Common use of CULTURALLY COMPETENT SERVICES Clause in Contracts

CULTURALLY COMPETENT SERVICES. (A) The CONTRACTOR shall develop and implement a Cultural Competency/Sensitivity Plan through which the CONTRACTOR shall ensure that it provides, both directly and through its Network Providers and subcontractors, culturally competent services to its Members. The CONTRACTOR shall participate with HSD’s efforts to promote the delivery of Covered Services in a culturally competent manner to all CoLTS Members, including those with limited English proficiency and diverse cultural and ethnic backgrounds. The CONTRACTOR shall: (1) develop a Cultural Competency Plan that describes how the CONTRACTOR shall ensure that Covered Services provided to Members are culturally competent and shall submit the plan to HSD on an annual basis for approval; (2) develop written policies and procedures that implement the Cultural Competency Plan; (3) target cultural competency training to PCP, Service Coordinators, home health care staff and ensure that staff at all levels receive on-going education and training in culturally and linguistically appropriate service delivery; (4) develop and implement a plan for interpretive services including oral translation services and written materials to meet the needs of Members, potential Members, and their decision-makers whose primary language is not English, using qualified medical interpreters, if available, and make available easily understood Member-oriented materials and post signage in the languages of the commonly encountered group and/or groups represented in the service area; (5) identify community advocates and agencies that could assist non-English and limited-English speaking individuals and/or that provide other culturally appropriate and competent services, which include methods of outreach and referral; (6) incorporate cultural competence into utilization management, quality improvement and planning for the course of treatment; (7) identify resources and interventions for high-risk health conditions found in certain cultural groups; (8) develop and incorporate contract language to cultural competency requirements for inclusion in contracts between the CONTRACTOR and its Network Providers and subcontractors; (9) recruit and train a diverse staff and leadership that are representative of the demographic characteristics of the CONTRACTOR’s service area; and (10) ensure that new Member assessment forms contain questions related to primary language preference and cultural expectations and that information received is maintained in the Member’s file. (B) The CONTRACTOR shall conduct initial and annual organizational self- assessments of culturally and linguistically competent-related activities and are encouraged to integrate cultural and linguistic competence-related measures into their internal audits, performance improvement programs, Member satisfaction assessments and outcomes-based evaluations. The CONTRACTOR shall submit the organizational self-assessment to HSD annually, and include the results of performance improvement programs and outcome based evaluations, as they relate to health disparities in the CONTRACTOR’s Membership. (C) The CONTRACTOR shall identify a “tribal liaison” to assist the CONTRACTOR with issues specifically related to Native Americans and IHS and Tribal facilities and report such “tribal liaison” to HSD for approval. (D) The CONTRACTOR shall hold semi-annual meetings with Native American representatives from around the State of New Mexico that represent geographic and Member diversity. Minutes of such meetings shall be transmitted to HSD within thirty (30) calendar days of such meetings, identifying: (1) how the CONTRACTOR determined the representation of Native American representatives; (2) how notice of such meeting was delivered to Native American representatives that were asked to attend the meeting; (3) matters discussed at the meeting; (4) action items and/or recommendations to the CONTRACTOR and/or HSD; and (5) the date, time and location of the next meeting. (E) Services provided within the IHS or Tribal 638 facilities are not subject to prior authorization requirements.

CULTURALLY COMPETENT SERVICES. (A) The CONTRACTOR shall develop and implement a Cultural Competency/Sensitivity Plan through which the CONTRACTOR shall ensure that it provides, both directly and through its Network Providers and subcontractors, culturally competent services to its Members. The CONTRACTOR shall participate with HSDthe State’s efforts to promote the delivery of Covered Services in a culturally competent manner to all CoLTS CLTS Members, including those with limited English proficiency and diverse cultural and ethnic backgrounds. The CONTRACTOR shall: (1) develop a Cultural Competency Plan that describes how the CONTRACTOR shall ensure that Covered Services provided to Members are culturally competent and shall submit the plan to HSD the State on an annual basis for approval; (2) develop written policies and procedures that implement the Cultural Competency Plan; (3) target cultural competency training to PCP, Service Coordinators, home health care staff and ensure that staff at all levels receive on-going education and training in culturally and linguistically appropriate service delivery; (4) develop and implement a plan for interpretive services including oral translation services and written materials to meet the needs of Members, potential Membersenrollees, and their decision-makers whose primary language is not English, using qualified medical interpreters, if available, and make available easily understood Member-oriented materials and post signage in the languages of the commonly encountered group and/or groups represented in the service area; (5) identify community advocates and agencies that could assist non-English and limited-English speaking individuals and/or that provide other culturally appropriate and competent services, which include methods of outreach and referral; (6) incorporate cultural competence into utilization management, quality improvement and planning for the course of treatment; (7) identify resources and interventions for high-risk health conditions found in certain cultural groups; (8) develop and incorporate contract language to cultural competency requirements for inclusion in contracts between the CONTRACTOR and its Network Providers and subcontractors; (9) recruit and train a diverse staff and leadership that are representative of the demographic characteristics of the CONTRACTOR’s service area; and (10) ensure that new Member assessment forms contain questions related to primary language preference and cultural expectations and that information received is maintained in the Member’s file. (B) The CONTRACTOR shall conduct initial and annual organizational self- self-assessments of culturally and linguistically competent-related activities and are encouraged to integrate cultural and linguistic competence-related measures into their internal audits, performance improvement programs, Member satisfaction assessments and outcomes-based evaluations. The CONTRACTOR shall submit the organizational self-assessment to HSD annually, and include the results of performance improvement programs and outcome based evaluations, as they relate to health disparities in the CONTRACTOR’s Membership. (C) The CONTRACTOR shall identify a “tribal liaison” to assist the CONTRACTOR with issues specifically related to Native Americans and IHS and Tribal facilities and report such “tribal liaison” to HSD the State for approval. (D) The CONTRACTOR shall hold semi-annual meetings with Native American representatives from around the State of New Mexico that represent geographic and Member diversity. Minutes of such meetings shall be transmitted to HSD the State within thirty (30) calendar days of such meetings, identifying: (1) how the CONTRACTOR determined the representation of Native American representatives; (2) how notice of such meeting was delivered to Native American representatives that were asked to attend the meeting; (3) matters discussed at the meeting; (4) action items and/or recommendations to the CONTRACTOR and/or HSDthe State; and (5) the date, time and location of the next meeting. (E) Services provided within the IHS or Tribal 638 facilities are not subject to prior authorization requirements.

CULTURALLY COMPETENT SERVICES. (A1) The CONTRACTOR shall develop and implement a Cultural Competency/Sensitivity Plan Plan, through which the CONTRACTOR shall ensure that it provides, both directly and through its Network Providers health care providers and subcontractors, culturally competent services to its Membersmembers. The CONTRACTOR shall participate with HSD/MAD’s efforts to promote the delivery of Covered Services services in a culturally competent manner to all CoLTS Membersmembers, including those with limited English proficiency and diverse cultural and ethnic backgrounds. The CONTRACTOR shall: (1) A. develop a Cultural Competency Plan that describes how the CONTRACTOR shall ensure that Covered Services services provided to Members are culturally competent and shall submit the plan to HSD on an annual basis HSD/MAD annually for approval; (2) B. develop written policies and procedures that implement the Cultural Competency PlanPlan and ensure that culturally competent services are provided by the CONTRACTOR both directly and through its health care providers and subcontractors; (3) C. target cultural competency training to PCPprimary care providers, Service Coordinatorscare coordinators/case managers, home health care staff and ensure that staff at all levels receive on-going education and training in culturally and linguistically appropriate service delivery; (4) D. develop and implement a plan for interpretive services including oral translation services and written materials to meet the needs of Members, potential Members, consumers and their decision-makers whose primary language is not English, using qualified medical interpreters, if available, available and make available easily understood Membermember-oriented materials and post signage in the languages of the commonly encountered group and/or groups represented in the service area; (5) E. identify community advocates and agencies that could assist non-English and limited-English English-speaking individuals and/or that provide other culturally appropriate and competent services, which include methods of for outreach and referral; (6) F. incorporate cultural competence into utilization management, quality improvement and planning for the course of treatment; (7) G. identify resources and interventions for high-risk health conditions found in certain cultural groups; (8) H. develop and incorporate contract language specific to cultural competency requirements for inclusion in contracts between the CONTRACTOR and its Network Providers providers and subcontractors; (9) I. recruit and train retain a diverse staff and leadership that are representative of the demographic characteristics of the CONTRACTOR’s ’S service area; and (10) J. ensure that new Member member assessment forms contain questions related to primary language preference and cultural expectations and that information received is maintained in the Member’s member file. (B2) The CONTRACTOR shall conduct initial and annual organizational self- self-assessments of culturally and linguistically competent-related activities and are encouraged to integrate cultural and linguistic competence-related measures into their internal audits, performance improvement programs, Member member satisfaction assessments assessments, and outcomes-based evaluations. The CONTRACTOR shall submit the organizational self-assessment to HSD annually, and include the results of performance improvement programs and outcome based evaluations, as they relate to health disparities in the CONTRACTOR’s Membership. (C) The CONTRACTOR shall identify a “tribal liaison” to assist the CONTRACTOR with issues specifically related to Native Americans and IHS and Tribal facilities and report such “tribal liaison” to HSD for approval. (D) The CONTRACTOR shall hold semi-annual meetings with Native American representatives from around the State of New Mexico that represent geographic and Member diversity. Minutes of such meetings shall be transmitted to HSD within thirty (30) calendar days of such meetings, identifying: (1) how the CONTRACTOR determined the representation of Native American representatives; (2) how notice of such meeting was delivered to Native American representatives that were asked to attend the meeting; (3) matters discussed at the meeting; (4) action items and/or recommendations to the CONTRACTOR and/or HSD; and (5) the date, time and location of the next meeting. (E) Services provided within the IHS or Tribal 638 facilities are not subject to prior authorization requirements.