(928) 779-2113
Cultural Competence
Capstone Health Plan will assist its providers and its Members with the ability to develop and apply pragmatic approaches to enhancing the understanding of Cultural and Linguistic Competence and the interactions necessary to communicate. This Cultural Competence is predicated on applying methods to achieve desired health care outcomes and satisfaction by Members and the providers serving those Members.
Pertinent to practicing effective cultural competence is the associated ability to impact costs in the delivery of appropriate and necessary services. This cost-efficiency goal can be gained through communication and cultural understanding which may be realized though several of the following expectations:
- Understanding and practicing culturally sensitive approaches will allow you to draw more specific and complete information to make a more complete diagnosis.
- Practicing culturally competent methods will facilitate the development of a treatment plan that the Member will follow and which might be supported by the family or interested parties increasing the opportunity for desired outcomes.
- Practicing cultural competence enhances overall communication and clinical interaction between provider and Member.
Capstone Health Plan adopts the understanding that lower-quality and ineffective interactions between Member and provider are associated with lower overall satisfaction with healthcare and in achieving desired outcomes and performance standards.
Definition of Cultural Competence
Capstone Health Plan shall adopt the definition of Cultural Competence as used in the "National Standards for Cultural and Linguistically Appropriate Services (CLAS) in Health Care". This definition was adapted from a definition developed in the mental health field. Capstone Health Plan acknowledges much of the contained CLCP is derived from information published by the Office of Minority Health of the U.S. Department of Health and Human Services. For additional resources, please visit the Office of Minority Health website.
The CLAS definition is as follows:
Cultural and linguistic competence is a set of congruent behaviors, attitudes and policies that come together in a system, agency or among professionals that enables work in cross-cultural situations.
- "Culture" refers to integrated patterns of human behavior that includes the language, thoughts, communications, actions, customs, beliefs, values and institutions of racial, ethnic, religious or special groups.
- "Competence" implies having the capacity to function effectively as an individual and an organization within the context of the cultural beliefs, behaviors and needs presented by consumers and their communities.
Aside from language, race, ethnic or spiritual cultural preferences by our Members, it is important to realize that each family or significant other along with the Member may constitute their own unique culture. At times, it is necessary to use an interpreter not only for language barriers but also for cultural practices. Keep these 5 basic tools in mind when it is necessary to utilize an interpreter.
- During the medical interview when using an interpreter, speak directly to the patient, not interpreter.
- When using an interpreter, assume that, and insist that, everything you, the provider, say and everything that the Member and Member's family says is interpreted.
- Be aware that many concepts that you, the provider, express might have no linguistic or often even conceptual equivalents in other languages. The interpreter may have to paint word pictures of many terms you use, which could be time-consuming.
- Encourage the interpreter to ask questions and alert you about potential cultural misunderstandings that may come up. Respect an interpreter's judgment that a particular question is culturally inappropriate and either re-phrase the question or ask the interpreter's help in eliciting the information in a more appropriate way.
- Be patient. Providing care across barriers caused by language (or for that matter sensory deficits) takes time. Time spent up front will be paid back by good rapport and clear communication that will avoid wasted time and potential problems later.
To further the provider's ability to patiently and completely interact with the Capstone Member, Capstone reimburses physicians for prolonged service codes when the claim is submitted with proper documentation including actual time spent in providing the service.
Interpretation Services
Capstone currently offers to its providers and Members the use of the Language Line Interpreter services. The provider or the Member may contact the Capstone office which will then connect the two with a Language Line Interpreter. For assistance, please contact Capstone Health Plan's Interpreter Services at (800) 336-3874 or (928) 779-2113.
