Ethical and Cultural Considerations

For your initial post, select one need identified for the community you examined in the multimedia presentation in the Studies for this unit. Formulate the list of ethical and cultural aspects that would need to be taken into account for designing a program to address this need, based on the National Standards on Culturally and Linguistically Appropriate Standards (CLAS) shared on page 111 of your Program Development in the 21st Century textbook.

Pg 111 from the book

National Standards

Providing another form of guidance on a national level, the standards promulgated by the Department of Health and Human Services’ (2007) Office of Minority Health focus specifically on cultural and linguistic competencies for health care providers (see Box 4.1). In addition, the National Center for Cultural Competence at Georgetown University provides a host of resources for integrating cultural competence in mental health program design (http://nccc.georgetown.edu). Both of these may prove significant resources in comprehensive program development to ensure that cultural competence remains a central part of services and treatment.

BOX 4.1

NATIONAL STANDARDS ON CULTURALLY AND LINGUISTICALLY APPROPRIATE STANDARDS (CLAS)

Health care organizations should take the following actions to meet CLAS standards:

1. Ensure that patients/consumers receive from all staff members effective, understandable, and respectful care that is provided in a manner compatible with their cultural health beliefs and practices and preferred language
2. Implement strategies to recruit, retain, and promote at all levels of the organization a diverse staff and leadership that are representative of the demographic characteristics of the service area
3. Ensure that staff at all levels and across all disciplines receive ongoing education and training in culturally and linguistically appropriate service delivery
4. Offer and provide language assistance services, including bilingual staff and interpreter services, at no cost to each patient/consumer with limited English proficiency at all points of contact, in a timely manner during all hours of operation
5. Provide to patients/consumers in their preferred language both verbal offers and written notices informing them of their right to receive language assistance services
6. Assure the competence of language assistance provided to limited English proficient patients/consumers by interpreters and bilingual staff; family and friends should not be used to provide interpretation services (except on request by the patient/consumer)
7. Make available easily understood patient-related materials and post signage in the languages of the commonly encountered group and/or groups represented in the service area
8. Develop, implement, and promote a written strategic plan that outlines clear goals, policies, operational plans, and management accountability/oversight mechanisms to provide culturally and linguistically appropriate services
9. Conduct initial and ongoing organizational self-assessments of CLAS-related activities and, ideally, integrate cultural and linguistic competence-related measures into internal audits, performance improvement programs, patient satisfaction assessments, and outcomes-based evaluations
10. Ensure that data on the individual patient’s/consumer’s race, ethnicity, and spoken and written language are collected in health records, integrated into the organization’s management information systems, and periodically updated
11. Maintain a current demographic, cultural, and epidemiological profile of the community as well as a needs assessment to accurately plan for and implement services that respond to the cultural and linguistic characteristics of the service area
12. Develop participatory, collaborative partnerships with communities and utilize a variety of formal and informal mechanisms to facilitate community and patient/consumer involvement in designing and implementing CLAS-related activities
13. Ensure that conflict and grievance resolution processes are culturally and linguistically sensitive and capable of identifying, preventing, and resolving cross-cultural conflicts or complaints by patients/consumers
14. Try to regularly make available to the public information about the organization’s progress and successful innovations in implementing the CLAS standards and provide public notice in their communities about the availability of this information

Reference for the book

Program Development in the 21st Century

AN EVIDENCE-BASED APPROACH TO DESIGN, IMPLEMENTATION, AND EVALUATION

Nancy G. Calley

University of Detroit Mercy