What is Cultural Competency in Healthcare?
Cultural competency in health care describes the ability of systems to provide care to patients with diverse values, beliefs, and behaviors, including the tailoring of health care delivery to meet patients’ social, cultural, and linguistic needs. A culturally competent health care system acknowledges the importance of culture, incorporates the assessment of cross-cultural relations, recognizes the potential impact of cultural differences, expands cultural knowledge, and adapts services to meet culturally unique needs. Ultimately, cultural competency is recognized as an essential means of reducing racial and ethnic disparities in health care.
Purpose of BCBSAZ Health Choice Cultural Competence
BCBSAZ Health Choice has a Cultural Competency Program, which includes a Cultural Competency Plan (CCP). The vision of the cultural program is to ensure all members have access to quality health care and can achieve their potential for health and well-being. The program is managed on a set of principles that guide our decision-making and practices for collaboration.
Our plans are designed to guarantee a member’s right to be treated fairly and with respect without regard to age, ethnicity, race, sex (gender), religion, national origin, creed, tribal affiliation, ancestry, gender identity, sexual orientation, marital status, genetic information, socio-economic status, physical or intellectual disability, ability to pay, mental/physical diagnosis and/or cultural and linguistic need. We ensure delivery of services in consideration for the member’s preferred language, English proficiency, literacy, and visual, and auditory abilities.
Our approach in honoring diversity is by understanding the core needs of those in our service areas and designing services and materials to meet those unique needs strategically. HCA oversees and manages the delivery of services with the understanding that these needs must be met within the context of varying human behavior, which includes but is not limited to thought, communication, actions, customs, beliefs, and values. With these key elements in mind, our CCP aims to ensure:
- HCA meets the unique diverse needs of the populations we serve,
- Our staff value, foster and embrace diversity within the organization,
- Services are provided in a culturally and linguistically competent manner to all enrollees, including those with Limited English Proficiency (LEP),
- Members with LEP have their communication needs met, and
- Our provider partners fully recognize and are sensitive to the cultural and linguistic differences of the populations we serve.
The delivery of culturally and linguistically competent health care and services requires health care providers and/or employees to possess a set of attitudes, skills, behaviors, and policies which enable the organization and staff to work effectively in cross-cultural situations1. It reflects an understanding of the need for acquiring and using knowledge of the unique health-related beliefs, attitudes, practices, and communication patterns to improve services, strengthen programs, increase community participation, and eliminate disparities in health status among diverse population groups.
Cultural Competency Administrator
Jeanette Mallery, M.A.
Culture and Diversity Council, Chair
BCBSAZ Health Choice oversees language services for the System of Care in accordance with Title VI of the Civil Rights Act of 1964, 42 CFR Part 438, URAC Accreditation Standards (URAC v7.2, CORE 34, 37 & 40), related state requirements including ACOM Policies 404 and 406, and Section 1557 of the Patient Protection and Affordable Care Act (ACA), prohibiting discrimination on the basis of race, color, national origin, sex, age, or disability in certain health programs or activities. The goal of the language services is to ensure that BCBSAZ Health Choice staff and BCBSAZ Health Choice provider staff communicate effectively and meaningfully with LEP individuals.
BCBSAZ Health Choice (Health Choice) and subcontracted providers must make oral interpretation services and translation services available to persons and/or their families with Limited English Proficiency (LEP) at all points of contact. This is to ensure appropriate delivery of mental health and physical health services for individuals. Oral interpretation and sign language (ASL) services are provided at no charge to the member and/or the member’s family seven days a week, 365 days a year. These services ensure access to qualified interpreters trained in health care terminology. Oral interpretive services must be provided by: qualified interpreter staff, qualified bilingual staff, contracted qualified interpreters, telephone interpretation services, video remote interpretation services, or from a qualified individual provider office, agency, or facility. Sign language services are to be provided by licensed interpreters for the deaf and the hard of hearing pursuant to A.R.S. § 36-1946.
BCBSAZ Health Choice provides these services to our members when communication occurs with BCBSAZ Health Choice staff. Our providers are to deliver interpretation and translation services in accordance with Federal and State requirements when communicating with our members. Please refer to the attached document for more information and guidance on delivering these services.
Resources: Improving Cultural Competence
SAMHSA has published a guide for professional care providers and administrators to help understand the role of culture in the delivery of mental health and substance use services. It describes cultural competence and discusses racial, ethnic, and cultural considerations.
The following are resources for understanding basic cultural competence principles.
- National Standards on Culturally and Linguistically Appropriate Services(HHS, Office of Minority Health)
- Challenges and Strategies in Achieving Cultural Competence in Child Welfare Driven Systems of Care(HHS, Administration for Children & Families)
- Enhancing Cultural Competence in Social Service Agencies: A Promising Approach to Serving Diverse Children and Families – PDF(HHS, Office of Planning, Research, and Evaluation); July 2014
The following are resources to provide guidance for cultural competency in specific settings.
- A Physician’s Practical Guide to Culturally Competent Care(HHS, Office of Minority Health)
- Culturally Competent Nursing Care: A Cornerstone of Caring(HHS, Office of Minority Health)
- Health Literacy for Public Health Professionals (HHS, Centers for Disease Control and Prevention)
- Talking with Teens about Reproductive Health: How to Tackle the Tough Topics(HHS, Office of Adolescent Health); May 2013
- Telehealth and Patient Engagement Tip Sheet
- Telehealth Member Tip Sheet
LGBTQIA+ Resources and Tools
Lesbian, gay, bisexual, and transgender (LGBT) populations, in addition to having the same basic health needs as the general population, experience health disparities and barriers related to sexual orientation and/or gender identity or expression.
The resources found in this section are to be referenced for guidelines and tips when providing care for the LGBTQIA+ community. Please refer to these tools to help you and your staff gain an understanding of how to be more inclusive and increase your knowledge of the LGBTQIA+ community.
Social Determinants of Health
- Social Determinants of Health: Know What Affects Health(HHS, Centers for Disease Control and Prevention)
- Co-Occurring Risks in Adolescence: Implications for Teen Pregnancy Prevention – PDF(HHS, Office of Adolescent Health)
- Conducting a Root Cause Analysis and Action Planning Process – PDF (JSI Research and Training Institute)
- Social Determinants of Health that Impact Teen Pregnancy (HHS, Office of Adolescent Health); Audio, Transcript – PDF
- Promoting Health Equity in Your Community: Utilizing the Working with Diverse Communities (WDC) Strategies Guided by Best Practice – PDF(HHS, Office of Adolescent Health); May 2013
- Social Determinants of Teen Pregnancy (HHS, Office of Adolescent Health); May 2013; Slides – PDF, Audio, Transcript – PDF
- Promoting Health Equity: A Resource to Help Communities Address Social Determinants of Health – PDF(HHS, Centers for Disease Control and Prevention); 2008