Addressing Diversity and Disability:
A Discussion on Improving Systems-Level Cultural Competency
for National Service Programs
Webinar for the National Service Inclusion
May 15, 2012
Rooshey Hasnain, Ed.D.
University of Illinois at Chicago, Chicago, IL
Nicholas V. Montalto, Ph.D.
Diversity Dynamics, Cranford, NJ
Patience Lehrman, Ph.D.
Project Shine, Philadelphia, PA
Sean Cariño
Student Research Intern, Chicago, IL
www.serviceandinclusion.org
Toll-free hotline: 888-491-0326 (voice/TTY)
National Partnerships
Addressing Diversity and Disability:
A Discussion on Improving Systems-Level Cultural Competency
for National Service Programs
Webinar for the National Service Inclusion
May 15, 2012
Rooshey Hasnain, Ed.D.
University of Illinois at Chicago, Chicago, IL
Nicholas V. Montalto, Ph.D.
Diversity Dynamics, Cranford, NJ
Patience Lehrman, Ph.D.
Project Shine, Philadelphia, PA
Sean Cariño
Student Research Intern, Chicago, IL
Something to think about…
A refugee with a disability shares his experience
A Case Example from Asian Human Services
http://www.asianhealthservices.org/handler.php?p=about-videos
Why Does Cultural Competency Matter?
The Reality Facing People with Disabilities
• Many
studies highlight disparities and poorer quality-of-life
outcomes for immigrants, refugees, and minorities with disabilities
• Limited awareness of available care and support options
• Limited access to disability/rehabilitation services
• Limited availability of culturally and linguistically appropriate
services
(Taylor-Ritzler et al., 2010; Koehn & Swick, 2006; Beach, 2005; Moffat, 2004)
We Continue to Face Several Challenges
What systems level approaches can we begin to integrate in our work to
address these disparity issues?
Project Title: Culturally Competent Access to Human Services
Our Proposed Approach to the Solution
• To
identify what works and conduct a comprehensive review of
model practices
Project Highlights
April 2009:
October 2010 - March 2011:
Worked in partnership:
Established a reader’s panel:
Responded to a Request for Proposals
issued by the Pennsylvania
Developmental Disabilities Council
(PDDC)
A contract awarded to Diversity
Dynamics, a New Jersey-based
consulting firm, to conduct a 18-month
project in partnership with the
University of Illinois at Chicago
A project advisory committee was
formed to work with the project
consultants and the multicultural
outreach workgroup
Identified 7 outside cultural expectancy
experts reviewed the report
Our approach was to
work with a network of
key stakeholders and
organizations
We are here today to
share our findings,
model practices/
principles, and
recommendations as a
result of this
collaborative effort
Establishment of a Project Advisory Committee
• Judy Banks, Deputy Director, Disability Rights Network
of Pennsylvania
• Amanda Bergson-Shilcock, Director of Intake and
Operations, Welcoming Center for New Pennsylvanians
• Gene Bianco, Executive Director, Pennsylvania
Association of Rehabilitation Facilities
• Norman Bristol-Colon, Executive Director, Governor’s
Advisory Commission on Latino Affairs
• Kevin Burrell, Former Project Officer, Pennsylvania
Developmental Disabilities Council
• Shamaine Daniels, Staff Attorney, Disability Rights
Network of Pennsylvania
• Dara DeRoiste, Human Resources Director,
Pennsylvania Department of Banking
• Graham Mulholland, Executive Director, Pennsylvania
Developmental Disabilities Council
• Javier Robles, President, ThisAbled
• Ronald Sy, Former Executive Director, ASIAC
(Formerly AIDS Services in Asian Communities)
So, What is Cultural Competency (CC)?
- Commonly defined as having the awareness, knowledge, and skills
to work effectively with diverse populations
- The ability to adapt institutional policies and professional practices
to meet the unique needs of client populations
In practice, cultural competency is a mechanism that can:
- Improve quality of service and outcomes for people from diverse
backgrounds
- Reduce ethnic and racial disparities
What We Know…
Much of the research on cultural competency (CC) has
focused on theoretical and conceptual models, but not the
practical
Drawbacks to previous work include:
• No universally accepted definition
• Guidelines and standards have been developed, but not
widely applied in the disability field (e.g., CLAS; Office of
Minority Health, 2001)
• Most studies focus on provider-level outcomes, rather than
at the client or systems level
Bottom Line:
Cultural competency is difficult for providers and researchers
to put into practical use (Price and et al., 2005, Geron, 2002)
Key Guiding Question
What systems level approaches can we take to help
improve access and quality-of-life outcomes for culturally
and linguistically diverse individuals with disabilities?
Project Spotlight
Targeted Populations
Newer Cultural and Linguistic Groups
•
•
•
•
•
•
•
•
Asian Indian
Chinese
Jamaican
Korean
Liberian
Mexican
Nigerian
Vietnamese
http://www.webpagefx.com/images/portfolio/Refugees/01.jpg
Study Methods
•
•
•
•
Extensive literature review
Analysis of key elements of culturally competent systems
Identification of model programs
Conducted:
-Structured in person and telephone interviews (n=20)
-2 focus groups
-Immigrant Organization Survey (n=37)
-Disability Provider Survey (n=102)
Immigrant Organization Survey
The survey included:
• 37 organizations that specialize in providing services
to minority, immigrant and refugee communities
• Questions asking immigrant providers to identify
barriers that prevented underserved groups from
obtaining mainstream services
• Respondents could answer survey questions in one of
three ways:
-Major problem
-Minor problem
-No problem
Figure 2.1 Percentage of Immigrant Service Professionals who Consider Problem "Major" in Nature
100%
93%
85%
81%
80%
70%
59%
60%
40%
20%
0%
Lack of language capacity of Failure of disability providers Lack of client awareness of
disability service providers
to deliver services in a
available services
culturally competent manner
Lack of client eligibility for
federal or state-funded
services
Discrimination against
immigrants
Figure 2.3 Extent to which members of clientele or community refrain from seeking services because of
cultural values and beliefs
50%
40.7%
40%
33.3%
30%
22.2%
20%
10%
3.7%
0%
Great extent
Some extent
Not at all
I don't know
Disability Organization
Survey
This survey included:
• 102 organizations that specialize in providing services
to individuals with disabilities
• Disability providers were asked to:
-Discuss their successful and unsuccessful efforts to
serve diverse ethnic and racial communities
-Provide suggestions for system improvements
-Identity different forms of training and areas of
technical assistance that would be of “great value”
Figure 3.2: Outside Services, Resources, and Policy Initiatives Considered of
"Great Value" by Disability Service Providers
A. Increasing the pool of qualified bilingual/bicultural job candidates
B. Easy access to a reliable and current data source for demographic information about diverse communities in my geographic service area
C. Mission and capacity information about grassroots organizations active in specific ethno-cultural communities
D. In-depth studies about particular ethno-cultural communities in Pennsylvania related to the work of my organization, e.g. needs or asset assessments
E. Establishment of a comprehensive state clearinghouse of information about disabilities and cultural diversity
F. Refinements in state data collection to capture information on race, ethnicity, and language preference
G. A multilingual hotline staffed by people knowledgeable about immigration and disability services who can refer people to my organization
H. Capable grassroots organizations willing to partner with our organization to deliver services to specific ethno-cultural communities
I. Funding for cultural brokers, i.e. cultural liaisons, to work within my organization
J. Formation of a state leadership council consisting of individuals with disabilities from diverse communities
K. Funding for educational programs within ethno-cultural communities to heighten awareness of disability services
L. Access to free or low-cost per-diem interpreters
M. Access to free or low-cost written translation services
N. Participation in group contract for discounted Language Line services
O. State certification standards for interpreters and translators to improve the quality of communication between service providers and limited English proficient individuals
P. Broadened immigrant eligibility for publicly-funded services
Q. Use of more culturally appropriate language by disability service providers in describing their services
Criteria for Selecting Model Practices
Our Choice of Model Practices was Based on
Four Criteria:
-Relevance to the needs of ethnic, racial, and
cultural/linguistic populations
-Ability to make a positive difference in the lives
of people
-Sustainability
-Replicability in other settings
Benavides & Hernandez, 2007
Layout of the Report
Twenty of these cultural
competency model
practices are described in
the main body of this
report; an additional 34 are
profiled in Appendix 1.
We have included both practices specific to the
disability field and those from related fields that may
be suggestive of new approaches in disability.
Our listing of practices is not meant to be encyclopedic, but merely to be illustrative
of each principle.
Ten Principles of
Cultural and Linguistic Competence
Advocacy & Empowerment
Research & Evaluation
Practice & Service Design
Community Collaborations
Language & Communication
Public Policy & Legal Framework
Leadership
Recruitment Policy
Training & Professional Development
Community Outreach
1. Empowerment and Advocacy
• The “bottom-up principle”
• Important for the people
most affected by unsound
policies to advocate for
social change
• Asians and Pacific Islanders with Disabilities of California
• Ethno-Racial Disabilities Coalition of Ontario (Canada)
• National Ethnic Disability Alliance (Australia)
2. Public Policy & Legal Framework
• Good laws and regulations
give everyone a fair
chance.
• California Language Access Law (1973, 2002)
– covers every state agency directly involved in providing
information or services to the public
– requires the use of bilingual staff or qualified interpreters
whenever 5% or more of the people served by a local office
or facility are Limited English Proficient
3. Leadership
• What the “head honcho”
says (and does!) matters!
– Creation of the New Americans
Agenda and Action Plan by
Governor Deval Patrick of
Massachusetts
4. Recruitment Policy
• Get the right people
for the job!
• Recruit and
compensate for
CLC
•Step by Step (PA)
•City of Aurora (IL)
•Project Shine
5. Training and
Professional Development
• CLC challenges are many
and ever-changing
• Consider using innovative
in-service training
approaches
• Online Peer-learning Networks
– The Your Voice Project of DiversityRx
• Cultural Brokering Workshops
– Institute for Community Inclusion and Center for Capacity Building on Minorities
with Disabilities Research (University of Illinois)
• Experiential Programs
– West Chester State University
• Interpreter Training
– Center for New North Carolinians
6. Community Outreach
• “Seek and ye shall find”
• Go where the people are
physically, socially, and
culturally
Promising Approaches
– Home Visitation Programs
• Migrant Education Program, Chester
County Intermediate Unit
– Welcome Centers (IL)
7. Language and Communication
• An “English only” approach
is generally exclusionary.
• Use multilingual resources
to communicate with LEP
individuals
Interpreting solutions fall into two broad categories:
• In-house approaches: qualified bilingual or
multilingual staff (dedicated, dual-role or primary role)
• Shared resources: language banks, language line,
video interpreting, multilingual I & R hotlines,
organizational partnerships
8. Community Collaborations
• Partner with qualified
grassroots
organizations
• Why? For cultural
insights, language
capabilities,
community access,
and greater efficiency
• Some Examples of Effective Partnerships
– Stairways Behavioral Health and the Multicultural Resource
Center (Erie)
– Multicultural Health Brokers Co-op (Edmonton) and a
variety of health/disability organizations
9. Practice and Service Design
• Return to the drawing
boards
• Reconsider inherited
wisdom
• Implement acrossthe-board change
•Therapy Program for Immigrant and
Refugee Families, Aurora Family Services
(Winnipeg, Canada)
10. Research and Evaluation
• Few studies have evaluated
the effectiveness of CLC
initiatives.
• Let’s learn from our
successes and failures.
• The journey is just beginning!
•
National Center for Cultural Competence, Inventory of Promising Practices
– http://nccc.georgetown.edu/resources/publicationstype.html#promising
•
Systems Change for Greater Cultural Competence (Diversity Dynamics
Pennsylvania Study)
–
http://www.paddc.org/images/stories/pdfs/systems_change_for_greater_cultural_competenc
e_in_pa_disability_service_sector.pdf
A Model Practice
Building partnerships
between higher education
and immigrant communities
for over 25 years…
Project SHINE Mission and Work
• Project SHINE is an award-winning national immigrant integration
imitative that help college students, older adult volunteers, and
immigrant elders connect and contribute to their communities.
• SHINE builds meaningful campus community partnerships to promote
intergenerational engagement between college students, older adult
volunteers and immigrants.
• SHINE builds the capacity of ECBOS and CBOS to deepen their
services in immigrant and refugee communities.
Pathways for Promoting Immigrant Integration
Project SHINE’s Impact
The SHINE Philosophy
From Client to Colleague to Community Leader
Approach
Orientation
Community
Members as
“Clients”
Service
Provider
Role of
Agency
Agency
identifies the
needs of the
community
and provides
culturally and
linguistically
appropriate
services.
Approach
Approach
Community Members as Community Members as
“Contributors and
“Community Leaders”
Colleagues”
“Authentic” Partner and
Colleague
Capacity
Builder/Supporter
Agency seeks and obtains
community advice in
identifying the
community needs.
Community needs and
goals are identified by
community leaders.
Agency invites
community members to
participate in program
development,
implementation and
evaluation.
Project design originates
with community
members.
Program is run by
community leaders.
Approaches
Asset-Based Approach
• Value team members’ assets
• Value elders’ and organization’s
assets
Team and Partnership Approach
• Team-based services at host
agency
• Partnership across cultures,
generations and disciplines
AmeriCorps Health Literacy
Objectives
•
Enhance English Language and
Health Communication Skills of
Immigrant Elders and Refugees
•
Increase Knowledge of Practices that
Promote Healthy Aging for Older
Immigrants and Their Families
•
To Deepen the Existing Health
Literacy Project by Focusing on
the Role of Families in Promoting
Healthy Aging
Patient Listening Publication
AmeriCorps Volunteers as Bridge
Builders
• Connecting immigrants and
refugees with resources
• Serve as health navigators
• Promote healthy aging through
Health Literacy ESL classes and
workshops
• Form non-familial relationships
with immigrant communities
Project SHINE AmeriCorps Health
Literacy Volunteer Cohort
•
•
•
•
•
•
50+% are 1st or 2nd generation immigrants
From 18 countries
Age range between 20 - 75
Speak 25 languages
Worked with over 150 community partner sites
Over 270 AmeriCorps volunteers Contributed
over 90,000 hours of service
Definition of Authentic Partnership
“A close mutual
cooperation between
parties having common
interests, responsibilities,
privileges and power.”
(Community Campus Partnership for Health)
Best Practices for
Building Authentic Partnerships
• Joint Commitment to Shared Goals
• Acknowledge and Value Mutual Skills and
Expertise
• Mutual Trust and Respect
• Joint Decision Making
• Balance of Power
• Open, Clear, and Ongoing Communication
Best Practices for Recruiting
Diverse Volunteers
Civic Connectors
•
Ethnic-based social service agencies
• Aging/volunteer networks
•
Religious Institutions
•
Community-led Informal Networks
•
Family Members
University Partnership
•
Community-Based Learning Courses
•
Student-Leadership Department
•
Second/Foreign Language Department
•
Sociology, Anthropology, Gerontology
Best Practices for Engaging
Diverse Volunteers
Understand what drives diverse volunteers and leverage their passions in
your outreach.
(e.g. Giving Back, Connection and Purpose, Faith, Influencing Young
Generations , Preserving Culture, Addressing Community Concerns)
Develop a continuum of meaningful volunteer roles that targets
volunteers at different stages to meet their changing needs
Align organizational practices to meet volunteer needs. (hiring bilingual
staff, creating flexible schedule
Any Questions?
Rooshey Hasnain
[email protected]
(312) 413-0416
Nicholas V. Montalto
[email protected]
(201) 320-1669
Patience Lehrman
[email protected]
(215) 204 -3212
Diversity Dynamics
Thank you!
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