Culturally Responsive Services

Community Counseling Solutions (CCS) will promote and implement a cultural competence framework within the delivery of behavioral health services and supports in a culturally competent manner to all those served, including those with limited English proficiency and diverse cultural and ethnic backgrounds in order to ensure patients/customers receive effective, understandable, and respectful care compatible with their cultural health beliefs and practices and preferred language.

  • Implement strategies to recruit, retain, and promote at all levels of the organization a diverse staff and leadership that are representative of the demographic characteristics of the service area.
  • Conduct initial and ongoing organizational self-assessments of Culturally and Linguistically Appropriate Services (CLAS)-related activities and integrate cultural and linguistic competence-related measures into internal audits, performance improvement programs, patient satisfaction assessments, and outcomes-based evaluations.
  • Ensure that data on the individual patient’s/customer’s race, ethnicity, and spoken and written language are collected in health records, integrated into the organization’s management information systems, and periodically updated. (Patients have a right to voluntarily provide this information.)
  • Maintain a current demographic, cultural, and epidemiological profile of the community to accurately plan for and implement services that respond to the cultural and linguistic characteristics of the service area.
  • Ensure that conflict and grievance resolution processes are culturally and linguistically sensitive and capable of identifying, preventing, and resolving cross-cultural conflicts or complaints by patients/customers.
  • Regularly make available to the public information about progress and successful innovations in implementing the CLAS standards and to provide public notice in their communities about the availability of this information.

LGBTQ2SIA+ Inclusion and Provider Competency Project Proposal

Partner Project between: Greater Oregon Behavioral Health Inc. (GOBHI), Community Counseling Solutions (CCS), New Directions Northwest (NDN), and Grant County Community Health Improvement Coalition (CHIC)

Project Goals:

  • LGBTQ+ inclusion Eastern Oregon Counties through local workgroups.
  • Increase provider capacity to deliver equitable services to LGBTQ+ individuals in frontier and rural communities.
  • Increase knowledge of population intersectionality factors and integrate best practices for vulnerable populations throughout partnering organizations (Community Counseling Solutions, New Directions Northwest, and GOBHI).
  • Create LGBTQ+ Resource Guide and Networking System.
  • Collect quality data to use toward future advancement of equity and inclusion for the LGBTQ+ population in Eastern Oregon.

Why is this work important in Eastern Oregon?

The LGBTQ+ population in Eastern Oregon has long faced health inequity through discrimination, social ostracization, and other unnecessary barriers to culturally competent health services. These health disparities have led to higher rates of mental illness, including depression, anxiety, and higher rates of suicidality among the LGBTQ+ population. Research shows that sexual minorities experience higher levels of discrimination, stigma, and stress and are at higher risk of multiple poor health outcomes and unhealthy behaviors compared to their heterosexual counterparts. In addition to the health disadvantages related to sexual orientation and gender identity, many LGBTQ+ people in Eastern Oregon experience health inequity due to the intersection of other risk factors, including age, ethnic origin, disability, income, and inadequate access to care due to frontier and rural living.

Mental health care service provider knowledge and cultural competence regarding LGBTQ+ health is crucial to achieving health equity and meeting the needs of this vulnerable and historically disadvantaged population. The lack of sufficient research regarding the health of individuals who identify as LGBTQ+  is also a major contributing factor, which negatively impacts both quality of and access to appropriate care among the population. Sexual and gender minorities have frequently reported needing to educate providers on their health needs. It is not uncommon for providers to refuse treatment for people belonging to sexual or gender minorities because they do not feel that they are sufficiently trained. Additionally, recent research has shown that many practicing healthcare professionals and healthcare trainees are often lacking knowledge, comfort, or cultural competence in addressing a variety of health issues facing LGBTQ+ populations.

Transgender people in particular represent one of the most marginalized groups who experience the greatest stigma and discrimination when accessing health and social services. Experiences and fear of mistreatment, confidentiality breaches, reluctance to disclose status, and the burden of teaching health care providers about trans care all contribute to disparities in accessing care. By strengthening our foundation of care, advocacy, and education, Community Counseling Solutions, New Directions Northwest and GOBHI will improve health outcomes for some of our most vulnerable and underserved community members.

What We Plan to Do

Community Counseling Solutions, New Directions Northwest and GOBHI all recognize the importance of prioritizing health equity, both internally and through the services we provide in our Eastern Oregon communities. Through assessing the climate of LGBTQ+ inclusion and mental health support provided through our organizations and to our communities, we will work strategically and collaboratively to  create a network of support and improve equitable access to quality mental health services for our most vulnerable community members. 

Together, we are committed to creating meaningful and sustainable change within our organizations and across Eastern Oregon. This focused work will help partners advance health equity from within their organizations by providing trauma-informed, culturally competent behavioral health services while promoting self-acceptance and positive social engagement, thus improving health outcomes and overall well-being of the LGBTQ+ community in Eastern Oregon.

Partnering organizations will host a series 3 of listening sessions in their respective counties to better understand gaps and barriers the LGBTQ community face as well as ideas for improved services, provider and community education, and how to dispel the stigma around mental health specific to the LGBTQ+ community. Listening sessions will have 6-12 participants in attendance per session and will be open to people 15 years and older. A tri-county advisory committee will be formed to continue community involvement and engagement throughout the duration of this project.

Concurrent to these listening sessions, Community Counseling Solutions, New Directions Northwest, GOBHI and the Community Health Improvement Coalition will work collaboratively to develop an organizational survey that will be used as a tool to collect data and to gauge behaviors and attitudes of employees towards our LBGTQ+ community. After data regarding specific areas of need is gathered through the listening sessions and organizational surveys, clinical staff of the partnering organizations will be provided with opportunities to receive the most appropriate LGBTQ+ cultural competency training(s) for their communities. All data collected from the listening sessions and the organizational survey will be compiled and the report will be shared with partnering organizations. 

In the early summer of 2023, partners will host a 3-day LGBTQ+ Learning and Networking Festival. The data collected from the listening sessions and organizational survey will inform the direction of the training menu for the LGBTQ+ Learning portion of the gathering and the tri-county advisory committee will inform the direction of the LGBTQ+ Networking portion of the event. We anticipate learning opportunities at this event may include: 

  • Understanding and Preventing Suicide in the Transgender Community (Gender Education Network): This workshop aims to increase participants’ understanding of the risk and resilience factors for suicidal behaviors in transgender people. In order to improve treatment, providers’ ethical responsibility will be reviewed. Recommendations for suicide assessment and prevention will be provided.
  • Connect, Accept, Respond, Empower: How to Support LGBTQ+ Youth (The Trevor Project): An interactive and intense training that provides adults with an overview of suicide among lesbian, gay, bisexual, transgendered, queer and questioning youth and the different environmental stressors that contribute for their heightened risk for suicide.
  • Trevor Ally Training (The Trevor Project): Basic framework of understating LGBTQ+ youth and the unique challenges they face. This training is designed to create dialogue regarding what it means to be an adult ally for LGBTQ+ youth by informing participants about terminology used in the LGBTQ+ community, the process of “coming out” as a LGBTQ+ person and a discussion of the challenges faced by LGBTQ+ youth in their homes, schools and communities. Participants are encouraged to explore their own biases, build their knowledge and understanding and develop empathy. This training offers specific action items to improve the environment for LGBTQ+ youth.
  • Queer in the Country: Supporting Inclusive Practices in Rural Settings: Participants will understand the unique challenges for people who are apart of LGBTQ+ communities in rural setting when accessing health care. Participants will appreciate the power of language, including demographic terminology, to create safe and welcoming spaces for members of the LGBTQ+ communities.


The overall project timeline is outlined below, beginning in January 2022 and concluding in June 2023.

January/February 2022

  • Review GOBHI provider survey data
  • Develop Organizational Survey for tri-county agencies

Spring 2022

  • Form focus groups, begin listening sessions in tri-county areas
  • Begin implementation of providers competency trainings
  • Implement organizational survey
  • Create tri-county advisory committee of champions

Fall/Summer 2022

  • Publish Baker County 2S+ Community Resource Guide
  • Create summary report from focus group data
  • Create organizational study report
  • Tri-county advisory committee meeting

Winter 2022

  • Share focus group report with tri-counties agencies
  • Share organizational study report with tri-county agencies
  • Tri-county advisory committee meeting


January – May 2023

  • Tri-county advisory committee meeting
  • Plan LGBTQ2SIA+ Regional Festival

June 2023:

  • Implement Tri-county LGBTQ+ Learning and Networking Festival



Year 1

Focus Group & Tri-County Advisory Committee  Incentives

                Organizational Survey


Year 2

Plan LGBTQ2SIA+ Regional Festival  

In addition to our CLAS, cultural competency and LGBQT+ initiatives, we also assess for religious beliefs, ability and other axes of identity to ensure individualized services that honor and align with the beliefs, practices, culture and linguistic needs of the diverse populations we serve. Furthermore, our staff are representative and reflective of the people and communities we serve.