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Providing Care to Diverse Populations

State Roles, Strategies, & Issues

In Promoting Cultural Competency


Larry Bartlett, Ph.D., Health Systems Research, Inc., Washington, DC.

State governments carry out a range of different roles and responsibilities within the health care field, including:

  • Regulator.
  • Purchaser of health care services.
  • Educator.
  • Protector of the public health.

In this session, the issues, opportunities, and challenges that States encounter in each of these roles to promote cultural competency were reviewed.

In addition to discussing these specific roles and related activities, a particularly active discussion was generated around issues including:

  • The provision of cultural-competence activities currently underway independent of State governments.
  • The unknown costs and benefits associated with culturally competent care.
  • The overall State responsibility for monitoring and enforcing cultural competence in health care delivery.

Although there was agreement that initiating cultural-competence activities is essential because it is the right thing to do, this belief is not always enough to build the case for cultural competence for those making State policy decisions around these issues. State officials argued that they are being held to a higher standard when it comes to incorporating and enforcing cultural competency into service delivery than with other health care initiatives.

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