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

Staff Training and Development

 

Standard

Staff training and development in the areas of cultural competence and Native American mental health should be implemented at all levels and across disciplines, for leadership and governing entities, as well as for management and support staff. The strengths brought by cultural competence serve to enhance total system performance rather than detract or formulate separate agendas.

 


Implementation Guidelines

1. Urban/Suburban:

Specific requirements should be established for the credentialing of Native American Mental Health Specialists. Recommendations are as follows.

• Clinical licensure in a behavioral health field or as required by state or relevant certification in the designated mental health field as required by applicable state law, e.g., state alcohol and drug certification;

• Previous experience in cross cultural mental health setting;

• Demonstration of cultural competence, for example, consensual validation of professional expertise and competence in Native American mental health by a panel of experts

Rural/Reservation:

Specific requirements should be established for the credentialing of Native American Mental Health Specialists. Recommendations are as follows.

• Clinical licensure in a behavioral health field or as required by state or relevant certification in the designated mental health field as required by applicable state law, e.g., state alcohol and drug certification;

• Previous experience in cross cultural mental health setting or provisions made for mentoring individual with little cross-cultural experience.

• It is important to note that in rural and frontier settings, it may be very difficult to require the demonstration of cultural competence criteria.

2. Urban/Suburban:

The Health Plan’s clinical workforce should include and make special effort to recruit and retain at least a representative percentage of Native American mental health professionals.

Rural/Reservation:

The Health Plan’s clinical workforce should include and make special effort to recruit and retain at least a representative percentage of Native American mental health professionals from primary tribe or tribes being served.

3. Urban/Suburban and Rural/Reservation:

Career ladders for the development and advancement of Native American staff should be established for clinical and administrative supervisory and senior positions.

4. Urban/Suburban and Rural/Reservation:

Differential pay rates should be developed and implemented for specialized skills in cultural and linguistic competence in general, and for Native American Mental Health Specialists in particular.

5. Urban/Suburban and Rural/Reservation:

There should be regularly required cultural competence training for all staff (see section on Cultural Competence Planning).

6. Urban/Suburban and Rural/Reservation:

Specific continuing education requirements and performance based standards should be established for the development, maintenance, and continuance of clinical and cultural competence as mental health provider.

7. Urban/Suburban and Rural/Reservation:

The Cultural Competence Plan should develop clinical performance evaluations and promotion opportunities which reward cultural competence among all staff.

 

Recommended Performance Indicators

  1. Establishment and evaluation of a credentialing process for Native American Mental Health Specialists.
  2. Recruitment, retention, and career development plan for Native American and other culturally competent mental health professionals.
  3. Where appropriate, use of language fluency examinations to determine the level of competence of clinicians to provide comprehensive clinical and preventive care.

 

Recommended Outcomes

  1. Percent of Native Americans served in their preferred language
    Benchmark: 60%
  2. Percent of Native Americans served by, or under the supervision of, Native American Mental Health Specialists
    Benchmark: 80%
  3. Proportionality of Native American staffing to the needs of the Native American population
    Benchmark: 1:1 match between need (not strict percent of population) and staffing
  4. Percent of staff receiving the required hours of training annually in cultural competence awareness
    Benchmark: 100%