Cultural Competency Checklist

Organization and Client LGBTQ+ Cultural Competency Checklist.

This tool consists of a checklist that can be used to assess both providers’ and clients’ perspectives of cultural competency in an organization. Please see relevant New York State law and other resources at the end.

Purpose

This checklist offers organizations a way to assess LGBTQ+ Cultural Competency within their organization and an opportunity to compare staff perspectives of LGBTQ+ cultural competency within the organizations with client perspectives. While organizational staff have their own perceptions of care provision, client perspectives are helpful for comparison to make meaningful organizational changes.¹We use the term cultural competency to mean “a set of congruent behaviors, attitudes, and policies that come together in a system, agency, or among professionals that enables effective work in cross-cultural situations.²

Who We Are

LGBTQ+ Health Initiative

The mission of the LGBTQ+ Health Initiative is to reduce disparities experienced by gender and sexually diverse populations by helping health and human services agencies that are a part of the NYS HHS LGBT Network more effectively reach and serve these groups.

The LGBTQ+ Health Initiative’s Community Advisory Board is composed of 15+ members of our LGBTQ+ community in New York State. The CAB provided sexual and gender minoritized community perspectives into the LGBTQ+ Health Initiative’s work.

Collective Justice Consulting

We work with individuals, organizations, and collectives to overcome obstacles and create the change they seek. We integrate liberation frameworks into all our services. We integrate a “yes, and” perspective within our listening and collaborative practices.

This checklist was created in partnership between the LGBTQ+ Health Initiative,³ Collective Justice Consulting,^4,5 and LGBTQ+ community members, and was funded by the New York State Department of Health AIDS Institute.⁶ It was based on the National LGBT Cancer Network’s “LGBTQ Cultural Competency Toolkit Recognition Criteria”⁷ and the Human Rights Campaign’s “Healthcare Equality Index 2024”.⁸ A community advisory board (CAB) of LGBTQ+ community members reviewed these surveys for relevance to our community, removed irrelevant or duplicative questions, and suggested clarifying language edits in order to create our Organization Survey and Client Survey.

We sent our surveys to health and human service organizations that are a part of the NYS LGBT Network.⁹ 31 organizations completed the Organization Survey. While 19 organizations expressed interest in piloting the Client Survey, 5 organizations recruited participants who completed the survey.

Basic univariate analyses and chi-squared tests were conducted on quantitative data from both surveys, using a p-value of 0.10. For the qualitative data, our CAB used the Most Significant Change technique to review and analyze answers to two open-ended questions that captured client’s stories of care, identify themes or domains of change, and select the stories that represented the “most significant change”.¹⁰

If you want to learn more about our methods and the results of our project, please see our manuscript.¹¹

We collected Organizational Survey data using REDCap online surveys, which included a drop down list of organization names in the beginning, allowing us to combine responses if more than one person per organization completed the survey. We recommend that Organizational Surveys are completed in teams of at least two people, and that results are used as a basis for organizational conversations about where to begin cultural competency initiatives or place continued effort.

We collected Client Survey data using REDCap online surveys which were specific to each organization who recruited clients. We paid recruiting staff extra incentives in the form of gift cards, to compensate for additional time required to recruit out of their existing job responsibilities. We offered clients the opportunity to complete a linked survey to be entered into a drawing for gift cards as an incentive to complete. While we collected anonymous client data, the opportunity to enter unrequired demographic data was offered to clients. We caution survey implementers to be careful about collecting demographic data that could be traced back to specific clients, as it may limit the candor with which clients complete the survey.

Yu, H., Flores, D. D., Bonett, S., & Bauermeister, J. A. (2023). LGBTQ + cultural competency training for health professionals: a systematic review. BMC Med Educ, 23(1), 558. https://doi.org/10.1186/s12909-023-04373-3
Cross, T. L., Bazron, B. J., Dennis, K. W., & Isaacs, M. R. (1989). Towards a Culturally Competent System of Care. Georgetown University Child Development Center, CASSP Technical Assistance Center. https://spu.edu/-/media/academics/school-of-education/Cultural-Diversity/Towards-a-Culturally-Competent-System-of-Care-Abridged.ashx
LGBTQ+ Health Initiative: https://lgbtqplushealth.org/
Collective Justice Consulting: https://www.collective-justice.com/
Margolies, L., Joo, R., & McDavid, J. (2019). Best Practices in Creating and Delivering LGBTQ Cultural Competency Trainings for Health and Social Service Agencies. https://static1.squarespace.com/static/555f3f80e4b097734e13e9aa/t/55b7d2aee4b070972f6e2db3/1438110382030/Best+Practices+Manual.pdf
AIDS Institute: https://www.health.ny.gov/diseases/aids/general/about/prevention.htm#lgbt
Margolies, L., Joo, R., & McDavid, J. (2019). LGBTQ Cultural Competency Tool Kit: Recognition Criteria. Retrieved October 10, 2024 from https://cancer-network.org/resources/recognition-criteria/.
Human Rights Campaign. (2024). Healthcare Equality Index 2024: Promoting Equitable and Inclusive Care for LGBTQ+ Patients and Their Families. Retrieved May 21 from https://www.hrc.org/resources/healthcare-equality-index
The NYS LGBT Health and Human Services Network: https://gaycenter.org/advocacy/lgbt-health-network/
Davies, R., & Dart, J. (2005). The ‘Most Significant Change’ (MSC Technique: A Guide to Its Use.
In Press. Levandowski, BA; Naimool, k; Rietberg-Miller, SB; Aldrich, PL. Yes it matters: Assessing service-related cultural competency of New York State Department of Health-funded providers from multiple angles. Health Promotion Practice.

Cultural Competency Checklist for use within Organizations and with Clients

Patient/Client Services and Support

Employee Benefits and Policies

Patient/Client and Community Engagement

Environment

Policy: Non-discrimination and staff training

New York State Human Rights Law (NYSHRL) – NYCRR § 466.13 (PDF)

Designates as professional misconduct, engaging in sexual orientation change efforts by mental health care professionals upon patients under 18 years of age.

FAQs on Patient Visitation at Certain Federally Funded Entities and Facilities

“Patients and residents have the right to receive the visitors whom the patient or resident designates. These visitors can include, but are not limited to, a spouse or a domestic partner (including a same-sex spouse or domestic partner), another family member, or a friend.”

Paid Family Leave: LGBTQIA+ Fact Sheet (PDF)

Your gender, gender identity, or sexual orientation has no impact on your eligibility for Paid Family Leave

Fact Sheet: Final Rule to Amend the Definition of Spouse in the Family and Medical Leave Act Regulations

OSHA guidelines: A Guide to Restroom Access for Transgender Workers (PDF)

All employees, including transgender employees, should have access to restrooms that correspond to their gender identity.

Ban on Conversion Therapy in New York State

Designates as professional misconduct, engaging in sexual orientation change efforts by mental health care professionals upon patients under 18 years of age.

Gender Expression Non-Discrimination Act (GENDA)

Offers protection for transgender, gender nonconforming and nonbinary persons from discrimination in employment, housing, credit, education and public accommodation based on real or perceived gender identity or expression.

Sexual Orientation Non-Discrimination Act (SONDA)

Offers protection for lesbian, gay, and bisexual persons from discrimination in employment, housing, credit, education and public accommodation based on real or perceived sexual orientation.

Know Your Rights: Frequently Asked Questions about New York’s Marriage Equality Act

NYS employees can elect coverage for a legally married spouse, regardless of the sexual orientations of the couple.

Health care coverage options for same-sex couples

An insurance company that offers health coverage to opposite-sex spouses must do the same for same-sex spouses.

The Dignity for All Students Act

Seeks to provide the State’s public elementary and secondary school students with a safe and supportive environment free from discrimination, intimidation, taunting, harassment, and bullying on school property, a school bus and/or at a school function.