Show Policy Developments in Cultural Competence of Health Care Marlene Egger Ph University of Utah Public Health Program Luis Paita Ph NAHDO David Mosen Ph Intermountain Health Care Abstract Cultural and linguistic differences between health care providers and their patients can result in substantial barriers to access to health care Currently the Health Care Financing Administration HCFA and other agencies create de facto requirements for cultural and Jinguistic competence of health care but they are variable and fragmented In December 2000 the Office of Minority Health of theS Department of Health and Human Services finalized national standards for cultural competence in health care Anticipated effects on managed care might include improved access to culturally competent care and greater community participation in health services development Impact on cultural competence of health care in Utah might be achieved by peer feview organizations professional associations Medicaid Medicare HMO contracts and other projects at the state Department of Health and legislative and administrative requirements which provide incentives for compliance Introduction Cultural differences can make it difficult to achieve the most appropriate and effective care Cultural background along with individual experiences affects health beliefs practices and behavior on the part of both patient and provider and also influences the expectations that patient and provider have of each other In December 2000 the Office of Minority Health OMH of theS Department of Health and Human Services DHHS finalized national standards on culturally and linguistically appropriate services CLAS in health care DHHS 2000 Office of Minority Health 2000 Table outlines these standards The CLAS standards reflect combination of HCFA guidelines and other regulations which create de facto standards for cultural competence of health care Standards 4-7 are mandatory standard 14 is recommended for voluntary adoption and the remainder are guidelines which OMH recommends other agencies make mandatory Table Some of these standards are already in place in Utah particularly linguistic requirements in hospitals and other patient care settings Join Commission on Accreditation of Healthcare requires cultural Organizations JCAHO competence standards The CLAS standards would potentially enhance access to health care by Utahgrowing minority population Culturally Competent Health Care Cross et al 1989 and Isaacs and Benjamin 1991 defined cultural competence as set of congruent behaviors attitudes and policies that come together insystem agency or among professionals and enables that system agency or those professionals to work effectively in cross-cultural situations Culture refers to the integrated patterns of perceiving interpreting and interacting with others and with the environment Jezewski 1990 that include thoughts communications actions customs beliefs values and institutions of racialfethnic religious or social groups Competence implies having the capacity to function effectively as an individual or an organization within the context of the cultural beliefs behaviors and needs presented by consumers and their communities Being competent in 2000 DHHS cross-cultural functioning means leaming new patterns of behavior and effectively applying them in the appropriate settings culturally competent physician will use an approach or tone appropriate to the patientculture culturally competent patient will recognize the potential for conflict between their culture and aspects of care and will use this recognition to help the provider explore alternative approaches 134 Digital image 2005 Marriott Library University of Utah Al rights reserved |