Fulfilling the Promise of 
Community Living
Achieving Cultural Competence in Organizations:  Implications for Systems of Support for Individuals with Disabilities
Tawara D. Goode
National Center for Cultural Competence
Georgetown University Child Development Center
University Center for Excellence in Developmental Disabilities  Education, Research & Service

Rationale for Cultural Competence in Health Care & Human Services
* Respond to current and projected demographic changes
* Eliminate long-standing health disparities
* Improve quality of services and health outcomes


Rationale for Cultural Competence in Health Care & Human Services
* Meet legislative, regulatory and accreditation mandates
* Gain a competitive edge in the market place
* Decrease risk of liability/malpractice


DATA FROM 2000 CENSUS
* Diversity is much more complex than ever measured by the census bureau.
* Almost one-third of the U.S. Population is from racially, ethnically and culturally diverse groups.
* 2.4% of people described themselves as belonging to more than one race.
* Single largest multiracial category is white and "Some Other Race."

Cultural Factors That Influence Diversity Among Individuals and Groups
Internal Factors
• Cultural/Racial Identity
• Socioeconomic Status/Class
• Nationality
• Language
• Family Constellation
• Social History
• Health Beliefs & Practices
• Perception of Disability
• Age & Life Cycle Issues
• Spatial & Regional Patterns
• Gender & Sexuality
• Sexual Orientation
• Religion & Spiritual Views
• Political Orientation & Affiliation
External Factors
• Institutional Biases
• Community Economics
• Intergroup Relations
• Natural Networks of Support
• Community History
• Political Climate
• Workforce Diversity
• Community Demographics

Cultural Influences on Perceptions of Disability , Health Beliefs & Practices
• Superstition
• Malevolent Forces
• Religiosity
• Spirituality 
• Familial Folklore
• Natural life occurrence

Cultural Competence
Culture
	Culture is an integrated pattern of human behavior which includes - thought, communication, languages, beliefs, values, practices, customs, courtesies, rituals, manners of interacting, roles, relationships, and expected behaviors of a racial, ethnic, religious or social group; the ability to transmit the above to succeeding generations.

Competence
   	The word competence is used because it implies having the capacity to function within the context of culturally-integrated patterns of human behavior: values, attributes, knowledge and a skill set to work effectively cross culturally.

Five Elements of Cultural Competence
* valuing diversity
* cultural self-assessment
* managing the dynamics of difference
* institutionalization of cultural knowledge
* adapting to diversity
- policies         - structures
- values	   - services

ESSENTIAL ELEMENTS IN A CULTURALLY COMPETENT SYSTEM
   These five elements must be manifested at every level of an organization - policy making, administrative, practice/service delivery and consumer/family levels - and reflected in its attitudes, structures, policies and services.

Culturally Competent Practices
• Policy making
• Administrative
• Service delivery
• Consumer


Culturally Competent Practices Consumer Level
• advocacy
• partnerships with other families/individuals
• advisory groups
• board membership
• knowledge beacon