ADHS/DBHS Organizational Culture Assessment 2014
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1 ADHS/DBHS Organizational Culture Assessment 2014 Welcome, Thank you for your participation in the 2014 Organizational Culture Assessment for the ADHS Division of Behavioral Health Services. Please read the following instructions carefully before completing the survey. Before starting the survey, all respondents will need their location s AHCCCS Provider ID Number which is a six (6) digit number. **Each provider location has a unique AHCCCS Provider ID Number, which will vary by location. If your location has more than one ID, there is a space for an additional ID.** If you, as the respondent, do not know your AHCCCS Provider ID Number for your location, please obtain the Provider ID Number prior to beginning the survey. The survey is divided into nine (9) sections: 1. Organization and Leadership Values 2. Policies, Procedures, and Governance 3. Planning, Monitoring, and Evaluation 4. Communication and Language Assistance 5. Workforce Development 6. Community and Individual/Peer and Family Engagement 7. Facilitation of Services 8. Organizational Resources 9. Values and Attitudes The purpose of the survey is to identify opportunities or needs for education and training relating to cultural competency. We value your honest response to this survey, as the results of this survey will be combined into one report. Questions with an asterisk ( * ) are required to have an answer in order to continue the survey. When you have completed the survey, click the Done' button. Page 1
2 This survey will take approximately 25 minutes to complete. Click on the 'Next' button below to begin the survey. Page 2
3 About Your Organization * Provider ID 1 1. Please enter your agency's site AHCCCS Provider ID (6 digit number Enter at least ONE ID) Provider ID 2 2. Name of Agency/Site 3. Agency/Site Address Address: Address 2: City/Town: State: 6 ZIP: Page 3
4 4. Agency/Site County (Select all that apply): Apache County Cochise County Coconino County Gila County Graham County Greenlee County La Paz County Maricopa County Mohave County Navajo County Pima County Pinal County Santa Cruz County Yavapai County Yuma County All of the Above Other (please specify) Page 4
5 * 5. Name of Tribal/Regional Behavioral Health Authority (T/RBHA) or Intergovernmental Agreement (IGA) for which your provider serves (Select all that apply): Cenpatico GSA2 Cenpatico GSA3 Cenpatico GSA4 Colorado River Indian Tribe (CRIT) Community Partnership of Southern Arizona (CPSA) Gila River Indian Community (GRIC) Mercy Maricopa Integrated Care (MMIC) Navajo Nation Northern Arizona Behavioral Health Authority (NARBHA) Pascua Yaqui Tribe White Mountain Apace Tribe (WMAT) All of the Above NON T/RBHA or IGA Affiliation Other (please specify) Page 5
6 *6. Which of the following best describes your staff level: Clerical staff Clinical staff Community member/stakeholder Executive leadership Family member Front line staff Mid Management staff Non Clinical staff Peer/Family support specialist Prevention specialist Program manager (non supervising) Volunteer (intern, fellow) Other (please specify) Page 6
7 1. Organization and Leadership Values 7. My organization has a cultural competency committee (i.e., diversity/awareness committee) who is responsible for reviewing policies and procedures and making recommendations related to cultural competency. Yes 8. My organization has developed a designated position and/or office function to address cultural and linguistic need. (i.e., Cultural Competency Coordinator) Yes 9. My organization has a mission statement that commits to cultural competence and reflects compliance with all federal and state statues, as well as any current state or local discriminatory and affirmative action policies 10. My organization encourages staff to participate in meetings with culturally diverse communities. 11. My organization actively reviews the organization s mission statement, goals, policies, and procedures to ensure the inclusion of principles and practices that promote diversity and cultural and linguistic competence. 12. The executive leadership of my organization includes cultural competency in staff communications. No No Page 7
8 13. The executive leadership of my organization participates in the following cultural competency (CC) areas: Do Not Have a CC Commitee/Plan/Policy Cultural competency committees Cultural competency plans Cultural competency policy development Cultural competency events/conferences 14. The cultural competency staff participates in executive leadership decisions. Do Not Have CC Staff Page 8
9 2. Policies, Procedures, and Governance 15. My organization has a designated position (e.g., cultural competency coordinator) that is responsible for the review of major policies and procedures to ensure that cultural competency is included and/or addressed. Yes 16. My organization incorporates cultural competency in its policies and procedures in the following areas: Individual Rights Confidentiality Grievance & Appeals Procedures Legal Assistance Vital Documents (i.e., medication fact sheets) Member Handbook System of Care Network & Management Communications Quality Improvement Finance Management (i.e., procurement) Information Technology Prevention (physical/mental health) 17. Standards of care exist that incorporate the Culturally and Linguistically Appropriate Services (CLAS) Standards in the organization's policies and procedures. No Page 9
10 18. My organization has: Policies/procedures for access to interpreters Policies that address the needs of various culturally diverse groups Uses culture specific assessment instruments Policies/procedures for the translation of written materials 19. My organization has policies regarding diversity, non discrimination, and sexual harassment that explicitly include: Age Blind and/or Visually Impaired Deaf and the Hard of Hearing Disability Gay, Lesbian, Bisexual, Transgender Populations Military/Veterans National Origin Race/Ethnicity Sex (Gender) Tribal Affiliation/Tribal Membership Page 10
11 20. My organization has written procedures for individuals to file and resolve complaints regarding discrimination based on: Age Blind and/or Visually Impaired Deaf and the Hard of Hearing Disability Gay, Lesbian, Bisexual, Transgender Populations Military/Veterans National Origin Race/Ethnicity Sex (Gender) Tribal Affiliation/Tribal Membership Page 11
12 3. Planning, Monitoring, and Evaluation 21. Data elements exist in my organization s databases and/or information systems on the following: (Check all that apply) Age Primary Language Blind and/or Visually Impaired Preferred Language Deaf and/or the Hard of Hearing Race Disability Sex (Gender) Ethnicity Sexual Orientation Gender Identity Social Economic Status (SES) Military/Veterans Tribal Affiliation/Tribal Membership National Origin Page 12
13 22. My organization has a system to monitor and track data elements in the following areas: Utilization of Utilization of Intake/Enrollment Outcomes Re admission Referrals Transfers Interpreter Care Services Utilization of Translation Services Crisis Age Blind and/or Visually Impaired Deaf and/or the Hard of Hearing Disability Ethnicity Gender Identity Military/Veterans National Origin Primary Language Preferred Language Race Sex (Gender) Sexual Orientation Social Economic Status (SES) Tribal Affiliation/Tribal Membership Page 13
14 23. My organization has a system to collect the following specific cultural and linguistic needs: Do Not Have a System Inclusion of extended family and/or family of choice Inclusion of spiritual or cultural beliefs and practices Interpreter Services Preferred Language Primary Language Translation Services 24. My organization produces reports related to utilization of services, performance measures and outcomes that include race/ethnicity. 25. My organization prepares reports regarding accomplishments in cultural competence that are: (Check all that apply) Available and accessible to individuals/public Distributed to the organization Reviewed by executive leadership Reviewed by the cultural competency committee Reports on cultural competency do not exist 26. How often does your organization: Conduct an assessment of community and/or individuals needs? 6 Assess consumer satisfaction in the areas of cultural diversity? 6 Page 14
15 27. Does your consumer satisfaction survey include the following: (Check all that apply) Extended Family Support Family Education Language Needs/Preferences Service Delivery Hours Service Delivery Locations Traditional Healing/Spiritual Beliefs Tribal Customs/Beliefs Cultural Needs/Preferences Supportive Environment/Feeling Safe Page 15
16 4. Communication and Language Assistance 28. My organization provides individuals with information about programs, covered services, policies, and procedures in the individuals preferred language. Information Does Not Exist Not at All Very LIttle Somewhat To a Great Extent Do Not Know 29. My organization has the following communications available to individuals in languages other than English: Materials Do Not Exist Educational materials communication/exchanges Forms (consent, intake, grievance, appeals, complaints) Member handbook Newsletters Notices (action, extension, denial, decision) Notice of change (transition, transfers, network) Telephone messages Vital documents (advanced directives, confidentially, individual rights) Websites Page 16
17 30. The staff in my organization are informed about the availability and how to access: Services Do Not Exist Interpreter (i.e., oral, sign language) services Translation (i.e. written) services 31. The individuals served by my organization are informed about the availability and how to access: Services Do Not Exist Interpreter (i.e., oral, sign language) services Translation (i.e. written) services Page 17
18 5. Workforce Development 32. My organization has: Executive leadership who reflect the cultural and linguistic diversity of the local population Staff that reflects the cultural and linguistic diversity of the local population Strategies in place to retain culturally and linguistically diverse staff/administration Policies and/or procedures for recruiting culturally and linguistically diverse staff Cultural competency committee members who are culturally and linguistically diverse 33. My organization actively recruits and employs from the following groups: Age Blind and/or Visually Impaired Deaf and/or the Hard of Hearing Disability LGBTQ Military/Veterans Multilingual Peer and Family Members Race/Ethnicity Tribal Affiliation/Tribal Member Page 18
19 34. To what extent are the following culturally competent trainings available to staff: Confidentiality requirements (i.e., data collection, information disclosure) Cross cultural communication Cultural awareness (i.e., diversity, culture, language) Cultural beliefs, values and behaviors Culturally and Linguistically Appropriate Standards (CLAS) Culturally and linguistically specific data elements Family and/or family of choice Health disparities Laws and regulations against discrimination Limited English Proficiency (LEP) Professional development in cultural competency areas Sex (Gender) roles Sexual orientation and/or gender identity Stigma awareness/reduction Traditional healing/spiritual beliefs Treatment and medication response Tribal customs/beliefs Working with diverse populations Page 19
20 35. My organization provides training to staff on cultural competence: Never Once Monthly Quarterly Semi Annually Annually Every couple years Do Not Know 36. My organization s cultural competence trainings are: Voluntary Mandatory Both Voluntary/Mandatory No cultural competence trainings available 37. Cultural Competency training is provided to: (Check all that apply) Clerical staff Clinical staff Community member/stakeholder Executive leadership Family member Front line staff Mid Management staff Non Clinical staff Peer/Family support specialist Prevention specialist Program manager (non supervising) Volunteer (intern, fellow) Page 20
21 38. The cultural competence trainings are evaluated by assessments/tests. Yes No No competence trainings available Do Not Know 39. Please check all that apply The interpreters (i.e., oral, sign language) utilized by my organization are: The translators (i.e., written documentation) utilized by my organization are: Certified and/or licensed Qualified Trained in ethics Trained in LEP needs Trained in various modalities of interpretation/translation Required to complete proficiency testing Knowledgeable of specialized terms in healthcare None of the above Page 21
22 6. Community, Individual/Peer, and Family Engagement 40. My organization actively advocates for cultural competence promotion and inclusion within public/mental/physical health, partner and community organizations. 41. My organization has a cultural competency committee that includes individual/peer, family, and community members that reflect the cultural and linguistic diversity of the local population. Do Not Have CC Committee 42. My organization includes cultural competence requirements in contracts with outside agencies. 43. My organization includes individual/peer, family, and community participation requirements in contracts with outside agencies. 44. My organization solicits stakeholder input from individuals/peers, families, and communities in developing programs, models, guidelines, and/or training materials. 45. My organization involves community partners representing culturally and linguistically diverse populations in strategic planning and policy development. Page 22
23 46. My organization has identified and established collaborative partnerships with the following community organizations and/or resources: (Check all that apply) Advocacy Groups City Agencies Community Agencies Education Education Systems Ethnic/Cultural Social Groups Faith Based Organizations First Responders Justice/Judicial Systems Law Enforcement LGBTQ Communities Military/Veterans Minority Business Groups Natural/Holistic Healers State and Federal Agencies Spiritual/Traditional Leaders Tribal Nations Voluntary Associations Page 23
24 7. Facilitation of Services 47. My organization incorporates the needs of individuals in the following ways: Collaborating with community members Collaborating with family members Collaborating with traditional healers/spiritual leaders Using culturally relevant assessment tools Inclusion of cultural needs (i.e., age, ethnicity, race, sex (gender), sexual orientation, gender identity, national origin, tribal affiliation, etc.) Inclusion of linguistic need (i.e., primary language, preferred language, language spoken at home, alternative language) Creation of culturally and linguistically appropriate treatment/service plans Page 24
25 48. My organization provides a continuum of care that is culturally and linguistically appropriate in the following ways: (Check all that apply) Audio/Visual media in languages other than English Culturally appropriate educative approaches (i.e., films, presentations, brochures, etc.) Extended family and/or family of choice support Facilities that are accessible to persons with disabilities Family education Inclusion of tribal customs/beliefs Interpretation (i.e., oral, sign language) services Materials in larger fonts for the visually impaired Recorded messages in languages other than English Signage in Braille Signage at key locations regarding language assistance services Traditional/Spiritual support Translation (i.e., written material) services 49. My organization incorporates aspects of individual s ethnic and cultural heritage into the design of specialized treatment services and/or interventions. 50. My organization distributes and makes available to individuals signage and materials that advise on how to access alternative cultural and linguistic services. Page 25
26 51. My organization provides the following to assist individuals with Limited English Proficiency (LEP) in their preferred language: (Check all that apply) Alternative formats of materials (i.e., consent to video/audio tape, etc.) Bilingual or multilingual staff Consumer satisfaction surveys Contracted interpreters Education materials (i.e., provider directories, newsletters, etc.) Handbook (i.e., member, information) In house interpreters Interpretation (i.e., oral, sign language) services Legal assistance Marketing/Advertisements Releases of information (ROI) Resource materials Translation (i.e. written) services Telephone interpreters Vital documents (i.e., HIPPA, medication fact sheets, confidentiality) Written notices of rights to receive language assistance services None of the above Page 26
27 8. Organizational Resources 52. My organization maintains and/or helps develop directories of qualified interpreters that are available to staff. 53. My organization has collaborative partnerships with agencies to support the cultural and linguistic needs of staff, programs and/or individuals in the following areas: Blind and/or Visually Impaired Community Service Agencies Crisis Services Deaf and/or the Hard of Hearing Dental Disability Domestic Violence Shelters Emergency Personnel Support Employment Housing Income Assistance LGBTQ Communities Medical Military/Veterans Prevention Refugee Services Page 27
28 Substance Abuse Tobacco and Chronic Disease Women and Children s Health 54. My organization has funds designated for cultural and linguistic needs in the areas of: (Check all that apply) Community Services Direct Services Education and Professional Development Marketing and Outreach Trainings None of the Above Other 55. My organization has the following culturally and linguistically diverse resources available to staff and individuals: (Check all that apply) Brochures/Flyers Guides Literature Publications Service Directories Service Manuals Touch Screen Computer Visual Presentations (i.e., DVD, video, media) Other Page 28
29 9. Values and Attitudes The following questions focus on your personal view regarding your organization s values and attitudes towards cultural competency. Please let us know how much you agree or disagree with the following statements. As a reminder your responses are confidential and your responses will be used to create a culturally welcoming environment. 56. I feel my organization values and supports the cultural and linguistic needs of populations: Within our geographical service area. Strongly Disagree Disagree Agree Strongly Agree Within our staff. 57. I understand the importance of health (physical/mental) literacy as it relates to staff roles and responsibilities in meeting the needs of the culturally and linguistically diverse population within our geographical service area. Strongly Disagree Disagree Agree Strongly Agree 58. I believe I intervene in an appropriate manner when I observe other staff, individuals, and/or family members within my organization engaging in behaviors that are culturally insensitive, biased and/or prejudiced. Strongly Disagree Disagree Agree Strongly Agree 59. I know the meaning and/or value of health (physical/mental) intervention, prevention, and/or treatment varies among cultures. Strongly Disagree Disagree Agree Strongly Agree 60. I recognize and understand that beliefs and concepts of emotional well being vary significantly from culture to culture. Strongly Disagree Disagree Agree Strongly Agree Page 29
30 About You Optional Questions We would like to know a little more about you; however the following questions are optional and are not required in order to complete this assessment. If you would not like to complete these questions, please click the 'Done' button at the bottom of this page. 61. What is your sex (gender)? Female Male 62. Are you Hispanic, Latino/a, or Spanish origin? (Check all that apply) Yes, Hispanic, Latino/a, or Spanish origin Yes, Mexican, Mexican American, Chicano/a Yes, Puerto Rican Yes, Cuban Yes, another Hispanic, Latino/a, or Spanish origin No, not of Hispanic, Latino/a, or Spanish origin 63. What is your race? (Check all that apply) White Black or African American American Indian or Alaska Native Asian Native Hawaiian or Other Pacific Islander Page 30
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