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The Illinois Department of Human Services (DMH)

The Illinois Department of Human Services (DMH). Phase III – Systems Reform & Integration of Culturally and Linguistically Competent Service Delivery _____________________ Consultation Report of Findings & Recommendations. Short-term Goals

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The Illinois Department of Human Services (DMH)

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  1. The Illinois Department of Human Services (DMH) Phase III – Systems Reform & Integration of Culturally and Linguistically Competent Service Delivery _____________________ Consultation Report of Findings & Recommendations AHP/Gallup/NAPAS - Mbionwu September 2003

  2. Short-term Goals Identification of systemic barriers to accessing care and treatment Culturally and Linguistically Long-term Goals 2004 Strategic Plan Establishment of an Office on Cultural and Linguistic Competence Project Overview AHP/Gallup/NAPAS - Mbionwu September 2003

  3. Springfield (Site 1) 26 Participants 3 Stakeholders 23 Providers 57 Generated Statements Chicago (Site 2) 40 Participants 5 Stakeholders 32 Providers 43 Generated Statements June 2003 Consultation AHP/Gallup/NAPAS - Mbionwu September 2003

  4. Reform Framework (Guideposts) • Domain 1 – Values & Attitudes • Domain 2 – Cultural Sensitivity • Domain 3 – Communication • Domain 4 – Policies & Procedures • Domain 5 – Training & Staff Development AHP/Gallup/NAPAS - Mbionwu September 2003

  5. Reform Framework (Guideposts) • Domain 6 – Facility Characteristics, Capacity, and Infrastructure • Domain 7 – Intervention & Tx Model Features • Domain 8 – Family & Community Participation • Domain 9 – Monitoring, Research, and Evaluation AHP/Gallup/NAPAS - Mbionwu September 2003

  6. Site 1 – Domain HitsCombined Group Matrix • This chart is reflective of the individual statement sorting activity completed by Springfield participants. • Each participant was asked to sort the final list of 57 generated statements across the 9 critical domain areas for measuring a culturally and linguistically competent system.  • The individual sorting data was synthesized to produce a combined group matrix illustrative of the sorting frequency/dominance across the 9 domains. AHP/Gallup/NAPAS - Mbionwu September 2003

  7. Site 1 – Domain Hits AHP/Gallup/NAPAS - Mbionwu September 2003

  8. Site 1 – Top 3 Domain Hits • Domain 1 – Values and Attitudes (80) • Domain 5 – Training & Staff Development (83) • Domain 7 – Intervention & Treatment Model Features (97) Note: Domain rank by frequency (7, 5, and 1) AHP/Gallup/NAPAS - Mbionwu September 2003

  9. Site 1 – Primary Statement Hits by Domain • Most frequently sorted statement(s) by domains (1, 5, and 7) Domain 1 – Culturally competent systems remove fear from the concept of diversity Domain 1 – Consumer will be empowered to exercise self-determination and choice AHP/Gallup/NAPAS - Mbionwu September 2003

  10. Site 1 – Primary Statement Hits by Domains Domain 5 – Education of personnel in multi-addiction Domain 7 – More integration of the treatment plan to facilitate cross-programming (MI/SA) Domain 7 – 18-25 pop. Critical service needs AHP/Gallup/NAPAS - Mbionwu September 2003

  11. Site 1 - Frequently sorted statements • Subset issue areas (critical attention) Statement 47 – Develop a uniform reporting system/measurement tool to capture consumer satisfaction (Domain 9 - Monitoring, Evaluation, and Research) Statement 20 – Ongoing monitoring, assessing, and evaluating the system’s cultural competence (i.e., access, etc.) (Domain 9 – Monitoring, Evaluation, and Research) AHP/Gallup/NAPAS - Mbionwu September 2003

  12. Site 1 – Frequently sorted statements • Statement 66 – Some support should be state mandated (i.e., contractual relationships, regulations, etc.) (Domain 4 – Policies & Procedures) AHP/Gallup/NAPAS - Mbionwu September 2003

  13. Statement Sort – 9 Domains (S1) AHP/Gallup/NAPAS - Mbionwu September 2003

  14. Critical Domain Ranking – S1 AHP/Gallup/NAPAS - Mbionwu September 2003

  15. Site 2 – Domain HitsCombined Group Matrix • This chart is reflective of the individual statement sorting activity completed by Chicago participants. • Each participant was asked to sort the final list of 43 generated statements across the 9 critical domain areas for measuring a culturally and linguistically competent system. • The individual sorting data was synthesized to produce a combined group matrix illustrative of the sorting frequency across the 9 domains. The qualitative/quantitative results of the combined group matrix are as follows: AHP/Gallup/NAPAS - Mbionwu September 2003

  16. Site 2 – Domain Hits AHP/Gallup/NAPAS - Mbionwu September 2003

  17. Site 2 – Top 3 Domain Hits • Domain 1 – Values and Attitudes (285) • Domain 2 – Cultural Sensitivity (297) • Domain 7 – Intervention & Treatment Model Features (249) Note: Domain rank by frequency (2, 1, and 7) AHP/Gallup/NAPAS - Mbionwu September 2003

  18. Site 2 – Primary Statement Hits by Domain • Most frequently sorted statement(s) by domain (1, 2, and 7) Domain 1 – Providers must step out of the box and realize that they don’t know what’s best for the client Domain 2 – What does it mean? Recognizing it’s the fluidity of culture, the transcultural circumstances of culture, the diversity of diversity within diversity, and recognize those cultures that are not celebrated and/or appreciated AHP/Gallup/NAPAS - Mbionwu September 2003

  19. Site 2 – Primary Statement Hits by Domain • Domain 7 – The system delivers consumer directed, recovery-based services incorporating treatment approaches broader than the traditional medical model AHP/Gallup/NAPAS - Mbionwu September 2003

  20. Site 2 – Frequently sorted statements • Subset issue areas (critical attention) Statement 42 – System managers need something tangible in order to measure outcomes at all levels (evaluation and monitoring, etc.) (Domain 9 – Monitoring, Research, and Evaluation) AHP/Gallup/NAPAS - Mbionwu September 2003

  21. Site 2 – Frequently sorted statements • Statement 43 – Systems need to include family members and loved ones as determined by the consumer (Domain 8 – Family and Community Participation) • Statement 11- There is no such thing as a culturally competent clinician. The system should always be in a place of learning and striving towards competence (Domain 4 – Policies and Procedures) AHP/Gallup/NAPAS - Mbionwu September 2003

  22. Statement Sort – 9 Domains (S2) AHP/Gallup/NAPAS - Mbionwu September 2003

  23. Critical Domain Ranking – S2 AHP/Gallup/NAPAS - Mbionwu September 2003

  24. Site 1 – Springfield Domain 1 (Values & Attitudes) Domain 5 (Training & Staff Development) Domain 7 (Interv. Tx. Model Features) Site 2 – Chicago Domain 1 (Values & Attitudes) Domain 2 (Cultural Sensitivity) Domain 7 (Interv. Tx Model Features) Site Comparative Analysis(Domain Sorting Frequency) AHP/Gallup/NAPAS - Mbionwu September 2003

  25. Site 1 - Springfield Note: (Likert-scale) Domain 1* Domain 2* Domain 5 Domain 7 * Level of importance weighted equally Site 2 – Chicago Note: (Likert-scale) Domain 1 Domain 2* Domain 5* Domain 7 * Level of importance weighted equally Site Comparative AnalysisCritical Domain Ranking (1-5) AHP/Gallup/NAPAS - Mbionwu September 2003

  26. Systemic Primary and Subset Issue Areas • Primary Focus: (Domains 1, 2, 5, and 7) • Subset Issues: Domain 4 – Policies & Procedures Domain 9 – Monitoring, Research, and Evaluation AHP/Gallup/NAPAS - Mbionwu September 2003

  27. Beginning the Process… • Measurement Framework 1) Capacity/Structure 2) Process Measures 3) Impact/Outcome Measures 4) Organizational Viewpoint Measures AHP/Gallup/NAPAS - Mbionwu September 2003

  28. Framework (cont’d.) • Capacity/Structure – assess the organization’s capability to support cultural competence 1) adequate/appropriate settings 2) staffing 3) facilities/equipment 4) financial 5) information systems 6) governance 7) administrative structures AHP/Gallup/NAPAS - Mbionwu September 2003

  29. Framework (cont’d.) • Process measures – assess the content and quality of activities, procedures, methods and interventions in the practice of culturally competent care and in support of such care • Impact outcome measures – assess the contribution of cultural competence to the achievement of various levels of objectives (e.g., intermediate, ultimate), with respect to the provision of care, the response to care, and the results of care AHP/Gallup/NAPAS - Mbionwu September 2003

  30. Framework (cont’d.) • Organizational viewpoint measures – assess the values, principles, perspectives, outlook, and organizational attitudes communicated and displayed by your system • Purpose of framework measures include: 1) oversight; 2) quality improvement; 3) evaluation • Analysis (individual, organizational, etc.) AHP/Gallup/NAPAS - Mbionwu September 2003

  31. Process Measurement Framework • Domain • Topic Area • Measures/Indicators • Type of Measure 1) Capacity/Structure 2) Process 3) Outcome/Impact 4) Organizational Viewpoint • Vantage Point • Usage AHP/Gallup/NAPAS - Mbionwu September 2003

  32. Measures/Indicators – Group Activity • Assessing and Operationalizing Cultural Competence Domain 1 – Values & Attitudes Domain 2 – Cultural Sensitivity Domain 5 – Training & Staff Development Domain 7 – Intv. & Tx Model Features Domain 9 – Monitoring, Research, Evaluation Domain 4 – Policies & Procedures AHP/Gallup/NAPAS - Mbionwu September 2003

  33. S.W.O.T Analysis • Strengths, Opportunities, Weaknesses, & Threats 1) Internal (resources and experiences) a. Strengths (assets, resources, prospects) b. Weaknesses (limitations, restrictions, challenges) 2) External (forces/factors beyond control) a. Opportunities (coalition building) b. Threats (demographics, funding, economy) AHP/Gallup/NAPAS - Mbionwu September 2003

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