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Cultural Competence 

In 1997, the former California Department of Mental Health, formed a Cultural Competence Task Force (subsequently changed to the Cultural Competence Advisory Committee) to begin developing the first set of cultural competence plan standards, to address the needs of multicultural communities by implementing culturally and linguistically competent mental health services. The 35 member team charged with developing the initial cultural competence standards, worked in partnership with the California Mental Health Directors Association and community partners inclusive of mental health consumer and family members. This was the first endeavor of its kind in the nation, recognized for pioneer leadership by the Georgetown University Cultural Competence Center. Since 1997, three evolutions of the plan have been developed and implemented culminating in the most recent version, the Cultural Competence Plan Requirements (CCPR).  

The CCPR establishes further standards and criteria for the entirety of the California County Mental Health System, including Medi-Cal services, Mental Health Services Act (MHSA), and Realignment as part of working toward achieving cultural and linguistic competence. Each county must develop and submit a cultural competence plan consistent with these CCPR standards and criteria (per California Code of Regulations, Title 9, Section 1810.410). This plan shall address all mental health services and programs throughout the County Mental Health System. This CCPR seeks to support full system planning and integration and includes the most current resources and standards available in the field of cultural and linguistic competence. It is intended to move county mental health systems toward the reduction of mental health service disparities identified in racial, ethnic, cultural, linguistic, and other unserved/underserved populations. The CCPR works toward the development of the most culturally and linguistically competent programs and services to meet the needs of California’s diverse racial, ethnic, cultural, and linguistic communities in the mental health system of care.

Eight criteria were developed to encompass the CCPR and assist county Mental Health Plans (MHPs) in identifying and addressing disparities and inequities across the entire mental health system. Those eight criteria are as follows: 

      • Criterion I: Commitment to Cultural Competence
      • Criterion II: Updated Assessment of Service Needs
      • Criterion III: Strategies and Efforts for Reducing Racial, Ethnic, Cultural, and Linguistic Mental Health Disparities
      • Criterion IV: Client/Family Member/Community Committee: Integration of the Committee Within The County Mental Health System
      • Criterion V: Culturally Competent Training Activities
      • Criterion VI: County’s Commitment To Growing a Multicultural Workforce: Hiring and Retaining Culturally and Linguistically Competent Staff
      • Criterion VII: Language Capacity
      • Criterion VIII: Adaptation of Services


These eight criteria are a mechanism to examine where MHPs lie on the scale of cultural competence. Having used the criteria to form a logic model, the CCPR’s development and inclusion of the eight criteria allow MHPs to implement cultural and linguistic competence in a variety of settings and move toward operationalizing the concept of cultural competence.

Technical Assistance

To support MHPs in the development of their CCPR, the Department of Healthcare Services provides an array of website resources detailed below. This page will be updated so as to keep all county MHPs informed and up to date on pivotal technical assistance data, resources, and trainings that will support the work of county MHPs as they develop, expand, and integrate cultural competence across the entire public mental health system.

To support MHPs in their development of the CCPR, multiple technical assistance trainings were conducted, in different regions throughout the state.  The following documents were shared and discussed during those trainings:

CCPR Notice (For mid-size and large county MHPs)

CCPR Enclosure (For mid-size and large county MHPs)

CCPR Modification Notice (For small county MHPs)

CCPR Modification Enclosure (For small county MHPs)

Definition and List of Small County Mental Health Plans (relative to the CCPR)

CCPR Criterion II Supplemental Handout  

CCPR Technical Assistance Presentation  

Additional Resources

CCPR Scoring Tool

CCPR Scoring Tool Instructions

Formula for the CCPR Scoring Criteria

CCPR Summary Report

WET Findings

WET Resources

Threshold Language Notice

Threshold Language Enclosure

California Department of Public Health


Last modified on: 12/28/2015 4:10 PM