Guidelines for Culturally Competent Organizations

Second Edition — May 2004

Minnesota Department of Human Services

The Minnesota Department of Human Services wishes to acknowledge the contributions of:

Gary Cox with Dr. Glenace Edwall, Debra Davis-Moody, Patricia Ray, and Mark Toogood

This information is available in other forms to people with disabilities by contacting us at 651-282-5329 (voice), or through the Minnesota Relay Service at 800-627-3529 (TDD), 711or 877-627-3848 (speech-to-speech relay service).

Executive Summary: Policy and Overview


The Minnesota Department of Human Services (DHS) encourages health and human services providers and organizations to demonstrate their ability to serve diverse populations before they serve individuals from diverse cultures. When an organization lacks knowledge and skills in a client’s culture, it refers the client to someone who has the expertise. The organization and its personnel are always accountable for culturally appropriate services.

An organization cannot be clinically or programmatically competent unless it is culturally competent. Health and human services organizations can enhance their cultural competence with:

  • • culturally competent personnel
  • • culturally appropriate services
  • • culturally competent organizations
  • Why cultural competence?

    Culture influences one’s behavior and family practices. Culture influences an individual’s health and mental health beliefs, practices, behaviors, and even the outcomes of interventions. Health behavior depends on how one understands the cause of illness. In mental health and medicine, research indicates that culturally-appropriate service improves diagnostic accuracy, increases adherence to recommended treatment, and reduces inappropriate emergency room and psychiatric hospital use. Cultural competence is a requisite of doing business with diverse clients. Organizations enhance their cultural competence because:

  • • Demographics of the state are rapidly becoming more diverse.
  • • Disparities in health and service outcomes exist between mainstream and diverse populations.
  • • Access barriers mean clients’ needs are not identified and effective service is not provided.
  • • Culture influences assessment accuracy and service effectiveness so quality may suffer.
  • • Law and accreditation standards increasingly demand cultural competence.
  • • Liability exposure increases and costs rise when services are not effective.
  • • Competition in funding and business markets favor the culturally competent organization.
  • Who should implement these guidelines?

    County social services organizations and their vendors; managed care organizations and their providers; and community-based mental health and human services providers will benefit from implementing these Guidelines. Health care providers may be more familiar with the national CLAS standards for cultural competence. The CLAS standards are consistent with the Guidelines but the Guidelines go further to support direct case work by agency staff. The Guidelines are not a mandate but are designed as an educational tool that answers the question: How do we become more culturally competent?

    Incremental approach and coalition building

    Striving toward cultural competence is a developmental process, a goal toward which professionals and organizations can strive. These Guidelines envision an incremental approach toward cultural competence, based on a sustained, achievable actions with realistic time lines. Organizations can implement these guidelines according to a plan they develop for themselves.

    What is cultural competence?

    Cultural competence or culturally competent is the ability and the will to respond to the unique needs of an individual client that arise from the client’s culture and the ability to use the person’s culture as a resource or tool to assist with the intervention and help meet the person’s needs.

    Table of Contents

    Action and Planning Guide

    I. Policy and Overview: Why Cultural Competence?

  • • Why cultural competence?
  • • What is cultural competence?
  • • Who can receive culturally appropriate service?
  • • Individualized services and cultural competence
  • • Who should implement these guidelines?
  • • Why does cultural and linguistic competence matter to your organization?
  • • Incremental approach and coalition building
  • • A culture is not monolithic
  • • Culture is not just race and ethnicity
  • • Sovereignty of American Indian tribes
  • • Is cultural competence aimed at the provider or the administration?
  • II. Organization and Administration Supporting Service Delivery

    1. Cultural Competence Planning.

    2. Community Partnership and Governance.

    3. Human Resource Development.

    4. Prevention, Public Education, and Client Outreach.

    5. Eligibility, Intake, and Client Education.

    6. Conflict Resolution.

    7. Quality Management.

    8. Data and Management Information Systems (MIS).

    III. Service Delivery System Supporting Culturally Competent Practice

    9. Service Array or Benefit Design.

    10. Access and Service Authorization.

    11. Client Needs Determination.

    12. Service Planning.

    13. Service Coordination/Case Management.

    14. Self-Help.

    15. Practice Standards for Health and Mental Health.

    16. Child Welfare and Social Work Practice.

    IV. Linguistic Competence

    17. Language Assistance.


    Appendix A: Legal Requirements

    Appendix B: Knowledge and Skills

    Appendix C: Diversity Among Five Major Racial/Ethnic Groups

    Appendix D: DHS Multilingual Telephone Service

    Appendix E: Definitions of Cultural Competence

    Appendix F: Data Sources

    Appendix G: CLAS Standards

    Appendix H: Organizational Self-Assessments

    Appendix I: Resources

    Appendix J: Bibliography


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