by cabinet agencies. SRS, Corrections, Revenue, Kansas Highway P, KDHE(?). Voluntary. To promote diversity in state government.

Have a webpage: http://www.kansas.gov/ksdiversity/

Representative Garcia: Had one of those meetings Wichita recently.

Emerging issues.

Have been pushing to get executive order on diversity.

Are commissions involved? Yes.

Guidance on whether or not itís appropriate to write-in to position a description of certain skills you would give preference to (e.g., language proficiency).

Would approach with competency (vs. affirmative action, e.g.). Looking at inclusiveness, demonstration of their ability to work with diverse populations.

Could be concrete recommendation - evaluate position descriptions and address needs related to cultural competence.

Compensate support staff, e.g., that help with interpreters. Additional compensation for bilingual.

Gaby: Related to Oliver's comment...I work for safety net hospital in KC...a lot of people are claiming to be bilingual, but when you do a competency assessment, you find that they actually are not. Bilingual employees mostly demonstrate competency to have pay increase.

One of things that has been beneficial for us...use recommendations put forward by Institute of Medicine on Unequal Treatment. In that work, there is a list of recommendations. A lot of the groundwork is already done. Can be used at institutional or state level. Very multi-faceted (R&R, language access, clinical outcomes).

Representative Garcia: Iowa has passed linguistic accountability bill...have 16-year-olds going in to translate for parents & not knowing medical terms. Have people who are bicultural and bilingual but aren't fluent in medical terms. We are working on this bill right now. Strategically, will start with health, and then move to other areas (judicial, etc.) It is a certification.

Gaby: Some of the challenges Missouri has faced in court certification process for interpreters, is having had a hard time getting people to pass. You end up with very few to cover the whole state. Hasn't been very successful; low passing rate. People that have been working in the field for a long time hasn't been able to pass.

Other great bit of news, working with Johnson County Community College, have just started health care interpreter program. Gaby and another person are teaching courses. Year-long program with practicum.

Want support from regents so training happens at many community colleges. De-centralize. Make programmatic initiative across the state of Kansas.

Tools for organizations - would turn to Gaby and others for tested, reliable tools. Tap panel of experts to help state identify in ongoing way - some are tailored for certain industries & allow cultural competency training/assessments to be woven into other requirements and processes.

Not static. Needs to be updated. Could be an advisory committee to review and consult. Keep fresh and ongoing.

Related to #6 on summary...

Ghazala: Linked to other steps.

Karry: Does the language also change?

Yes, need to review.

Adopt definition of cultural competency (see workgroup plan)

Ongoing evaluation of definition, language.

If this is done through the Office of Minority Health as a clearinghouse, this can be done behind the scenes rather than happening all over the place like it does now.

7. Develop advanced cultural competency training courses...

Gaby: KDHE has contracted with Jewish Vocational Service for a number of years to provide medical interpreter training. Also contracted to do the Cultural Competency training...the course that Johnson County is offering is specific to Spanish-speakers. A number of community colleges have various courses. Not sure that there are products out there now that would be appropriate. We're looking at this now. Are some resources out there now specializing in reducing and eliminating health disparities...National Council on Healthcare Leadership has great assessment tools available.

No need to reinvent the wheel.

Barb: Can take advantage of electronic media. Assemble and endorse the best of the best that's available electronically. Even though the around the state meetings are very useful, but it doesn't reach everyone.

Oliver: Found the same thing. Training around the state useful, but not everyone can come.

Ghazala: If interactive, these types of training are great. Interactive component is useful.

Barb: We're doing all of our training for HPSAs using computer-facilitated tools.

Barb: We've developed a language access tool for local health departments, walks them through online.

Ghazala: Advanced courses for certain cultures. Basic for everyone, then advanced for certain cultures.

Identify tools, have resource-directory, library.

Is Jewish Vocational Service training certified?

Gaby: Students are self declared. No assessment of their language skills. Course is taught primarily in English. They do complete a certification test. But only certificate of completion.

Use telephonic service that assess language skills, competency. Can use to assess employees. Competency assessment is so critical. Want to see some documentation that you have evaluated language in some way. That is done by phone.

If can't find a qualified candidate, continue using telephonic interpretive services.

Ghazala: Health care providers from that culture, utilize individuals like this to help on advisory board. ...if we know that there are individuals in certain communities, can use to help create guidelines.

We will put notes together, post on web, and notify you. Please be critical in your comments.

Meeting 2 Discussion Board is now closed. Please add additional comments to the General Discussion Board.
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Cyndi - thanks for your comments and sorry about the problems with the conference call. Connie
Sorry I was unable to get into the meeting yesterday by conference call. I tried several times and finally gave up. I read the discussion from yesterday and wanted to share some of my thoughts. I spent quite a long time reviewing the Minnesota Dept of Human Resources Guidelines for Culturally Competent Organizations. While I thought it was entirely too long and a bit wordy, it had some great information. While I donít want to print anything like this for Kansas, I do think having a website, where individuals and agencies interested in cultural competency could go for information and direction would be great. We could then add new information; delete outdated info as needed, etc. As for where this website would reside is up for discussion. On the website we could include definitions of cultural competency, and language access law and guidance relating to these topics (Civil Rights Act of 1964, HHS Guidance in form of CLAS standards, WICHE Standards, etc.) We could have info about levels of cultural competency such as individual/provider, governance, agency policy and procedures. We can have links to data that would facilitate assessment of the local population served (census, vital statistics, KS bilingual education stats, etc), links to already existing agency level assessment tools (like Georgetownís), and resources for examples and/or support for cultural competency development/plans. Training opportunities that would facilitate cultural competency and language access could also be included. Cyndi
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