Report of the Cultural Competence Workgroup

Report of the Cultural Competence Workgroup
for the
Projects for Assistance in Transition from Homelessness

(PATH)

August 2002

Acknowledgments

The Cultural Competence Workgroup for the Projects for Assistance in Transition from
Homelessness (PATH) and the Center for Mental Health Services Homeless Programs
Branch gratefully acknowledges the participation of State PATH Contacts from the
following states, who helped shape our efforts throughout:

Arkansas, California, Colorado, Idaho, Illinois, Iowa, Louisiana, Maryland, Michigan,
Minnesota, Mississippi, Missouri, Montana, New Hampshire, New Jersey, New Mexico,
New York, Nevada, North Carolina, Oklahoma, Oregon, Pennsylvania, South Carolina,
Texas, Wisconsin, and Wyoming.

The workgroup wishes to thank and pay special tribute to Jim Chesnik for his vision,
organization, and leadership. He championed the project throughout his tenure as
Coordinator and the workgroup members missed his good humor and attention to detail
when he left.

Cathy Cave lent her expertise to specific content areas, and the importance of addressing
cultural competence at all levels. We also thank Dolores Jimerson, Community Program
Specialist and Cultural Competence Coordinator for the State of Wyoming Department of
Mental Health, who consulted with our workgroup, provided additional materials, and
leant strong moral support and special credence to the topic. Susan Milstrey Wells of
Advocates for Human Potential, Inc., transformed the group’s struggle into an organized
report.

Finally, the workgroup thanks Debbie Webster for taking on the role of Coordinator and
presenting this report to the State PATH Contacts. Chris Ringwald of Advocates for
Human Potential, Inc. provided final editing.

TABLE OF CONTENTS

of the

PATH Cultural Competence Workgroup Report

A Executive Summary_________________________________________________4
B Introduction________________________________________________________5
B.1 Background________________________________________________________________________5
B.2 Description of Work__________________________________________________________________5
B.3 The Need for Cultural Competence______________________________________________________6
B.4 Definitions of Culture and Diversity_____________________________________________________8
C Workgroup Findings_________________________________________________8
C.1 Definition__________________________________________________________________________8
C.2 Guiding Principles and Suggested Action Steps____________________________________________9
C.3 Self-Assessment Recommendations____________________________________________________14
D Conclusion________________________________________________________15
E Appendixes________________________________________________________16
E.1 References________________________________________________________________________16
E.2 Contacts__________________________________________________________________________19
A Executive Summary

The national Projects for Assistance in Transition from Homelessness (PATH) State
Contacts group comprises representatives of the 50 States, the District of Columbia, Puerto
Rico, and four U.S. Territories. At its June 2000 meeting, this group identified cultural
competence as a critical topic for PATH, a formula grant program that funds outreach and
services to people with serious mental illnesses (and those with co-occurring substance use
disorders) who are homeless or at risk of becoming homeless.

Between February and November of 2001, a small workgroup of State PATH Contacts
examined cultural competence by collecting and reviewing related documents from State
PATH Contacts and other public and private agencies, convening teleconferences, and
using e-mail discussions. Workgroup members synthesized the available information and
developed this report to 1) define cultural competence in the context of the PATH
program; 2) identify guiding principles for the development of culturally competent
services within PATH programs; 3) suggest action steps to help implement these
principles; and 4) recommend self-assessment tools to help PATH programs judge the
degree of cultural competence they have achieved.

For purposes of PATH-related activities, the workgroup defined cultural competence as:

“An ongoing and evolving process that comprises knowledge attainment and the
development of behaviors, attitudes, policies, and practices that come together in a system
of care enabling agencies, programs, and individuals to increase access to services and to
develop or adapt services that are appropriate to specific cultural needs.”

Guiding principles for the development of culturally competent services within PATH
programs are noted below:

1. Cultural competence requires development of a plan that is integral to an agency’s
strategic plan.
2. Cultural competence requires services to be driven by consumer needs and
preferences.
3. Cultural competence requires services to be delivered in the languages clients use.
4. Cultural competence requires a diverse and well-trained staff.
5. Cultural competence requires opportunities for continuing education and ongoing
knowledge development.
6. Cultural competence requires self-assessment, including measurement of program
outcomes and client satisfaction.

B Introduction
B.1 Background

Projects for Assistance in Transition from Homelessness (PATH) is a formula grant
program created under the Stewart B. McKinney Homeless Assistance Act of 1987
(P.L.100-77). This program funds the 50 States, the District of Columbia, Puerto Rico,
and four U.S. Territories to provide outreach and services to people with serious mental
illnesses (and those with co-occurring substance use disorders) who are homeless or at risk
of becoming homeless. PATH is administered by the Center for Mental Health Services
(CMHS) in the Substance Abuse and Mental Health Services Administration, U.S.
Department of Health and Human Services.

Each of the PATH-funded entities has a State Contact who provides oversight to the
program’s local implementation. At their biennial meetings, State PATH Contacts identify
topics that are of special interest to the PATH program and select workgroups to study
these topics in depth. At their meeting in June 2000, held in Washington, DC, State PATH
Contacts chose mainstream services, consumer issues, and cultural competence as the
areas they would explore. This is the report of the cultural competence workgroup.

Jim Chesnik of the Iowa Department of Human Services chaired the first phase of the
cultural competence workgroup, which included State PATH Contacts from around the
country; and Debbie Webster chaired the final phase. A list of workgroup members is
included in Appendix E.2. Pam Rainer of Advocates for Human Potential, Inc., the PATH
technical assistance contractor, participated in the group’s deliberations and provided
ongoing support. Dr. Michael Hutner and Dorrine Gross represented the CMHS Homeless
Programs Branch.

B.2 Description of Work

Between February and November of 2001, we examined the issue of cultural competence
by collecting and reviewing documents from other State PATH Contacts, as well as
materials from numerous federal, state, and private agencies (see Appendix E.1 for a list of
the resources we consulted). While this effort yielded numerous documents, the process
also revealed that there is still a great lack of attention to, and knowledge of cultural
competence. In particular, we found little information on cultural competence that
specifically relates to people who are homeless and have serious mental illnesses.

States varied in the degree to which their PATH programs were addressing cultural
competence, and most State PATH Contacts said they would welcome additional
information on this critical topic.

In teleconferences and e-mail discussions, we examined and synthesized the available
information and developed this report with four key goals in mind:

! To define cultural competence in the context of the PATH program.
! To identify guiding principles for the development of culturally competent services
within PATH programs.
! To suggest action steps to help implement these principles.
! To examine self-assessment tools and their relevance and importance in assisting
PATH programs in judging the degree of cultural competence they have achieved.

B.3 The Need for Cultural Competence

Culture counts. That simple but profound statement is at the heart of the U.S. Surgeon
General’s report Mental Health: Culture, Race, and Ethnicity, published as a supplement
to Mental Health: A Report of the Surgeon General (see Appendix E.1). Culture, in its
many forms, is primarily a source of creativity, strength and resilience for society, as a
whole, and for individuals. The Surgeon General’s report notes that America’s boundless
diversity yields, “incalculable energy and optimism”, by bringing “global ideas,
perspectives, and productive contributions to all areas of contemporary life.”

As culture shapes the nation, so too does it shape individuals. It provides them with the
skills, manners and attitudes with which they make their way through life. In times of
trouble, culture prepares or predisposes them for difficulties; it also determines their
reaction and recovery or resolution. While important for health and health care, generally,
the role of culture appears all the more critical in mental health, itself the product of a
complex and incompletely understood interplay among biology, psychology, society and
culture.

Race, ethnicity and culture impart many gifts. But differences among these often correlate
with differences in mental health care due to discrimination, inequality, and poverty or
disease, suffering, depression and anxiety that may cause or exacerbate problems.
Research cited by the Surgeon General indicates that racial and ethnic minorities are over-
represented among the nation’s most vulnerable groups, including people who are
homeless. Further, though the prevalence of mental disorders for racial and ethnic
minorities in the United States is largely the same as for whites, minorities are less likely
than whites to receive needed mental health services and more likely to receive poor
quality of care.

“Taken together,” the Surgeon General concluded, “these disparate lines of evidence
support the finding that minorities suffer a disproportionately high disability burden from
unmet mental health needs.” Consider the prominent role of culture in these disparities.
One of the major causes of untreated or under treated mental health problems is the stigma
associated with admitting to such problems or receiving care. The shape, type and
consequences of stigma are all shaped or determined, to varying degrees, by culture.

Culture, as well as race and ethnicity, can influence how individuals express problems,
whether or not they seek help, and the type of services they will accept. Culture, the
Surgeon General reported, “can account for variations in how consumers communicate
their symptoms and which ones they report. Some aspects of culture may also underlie

culture-bound syndromes – sets of symptoms much more common in some societies than
in others.”

What does this mean in real terms? The Surgeon General’s report gave examples.

Many African Americans, for instance, still bear the legacy of slavery, racism and
discrimination socially and economically. And when they are treated, it is more often in
primary care settings or by “safety net” providers. American Indians have a suicide rate
that is 50 percent above the national average and a greatly reduced access to mental health
services. Among Asian Americans and Pacific Islanders, though the prevalence of mental
disorders is similar to the general population, their utilization of services is lower. Hispanic
Americans, the largest and fastest growing minority group, display considerable variations
among sub-groups. Mexican Americans have nearly double the poverty rate of Cuban
Americans, while foreign born Hispanic Americans have lower rates of mental illness than
do their native-born counterparts. Minority groups share many characteristics, especially
in access and treatment. Both African American and Hispanics are less likely than whites
to receive evidence-based care.

The cultures of the clinician and the service system are important, as well. These cultures,
both social and professional, shape the attitudes, manners and methods of counselors,
administrators, nurses, doctors, case managers and social workers. These affect diagnosis,
treatment, and the organization and financing of services. Indeed, the Surgeon General
notes, “culture is important because it bears upon what all people bring to the clinical
setting.”

Despite their universal nature and influence, cultural and social influences on mental
health and the treatment of mental illness or disorders have been historically
underestimated. To ensure that minorities, and all Americans, receive the best possible
mental health services, culture must be considered, studied, and incorporated into research,
prevention and treatment.

To reduce the disparities in mental health care, the Surgeon General suggests we must
reduce social, geographic, and financial barriers to care; improve access to services; and
better understand cultural competence. We must, therefore, remain aware of the changing
nature of the populations we serve. Lack of awareness leads to a poor understanding of
real needs and to miscommunication that, in turn, leads to poor care. Why are we
unaware? As suggested by our workgroup and DiversityRx (see Appendix E.1), some
possible reasons include the following:

! Insufficient knowledge that results in an inability to recognize differences.

! Self-protection and denial leading to the attitude that differences are insignificant.

! Fear of the unknown—It can be challenging and intimidating to try to understand
something new.

! Feeling pressure due to time constraints in our lives and jobs.

! The belief that cultural competence refers only to race, rather than to the whole range
of differences that diversity represents.
B.3 Definitions of Culture and Diversity

To examine cultural competence, we began by reviewing definitions for two key terms:
culture and diversity.

Culture is defined by, among other things, the shared values, traditions, customs, arts, and
history of a group of people unified by such characteristics as age, gender, race, ethnicity,
spirituality, language, English language proficiency, literacy levels, sexual orientation,
education, employment, income, geography, immigrant status, and disabilities. In turn,
culture defines a person’s reality.

Diversity is the combined differences in race, ethnicity, language, nationality, and religion
among community groups.

We believe there is a difference between cultural competence and cultural sensitivity
(which is an awareness of the cultures around us). There are important distinctions
between these terms.

What, then, is cultural competence?

C Workgroup Findings
C.1 Definition

Our research shows that there is no single, commonly accepted definition of cultural
competence, but most of the definitions share a number of common elements. In
particular, cultural competence is a process, rather than a single point in time. Further,
cultural competence requires the attainment of knowledge and skills that will help
providers and programs work more effectively with people who have diverse backgrounds
and experiences. Finally, cultural competence requires action to increase access and
cultural adaptation of services based on what is learned about individuals and
communities.

One of the more widely cited definitions of cultural competence was developed in 1989 as
part of a monograph on effective services for minority children with severe emotional
disturbances. As cited in the Surgeon General’s Report on Mental Health, this early work
defines cultural competence as “a set of behaviors, attitudes and policies that come
together in a system or agency or among professionals that enables that system, agency, or
professionals to work effectively in cross-cultural situations.”

Many of the more recent definitions of cultural competence build on this work. In our
definition of cultural competence specific to PATH-related activities, we include the
importance of a system of care for people with serious mental illnesses who are homeless
and the need to improve access and adapt services to address specific cultural needs.

For the purposes of PATH-related activities, we define cultural competence as:

Cultural competence requires ongoing education, training, managerial dedication, and
organizational commitment at all levels, as well as appropriate public policy and consumer
involvement. These points are addressed in the guiding principles and action steps that
follow.

C.2 Guiding Principles and Suggested Action Steps

The core of culturally competent service delivery involves improving access to services for
racial and ethnic minorities and adapting those services to individuals’ specific cultural
needs. Our workgroup identified the following six guiding principles to help PATH
programs achieve the goals of improved access and cultural adaptation.

The first two principles are value-driven and reflect the need for cultural competence and
consumer centeredness to be woven into the fabric of everything a PATH program does.
The next four principles offer specific guidance on how PATH-funded programs can
develop culturally competent services. Each principle is accompanied by a set of
suggested action steps that can be used to help implement these principles. The action
steps can also be cross-referenced as we found them to be relevant to more than a specific
principle. We encourage PATH programs to identify action steps of their own and/or to
apply the action steps we have suggested to meet their own goals and priorities.

1 Cultural Competence Requires Development of a Plan That Is Integral to an
Agency’s Strategic Plan. Cultural competence must be addressed at the
administrative, organizational, and individual levels of the delivery systems that
serve people with serious mental illnesses who are homeless. Effective cultural
competence requires “buy-in” both vertically, within an organization, and
horizontally, across the various systems with which PATH-funded providers
collaborate.

Suggested Action Steps:

1.1 Ensure that your organization or program has a cultural competence plan
that is integral to the agency’s strategic plan, including action steps and

provision for oversight. A cultural competence committee should be
involved in developing this statement.
1.2 Convene a cultural competence committee or task force within your
organization. This committee should be ethnically diverse and should
represent all key stakeholders, including policy makers, administrators,
providers, and consumers. The committee can serve as the primary
governing body for planning, implementing, and evaluating organizational
cultural competence.
1.3 Develop collaborative partnerships with organizations and programs that
have begun developing and implementing culturally competent service
delivery systems. Adapt processes and information that are consistent with
your program’s needs and interests.
1.4 Identify state or local representatives of the cultures that you may serve
(potential system users) in your PATH project and include them as
members of advisory groups to help you develop or expand culturally
competent outreach, intake, treatment, and discharge protocols.
1.5 Clearly articulate organizational linkages and establish dialogues about
cultural competence with community groups that provide services to your
enrollees (e.g., shelters, workshops, faith-based groups, housing providers,
childcare providers, primary health care providers, hospitals, emergency
rooms, natural supports, alternative/supplementary healers, etc.).
1.6 Advocate for cultural competence in other groups to which your agency
belongs or with which you collaborate, e.g., community development
boards, United Way, Continuum of Care planning groups, involvement
with the ConPlan development, or input into the development of Public
Housing Authority administrative plans.
1.7 Include criteria for cultural competence in requests for proposals and other
contracts. Emphasize the ability of the contractor/consultant to
demonstrate success in achieving positive results that are culturally
appropriate and applicable for the population(s) served.

2 Cultural Competence Requires Services to Be Driven by Consumer Needs and
Preferences. Consumers, families, and stakeholders from the cultural groups
represented in your service areas must be involved in developing policies for the
delivery of PATH-funded services to people with serious mental illnesses who are
homeless. The services themselves must be compatible with individuals’ cultural
beliefs and preferred languages.

Suggested Action Steps:

2.1 Conduct active outreach to ethnically diverse groups in your community
to improve their access to services and to involve them in the organization
and delivery of culturally adapted services and programs.
2.2 Provide the full range of services that make it possible for diverse
populations to gain access to your programs, including language
assistance (see principle 3), transportation, flexible hours, convenient
locations, etc.
2.3 Clearly articulate methods that a PATH program will use to operate as a
consumer-driven, community-based organization, e.g., consumer
representation on program development committees and seeking consumer
input related to hiring homeless services staff.
2.4 Seek consumer input, recognize consumer strengths, and adopt self-help
and recovery concepts when setting individual treatment goals.
2.5 Build collaborative, respectful partnerships with natural helpers (including
immediate and extended family members), native healers, community
informants, and other experts who have knowledge of the culturally,
linguistically, racially, and ethnically diverse groups served by your
program.

3 Cultural Competence Requires Services to Be Delivered in the Languages
Clients Use. PATH-funded programs must provide services that are linguistically
relevant and offer mandated language assistance at no cost to people with limited
English language proficiency.

Suggested Action Steps:

3.1 Offer services in relevant languages, provided by people who are bilingual
and bicultural. These are people who are native speakers of the
language(s) and/or fluent in the language(s), and who have direct
experience with the social, cultural, historical, and familial context of the
groups you serve, either by virtue of being a member of the group or
having received (and continuing to receive) extensive cultural competence
training. These individuals will be more adept at responding to a host of
non-verbal cues, including hand gestures, eye contact, tone of voice, and
personal space.
3.2 When the individuals described in step 3.1 are not available, identify the
capacity in your state, territory, or community to provide translation
services, and use these services to offer appropriate outreach and
treatment. Translation services may be required for people who are deaf
or hard-of-hearing and for others for whom English is not their primary
language. Develop and implement training for translators in special issues

related to mental health and homelessness. Because of the need to
maintain client confidentiality, it may not be appropriate for an
individual’s family member to serve in this role.
3.3 Identify how your state is responding to federal legislation or state
regulations related to limited English proficiency and become partners in
this effort.
3.4 Translate relevant program materials, including the right to receive
language assistance, in various languages to help improve access to
services. As per step 3.1, consider having such material written first in the
clients’ native language(s).
3.5 Use not only the language of the community, but also relevant
communication media that are used in the community, e.g., radio stations,
community newspapers (both rural and urban), bilingual television
stations, videos, grocery store windows, community bulletin boards, etc.
Include audio, video, and print materials developed for people who are
deaf or hard-of-hearing and people who are visually impaired.
3.6 Work with community leaders to develop materials designed to reduce the
stigma associated with mental illness, homelessness, race, and ethnicity;
acknowledge value differences; and raise awareness of the dynamics of
cross-cultural communication.

4 Cultural Competence Requires a Diverse and Well-Trained Staff. Human
resource policies, practices, and procedures (e.g., performance appraisals,
promotions, raises, etc.) must be designed to promote and enhance a staff that
reflects the diversity of clients being served in PATH-funded programs. Staff at
all levels of the organization must be trained in providing culturally competent
services.

Suggested Action Steps:

4.1 Use principles of cultural competence in the recruitment, hiring, and
orientation of staff members and volunteers. Program staff should reflect
the race, ethnicity, and culture of the community members being served.
4.2 Survey staff about what they need to be more effective in cross-cultural
situations. Tailor training to address their concerns.
4.3 Involve representatives of your community’s cultures in staff training and
in-service training activities.
4.4 Train PATH staff at all levels in the provision of culturally designed or
adapted services. Remember that training is only a single component of a

broader process of developing cultural competence. Training should not
be considered the only approach or the end of the process; all training
should be progressive and ongoing. Effective training includes provision
for performance monitoring and continuing education (see principle 5).

5 Cultural Competence Requires Opportunities for Continuing Education and
Ongoing Knowledge Development. Staff of PATH-funded programs must have
ongoing opportunities to expand their cultural knowledge and increase their
understanding about how to improve service quality for all PATH consumers.

Suggested Action Steps:

5.1 Articulate a plan to deliver information about cultural competence to all
staff within the organization.
5.2 Provide regular access to resource materials related to cultural
competence, in general, and to the primary cultures served by PATH
projects, in particular.
5.3 Collaborate with academic institutions, human or civil rights
organizations, and national researchers to remain current and to further
develop culturally competent practices.
5.4 Seek technical assistance and resources on cultural competence from
federally funded technical assistance providers, such as Advocates for
Human Potential, Inc., the PATH technical assistance contractor, and
Policy Research Associates, Inc., which operates the National Resource
Center on Homelessness and Mental Illness and maintains the PATH Web
site. Contact information for these organizations is included in Appendix
E.2.
5.5 Identify and include resources in each year’s budget to facilitate
professional and personal development through staff participation in
conferences, workshops, and seminars on cultural competence.
5.6 Facilitate staff participation in events that may celebrate the culture,
traditions, artwork, and dance of racial and ethnic groups. Encourage
consumers to share their knowledge about the cultural groups to which
they belong.

6 Cultural Competence Requires Self-Assessment, Including Measurement of
Program Outcomes and Client Satisfaction. PATH-funded programs must adopt
or adapt self-assessment tools that allow them to gauge their progress toward
developing culturally competent services. Consumer satisfaction surveys can be
an important part of this effort.

Suggested Action Steps:

6.1 Develop or adapt an instrument that best matches the needs and interests
of your organization or program, and conduct a comprehensive agency
self-assessment related to cultural competence at least once a year. Use
the self-assessment results to develop a long-term plan, with measurable
goals and objectives, to incorporate culturally competent principles,
policies, structures, and practices into all aspects of your organization or
program. This may include, but is not limited to, changes in the following:
mission statement, policies and procedures, administration, staffing
patterns, service delivery practices and approaches, outreach,
telecommunications and information dissemination systems, and
professional development activities.
6.2 Identify and collect objective data to verify progress in meeting cultural
competence goals and objectives.
6.3 Identify and collect objective data to verify whether service adaptations
are appropriate to consumers’ race, ethnicity, gender, age, and primary
language, among other variables.
6.4 Examine how cultural competence is evolving in your state or local
projects and identify ways to report this with your PATH annual reports to
CMHS, or with other reports within your state or territory.
6.5 Request assistance from diverse groups and stakeholders with a PATH
investment (e.g., families, neighborhoods, cultural leaders, supplemental
funders, other programs serving people with serious mental illnesses who
are homeless) to develop consumer satisfaction surveys, outcome
measures, and evaluation components of your PATH project.
6.6 Develop and use surveys to measure individuals’ satisfaction with services
relative to specific cultural factors.
6.7 Examine and strengthen current feedback mechanisms and articulate
methods for using consumer satisfaction information to improve and
adjust program services.
C.3 Self-Assessment Recommendations

Assessment for cultural competence is a fairly new endeavor. Formal self-assessment
programs have been developed, but their effectiveness needs to be further explored. Our
workgroup reviewed materials for developing and reviewing cultural competence plans
and concluded that more research is needed to provide a comprehensive view and possible
recommendations for specific tools.

Program evaluation also includes consumer satisfaction surveys, ongoing staff
supervision, training provided by community group members of various cultures, as well
as development of agency specific performance measures. Currently, on a national level,
additional evaluation tools are under development.

Regardless of the specific tools they choose, PATH programs must develop a plan that
includes assessment, a budget to accomplish it, and the commitment to implement it and to
adapt program delivery methods if suggested by the results. We must continue to follow
state and national cultural competence assessment activities, some of which, the results are
on the horizon at the conclusion of the workgroups’ efforts.

D Conclusion

The workgroup learned a great deal about cultural competence by studying this topic and
preparing this report. We hope State PATH Contacts and others will use this information
to take an active role in improving access and adapting services for people of diverse
racial, ethnic, and cultural groups.

Just as cultural competence itself is an ever changing and evolving process, we expect that
the information in this report represents a work in process and will change, too, as State
PATH Contacts implement some of these ideas and provide feedback. We encourage you
to do so.

We consider this report a first step in raising awareness about the importance of cultural
competence among State PATH Contacts and PATH-funded providers. We will discuss
next steps for ongoing workgroup activity at the September 2002 national State PATH
Contacts meeting.

E Appendixes
E.1 References

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the Oregon Youth Authority.

Western Interstate Commission for Higher Education (WICHE), (date unknown). Cultural
Competence Planning. http://www.wiche.edu/home.htm.

Wyoming Department of Health, Mental Health Division, (November 1998). Self-
Assessment Tools, Office of Multicultura1 Affairs Strategic Plan.

E.2 Contacts

Workgroup Members

Jim Chesnik, Chair

Housing Specialist

Division of Mental Health &
Developmental Disabilities

Iowa Department of H. S.

Hoover Building, 5th Floor

1305 East Walnut Street

Des Moines, IA 50319-0114

Phone: (515) 281-8472

Fax: (515) 281-8512

E-mail: jchesni@dhs.state.ia.us

Monica Bellamy

Housing Coordinator

Community Living, Children

& Families Administration

Michigan Dept.of Community Health

Parent Participation Program

Plaza Building, 3rd Floor, Suite #316,
South Tower

1200 6th Street

Detroit, MI 48826

Phone: (313) 256-3065

Fax: (313) 256-2049

E-mail: bellamy@michigan.gov

Cathy Cave

Cultural Competence Coordinator

New York State Office of MH

44 Holland Avenue

Albany, NY 12229

Phone: (518) 408-2026

Fax: (518) 486-7988

E-mail: ccave@omh.state.ny.us

Debbie Webster, Coordinator

Community/PATH Program Coordinator

North Carolina Division of Mental
Health, Developmental Disabilities &
Substance Abuse Services

3014 Mail Service Center

Raleigh, NC 27699-3014

Phone: (919) 715-1294 ext. 233

Fax: (919) 508-0959

Email: Debbie.webster@ncmail.net

Albertstein Johnson-Pickett

Division Director II

Division of Community Services

Mississippi Dept.of Mental Health

1101 Robert E. Lee Building

239 North Lamar Street

Jackson, MS 39201

Phone: (601) 359-1288

Fax: (601) 359-6295

E-mail: ajohnson@msdmh.org

Lynn Marshall, MA, LPC

PATH Contact and Housing and
Homeless Coordinator

New Mexico Dept. of Health

Behavioral Health Services Division

1190 St. Francis Drive,

Suite North 3300

Santa Fe, NM 87502

Phone: (505) 827-0577

Fax: (505) 827-0097

E-mail: lmarshal@doh.state.nm.us

Pam Rainer, CSW

Project Coordinator

Advocates for Human Potential, Inc.

262 Delaware Ave

Delmar, NY 12054

Phone: (518) 475-9146 x 246

Fax: (518) 475-7654

E-mail: prainer@ahpnet.com

CMHS Homeless Programs Branch

Dorrine Gross

PATH Co-Director

Room 11-C-05

5600 Fishers Lane

Rockville, MD 20857

Phone: (301) 443-1237

Fax: (301) 443-0256

E-mail: dgross@samhsa.gov

Michael Hutner, Ph.D.

PATH Program Director

Room 11-C-05

5600 Fishers Lane

Rockville MD 20857

Phone: (301) 594-3096

Fax: (301) 443-0256

E-mail: mhutner@samhsa.gov

Laura Valentine

Quality Assurance Specialist

Nevada Division of Mental Health &
Developmental Services

505 East King Street, Room 602

Carson City, NV 89701-3790

Phone: (775) 684-5979

Fax: (775) 684-5964

Email: lvalentine@dhr.state.nv.us

PATH Technical Assistance
Contractors

Advocates for Human Potential, Inc.

262 Delaware Avenue

Delmar, NY 12054

Phone: (518) 475-9146

Fax: (518) 475-7654

Web site: www.ahpnet.com

Policy Research Associates, Inc.

345 Delaware Avenue

Delmar, NY 12054

Phone: (518) 439-7415

Fax: (518) 439-7612

Web site: www.prainc.com