October 30, 2019
Cultural competence is the key to trust and respect between clients and direct care workers
By: Diverse Elders

Dear Colleague,

Resources for Integrated Care (RIC) has developed a series of briefs, described and linked below, to help long-term services and support (LTSS) providers, administrators, and other stakeholders, support a diverse direct care workforce that can meet the cultural needs and preferences of dually eligible beneficiaries. These resources contain information and promising practices related to organizational cultural competence in LTSS provider settings, training culturally competent direct care workers, and recruiting and retaining a diverse direct care workforce.

Click here to access the direct care workforce briefs.

Nearly half of all individuals dually eligible for Medicare and Medicaid receive help with personal care, such as bathing, dressing, managing medications, and other long-term services and supports (LTSS). Given the intimate nature of these services, cultural competence – the ability to work effectively in cross-cultural situations – is a key part of establishing trust and respect between direct care workers and their clients. As the population of individuals using LTSS grows increasingly diverse in race and ethnicity, the ability of direct care workers to provide culturally competent care is increasingly vital. We invite you to explore each of the briefs linked below to learn more:

  • Organizational Cultural Competence: This brief highlights strategies for developing cultural competence within LTSS provider organizations to support a culturally competent direct care workforce. The brief provides strategies for assessing organizational cultural competence, supporting diversity across all levels of an organization, addressing linguistic competence, and engaging community partners.


  • Training Culturally Competent Direct Care Workers: This brief focuses on strategies for training direct care workers in cultural competence. Highlighted strategies include establishing and building on organizational policies to support cultural competence, using adult learner-centered training methods, and identifying setting- and community-appropriate training programs for direct care workers.


  • Recruiting and Retaining a Diverse Direct Care Workforce: This brief focuses on strategies for recruiting and retaining a diverse direct care workforce. This brief includes approaches for inclusive hiring practices, supporting staff through an inclusive environment, and proving comprehensive training for direct care workers, supervisors, and administrators.


Did you miss the Culturally Competent Direct Care: Meeting the LTSS Needs of Diverse Dually Eligible Beneficiaries webinar?

This webinar discusses strategies for providing direct care services with cultural sensitivity, as well as training elements for direct care workers to achieve cultural competence. Speakers share strategies for effectively identifying and meeting beneficiaries’ LTSS needs, in both institutional and community-based settings, while respecting their diverse cultural preferences. Finally, a direct care worker shares her firsthand experiences and recommendations on providing culturally competent direct care.

For additional resources, please refer to the Resource Guide for this webinar here.

Follow us on Twitter @Integrate_Care, as we highlight additional resources.



RIC develops and disseminates technical assistance and actionable tools for providers of beneficiaries dually eligible for Medicare and Medicaid based on successful innovations and care models. The RIC website features additional resources and tools for providers and health plans, available at https://www.resourcesforintegratedcare.com. RIC is supported by the CMS Medicare-Medicaid Coordination Office.

The opinions expressed in this article are those of the author and do not necessarily reflect those of the Diverse Elders Coalition.