Diversity training helps CMs understand patients
Being aware of beliefs, values is important
Increasingly, health plans and provider organizations are taking steps to understand the beliefs and values in the populations they serve and help gear their treatment plan to accommodate them.
For instance, BlueCross and BlueShield of Florida encourages all employees to go through diversity training.
"Our case managers coordinate care for a diverse membership and are required to participate in formal diversity training. After that, they are required to present an overview to their peers as how to identify a member's cultural beliefs and to incorporate them in their role as case managers," says Trish Nguyen, MD, senior medical director of medical operations.
The company has a diverse employee group and attempts to hire staff who mirror its membership and who are fluent in the languages that their members speak.
"We require cultural competency as a skill for all our care managers, so we don't necessarily pair them with someone from their own culture. We don't want to label people and make assumptions about their beliefs. After the case manager conducts an assessment and determines the member's needs, we can align them with someone from their own culture if appropriate," Nguyen says.
BlueCross and BlueShield of Florida also offers computer-based on-site training and e-learning programs for employees who want to hone their cultural competency skills. Nearly 70 workshops are available on topics that include cross-cultural communication, bridging the generation gap, culturally competent hiring practices, dealing with prejudice and racism, and workshops that speak to specific populations.
"With all of these requirements, it becomes innate to the case managers to become sensitive and to remain cognizant of the needs of the whole person," Nguyen says.
At AmeriHealth Mercy, all employees who interface with members receive training in cultural and language awareness.
"We serve a large Latino population and an increasing Asian population. We try to be culturally sensitive and language oriented," says Jay Feldstein, DO, corporate chief medical officer for the AmeriHealth Mercy family of companies.
Passport Health Plan offers free cultural competency training to its providers and advocates.
The health plan has assembled a cultural and linguistic services council, a cross-functional group of associates that meets regularly to come up with strategies for providing care for an increasingly diverse population.
Passport Health Plan sponsors an annual professional conference on culturally and linguistically appropriate care that is free to providers and offers providers free continuing education units. The conference focuses on different cultures each year.
For instance, the 2008 conference focused on the Somali and Hispanic/Latin cultures along with a presentation on cultural competency and treating individuals with disabilities. A video presentation entitled "They Bring the World" was produced by Passport Health Plan and is available free to interested organizations.
"We provide a lot of diversity and cultural competency training for our associates and our providers. We offer classes for providers about Title 6 and CLAST standards, diversity, and stereotypes," says Loretta Estes, cultural and linguistic services coordinator for Passport Health Plan.
Passport Health Plan has enlisted the help of Spanish-speaking individuals and advocates to provide feedback on diabetes materials so they can be appropriately written and designed for Latino members, according to Lucy Ricketts, the plan's director of public affairs and cultural and linguistic services.
Passport Health Plan's disease managers and case managers use the AT&T Language Line, which offers interpreters in 150 languages to facilitate conversations with members.
"We have member services representatives who are bi-lingual and are assessed annually in Spanish and English. If they don't meet the highest levels of proficiency, they are not assigned to speak with members in Spanish until they do," Estes says.
When working with members from Somalia, the health plan often will provide translated printed material along with a professionally recorded CD so the person can hear and read the text at the same time.
Non-English-speaking members receive "I Speak" cards that are about the size of business cards and printed in English and their native language. They receive the cards at outreach events and are encouraged to give the cards to their providers to request an appropriate interpreter and request that the information is documented in their medical record.
The cards are available in Arabic, French, German, Maay, Russian, Somali, Spanish, Swahili, and Vietnamese.
"We also work with our members who aren't fluent in English to make sure they ask for an interpreter, to write down all the questions they have for their physician, and to make sure they understand everything they hear," Estes says.
If case managers feel that language or cultural beliefs are interfering with a member's care and they can't make any inroads telephonically, they can arrange a home health visit with a qualified interpreter to help bridge the gap, she says.
Increasingly, health plans and provider organizations are taking steps to understand the beliefs and values in the populations they serve and help gear their treatment plan to accommodate them.You have reached your article limit for the month. Subscribe now to access this article plus other member-only content.
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