Implementation of Culturally and Linguistically Competent Policies by State Title V Children with Special Health Care Needs (CSHCN) Programs
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Objective This descriptive study was intended to identify actual actions, steps and processes of Children with Special Health Care Needs (CSHCN) programs to develop, implement, sustain and assess culturally and linguistically competent policies, structures and practices. Methods An online 52-item mixed format survey of Maternal and Child Health (MCH) CSHCN directors was conducted. In April 2003 and May 2004, 59 directors were solicited to participate in the survey and 42 (86%) responded. Standard quantitative and qualitative analyses of the data were conducted to address key questions linked to the study’s overall objective. Results Findings indicated that almost all respondents are implementing some actions to provide culturally and linguistically competent services including adapting service practices, addressing workforce diversity, providing language access, engaging communities and including requirements in contracts. These individual actions were less often supported by processes such as self-assessment and creating an ongoing structure to systematically address cultural and linguistic competence. Programs are challenged to implement cultural and linguistic competence by state agency organization and budget restrictions. Conclusions The results of the study indicate a continued need for support within state MCH CSHCN programs in order to maintain or enhance the systematic incorporation of culturally and linguistically competent efforts.
KeywordsCultural and linguistic competency Children with Special Health Care Needs US State Title V programs Federal Maternal and Child Health Bureau
Eileen Miller, BS, the staff of the National Center for Cultural Competence and the State CSHCN Directors, without all of whom this study would have not been possible. This study was funded through Cooperative Agreement #U93-MC-00145 from the Maternal and Child Health program (Title V, Social Security Act), HRSA, DHHS.
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