Cultural and Linguistic Requirements

"Culturally responsive and linguistically appropriate care" plan requirements (former term: "Cultural Competence") are now included in BHSA Integrated Plans, beginning with the 2026 BHSA Integrated Plan (IP) (FY26-29) and the Year 1 Annual Update (FY27-28). The Behavioral Health Outcomes, Accountability, and Transparency Report (BHOATR) requirement begins on January 30, 2029, requiring reporting on Cultural Competence Plan progress (for FY26-27). Timeline for Plan Refresh

Definitions

Community Defined Evidence Practices (CDEPs) The term, “community-defined evidence practices” or CDEPs, derives from what a community considers illness and healing as well as their positive attributes of cultural or traditional practices. They describe “a set of practices that communities have used and determined by community consensus over time and which may or may not have been measured empirically but have reached a level of acceptance by the community.” CDEPs originate within the community and the organizations that serve them, and can range from mental health treatments to community outreach to other services and supports. These practices developed in response to the lack of recognition of mental health services grounded in a community’s cultural norms, unique symptoms, and risk and resilience factors. Examples of these types of practices include but are not limited to: traditional healing; life coaching; sister circles; mindfulness, radical inclusivity, and bilingual/bicultural outreach.
Learn more: CDEP Concept Paper, April 2021

Culturally responsive and linguistically appropriate care: BHSA 3-Year Plan/Annual Update requirements include: the ability to reach underserved cultural populations and address specific barriers related to racial, ethnic, cultural, language, gender, gender identity, sexual orientation, age, economic, or other disparities in mental health and substance use disorder treatment services access, quality, and outcomes” (WIC § 5840.6(g)(1)). All county BHSA programs must include culturally responsive and linguistically appropriate interventions (WIC § 5840(b)(3)(C));

Counties are encouraged to implement community-defined evidence practices that reflect the values, histories, and lived experiences of the communities served (WIC § 5892(k)(6));
Counties may invest Workforce and Education (WET) funds to build and maintain a workforce that is culturally and linguistically representative of the populations served (WIC § 5892(k)(5));
Each county Integrated Plan must describe how the county will provide high-quality, culturally responsive, and timely care across the full behavioral health continuum (WIC § 5963(a)(1)), address disparities, and include a workforce strategy that ensures a network of providers that are culturally and linguistically concordant with the communities served and robust enough to achieve the statewide and local behavioral health goals and measures. (WIC § 5963.02(c)(8));
Community planning processes must affirmatively reach out to culturally and linguistically diverse stakeholders (WIC § 5963.03)

Implicit biases occur outside of conscious awareness and often may not be consistent with a person’s overt or conscious beliefs. Strategies such as increasing awareness of implicit bias, increasing exposure to groups that are the target of stereotypes, and explicitly practicing changing one’s overt thought processes may reduce the influence of implicit bias in decision-making. Implicit bias training was recommended by the President’s Task Force on 21st Century Policing and has been implemented in many law enforcement agencies across the country.

Guidance for Boards/Commissions

Best Practices for Boards and Commissions and Requirements for Staff

Resources / Reports

BHSA Racial Equity Scorecard, CA Pan Ethnic Health Network

Cultural Issues Page

CLAS Standards

The National Standards for Culturally and Linguistically Appropriate Services in Health and Health Care (The National CLAS Standards) aim to improve health care quality and advance health equity by establishing a framework for organizations to serve the nation's increasingly diverse communities.

Principal Standards
1) Provide effective, equitable, understandable and respectful quality care and services that are responsive to diverse cultural health beliefs and practices, preferred languages, health literacy and other communication needs.

Governance, Leadership and Workforce
2) Advance and sustain organizational governance and leadership that promotes CLAS and health equity through policy, practices and allocated resources.
3) Recruit, promote and support a culturally and linguistically diverse governance, leadership and workforce that are responsive to the population in the service area.
4) Educate and train governance, leadership and workforce in culturally and linguistically appropriate policies and practices on an ongoing basis.

Communication and Language Assistance
5) Offer language assistance to individuals who have limited English proficiency and/or other communication needs, at no cost to them, to facilitate timely access to all health care and services.
6) Inform all individuals of the availability of language assistance services clearly and in their preferred language, verbally and in writing.
7) Ensure the competence of individuals providing language assistance, recognizing that the use of untrained individuals and/or minors as interpreters should be avoided.
8) Provide easy-to-understand print and multimedia materials and signage in the languages commonly used by the populations in the service area.

Engagement, Continuous Improvement and Accountability
9) Establish culturally and linguistically appropriate goals, policies and management accountability, and infuse them throughout the organizations’ planning and operations.
10) Conduct ongoing assessments of the organization’s CLAS-related activities and integrate CLAS-related measures into assessment measurement and continuous quality improvement activities.
11) Collect and maintain accurate and reliable demographic data to monitor and evaluate the impact of CLAS on health equity and outcomes and to inform service delivery.
12) Conduct regular assessments of community health assets and needs and use the results to plan and implement services that respond to the cultural and linguistic diversity of populations in the service area.
13) Partner with the community to design, implement and evaluate policies, practices and services to ensure cultural and linguistic appropriateness.
14) Create conflict- and grievance-resolution processes that are culturally and linguistically appropriate to identify, prevent and resolve conflicts or complaints.
15) Communicate the organization’s progress in implementing and sustaining CLAS to all stakeholders, constituents and the general public.

Learn more about implementing The National CLAS Standards within your organization to help advance and sustain culturally and linguistically appropriate services.