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National Technical Assistance and Evaluation Center for Systems of Care
Challenges and Strategies in Achieving Cultural Competence in Child Welfare Driven Systems of Care
The experiences of the nine grant communities involved in the Improving Child Welfare Outcomes Through Systems of Care initiative, the challenges they faced, and the strategies they implemented to address them provide useful information to administrators nationwide for operationalizing cultural competency in a systems of care framework for change.
1. Limited baseline knowledge of agency performance on cultural and linguistic competence
Challenges. Grant communities had to engage and educate key system stakeholders to advance from individual to system impact on cultural and linguistic competence. Many grantees invested considerable time in obtaining agency leadership support for an in-depth examination of agency performance in the area of cultural competence.
Strategies. Jefferson County (Colorado) System of Care conducted two analyses about racial disparities and disproportionality in the child welfare system. In the first, a local evaluation team analyzed Global Positioning System data that cross-referenced the origination point for child maltreatment allegations and referrals with demographic data. This analysis revealed that communities with high concentrations of families of color tended to have higher numbers of allegations and referrals than their White counterparts. Preliminary analysis of agency data indicated differences in assessments and subsequent decision by race/ethnicity. The results were the foundation for a community engagement strategy with various communities of color and agency staff. A Minority Overrepresentation Forum was designed to draw attention to the issue and establish a partnership with the community for collaborative problem solving.
Kansas Family Centered Systems of Care conducted an organizational self-assessment on cultural competency within the child welfare agency's central office. After learning the results, the leadership authorized a cultural competency charter work team to identify and assess agency activities, resources, or assets that focused on multiculturalism, cultural diversity, and/or cultural and linguistic competency. These assessment activities led to the establishment of a cross-function team composed of customers, community stakeholders, staff, and leadership to develop short- and long-term strategies to improve cultural and linguistic competency throughout all divisions.
"Cultural competence will have to be inextricably linked to the definition of specific child welfare outcomes and to an ongoing system of accountability that is committed to reducing the current disparities among racial, ethnic and cultural populations." (Cultural Competency Charter Team, Kansas Family Centered Systems of Care, n.d.)
2. Difficulty defining and operationalizing the cultural and linguistic competence principle
Challenges. The comprehensive nature of cultural and linguistic competency made it challenging for many demonstration sites to find a starting place that maintained an emphasis on infrastructure development and foundation-building activities required by the initiative. Justifying a focus on cultural competency to child welfare agency staff was especially challenging in communities where cultural competency was associated with racial/ethnic diversity. Additionally, making the case for cultural competency to agency staff was challenging in some grant communities because staff considered their practice culturally competent.
Strategies. To increase awareness of cultural diversity, many grant communities went beyond merely providing information on shifting demographics.
Jefferson County System of Care created a cultural awareness training program that included a monthly brown-bag lunch series for agency staff to discuss the meaning of cultural competence, explore their own cultures, and gain awareness of the diverse cultures represented in the community. In addition, the grant team followed a community engagement and education approach to raise awareness of cultural diversity within the county agency and to present information about child welfare services and supports at an annual community resource fair. These community engagement activities laid a foundation of inter- and intracultural appreciation upon which some of the more challenging work of assessing minority overrepresentation and disproportionality in the county system could be based.
The Family Centered Systems of Care in Kansas followed a similar strategy that included leadership support for events that highlighted the cultural diversity of agency staff. Such a strategy is particularly important in culturally homogeneous communities where, without the presence of racial/ethnic diversity, an erroneous assumption about an absence of culture can persist. Encouraging agency staff to acknowledge and appreciate their own cultural heritage creates opportunities for a broader understanding of the impact of cultural heritage, and promotes recognizing and addressing cultural biases in everyday experience and practice.
In the cultural and linguistic competence continuum, staff and community awareness of cultural diversity is considered an entry-level intervention. Yet in many cases, awareness of cultural diversity is the extent of the agency's strategy to become culturally competent, rather than just the beginning. However, the grant communities found that such a beginning, as part of a comprehensive cultural and linguistic competency strategy within a system change context, can advance agency progress toward cultural and linguistic competence. The CRADLE in Bedford-Stuyvesant in New York City used a multifaceted outreach strategy that began with multicultural awareness community events, as well as training and professional development for agency staff, and progressed to an intensive joint training curriculum, including the Undoing Racism™ workshop, for community members, community-based agency staff, and city staff. The Medicine Moon Initiative in North Dakota developed and administered a survey that emphasized identification of cultural strengths and showed that communities were interested in bolstering and reconnecting to cultural values for building the system of care infrastructure for a tribal child welfare agency.
3. Unclear connection between cultural bias and its impact on everyday decision-making
Challenges. Even when grant communities increased awareness of cultural diversity, generating awareness of the role of culture in everyday decision-making often was challenging. Barriers existed to encouraging frontline workers, supervisors, and other agency and community-based organization leaders and managers to take the next steps to understanding cultural bias and its impact on child welfare decisions. Grant communities found that awareness-building activities needed to provide personal reflection on entrenched beliefs as well as introduction of new concepts.
Strategies. Partnering4Permanency in Contra Costa County, California, created a training program designed to help staff understand cultural bias and its impact on decision-making and practice. To complement this training, each office scheduled a facilitated, intensive staff retreat at which they addressed performance indicators related to racial disparities and disproportionality, reviewed staff activities to determine effectiveness in addressing disparities, and provided an opportunity for each workgroup to draft an equity plan. The county ultimately created a comprehensive strategy that provided this training to all agency administrators, managers, supervisors, frontline social workers, and support staff.
The CRADLE expanded this approach to incorporate personal learning and reflection on culture, offering the Undoing Racism Community Organizing Workshop for child welfare professionals, family partners, and community members. The training helps participants surpass the symptoms of racism to reach a clear understanding of what it is, where it comes from, how it functions, why it persists, and how it can be undone. To date, the CRADLE has blended funds with 29 local providers and trained more than 140 staff and community members, including executive directors and agency directors.
"The Undoing Racism workshop...gave me a better understanding as to what role I play in my community and how I can be better for my own community."
4. Staff turnover
Challenges. According to a nationwide study, child welfare agencies averaged 20-40 percent staff turnover in 2006. The same study revealed that some agencies experienced 100 percent turnover (Westbrook, Ellis, & Ellett, 2006). Worker retention presented a challenge for grant communities as they operationalized the cultural and linguistic competence principle in systems of care. System transformation depends on staff being available to design and implement new policies and practices. Systems change initiatives in child welfare can be adversely affected unless the issue of staff retention is addressed throughout and beyond the change process. Staff turnover can impede agencies' ability to make immediate and long-term progress toward improving outcomes for children and families.
Strategies. Many grant communities offered training and professional development to improve staff, agency, and community cultural and linguistic competence. However, even for communities with extensive training and workshop offerings, gauging progress in the beginning and intermediate stages of the grant was difficult because of frontline and leadership staff turnover. After cultivating leadership awareness and support for cultural competence work, several grant communities had to begin again several times due to turnover in agency, tribal, court, and other crucial leadership positions.
Several grant communities embedded cultural competence objectives into existing State reforms or federally mandated activities to maintain a focus on cultural and linguistic competence and guide practice, despite staff turnover. Partnering4Permanency included cultural and linguistic competency goals in its State Program Improvement Plan. Kansas Family Centered Systems of Care integrated performance indicators for cultural and linguistic competence, along with the other systems of care principles, in the contracts for private service providers. The North Carolina Department of Social Services developed a comprehensive 3-day cultural competency training curriculum in partnership with culturally diverse staff and community-based organizations serving overrepresented communities of color. The curriculum is being piloted in three regions in the State, and is slated to become a mandated training for all child welfare workers and supervisors.