Cultural Competence Standards in Managed Care Mental Health Services For Native American Populations

Glossary

Access

Accessibility of mental health services to people who need them in a manner that facilitates their use; providing the opportunity for people to obtain mental health services from behavioral health providers; providing an active program of community information and outreach to motivate participation in mental health services.

Alternative/Traditional Healer (folk healer)

An individual who is respected by the community, who has cultural knowledge and training to relieve people of their physical and emotional afflictions within their cultural beliefs who sometimes uses physical approaches, spirituality, herbs, and other techniques as a form of healing; individual recognized by a cultural group or tradition with the authority and power to perform rituals, ceremonies, or utilize medicinal substances for physical and spiritual healing.

Bicultural

The ability to understand and function effectively in two or more cultural environments. An individual who is bicultural is not necessarily culturally competent.

Bilingual

The ability to effectively speak two or more languages. Individuals who are involved in serving limited English-proficient persons shall be certified to do so.

Case Manager (or Care Manager)

Individual with special skills in advocacy, access of community-based services and systems, and inter-agency coordination; a key person on the treatment team and the first point of contact for a consumer.

Comparability of Benefits

Benefits, afforded to various cultural/ethnic or socioeconomic groups which are relatively equal to each other; relatively the same services provided across all populations served, including any adaptations necessary to reach equal access and utilization.

Competence

Competence is the application of knowledge and the interpersonal, decision-making, and psychomotor skills expected for the practice role.

Competent

Properly or well qualified and capable.

Critical Service Junctures

Critical service junctures include crisis, evaluation/assessment, treatment planning, treatment plan review/renewal, crisis planning, placement in residential or restrictive settings (including inpatient) and discharge determinations.

Cultural Competency

Acceptance and respect for difference, continuing self-assessment regarding culture, attention to the dynamics of difference, ongoing development of cultural knowledge and resources and flexibility within service models to work towards better meeting the needs of minority populations.

Cultural Consultation

Consultation from an individual knowledgeable about a particular culture. Having to do specifically with culture but not necessarily with mental health clinical issues.

Culture

The integrated pattern of human behavior that includes thought, communication, actions, customs, beliefs, values and institutions of a racial, ethnic, religious, or social group. Culture defines the preferred ways for meeting needs.

Folk Healer

See Alternative/Traditional Healer.

Grievance

A problem or complaint presented formally, orally and/or in writing in a prepaid Health Plan for information, action, or resolution.

Health Plan/Plan

Managed Care Plan or network; equally applies to public agencies delivering managed services; a care system, public or private, based on capitated rates in which costs shall be managed through effective care.

Interpreter

Individual trained and certified in facilitating oral, written, or manual communication between two or more people of different languages; interpreters shall have in-depth knowledge not only of the language, but also of cultural values, beliefs, and verbal and non-verbal expressions.

Management Information System

A system (almost universally automated or computer based) which collects the necessary information in proper form and at appropriate intervals for managing a program or other activities. The system shall afford indicators which measure program progress toward objectives, identify discrete costs, and facilitate identifying problems that need attention.

Mental Health Cultural Specialist

A mental health professional who is certified culturally competent and has demonstrated skill and in-depth knowledge of a specific racial/ethnic group, including skills and knowledge of mental health needs, to serve as a resource person for this particular culturally distinct population.

Provider

An organization or individual, such as a hospital or physician, that provides and is reimbursed for behavioral health care service.

Quality Assurance

Systematic efforts to review and improve the caliber of services provided; activities and programs intended to assure the improvement of care in a defined medical setting or program. Such efforts shall include educational or other approaches intended to remedy identified deficiencies in services and methods, as well as the components necessary to identify such deficiencies (such as peer or utilization review components); the intended objective shall be to assess the program’s own effectiveness.

Sponsored Person

Person covered by a particular health plan.

Standards

Standards are the generally accepted principles for the best/most appropriate way to provide clinical care for patients with mental illness.

Standards are the criteria or set of rules that describe the expected levels of clinical and system behavior as well as courses of action based on research and experience.

Traditional

Time-honored practices, which vary among groups.

Translator

Individual trained to render written or spoken information from one language to another.

Unsponsored Person

Person not covered by a particular health plan.

Value Added

Greater clinical or cost-effectiveness in a service when it is provided in a specialized or modified manner. As an example, a person with skills to perform in more than one capacity (i.e., professionally serve both English-speaking and Spanish-speaking consumers).

Wrap-around Services

A continuum of benefits organized around an individual enrollee’s treatment needs (e.g., transportation, childcare, interpretation services).