| CULTURAL COMPETENCY PLAN
Cultural competency training is conducted in conjunction with the Centene Corporate “Business Ethics and Conduct Policy” via an on-line module at Centene University. New employees receive training within the first two (2) weeks of hire date. Existing employees receive annual refresher training during the first two (2) quarters. For OMV panel providers, this information is included in OMV’s Office Staff Manual. OMV employs bilingual Member Services representatives to handle Spanish speaking members in addition to contracting with AT&T language line for members speaking other languages (see W-F ATT Language Line 2001 OptiCare). The following information represents the cultural diversity and sensitivity concepts presented to staff and providers.
Cultural Competency Information Keep in mind . . .
Triple Discrimination In our society people who are low-income, of minority status, and labeled as having a disability are often at a disadvantage within the health care delivery system. It has been suggested that when these elements intersect, families and people with disabilities are more vulnerable to discrimination. Disability has existed since the beginning of time. The ways in which people with disabilities have been treated and represented, for example, in art and media varies dramatically throughout history and among different cultures. Disabled people have been revered or ascribed with superhuman characteristics in some cases and disparaged, tortured, and even systematically murdered in others. People with disabilities also have a long history of attempting to better their situation through self-advocacy and self-determination. Ethnicity Though there are many aspects that shape a person, ethnicity has a major influence on how a child understands him/herself. Often it is the cultural patterns that a child learns from his/her family that form his/her view of many things including disability. How disability is constructed within a specific culture plays a key role in understanding the meaning of disability for that person or family. The cultural context within which disability is perceived is important in knowing the kinds of services to be provided to families and people with disabilities. This notion brings up the question of how a label is defined and to who is it important. What is imposed on a family or person may be treated very differently within their cultural context. This difference is not only true in relation to labels but also in relation to parenting practices within a family. One African-American mother may talk about sending her child to her mother in the south when she felt she needed a break. What she perceived as good parenting and love, workers entering her home see as her inability to care for her child. When the perceived difference is seen as a deficit that needs to be worked on, people often experience a cadre of workers involved in their lives, and a new specialist for each difference identified. A number of additional conflicts emerge when services are provided based on values of the dominant culture. Often support agencies are located outside of a community and transportation becomes a problem. This development, in addition to a lack of trust in the system outside of their culture, often leads to people being labeled as unconcerned, non-compliant or uncaring about their children. It is clear that to some families the issue of disability is secondary to health issues or day to day getting by based on the overall needs of the family or person.
Culture of the Child America is very health-conscious. More than 11 percent (11%) of the gross national product is spent on health. Yet many of America's children suffer from health problems related to poverty. One out of five children under six live in poverty and their health status is worse than that of non-poor children. Children in poverty experience more of many types of health problems than do children in families with more adequate incomes. A particular problem's incidence, prevalence, or severity may be higher among low-income children. Rates of infant mortality (under age one) and overall childhood mortality is higher among low-income children, and certain causes of death are higher: sudden infant death syndrome (SIDS), unintended injuries, child abuse, and infectious diseases including AIDS. Rates of morbidity are also higher. Conditions that the low-income suffer disproportionately include low birth weight, HIV infection, asthma, dental decay, measles, nutritional problems, lead poisoning, learning disabilities, unintentional injuries, and child abuse and neglect. Low-income infants and children have higher rates of hospitalization, and their health status as reported by their parents is lower than that of the non-poor. For some low-income children, unstable or dangerous physical environments compound the difficulties created by their economic circumstances. These environments include children without permanent homes because low-cost housing is unavailable; children whose parents are migrants; and children who are in foster care. Some Native American children and children who live in rural areas or central-city urban areas also experience special health problems.
Foster Care The number of children under the age of 18 living in Texas is 6,300,598. Approximately 31,398 were in Foster Care at the end of the 2006 fiscal year. Of the total number of foster care children, minorities are over-represented. The top three demographic groups are Hispanic at 7,509, Anglo at 6,439 and African American or Black at 5,581. Although foster care placement may become the permanent placement for some children, foster care is meant to be a temporary situation until a permanent living arrangement can be achieved. Children in foster care face a multitude of challenges. They have multiple needs that include emotional and/or psychological stress. Typically, foster children have experienced abuse (physical, emotional and/or sexual), neglect, and chaotic family environments. Most foster children, if not all, require extensive psychological testing, which makes behavioral health an essential and vital component in each of these children’s health care. According to the National Academy for State Health Policy, foster care children are typically: maltreated, of a young age, sometimes have severe disabilities, chronic health problems and most are in need of behavioral health services. The separation of foster care children from their biological parents creates lifelong issues for most of these children. Foster care parents are charged with creating supportive and loving environments in order to improve the child’s functioning – changing the focus on their behaviors to their needs. Unfortunately, the shortage in foster care parents presents a challenge in achieving such results.” Impact of Poverty on Health The reasons for higher rates of health problems among low-income infants and children are complex and difficult to analyze. A family's low-income, relative to its size, is associated with several demographic and psychological factors that may lead to poor health--independent of the receipt of personal health services. These factors include less than a high school education, limited English proficiency, single-parent household, teenage motherhood, and feelings of stress and depression. Poverty also makes it difficult to purchase some of the commodities conducive to good health. These commodities include adequate housing, nutritious food, transportation, drugs, medical equipment, and safety devices. In addition, low-income families frequently have little time available for health-promoting activities. For economic, educational, and other reasons, low-income families are less likely to have healthy life-styles or to engage in health-promoting behaviors. Finally, low-income families may seem unmotivated to seek personal health services when the problem is actually lack of information, ability to communicate, fear, or different priorities regarding the use of time and money. When financial barriers are removed, the care-seeking behavior of many of the poor closely resembles that of the non-poor. The Personal Health Care Patterns of Families in Poverty Even though many of the health problems experienced by low-income children are the direct or indirect consequences of poverty and related factors, health-related services can play an important role in preventing and ameliorating these problems. Low-income families have different patterns of health service utilization than do non-poor families, but these differences may be largely a function of financial constraints. Low-income families participate less in activities that reduce injuries and poisonings. Low-income women are more likely to have unwanted or mistimed births, and they are less likely to use contraceptives. Low-income pregnant women are less likely to begin prenatal care in the first trimester and more likely to receive no care at all. The number of physician visits per year is lower for low-income children than non-poor children. The source of medical care also differs, with non-poor children less likely to be seen in a physician's office and more likely to be seen in an emergency room, a clinic, or a hospital outpatient department. Children of color are less likely to be fully immunized than white children.
If you could walk a mile in my shoes . . . We wonder why they are always late for appointments . . . Stop wondering . . . Just ask . . . Then offer positive support 1. All staff and subcontractors should have baseline knowledge of:
Both Acts may be reviewed on the Internet. Title VI of the American Civil Rights Act can be found at www.access.gpo.gov/nara/cfr/waisidx_99/34cfr100_99.html. Americans with Disabilities Act, Title III, is located at www.usdoj.gov/crt/ada/adahom1.html. |
OptiCare Managed Vision (OMV) is committed to providing quality eye care services to all members regardless of age, gender, ethnicity, socioeconomic status, or sexual orientation. In conjunction with our parent company, Centene Corporation, OMV provides cultural diversity and sensitivity training and educational information to internal staff and panel providers and their staffs to foster equitable treatment of all members and prevent discrimination.