limited english proficiency & cultural diversity · 3 lep & cultural diversity “…we...

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LIMITED ENGLISH

PROFICIENCY &

CULTURAL DIVERSITY

LIMITED ENGLISH

PROFICIENCY &

CULTURAL DIVERSITYTaylor Special Care Services,

Inc.

Simon Pop, MBA

Chief Operating Officer

2012 - 2013

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Adopted from

“Limited English Proficiency: It’s not about

speaking English”

Michigan Association of Community Mental

Health Boards

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LEP & Cultural Diversity

“…we sometimes forget…how much a barrier language can pose for a

person who does not speak English

• It can be a barrier to accessing important benefits and services;

• It can be a barrier to understanding the exercising important rights;

• It can be a barrier to complying with governmental or other responsibilities;

• It can be a barrier to understanding how to participate fully in our society…

Ralph R. Boyd, Jr.

Assistant Attorney for Civil Rights (U.S. Dept. of Justice)

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LEP & Cultural DiversityOur Intent:

• To fulfill our Mission: Our commitment and

goal is to provide the highest-quality services and clinical

support to people with chronic mental illness and residential

young adults to meet their individual needs.

• To inform that limited English

proficiency shall not serve as a

barrier to receiving services and

supports from our organization.

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LEP & Cultural DiversityOur Legal Responsibility:

To fulfill value of Integrity:

- TSCS shall comply with all applicable

laws and regulations regarding

Limited English Proficiency.

- Enhancing staff and volunteer

knowledge and understanding of these

requirements are aspects of our

Accessibility Planning.

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LEP & Cultural DiversityQuestion:

• Is English the official

language of the United

States?

NO

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LEP & Cultural DiversityRehabilitation Act of 1973:

• “No otherwise qualified individual with a disability in the United States…shall, solely by reason of his disability, be excluded from participation in, be denied the benefits of, or be subjected to discrimination under any program activity receiving Federal financial assistance…”

• The preponderance of clients served by Taylor Special Care Services, Inc., under public funds, are served through Federally financed programs through the County and Core Providers.

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LEP & Cultural DiversityAmericans’ with Disabilities Act (PL 101-336 of July 26, 1990)

• “Handicapped – any person who has physical or mental impairment…which substantially limits one or more life activities…substantially equal…”

• Based on the U.S. Constitutional principle, embodied in the Bill of Rights, namely: equal protection of the laws, our obligation in serving and supporting people with disabilities includes the responsibility to provide reasonable support to accommodate to help clients overcome barriers affecting accessibility to our services and supports (Refer to TSCS Accessibility Policy).

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Executive Order 13166 of August 11, 2000…namely “Presidential Order”

stressed the importance of language accommodation for

persons with

Limited English Proficiency.

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Our legal basis, in the U.S., for accommodating people with

Limited English Proficiency:

The Voting Rights ActThe Food Stamp ActJudicial Procedures

The Older Americans ActThe Substance Abuse and Mental Health

Administration Reorganizing ActThe Disadvantaged Minority Health Improvement Act

The Equal Educational Opportunities Act of 1974HCFA Regulations

State Law and Regulation

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Also, Accreditation Organizations expect accommodation as an aspect of assuring

accessibility to clients, staff, etc.:

CARFJCAHONCQA

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There are two (2) means by which TSCS can accommodate clients with Limited English Proficiency

1. Interpreter Services2. Bi-Lingual Services

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Accommodations for Limited English Proficiency must be made to assist

client in:

Assessment and Eligibility Determination

Services and Support Planning and Review

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Accommodations help enhance:

Services and support effectiveness in general service delivery as well

as crises and emergenciesProfessional ethics and practice

Fulfill regulatory requirements.

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Documents, as well as verbal communication must be

translated.

Accommodations to assist clients with Limited English Proficiency

are:

NOT OPTIONAL!

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LEP & Cultural DiversityUnderstanding Culture:

CULTURE:- Influences how we perceive the world

around us.- Involves shared customs, values, social

rules of behavior, rituals and traditions and perceptions of human nature and

natural events.

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2000 U.S. Census Data Revealed That:

- Hispanics have replaced African Americans as the second largest ethnic group after whites.

- Higher birth and immigration rates has made the Hispanic population the fastest growing minority group.

- The Asian American population is growing and is projected to continue to grow throughout the first half of the 21st century.

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2000 U.S. Census DataBy 2010:

- Hispanic Americans – 14.6%.- African Americans – 12.5%.- Asian Americans – 4.8%.- Native Americans – Less than 1%.

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These Demographic Changes Have:

- Given the U.S. the benefits and richness of many cultures, languages and histories.

- Made it more important than ever for health and human service providers to recognize, understand, and respect the diversity found among cultural groups and subgroups.

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Service Providers MUST:

- Find ways to tailor their services to individuals’ and communities’ cultural identities, languages, customs, traditions, beliefs, values, and social support systems.

THIS IS THE FOUNDATION FOR CULTURAL COMPETENCY.

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DEFINITIONS:

- “Ethnicity” – refers to a common heritage of a particular group. Elements of this shared heritage include history, language, rituals, and preferences for music and foods.

- “Culture” – refers to the shared attributes of a group of people and is broadly defined as a common heritage or learned set of beliefs, norms, and values.

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DEFINITIONS:

- Culture can be defined by characteristics such as:- National Origin- Customs/Traditions- Language / Age / Gender / Education Level- Geographic Location- Religious Beliefs- Political Beliefs - Sexual Orientation- Physical Ability or Limitations- Socioeconomic Status

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DEFINITIONS:

- “Cultural Awareness” – suggests that it may be insufficient to be cognizant, observant, and conscious of similarities and differences among cultural groups.

- “Cultural Sensitivity” – connotes the ability to empathize with and understand the needs and emotions of person of one’s own culture as well as those of others and to identify with emotional expressions and the problems, struggles, and joys of someone from another culture.

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DEFINITIONS:

- “Cultural Competency” – is a set of values, behaviors, attitudes, and practices within a system, organization, programs, or among individuals that enable people to work effectively across cultures. Refers to the ability to honor and respect beliefs, language, interpersonal styles, and behaviors of individuals and families receiving services, as well as the staff who provide such services. Is a dynamic, ongoing, developmental process that requires a long-term commitment. Is achieved over time. Emphasizes that being aware of or sensitive to the differences between cultures is not sufficient.

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Culturally Competent Organizations:

- Value Diversity.- Have the capacity for cultural assessment.- Are aware of cross-cultural dynamics.- Develop cultural knowledge.- Adapt service delivery to reflect an understanding

of cultural diversity. - Requires an understanding of one’s own culture and

worldview as well as those of others. - Involves the examination of one’s attitudes and

beliefs, and the ability to demonstrate values, knowledge, skills and attributes needed to work sensitively and effectively in cross-cultural situations.

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Culturally Competency at the Organizational and Programmatic Levels:

- Requires a comprehensive, coordinated plan that cuts across policy-making, infrastructure building, program administration and evaluation, and service delivery.

- Requires acknowledgment of the importance of culture and the assessment of cross-cultural relations.

- Requires an awareness of dynamics that can result from cultural differences and ethnocentric attitudes.

- Is demonstrated through the expansion of cultural knowledge.- Is demonstrated through the adoption of services that meet

unique cultural needs.

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CULTURAL COMPETENCE IS NOT:

- A matter of being politically correct.- Simply assigning one person to handle

diversity issues.- Simply translating materials into other

languages.

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LEP & Cultural DiversityCULTURAL COMPETENCE CONTINUUM:

- Assumes that cultural competence is a dynamic process with multiple levels of achievement.

- Can be used to assess an organization’s or individual’s level of cultural competence.

- Can be used to establish benchmarks and to measure progress.- Includes six (6) stages:

1. Cultural Destructiveness – at this stage, organizations and individuals view cultural differences as a problem and participate in activities that purposely attempt to destroy a culture. They operate on the assumption that one culture is superior and that is should eradicate “lesser” cultures.

2. Cultural Incapacity - at this stage, organizations and individuals lack the ability to help cultures from diverse communities. They believe in the superiority of their own racial or ethnic group and assume a paternalistic posture toward “lesser” groups. They maintain stereotypes and employ practices that are discriminatory.

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3. Cultural Blindness - at this stage, organizations and individuals believe that culture makes no difference and that all people are the same. They believe that they are unbiased and address cultural needs. Are unable to perceive the differences among diverse groups. Are unable to benefit from the valuable differences among diverse groups – therefore, they are unable to address the needs of diverse groups.

4. Cultural Pre-competence - at this stage, organizations and individuals realize the weakness in their attempts to serve various cultures and make efforts to improve the services offered to diverse populations. Hire staff from the cultures that they serve and involve people of different cultures on their board of directors and advisory committees. Provide basic training in cultural differences. Become complacent – tokenism is a danger.

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5. Cultural Competence - at this stage, organizations and individuals accept and respect cultural differences. Participate in continuing self-assessment regarding culture. Expand cultural knowledge and resources. Adopt service models that better meet the needs of minority populations. Strive to hire unbiased employees. Seek advice/consultation from representatives of cultures served.

6. Cultural Proficiency - at this stage, organizations and individuals hold diversity of culture in high esteem. Seek to add to the knowledge base of culturally competent practice by conducting research, developing new approaches based on culture, and publishing/disseminating the results or projects. Hire staff members who are specialists in culturally competent practices.

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LEP & Cultural DiversityACIEVE CULTURAL COMPETENCE:

Organizations MUST include the Principles of Cultural Competence in:

- Policies and Procedures- Hiring Practices- Service Delivery- Community Outreach

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LEP & Cultural DiversityImportant Considerations when Dealing with

People of Other Cultures

Communication: Culture influences how people express their feelings. The inability to communicate can make both parties feel alienated and helpless.

Personal Space: This is the area that immediately surrounds a person. A person from one subculture might touch or move closer to another person as a friendly gesture, whereas someone from a different culture might consider such behavior invasive.

Social Organization: Beliefs, values, and attitudes are learned and reinforced through social organization such as family, kinships, tribes, and political, economic, and religious groups.

Time: People from different cultures have a different interpretation of the overall concept of time (Ex. “Clock Time” and “Social Time” such as dinner time, worship time, harvest time, etc.).

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LEP & Cultural DiversityImportant Considerations when Dealing with

People of Other Cultures

Environmental Control: A belief that events occur because of some external factor such as luck, chance, fate, will of God, or the control of others.

Personal Attributes: Empathy, acceptance and awareness of cultural differences and dynamics, willingness to work with people of diverse cultures, ability to articulate self-values and biases, openness to learning.

Knowledge & Skills: Stressors relative to diverse groups, community resources, ability to discuss cultural issues and respond to culturally-based cues.

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LEP & Cultural DiversityCOMMUNITY-BASED ORGANIZATIONS

Organizations representing various cultural groups and other special interest groups should be invited to participate, including:

- Civic Associations- Social Clubs- Neighborhood Groups- Faith-Based Organizations and Interfaith Groups- Mutual Aid Societies- Voluntary Organizations- Healthcare & Social Service Providers- Non-Profit Advocacy Organizations

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QUIZ1. TSCS clients are required to be proficient in

English.

TRUE FALSE

2. Limited English Proficiency (LEP) requirements were based on TSCS policies only.

TRUE FALSE

3. Assisting clients with LEP only applies to the initial assessment of their needs.

TRUE FALSE

4. If a client needs assistance with LEP, they will have to receive services elsewhere.

TRUE FALSE

5. Culture influences how we perceive the world.

TRUE FALSE

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QUIZ6. Demographic changes have made it vital for health and human

services providers to recognize, understand and respect the diversity found among cultural groups and subgroups.

TRUE FALSE

7. Cultural Awareness is the ability to empathize with and understand the needs and emotions of persons’ various cultures, as well as identify with emotional expressions and problems of other cultures.

TRUE FALSE

8. Culturally competent organizations accept and respect cultural differences, participate in on-going self-assessment regarding culture, expand their knowledge and resources, and strive to hire unbiased employees.

TRUE FALSE

9. Achieving cultural competence is the ultimate goal on the Cultural Competence Continuum.

TRUE FALSE

10. People from different cultures have a different interpretation of the overall concept of time.

TRUE FALSE